The Boy Who Was Raised as a Dog (10 page)

It was to attempt to solve this problem that I, in coordination with BCM, TCH, and VAMC, put together a “rapid response” Trauma Assessment Team. It was our hope that while helping children cope with acute traumas like shootings, car accidents, natural disasters and other life threatening situations, we could learn what to expect from children in the immediate aftermath of a traumatic experience and how this related to any symptoms they might ultimately suffer. The children of Waco would provide one unfortunately apt sample to study.

 

ON FEBRUARY 28, 1993, the “Babylonians” in the form of the Bureau of Alcohol, Tobacco and Firearms (BATF) came to the Branch Davidian compound to arrest David Koresh for firearms violations. He would not allow himself to be taken alive. Four BATF agents and at least six Branch Davidians were killed in the ensuing raid. The FBI and its hostage negotiation team managed to secure the release of twenty-one children over the following three days. It was at this point that my team was brought in to help with what we thought would be the first wave of children from the compound. What none of us knew at the time was that we would never meet more Davidian children. The siege would end with a second and far more catastrophic raid on April 19, which left eighty members (including twenty-three children) dead in a horrific conflagration.

I heard about the first raid on the Branch Davidian compound like most people did: from the news on television. Almost immediately, reporters began calling to ask me how the raid might affect the children. When I was questioned about what was being done to help those who'd been removed from the compound, I replied almost off-handedly that I was sure the state was making sure they were properly cared for.

But just as soon as the words left my mouth, I realized that this was probably not true. Government agencies—especially the chronically underfunded and overburdened Child Protective Service (CPS) systems—rarely have concrete plans to deal with sudden influxes of large groups of children. Furthermore, chains of command between the federal, state and local agencies involved in law enforcement and CPS are often unclear in unusual, fast-moving crises like the Waco standoff.

As I thought more about this I felt pulled to see whether the expertise on childhood trauma that our Trauma Assessment Team had been developing could be helpful. I figured we could provide the people working with these children some basic information, consult by phone to help them solve particular problems, and play a supportive role in helping them better understand the situation. I contacted several agencies but no one could tell me who was “in charge.” Finally I reached the governor's office. Within a few hours I was called by the state office of CPS and was asked to come to Waco for what I thought would be a one-time consultation. That afternoon meeting turned into six weeks of one of the most difficult cases I have ever had.

 

WHEN I ARRIVED in Waco I found disarray, both in the official agencies responding to the crisis and in the care of the children. During the first few days, when the children were released, they were driven away from the compound in large tank-like vehicles. No matter what time of day or night it was when they came out, they were immediately interrogated by the FBI and the Texas Rangers, often for hours. The FBI had the best intentions; they wanted information quickly so that they could help defuse the situation at the Ranch and get more people out safely. Witness's
statements were needed, and the Texas Rangers were charged with gathering evidence for future criminal trials in order to prosecute those involved in the shooting deaths of the BATF agents. But neither group had thought through how overwhelming it would be for a child to be taken from his parents, put in a tank after witnessing a deadly raid on his home, driven to an armory and questioned at length by numerous armed, strange men.

It was only dumb luck that kept the Davidian children together after the first raid. Originally, Texas CPS had planned to place them in individual foster homes, but they couldn't find enough homes fast enough to take all of them. Keeping them together turned out to be one of the most therapeutic decisions made in their case: these children would need each other. After what they had just experienced, ripping them from their peers and/or siblings would only have increased their distress.

Instead of foster homes the children were brought to a pleasant, campus-like setting, the Methodist Children's Home in Waco. There, they lived in a large cottage, initially guarded by two armed Texas Rangers. They were cared for by two rotating live-in couples, the “house mothers” and “house fathers.” While the state's efforts to provide mental health care were well intentioned, unfortunately, they were not especially effective. Texas had pulled in professionals from its busy public systems, basically utilizing anyone who could spare an hour. As a result, the timing and consistency of these mental health visits was random, and the children were further confused by meeting with yet more strangers.

In those early days the atmosphere of the cottage was also chaotic. Officers from various law enforcement agencies would show up at any time, day or night, and pull aside particular girls or boys for interviews. There was no schedule to their daily life and no regularity to the people that they would see. One of the few things I knew for sure by then about traumatized children was that they need predictability, routine, a sense of control and stable relationships with supportive people. This was even more important than usual for the Davidian children: they were coming
from a place where they had for years been kept in a state of alarm, led to expect catastrophe at any minute.

During my initial afternoon meeting with the key agencies involved, my advice boiled down to this: create consistency, routine, and familiarity. That meant establishing order, setting up clear boundaries, improving cross-organizational communication and limiting the mental health staff to those who could regularly be there for the children. I also suggested that only those who had training in interviewing children be allowed to conduct the forensic interviews for the Rangers and the FBI. At the end of the meeting CPS asked me if I would be willing to lead in the coordination of these efforts. Later that day, after meeting with FBI agents, I was also asked to do the forensic interviews myself. At that point we still thought that the crisis would be over in days, so I agreed. I figured it would be an interesting opportunity to learn while simultaneously helping these children. I drove to the cottage to meet a remarkable group of young people.

 

WHEN I ARRIVED one of the Rangers stopped me at the door. He was tall, imposing in his hat, the archetype of Texas law enforcement. He was not impressed by this long-haired man in jeans claiming to be a psychiatrist who had come to help the children. Even after I'd established that I was indeed Dr. Perry, he told me that I didn't look like a doctor, and further, “Those kids don't need a shrink. All they need is a little love and to get as far away from here as possible.”

Ultimately, this Ranger would turn out to be one of the most positive and healing figures in the children's lives for the weeks they stayed at the cottage. He was calm, good with children, and intuitively seemed to know how to provide a supportive but not intrusive presence. But right then, he was in my way. I said to him, “OK, I'll tell you what. Do you know how to take a pulse?” I directed his attention to a young girl who was fast asleep on a nearby couch. I told him that if her pulse was less than 100, I would turn around and go home. The normal heart rate range for a child her age at rest is 70-90 beats per minute (bpm).

He bent down gently to pick up the girl's wrist, and within moments his face filled with anxiety. “Get a doctor,” he said. “I am a doctor,” I replied. “No, a real doctor,” he said, “This child's pulse is 160.”

After reassuring him that psychiatrists are physicians with standard medical training, I began to describe the physiological effects of trauma on children. In this case an elevated heart rate was likely a reflection of the girl's persistently activated stress-response system. The ranger understood the basics of the fight or flight response; almost all law enforcement officers have some direct experience with this. I noted that the same hormones and neurotransmitters that flood the brain during a stressful event—adrenaline and noradrenaline—are also involved in regulating heart rate, which makes sense since changes in heart rate are needed to react to stress. From my work with other traumatized children, I knew that even months and years after trauma many would still exhibit an overactive stress response. It was a safe bet then that being so close to an overwhelming experience, this little girl's heart would still be racing.

The Ranger let me in.

 

THE DAVIDIAN CHILDREN had been released in small groups—two to four at a time—in the first three days following the February raid. They ranged in age from five months to twelve years old. Most were between four and eleven. They came from ten different families and seventeen of the twenty-one were released with at least one sibling. Although some former members have disputed accounts of child abuse among the Davidians (and although I was misquoted in the press to suggest that I didn't believe that the children were living in an abusive situation), there was never any doubt that the children had been traumatized, certainly by the raid on the compound, but also by their life beforehand.

One little girl had been released with a note pinned to her clothing that said her mother would be dead by the time the relatives to whom it was addressed got to read it. Another was given a kiss by her mother, handed to an FBI agent and told, “Here are the people who will kill us. I
will see you in heaven.” Long before the compound burned, the Davidian children released to us acted as though their parents (at least one of whom they knew to be alive at the time they left) had already died. When I first met the children, in fact, they were sitting and eating lunch. As I walked into the room one of the younger children looked up and calmly asked, “Are you here to kill us?”

These children did not feel as though they had just been liberated. Instead, because of what they'd been taught about outsiders and because of the violence they'd survived, they felt like hostages. They were more frightened of us now than they had been at home, not only because they were suddenly deprived of family and familiarity, but also because Koresh's predictions about an attack had come true. If he was right that the “unbelievers” had come for them, they figured, his assertion that we intended to kill them and their families was probably correct as well.

 

WE IMMEDIATELY RECOGNIZED that we had a group of children that had essentially been marinated in fear. The only way we could get them the help they needed was to apply our understanding of how fear affects the brain and then consequently changes behavior.

Fear is our most primal emotion, and with good evolutionary reason. Without it few of our ancestors would have survived. Fear literally arises from the core of the brain, affecting all brain areas and their functions in rapidly expanding waves of neurochemical activity. Some of the critical chemicals involved include those we've already discussed, such as adrenaline and noradrenaline, but also important is a stress hormone called cortisol. Two of the key brain regions involved with fear are the locus coeruleus, the origin of the majority of noradrenaline neurons in the brain, and an almond-shaped part of the limbic system called the amygdala.

As noted earlier, the brain evolved from the inside out, and it develops in much the same order. The lowest, most primitive region—the brainstem—completes much of its development in utero and in early infancy. The midbrain and limbic systems develop next, elaborating themselves
exuberantly over the first three years of life. Parents of teenagers won't be surprised to learn that the frontal lobes of the cortex, which regulate planning, self-control and abstract thought, do not complete their development until late in adolescence, showing significant reorganization well into the early twenties.

The fact that the brain develops sequentially—and also so rapidly in the first years of life—explains why extremely young children are at such great risk of suffering lasting effects of trauma: their brains are still developing. The same miraculous plasticity that allows young brains to quickly learn love and language, unfortunately, also makes them highly susceptible to negative experiences as well. Just as fetuses are especially vulnerable to particular toxins depending on the trimester of pregnancy in which they are exposed, so are children vulnerable to the lasting effects of trauma, depending on when it occurs. As a result different symptoms may result from trauma experienced at different times. For example, a toddler with no language to describe the painful and repetitive sexual abuse he experiences may develop a complete aversion to being touched, wide-ranging problems with intimacy and relationships and pervasive anxiety. But a ten-year-old who is subjected to virtually identical abuse is more likely to develop specific, event-related fears and to work deliberately to avoid particular cues associated with the place, person and manner of abuse. Her anxiety will wax and wane with exposure to reminders of the molestation. Further, an older child will probably have associated feelings of shame and guilt—complex emotions mediated by the cortex. That region is far less developed in a toddler, therefore related symptoms are less likely if abuse begins and ends earlier in life.

At any age, however, when people are faced with a frightening situation their brains begin to shut down their highest cortical regions first. We lose the capacity to plan, or to feel hunger, because neither are of any use to our immediate survival. Often we lose the ability to “think” or even speak during an acute threat. We just react. And with prolonged fear there can be chronic or near-permanent changes in the brain. The
brain alterations that result from lingering terror, especially early in life, may cause an enduring shift to a more impulsive, more aggressive, less thoughtful and less compassionate way of responding to the world.