Dear Tony,
In pieces of these blogs, I will tell you directly what has worked for me. Most of my treatment is based on Bruce Perry’s ideas. All I know is what worked for me. They are not intended to be general. They are simply suggestions.
Dr. Perry would say that one critical piece in my treatment was that I was about two-and-a-half when these traumas started happening. (There were multiple changes at once — my illness was the largest, but there was a number of other factors.) That meant that my brain and development had the chance to have a good start. If I had become ill when I was six months old I would have likely had very different problems. Most of his book focuses on children who were traumatized at a younger age. Dr. Perry gave me the essential philisophical underpinning, but I was on my own to devise specific strategies.
My first strategy was for a problem I have described earlier: my inability to communicate effectively. That was at the time my most critical problem. My difficulties communicating had landed me into extremely uncomfortable and sometimes even dangerous situations. I tried to think of what young children do and what I missed. Young children struggle to communicate. They focus only on learning to communicate, and often make mistakes with wording, tone of voice, or volume. Which was basically what I needed to do.
I don’t have much experience with children. I have a younger sibling and my mother is an elementary school teacher. Much of what I used is based on stereotypes and my own vague memories. While stereotypes are problematic, it was enough to give me a start.
Another stereotypical young-child activity which helped me is to watch the same television show again and again and ask for the same bedtime story again and again. I started doing that without realizing it, and eventually was focusing on it. I can feel the changes in my own brain. It has to do with moving beyond understanding information told to me directly to picking up cues and subtle hints from the broader culture. I have always had difficulty with that. You need some sort of template in place to do that, and I was lacking one.
I worked with the first season of ER, something which I had rarely watched when it was originally aired. I focused on television strictly for practical reasons: It is much faster to watch the same forty-five minute television show again and again than it is to read the same two hundred page novel again and again. I watched one specific episode over and over again, and eventually was able to figure out what was happening and how people’s words and actions led to different outcomes. It helped me learn to sort out what I do and do not need to pay attention to. I gradually learned to identify what was important and how one specific incident led to another. All of these were things I was not able to do before. If asked, I could explain the meaning of one specific scene, but I could not figure out how that scene connected to those before and after it. I gradually grew able to understand how different interactions worked together.
Although I did not know it at the time, ER was a really good choice because it focuses on multiple characters and on-going situations. Once I had the basic template from one episode in place I was able to follow the different story lines to other episodes. I needed to watch each episode at least twice — and some I watched more than ten times — but slowly I was able to build my capacity to follow different characters and story lines and see how they related to specific incidents.
One final note: I am not advertising ER. It benefited me because it was a longer show (a half-hour sitcom was too short to push me) and had multiple on-going story lines. I think another reason ER worked well for me was because I could remember some of the details people discussed when it was aired and some scenes which I could not understand back then. It was a great thrill to be able to put those memories in context at long last. I later tried to do the same thing with the first season of The West Wing, which meets all the above criteria but aired when I was out of the country. I thought I would enjoy the show, but I just could not become interested. At least for me, it seems that connecting my actions with ancient memories is a critical piece.
