My life-mate, Tom, had a childhood filled with toxic stress. The abuse and neglect were significant during his formative brain development years — when children acquire important functions in emotional control, trust, and forming attachments. It led to a life of post-traumatic stress disorder, self-doubt, depression, and anxiety.
One day, for example, I entered a room where he was working. I accidentally stepped on a piece of crisp paper that made a crackling sound. He whirled around and screamed loudly, with a look of terror. How does this happen to an accomplished man in his 78th year?
Research published in 1998, known as the ACE Study — Adverse Childhood Experiences — revealed the connection between early childhood trauma and chronic illnesses, such as cancer, heart disease, diabetes type 2, obesity, drug use, smoking, mental illness, substance abuse, violence, and early death.
My partner also had Attention Deficit Hyperactivity Disorder (ADHD), and could act impulsively. Organizing anything was difficult. Yet he earned a medical degree and published articles in scientific journals, having become a child, adolescent, and adult psychiatrist.
It wasn’t until I read “The Deepest Well: Healing the Long-Term Effects of Childhood Adversity,” by Dr. Nadine Burke Harris, that I had a greater appreciation of the trauma he suffered from and the resilience it required of him. Harris is a crusading pediatrician involved with early childhood trauma and the life-long consequences it has for its survivors.
She explains early trauma this way: “Imagine you’re walking in the forest and you see a bear. Immediately, your brain sends signals to your adrenal glands (perched on your kidneys) saying, ‘Release stress hormones! Adrenaline! Cortisol!’ Your heart starts to pound, your pupils dilate, your airways open, and you are ready to either fight the bear or run from the bear.
Living With the Bear
Most of us have heard of this common “fight or flight” response. The stress responses are turned off after a person returns to the safety of the cave. As Harris asks, however, “What happens when you can’t experience safety in your cave because the bear is living in the cave with you?”
This kind of strong, frequent, and prolonged adversity is known as toxic stress. It is what my partner lived with all of his life. He was accomplished, despite the toxic environment of his childhood that never left him, despite the ongoing undercurrent of self-doubt and anxiety, despite his ability to demonstrate resilience.
In his lifetime, he ran 19 marathons, biked, played the guitar and harmonica, started and directed a residential program for children with serious mental illness, and had a thriving private practice, until deep depression took over. Art was therapeutic for him. After he died, colleagues and parents of his young patients wrote wonderful things about him.
Yet, he screamed at the sound of crackling paper.
One piece of my vision to reduce childhood trauma in Minnesota is that we have trauma-informed policy-makers. All legislators, school board members, and other elected officials will be able to ask themselves: “How will this (law, regulation, rule, policy) impact the lives of children?”
This will lend itself to more informed funding decisions for child protection, housing, education, affordable/quality childcare, alternatives to incarceration, addiction treatment programs, and the right to quality health care.
Another hope is that all licensed pediatricians in Minnesota will be required to administer a trauma assessment with each checkup, and develop relationships with agencies in their communities to help the level of stress for the whole family.
Dr. Nadine Harris suggests pediatricians administer a trauma assessment to young patients with each annual checkup. She has devised a simple assessment, based on the ACE Study, that could be completed by a caregiver while in the waiting room. She uses this tool at her Center for Youth Wellness (CYW) in Bayfield, CA, connecting families to a network of support agencies dependent on the results — whether traumas require services in food, housing, employment, or addiction treatment.
One local program where I find hope is the Northside Achievement Zone (NAZ) in North Minneapolis. Minnesota’s academic achievement gap between races is among the highest in the nation — partly due to traumas from violence, poverty, homelessness, and more — and that gap is most apparent in North Minneapolis.
NAZ has developed a structure that provides support to families in every part of their lives: family classes, partnerships with schools, out-of-school enrichment, collaborations with local physical health/behavioral health providers, financial literacy education, career training, and housing stability.
A Wilder Foundation evaluation in 2015 concluded that for every dollar spent the program was returning more than $6 in social benefits, such as increased future earnings, fewer felonies, reduced public assistance, or less child abuse. Ballmer Group, General Mills, the Edward J. Phillips Family Foundation, the Pohlad Family Foundation, Target Corp and Bank of America all have invested in the program to help address the impact of multi-generational poverty and trauma on families in North Minneapolis.
I see another promising development in Hennepin County’s Child Protection Services, where additional funding has gone to hiring more caseworkers to help families develop trusting relationships, especially those impacted by drug addiction.
There is much to be done. There are no easy solutions. I think informed policy-makers can help us heal the trauma that impacts so much of our community.