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January 24 - September 3, 2023
Children have faced trauma and stress in the form of abuse, neglect, violence, and fear since God was a boy.
The people who are smart and strong enough are able to rise above the past and triumph through the force of their own will and resilience.
Twenty years of medical research has shown that childhood adversity literally gets under our skin, changing people in ways that can endure in their bodies for decades. It can tip a child’s developmental trajectory and affect physiology. It can trigger chronic inflammation and hormonal changes that can last a lifetime. It can alter the way DNA is read and how cells replicate, and it can dramatically increase the risk for heart disease, stroke, cancer, diabetes—even Alzheimer’s.
These babies came into the world no different than the ones born in Laurel Heights, yet as I did newborn exams in Bayview, I knew that these human beings’ lives would, according to the statistics, be twelve years shorter than the lives of the children in Laurel Heights. Not because their hearts were made differently or because their kidneys didn’t function the same way, but because somewhere in the future, something in their bodies would change—something that would alter the trajectory of their health for the rest of their lives. At the beginning, they are equal, these beautiful bundles of
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there is a molecular mechanism behind every natural phenomenon—you just have to look for it.
Corticosterone is a stress hormone—its equivalent in humans is cortisol—so
One of the biggest parts of this process is the increased production of cortisol, and a major effect of cortisol is an increase in blood sugar.
difference between adaptive and maladaptive reactions is all about the when.
In 1990 he presented his findings at a national obesity meeting in Atlanta and was roundly criticized by his peers. One physician in the audience insisted that patients’ stories of abuse were fabrications meant to provide cover for their failed lives. Felitti reported that the man got a round of applause.
For instance, a person with four or more ACEs was twice as likely to develop heart disease and cancer and three and a half times as likely to develop chronic obstructive pulmonary disease (COPD) as a person with zero ACEs.
The body of research sparked by the ACE Study makes it clear that adverse childhood experiences in and of themselves are a risk factor for many of the most common and serious diseases in the United States (and worldwide), regardless of income or race or access to care.
It’s possible that we marginalize the impact of trauma on health because it does apply to us.
Essentially, cortisol helps the body adapt to repeated or long-term stressors,
cortisol stimulates fat accumulation and also triggers the body to crave high-sugar, high-fat foods.
What the research tells us is that those daily challenges can be overcome with the right support from a loving caregiver.
They need to be able to trust and secure attach to one person.
Toxic stress response can occur when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support. This kind of prolonged activation of the stress-response systems can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years.
When you put a kid who had experienced adversity in an MRI machine, you could see measurable changes to the brain structures.
Dysregulation of the stress response has a profound impact on immune and inflammatory responses because virtually all the components of the immune system are influenced by stress hormones.
The fact that environment is something we can modify means there is a lot of hope for human pups born to “low-licker” moms.
After years as a clinician, Dr. Lieberman came to understand that children’s need to create a story or narrative out of confusing events is actually very normal.
When there is no clear explanation, they make one up; the intersection of trauma and the developmentally appropriate egocentrism of childhood often leads a little kid to think, I made it happen.
This allows patients to make connections between the traumas of the past and the stressors of the present, so they can better recognize their triggers and manage their symptoms.
CPP’s approach is based on the understanding that the quality of the relationship and the health of the attachment between the parent and child are absolutely fundamental to health and well-being.
Childhood adversity significantly increases the risk for just about every sleep disorder there is, including nightmares, insomnia, narcolepsy, sleepwalking, and psychiatric sleep disorders (sleep-eating, anyone?). Nighttime sleep plays a powerful role in influencing brain function, hormones, the immune system, and even the transcription of DNA.
Other studies have shown that meditation decreases cortisol levels, enhances healthy sleep, improves immune function, and decreases inflammation—all critical parts of keeping our biological systems balanced and able to mitigate the effects of toxic stress.
preventing rather than simply responding to the downstream effects once the chain of violence had been set in motion.
When statistics have faces, they feel a lot heavier.
Guthrie’s true legacy was that he set the precedent for universal screening.
The most effective way to rewire the brain is to implement early interventions that help to prevent the stress response from becoming dysregulated and that support practices that buffer the stress response (as with child-parent psychotherapy).
These times represent special opportunities for healing, moments when enriching experiences have an even better shot at being “wired in.”
the preliminary data indicates that stressors at the household level (the traditional ACEs) seem to have a greater effect on health than stressors at the community level.
the world was missing the point that toxic stress is about basic human biology and that adversity happens everywhere, among all races and geographic areas. I shared my fear that if this became a poor-people-of-color issue, we would miss an opportunity to help all children. I asked how they thought I could get my colleagues to understand that it was important to screen everyone for ACEs, not just people in low-income or vulnerable communities.
but what struck me was how hidden it had been.
Number one, reduce the dose of adversity; number two, strengthen the ability of the caregiver to be a healthy buffer.
The single most important thing is recognizing what the problem is in the first place.”
healing. I went on to explain that for toxic stress, the six things that I recommend for my patients—sleep, exercise, nutrition, mindfulness, mental health, and healthy relationships—were just as important for adults.
We literally have the capacity to change our own and one another’s biology.
The evening showed me the power of the ACEs framework to open a dialogue about topics that feel largely taboo in our society.
the risk to reputations was so high.
The hiding is pervasive because exposure can cost people their careers.
The communities near Ground Zero were equipped with more resources, which meant adults were far more able to act as effective buffers, keeping the kids’ stress out of the toxic zone and into the realm of tolerable. Whether it was a teacher, a religious leader, a grandparent, or a coach, the children closer to Ground Zero had many more sources of buffering that could help stabilize them in moments of acute trauma, even if it was severe.
In order to be able to pay attention and learn in school, a kid needed to engage his prefrontal cortex (the conductor), which meant the amygdala alarm had to be silent.
They also knew that the natural antidote to toxic stress—having a well-regulated caregiver who could buffer the stress response—was often in very short supply.
healthy attachment begins at birth and forms the basis from which we all learn to trust and relate to one another.
Whether it was chaos at home, violence in the community, the crushing weight of poverty, or the fog of drugs, alcohol, and mental illness, families often faced overwhelming challenges in providing safety and security for their children.
It hit me that ACEs weren’t just at the root of a public-health crisis in America, they were at the root of our public-education crisis as well.
Toxic stress affects how we learn, how we parent, how we react at home and at work, and what we create in our communities. It affects our children, our earning potential, and the very ideas we have about what we’re capable of. What starts out in the wiring of one brain cell to another ultimately affects all of the cells of our society, from our families to our schools to our workplaces to our jails.
We keep talking about stress, stress, stress, and let’s study, study, study, when the axiology of black people is relationship.
when you bring it down to the level of cells, the level of biological mechanisms, then it is about all of us. We are all equally susceptible and equally in need of help when adversity strikes. And that is what a lot of folks don’t want to hear.
It is easy to get stuck on your own suffering because, naturally, it is what affects you most, but that’s exactly the mentality that is killing black people, white people, and all people. It perpetuates the problem by framing it in terms of us versus them. Either we get ahead or they get ahead. That leads quickly to a fight for resources that fragments efforts to solve the same damn problem.
