The Deepest Well: Healing the Long-Term Effects of Childhood Trauma and Adversity—A Transformative Guide to Understanding Childhood Trauma and Health

by Nadine Burke Harris

Every day I witnessed my tiny patients dealing with overwhelming trauma and stress; as a human being, I was brought to my knees by it. As a scientist and a doctor, I got up off those knees and began asking questions.

While my mother was none too pleased about the stench of sour milk or a ruined blouse, I learned something that became fundamental to my adult worldview: there is a molecular mechanism behind every natural phenomenon—you just have to look for it.

It was exactly what happened to the younger tadpoles versus the closer-to-metamorphosis froglets—the difference between adaptive and maladaptive reactions is all about the when.

cortisol? Is it possible that the daily threat of violence and homelessness breathing down your neck is not only associated with poor health but potentially the cause of it? It

behavioral therapy (TF-CBT for short), a clinical protocol designed to address the impact of trauma on a child’s development by working with both parent and child.

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.

abandonment. The body senses danger, and it sets off a firestorm of chemical reactions aimed to protect itself. But most important, the body remembers. The stress-response system is a miraculous result of evolution that enabled

Despite the fact that these kids were no longer experiencing trauma, the parts of their brains responsible for learning and memory were still shrinking, showing us that the effects of earlier stress were still acting on the neurological system. Dr. Carrion agreed with me that it was

actually “read” every “word” of its DNA. What scientists have discovered is that baked into the cells are both the genome (your entire genetic code) and the epigenome, another layer of chemical markers that sit on top of your DNA and determine which genes get read and transcribed into proteins and which ones don’t. The term epigenetic actually means “above

The study found that the pups’ DNA methylation took on the pattern of their foster moms’, not their genetic moms’. So did their behavior—if a rat pup born to a high-licker mom was fostered by a low licker, she grew up to be an anxious adult rat with high levels of stress hormones who was a low licker herself when she had her own pups.

telomere. Once again, the science is new, but it suggests that even if you start out with shorter-than-normal telomeres, you can still slow decline by increasing your telomerase with things like meditation and exercise. …

As we saw with Diego, psychotherapy was in fact one of the most well-supported therapeutic interventions for patients with symptoms of toxic stress whether those symptoms were behavioral or not.

But in the months leading up to when I started treating Nia, we had begun working with Dr. Alicia Lieberman at the University of California, San Francisco, a renowned child psychologist who specialized in child-parent psychotherapy (CPP). This type of therapy focuses on children from birth to five years old and is built on the notion that to help young kids experiencing adversity, you have to treat the parent and child like a team. The groundbreaking aspect of CPP, and what Dr. Lieberman believes makes it so effective, is the recognition that real conversations with kids about how trauma is affecting them and their families—even when kids are really little—are critical.

Despite setbacks along the way, the child-parent psychotherapy had been a real success, changing the dynamic that was affecting Nia’s health and strengthening Charlene’s ability to act as a buffer for her child when problems arose.

Over and over again the research pointed to one treatment in particular—meditation.

Sleep, mental health, healthy relationships, exercise, nutrition, and mindfulness—we saw in our patients that these six things were critical for healing.

As important, the literature provided evidence of why these things were effective. Fundamentally, they all targeted the underlying biological mechanism—a dysregulated stress-response system and the neurologic, endocrine, and immune disruptions that ensued.

That is why an ounce of screening is better than a pound of cure.

Services. The de-identified screening tool takes all of these concerns out of the equation.

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.

But the general idea is, the more of the six things you do, the more you’ll reduce stress hormones, reduce inflammation, enhance neuroplasticity, and delay cellular aging.

Toxic stress is a result of a disruption to the stress response. This is a fundamental biological mechanism, not a money problem or a neighborhood problem or a character problem. That means we can look at one another differently. We can see one another as humans with different experiences that have triggered the same physiological response. We can leave the blame and shame out of it and just tackle the problem the same way we would treat any other health condition. We can see this problem for what it really is, a public-health crisis that is as indiscriminate as influenza or Zika.

Over the next weeks, our team worked with Diego to assess how he was doing in the six critical areas of sleep, exercise, nutrition, mindfulness, mental health, and healthy relationships.

I don’t think people who grew up with ACEs have to “overcome” their childhoods. I don’t think forgetting about adversity or blaming it is useful. The first step is taking its measure and looking clearly at the impact and risk as neither a tragedy nor a fairy tale but a meaningful reality in between. Once you understand how your body and brain are primed to react in certain situations, you can start to be proactive about how you approach things. You can identify triggers and know how to support yourself and those you love.

If you’re someone with an ACE score of your own, learning to recognize when your stress response is getting out of whack can be hard. Taking the time and finding the resources to do self-care and get yourself on the path to healing can be even harder. If you’re a parent with ACEs, or even a parent without ACEs, you have a double challenge because you have to worry about taking care of yourself and protecting your child. Or, as we’ve learned, doing the former so you can do the latter.