Living with the bear...

 “One believes things because one has

been conditioned to believe them.”

‑ Aldus Huxley, Brave New World

The week-long virtual conference was presented by the Peace and Justice Institute of Valencia College in Orlando, Florida. Of the innumerable courses and seminars, I had taken, this would be the first one sitting behind my computer for six-content hours a day. Would it work?

The focus of this course was to sensitize teachers in areas such as race, gender, culture, resilience, and emotional intelligence. These were topics with which I had interest and experience.

Then there was this…

Mid-week, the conference shifted and introduced something called the Adverse Childhood Experiences (ACE)…a link between chronic disease and early abuse in the home. This was brand new and intriguing.

A study was presented based on research by a San Diego Kaiser Permanente physician and a Centers for Disease Control (CDC) researcher (ref 1). They recruited 17,500 subjects, 70% of which were Caucasian, and 70% college-educated, and presented them with the following questions:

Prior to your 18^th birthday:

1.  Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?

2.  Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?

3.  Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?

4.  Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?

5.  Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

6.  Were your parents ever separated or divorced?

7.  Was your mother or stepmother:
Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

8.  Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?

9.  Was a household member depressed or mentally ill, or did a household member attempt suicide?

10.  Did a household member go to prison?

The researchers found strong relationships between ACE scores and health outcomes. The higher the ACE score, the greater the risk for chronic disease.

Among other things, 67% of the respondents had at least one ACE point, and 12.6% had scores of four or higher. Persons with a score of four or more were 2.5 times higher risk for chronic obstructive pulmonary disease (COPD) and hepatitis. Scores of four or more were 4 times more likely to have depression and at 12 times greater risk for suicide. A score of seven or more had a 3 times greater lifetime risk for lung cancer and 3.5 times higher risk for ischemic heart disease, the number one killer in this country.

It didn’t seem to matter which specific items were chosen, but rather the number of adverse experiences children had been exposed to.

One coin, two sides…

One of the wonders of the human body is its ability to protect us. The autonomic (read, automatic) nervous system has a couple of divisions. The 'alarm side' is referred to as flight or fight. The 'calming side' is known as rest and digest where the body does just that, going about the business of supporting our daily lives.

It works like this: When confronted with a perceived threat, say a bear suddenly appears while hiking in the woods. Our bodies go into full alert. Adrenalin drives our heart rate up, opens our lungs for more air, increases nutrition to our muscles, and increases blood pressure. Hormones designed to save our lives are poured into our systems. Other regulators take over once the threat has been removed and we return to physiologic balance. All of us have experienced this kind of response in our lives.

But what happens when we live with the bear? What happens when we find ourselves on alert daily because of continual threats? What happens when this occurs consistently throughout childhood years? Hormones designed to save, in the ebb and flow of normal life, become toxic and, over time, lead to chronic disease. The lifesavers becoming life takers. Rest and digest never fully returns the body to physiologic balance.

Traditional thinking has been that children are resilient. Kids that overcome early adversity leave it all behind. This, like a lot of non-scientific medical opinion, is simply wrong! Moreover, anyone reading this who has survived childhood trauma knows of a certainty it is wrong. The tail on that dog, while buried, influences our lives in immeasurable ways.

Many adults who have had early life experiences like those unearthed in the ACE questions, are ashamed of them, or have buried them so deeply they are never spoken of.

An epiphany

I couldn’t believe what I was hearing or reading. It wasn’t that I didn’t understand the effects of chronic stress. I had taught stress management my whole professional life. But I was missing a critical piece related to the source of many of the chronic disease lifestyle issues I had worked with. My curiosity was peaked.

In the reference material for the course was a book titled deepest well by Nadine Harris, MD, a pediatrician from San Francisco. I was curious, did a web search, and read a review. I found her giving a TED Talk on early childhood adversity. It was an articulate and compelling overview of this topic (ref 2). It inspired me to read her book. It was an awe-inspiring read, that was a revelation of understanding. Her ability to raise social awareness was great, but the physiology she presented was compelling.

What to do?

Bill Bryson in The Body: An operator’s manual says most of us commit suicide by lifestyle, and it takes ages. That is an entertaining, but fairly accurate of the ‘…is what it is…’

But what do we do when we realize we are carriers of deeply rooted chronic stressors, when the ‘turn off’ mechanisms are broken? What does it mean to appreciate unrelenting stress in our early lives that may have unknowingly led to chronic health issues we may be suffering now? Is there anything that can be done?

The good news lies in the amazing recuperative power of the body. There are tools we can use to help it in the process of recovery.

The following are areas of life that, if addressed, have been shown to work as antidotes to the contamination of chronic disease. They are sleep, mental health, healthy relationships, exercise, nutrition, and mindfulness. Healthy changes in these areas of life may not turn back the clock, but they can help repair long-term physiologic damage and increase quality of life.

It might take professional help to address some of these areas, but for the most part, they are things over which we can take control. Sometimes we just need permission, a nudge to begin to take power in our lives.

When I return to the classroom, I will have a new and deeper appreciation for the way I interact with my students. The 'Peace and Justice Institute' is responsible for increasing my sensitivity toward students (and administration).

As a result of the ACE, however, I will never look at my students the same way again. I don't really have a lot of answers, but a place to start is to ensure they have a safe place to learn. A place where I can teach some of the new things I have learned...so that it won't take them seventy-three years to think about the decisions they make in their lives.

If I thought attending a weeklong virtual conference behind a computer screen, might not be the best way to learn – I was wrong. Maybe it wasn’t touchy-feely, but the jury is in. I would do it again in a heartbeat!

- ted

References:

1.   Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse Child Experience Study – Amer Jour of Prev Med. 14(4), 1998, pp245-258.

2.   https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime/transcript).