WEBVTT - Childhood Stress and Our Health w/ Dr. Nadine Burke Harris 0:00:01.600 --> 0:00:04.680 Welcome to Go, ask Alli, a production of Shonda Land 0:00:04.760 --> 0:00:08.760 Audio and partnership with iHeartRadio. When I have been with 0:00:08.840 --> 0:00:11.200 friends and that happened and I paid my pants, I 0:00:11.720 --> 0:00:14.960 did lose the room, they did leave. I saw her 0:00:15.040 --> 0:00:17.040 light up and I was like, I'm just going to work. 0:00:17.120 --> 0:00:20.480 But we are here until one of our last rips. Yeah. 0:00:20.600 --> 0:00:22.160 I was just the one that was meant to take 0:00:22.200 --> 0:00:24.119 care of mamma. It's for me to remember every single 0:00:24.239 --> 0:00:28.040 day is that I always have a choice. Everyone always 0:00:28.040 --> 0:00:31.800 has a choice. Whenever somebody says no, you can't or 0:00:32.400 --> 0:00:34.839 there's no roles for you, or you have to look 0:00:34.880 --> 0:00:38.600 like this, I go. I'll show you. I'll show you. 0:00:42.280 --> 0:00:45.280 Welcome to Go, ask Alli. I'm Alle Wentworth. A few 0:00:45.280 --> 0:00:48.160 weeks ago, we did a podcast with doctor Lisa Damore 0:00:48.360 --> 0:00:50.920 about her new book, The Emotional Lives of Teenagers, and 0:00:50.960 --> 0:00:53.280 as we chatted, she mentioned a couple of times how 0:00:53.320 --> 0:00:57.480 trauma causes a concerning level in their well being. So 0:00:57.600 --> 0:01:02.120 we decided to do a very deep guy into childhood trauma, 0:01:02.360 --> 0:01:05.360 and we decided that what we need to really explore 0:01:05.560 --> 0:01:09.120 is aces, which is adverse childhood experiences and they can 0:01:09.160 --> 0:01:13.720 include poverty, domestic abuse, or maternal depression and can profoundly 0:01:13.720 --> 0:01:16.600 affect the development of the brain and cause a lifelong 0:01:16.640 --> 0:01:20.200 harm to children's physical, mental, and emotional health. And there 0:01:20.280 --> 0:01:23.080 is no better person to talk to about this than 0:01:23.240 --> 0:01:27.800 doctor Nadine Burke Harris. She's an award winning physician, researcher 0:01:28.000 --> 0:01:31.880 and was California's first ever surgeon General. She's a founder 0:01:31.880 --> 0:01:34.680 of the Center for Youth Wellness, and organization leading the 0:01:34.720 --> 0:01:39.200 effort to advance pediatric medicine, raise public awareness, and transform 0:01:39.280 --> 0:01:43.280 the way society responds to children exposes to adverse childhood 0:01:43.319 --> 0:01:47.120 experiences ACES. Doctor Burke Harris is ted talk how childhood 0:01:47.160 --> 0:01:50.640 trauma affects health across the lifetime has been viewed almost 0:01:50.680 --> 0:01:54.640 eleven million times. Her book, The Deepest Well Healing the 0:01:54.760 --> 0:01:58.880 Long Term Effects of Childhood Diversity was called indispensable by 0:01:58.880 --> 0:02:03.600 The New York Times. So, doctor Burke Harris, thank you 0:02:03.640 --> 0:02:06.520 so much for being with me. I am going to 0:02:07.360 --> 0:02:09.800 have the audacity to call you Nadine during the rest 0:02:09.800 --> 0:02:12.560 of this podcast, because I want to be your friend, 0:02:12.760 --> 0:02:14.480 and the first way to do that is to call 0:02:14.520 --> 0:02:17.560 you by your first name. We're friends already, yes, we are, 0:02:17.919 --> 0:02:22.040 so you know, I think everything you're doing is so incredible. 0:02:22.600 --> 0:02:25.440 And I've done a lot of child advocacy, so I 0:02:25.480 --> 0:02:29.639 am fascinated by how childhood trauma affects us as adults, 0:02:30.240 --> 0:02:33.239 and I wanted to start. I was worked with Marion 0:02:33.240 --> 0:02:36.720 Wright Edelman in Washington, d C. With a Children's Defense Fund, 0:02:37.600 --> 0:02:40.679 and one of the things we did was we had 0:02:40.720 --> 0:02:44.160 an organization in a charity called Beat the Odds and 0:02:44.320 --> 0:02:47.359 a lot of times I would go through these files 0:02:48.200 --> 0:02:51.560 of kids that we were giving scholarships to to college, 0:02:51.560 --> 0:02:54.840 and we'd have to go through and assess who really 0:02:54.919 --> 0:02:57.960 beat the odds, which is kind of a crazy idea 0:02:58.080 --> 0:03:01.200 that we had to determine who went through the worst 0:03:01.320 --> 0:03:05.359 childhood traumas to be able to have this college scholarship. 0:03:05.360 --> 0:03:08.639 But anyway, my point is that I would read these 0:03:08.680 --> 0:03:13.640 stories that were just heartbreaking about childhood abuse, you know, 0:03:13.680 --> 0:03:15.600 and you'd have a child who lived in a car, 0:03:15.639 --> 0:03:19.079 who was raped by their father. I mean, just layer 0:03:19.280 --> 0:03:23.840 upon layer of trauma, and yet some of them still 0:03:24.240 --> 0:03:27.280 had a high grade point average. They went on to 0:03:27.360 --> 0:03:32.040 be you functional adults, and some did not. And to me, 0:03:32.440 --> 0:03:36.600 it is all about the childhood trauma. And you have 0:03:36.680 --> 0:03:40.480 gone even further and researched it because I think a 0:03:40.920 --> 0:03:44.960 certainly our culture tries to deal with it on a 0:03:44.960 --> 0:03:48.480 psychological way, like, oh, maybe if they have therapy, everything 0:03:48.480 --> 0:03:52.280 will be fine, and you basically say that's not exactly true. 0:03:52.400 --> 0:03:56.840 The ramifications are physical and neurological and biological, and so 0:03:56.920 --> 0:04:00.960 I want to talk to you about all of this. Yeah. Yeah, 0:04:01.000 --> 0:04:05.480 what we experience as children actually gets under our skin 0:04:05.600 --> 0:04:10.000 and changes our biology, and it can have a profound effect. 0:04:10.040 --> 0:04:12.440 I think most people recognize it when the effect is 0:04:12.440 --> 0:04:17.479 on behavior, but we recognize it a lot less when 0:04:17.480 --> 0:04:21.200 it shows up as asthma or diabetes or heart disease 0:04:21.279 --> 0:04:24.880 later on down the road. And that's important for a 0:04:24.920 --> 0:04:28.760 lot of reasons in terms of how it affects our health, 0:04:28.760 --> 0:04:31.719 our well being, our mental and emotional and behavioral health. 0:04:32.000 --> 0:04:34.960 But it's also really important in terms of how we 0:04:35.080 --> 0:04:41.520 structure solutions because when we approach it in terms of 0:04:42.480 --> 0:04:45.000 beating the odds, which I think a lot of us do, 0:04:45.120 --> 0:04:47.600 I mean in the United States but also globally, in 0:04:47.720 --> 0:04:50.880 terms of beating the odds, I think that's one thing. 0:04:50.960 --> 0:04:53.000 I think that's what we're able to do when we 0:04:53.040 --> 0:04:56.760 start recognizing the problem. I think my focus has been 0:04:56.920 --> 0:05:00.640 very much in changing the odds, right, So so that 0:05:01.120 --> 0:05:04.159 so that that's not like, yeah, it's not like a thing, 0:05:04.480 --> 0:05:08.479 you know what I mean of that association between childhood 0:05:08.480 --> 0:05:16.239 adversity and just really really difficult lifelong stressors. So so yeah, 0:05:16.279 --> 0:05:21.320 you know what's amazing is that the real signature research 0:05:21.440 --> 0:05:26.839 on this was I think really came together in a 0:05:26.960 --> 0:05:30.080 study that was done by the CDC and Kaiser Permanente, 0:05:30.120 --> 0:05:34.320 and it was published in nineteen ninety seven, and it 0:05:34.400 --> 0:05:42.719 really showed that experiencing adversity and childhood like experiencing abuse 0:05:43.040 --> 0:05:46.960 or neglect, but even things that I think many of 0:05:47.040 --> 0:05:50.240 us who kind of don't consider ourselves to have like 0:05:50.279 --> 0:05:53.719 this incredibly tough childhood, but things like growing up in 0:05:53.720 --> 0:05:56.279 a household where there was divorce or where a parent 0:05:56.400 --> 0:05:59.440 struggled with mental health issues, or where there was intimate 0:05:59.480 --> 0:06:04.039 partner islands that these factors have a profound impact on 0:06:04.080 --> 0:06:07.320 our health. And actually, for an individual with four or 0:06:07.400 --> 0:06:11.760 more of these adverse childhood experiences, you know, we know 0:06:11.920 --> 0:06:15.719 that they're the risk of something like depression was four 0:06:15.760 --> 0:06:21.520 and a half times, for attempting suicide was over thirty times. 0:06:21.560 --> 0:06:24.440 But for things like heart disease. The number one kill 0:06:24.520 --> 0:06:27.039 in the United States was more than double. You know, 0:06:27.279 --> 0:06:31.440 heart disease, chronic lung disease, diabetes, kidney disease, all of 0:06:31.440 --> 0:06:35.800 these different things. And so we now understand that that 0:06:35.960 --> 0:06:39.800 experience of scary or traumatic things in our childhood affects 0:06:39.800 --> 0:06:44.680 our biology by activating our stress response, and then that 0:06:44.720 --> 0:06:50.240 affects our whole bodies, our brains, our hearts, our cardiovascular system, 0:06:50.320 --> 0:06:55.560 our neurologic system, our immune system. And so I think 0:06:55.600 --> 0:06:58.560 when we when we look at it and we kind 0:06:58.560 --> 0:07:00.559 of hear this information, it makes a lot of sense. 0:07:00.560 --> 0:07:02.840 I think for a lot of people it makes sense intuitively. 0:07:03.320 --> 0:07:06.080 But now that we understand that, it means that we 0:07:06.080 --> 0:07:08.919 can approach it very differently. So let me ask you 0:07:08.920 --> 0:07:13.440 a question in terms of degrees of trauma. So in 0:07:13.600 --> 0:07:17.000 your research, let's say we take a child from Yemen 0:07:17.320 --> 0:07:21.480 who right now is experiencing extreme trauma on every level, 0:07:22.080 --> 0:07:26.240 as opposed to a child right now who has food 0:07:26.280 --> 0:07:29.960 and shelter, but parents are getting divorced. You know, there's 0:07:30.000 --> 0:07:33.400 a huge gap between the level of trauma both these 0:07:33.480 --> 0:07:39.680 children are experiencing. Does that then equals the physical ramifications 0:07:39.680 --> 0:07:42.520 of the stress, meaning is this child in Yemen going 0:07:42.560 --> 0:07:46.040 to have heart disease whereas this child who's experiencing divorce 0:07:46.080 --> 0:07:50.400 will probably just need some antidepressants. That's a great question. 0:07:50.960 --> 0:07:54.920 There's two parts to that. So one, what we know 0:07:55.200 --> 0:07:59.040 is that the dose of adversity. As a doctor, I'm 0:07:59.040 --> 0:08:02.679 always thinking about things in this way. But the higher 0:08:02.720 --> 0:08:05.960 the dose of adversity, the greater the risk. And it's 0:08:06.000 --> 0:08:09.760 like anything else. It's like if you're exposed to radiation, right, 0:08:09.840 --> 0:08:11.920 Like the higher the dose, the greater the risk. If 0:08:11.920 --> 0:08:15.320 you are exposed a little bit, you have you know, 0:08:15.360 --> 0:08:17.360 you have an elevated risk by a little bit. If 0:08:17.360 --> 0:08:19.840 you're exposed to a lot, you have an elevated risk 0:08:19.880 --> 0:08:22.400 by a lot. And what we also know is that 0:08:22.440 --> 0:08:27.080 the impacts are cumulative throughout the lifetime. So for example, 0:08:27.520 --> 0:08:33.080 if you experience significant adversity in childhood, like this child 0:08:33.200 --> 0:08:38.440 in Yemen, you're going to have greater risk. And then 0:08:38.480 --> 0:08:43.240 if you so. One thing that's really important is that 0:08:43.920 --> 0:08:50.840 the doses also of safe, stable, nurturing, supportive relationships and 0:08:50.880 --> 0:08:56.200 experiences counteract that. Right, So it's this balance between the 0:08:56.240 --> 0:09:00.800 adversity that you experience the nurturing relationships that you experience 0:09:00.840 --> 0:09:04.560 that counteract that. And then there's a second component, which 0:09:04.640 --> 0:09:09.880 is our biology. So each of us has a different threshold, 0:09:09.960 --> 0:09:12.840 a different biological threshold, just like you know, we're each 0:09:12.840 --> 0:09:15.839 a different height, right. So you could even have two 0:09:15.920 --> 0:09:19.320 kids in the same family that are exposed to, you know, 0:09:20.040 --> 0:09:25.160 roughly the same dose of adversity, but have different outcomes. 0:09:25.400 --> 0:09:29.160 So I think those pieces are really important. But the 0:09:29.160 --> 0:09:33.040 other thing that it's important to remember is that the 0:09:33.120 --> 0:09:36.360 way that it shows up in our bodies also may 0:09:36.360 --> 0:09:40.720 be different. So for example, you may have again two 0:09:41.520 --> 0:09:45.040 siblings in the same household, or or one of the 0:09:45.080 --> 0:09:47.000 common things that I saw in my clinical practice is 0:09:47.000 --> 0:09:49.839 that you might have five kids in the same household, right, 0:09:50.160 --> 0:09:54.200 who are all experiencing high doses of adversity, and for 0:09:54.480 --> 0:10:01.360 one child the impact is on their behavior. For another child, 0:10:01.720 --> 0:10:05.680 they just have really bad asthma. For another child, they're 0:10:05.720 --> 0:10:09.360 not growing as quickly as they should, you know. For 0:10:09.400 --> 0:10:14.160 another child, it may be reflected in their weight, right, 0:10:14.520 --> 0:10:19.720 they might be really overweight or underweight. And so the 0:10:19.760 --> 0:10:23.280 way that it shows up in kids and then in 0:10:23.480 --> 0:10:26.719 us as we carry that forward into adulthood, can be 0:10:26.800 --> 0:10:30.280 very different. And the reason I mentioned that is because 0:10:30.720 --> 0:10:34.240 I often hear people say, oh, you know what, I 0:10:34.320 --> 0:10:38.080 experience a lot of adversity in my childhood and I 0:10:38.120 --> 0:10:42.560 didn't have any you know, symptoms or outcomes that you're 0:10:42.600 --> 0:10:46.280 aware of. So I literally had this conversation with a 0:10:46.320 --> 0:10:48.280 woman where she's like, oh, you got to meet my friend. 0:10:48.400 --> 0:10:51.960 She's amazing. She experienced a lot of these adverse childhood 0:10:51.960 --> 0:10:54.959 experiences that you're talking about, and she was so resilient. 0:10:55.080 --> 0:10:58.440 She overcame you guys got to connect, But don't call 0:10:58.520 --> 0:11:00.960 her now because she's in the hospital. She just had 0:11:00.960 --> 0:11:04.320 a major heart attack. Oh my god. Literally, I'm not 0:11:04.360 --> 0:11:07.120 making this up. This is an honest conversation that I 0:11:07.160 --> 0:11:10.000 had with someone. And so I think that when we 0:11:10.440 --> 0:11:15.240 do a better job in recognizing what all the potential 0:11:15.320 --> 0:11:19.439 outcomes are, it really helps us to think about to 0:11:20.120 --> 0:11:27.040 put systems in place right, to really invest in prevention 0:11:27.559 --> 0:11:31.480 right right that that prevention and early identification. When you're 0:11:31.520 --> 0:11:34.760 saying this, I'm thinking about I have two daughters, and 0:11:35.120 --> 0:11:38.800 when they came out, they were completely different, right, so 0:11:39.000 --> 0:11:43.880 just genetically personality was very, very different, And I'm thinking 0:11:43.960 --> 0:11:48.559 about how, you know, if they had experienced a lot 0:11:48.600 --> 0:11:50.880 of trauma, which I don't think they did, but you know, 0:11:50.960 --> 0:11:54.040 they might be telling their therapists something else. But I 0:11:54.080 --> 0:11:56.680 think that two of them would react to it very differently. 0:11:56.760 --> 0:11:58.960 I think one of them would internalize it, which I 0:11:59.000 --> 0:12:03.040 think would end up showing itself physically more quickly than 0:12:03.120 --> 0:12:07.640 my other daughter, who is an extrovert and lets everything 0:12:07.640 --> 0:12:09.880 out and lets people know what's going on and says 0:12:09.920 --> 0:12:14.200 I'm hurt, I'm angry. And so it seems to me 0:12:14.320 --> 0:12:18.480 that that does really show up in different degrees and 0:12:18.520 --> 0:12:21.960 at different times, like you said, depending on literally the 0:12:22.000 --> 0:12:24.480 person you are when you come into the world. Ali, 0:12:24.559 --> 0:12:26.520 I'm going to give you some real talk right now. 0:12:26.600 --> 0:12:32.600 So we just had something happen in my household. My 0:12:32.720 --> 0:12:36.800 husband built a go cart for my kids and kind 0:12:36.840 --> 0:12:40.360 of for himself, but purportedly for the kids. Well, at 0:12:40.440 --> 0:12:42.400 least he can build a go cart. My husband can't 0:12:42.480 --> 0:12:45.160 change a light bulb, so that's good. Oh oh, he's 0:12:45.280 --> 0:12:47.480 I mean, my husband tricked it out. It's an ev 0:12:47.679 --> 0:12:51.360 He even got an electric motive for it, and he 0:12:52.920 --> 0:12:55.240 they were all driving the go cart having a great time. 0:12:55.320 --> 0:12:57.320 And you know, it has like a chain, almost like 0:12:57.320 --> 0:12:59.400 a bike chain, and they're driving around sometimes a chain 0:12:59.440 --> 0:13:02.719 would fall off and the chain fell off and my 0:13:02.800 --> 0:13:04.840 husband was putting it back on and there was some 0:13:05.200 --> 0:13:12.040 horrible accident and he amputated like piece of his finger, 0:13:12.600 --> 0:13:16.640 like it got cut off, your husband, my husband. Literally 0:13:16.679 --> 0:13:21.160 this happened three weeks ago, and it was right there 0:13:21.200 --> 0:13:23.200 in front of the kids. Oh my god. And so 0:13:23.280 --> 0:13:27.040 that is like dramatic like it m So it was 0:13:27.080 --> 0:13:28.920 pretty you know, and of course, you know, I'm checking 0:13:28.920 --> 0:13:32.840 in with them, I'm doing all the things. And my 0:13:32.960 --> 0:13:36.400 ten year old was like, oh my god, Mom, I 0:13:36.440 --> 0:13:38.400 saw it. I saw the figure, I saw the finger, Bob, 0:13:38.480 --> 0:13:40.200 I saw it. I saw the blood, and he was 0:13:40.280 --> 0:13:46.319 really you know, and my seven year old was just like, 0:13:47.400 --> 0:13:49.320 you know, he just he kind of was like, I 0:13:49.360 --> 0:13:51.040 hope that doesn't happen to me when I grow up. 0:13:51.080 --> 0:13:54.200 But he otherwise like you wouldn't see anything on the surface, 0:13:54.360 --> 0:13:59.680 right and literally probably oh it was you know earlier 0:14:00.360 --> 0:14:04.120 last week maybe, And last week my ten year old 0:14:04.120 --> 0:14:08.360 says to me, Hey, mom, what's mental health? And I 0:14:08.440 --> 0:14:11.240 started explaining it to him and he said, I think 0:14:11.320 --> 0:14:15.960 I'm having some mental health because I'm feeling like I'm 0:14:16.000 --> 0:14:19.640 having you know, a hard time around daddy and his 0:14:19.680 --> 0:14:24.400 finger and it was amazing to see the ways in 0:14:24.480 --> 0:14:29.480 which the two of them just reacted so differently. Yeah, 0:14:29.720 --> 0:14:32.400 and I have to say, I'm super proud of my 0:14:32.760 --> 0:14:35.840 ten year old. And I literally was able to sit 0:14:35.880 --> 0:14:38.840 down and say to him, Hey, you know what, these 0:14:38.880 --> 0:14:41.800 are the things that make a difference when you are 0:14:42.080 --> 0:14:46.120 struggling with your mental health and when you are you know, 0:14:46.240 --> 0:14:48.920 because he literally said, he said, I think I'm traumatized. 0:14:49.440 --> 0:14:53.000 My ten year old said this to me though, and 0:14:53.080 --> 0:14:54.920 I said, well, here are some of the things you 0:14:54.960 --> 0:14:58.760 can do. You find somebody who you trust, who you 0:14:58.760 --> 0:15:01.960 feel safe with, and you just talk to them about 0:15:01.960 --> 0:15:06.080 how you're feeling and just, you know, really just share 0:15:06.120 --> 0:15:08.320 everything in your heart, the things that you're afraid of, 0:15:08.760 --> 0:15:11.480 the things that you're worried about, what the thoughts that 0:15:11.520 --> 0:15:15.120 are happening in your in your mind, and we just, like, 0:15:15.560 --> 0:15:20.400 you know, went through the whole thing. And he just said, 0:15:20.480 --> 0:15:24.000 you know, anytime you feel overwhelmed, getting connected with someone 0:15:24.040 --> 0:15:27.720 you feel safe with. And so literally we're in the 0:15:27.760 --> 0:15:32.120 middle of it right now in my household. Yeah. Wow, 0:15:34.320 --> 0:15:36.360 there's a lot more to come after the short break 0:15:44.400 --> 0:15:49.560 and we're back. Well, let me ask you this. It 0:15:49.640 --> 0:15:54.760 sounds like you're saying, if you are able to verbalize it, 0:15:54.800 --> 0:15:57.080 if you're able to go to somebody that you trust 0:15:57.240 --> 0:16:00.960 and discuss it, is that sense of relief, way of 0:16:02.000 --> 0:16:05.640 physically helping yourself is at the first step towards healing. 0:16:06.360 --> 0:16:10.200 That is an absolute yes. And this is why it's 0:16:10.200 --> 0:16:14.000 so important for us to create safe spaces for young people. 0:16:14.400 --> 0:16:16.000 And this is one thing that I would say is 0:16:16.000 --> 0:16:21.800 that every adult has the opportunity to be that safe relationship, 0:16:22.080 --> 0:16:25.440 because this is not just a thing that like, oh 0:16:25.520 --> 0:16:28.600 it feels better. When we look at research that's done 0:16:28.680 --> 0:16:34.000 and it's you know, around the world, when kids have safe, stable, 0:16:34.120 --> 0:16:41.520 and nurturing relationships and environments, the risk of negative mental 0:16:41.640 --> 0:16:46.960 and physical health outcomes as a result of ACES drops 0:16:47.160 --> 0:16:51.440 dramatically by more than fifty percent. Wow. And so yeah, 0:16:51.480 --> 0:16:55.920 so these things really really do make a huge difference. 0:16:55.920 --> 0:16:57.960 And the thing that I that I also want to 0:16:58.000 --> 0:17:02.920 say about that is that the earlier you do that right, 0:17:03.320 --> 0:17:06.800 the better. So are there are things Some of the 0:17:06.840 --> 0:17:10.879 things that make a difference in addition to nurturing supportive 0:17:10.920 --> 0:17:15.080 relationships include things like exercise that actually just helped to 0:17:15.200 --> 0:17:18.120 metabolize stress hormones, right because stress hormones are going wild 0:17:18.160 --> 0:17:20.760 in your body. You get out there, you go for 0:17:20.760 --> 0:17:22.919 a long walk, you play some basketball, you do whatever. 0:17:23.240 --> 0:17:27.160 That also helps to metabolize stress hormones. Having good sleep 0:17:27.240 --> 0:17:30.920 hygiene and having a really good sleep schedule because stress 0:17:31.000 --> 0:17:35.200 disrupts sleep, but also lack of sleep increases stress hormones. 0:17:35.240 --> 0:17:39.560 So that's another thing. Being in nature. Like you know 0:17:39.600 --> 0:17:44.360 how when you get out in this really beautiful natural environment, 0:17:44.440 --> 0:17:47.280 how you kind of just you just like xmail, you 0:17:47.359 --> 0:17:49.360 kind of feel your blood pressure go down a little bit. 0:17:49.720 --> 0:17:56.600 It's actually being in nature helps to regulate the brain's 0:17:56.640 --> 0:18:02.119 stress response. Also, things like mindfuls like meditation, that also 0:18:02.200 --> 0:18:05.119 helps to regulate the stress response. So these are things 0:18:05.200 --> 0:18:10.439 that are actual interventions that are demonstrated to reduce stress 0:18:10.480 --> 0:18:14.600 hormones and reduce actually inflammation, so reducing some of that 0:18:14.680 --> 0:18:20.320 health damaging aspect of it, and then at increase some 0:18:20.440 --> 0:18:23.880 of the endorphins and healthy hormones that really actually protect 0:18:23.960 --> 0:18:28.159 us from the effect of stress. So in a perfect world, 0:18:28.600 --> 0:18:33.080 a world that you're managing, if I presented a child 0:18:33.200 --> 0:18:36.919 who has lived in poverty in the foster care system, 0:18:37.040 --> 0:18:41.720 Let's say there's been abuse emotional and physical and let's 0:18:41.760 --> 0:18:44.400 say she's eight years old and I presented her to you, 0:18:45.080 --> 0:18:49.120 would you first deal with the psychological things before you 0:18:49.720 --> 0:18:52.600 got into any kind of physical stuff that's beginning to 0:18:52.640 --> 0:18:57.679 grow within her body. So what you just described as 0:18:57.760 --> 0:19:01.119 the clinical practice that I had in Hunter's Point for 0:19:01.160 --> 0:19:04.560 a decade and a half, and what I would say 0:19:04.680 --> 0:19:10.480 is that we start with wherever the family and the 0:19:10.640 --> 0:19:16.840 child is ready to start. So in my practice, which 0:19:17.000 --> 0:19:22.360 was very low income, predominantly African American, Latino and Pacific Islander, 0:19:24.200 --> 0:19:27.200 some folks were ready to start with therapy and mental 0:19:27.200 --> 0:19:31.719 health interventions. Some folks weren't. Some folks were, you know, 0:19:31.800 --> 0:19:36.640 what they could do to start was really starting with 0:19:36.840 --> 0:19:41.760 joining a basketball team, you know, and having that nurturing, 0:19:41.960 --> 0:19:46.280 caring relationship be with a coach. Some folks were able 0:19:46.400 --> 0:19:51.119 to start by you know, parent and child going for 0:19:51.720 --> 0:19:55.000 a walk together, or caregiver, you know, foster mom and 0:19:55.119 --> 0:19:57.959 child going for a walk together every day and just 0:19:58.080 --> 0:20:02.280 beginning to build up those bonds of trust. But even 0:20:02.520 --> 0:20:06.199 before starting with an intervention, I think one of the 0:20:06.240 --> 0:20:11.320 most important things to do was to recognize what folks 0:20:11.400 --> 0:20:14.679 were doing right, because I think many of us have 0:20:14.880 --> 0:20:21.240 these innate you know, just survival skills, right, Yeah, definitely. 0:20:21.400 --> 0:20:25.359 I had one patient who would just music was his 0:20:25.440 --> 0:20:28.640 meditation and he you know, he was in foster care 0:20:29.160 --> 0:20:32.720 and he was really struggling, but the place where he 0:20:32.800 --> 0:20:37.960 felt tuned in and that he felt at his best 0:20:38.200 --> 0:20:41.240 was in his music. And so really just figuring out 0:20:41.359 --> 0:20:46.800 how to number one really validate and be like, wow, 0:20:47.080 --> 0:20:51.520 you are knowing yourself and you are tuning into what 0:20:51.640 --> 0:20:54.960 really works for you, and let's do more of that, 0:20:55.040 --> 0:20:57.879 and let's figure out, let's let's layer on that. What 0:20:58.040 --> 0:20:59.760 is the next thing that we can do to help 0:21:00.000 --> 0:21:03.480 support you. And then just having these regular check ins 0:21:03.560 --> 0:21:08.360 and moving, you know, jointly setting a goal and so, 0:21:08.720 --> 0:21:11.840 you know, sometimes it was therapy, sometimes it wasn't. I 0:21:11.880 --> 0:21:14.439 will say that one of the most effective therapies that 0:21:14.520 --> 0:21:19.479 I've seen for little kids kind of under six is 0:21:19.720 --> 0:21:24.479 child parents psychotherapy, where both the caregiver and the child 0:21:24.760 --> 0:21:28.960 are doing therapy together as a diad. And you're talking 0:21:29.000 --> 0:21:32.520 about the caregiver or the parent. They're not the ones 0:21:32.640 --> 0:21:38.080 that were being abusive, right, You're not taking the abuse 0:21:38.160 --> 0:21:43.119 of Oh so you are, so you I'm going to 0:21:43.240 --> 0:21:46.960 say that. Yeah, So the number one thing, and I 0:21:46.960 --> 0:21:50.400 should have said this before. The number one, number one, 0:21:50.520 --> 0:21:55.480 number one thing is to establish safety. So people can 0:21:55.520 --> 0:21:58.159 talk about like oh, therapy and learning to manage your 0:21:58.160 --> 0:22:02.600 emotions and learning to dada. But if you're not safe, 0:22:02.840 --> 0:22:06.040 if you continue to be in this situation where you 0:22:06.119 --> 0:22:11.719 are threatened and your trauma response is being activated on 0:22:11.760 --> 0:22:16.640 a daily basis, multiple times a day, no amount of 0:22:16.800 --> 0:22:22.560 external intervention is going to solve the problem. So the 0:22:22.680 --> 0:22:27.920 number one thing is safety. So yes, definitely with the 0:22:29.200 --> 0:22:31.600 parent who is safe you when you're talking about doing 0:22:31.760 --> 0:22:38.879 child parents psychotherapy, But you know, surprisingly, ultimately we have seen, 0:22:39.840 --> 0:22:43.480 for example, if there's a situation where there's visitation or 0:22:45.240 --> 0:22:52.760 where the parent who has been the harming parent, we 0:22:52.920 --> 0:22:56.800 have seen situations where as part of trying to get 0:22:56.880 --> 0:23:01.920 their custodial rights back, you know, in that whole process, 0:23:01.960 --> 0:23:05.280 that that parent and the child have done child parents 0:23:05.320 --> 0:23:08.560 psychotherapy together. And it really because I'm just going to 0:23:08.600 --> 0:23:14.280 say this, I have seen a lot of parents who 0:23:14.320 --> 0:23:19.160 have been harming their kids, unfortunately a lot, and almost 0:23:19.400 --> 0:23:24.160 every single one was harmed themselves as a child. Yeah yeah, right, 0:23:24.240 --> 0:23:28.879 So when we do this work, what we also have 0:23:29.119 --> 0:23:34.280 the opportunity to do is break that intergenerational cycle and 0:23:34.440 --> 0:23:39.680 help that parent to see that they themselves have an 0:23:39.720 --> 0:23:46.040 overactive stress response, right right, so for them it does 0:23:46.160 --> 0:23:49.280 feel like life or death and for them and just 0:23:49.680 --> 0:23:57.080 being able to help them reregulate themselves literally helps the 0:23:57.280 --> 0:24:03.239 entire family and ultimate if that parent is able to 0:24:03.280 --> 0:24:06.480 successfully do that, right, Like, we're not for sure not 0:24:06.480 --> 0:24:08.159 going to put anybody in harm's way, but if that 0:24:08.240 --> 0:24:12.160 parent is ultimately able to successfully do that, then that 0:24:12.400 --> 0:24:16.280 is a huge breakthrough. Do you find that there's a 0:24:16.280 --> 0:24:20.200 correlation between the kind of trauma and how it manifests 0:24:20.240 --> 0:24:23.919 itself physically? You know, just based on my small amount 0:24:23.920 --> 0:24:27.840 of reading, a lot of times, if there's sexual abuse, 0:24:28.119 --> 0:24:32.840 there's abesity, or there's some kind of eating disorder, correlation 0:24:33.320 --> 0:24:37.280 does that exist in aces? So a lot of people 0:24:37.440 --> 0:24:42.159 have looked at that and studied trends, and it's really interesting. 0:24:42.280 --> 0:24:47.400 It's a little tricky because when you look at there 0:24:48.000 --> 0:24:53.520 is a strong association between sexual abuse and disordered eating, 0:24:53.640 --> 0:24:57.960 whether it's you know, overeating or restricting or under eating 0:24:58.080 --> 0:25:03.840 or bulimia or any of the above. I think where 0:25:03.880 --> 0:25:07.439 it gets more tricky is that if you if you 0:25:07.440 --> 0:25:10.120 look at all of the people who are OBEs. Right, 0:25:10.200 --> 0:25:14.520 it's a smaller proportion that have experienced sexual abuse. So 0:25:14.600 --> 0:25:18.080 that being said, there's no like clear formula, right, I 0:25:18.119 --> 0:25:22.840 would say again, it's all it's filtered through an individual's biology, 0:25:23.119 --> 0:25:27.760 their experiences, their cultural norms, they're you know, all of 0:25:27.840 --> 0:25:31.639 the above. How do you deal with an adult who's 0:25:31.720 --> 0:25:34.359 had a lot of childhood trauma. Let's say an adult 0:25:34.440 --> 0:25:38.320 in their fifties, Is there hope for them? Is there? 0:25:38.960 --> 0:25:42.560 And they're dealing with all kinds of physical issues. Let's 0:25:42.600 --> 0:25:46.960 say they have, you know, gout, depression, suicidal thought, all 0:25:47.000 --> 0:25:51.320 those things. Is it possible to reboot that adult and 0:25:51.400 --> 0:25:53.920 deal with some of the childhood trauma that is causing 0:25:53.960 --> 0:25:59.160 all this? For sure? Good. I just want to say 0:25:59.200 --> 0:26:04.000 that that is a sounding yes. Great. So for that adult, 0:26:04.600 --> 0:26:10.760 one of the things that is really important is number one, 0:26:11.040 --> 0:26:15.000 just understanding what we're dealing with. So I think that 0:26:15.040 --> 0:26:19.119 for many people who are struggling with that depression or 0:26:19.160 --> 0:26:23.160 those suicidal thoughts, who are struggling with those those health 0:26:23.160 --> 0:26:26.560 conditions that seem to especially get worse and flare up 0:26:26.600 --> 0:26:30.840 when we're under stress or when we're experiencing conflict, and 0:26:31.960 --> 0:26:34.560 so many of those people have been told it's in 0:26:34.600 --> 0:26:38.560 their head, that it's you know, maybe that they're the problem, 0:26:38.720 --> 0:26:47.360 or they just they feel Oftentimes a person can feel broken, right, 0:26:47.520 --> 0:26:51.920 and I one thing that I want to say is 0:26:52.359 --> 0:26:56.920 is number one, they're not broken, They're injured and they 0:26:56.920 --> 0:27:02.480 can heal. And number two that actually what's happening in 0:27:02.520 --> 0:27:07.480