• Echo Parenting & Education rides the trauma wave

    Changing the Paradigm keynote speakers Dr. Janina Fisher and Ruth Beaglehole, Founder of Echo Parenting & Education

    Sometimes we don’t notice when history is being made. We ride a wave of logical progression and don’t even notice when it peaks – that snapshot moment when we are lifted, arms outstretched, into the waiting air and remain suspended for one glorious second before the wave breaks and pushes powerfully to shore.

    What the heck am I talking about? Our Changing the Paradigm conference. Last month, 120 participants, 22 speakers and a slew of volunteers gathered at The California Endowment for our two-day conference on developmental trauma. Everything went off perfectly. The evaluations were glowing (apart from the person who wanted avocado on the lunchtime sandwiches – I guess you can’t please everyone). But don’t take my word for it. Here’s what some of the speakers had to say:

    “It was a deep honor and a pleasure to be part of such a wonderful and inspiring exchange of hearts, minds and souls. You gave me and so many of us the opportunity to increase understanding about the critical topic of trauma, especially as it relates to children and nonviolence. The conference really called on its attendees to take bold action, and I hope that we, as speakers provided some tools to continue the work of healing trauma and ending the cycle of violence that perpetrates and perpetuates developmental trauma.” — Melissa Susman, therapist.

    Echo staff member Jessica LeTarte greets speakers Peggie Reyna and Laura Ripplinger, Peace Over Violence.

    “Congratulations to your amazing team! We learned, we cried, we healed, we cheered, and left inspired by the community of people at the center of this movement! Thank you for letting us be a part of it. We are already looking forward to next year!” — Olivia Piacenza, A Window Between Worlds.

    “I have presented at many, many… maybe too many (!) conferences over the years, and NEVER have I felt so well taken care of… from beginning to end. While I hadn’t much of a clue, when first invited to present, about the audience and what Echo Parenting was about, I do now and it is a fabulously meaningful and worthwhile effort that you have undertaken. I applaud you and admire all that you represent. Thank you for asking me to be one cog in a magnificent wheel for change for children and for their parents.” — Beth Kalish, LAISPS – Infant, Early Childhood, & Parent Psychotherapy Program.

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  • Vermont first state to propose bill to screen for ACEs in health care

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    Dr. George Till, Vermont state legislator and physician

    When Vermont State Legislator and physician Dr. George Till heard Dr. Vincent Felitti present the findings of the CDC’s Adverse Childhood Experiences Study at a conference in Vermont last October, he had an epiphany that resulted in a seismic shift in how he saw the world. The result: H. 762, The Adverse Childhood Experience Questionnaire, the first bill in any state in the nation that calls for integrating screening for adverse childhood experiences in health services, and for integrating the science of adverse childhood experiences into medical and health school curricula and continuing education.

    That Vermont would be the first in the nation to address adverse childhood experiences so specifically in health care at a legislative level isn’t unusual. More than most states, Vermont is a “laboratory of change” for health care. It has embraced universal health care coverage for all Vermonters, and it passed the nation’s first comprehensive mental health and substance abuse parity law. (Washington State passed a law in 2011 to identify and promote innovate strategies, and develop a public-private partnership to support effective strategies, but it was not funded as anticipated. The Washington State ACEs Public-Private Initiative is currently evaluating five communities’ ACE activities.)

    Vermont is also a state grappling with a number of social and health problems, including high rates of underage and binge drinking and a highly publicized drug-abuse crisis. A bright spotlight was shown on the state’s drug-related ills with Governor Shumlin’s single-issue state of the state address.

    ImageThe ACE legislation came about as a result of the state’s activist traditions. Knowledge of the ACE Study had been percolating among people in several state-level departments. Essentially, the study links adverse childhood experiences with the adult onset of chronic mental health, physical health and social health issues. Other studies have shown short-term consequences in school-age children; ACEs are the best predictor for poor health and the second-best predictor for academic failure. Last year, says Kathy Hentcy, chronic disease prevention specialist at the Vermont Department of Health, the cross-agency group developed a consensus that the findings and implications of the ACE Study would be a focal point to convene diverse leaders from around the state for a series of meetings: a state-wide meeting, followed by a series of regional meetings. The goal was to plant seeds in communities around the state to examine the root causes of childhood trauma and find solutions.

    The first meeting —  VT ACE Conference:  Improving Clinical Outcomes for Complex Patients – was where Till, a specialist in obstetrics and gynecology, had his epiphany. The conference was structured to encourage physicians, mental health experts, educators, state officials, legislators, corrections personnel, and others, to talk with each other and share ideas. The statewide conference set the stage for plans to be developed and implemented at the regional level. Hentcy says the high noise level of the breakout sessions reflected the energetic engagement

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  • Trying to make LA schools less toxic is hit-and-miss; relatively few students receive care they need

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    The Peacemakers of Harmony Elementary School in Los Angeles, CA.

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    For millions of troubled children across the country, schools have been toxic places. That’s not just because many schools don’t control bullying by students or teachers, but because they enforce arbitrary and discriminatory zero tolerance school discipline policies, such as suspensions for “willful defiance”. Many also ignore the kids who sit in the back of the room and don’t engage – the ones called “lazy” or “unmotivated” – and who are likely to drop out of school.

    In the Los Angeles Unified School District (LAUSD), which banned suspensions for willful defiance last May, the CBITS program (pronounced SEE-bits), aims to find and help troubled students before their reactions to their own trauma trigger a punitive response from their school environment, including a teacher or principal.

    Gabriella Garcia’s son attended Harmony Elementary School during the 2012-2013 school year. The school has 730 children in kindergarten through fifth grade. She says without CBITS, she would have lost custody of him and her other two children. “But for some reason,” she says, “I let him (her son) take that test.”

    “That test” is a questionnaire given to some of the fifth-grade students at the school, which is located in a mostly Hispanic neighborhood south of downtown Los Angeles.

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    Every semester, Lauren Maher, a psychiatric social worker, gives all the children in Harmony’s fifth grade a brightly colored flyer to take home. It asks the parent to give permission for her or his child to fill out a questionnaire about events the child may have experienced in, or away from, school. “Has anyone close to you died?” “Have you yourself been slapped, punched, or hit by someone?” “Have you had trouble concentrating (for example, losing track of a story on television, forgetting what you read, not paying attention in class)?” are three of the 45 questions.

    Garcia’s son was one of a small group of students whose answers on the questionnaire, as well as his grades and behavior, were showing signs that he was suffering trauma. He joined one of the two groups, each with eight students that met once a week for 10 weeks at the school. In the group, the students don’t

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  • Top U.S. health philanthropy – Robert Wood Johnson Foundation – awards ACEs Connection Network $384,000

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    As part of its commitment to improving the health of the nation’s most vulnerable people and building a culture of health, the nation’s largest health-focused philanthropy, the Robert Wood Johnson Foundation, recently awarded a $384,000, two-year grant to the ACEs Connection Network.

    Jane Stevens, a long-time health, science and technology journalist, launched the network two years ago. It comprises ACEsConnection.com, a community of practice social network, and its accompanying news site, ACEsTooHigh.com.

    ACEsTooHigh publishes news, features, essays and analysis for the general public about the short- and long-term consequences of adverse childhood experiences (ACEs). The site has received more than one million page views over the last two years. Its stories are also distributed to other media sites, including The Huffington Post and SocialJusticeSolutions.com. With the additional resources provided by the grant, the site will feature more stories about how people and communities are implementing practices based on ACEs research and concepts, and distribute these stories more widely.

    The grant will also help grow ACEsConnection, ACEsTooHigh’s companion community of practice social network, from its current 2,000 members to 8,000 participants and more than 100 groups. ACEsConnection links people – online and face-to-face — who are implementing trauma-informed and resilience-building practices based on adverse childhood experiences research. ACEsConnection participants include physicians, judges, social workers, nurses, academics, educators, legislators, advocates, philanthropists, peer support specialists, probation and parole officers, therapists, researchers, members of the faith-based community, writers, documentary producers, business owners, artists, and community officials.

    The first five members of the ACEs Connection Network team are:

    • Valerie Krist, graphic designer for ACEsConnection and ACEsTooHigh. She also provides design assistance for group pages on ACEsConnection, and creates infographics for selected articles.
    • Sylvia Paull, a well-known network marketing strategist, develops marketing materials, strategic partnerships, outreach strategies, and new distribution channels for content.
    • Jasmine Pettis, a Masters of Public Health student at San Jose State University, is ACEsConnection’s information specialist.
    • Elizabeth Prewitt, ACEsConnection community manager, also does policy analysis for both sites. Formerly, she was director of public policy for the National Association of State Mental Health Program Directors and director of government affairs and public policy for the American College of Physicians.
    • Joanna Weill, ACEs Connection Network intern. She is working on her doctorate in social psychology at the University of California, Santa Cruz. Her research focuses on the experiences and relationships that put people at risk for criminal behavior and recidivism.
  • “Dear Survivor”: A letter about the hard truths of healing from child abuse

    Dear Survivor,

    Credit: Oldangelmidnight from Northampton, MA

    Credit: Oldangelmidnight from Northampton, MA

    “Because then I knew it was over.”

    That’s what most strive to feel about the lingering effects of childhood abuse, although not about the actual events. Those are long gone, and often dissociated from awareness.

    Rather, most want to end sleepless nights and startled awakenings; feeling as if they live in a parallel universe, outside the world inhabited by ‘normal’ people who lack histories of abuse; intrusive images, feelings, sounds, and smells; the desire to drink, smoke, toke, shoot up, sex to oblivion; the avoidance of intimacy because of a seemingly endless reserve of anxiety simmering below a brittle surface of civility; or fighting because the rage never seems to dissipate and you just want to push back, because the planet is not big enough to hold all your hurt, let alone the emotional needs of another person.

    At the first inkling of the wish to heal, some try to barter with themselves as a way out of this paradoxical life of repetitive chaos. This often starts with a naïvely made promise with oneself to be good. This promise usually starts with the belief that by being good and trying really hard, one day life will finally, if not miraculously, turn out differently. This is not an easy promise to let go of; even when it’s obvious you are failing miserably at keeping it.

    Even so, there will still be a part of you that keeps the promise. Why? Often because of the secretly held wish that if you finally get it ‘right’ the love that wasn’t there will materialize, or your savior will come and magically change everything (releasing you from both effort and responsibility), or the opportunity for revenge will become available, and there you have it: the transformative moment you have waited for has arrived.

    This I can tell you is a colossal waste of time and the imagination. Even if the perfect love, the ideal savior, or the opportunity for the most humiliating payback becomes available, you will never become who you might have been had the abuse never happened, or get the time back that you have wasted waiting for your personal Godot.

    You might think I am giving you that old song and dance about picking your ass up off the curb, brushing off the dust of trauma, stomping its dirt from your shoes, and manning up to life’s inevitable trials and tribulations. Not at all. Rather, I think childhood

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  • In mental illness, let’s go beyond nature v. nurture to look at what interferes with the brain’s function

    AmindbodyBased on her ethnographic study of psychiatric residency programs, anthropologist T.M. Luhrmann concluded psychiatry is “of two minds”: one “mind” emphasizes the role of neurochemistry, while the other “mind” places more importance on the context of our suffering, including relationships past and present.

    Identifying the origins of mental illness likely depends on both interpretations. There is an undeniable organic component to mental illness, just as psychological and social conditions are inexorably linked to mental well-being. But like the Democrats and Republicans, these two approaches are often pitted against one another, often leading to that old, tiresome nature versus nurture debate.

    Unfortunately, in a world of limited resources, including limited time, the implicit guiding question — Where should we place our focus? — naturally divides our attention. Is it helpful to explore genes and neurobiology in our efforts to reach best outcomes? Or is it better to explore the social conditions that contribute to mental disorders? Unfortunately, much like U.S. politics, the treatment of mental illness often is derailed when such questions become fodder for polarizing arguments that serves allegiances and professional agendas more than persons in the throes of mental suffering.

    Instead of worrying if nature is more influential than nurture, perhaps it would be more helpful to identify what counts as optimal functioning for the brain. Perhaps we could then focus on the value of combining information, thus leading to better outcomes rather than increased competition (and often, market share). I think the significance of function often gets overlooked because we aren’t adept at looking at any issues from multiple levels. Although the term biopsychosocial was coined to address the issue of scale and focus in the treatment of mental illness, it often feels piecemeal in approach.

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