Failing schools or failing paradigm?

Roberto is an eight-year-old, former student in my second-grade class.  (All names are pseudonyms.)  In his short life, he’s experienced at least five major life traumas. One: his mother abandoned him when he was a baby. Two: he was placed in foster care with strangers. Three: he joined his father, but shortly after, Daddy was sent to prison. Four: Roberto moved again to live with Grandpop. Grandpop was ill and on house arrest, unable to leave his home, so Roberto was essentially under “house arrest” too, except for school. Roberto came to school, walked the perimeter of the classroom staring out windows, distracting other children. Sometimes, he just walked out of the classroom. His father was eventually released from prison and came to live with Grandpop, but Grandpop soon evicted Daddy after a fight with him. Five: Grandpop died.

Ashley, a bright and engaging nine-year-old, witnessed her stepfather break her stepbrother’s leg with a baseball bat last night. The police were called, invaded her home about 1 a.m., and took her stepfather away. This morning, she came to school as usual, but in a trance, unable to focus.

Jasmine responds much more aggressively. When she is off her medications, and her traumas are re-triggered, her tiny, wiry 45-pound frame can muscle a chair over her head. She screams and curses in guttural tones while heaving the chair at a classmate. She’s being raised by a hesitant uncle in place of her deceased parents.  Jasmine goes home to a darkened row-house, with ”illegal smoke” wafting out the front door that hangs wide open to the street.

Jamar’s been absent from school. After several suicide attempts, he’s at the Crisis Center. Jamar suffered brutal beatings from Mom’s boyfriend, who stuffed a sock in his mouth to muffle his screams. He will come back directly to my classroom from the Crisis Center, without the dedicated adult support he is due.

Ashley, Roberto, Jasmine and Jamar had at least eight other classmates with similar stories in our one classroom at the same time. These four real vignettes are hard to read. They’re tragic. Yet these kids are only a small portion of my class.  For the last 13 years, one-half to two-thirds of the students in my urban, public school classrooms have experienced similar lives.  These children are only four of the thousands across only one city: Philadelphia.

Theirs is not a deficit issue. They’re not “sick” or “bad” children; they’re injured.

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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

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

APeacemakers

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.”

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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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Trauma-informed psychotherapy puts the body – and love – back in mental healthcare

AloveFor the past 50 years, psychotherapy has taken a back seat to biomedical psychiatry, largely due to reliance on medications for the treatment of mental disorders. Yet clinical evidence increasingly points to chronic, unresolved traumatic stress as the source of many — if not most — mental disorders. Furthermore, longitudinal analyses show continued use of psychotropic medications is bad for the body, even causing chronic diseases. Granted, medications can stabilize a body wracked by recurrent distress, but such an approach is hardly a long-term cure. According to psychiatrist and trauma specialist Bessel Van der Kolk, “dramatic advances in pharmacotherapy have helped enormously to control some of the neurochemical abnormalities caused by trauma, but they obviously are not capable of correcting the imbalance.” To correct the “imbalance” often requires learning to inhabit one’s body and relationships in new ways.

Fortunately, the psychotherapeutic treatment of psychological trauma has advanced significantly the past several decades. In part, this is due to scientific discoveries of how the body and relationships naturally defend against traumatic stress. In particular, trauma-informed psychotherapies that draw from neuroscience and attachment studies are more holistic and scientifically based than ever before, although they often support the intuitions held by originators of psychotherapy such as Pierre Janet, Sigmund Freud, and C. G. Jung.

The neurobiology of trauma

Pierre Janet was the first to recognize how the body responds to present events as if past traumas were recurring — what today we call flashbacks. He observed patients

“continuing the action, or rather the attempt at action, which began when the [traumatic event] happened, and they exhaust themselves in these everlasting recommencements.”

Today we know the neurobiological reasons for flashbacks. Unlike narrative memories that seamlessly integrate

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Trauma nation: Has the U.S. become a pharmacracy?

Photo of American flag above graffiti-covered wall.

Medicine is where hope is alive and well in America. During the last 50 years, due to rapid advances in microbiology, many persons who once might have died prematurely, or suffered debilitating diseases or disorders, instead enjoy productive lives, albeit often with chronic illnesses to manage. Through its near-miracle successes, the field has engendered the belief that if we delve deeply enough into the secrets of the human genome (and other microscopic aspects of our bodies) we will eventually escape many afflictions and much suffering — an attitude that seems similar to

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Terrifying children into a life of asthma

Credit: Cellular Image/Flickr

Credit: Cellular Image/Flickr

Sometimes the clearest indicator of a family’s dysfunction is, unfortunately, illness in its children. Like the proverbial canaries in the coal mine, it’s the children who are most susceptible to the toxicity of family addiction and dysfunction. Hurt people hurt people, and literally scare the life out of little kids.

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The brain of a serial killer…is a story about child abuse

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There are three interesting aspects of this infographic about the brains of serial killers:

  • The acknowledged link to high levels of childhood trauma.
  • That brain scans of psychopaths are similar to others who exhibit evidence of behaviors besides rage and violence, such as overeating, drinking too much, inappropriate sex and workaholism. Rage, violence and the other behaviors are all  coping skills to deal with childhood adversity.
  • That the experts mentioned in the infographic are coming around to the conclusions from epidemiological research in the CDC’s ACE Study, and from neurobiological research about the effects of toxic stress on children’s brains.

brain2You can find the entire infographic here. There’s one part that’s not accurate  – the concept of a warrior gene. Epigenetics research shows that the social environment turns our genes on and off, so any behavior is likely to be a result of an interplay among many genes and neurodevelopment.

And who put this infographic together? Bestcounselingdegrees.net. Really.

At Cherokee Point Elementary, kids don’t conform to school; school conforms to kids

Kids run to greet Godwin Higa, principal of Cherokee Point Elementary School, during lunch.

Kids run to greet Godwin Higa, principal of Cherokee Point Elementary School, during lunch.

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What does ANY of the following POSSIBLY have to do with school discipline?

  • Every day at 7:40 a.m., all of the school’s 570 children start their day by eating a free breakfast. In their classrooms. With their classmates.
  • Every other week, the San Diego Food Bank drops off 4,000 pounds of fruits or vegetables for families of students, and another 12,000 pounds every month for the community. Nothing goes to waste.

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A theory of change from Harvard’s Center on the Developing Child

Frontiers of Innovation, part of Harvard University’s Center on the Developing Child, was launched in May 2011 at a meeting of 65 researchers and policymakers from diverse fields. They came with “minds wide open” to bridge their silos and developcreative approaches to help the most vulnerable children in society. This network has grown to more than 400 people.

The video provides a 5-minute look at the Frontiers of Innovation community’s goal of focusing on adults and strengthening communities to build a strong foundation for children’s lives. Here’s a slideshow that reviews the first year of work of this community.