• Shifting the focus from trauma to compassion

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    Dr. Arnd Herz

    Dr. Arnd Herz, a self-described champion for ACEs science, would like nothing more than to witness a greater appreciation of how widespread adverse childhood experiences are. Herz, a pediatrician and director of Medi-Cal Strategy for the Greater Southern Alameda Area for Kaiser Permanente Northern California, would also like to encourage more people in health care to engage in a trauma-informed care approach, a change in practice that he says not only benefits patients, but also health care providers and their staff.

    “It makes so much sense,” say Herz. “This is why I went into medicine. I don’t want to just click off diagnoses, but create relationships and help people by understanding them better, and trauma-informed care is just a way to bring compassion back into the care that we do.”

    For the uninitiated, a trauma-informed approach includes an awareness that adverse childhood experiences (ACEs) are common, knowing how to recognize the signs and symptoms of trauma, creating a safe environment where the focus is on “What happened to you?” rather than “What’s wrong with you?”, engaging trauma survivors as equal decision-makers in their care, and offering patients referrals to supportive services as needed, according to a report by the Substance Abuse and Mental Health Services Administration and a primer by the Center for Health Care Strategies.

    In practice, Herz describes how clinicians use a trauma-informed approach to forge closer ties with patients and at the same time discover how ACEs may lurk beneath the surface of a health condition.

    “I see so many children who really struggle with obesity at a young age,” explains Herz, who is based at Kaiser Permanente in Hayward, Calif., which is testing ACEs screening of children from 12 months through 5 years old in a three-year pilot study that began in 2016. He says that he sees many patients whose weight and height are on par for a number of years and then suddenly veer off course as a child begins gaining weight. “I’ll ask ‘What happened?’, and sometimes it’s that the grandmother has moved in and is overfeeding the child,” explains Herz. But often there’s another explanation.

    “I pointed to the growth curve and asked ‘What happened two and a half years ago?’ And the mom said, ‘Dad came back from jail and is living with us,’” reports Herz as he cites the case of one patient. And he didn’t stop there — he wanted to find out how the mom and the child experienced the father’s return. “And I looked at her and said, ‘So, it’s been stressful?’ And she said yes.”

    “And rather than talking to her about removing the sodas, and exercising more and removing the junk food,” continues Herz, “I talked to her about the stress and how can we make things feel better, because the weight gain was in response to stress.” Herz made sure they were safe and when the mother expressed interest, helped her and the child link up with a psychologist for additional support.

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  • Investing in cross-sector networks to build a trauma-informed region

    Participants at a Pottstown Trauma Informed Community Connection community meeting, which typically draw between 75 and 130 people. Courtesy of Valerie Jackson/PTICC.

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    When Suzanne O’Connor first joined the Philadelphia ACE Task Force (PATF)—a group then composed mostly of pediatricians who wanted to put ACE science into practice—she did more listening than talking.

    “I wasn’t a doctor, I wasn’t a clinician, but a teacher trying to integrate trauma-informed care into early childhood education,” she says. “What struck me the most was what educators didn’t know about social services, mental health and even physical health. We didn’t have language for what we were seeing with kids who were particularly challenging.”

    ACEs gave O’Connor that language. She became a passionate advocate for trauma training for early childhood and K-12 teachers. Now, as director of education for United Way of Greater Philadelphia and Southern New Jersey, O’Connor is helping trauma-informed practice to ripple across the region.

    United Way, which recently honed its mission to focus on ending intergenerational poverty, funds and supports cross-sector networks in Philadelphia, surrounding counties and the borough of Pottstown, all part of United Way’s effort to “build a trauma-informed region.”

    What O’Connor learned as part of the ACE Task Force informs her approach now: an emphasis on two-generation solutions to seemingly intransigent problems like poverty or homelessness. “There are reasons why a child can’t sit still and learn how to read,” she says. “There’s the whole family system. There’s ACEs. Our approaches are embedded in [the idea that] we need to understand the root cause.”

    In 2018, United Way awarded three-year grants to PATF ($20,000 per year) and the Pottstown Trauma Informed Community Connection (PTICC; $50,000 per year), cross-sector networks that include community members along with organizational representatives from across education, juvenile justice, human services, law enforcement, philanthropy and public policy.

    O’Connor noted that such networks foster a momentum and sense of shared mission that sustains the work over time. “People change jobs, but the same organizations keep coming [to the table],” she said. “The agencies are committed.”

    Cross-sector networks also build relationships that help agencies make meaningful and timely referrals for clients who need help. “If child care centers have partnerships with neighborhood social service providers, that is a trauma-informed system…that is something very concrete,” she said.

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  • Radical Inquiry: Research Practices for Healing and Liberation

    Radical Inquiry

    RYSE Center in Richmond, CA, was born of out of young people of color (YPOC) organizing to shift the conditions of violence, distress, and dehumanization in which they suffer, survive, succeed, dream, and die.  We center the lived experiences of YPOC, we lead with love and sacred rage to cultivate healing and build movement, and we take risks as an essential part of transformation and justice, of liberation. We do this in a physical space that feels safe, welcoming, and affirming; that is vibrant with aesthetics created by and for YPOC, and in which members feel ownership, agency, and responsibility.  We do this through cultivating a staff team and organizational culture that is reflective of and responsive to our members, and which engages in ongoing learning, healing, and movement-building.

    A third of our current staff started at RYSE as members, half of our staff are under the age 27, and over 90% are people of color. RYSE runs programs across areas of community health; education and justice; youth organizing and leadership; and media, arts, and culture. All programs serve as platforms to cultivate connection, healing, love, and resistance.

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  • I Was a Witness to Serial Silence

    I felt the foot as it thrust between my legs and rammed over and over and over again into my crotch. I was lying on my back in the dirt. Strands of my long hair pulled from their roots under the weight of my body as my torso was forced forward. My head was tethered. My neck bent back nearly to its limit.

    I felt the shoe. No one had touched me there before.

    Shoes.

    There wasn’t just one. They took turns. Chuck Taylors, Hush Puppies, Wallabies. The Waffle Stompers were the worst. They hurt.

    It all hurt. Did no one hear me screaming? Was that even possible? There was a parade of people walking by. There were people all around.

    I cried for help. My voice was my only defense as they held my arms and penetrated my dignity. Their grubby hands were on my breasts. They squeezed, and grabbed, and pinched, and wrung the newly mounded flesh.

    They tore the pink bow off the center of my first bra. A metaphoric deflowering.

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