In “Childhood Disrupted”, Donna Jackson Nakazawa explains how your biography becomes your biology…and that you really can heal

childhood-disruptedcovIf you want to know why you’ve been married three – or more — times. Or why you just can’t stop smoking. Or why the ability to control your drinking is slipping away from you. Or why you have so many physical problems that doctors just can’t seem to help you with. Or why you feel as if there’s no joy in your life even though you’re

“successful”, there’s a book that will show how the problems that you’ve been grappling with in your adult life have their roots in childhood events that you probably didn’t even consider had any bearing on what you’re dealing with now. After hundreds of interviews and two years of writing, science journalist Donna Jackson Nakazawa’s long-awaited book, Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal, hits the bookstores (and e-bookstores) on Tuesday.

Besides being the first self-help book about ACEs, it’s the first book that explains what’s been called the unified science of human development in clear language for people who aren’t scientists or medical professionals. ACEs refers to adverse childhood experiences, a term coined in the CDC-Kaiser Permanente ACE Study that was first published in 1998.

The study revealed that childhood trauma is very common — two-thirds of us have experienced at least one type — and how that can lead to adult onset of chronic disease, mental illness, violence and being a victim of violence. It also showed that the more types of trauma you experience, the greater the risk of alcoholism, heart disease, cancer, suicide, etc. (Got Your ACE Score?) Childhood Disrupted goes into great detail about how the consequences of the toxic stress caused by that trauma damages kids’ developing brains (and damaged our developing brains when we were children), as well as our bodies and genes. The good news is that the resilience research shows just our plastic our brains are, and how much our bodies can heal, given the chance. What makes Childhood Disrupted come to life are the 13 people whom Nakazawa followed for year through their histories of trauma and their journeys of healing. Through their stories, it’s easy to see ourselves.

Donna Jackson Nakazawa

Donna Jackson Nakazawa

Last week, as Donna was preparing for launch party for Childhood Disrupted at her local bookstore, The Ivy Bookshop in Baltimore (7 pm ET, Tuesday, July 7), she and I talked about how she came to this day.

Jane Stevens: Why did you decide to write Childhood Disrupted

Donna Jackson Nakazawa: As a science journalist specializing in the intersection of neurobiology, immunology and the inner workings of the human heart, I had already spent 20 years writing about the human immune system and the human brain. I began thinking of the immune system like a barrel. If you put enough stress on the immune system, there can be that last drop of water that it can’t hold, causing the barrel to spill over, and havoc ensues. What causes the immune system to be overwhelmed is different for every person – including infections, stress, toxins, a poor diet.

When I came across the CDC’s ACE Study (Adverse Childhood Experiences Study), it struck me like a lightning bolt. I realized that after 20 years of writing about how we become ill and how we heal, I had been missing a huge piece of what can cause the human immune system to “spill over” into disease.

This childhood adversity was something that was preloading the barrel. People who have experienced childhood adversity undergo an epigenetic shift in childhood, meaning that their stress-response genes are altered by those experiences, and that results in a high stress level for life. Stress promotes inflammation — when we understand that children who’ve faced Adverse Childhood Experiences marinate in toxic and inflammatory chemicals, then it makes sense how those experiences are tied to depression, autoimmune disease, heart disease, and cancer during adulthood. I was also intrigued because in no other area of medicine would we ignore such a strong genetic link to disease.

Researchers have been able to show, in the lab, the epigenetic effects of toxic stress in childhood on all 23 chromosomes. The scientific philosopher Thomas Kuhn says it takes 20 years to rewrite our medical paradigm. We’ve known about ACE research longer than that already, and we’ve barely scratched the surface of change. So I had to lend my shoulder to the wheel.

It also resonated for me on a personal level. If you experience something very stressful, your body becomes much older than you are in years, because ACEs lead to epigenetic changes, including changes in how your DNA ages. All this just made complete sense to me, because when I was 12 years old, my father — a writer, a publisher, a man who taught me how to sail, how to laugh and how to read Shakespeare — went into the hospital for a very routine surgery and never came out. When he died, my childhood ended. It was as if someone had taken all the color out of the world. I do not remember a good day in my childhood after that and it was nobody’s fault.

But it made sense to me that my experience had changed me in every system and cell of my body. My body was set on high stress response when I was 12, and my body marinated in stress chemicals for a long time. So it was no wonder that as an adult, I’ve come down with, and been paralyzed twice, by the autoimmune disease Guillain-Barré Syndrome, I have a pacemaker, bone marrow issues, and lots of other immune system problems that put me in and out of hospitals for more than a decade.

When I saw the research that showed that for every additional ACE score a woman had, the likelihood that she would be hospitalized with an autoimmune disease as an adult increased by 20 percent, I decided that I had to devote myself to helping people to better understand this research.

Jane: How long did it take you to write the book?

Donna: It took two years. I interviewed 40 scientists, and followed more than a dozen individuals for a year to get their full breadth of suffering and healing. I interviewed about 25 people to choose 13 to follow.

It was very important to me that their stories reflect everyday stressors that people haven’t considered to be traumatic — common and insidious toxic stressors such as constant humiliation from an emotionally abusive parent, growing up with a depressed parent, or an alcoholic parent. All these childhood stressors damage people’s long-term health just as much as those who experienced situations that have long been thought of to be damaging, such as sexual or physical abuse. These children living with the common situations that haven’t normally been considered a threat to health have never had a voice, and yet they experience the same likelihood of developing chronic disease as an adult as do those who live with experiences commonly regarded as abusive.

I also wanted to be really sure that these were people who had found pathways toward healing that were unique to them — pathways that made it possible for them to experience who it is they felt they really were, so that they could in their adult life not have the trauma they experienced as a child direct their relationships, how they react at work, or how they raise their kids. I wanted to know what was helping people.

Journalists aren’t here just to describe the problem. Ultimately we’re here to end the cycle of suffering. I found people who were able to say: “I found this which is helping me. I no longer feel that the past controls me, I feel I’m becoming who I was meant to be. “

Jane: How did you find them?

Donna: In the years after the publication of my last few books, The Autoimmune Epidemic, and The Last Best Cure, a community of a few thousand individuals began to follow my work. I knew that a history of ACEs was so true for many of them. I sent out emails to about 100 people asking if they knew anyone who fit these criteria. I ended up with far more people I could fit into the book. Some of them I had begun corresponding with after the autoimmune book was published, and they came to mind immediately when I read the ACE research.

Jane: What impact do you want the book to have?

Donna: One of things that I hope the book does is to steer people toward hope, and also toward action — to take and use the ACE survey and resilience surveys, and to take this information to their doctors, their mental health care providers, and share it with their families, if they feel it’s safe to do so.

I want people to understand the science so that we no longer see behavior that is merely a long-term, biological reaction to early trauma as “just” a mental health issue. Or see adult physical disease as separate and unrelated to the biological changes an individual might have undergone in childhood. Instead, we need to move toward medical care that encompasses physical and mental illness and health. I want to change the conversation so that we combine physical and mental health into one entity. This will help people remove shame from their experiences as children, and remove the idea that they were responsible for their own childhoods. I want to show them the scientific certainty of this research as a way to bolster them to embrace self-care, including meditation, exercise, enough sleep, good nutrition, living in a safe environment, and having safe relationships.

Just as importantly, I want to introduce them to science-based approaches that have been shown to help heal the brain and body on a biophysical level – approaches which include MBSR (mindfulness-based stress reduction), EMDR (eye movement desensitization and reprocessing) therapy, cognitive behavioral therapy, hypnotherapy, writing to heal, neurofeedback, and many others. This way they can find a therapy that works for them.

I hope that they will understand that there are different strategies that work for different people, and that they can ask for help to get the types of care they need, and that there are different approaches toward healing that should be part of any journey.

I also want to help women in particular to understand that ACEs affect the female body in unique ways, because of our female biology. Women who suffered ACEs face twice the likelihood of developing autoimmune disease and depression in adulthood than do men. Often these are the very diseases that physicians find so hard to diagnose and treat, and this science may help to counter the medical community’s tendency to underserve women who suffer from difficult to define health problems such as fibromyalgia, chronic fatigue, irritable bowel syndrome, chronic back pain, and autoimmune disorders.

Change in the medical care community is interminably slow. There are pediatric clinics that are now offering team care — incorporating social workers, psychiatrists in one clinical setting— but it’s a small number. The average person who picks up this book is not getting medical care that’s even remotely addressing them as a whole patient, or seeing their physical health as a sum of their experiences.

I hope the book can be used as a tool to break down barriers between patient and doctor, so that physicians start looking at the physical body with a holistic view, with a view toward who the patient is based on their past and present, and who they can be in the future. When physicians begin to view the patient in this way, they can begin to incorporate a far wider array of approaches to healing. This will require team care versus our current system.

Our current system of care allows a patient 10 minutes with a primary care physician who has been trained in a medical school program where ACEs were never mentioned, where they’re taught that physicians are not supposed to talk with their patients about how their past experiences may be affecting their current health.

Yet the science is very clear. When a child faces chronic and unpredictable stressors their developing body and brain become routinely flooded with inflammatory stress chemicals that alter the expression of genes that control stress hormone output, triggering an overactive inflammatory stress response for life. When these changes occur in genes that should regulate a healthy stress response, a child’s inflammatory stress response becomes reset to “on” for life – and the brakes that should turn that stress response off don’t work. These epigenetic changes predispose an individual to lifelong inflammation and turn on genes associated with developing a range of adult diseases.

As an adult, if we find ourselves overreacting to stressors in our life with a heightened stress response – an argument with our spouse, a bill we weren’t expecting, a car that swerves in front of us on the highway – our inflammatory response stays on high, and this leads to physical disease and neuroinflammation, and mental health disorders. Mental and physical health disorders are a result of both the toxic stress response that developed in childhood, intertwined with our behavior — how we react to the adversity around us now — and together this becomes embeds deep into our biology.

Jane: What should physicians do differently?

Donna: I’m not trying to throw physicians under the bus. I’m trying to throw the system under the bus.

We’re going to have to create system change from the patient up, from health care corporations down, and reaching all the way back to medical school. At the moment, we are choosing medical students based on their MCAT scores, not their listening skills. And we’re not training them to be ACE-aware.

Even when some learn about the link between childhood adversity and adult onset of disease, the health care system does not reward them for applying that knowledge. They’re stuck in an allopathic differential diagnosis model – to look at disease symptoms and look at possible drugs and treatments. By the time a physician gets through that grueling medical school, they’re not rewarded to spend time getting a patient’s history, and yet, according to Dr. Vincent Felitti, one of the co-founders of the ACE Study, 75% of a patient’s diagnosis lies in listening to their history.

Physicians are not trained to assess a patient’s ACE score when taking that patient’s history. It’s not that they’re not doing that because they don’t have compassion or a desire to care for their patients. It’s that the system doesn’t train or reward them.

Physicians aren’t rewarded for spending more time to help a patient. They are not rewarded for suggesting mindfulness or EMDR or writing-to-heal or embrace self-care. I talked to a physician recently who suggested that a patient practice mindfulness and several other brain-body practices, and the physician was accused by her hospital of offering concierge medicine.

The medical tradition is to train doctors to stay away from anything that blends psychiatry with physical medicine. We need a system where physicians are trained to see their patients as the sum of their experiences and are rewarded by doing so. As Dr. Jeffrey Brenner says, physicians should consider a patient’s ACEs as a vital sign just like their blood pressure or heart rate.

Physicians need to understand how to treat the processes in the brain that keep people with high ACE scores locked in a cycle of over-responding to stressors,, and therefore locked in a cycle of inflammation and suffering. We need to create a new medical paradigm. Thirty years after ACE research began, why are there no changes in how we “do” medicine?

We’re still just at the very beginning of trying to solve this problem. We need a medical system in which physicians offer not just a drug, but a recovery plan.

44 responses

  1. A very interesting read and something which I think relates very much to me and childhood trauma. I need to heal but need to know where to start. Can you recommend or know of anyone in the UK that can assist. Based in the London area.

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  2. I think so many alcoholics are medicating themselves to not feel these stored childhood traumas, and because the numbers are so high and everyone around them is doing the same thing, they believe it’s normal. And many spouses support and enable in ways that treatment is never asked for or sought. and the cycles continue

    Liked by 1 person

  3. I feel I’ve just been struck by a bolt of lightning! This is my life. Actually, this response is being written from a life care ficility where I’ve been for four weeks. I am 61 years old, and have been plagued with chronic pain and illnesses for the last 30 years. I will difinately be getting the book to gain a better understanding, all very interesting.

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    • I do not really see any relief for children here. When I was growing up our home was completly dominated my my mothers´ moods. She would scream and shout at all the family. We were all terrified of her and thought that was natural, as we were all so bad. Our father worked a lot, something she greatly resented. He also stayed away from us children most of the time and basically shut himself off from us.
      When my brother and I were small, our mother would sometimes lock herself in a room, screaming and shouting from inside that she wanted to die, because she had such bad children. We would cry and bang at the door for hours, promising that we would not be such bad children ever again. Eventually she would come out and make us promise all over again that we would be good for the rest of our lives. Then our father would come home and all hell would break loose again. I never got any sleep as she would always come into my bedroom, crying and screeming and asking me what to do, even if I was just a young child.
      This is what our childhood was like. It is only in my middle age that I have come to realize that this wasn´t quite normal. I grew up thinking that we were simply so “bad” that our mother couldn´t take it, feeling sorry for her all the time. Only after my father died, 4 years ago, did I start to think that he wasn´t a particularily bad man, and that my brother and I were not specially bad children. My mother is still alive, in good health, though very old, despite having been at deaths door since I can remember. My brother, who once said that he would be so pleased when these two monsters died, has now gone to live with her -and off our fathers´ pension, and has turned against me in a very bad way. Seems that after my father died, another “monster” is needed in the family. I have a wonderful young son, that I have tried to keep out of all of this, but that is difficult. I so do not know how to handle this situation. My old mother is in total denial, and my brother is only thinking about what he can get out of our parents´ house. (He is 56 yrs and has never held a paid job in his live !)
      This is a bit of a rant, but brought on by what I read here above. Please do not post this very personal letter anywhere else on the net.

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      • my upbringing is similar to yours…please look into a book called Daughters of Narcissistic Mothers, the author has written scripts to use with emdr/tapping, that I found very helpful. If you’d like to contact me privately I can find her website and send it to you. Best wishes for your healing journey.

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  4. Pingback: Childhood trauma and addiction | Real Edition

  5. This was brought to my attention by a friend. My mother was murdered when I was 12 & my whole world changed. Now as an adult, I deal with multiple sclerosis. My morher’s death is harder now than it was then bc of my own children. I am ending my third marriage. This all makes sense. I am not a stressful person but I know these things eat at me privately. I will be reading this book when I can afford it bc I live on my disability.

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  6. Pingback: The Link Between Childhood Trauma and Chronic Pain (And How You can Heal)… - Chronic Pain Relief

  7. Pingback: Giving Neurofeedback Another Go for Chronic Headache, Anxiety and Migraine | Jasmine's Vision

  8. Pingback: "Childhood Disrupted": ACES and Your Physical Health

  9. Reblogged this on Live a Great Life Anyway … and commented:
    This is a revolutionary cutting edge approach to healing. It won’t be long before we recognize that the medical issues that we think are the “problem” to be treated are actually just “symptoms” of deeper issues. Once we identify the problem with new eyes, the solutions look entirely different!

    Liked by 1 person

  10. I’m an MD. When I met a new patient I would ask them this one question:
    If you could magically change one thing about your childhood what would that be?
    The answers were often shocking and always informative.
    Agree that psychiatry is overloaded and drug based.
    Good care starts with a personal connection between doctor and patient. We are losing this. Doctors are overwhelmed with patients – as society becomes more dysfunctional the sicker people become, mentally and physically. Doctors are burning out because there is an increasing level of dis-ease that they just can’t keep up with. We see the limits of our resources and eventually get beaten down. You’d likely be surprised by the number of doctors who became doctors in an effort to gain a sense of control stemming from their own ACEs, myself included.
    Additionally, most doctors aren’t trained in the mind and most MDs that are trained in the mind are following a model that treats symptoms and not the underlying cause. It’s not their “fault” they are just following their training. There are a few psychiatrists that are trailblazing new treatments, but the medical profession selects for conservatism by nature these docs are rare.
    So, books like this are most welcome by this doc!!!

    Liked by 3 people

    • Not to mention the medical system culture in the USA drive by capital and influenced heavily on the Big Pharm.. I was shocked by a question most often asked. Do you think you need a psychiatric med ? As if the patient ought be catered and the physician has very little input.

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  11. There are still good MDs about and all of them should read this book and have the address of a good Hypnotherapist available. Doctors are only expert with the body and many problems they deal with are of the mind about which they know nothing. If your neighbour was unable to help you you wouldn’t blame them would you, so why blame your doctor who is equally ignorant of the cause of your problem? A psychotherapist uses their knowledge to find cause and change it. A Hypnotherapist uses YOUR mind to .locate the problem and heal it. Personally I think the later is prefferable

    Liked by 1 person

    • Another bizarre issue is how private insurances patients are given the privilage to certain treatments and MD’s while those on public insurance or state finance are deprived of these services. The hate towards the poor is evident in the USA. The government rather spends trillions on the defense industry than to take care of their unprivileged society. This phenomenon is only seen in the USA and third world countries not in the EU.

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    • Not all MDs are ignorant of the mind, although many are. Also, hypnotherapy has limited success with much of the population but works well for some. Some people are much more “hypnotizable” than others. The mind is a very slippery thing. In 30 years as MD and neuroscientist I’ve realized that different approaches are needed with different people depending on level of resitance, degree of trauma and many many other things. One thing I can tell you from 30 years of practice is there is no one size fits all therapy. Some approaches work for some and not for others. I find for people who are in a high degree of defensive detachment that hypnotherapy is of very limited value. In people who are more open and their subconscious minds can be accessed fairly easily HT is a great option.

      Liked by 2 people

  12. I am wondering if you have come across a physical therapy modality called Associative Awareness Technique. I am a survivor of severe abuse. I am 53 years old and have been in and out of traditional therapy for decades and still, my abuse had directed my choice in relationships to the point where my heart feels permanently broken. I have also tried many alternative trauma treatments. The EMDR clinic in NYC refused to take me as a client because I was too suicidal. This has been a huge barrier. Therapists only want to work with your despair up to a point. I will also add that I have worked with psychiatrists and have tried many pharmaceutical options. I have been on many spiritual retreats as well. For me mindfulness is nothing but a nightmare – the last place I want to be is in my mind. Meditation can lead me into horrible places. I am making progress with a combination of AAT and Feldenkrais – both modalities focus on somatic experiences instead of mindfulness. Not only have my depression and anxiety been greatly lessened, but my body is physically healing from chronic pain as my nervous system learns to regulate itself. Unfortunately, I’m not out of the woods yet. Now I have to find my way through the emptiness that I am left with.

    Liked by 1 person

  13. I’ve been a child and family trauma therapist for over 30 years now, and I’m most excited to see this book coming out now.
    I’m particularly looking forward to our culture really understanding the implications of living in “low grade trauma” chronic patterns (not just “obvious” single events – like a murder, or suicide, or tragic car accident, or traumatic operation)….
    Because the reality is, we’re all living in a world that’s toxic and filled to overflowing with traumatic events. This impacts on all of us, as children, and ongoing over the trajectory of most peoples’ lives. We just haven’t recognized it enough. And having medical practitioners who really don’t understand the mind-body connection is also not supportive for people who are doing their very best to heal… Hearing “it’s all in your head”, related to physical symptoms of stress is neither empowering nor helpful. (And I’m not dissing doctors here – they’re just not taught to do more than focus on the physical).
    I can hardly wait to read this book – it’s my next ”GOTTA READ”!!.

    Liked by 2 people

  14. Reblogged this on Living with Trauma and commented:
    “Children who’ve faced Adverse Childhood Experiences marinate in toxic and inflammatory chemicals, then it makes sense how those experiences are tied to depression, autoimmune disease, heart disease, and cancer during adulthood.”

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  15. This book could be a wake up call for all nations to implement, humanist parenting classes in every school on this planet.

    It won’t happen though. In the UK medicine/psychiatry has been reduced to cheap, generic responses from practitioners that boil down to

    1) SSRIs
    2) CBT
    3) Blame the patient
    4) Diagnosis by herd
    5) Treatment by directive.

    That’s it. Nothing more. If the treatments don’t work. The patient will be blamed, then abandoned, labelled as deviant and consigned to the scrap heap where all the heart sink patients are dumped.

    My GP claims to be the MH expert for the practice. When one of her vulnerable patients who has Type 2 Diabetes told her he was suicidal, her response was to cut his insulin prescription so he only had enough insulin issued for one week at a time

    He saved up his insulin, and killed himself

    The response of the GP to the press, who were present at the inquest was to state that she felt that everyone had failed the lad in some way and that even if she (and his so called care team) didn’t actually phone or visit him to check that he was ok, she did spend an awful lot of time on the phone discussing him with others.

    In the UK we have learned not to be 100% honest with our GPs, because our lives depend it.

    The ACE theory is bang on correct. The problem will sadly continue because doctors and their helpers insist that arrogance & blaming the patient is the most compassion they can muster.

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  16. I just looked up the ACES questionnaire because this blog post made it sound like it could be a useful thing to take to my psychiatrist. I found the questions to be terribly incomplete. I have significant PTSD from my childhood and none of the questions pertain to what I experienced, namely peer bullying among other things.

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    • From Got Your ACE Score?

      There are, of course, many other types of childhood trauma — watching a sibling being abused, losing a caregiver (grandmother, mother, grandfather, etc.), homelessness, surviving and recovering from a severe accident, witnessing a father being abused by a mother, witnessing a grandmother abusing a father, etc. The ACE Study included only those 10 childhood traumas because those were mentioned as most common by a group of about 300 Kaiser members; those traumas were also well studied individually in the research literature.

      The most important thing to remember is that the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences.

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  17. As a former physician who has retrained as a psychotherapist specializing in trauma, I’ve been researching the links between the field of medicine and psychology / mind and body / life experiences and adult disease. I’ve used this approach in working with adults with chronic disease and also been applying these theories in my own life with chronic physical illness.

    Trauma therapy is a huge and missing piece in working with chronic illness and I see this book as link to missing tools while we wait for medicine to catch up without having to wait for our doctors to figure this part out. I, too, find that a combination of additional approaches is helpful, including working with diet, sleep, activity levels as I can manage etc.

    What I’ve been learning, and what I’ve been seeing in the discussion and comments on your “Got Your ACE Score?” blog post is that these wounds really can heal, if slowly for mos to us and that it does seem to be a process that is likely lifelong. The beauty is that there really IS something we can do.

    I’m excited to read Donna’s book and see her way of putting this all together. I’ve preordered 🙂 .

    Thanks for sharing this interview Jane Ellen!

    Liked by 1 person

    • I admire your choice to redirect your talents from physical medicine to psychotherapist specializing in trauma! I’m a late in life recovering man who had fought sexual harm from childhood corporal punishment that eventually sought help from someone like you! The internet was a starting point but so many individuals having the same damage as I believed they were all normal and their sexual desires also. I’ve become an online anti-spanking advocate. The public has normalized some sexual harms from spanking so the work in science linking medical evidence of trauma to lifelong adult disease has more credibility. Hopefully this will help change our present culture to be less violent with it’s children and make for a less violent world!

      Liked by 1 person

      • Hi John, thanks so much for your kind response and I’m so very glad you got help from “someone like me!” 🙂 Our culture has normalized so much that is truly harmful in long-term ways and has simultaneously judged the role of life experiences in affecting physical health – it’s wonderful that research like the ACE studies are becoming so much more well known. Another thank you to Jane Ellen for this site!

        Liked by 1 person

  18. Pingback: In “Childhood Disrupted”, Donna Jackson Nakazawa explains how your biography becomes your biology…and that you really can heal | Phase Three

  19. Reblogged this on deersings and commented:
    A more substanative approach for adults and children who have struggled through trauma, which up till ACES has been relegated in separateness to medical industry or mental health industry. Holiness in giving people the tools they need to heal themselves, to help themselves in holistic approach that incorporates mind, body, thought patterns, wiring, biology and stress altered biology into a healthy wholesomeness. It’s coming people – finally putting it all together and I may yet see changes in approach in my lifetime!

    Liked by 2 people

  20. Very good post. Very soothing also.Having been to yet another new private physician, after my old one retired, this one shamed me deeply, while i was deeply depressed. Telling me it was body/mind and i just needed to eat healthy as the bloodresults were all ok.
    CPTSD kicking in i find myself unable to ever return to him, finding myself without a private physician. My old physician also knew nothing but once said Your questions are too difficult for me, they did not teach that at university in my time. He was kind and gentle always acknowledging my right of existence and making me feel valued.

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