Book review: “The Deepest Well: Healing the Long-Term Effects of Childhood Adversity” by Dr. Nadine Burke Harris

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Dr. Nadine Burke Harris debuted her book, The Deepest Well: Healing the Long-Term Effects of Childhood Adversity, at the Philadelphia Free Library this evening in a talk and book signing.

This first stop in an ambitious book tour that crisscrosses the country reflects a mission that Burke Harris has pursued for nearly a decade: to spread the knowledge about the science of adverse childhood experiences, and about how people can use this knowledge to help solve our most intractable problems. (Her TED Talk has nearly 3.5 million page views.)

The story that the pioneering pediatrician and CEO of the Center for Youth Wellnessrelates is hers. It begins when, as a young pediatrician, Burke Harris struggles to define what was happening to her young patients at the Bayview Child Health Center in the Bayview Hunters Point community in San Francisco, CA.

I believed, ever since we’d opened the clinic in 2007, that something medical was happening with my patients that I couldn’t quite understand. It started with the glut of ADHD cases that were referred to me.…most of my patients’ ADHD symptoms didn’t just come out of the blue. They seemed to occur at the highest rates in patients who were struggling with some type of life disruption or trauma….what if there was a more nuanced answer? What if the cause of these symptoms — the poor impulse control, inability to focus difficulty sitting still — was not a mental disorder, exactly, but a biological process that worked on the brain to disrupt normal functioning?

And thus begins something akin to a gripping medical detective saga. Burke Harris began her career as any other pediatrician, trained as pediatricians have been trained in medical schools for decades: to treat the symptoms in front of her. She paid little attention to the story behind the story, but those background stories would pop up time and again, practically yelling at her: “Pay attention! There’s something going on here!!”

I lived in that state of not-quite-getting-it for years because I was doing my job the way I had been trained to do it. I knew that my gut feeling about this biological connection between adversity and health was just a hunch. As a scientist, I couldn’t accept these kinds of associations without some serious evidence.

Pieces of evidence appeared as she pursued understanding the effects of stress hormones on kids’ development. But the turning point came when a co-worker handed her an article that had been published in 1998 in the American Journal of Preventative Medicine: “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: the Adverse Childhood Experiences Study,” by Dr. Vincent Felitti, Dr. Robert Anda, and six of their colleagues.

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