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.

It happened every day that spring. Every day after lunch they chased me down the hall to the exit door that led to an uphill path to the playground. When we got outside they grabbed my arms and pulled and groped. My resistance was no match for their single-mindedness. They jerked me to the ground for their ease and to let the hill give them cover. Eventually, they dragged me to a more concealed spot behind the building. Still, the cover was not absolute.

Every day more than 200 school children followed the same route down the hall from the cafeteria, out the door, and up the hill to the playground. At least some of them must have seen something – or heard – or told their parents.

There were adults – teachers and parents on lunch duty. There were visitors. Someone had to have seen me struggling. They had to have heard me screaming even above the cacophony of 200 children playing.

Distress makes a different sound.

It is not possible to ignore cries for help. You notice and then choose how you will react. You look up. You look in the direction of the noise. You decide.

There were dozens of witnesses to my molestation. There were dozens of people who saw or heard a gang-perpetrated serial sexual assault. They decided to look away.

I was 12. The gang were my classmates – catholic school boys. We were 7th graders. We lived in Portland, Oregon in 1972.

*****

Like the boys who sought cover behind the school building, these acts hid in the shadows of my memory until last spring when I was invited to an event that could have brought me face-to-face with some of my former classmates, and with some of my attackers. The invitation was like a spotlight that cast its beam on the unwitting secret and called it out.

At first the memories were obscured by the glare of immediacy, but now, having sat with them – having sat with the 12-year-old me – the experiences are present, and I am communicating with them.

I don’t remember exactly how it affected me then. I know it was ubiquitous, but I don’t remember nightmares or fear. I don’t remember anger or self-pity or hatred. I recall incredulity. It was much the same as that which I feel now.

My friend and I had attempted to escape the ritual by taking an alternative route from the cafeteria. We walked up the main staircase and tried to exit the building through the front door. We were met by a nun who turned us around. I remember trying to tell her what was happening. I remember my friend trying. I know that I got out the words, “they’re attacking me,” but she wouldn’t hear. She pointed us back down the stairs, back to the long hallway, back to the torture.

Eventually we fled the madness by volunteering to wash tables in the cafeteria after lunch. It gave us a reason to stay in. Even now, I can smell the stale water we carried with us in a gallon-sized pail. I can see 16 tan-colored tables set against the concrete floor. I can feel my knee pressing into the bench and the side of the table hitting my hips as I bent to reach across it with the smelly rag.

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The quest to find biomarkers for toxic stress, resilience in children — A Q-and-A with Jack Shonkoff

The JPB Research Network on Toxic Stress, led by Dr. Jack Shonkoff, is working on developing biological and behavioral markers for adverse childhood experiences (ACEs) and resilience that they believe will be able to measure to what extent a child is experiencing toxic stress, and what effect that stress may be having on the child’s brain and development.

The JPB Research Network on Toxic Stress is comprised of scientists, pediatricians and community leaders, and is a project of the Center on the Developing Child at Harvard University.

Jack P. Shonkoff, M.D. is the Julius B. Richmond FAMRI Professor of Child Health and Development at the Harvard T.H. Chan School of Public Health and Harvard Graduate School of Education; Professor of Pediatrics at Harvard Medical School and Boston Children’s Hospital; and Director of the Center on the Developing Child at Harvard University. He currently chairs the National Scientific Council on the Developing Child, whose mission is to bring credible science to bear on public policy affecting children and families, and The JPB Research Network on Toxic Stress. In 2011, he launched Frontiers of Innovation, a multi-sector R&D platform committed to achieving breakthrough outcomes at scale for young children facing adversity.

Dr. Shonkoff was interviewed by filmmaker Roger Weisberg about the innovations in research around developing ways of measuring toxic stress in Weisberg’s documentary Broken Placeswhich will be previewed at the National ACEs Conference. That interview was the impetus for the following conversation.

Laurie Udesky: In your interview with the filmmaker Roger Weisberg for the documentary Broken Places you said:

“We will have a measure to be able to differentiate between children who seem to be more sensitive to adversity and therefore need more attention. And at the same time this will be a measure of resilience because there are a lot of children living in very tough environments who are doing well and whose parents are doing a magnificent job. That’s the big breakthrough. It’s being able to measure this at an individual level.”

Laurie Udesky: Where is the science now in our ability to measure and differentiate children with ACEs who are more sensitive to adversity from those who are less so? 

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Dr. Jack Shonkoff

Dr. Jack Shonkoff: It’s very close; the measurement battery we’re working on is no more than a couple of years away from being ready to start being used widely in pediatric settings.

Basically what we’re talking about is the JPB Research Network on Toxic Stress, and I direct that group standing on the shoulders of a dream team of scientists, and a dream team of practicing pediatricians, and a dream team of community leaders, primarily community leaders of color, who have collectively been working together three and a half years now as coequal partners on this. And the reason that’s important is because there’s obviously a scientific dimension to this, which

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Kaiser family medicine clinic launches 4-question ACE survey pilot for adults

In July, medical residents in family medicine at Kaiser Permanente in San Jose, CA, began screening adult patients for adverse childhood experiences (ACEs). But it’s an ACE survey with a twist: it’s shorter, not the  10-question survey of the original CDC-Kaiser Permanente ACE Study, according to Dr. Kathryn Ridout who is leading the pilot along with Dr. Francis Chu and Dr. Alec Uy.

Why a shorter ACE survey?

KRidout headshot2

“When we were doing our initial discussions with stakeholders in the clinical setting, one of the barriers was the perception of the amount of time it takes to do a screening,” says Ridout. So, she and her colleagues developed a shorter ACE survey of four questions. The questions were adapted from the original ACEs screen of 10 questions as well as expanded ACE surveys that include statements about experiencing bullying or racism, living in a war zone, or in a violent neighborhood. (Since the four-question survey is currently being piloted, it’s not yet available for public release, according to Ridout.)

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Oakland, CA, trying out model used in Baltimore to reduce trauma, increase resilience

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Baltimore BSC faculty and planning team

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When a group of community organizations in Baltimore came together in 2015, they already knew trauma figured large in many lives. There was violence in the community, in schools, and in community members’ homes. Police brutality occurred. Many suffered the loss of loved ones to incarceration or death. There were house fires and homelessness. Much of the dysfunction was systemic and rooted in racism, according to a report on a collaborative effort to restructure city organizations and agencies. The goal was to build community resilience.

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Why early experience matters: Videos of scientists teach you

Scholars know so much about the importance of early experience–you should too!

A 2010 symposium brought together anthropologists, clinical, developmental and neuro-scientists to discuss early experience in light of evolution and human development. This is necessarily an interdisciplinary area of study because we have to know our history as social mammals, what optimizes our development in our sensitive early years and what undermines the development of a cooperative human nature. The talks are available for free online. Here is a sampling of the speakers with links.

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Study shows most pregnant women and their docs like ACEs screening

Would pregnant women participate in surveys from their doctors asking them about whether they had experienced trauma in their childhood? In surveying moms-to-be at two Northern California Kaiser sites, clinicians discovered that the women were receptive to filling out an adverse childhood experiences (ACE) survey, according to a study that was published earlier this year in the Journal of Women’s Health.

In fact, researchers found out that the vast majority of pregnant women — 91 percent of the 375 women— were “very or somewhat comfortable,” filling out the ACE survey. Even more, 93 percent, said that they were comfortable talking about the results with their doctors. The women were surveyed from March through June 2016 at Kaiser Permanente clinics in Antioch and Richmond, CA.

ACE refers to the groundbreaking CDC/Kaiser Permanente Adverse Childhood Experiences Study that tied 10 types of childhood trauma, including living with an alcoholic family member or experiencing verbal abuse from a parent, to a host of health consequences. (Got Your ACE Score?)

The higher the number of ACEs that people have, researchers learned, markedly increases their risk for poor health outcomes, as well as social and economic consequences. Having four ACEs, for example, nearly doubles a person’s risk for heart disease and cancer, raises the risk of attempted suicides by 1200 percent and alcoholism by 700 percent.

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“Government-Sanctioned Child Abuse”: Separating Kids, Parents at Border

Government officials are doing irreparable harm to families seeking asylum. They are separating children from their families, no matter the age of the child.

The American Academy of Pediatrics (AAP) and over 200 other child welfare organizations, which have become increasingly sensitized to early life stress, have condemned the practice of child-parent separations. The head of the AAP, Colleen Kraft, has written an op-ed against it.

She says: “Officials at the Department of Homeland Security claim they act solely “to protect the best interests of minor children.””

Hardly. Is it ignorance or malice? We don’t know, but the justifications sound both ignorant and malicious.

What ignorance are they displaying? Here is a short description:

Human children are not like other animals. They are born so immature they look like fetuses of other animals till about 18 months of age. In the first years of life, children co-construct their biological and social capacities, organizing their basic features around the experiences they have.  The norms for our species is the evolved nest. One specific need that separation denies is physical affection from known caregivers. This need among social mammals like us was well documented by Harry Harlow’s monkey experiments. Young monkeys deprived of their mother’s touch developed into aggressive and autistic (socially awkward) individuals, never to recover.

Extensive distress shifts development, undermining what otherwise develops in a loving supportive environment –biologically healthy systems and social engagement. Instead extensive distress enhances primitive survival mechanisms in ways that grow to harm self and others—e.g., the stress response becomes hyperreactive. Because the first years of life are so sensitive to experience, the individual may never recover to reach their full potential (although they may recover enough to survive—i.e., what is often called “resilience”).

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