Be worried about boys, especially baby boys

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We often hear that boys need to be toughened up so as not to be sissies. Parent toughness toward babies is celebrated as “not spoiling the baby.” Wrong! These ideas are based on a misunderstanding of how babies develop. Instead, babies rely on tender, responsive care to grow well—with self-control, social skills and concern for others.

A review of empirical research just came out by Allan N. Schore, called “All our sons: The developmental neurobiology and neuroendocrinology of boys at risk.”

This thorough review shows why we should be worried about how we treat boys early in their lives. Here are a few highlights:

Why does early life experience influence boys significantly more than girls?

  • Boys mature slower physically, socially and linguistically.
  • Stress-regulating brain circuitries mature slower in boys prenatally, perinatally and postnatally.
  • Boys are affected more negatively by early environmental stress, inside and outside the womb, than are girls. Girls have more built-in mechanisms that foster resiliency against stress.

How are boys affected more than girls?

  • Boys are more vulnerable to maternal stress and depression in the womb, birth trauma (e.g., separation from mother), and unresponsive caregiving (caregiving that leaves them in distress). These comprise attachment trauma and significantly impact right brain hemisphere development—which develops more rapidly in early life than the left brain hemisphere. The right hemisphere normally establishes self-regulatory brain circuitry related to self control and sociality.
  • Normal term newborn boys react differently to neonatal behavior assessment, showing higher cortisol levels (a mobilizing hormone indicating stress) afterward than girls.
  • At six months, boys show more frustration than girls do. At 12 months boys show a greater reaction to negative stimuli.
  • Schore cites the research of Tronick, who concluded that “Boys . . . are more demanding social partners, have more difficult times regulating their affective states, and may need more of their mothers support to help them regulate affect. This increased demandingness would affect the infant boys’ interactive partner” (p. 4).

What can we conclude from the data?

Boys are more vulnerable to neuropsychiatric disorders that appear developmentally (girls more vulnerable to disorders that appear later). These include autism, early onset schizophrenia, ADHD, and conduct disorders. These have been increasing in recent decades (interestingly, as more babies have been put into daycare settings, nearly all of which provide inadequate care for babies).

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From hell to healing: A survivor’s journey

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Malcolm Aquinas

It was a sweltering day in the summer of 1987 in Limestone County, Alabama. The air, thick with humidity, sapped what little strength remained from already heat-wearied bodies; the chittering of bush crickets rose as the sun sank.

Following 11 hours of clearing hillside with a sling blade at the Elk River State Park, I let my thoughts wander while resting my right arm on the window frame of my father’s pickup truck, grateful for the air rushing against me. He and my stepmother, Louise, were continuing a disagreement they’d begun some time earlier about the whereabouts of a frying skillet.

The combination of fatigue and stifling heat dulled my usual hypervigilance around my father, so my response to Louise’s seemingly innocent question, “Don’t you remember your Daddy using the skillet last?” was unusually honest and unfiltered.

Absentmindedly, I replied, “I think so.”

Suddenly, the lap-belt compressed against my waist as my body lurched violently forward, then quickly snapped back. My dad, trying to hit me while leaning over Louise, screamed, “You calling me a liar! I’ll f—ing kill you, boy!” Louise pleaded with him to calm down, and screamed at me to get out of the truck.

Fueled by adrenaline, I hopped over a roadside fence and ran at breakneck speed across a heavily vegetated field. I could hear my father screaming obscenities and threats as Louise begged him to stop. I heard Louise’s panicked cry, “Run! Run! Oh my sweet Jesus, he’s going to kill you! Run!” The next sound I heard was bullets flying past me.

Louise saved my life that day; of that, I have no doubt. She would lose her own life, violently, seven years later, shot twice.

This traumatic experience, and others too numerous to recall, left an indelible mark on me. Two and a half decades later, I filled out the Adverse Childhood Experiences (ACEs) questionnaire and began to understand trauma’s enduring impact on my life.

The questionnaire was derived from the CDC-Kaiser Permanente Adverse Childhood Experiences Study in which more than 17,000 members of Kaiser Permanente in San Diego participated. It asked participants if they had experienced abuse, neglect, and household dysfunction prior to their 18th birthday. Scores range from 0 (no ACEs) to 10 (each ACEs), and the results were used to determine if there was any correlation between adverse childhood experiences and adult physical and behavioral health difficulties.

My ACE score is 10.

How has that score played out in my life?

I was expelled from the fifth grade for repeated schoolyard fights. I was arrested for arson at 10 years old. I was arrested for assault at 14. I dropped out of high school at 17. I abused alcohol my first two years of college. I attempted suicide five times. I was diagnosed with major depression, bipolar disorder, borderline personality disorder, post-traumatic stress disorder, and a few other diagnoses along the way. I was hospitalized, voluntarily and involuntarily. I was placed on numerous psychiatric medications. I also underwent electroconvulsive therapy.

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Just one year of child abuse costs San Francisco, CA, $300 million….but it doesn’t have to

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In 2015, 5,545 children in San Francisco, CA, were reported to have experienced abuse. Of those, the reports of 753 children were substantiated. The expense to San Francisco for not preventing that abuse will cost $400,533 per child over his or her lifetime. That adds up to $301.6 million for just that one year, according to “The Economics of Child Abuse: A Study of San Francisco.”

And, because child abuse is profoundly underreported, the costs are likely to be as much as $5.6 billion for one year of children experiencing trauma, the report found.

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Dear doctor: A letter from a survivor of sexual trauma to all medical professionals

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Dear Doctor,

As a medical professional you have taken an oath to do no harm, but there are ways in which you can hurt your patients without even recognizing you are doing so. What seems to you as a simple exam may cause injury to those who have been victimized by someone’s touch. This is a subject that we, survivors of sexual violence, have been meaning to discuss with you for some time now, but your authority can be more intimidating than you may know. I am also unsure if you are aware just how much power you, as a physician, hold and to the extent that you affect the lives of all of your patients. Your interactions with us travel much deeper than the physical core.

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Artists in the ACEs and resilience movement: Creative avenues to change

 

From "Airings...Voices of our Youth", created by staff from the Bellingham and Mount Baker School Districts (WA), the Whatcom Family and Community Network, faculty at Western Washington University’s Psychology Department and, more than 20 teenagers from the community who have shared their stories (Photo: Angela Kiser and Nolan McNally).

From “Airings…Voices of our Youth”, created by staff from the Bellingham and Mount Baker School Districts (WA), the Whatcom Family and Community Network, faculty at Western Washington University’s Psychology Department and, more than 20 teenagers from the community who have shared their stories (Photo: Angela Kiser and Nolan McNally).

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At a June summit in Whatcom County, WA, titled “Our Resilient Community: A Community Conversation on Resilience and Equity,” the arts played a starring role.

Kristi Slette, executive director of the Whatcom Family and Community Network, one of two Washington sites participating in the Mobilizing Action for Resilient Communities (MARC) project, says the arts—music, dance, sculpture, storytelling—can help audiences understand trauma, resilience and hope in a visceral way.

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Pueblo, CO, clinic rewrites the book on primary medical care by asking patients about their childhood adversity

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In October 2015 in Pueblo, CO, the staff members of a primary care medical clinic – Southern Colorado Family Medicine at the St. Mary-Corwin Medical Center – start asking parents of newborn babies to kids five years old about the parents’ adverse childhood experiences and the resilience factors in their lives. They ask the same questions of pregnant women and their partners in the hospital’s high-risk obstetrics clinic.

The results are so positive after the first year that the clinic starts asking parents of kids up to 18 years old. The plans are to do the same in the hospital’s emergency room.

Why? They think it gives kids a leg up on a healthier start in life. They think it helps adults understand and manage their own health better. They think it helps physicians better understand and help their patients. Oh yeah – and it looks like it’s going to save money. Probably a lot of money.

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We have to partner with law enforcement around trauma

jjie_kathy-mcnamara-2-16-12-13Is there a need for trauma-informed training for police officers? Let me share an example of a situation where the outcome could have been very different if the responding officer had been trauma-informed.

I was working with a young man on probation who was a trauma survivor. He was being tested for drugs, and, unfortunately, the environment triggered a traumatic response. He came running out of the bathroom and I followed him as he wandered around in a highly agitated state. I was able to talk with him and was working on helping him reconnect with his environment.

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