A Kaiser pediatrician, wise to ACEs science for years, finally gets to use it

Dr. Suzanne Frank has known about the impact of childhood adversity on young lives for decades. She’s seen the fallout in the faces of young people huddled in beds at a children’s shelter where she worked years ago.

She’s seen it as the regional child abuse services and champion for the Permanente Medical Group.

And she’s seen it in hospital examination rooms where, as a member of the Santa Clara County’s Sexual Assault Response Team, she’s been called in to examine shell-shocked children and teens.

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ACEs science can prevent school shootings, but first people have to learn about ACEs science

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David Hogg, a senior at Marjory Stoneman Douglas High School, speaks at a rally calling for more gun control. Photo by Jonathan Drake / Reuters

After 17 people, mostly teens, were shot and killed by another teen last week in Parkland, FL, what seems to be a real movement is growing, propelled by kids devastated by their friends’ deaths and wanting to prevent such a massacre from ever happening again.

Their rallies and marches and lie-downs probably won’t have much effect in the short-term, as some of the Parkland teens learned as they witnessed — and some of them wept during — today’s lightning vote by state lawmakers along party lines to end debate on an assault weapons ban, which killed any further consideration of the bill in the Florida legislature’s current session.

But their persistence can make a difference in the long run, especially if they — and we — widen this to include the dozens of kids shot on the streets of Chicago or Camden or in other communities every week. We can even broaden the approach to include the 200 people, including many children, who died in Syrian air strikes in the last two days, because the roots and solutions are the same.

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We can’t stop sex harassment by firing or incarcerating our way out; we can stop it by using ACEs science

AMeToo

So, Harvey Weinstein has gone to ground, along with Charlie Rose, Matt Lauer, and Kevin Spacey, to name a few, and they’re likely never to work in their chosen fields again. This week, federal Appeals Court Judge Alex Kosinski retired after 15 women, including former clerks, accused him of sexual misconduct. Do a search for “sexual harassment” and stories about dozens of men across a variety of professions appears.

Sexual harassment is everywhere – all professions, including higher education, and all walks of life (see the NYTimes article about women who work in Ford’s Chicago plants). The U.S. Equal Employment Opportunity Commission says that 60% of women report having experienced sexual harassment. That’s 45 million women. Forty-five million. And a much smaller, but still in the millions, number of men have also been sexually harassed by their male or female bosses.

The solutions so far — Fire them! Jail them! Destroy them! — might garner some headlines and short-term satisfaction. The solutions certainly fit our traditional approach of using blame, shame and punishment to attempt to change human behavior.

But we can’t fire or imprison our way out of this — it’s too big and too complex. Here’s why:

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The primal wound: Do you have one?

Is suffering a necessary part of the human condition? Is it species normal for individuals to feel anxious—like impending doom, a fear of intimacy, or a sense of falseness and meaninglessness?

John Firman and Ann Gila, following the psychosynthesis tradition of Roberto Assagioli (1973), say no, this is not part of being human. The “anxious estrangement” that most people today feel is not normal but unnatural (The Primal Wound, 1997, p. 2). It is the result of a violation in early life that results in broken relationship to parents, others and the world. More deeply it is the missing connection to Ultimate Reality or the Ground of Being. The primal wound is:

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Patient’s murder leads to soul searching, shift to ACEs science in UCSF medical clinic

Patient’s murder leads to soul searching, shift to ACEs science in UCSF medical clinic

It was the murder of a beloved patient that led to a seismic shift in the Women’s HIV Program at the University of California, San Francisco: a move toward a model of trauma-informed care. “She was such a soft and gentle person,” said Dr. Edward Machtinger, the medical director of the program, who recalled how utterly devastated he and the entire staff were by her untimely death.

“This murder woke us up,” he said. ”It just made us take a deeper look at what was actually happening in the lives of our patients.” The Women’s HIVprogram, explained Machtinger, was well regarded as a model of care for treating HIV patients – reducing the viral load of HIV in the majority of its patients to undetectable levels.

But the staff was clearly missing something. A closer look at the lives of their patients revealed that 40 percent were using hard drugs – including heroin, methamphetamine and crack cocaine, according to Machtinger. Half of them suffered clinical depression, the majority had isolated themselves due to deep shame associated with having HIV, and many experienced violence.

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My encounter with Harvey Weinstein and what it tells us about trauma

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Harvey Weinstein, 2014/ Photo by Georges Biard

 

I have been watching the scandal about Harvey Weinstein emerge with great interest – in the early ‘90s, I too was one of the young women he preyed upon.

The details of what I have learned was not unique to me are out there now – the office tour that became an occasion to trap me in an empty meeting room, the begging for a massage, his hands on my shoulders as I attempted to beat a retreat… all while not wanting to alienate the most powerful man in Hollywood.

This morning I learned he was fired. His misdeeds are now common knowledge and I don’t see much mileage in adding my name to the list of women he abused, especially since those who were brave enough to come forward in the New York Times article are the ones who had to ride out the inevitable attempts to shame and discredit them in the face of Harvey’s denials, only to emerge vindicated. I salute these women. I would be a footnote to their courage. Thanks to them, this genie will not go back into the bottle.

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The Hague Protocol: Identifying kids at risk by interviewing parents in the ER

In the summer of 2007, a woman was brought by ambulance to the emergency department of the Medical Center Haaglanden, a hospital that serves an inner city area of The Hague. The woman was drunk and had a severe head injury. Her 8-year-old son was with her.

Hester Diderich, an emergency nurse, and other hospital staff members looked after the boy while they attended to his mother. “We were very nice to him,” Diderich remembers.

After treating the woman’s injuries, they were ready to release her and her son. What happened next led Diderich and her colleagues to realize they needed a better way to protect children and evaluate the risks they face. They created a new process, known as The Hague Protocol, and started a study to evaluate it. The protocol is now in use throughout the Netherlands and is being adopted by other European countries as well.

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