How We Talk about Trauma
Usually we think of childhood trauma in terms of the social and emotional issues that can manifest later in life. Which certainly are significant. But what we’re learning now is that exposure to early adversity has significant impacts on physical health outcomes, and represents a public health crisis.
Try to imagine this. It’s a sunny Saturday afternoon. Beautiful day.
You’re hiking alone in the forest. And then you hear some rustling leaves behind you.
Your heart begins to pound. You turn around to see a huge, snarling bear, staring directly at you.
In this moment, your body is releasing a ton of hormones that will help you either fight the bear or run away.
This is the body’s natural fight or flight response at work.
“If this happens once in a very long time, then that makes a lot of sense. It’s life saving and it’s this big activation in your system,” says Dr. Nadine Burke Harris, a pediatrician and the founder and CEO of the Center for Youth Wellness in San Francisco.
But what if that bear is an abusive parent?
“For kids who are exposed to repeated and intense trauma, that system is activated over and over and over and over again,” says Burke Harris.
If a person is exposed to a significant amount of adversity, she says things like domestic and sexual abuse, having an incarcerated parent, emotional neglect, “can more than double their risk of heart disease, the number one killer in United States of America. It increases their risk of chronic obstructive pulmonary disease, of certain types of cancers. And even autoimmune disease which is where your immune system attacks itself.”
This is a big idea. Usually we think of childhood trauma in terms of the social and emotional issues that can surface later in life. But it can also lead to serious physical problems
And so, to address this crisis, some health practitioners are working to identify signs of adverse childhood experiences from as early an age as possible.
An Integrated Approach
At the Western Wayne Family Health Center in Taylor, behavioral health consultants work alongside a team of doctors, nurses and therapists, in what Michelle Duprey calls a “one location, one visit type of service.” Duprey is an integrated healthcare manager with Starfish Family Services in Wayne County.
“If I’m a mother of one or two children or more, or less, it’s really a matter of where can I go. Maybe I don’t have a car, but I can get a ride. And I can go to the doctor and that’s it. I can’t get a ride to the doctor and the therapist and the social service agency, and DHS, and all these other places. But if I can get to the doctor, I’m gonna go to the doctor. And so if we have available at the doctors office all these other services, we are providing them something that they wouldn’t get otherwise,” says Duprey.
Integrated pediatric care is an emerging approach. It’s not the norm. However, advocates say it will save money in the long run. More importantly, addressing early childhood adversity can save lives.