A lot of my work over the past few years has been focused on improving access to mental and behavioral health care for youth and families who need it. I deal with occasional depression and PTSD-related anxiety myself, so this has been a natural interest for me. I created my Facebook page, Positively Mental, during a period of agonizing professional transition when I felt that the people who most needed to understand this as a priority, do not. I knew that whatever the end result of this transition was, that I wanted to be more open and honest as a complex trauma survivor, to fight the stigma against mental illness and bring hope to more people who desperately need it.
I love to read and explore the internet in search of all things mental health. I want to learn and connect the dots in my own mind about some of the many gaps that exist between the popular understanding of the brain and behavior (which is really in its infancy), and the real life experience of someone living with a mental condition that presents obstacles to daily living and thriving. There is so much about the brain and behavior that we don’t understand, but in the meantime, millions of people must somehow cope with mental illness in order to function and belong in modern American society.
One of the many little gems I have come across in my quest for understanding is one of the RSAnimates, the videos that pair the audio of someone’s talk on a complex subject with concise illustrations that make it easier to visualize and process the content. This one, The Empathic Civilization, had one statement in particular that really struck me. “The first drive is the drive to actually belong.” It’s not that this is a new idea or one I hadn’t known before. We know, for example, that the drive to belong is a powerful factor in gang culture: young people without strong family and community ties are easy pickings for gang recruiters because they so long for that fundamental human need to belong.
However, I began thinking more about how the drive to belong affects many of the major issues that impact young people. Although most people feel a strong inner drive to belong and actively seek to do so, there are some who struggle with the interpersonal skills needed to connect with others, though they do want to. For some, the desire to belong, to connect with a group or community that welcomes them is powerful, yet their way of relating to the world is not consistent with what the world expects. They want to belong, but don’t know how. The world also hasn’t learned how to accept and relate to them; this, to me, seems to be the greater problem.
Our society actively sends the message that “social misfits”, people who don’t naturally know how to fit in and belong, are somehow defective, and to be ostracized.
I think ensuring that odd-seeming young people with awkward or abrasive interpersonal characteristics are assisted in their attempts to belong, and doing everything we can to ensure that they do, is one of the most important changes needed to prevent tragedy and pain for youth. Think of all of those young people, trying to find their place in the world, and finding no welcoming arms. What does it do to the psyche of the individual, to feel so different that there is no place for you? How does that affect the way you see yourself and how you value other people? How often do disconnected young people devalue others as a method of self-preservation?
There are many labels that we put on people who may not relate to others in the expected way, who may not easily connect to others emotionally: sociopathy, antisocial personality disorder, borderline personality disorder, autism and Asperger’s, and many others. Yet when we look deeper we often find that what we have interpreted as a disinterest in connection is actually a difference in how they attempt to connect. These people may not go about it in the typical way, but they do want to connect, they do want to belong. And if they no longer want to belong, it’s often because they became conditioned to believe at an early age that connection and belonging was impossible for them. The more we begin to understand this, the more we learn that people with a lot to give are in pain for the lack of belonging.
The ramifications of our failure to meet our young people halfway in their natural desire to belong are huge. In fact, I would make the case that most of the violence perpetrated by young people toward themselves or others can directly linked to a preventable lack of healthy connection and belonging. The gang violence I mentioned earlier is a complex issue with several causes, but the lure of the gang as a substitute family is known to be a powerful one. Young people who are vulnerable to suicide are often tipped over the edge by an episode of humiliation and ostracism by their peers: the polar opposite of belonging. And the growing problem of mass school violence by young males has a clear link to this breakdown: these are often severely troubled young men who have lost all sense of connection; they often have come to believe that it is their destiny to carry out this devastation. They have come to believe that their only place of belonging is in the brotherhood of destruction and infamy. Many of these young men were known by their therapists and counselors to be deeply troubled and disconnected, but the traditional therapeutic methods attempted were not effective. Some, like the Virginia Tech shooter, were rejected even by the educators they had come to for belonging.
Access to affordable, effective therapy is a crucial, unmet need in our country, but there is a difference between talking to a therapist who is there to clinically evaluate you, and connecting to a peer, family member, or safe adult who genuinely accepts and understands you. We have to do better on both.
Imagine a world where all children and young people who struggle with belonging have a mentor or a guide to help them forge the connections they need to gain that sense of acceptance? We all know people who cannot easily connect with others. Putting some thought and effort into what could help them truly belong to something good can make all the difference: for them, for you, and for the world.
Monday, December 23, 2013
Saturday, November 23, 2013
Your Life Shapes Your Brain and Your Brain Shapes Your Life
In September, 2013 I attended a community-wide meeting about the effects of domestic violence on youth. Since I have been in human services since 1998, I have been seeing these effects on youth and their families played out in hundreds of scenarios for many years. This meeting, however, inspired me to act in a way I hadn't before. There was a woman, Mrs. H, at the meeting who has been working with families in domestic relations court for thirty years. She was knowledgeable, articulate, and passionate in urging this group of people to see how ongoing trauma and turmoil affected these kids and their families long term, and to adopt more effective strategies for mitigating its effects.
As a survivor of childhood trauma related to witnessing domestic violence, I sat in that meeting trying to both participate, and to dissociate-- to remove myself emotionally and mentally from the environment. It was painful to engage emotionally with this topic. But something about Mrs. H, who had managed to stay present with her anger and frustration toward a system that was not meeting the needs of traumatized youth changed the way I saw myself that day.
I left that meeting thinking about how little progress I have seen: Families are in turmoil, and society punishes them for the effects of that turmoil, the violence, instability, and neglect the children unfortunately experience. Human services workers are often knowledgeable and understanding, but the criminal justice system, and society overall, usually are not. I knew that after fifteen years, it was time for me to make the very risky move of blending my personal self, as a trauma survivor, with my professional self as a youth advocate.
I immediately wrote the piece, Little Girl about my experience, which begins like this: Little girl is four years old, in the kitchen with Mommy and Boyfriend #1 who are arguing. The arguing gets louder and soon they are fighting too, with slaps and punches.
Little Girl watches frozen in the corner as Boyfriend #1 chokes Mommy on the floor until she shows him he has won this round.
Little girl's spirit begins to crack.
It was terrifying to put myself in this vulnerable position, but I was also beginning to have faith that this was the right thing to do. I called Mrs. H and asked her to read Little Girl publicly at an upcoming event. She agreed without hesitation, and read it with tremendous understanding and heart.
Let's talk about what I mean by trauma. Researchers at the Centers for Disease Control and Prevention in Atlanta, GA, and Kaiser Permanente in San Diego, CA, have created the Adverse Childhood Experiences (ACE) Study, which "reveals staggering proof of the health, social, and economic risks that result from childhood trauma." They have an instrument to be used to assess the level of adverse childhood experience of an individual (http://acestudy.org/ace_score).
Most people will score at least a point or two, as things like parental divorce and alcoholism are counted toward the total trauma load. Some of us score higher, and the idea is that the higher your score, the greater your level of childhood trauma. However, everyone is different in how trauma affects them. An individual could have a low score and still have lasting and significant effects. Or they can have a higher score, but through resilience and other factors they may not have significant long term effects as an adult.
Of course, people can experience trauma as adults as well. There can be single incidents of major trauma, like witnessing a murder, or living through a natural disaster, and there can be complex or chronic trauma, such as experiencing ongoing domestic or sexual abuse that occurs over many months or years.
Those who go on to experience disruptive effects from their trauma, be it from childhood or adulthood, may meet criteria for Post Traumatic Stress Disorder (PTSD). PTSD is most often associated with soldiers returning from a war zone, but they are just one of the groups of people who have PTSD.
Anyone who has experienced trauma, whether they meet criteria for PTSD or not, may experience lasting or permanent effects. Serious or chronic trauma can cause permanent changes to the brain that affect mood and behavior, with symptoms like anxiety, depression, hypervigilance, rage, flashbacks, sleep problems, attention problems, irritability, sensory issues (such as sensitivity to loud or sharp noise), and more.
Many people with a primary diagnosis of Generalized Anxiety or Major Depression may be able to trace these conditions back to trauma. In that same meeting that I attended in September, a colleague of mine who works with traumatized clients said that she no longer asks them, "What is going on with you?" She now asks, "What happened to you?" Helping people to understand how adverse experiences shape their brains and behavior is the first step in helping them learn to cope, and overcome.
As a survivor of childhood trauma related to witnessing domestic violence, I sat in that meeting trying to both participate, and to dissociate-- to remove myself emotionally and mentally from the environment. It was painful to engage emotionally with this topic. But something about Mrs. H, who had managed to stay present with her anger and frustration toward a system that was not meeting the needs of traumatized youth changed the way I saw myself that day.
I left that meeting thinking about how little progress I have seen: Families are in turmoil, and society punishes them for the effects of that turmoil, the violence, instability, and neglect the children unfortunately experience. Human services workers are often knowledgeable and understanding, but the criminal justice system, and society overall, usually are not. I knew that after fifteen years, it was time for me to make the very risky move of blending my personal self, as a trauma survivor, with my professional self as a youth advocate.
I immediately wrote the piece, Little Girl about my experience, which begins like this: Little girl is four years old, in the kitchen with Mommy and Boyfriend #1 who are arguing. The arguing gets louder and soon they are fighting too, with slaps and punches.
Little Girl watches frozen in the corner as Boyfriend #1 chokes Mommy on the floor until she shows him he has won this round.
Little girl's spirit begins to crack.
It was terrifying to put myself in this vulnerable position, but I was also beginning to have faith that this was the right thing to do. I called Mrs. H and asked her to read Little Girl publicly at an upcoming event. She agreed without hesitation, and read it with tremendous understanding and heart.
Let's talk about what I mean by trauma. Researchers at the Centers for Disease Control and Prevention in Atlanta, GA, and Kaiser Permanente in San Diego, CA, have created the Adverse Childhood Experiences (ACE) Study, which "reveals staggering proof of the health, social, and economic risks that result from childhood trauma." They have an instrument to be used to assess the level of adverse childhood experience of an individual (http://acestudy.org/ace_score).
Most people will score at least a point or two, as things like parental divorce and alcoholism are counted toward the total trauma load. Some of us score higher, and the idea is that the higher your score, the greater your level of childhood trauma. However, everyone is different in how trauma affects them. An individual could have a low score and still have lasting and significant effects. Or they can have a higher score, but through resilience and other factors they may not have significant long term effects as an adult.
Of course, people can experience trauma as adults as well. There can be single incidents of major trauma, like witnessing a murder, or living through a natural disaster, and there can be complex or chronic trauma, such as experiencing ongoing domestic or sexual abuse that occurs over many months or years.
Those who go on to experience disruptive effects from their trauma, be it from childhood or adulthood, may meet criteria for Post Traumatic Stress Disorder (PTSD). PTSD is most often associated with soldiers returning from a war zone, but they are just one of the groups of people who have PTSD.
Anyone who has experienced trauma, whether they meet criteria for PTSD or not, may experience lasting or permanent effects. Serious or chronic trauma can cause permanent changes to the brain that affect mood and behavior, with symptoms like anxiety, depression, hypervigilance, rage, flashbacks, sleep problems, attention problems, irritability, sensory issues (such as sensitivity to loud or sharp noise), and more.
Many people with a primary diagnosis of Generalized Anxiety or Major Depression may be able to trace these conditions back to trauma. In that same meeting that I attended in September, a colleague of mine who works with traumatized clients said that she no longer asks them, "What is going on with you?" She now asks, "What happened to you?" Helping people to understand how adverse experiences shape their brains and behavior is the first step in helping them learn to cope, and overcome.
Friday, January 4, 2013
You're Blocking My Whole Crosswalk
It hasn’t been a great week…or month, come to think of it.
Last night I was at the emergency room with my son, who had slammed his pinky in
his bedroom door after a particularly rough dinner time. My husband, Sean, has been sick for
a month, and I was sick for the past week with a cold. We’re run down. We need
respite, but it’s not gonna happen.
So today I arrive at the kiss & ride pick up my daughter after school, and I’m a little early. As I’m pondering last night’s visit to the E.R. and how much I want to minimize future visits to the E.R., I pull too far forward so that I’m partially blocking the crosswalk. It was that, or block the intersection, so that’s where I end up. I’m too stressed to put a lot of thought into it.
Next thing I know, the crossing guard, a woman about my age, is standing next to my car, gesturing sarcastically that I am, indeed, blocking “her crosswalk”. She is pretty pissed off. The car behind me has pulled all the way up, so I can’t back up even if I want to. I attempt a guilty, “sorry, I’m a doofus” gesture in the crossing guard’s direction, but she isn’t satisfied, and motions for me to roll down my window.
Now let me say here, I have quite a lot of back-sass in me in general, and at this point I feel that her attitude is way over the mark of appropriate. But I am not going to make a scene in the kiss & ride line at my kid’s school, and I actually do appreciate that the crossing guard takes her job very, VERY seriously. So I roll down my window, and I say, “I’m sorry, I didn’t mean to pull up so far. I didn’t realize so many people would be coming through here before school let out.”
“Well you’re blocking my whole crosswalk. People have been doing it all week, and it’s RIDICULOUS,” she sputters.
“I think people are probably very frazzled,” I say.
Her exasperated expression softens. “WELL…it’s ok,” she mutters, and walks away.
What is it about a word of understanding that releases the flood gates? Have you ever been fighting back tears, until someone says “It’s ok…” and then it’s all over? Well that, plus the effort of putting on my big-girl pants and not telling the crossing guard she isn’t “the boss of me” pushed me over the edge. Reach for the sunglasses because here come the waterworks.
And then I’m thinking about The Feelings. The feelings without proper thoughts to support them, that people act on.
Another example:
A few weeks ago, I had been at stuck at home for two days for a 48-hour EEG. I had 21 electrodes glued to my head to monitor my brain waves. To get them removed, I had to go back to the neurologist’s office. Sean was driving me there through a construction zone, looking pretty pathetic, when we found we needed to merge into the left-turn lane to get to where we needed to go. The guy who needed to let us in didn’t want to, so Sean pulled some of his New York City driving moves and nosed our van into the lane.
We ended up very lightly bumping the car in front of us. The guy had to get out and make sure his car was ok, indignant looks were exchanged, etc, all while I sit there with electrodes sticking to my head, attached to a battery pack at my waist. I considered hopping out of the car looking like a mental science experiment to let them all stare and consider whether they had used their best manners that day. I didn’t.
So today I arrive at the kiss & ride pick up my daughter after school, and I’m a little early. As I’m pondering last night’s visit to the E.R. and how much I want to minimize future visits to the E.R., I pull too far forward so that I’m partially blocking the crosswalk. It was that, or block the intersection, so that’s where I end up. I’m too stressed to put a lot of thought into it.
Next thing I know, the crossing guard, a woman about my age, is standing next to my car, gesturing sarcastically that I am, indeed, blocking “her crosswalk”. She is pretty pissed off. The car behind me has pulled all the way up, so I can’t back up even if I want to. I attempt a guilty, “sorry, I’m a doofus” gesture in the crossing guard’s direction, but she isn’t satisfied, and motions for me to roll down my window.
Now let me say here, I have quite a lot of back-sass in me in general, and at this point I feel that her attitude is way over the mark of appropriate. But I am not going to make a scene in the kiss & ride line at my kid’s school, and I actually do appreciate that the crossing guard takes her job very, VERY seriously. So I roll down my window, and I say, “I’m sorry, I didn’t mean to pull up so far. I didn’t realize so many people would be coming through here before school let out.”
“Well you’re blocking my whole crosswalk. People have been doing it all week, and it’s RIDICULOUS,” she sputters.
“I think people are probably very frazzled,” I say.
Her exasperated expression softens. “WELL…it’s ok,” she mutters, and walks away.
What is it about a word of understanding that releases the flood gates? Have you ever been fighting back tears, until someone says “It’s ok…” and then it’s all over? Well that, plus the effort of putting on my big-girl pants and not telling the crossing guard she isn’t “the boss of me” pushed me over the edge. Reach for the sunglasses because here come the waterworks.
And then I’m thinking about The Feelings. The feelings without proper thoughts to support them, that people act on.
Another example:
A few weeks ago, I had been at stuck at home for two days for a 48-hour EEG. I had 21 electrodes glued to my head to monitor my brain waves. To get them removed, I had to go back to the neurologist’s office. Sean was driving me there through a construction zone, looking pretty pathetic, when we found we needed to merge into the left-turn lane to get to where we needed to go. The guy who needed to let us in didn’t want to, so Sean pulled some of his New York City driving moves and nosed our van into the lane.
We ended up very lightly bumping the car in front of us. The guy had to get out and make sure his car was ok, indignant looks were exchanged, etc, all while I sit there with electrodes sticking to my head, attached to a battery pack at my waist. I considered hopping out of the car looking like a mental science experiment to let them all stare and consider whether they had used their best manners that day. I didn’t.
Now I’m not one of those people who believe that everything
is getting worse, that people are more selfish, that kids today are more rotten,
that humanity is going down the tubes. There’s lots of evidence to the
contrary, if you’re looking for it. And I am aware that I can be very
self-centered…after all, what’s more self-centered than a blog?
I do think, however, that we are all so busy and so stressed with our modern, over-scheduled lives, that we tend to think our own problems are the most profound and the most challenging, and we give ourselves license to hold our neighbor accountable while we find reasons to justify our own reactive, petty behavior. I wish that people would give me the benefit of the doubt when I slip up and lose my cool. I’ll try to do the same for them.
I do think, however, that we are all so busy and so stressed with our modern, over-scheduled lives, that we tend to think our own problems are the most profound and the most challenging, and we give ourselves license to hold our neighbor accountable while we find reasons to justify our own reactive, petty behavior. I wish that people would give me the benefit of the doubt when I slip up and lose my cool. I’ll try to do the same for them.
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