As we expect more from technology, do we expect less from each other? Sherry Turkle studies how our devices and online personas are redefining human connection and communication — and asks us to think deeply about the new kinds of connection we want to have.
The Adverse Childhood Experiences (ACE) Study is one of the largest public health studies to examine the relationship between exposure to trauma and neglect in childhood and health across the lifespan. The study began in the mid-1990’s as a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s HMO.
Approximately 17, 500 patients were recruited for the study and asked whether they had experienced any of the following events in childhood:
3. Household dysfunction
- Mother treated violently
- Household substance abuse
- Parental separation or divorce
- Incarcerated family member
For each of these experiences a participant reported, they were given an ACE score of one. Over two-thirds of participants had an ACE score of one or more, and 87% of this group had actually experienced two or more adverse events (ACE score > 2). Apparently, exposure to childhood adversity of this nature is common.
LINK TO HEALTH PROBLEMS
The study found a direct link between experiencing these adverse events in childhood and being at risk for serious health and social problems later in life. In fact, compared to an ACE score of zero, an ACE score of four or more was linked to higher rates of heart disease and diabetes, as well as a:
- 240% increased risk of hepatitis
- 390% increased risk of chronic lung disease
- 460% increased risk of depression
- 1,220% increased risk of suicide
An ACE score above six was associated with a 30-fold increase in attempted suicide and a reduced life expectancy by 20 years compared to those with an ACE score of zero.
Why the increased health risks? In a nutshell, high levels of stress activate the body’s hardwired fight or flight response system. When fight or flight is activated, the body is washed in adrenaline and cortisol, hormones designed to help us fight the threat or escape it.
The body’s emergency response system is designed for short-term use. When someone is in a situation of chronically high stress, these hormones are released frequently, negatively affecting both nervous system development and long-term physical health. Social, cognitive and emotional development can also be disrupted, and a child or adolescent may turn to coping mechanisms such as substance use. Over time, all this can add up to poor health, social problems, and possible premature mortality:
It is important to remember that a high ACE score does not doom you to poor health outcomes. A person with a rough childhood may also develop resilience by exposure to people (helpful teachers, caring grandparents, an attentive physician) or experiences (counseling, financial help, education) that help mitigate stress.
FINANCIAL COSTS OF MALTREATMENT
The CDC estimates that the lifetime financial cost for each confirmed childhood maltreatment case is $210,012, comparable to serious health conditions such as stroke ($159,846) or type 2 diabetes ($181,000 to $253,000). This breaks down into:
- $32,648 in childhood health care costs
- $10,530 in adult medical costs
- $144,360 in productivity losses
- $7,728 in child welfare costs
- $6,747 in criminal justice costs
- $7,999 in special education costs
Of course, these numbers in no way measure the very real human suffering experienced by people who have faced significant adversity in childhood.
To learn more about this important study, follow these links:
- CDC: http://www.cdc.gov/violenceprevention/acestudy/
- Huffington Post 3-part series on the ACE Study: http://huff.to/1F0NYaS
- You can take the ACE quiz here: http://n.pr/1M29Wy7
- Also, here is a great presentation by pediatrician Dr. Nadine Burke Harris on how childhood trauma affects health across a lifetime:
Here’s a beautiful, touching article by Heather Plett about what it means to “hold space” for someone in your life. These lessons can be applied to all of the relationships we hold dearly.
When my mom was dying, my siblings and I gathered to be with her in her final days. None of us knew anything about supporting someone in her transition out of this life into the next, but we were pretty sure we wanted to keep her at home, so we did.
While we supported mom, we were, in turn, supported by a gifted palliative care nurse, Ann, who came every few days to care for mom and to talk to us about what we could expect in the coming days. She taught us how to inject Mom with morphine when she became restless, she offered to do the difficult tasks (like giving Mom a bath), and she gave us only as much information as we needed about what to do with Mom’s body after her spirit had passed.
“Take your time,” she said. “You don’t need to call the funeral home until you’re ready. Gather the people who will want to say their final farewells. Sit with your mom as long as you need to. When you’re ready, call and they will come to pick her up.”
Ann gave us an incredible gift in those final days. Though it was an excruciating week, we knew that we were being held by someone who was only a phone call away.
In the two years since then, I’ve often thought about Ann and the important role she played in our lives. She was much more than what can fit in the title of “palliative care nurse”. She was facilitator, coach, Sherpa, and guide. By offering gentle, nonjudgmental support and guidance, she helped us walk one of the most difficult journeys of our lives.
The work that Ann did can be defined by a term that’s become common in some of the circles in which I work. She was holding space for us.
What does it mean to hold space for someone else? It means that we are willing to walk alongside another person in whatever journey they’re on without judging them, making them feel inadequate, trying to fix them, or trying to impact the outcome. When we hold space for other people, we open our hearts, offer unconditional support, and let go of judgement and control.
Sometimes we find ourselves holding space for people while they hold space for others. In our situation, for example, Ann was holding space for us while we held space for Mom. Though I know nothing about her support system, I suspect that there are others holding space for Ann as she does this challenging and meaningful work. It’s virtually impossible to be a strong space holder unless we have others who will hold space for us. Even the strongest leaders, coaches, nurses, etc., need to know that there are some people with whom they can be vulnerable and weak without fear of being judged.
In my own roles as teacher, facilitator, coach, mother, wife, and friend, etc., I do my best to hold space for other people in the same way that Ann modeled it for me and my siblings. It’s not always easy, because I have a very human tendency to want to fix people, give them advice, or judge them for not being further along the path than they are, but I keep trying because I know that it’s important. At the same time, there are people in my life that I trust to hold space for me.
To truly support people in their own growth, transformation, grief, etc., we can’t do it by taking their power away (ie. trying to fix their problems), shaming them (ie. implying that they should know more than they do), or overwhelming them (ie. giving them more information than they’re ready for). We have to be prepared to step to the side so that they can make their own choices, offer them unconditional love and support, give gentle guidance when it’s needed, and make them feel safe even when they make mistakes.
Holding space is not something that’s exclusive to facilitators, coaches, or palliative care nurses. It is something that ALL of us can do for each other – for our partners, children, friends, neighbours, and even strangers who strike up conversations as we’re riding the bus to work.
Here are the lessons I’ve learned from Ann and others who have held space for me.
- Give people permission to trust their own intuition and wisdom. When we were supporting Mom in her final days, we had no experience to rely on, and yet, intuitively, we knew what was needed. We knew how to carry her shrinking body to the washroom, we knew how to sit and sing hymns to her, and we knew how to love her. We even knew when it was time to inject the medication that would help ease her pain. In a very gentle way, Ann let us know that we didn’t need to do things according to some arbitrary health care protocol – we simply needed to trust our intuition and accumulated wisdom from the many years we’d loved Mom.
Continue reading this article at: http://heatherplett.com/2015/03/hold-space
Many people suffer from stress-related illness. Here’s a great article on the long-term effects of pushing forward, even when your body is screaming for you to stop.
Sucking it up is highly overrated.
We operate in a society where it seems as if there is some secret committee that hands out awards for people who work through any sickness, embrace sleep deprivation or race through the work day without eating. It took me over 36 years to be able to admit to myself that no one was going to give me a gold star for constantly pushing myself forward.
I started asking others why they felt compelled to soldier on, and there seemed to be a few common themes: parents’ expectations growing up, needing to prove oneself and fear of rejection or loss. Regardless of the cause, most people who struggle with easing up on themselves also wrestle with admitting weakness. Fair enough.
When I look back on the years that I refused to admit weakness of any kind, I don’t think anyone could have convinced me to ease up. There were no magic words that would have made me pause and make some drastic changes.
The only reason I finally changed my pace was a health issue that brought me to a grinding halt. Doctor-ordered time off of work followed and I started to learn the first of a series of very hard lessons. I have several friends and acquaintances who have undergone a similar experience, where they were completely fine—until they were suddenly not. If we could see the brick wall we were about to collide with, we would have stopped.
The problem is that no one sees it coming.
To read more, go to: http://bit.ly/17GUHNr
Like everyone else, I was stunned to hear the news of Robin Williams’ suicide. Although I had known of his struggle with depression for many years, I was deeply saddened to learn that his suffering was so intense, that he actually took his own life.
As I read the reactions to the news of Williams’ death, I was dismayed by some of the harsh comments along the lines of: “How could he do something so selfish and leave his family to suffer? What a coward!” Although I became very angry reading these responses, I thought about it for a while and realized that the average person has no idea what severe depression is like, and certainly has even less understanding of suicide.
So, here’s my attempt to educate those of you who think Robin Williams “took the easy way out” and should be loathed for doing so. Yes, suicide ends suffering for the person who is depressed and leaves others with emotional pain. Sure, we wish he had not done this. Yes, we are all experiencing a loss. But please understand this: the decision to end your life does not come from a place of rational decision-making. A person who decides to end their life is not making a list of their options and then casually choosing “suicide” like some selection off a menu. The choice to end your life comes from a place of extremely deep pain, the kind that is so dark that you literally can’t see any other way out in that moment.
We can all judge Robin Williams and say that he was a “coward” or “should have gotten more help” or “should have thought about his wife and kids,” but that isn’t what this story is about. It’s not about courage or treatment options or how much you love your kids. It’s about vulnerability, suffering, deep despair, hopelessness, and being truly convinced that you will never find your way out of the pain.
No matter how well we think we know someone, none of us can ever fully understand another person’s experience. Everybody keeps parts of themselves hidden, sometimes out of fear of how others will react, and sometimes to protect loved ones. As we walk around our lives, there are always people in our midst that carry invisible emotional pain. In fact, you might be one of them. So, I urge you to be more compassionate and do as the quote says: “Be kind,” understanding fully that, “Everyone you meet is fighting a battle you know nothing about.”
RIP Robin Williams. Wishing peace to your loved ones.
Do not ask your children
to strive for extraordinary lives.
Such striving may seem admirable,
but it is a way of foolishness.
Help them instead to find wonder
and the marvel of an ordinary life.
Show them the joy of tasting
tomatoes, apples, and pears.
Show them how to cry
when pets and people die.
Show them the infinite pleasure
in the touch of a hand.
And make the ordinary come alive for them.
The extraordinary will take care of itself.
William Martin, The Parent’s Tao Te Ching
I recently attended a conference featuring Daniel Siegel, MD, one of the founders of the field of interpersonal neurobiology. One of the topics of discussion was a review of the neurological changes in the adolescent brain and the four extraordinary features that emerge as a result. Dr. Siegel believes these qualities are the ESSENCE of cultivating vitality and maintaining optimal brain health throughout the lifespan. As you read, ask yourself if these factors are still present in your life:
ES: Adolescents have an Emotional Spark which is the source of their tremendous passion about life. No doubt, at an extreme, this spark can also show up as moodiness and intense emotionality.
SE: The natural drive toward Social Engagement leads teens to turn more toward their peers. Although they may be vulnerable to peer pressure, adolescents also deeply understand the centrality of supportive relationships to our well-being.
N: Teens seek Novelty which allows for more courageous exploration of the world. The downside, of course, is the risk to personal safety that sometimes comes with being in unfamiliar territory.
CE: The Creative Exploration of adolescence allows for innovation and pushing against the status quo. When your mind can imagine possibility, true change is more likely to happen. Too much challenging of the status quo can, however, be stressful.
To learn more about the adolescent brain and it’s potential, I highly recommend Daniel Siegel’s insightful book, Brainstorm: The Power and Purpose of the Teenage Brain.