Breaking the Cycle of Toxic Stress

What we believe: "People who are smart and strong enough are able to rise above the past and triumph through the force of their own will and resilience." In The Deepest Well: Healing the Long-term Effects of Childhood Adversity (Bluebird, $21.90), Nadine Burke Harris says, "But with caveats." Childhood adversity can affect physical development, trigger chronic inflammation and hormonal changes, alter how cells replicate, and dramatically increase the risk for heart disease, stroke, cancer, obesity, diabetes and Alzheimer's. "Even bootstrap heroes find themselves pulled up short by their biology." Burke Harris wanted to know why; she found the answers in her pediatric clinic in a low-income community of color in San Francisco.

It began with Diego, a seven-year-old with ADHD and a physiology three years younger. He'd been sexually assaulted at age four; an endocrinologist confirmed that trauma was enough to stop his growth. Stunned, Burke Harris coupled that with the glut of ADHD children, all with high degrees of life disruption or trauma. She and her staff determined that high doses of stress hormones at the wrong developmental stage affected children's downstream health. "The difference between adaptive and maladaptive reactions is all about the when. "

Building on a 1998 article, "The Adverse Childhood Experiences (ACE) Study," she and her colleagues refined its ACE questionnaire to 10 questions covering emotional or physical neglect, abuse, etc., that a child has experienced up to 18 years of age, in order to evaluate stress. Burke Harris explains the biology and chemistry underlying the findings, the treatment of toxic stress, and says, "The first step is taking its measure and looking clearly at the impact and risk as neither a tragedy nor a fairy tale but a meaningful reality in between... you can be proactive… you can identify triggers and know how to support yourself and those you love." She believes that we can "rewrite the story of adversity and break the intergenerational cycle of toxic stress."

The Deepest Well is part medical detection, part personal story, and always inspirational. Nadine Burke Harris is on a mission to change every child's story. --Marilyn Dahl

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