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Self-regulation, toxic stress, and Baltimore.

On first sight, you might think that the title of this article leads to one of those four-part pictures from Sesame Street entreating you to decide “Which One of These Things Doesn’t Belong”. Actually, all three of the subjects in the title do go together, it’s just uncomfortable to confront that knowledge.

So, let’s break it down.

Self-regulation is a set of skills that stretch between the domains of cognition, emotion, and and behavior that allow adult humans to make good, prosocial, rational, decisions even under stressful conditions. This group of abilities is based on healthy brain development in the early years, which is fueled by good-enough parenting, and the meeting of the basic physical needs of food, water, and shelter (there is some debate about which is most damaging to forfeit, and the front runner may be the parenting). When things go right for a baby, s/he develops the capacity to regulate her own emotions, thoughts, and actions well enough to fit in socially and survive to adulthood. When things don’t go well, self-regulation may be delayed or halted in one or more domains. A kid or adult with crap self-regulation abilities might appear hostile, aggressive, violent, smart-mouthed, withdrawn, anti-social, hyperactive, lethargic, or unfocused. Other things can cause those behaviors, but quite often, self-regulation is the real culprit, especially when kid is exposed to what’s called toxic stress. Here is a recent research brief about this little combo, read it if you want more depth that a blog post can provide: http://www.acf.hhs.gov/programs/opre/resource/self-regulation-and-toxic-stress-foundations-for-understanding-self-regulation-from-an-applied-developmental-perspective. It’s fascinating.

Toxic stress is different from everyday stress in terms of frequency, intensity, and duration. Most people have some aggravations, annoyances, and frustrations every day. Folks with toxic stress have catastrophic, life-threatening, chaotic, terrifying stress every day, all day. Toxic stress is a nightmare for anyone trying to develop or maintain mental and physical health. There’s a mountain of evidence about ACEs (Adverse Childhood Experiences) and the nasty things too many of those can do to a person over time. Check out the ACE home page for the numbers: http://www.cdc.gov/violenceprevention/acestudy/

Lastly, Baltimore (and Ferguson, and North Charleston, etc. etc.).

The (White) police have been shooting up Black folks again. That this happens isn’t news to most people. That it is continuing to happen so often and that so many local jurisdictions haven’t done anything to assess or change the systems that set up the circumstances that foster these murders is shocking. For Black and brown people living in places with a high load of toxic stress, that’s the last straw. Toxic stress is literally poisonous. Chronically elevated levels of cortisol and other stress hormones cause the kidneys, heart, and lungs to overwork. Soft tissues like veins and arteries wear out early. In childhood, people exposed to too many ACEs face an uphill battle towards mastering self-regulation in all three domains. Regardless of gender or race, a person growing up amidst toxic stressors develops self-regulation later and less broadly than the same person would in a more safe and stable place. When an adult with a high toxic stress load and low levels of self-regulation is attacked, threatened, or in a hostile-seeming situation, he or she is more likely to react with violence and aggression than a person who lives somewhere safe.

This is not to say that adults shouldn’t be held responsible for damage they do while enraged. However, in places with high levels of toxic stress, no one should be surprised when the proverbial shit hits the fan when yet another citizen is murdered by the police. One of many reasons that the death of Walter Scott in South Carolina and Freddie Grey in Maryland provoked such extremely different reactions from the public was the response of the people who were perceived to be in charge. Although both cities have high levels of toxic stress, the officer who killed Scott was immediately arrested and fired from the force. In Baltimore, no arrests have been made, no announcements from the authorities have been made about suspending the officers involved, and it seems to the citizens there that no one cares. Both cases are obviously tragic and have provoked anger and grief in their respective communities.

In Baltimore, people who are already tired of not mattering have been reassured that they don’t. In North Charleston, it seems that the police force has found a way to communicate to its people that they do matter. When you’re already up against a wall, the last thing you need is someone to shove you up to it harder. That’s when people, many of whom are already short on patience, break. The limbic system essentially stops asking the upper levels of the rational brain for input, and action takes over from reason.

I wish I could close this little rant with some smiley sentence about things getting better. I am glad that Science has now empirically validated how important early environments are to healthy adult development. I am grateful that interventions for schools and clinics are in the works to help stressed out kids learn to self-regulate earlier and better. I’m left wondering if any of it matters.

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Revisiting the sham of culture: Public school edition

Last night in our training clinic, I watched one of our grad students conduct an intake interview with a 17 year old who was recently expelled from school. The idea of expelling kids from school makes me ill to start with, so I watched with a grumpy face. As the session unfolded, I only felt more angry and irritated. This 17 year old kid told the grad student that he was being expelled over, “a lot of little stuff” like tardies, disrespecting teachers, not doing work, etc. I’m not naive enough anymore to buy that story without checking it out with the school, but it was still disturbing. It could be true.

To complicate matters another step, this particular kid is Black, big for his age (athletic big, not fat big) and wore his hair shoulder-length and braided. He spoke very quietly, even after his great-grandmother, who is his guardian left to return to the waiting area. I could easily imagine this guy could scare the crap out of a teacher without really trying, just by being so tall and muscular. But being scared of a kid because he looks like he could tackle you with one arm doesn’t make it ok to throw him out of mainstream society.

[Didn’t you know that’s what expulsion is? Read more here: http://www.ed.gov/news/press-releases/expansive-survey-americas-public-schools-reveals-troubling-racial-disparities]

I know the U.S. government in general, and the states in particular don’t quite comprehend the problem, but it’s really pretty simple. Here’s the deal, in a simple geometry-ish proof:

1. There is a strong relationship between school failure and life failure (e.g., going to prison).

2. Some kids are at much higher risk than other kids for school failure. We know who they are. We’ve known this for decades (poor, black or brown boys, little to no adult support at home, bad neighborhoods, toxic stress, abused, neglected, and generally stressed out kids).

3. We know that when kids in #2 are given certain types of early and frequent intervention, they are much less likely to fail at school.

4. If they don’t fail at school, they have a hell of a lot better chance at staying out of prison.

5. If they don’t go to prison, they can get jobs. If they work, they pay taxes.

6. If we spend a little money now on those interventions in #3, we will have greater tax revenues in the future.

7. Investing in appropriate educational interventions for stressed out kids literally pays off.

QED, asshats in office. We need intervention for stressed out kids. We need it early. We need it often. We can not wait.

Back to the kid in my opening paragraph. I really hope he comes back. He said he would, but in my experience, it’s about 50/50 with adolescents in trouble who live with folks who aren’t their parents. Great granny looks like she’s about 80. I don’t know that she has the energy to make him get his act together. The kid seemed interested in doing things differently, but also seemed very doubtful about being able to make it happen. I fear we’ve lost this one, mostly due to this dubious expulsion. It’s way past time to stop expulsion.