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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 A kid or adult with crap self-regulation abilities might appear hostile, aggressive, violent, smart-mouthed, withdrawn, anti-social, hyperactive, lethargic, or unfocused.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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Heartache is a Real Thing.

Last night, I watched a documentary called “Shunned” about the old order Amish (old order is sort of like orthodox) practice of shunning. I have no idea how the filmmaker managed to get access to the people s/he interviewed, but the whole film was first-person stories of leaving the order. All of them, including a young woman who had only left home a few days prior to her first interview, talked about how painful it was to disconnect from the world they knew to enter a world they didn’t understand and were raised to believe is evil and dangerous.

The pain of being away from family was compounded greatly by the fact that leaving the order means you’re also excommunicated from the church, which means you’re going to hell. The Amish believe in a very literal, physical afterlife experience, so spending time in a burning pit is not a metaphor for them, it’s a real thing that happens. This belief is part of the reason that the Amish practice of shunning is so effective as a disciplinary method in the community.

In the Amish world, members of the community who don’t follow all of the rules can be shunned, usually for a specific period of time, but sometimes permanently. Shunning involves isolating the person from the group; they sit alone at meals, work alone at chores, sleep alone, sit alone in church. No one speaks to them except to give directions. Once the period of punishment is over, the person is usually able to rejoin the community, but will certainly think twice before making the same mistake again.

The Amish have been using shunning as a way to keep order in their communities since the inception of the religion. It works. Really well.

Shunning is sort of the idea behind our prisons, but far more effective because it’s even more painful. The people in the documentary used the term “heart broken” a lot when describing how it felt to be turned out by all of the people in their lives who matter to them. Heartache is a real, actual experience of pain. If you’ve ever been dumped, you know this. Science, however, has long poo-poo’d the idea of heartache as actual physical pain.

As it turns out, the Amish and dumpees everywhere are right. Emotional pain is just as painful and as real as physical pain. Eisenberger & Lieberman (2005), a couple of neuroscientists, proposed an idea they called “Social Pain Overlap Theory”, or SPOT. Essentially, the point they made is that the pain of social exclusion or teasing processed along the exact same neural and biological pathways as physical pain.

Another term I really like from neuroscience is “technomyopia” which is the idea that only studies that use fancy machines can prove things we know and have always known from common sense and common experience. SPOT is a great example of that; humans have always known that having your heart broken hurts like hell. In fact, it hurts as much as breaking any other part of you. But because scientists have seen this happen with fMRI’s and other fancy machines, it now has a name and is considered to be empirically true.

And that’s a good thing.

With Eisenberg & Lieberman’s work, therapists and other squishy-feelings types can say, Hey, because SCIENCE! when we talk about the pain of heart ache and social exclusion. So, back to the Amish for a minute.

One of the reasons the old-order Amish continue to exist, although their lifestyle is very harsh, non-luxe, zero-tech, and isolated is that they are geniuses at forming and maintaining communities. Amish families usually live in clumps of a dozen or so. Families tend to be large, so a dozen families can make up a community of enough folks to do all of the farming and other work needed to sustain themselves with almost zero contact with the rest of us. The people in the community come to depend on each other for their survival, as well as for friendship and emotional comfort. They are all important to the community; everyone matters to everyone else.

Amish folks are rarely alone; they work in groups, eat at long family tables, go to church every week without ever sleeping in, children share beds, etc. Shunning works because the communities are so effective. Because every individual matters to the community, the community matters to the individual. Shunning is horrible because the community is wonderful.

The dominant culture in the U.S. isn’t very good at the community thing. When was the last time you sat down to supper with all of your siblings, your parents, and your bachelor uncle? When was the last time you helped your bff build a house? Who grew your salad from lunch yesterday?

Shunning is still painful for the rest of us. SPOT insures that anytime a human being is isolated by others, removed from the communal table, and told they’ve done wrong, it’s terrible. When your co-workers don’t invite you to happy hour, it sucks, even if you’re 40 and you know it’s not really the end of the world.

Even when our communities are loose and poorly constructed, SPOT is real. The Amish are careful to put a time limit on the shunning. Amish people who are shunned know it will end, and they can go back to belonging (usually, excommunication is a little different, but even then, people can return, it’s just a lot harder. Forever shunning is like capital punishment and is reserved for serious offenses, like murder and rape). Shunned Amish people know it will only last a few days or weeks, and then they’ll be accepted right back into the fold.

When we shun or exclude people in our world, there’s no clear limit on how long it will go on, or what the person can do to return. This is particularly damaging for adolescents, who desperately need to matter, but don’t have the social skills to make it happen or the experience in life to know that everything is temporary, and that this too shall pass. To an adolescent who is excluded from the community of his/her peers, it seems like forever, like capital shunning.

And here’s my point: as adults, we know social exclusion hurts. As smarty-pantses, we even have scientific proof of this, the SPOT. We need to do a much better job of making sure there’s a way out of the shunning penalty box for kids. Kids who don’t believe that they matter often don’t think anyone else does, either, and we know where that leads.