Tag: social prescribing

Healing the Impacts of Adverse Childhood Experiences and Childhood Trauma

The classic study on Adverse Childhood Experience (ACE) conducted by CDC-Kaiser Permanente with more than 17,000 members of a health organisation found that two thirds had suffered at least one ACE and more than 20% reported suffering three or more adverse experiences in childhood.  Adverse childhood experiences cover the whole gamut of experiences resulting in immediate and long-term effects on a child – the experiences cover aspects such as physical, psychological or sexual abuse, violence in the home, mental illness of carers, separation from parents at an early age, divorce or suicide within the family.  ACEs occur irrespective of gender, culture, context or economic status – although, children in poverty situations are more likely to experience ACEs.  The range of adverse childhood experiences is extensive, their incidence is extremely high, and their impacts are long-lasting.

The impacts of adverse childhood experiences

This is an area that has been extensively researched and documented.  CDC (Centers for Disease Control and Prevention) summarises the long-terms effects of ACEs in terms of their physiological, mental, relationship and behavioural impacts.  The impacts are far-reaching and long-lasting.  Nadine Burke Harris found in her research that toxic stress arising from adverse childhood experiences changes a person’s biological and neurological make-up and can result in an over-active stress response.  

Nadine was inspired by the ACE study mentioned above and undertook extensive reading of research results and conducted her own research.  In a TED talk, she shared her conclusions that early childhood experiences and related trauma impacted every area of a developing mind and body:

High doses of adversity [in childhood] not only affect our brain structure and function, they affect the developing immune system, developing hormonal systems and even the way our DNA is read and transcribed.

Preventing and healing the impacts of adverse childhood experiences

Nadine has dedicated her life and work to redressing the impacts of adverse childhood experiences and related childhood trauma. In 2007, she founded, as medical director, the Bayview Child Health Center (BCHC) which is not only focused on individual child health and wellness but also activism, education and community development.

Also, as a founding member and CEO of the Center for Youth Wellness, Nadine has contributed substantially on a global basis to the development and implementation of strategies to prevent and heal the impacts of adverse childhood experiences in individuals, communities and society generally.  Some of the strategies developed by the Center and other activists in the area include:

  • Parental education in childhood development, sources of stress, the impacts of adverse childhood experiences and positive parenting
  • Multidisciplinary health care teams for children and youth
  • Screening for adverse childhood experiences by primary medical health practitioners and paediatricians
  • Community development to create social support systems and collaborative caring environments
  • Interventions in schools and political systems to raise awareness, support policies and action plans
  • Dissemination of the latest research into the nature and impacts of adverse childhood experiences.
  • Carer support centres
  • Early detection, intervention and home visitations for identified at-risk situations for children
  • Enabling reconnection with others through social prescribing and encouraging reconnection with nature
  • Adopting the guidelines and principles of trauma-informed mindfulness.

Nadine has documented her research and work in the area through her recent book, The Deepest Well: Healing the Long-Term Effects of Childhood Adversity.  Together with other concerned professionals, parents and community members from the Center for Youth Wellness, Nadine has contributed to the development of the Stress Health website designed to help carers and parents to develop the basic components of a child’s life that will protect them, or help to heal them, from toxic stress.  The website provides an ACE quiz based on the original ACE study to help you identify for yourself or your child the level of toxic stress experienced in childhood.  On completing the quiz, you are given access to several suggested strategies for stress reduction, including mindfulness.

Reflection

Many of us have experienced one or more adverse childhood events.  The care and concern of a loving friend or relative may have been instrumental in helping us to overcome or, at least, reduce the impacts of these experiences in our life, work and relationships.  Other formative experiences such as personal study, community engagement or personal development may have helped also.  As we grow in mindfulness, we can develop a deepened self-awareness and understanding of the impacts of adverse childhood experiences in our own lives, and increase our capacity for self-regulation to reduce those impacts.

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Image by Gerd Altmann from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

What Do You Do if Mindfulness Does Not Reduce Your Symptoms of Anxiety or Depression?

I was approached recently by a young man who was experiencing severe anxiety.  He was able to cope well with his work but had all kinds of difficulties coping at home, including endless self-doubts, negative self-stories and an inability to relax or concentrate.  He indicated that he had “tried everything’ – meditation, mindfulness practices and reflection. 

He found, for example, that “reflection” only resulted in his entertaining negative thoughts about himself and re-visiting his destructive self-stories.  So, reflection for him resulted in a downward spiral rather than a release from self-deprecation.

What does “tried everything” mean?

The first consideration is how did he approach these attempts to develop mindfulness and reduce his symptoms?  Given the young man’s level of agitation, it was likely that his efforts were somewhat frantic and unfocussed.  One could question whether he engaged in a sustained meditation practice in a focused way, e.g. working on his self-stories with the aid of a meditation teacher or meditation group.

One of the issues is that there are so many different forms of meditation that it is tempting to “try them all” and flit from one form to another, without addressing your specific needs or the causal factors of your depression or anxiety.  This is where a professional psychologist or dedicated professional group could help.  Organisations like Beyond Blue and the Black Dog Institute can help by providing knowledge, resources, group support, access to programs and advice in identifying a suitable medical practitioner, psychologist or psychiatrist.  Other specialist carer support groups can assist people who are experiencing anxiety or depression as a result of caring for someone who has a long-term need for care and support.

The Mental Health Care Plan

You may need medication and/or the aid of an allied health professional to overcome depression and/or anxiety. In Australia, there is a specialist form of help that can be accessed through your local medical practitioner, the Mental Health Care Plan.   You explain your symptoms and needs to a doctor who develops a mental health treatment plan with you.  This may include medication, referral to an allied health professional such as a psychologist and/or other forms of activity designed to address your specific mental health condition.  Medicare will provide rebates for visits to an authorised health care professional where the visits have been the subject of referral by a medical practitioner as part of a Mental Health Care Plan.  The number of visits covered by Medicare rebate is 10 (subject to a confirming review by the doctor after the first six visits).

Advancing our understanding of the causes of depression and anxiety

Johann Hari, in his book Lost Connections, highlights recent research undertaken worldwide that shows that anti-depression medication can be effective in the short term to reduce symptoms but that, in the medium to long term, it typically has to be increased and can reduce in effectiveness over time.  In his book, Johann focuses on the social factors contributing to the global rise in depression and anxiety and proposes solutions that support rather than replace medication treatments, although some people are able to give up their medication after a period of successful use of one or more of these alternative approaches.

Johann identifies seven social factors that contribute to the rise in depression and anxiety, all relating to a loss of connection.  He describes them as “disconnection from”:

Johann acknowledges the research that shows that in some instances a person experiences depression and/or anxiety because of their genes or a brain change brought on by some life experience (pp. 143-155).

Reconnection: alternative anti-depressant treatments

Johann describes several ways to reconnect to overcome depression and anxiety.  These include reconnecting with others, with meaningful work, with nature and/or meaningful values. He also includes chapters on finding “sympathetic joy” while overcoming self-obsession (Chapter 20), and a compelling chapter on acknowledging and overcoming childhood trauma (Chapter 21).

What I found particularly intriguing, as well as very practical, was a chapter on “social prescribing” (Chapter 17).  In this chapter, Johann highlights the work of the Bromley-by-Bow Center which combines a medication approach (where deemed necessary) with hundreds of social programs.  This medical centre is very different to most doctor’s clinics that you would normally visit, both in terms of the orientation of the medical practitioner and the physical environment.  The emphasis is on listening, not medication prescription, and treatment is strongly oriented to “reconnection” strategies such as a walking group, employment skills group, start-up support to establish your own business and a casual group focused on “Create Your Future”.

What further intrigued me was the effectiveness of one project described by Johann through the experience of Lisa, who was experiencing severe depression.  The project was the brainchild of Dr. Sam Everington who was concerned about the over-reliance on anti-depression medication.  Basically, he assigned some of his patients to a community project focused on beautifying a strip of bushland that had become overgrown and neglected but was a popular walk-through. 

The group of people experiencing depression, who had difficulty interacting with anyone and typically kept to themselves, eventually started having conversations, sharing their life histories and their personal mental health challenges as well as plans to beautify the bushland strip.  They had to learn about the seasons, plants and their nutrition needs and how to plant and cultivate different kinds of plants.  They took pride in their project and started to gain confidence and competence.  A moving story was that of a person who had initially presented as very angry and aggressive who went out of his way to help two people who experienced learning difficulties.  Eventually, the members of the group decided to do a Certificate in Horticulture.

Johann pointed out that this creative project addressed two major reconnection needs – reconnection with others and with nature.  It can also be seen that each of these reconnections reinforces the other.

As we grow in mindfulness, we can be open to new ways of dealing with depression and anxiety.  We can learn to reconnect with key elements in our life that induce mentally healthy living, including mindful connection to others, spending time in nature, being grateful for what we have (rather than suffer “status anxiety”) and being willing to show compassion towards others.

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Image by Henning Westerkamp from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.