August 12, 2021 • 44 mins
Dr. Nadine Burke Harris is changing the way governments think about and treat mental health. As the founder of the Center for Youth Wellness, she pioneered a system for evaluating Adverse Childhood Experiences (ACEs) in order to treat the physical symptoms of childhood trauma. Now, in her role as California’s first Surgeon General, she’s bringing that system to doctor’s offices across the state. Her goal is to integrate mental health evaluations into your regular physicals and check-ups— especially for kids. In this episode, her and Laverne discuss the effects of toxic stress and the challenges involved in addressing mental health on a systemic level. //
Please rate, review, subscribe and share The Laverne Cox Show with everyone you know. You can find Laverne on Instagram and Twitter @LaverneCox and on Facebook at @LaverneCoxForReal. //
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References:
Take the ACE test and learn more: https://numberstory.org/
Nadine Burke Harris TED Talk: https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime?language=en
Center for Youth Wellness: https://centerforyouthwellness.org/
Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
See omnystudio.com/listener for privacy information.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to The Laverne Cox Show, a production of Shondaland
Audio in partnership with I Heart Radio. I was seeing
kids coming in with chess pain. I was seeing kids
with autoimmune disease just off the charts, and you know,
most of these kids were black and brown kids, and
I just didn't believe the myth that somehow these people
(00:22):
are sicker, or because they're low income they're sicker. I'm like,
what if we're all the same and these kids are
not fundamentally broken, but they're showing a normal biological response
to a harmful experience. Hello, Hello, Hello everyone, and welcome
(00:50):
to the Laverne Cox Show. I'm Laverne Cox. Today I
am really excited and nervous to be talking to the
Surgeon General of California. And the reason I'm so nervous
but also excited is because this person's work has really
(01:12):
illuminated and helped explain a lot of what has been
going on with me my whole life. A few years ago,
my therapist said to me, you should go to this
website and take this quiz and find out your asist scored.
I'm like, ACES, what are you talking about? And she said,
ACES is an acronym for adverse childhood experiences. Adverse childhood
(01:35):
experiences can have effects on us throughout our lives, not
only in terms of our mental health and our behavioral capacities,
but also our physical health. Toxic stress PTSD has health consequences.
People with high ASIS scores have a higher rate of
heart disease, diabetes, and more. The person who has brought
(01:59):
the this research to the masses arguably is Surgeon General
of California, doctor Nadine Burke Harris Nading Burke Harris is
an award winning physician, researcher, and California's first ever Surgeon General.
After graduating from Stanford, she turned down multiple job offers
(02:20):
to work in the most underserved part of San Francisco,
where she found at the Center for Youth Wellness, an
organization leading the effort to advance pediatric medicine, raise public awareness,
and transform the way society responds to children exposed to
adverse childhood experiences, aces and toxic stress. Dr Burke Harris
(02:43):
is ted talk how childhood trauma affects health across the
lifetime has been viewed more than seven million times. Her
book The Deepest Dwell Healing the long term effects of
childhood adversity was called indispensable by The New York Times.
Please enjoy my conversation with Dr Nadine Burke Harris. Hello,
(03:21):
Dr Nadine Burke Harris, Welcome to the podcast. How are
you feeling today? I'm feeling very well. Thank you, Thank you.
It's a pleasure to be with you. I'm so excited
to have you here. Can you for those folks out
there who don't who aren't familiar with you and your work,
can you, dispersed of all, tell them what ACES is
and then then we can get some background on who
(03:42):
you are. But can you tell them what ACES stands
for and why it's important. Yeah. So, the term ACES,
they stand for Adverse Childhood Experiences and they refer to
ten categories of experiences of adversity that folks can have
during their childhood. And it actually comes from this groundbreaking
(04:04):
research study that was done by the CDC and Kaiser
Permanente now over two decades ago, when they asked adults
about their history of exposure to ten categories of adversity,
and those included physical, emotional or sexual abuse, physical or
emotional neglect, were growing up in a household where parent
(04:25):
was mentally ill, substance dependent, incarcerated, where there was parental
separation or divorce, or domestic violence. And what they found
in this research study was number one, these aces were
super common, right, and I think for for so many
people who have had these experiences, they feel like they're
(04:45):
the only one. And it turns out that two thirds
of Americans have experienced at least one of these ten
categories of average childhood experiences. But the second thing that
they found was that the more of these that a
person has exp varience, the more likely they are to
have not just the things that I think many of
us intuitively associate with child too trauma, so you know,
(05:09):
things like depression or anxiety, mental health conditions or behavioral
health conditions, substance dependence, suicidality, right, all of those things,
but also heart disease, right, that's the number one killer
in America. And the more aces a person has, the
more likely they are to have heart disease, stroke, asthma, diabetes,
(05:30):
all of these different health conditions. And what we now
understand from the science and the research that has happened
is that when we experience adversity and trauma as children,
because children's brains and bodies are just developing. All of
those stress hormones that are released during that adversity and
(05:54):
trauma actually changes the way our brains and bodies are
wired and can lead to an increased risk of different
types of health conditions later on down the line. Yeah,
and that is the piece that that that hits me
so hard. I was deeply triggered after I took the
(06:16):
ACES test. I was deeply triggered afterwards. For folks out there,
I encourage you to go to the website just google
um number story dot org, thank you, and take the test,
and I love the website has resources to just in
case you are triggered, which is great, and we can
talk about some of those. But for me taking the test,
I was like, well, my was my mother really mentally
(06:37):
ill when I think she had O c D And
so there was just sort of hedging on some of
the questions. Right when I've spoken about my mother and
I have my mother was emotionally abusive, and I've spoken
about this on the podcast before and we were in
a great place now and we reconciled and healed together
and it's beautiful. But they even when like no one's watching.
I feel like I'm sort of betraying my mother by
(06:57):
like telling the truth to myself on an ASIS test. Right.
So I think that's one of the things that gets
in the way because you you know, when your TED Talk,
you say that this is a public health crisis, and
I still don't feel like there's a big conversation about
adverse childhood experiences that I think a lot of it
has to do with shame. It has to do with
how difficult it is to confront this stuff. What do
(07:20):
you think about that piece of it? Oh, there's so
much in what you just said. I've been talking about
this for a long time. Obviously the TED Talk I
recorded in and it wasn't until when I wrote my
book in ten did I ever publicly say anything about
(07:43):
my own experience of growing up with a mom with
a chronic mental health condition and talk about being worried
about betraying your parents. Right, who my mom and I
My mom is defined as by so many things, right,
and she was very loving in many ways, but then
(08:05):
also there were a lot of scary moments. And the
piece of it that I find to be really important
and related to your point of what you're saying about
feeling triggered, which I think it's so good to recognize
(08:26):
that because when when we are triggered, there's something there, right, like,
there's something there where. We got to figure out what
that's about. But for me, ultimately, this work, this information
is all about healing. It's all about interrupting that intergenerational cycle.
(08:50):
Because I one of the most profound experiences that I
ever had was speaking at an onfrience for a bunch
of young women who rushed up to me and they,
you know, one young woman said to me, Dr Burke Harris,
my ACE score is a nine, but my kids are three,
(09:13):
and I'm going to make sure it stays that way, right,
And what makes that possible is our ability to have
a much broader national conversation about these topics, which requires
us to feel safe in doing that, right, It requires
(09:36):
some kind of normalizing and understanding that actually, you know,
you can go back and look at the experience you
had with whoever was the source of your ass But
then you go back and say, well, what was the
source of their aces? And you recognize there's no bad
guy here, right, There's there's no bad guy. You just
(09:58):
have a bunch of people who we're doing their best,
their best with what they can and now what we're
doing is opening up a conversation, having a dialogue and
arming people with resources so that we can maybe do
something different with what we've experienced. Right, And that's what
(10:21):
number story is all about. It's about raising awareness and
it's about arming people with resources to understand what does
their aces mean for them and how do they find
a path to healing. Absolutely, I love that. I gotta
take a tea easy break here, but I'll be fast alright.
(10:57):
Now that's all taken care of. That's get back to
our chat. So what do you think is getting in
the way of us having more protocols in place? You
talk about best practices with children, and you introduce some
of those at your clinic, and now you're a certain
(11:19):
in general, what is getting in the way of us
basically integrating mental health into you know, all of our
healthcare practices and measuring these kinds of things so that
we so we're doing asist test whenever people are going
in for a physical or whatever. Girl, do you know
that's what we're doing in California? Talk to me, tell me,
tell me I didn't know this so here in California,
(11:41):
we've launched an initiative. It's a hundred and fifty million
dollar initiative to train our healthcare clinicians on how to
screen for advertge childhood experiences, how to assess for that
toxic stress response, and how to respond with evidence based interventions.
(12:01):
And we have given over fifty million dollars in grants
to communities all over California to implement these practices. And
I will tell you we have trained almost nineteen thousand
health care clinician so far in California. Very exciting. This
(12:22):
is world leading stuff. We are the first in the nation,
first in the world to be doing something of this
scope and scale. And I will tell you some of
the difficulties that we have right Like, besides the fact
that you and I can look at each other right
now and know that there is not some amazing barrier
(12:43):
in the neck, right that separates the head from the
rest of the body, but somehow in medicine and in healthcare,
we are like, Okay, there's mental health and there's the
rest of traditional medicine, right, and they're totally separate, and
they're financed differently. It's just very very separate and that
(13:05):
doesn't make any sense because that's not actually the way
the body works. Right. The way the body works is
that this is all integrated our mood, our mental health
impacts our immune system. Think about our stress response and
the way our stress response develops. Two of the main
stress hormones that we have been most studied our adrenaline,
(13:29):
which is a short term stress hormone, and that is
the heart pounding. And then cortisol is thought of as
more of a long term stress hormone. So you can
imagine famine as something that was like a big stressor
back in the day. What cortisol does. It increases your
blood pressure, It increases your blood sugar. It tends to
(13:50):
make people more aggressive. It affects your sleep, so it
makes it hard to sleep. Right, All of these things
to help you stay awake at night so you can
hunt and eat any critters. And it um helps you
conserve fat and store belly fat, right because it's a famine, right,
you need need belly fat. And so all of these
things are adaptive in an evolutionary standpoint, but in our
(14:16):
day to day world, it's no longer a famine. Or
for example, I give the example of your walking in
a forest and you see a bear. It's not a
bear in the woods that you have to fight and
get away from. It's the bear coming home every night.
So you can imagine the way the stress response works.
It's supposed to be that almost like a thermostat, where
(14:39):
you have a set point, you experience a threat, you
activate your stress response. It goes up, up, up, up up.
When it's done its job, it turns itself off and
you go back to normal. And that is the fight
or flight response, and that's what we were designed to do.
The problem is when we experience high doses of adversity,
as specially in childhood, that stress thermostat can get a
(15:06):
little haywire, right, and so we activate our stress response
and it goes up, up, up, up up, and then
it stays there right. It doesn't turn itself off, or
or it gets triggered for teeny tiny things. So it's
either being activated much more frequently, or it has a
very hard time turning itself off. I think I'm the ladder, well,
(15:31):
the ladder, it doesn't turn it doesn't turn off, So
I'm just it's always heightened. I never feel safe, and
then I just and I give out and I'm fatigued
that I'm like, of course, I'm exhausted. That's but that's
right because that actually it takes a ton of energy
to do that, And if you were in an environment
of constant threat, that would be adaptive. But now your
(15:53):
body is wired that way, right, and it keeps going
even if there isn't an immediate threat. And this is
actually something that's really really important to me and toxic stress,
this prolonged activation of the stress response. And when I
first started talking about this, honestly, the place I got
them a lot of flak, like a surprising amount of
(16:15):
pushback was from mental health clinicians and they were like,
stay in your lane. You're a pediatrician, why are you
talking about this? What do you think that was about? Oh?
You know, I think honestly, I think a lot of
people didn't fully know and understand the science. So when
I learned about this, because what really brought me into
(16:36):
this work was I was running a clinic in Bay
View Hunters Point in San Francisco. This is one of
the hardest neighborhoods in the city, and I was seeing
child after child after child. Most of my patients were
experiencing high doses of adversity and it was impacting their health.
I was seeing it in asthma, but I was seeing
(16:59):
kids come in with chess pain. I was seeing kids
with autoimmune disease just off the charts. And you know,
most of these kids were black and brown kids. And
I just didn't believe the myth that somehow these people
are sicker or because their low income they're sicker. I'm like,
what if we're all the same, and what's happening is
that these children are being poisoned by what's happening to them, right, Like,
(17:25):
what if these kids are not fundamentally broken, but they're
showing a normal biological response to a harmful experience. I
started researching that, and then I started looking into okay,
so if we understand this and we see the a
science and we know all of this, what do we
do about it. I didn't learn this in medical school.
(17:48):
I didn't learn this in residency. I never learned how
to treat this. And so I'm like, well, good thing,
this is medicine, right, Because if doctors were like, oh, well,
we did learned it before, so we're never gonna do
anything about it, it's unsolvable. Where would we be right
now with COVID, where would we be right now with HIV?
(18:09):
Like we can respond to new challenges for stuff we
didn't know before. So that was the whole thing. I
started an organization to really do this research and find
this out this information, the Center for Youth Wellness, And
that was really how I approached this was just like, Okay,
so what is the biology behind it? Because if we
know the biology, we can treat that. And that's what
(18:32):
we started doing in my clinic and we learned a lot.
We learned a lot from other experts around the world,
and then we developed some clinical protocols for how to
screen for adverse childhood experiences and how to respond look
at the best evidence of how do you calm down
an overactive stress response, and a lot of the things
(18:52):
that you've been talking about meditation, regular exercise, nutrition and
even more like getting even more point like anti inflammatory diet.
You know, so certain pieces are really key. Now we're
seeing data coming out about experiencing nature, right like they
put e e g s on people and had them
(19:14):
walk through the city and then had them walk through nature,
and they see that being in like dense urban environments
activates the fight or flight response more and being in beautiful,
calm nature actually stimulates more the parasympathetic and it calms
down the fight or flight response. All of these things.
(19:37):
And my thing because I'm a hardcore science nerd, Like
science is mine. The story you tell about your father
is just it's so fantastic, and like Dr Nadieberg Harris
is definitely a nerd. Yeah, so I'll say my my
for those who don't know, So my dad's my dad's
a biochemist and my mom is a nurse. And even
(19:58):
though I have four brothers, none of the other of
them went into science. But when we were kids, man,
my dad, if there was something going on, my dad
would break it down into science. Like he'd see us
throwing paper airplanes at each other. And instead of your
standard parent being like stop that, you'll poke an eye out,
my dad, you know, measure the timing of the flight
(20:19):
and the wind resistance and gravity's nine point eight meters
per second squared, like what's the lift under the wings?
Like that was Basil Burke. So I definitely learned to
see everything in the world through a scientific lens. And
then when I became Surgeon General of California. When Governor
(20:40):
Newsom appointed me, one of the things that he said
is that we are looking for someone who can take
an upstream approach, someone who can tackle aces and toxic stress.
Like he said it specifically. And I just have to
tell you this because it means so much to me.
When I started, I got a ton of heat. People
(21:00):
were saying, you can't screen for aces, and you can't
do it because if there's not a therapist for every
single person who screams positive, it's irresponsible. It's all of
the above. And why were they did they say was irresponsible?
What was the logic there? People said, you shouldn't screen
for something that you cannot treat, right. People assume like, well,
(21:24):
aces happened in the past, and you can't fix what
happened in the past, So what are you doing? And
I said, okay, But the point of doing an a
screen is to understand whether that patient likely has that
prolonged activation of the stress response, because that is imminently treatable,
and that, ladies and gentlemen, is science. The National Academies
(21:45):
of Sciences, Engineering, and Medicine release the consensus report in
saying that toxic stress is treatable. The point is to
find out how their body is reacting and whether or
not that may put them at risk for a health
conditions that if we intervene and help to regulate that
stress response, we can prevent those health conditions. Right, And
(22:07):
the whole notion that this is not treatable is just ridiculous.
It's just ridiculous. And that is why I'm so excited
to bring evidence and medicine and science to bear against
something that, by the way, two thirds of Americans have
experienced at least one ACE. This has to be a
national priority, absolutely, and so what I'm so exciting about
(22:33):
what you're doing here in California is giving everyone access
to a level of care that we all deserve because
we all are thort of dealing with this toxic stress
in one way or another. And then I wonder if
there is because when I think about public health, and
I think about where we are with COVID, what's happened
(22:53):
over the past year with mask and vaccines, and you're
saying your tip talk, we know how to treat a
public health is right, and we identify it and we
know what to do. You know, people don't smoke on
airplanes anymore. But like right now people are fighting mask
on airplanes, like you know, so do you feel I
mean like there's a resistance and what would that resistance
be about? I feel like underneath it is a shame
(23:16):
around mental health. And then I wonder if there is
in the health care industry, if we are dealing with
people's stress, with with mindfulness, with meditation, with better nutrition,
than the sort of profit motives of medicating everything are diminished.
And you know that, I'm not a conspiracy theorists, but like,
I think about what gets in the way often, right, Yeah,
(23:38):
I have two answers to that. So Number one, some
of the biggest resistance doesn't come from patients, right Doctors say, oh,
I can't screen my patients will not you know, won't
like it. And the truth is, the patients all by
and large, vastly appreciate it. It's the doctors who are
terrified because they're afraid of opening Pandora's box. They're afraid
(23:59):
they don't know what to do with the information when
it comes out. And I think that's an understandable fear
and the way that we respond in medicine, and this
is why we stood up such a robust initiative in
California is because we trained doctors to do everything that
(24:19):
they do. We trained doctors to cut people open, take
out their organs, and then sew them back up again.
We can't train doctors to ask them questions safely, right
we can. We can. People are right in saying, hey,
if I'm going to do this as part of my
as part of screening in physical exams, which is what
(24:42):
we are doing in California, I need to have the training.
I need to have the resources, I need to have
the guidance. I need to have people who know what
they're doing, who have done this before, who tell me
how to do it safely. And that's what we're doing
in California. So for example, we are going to do
it really rigorously and provide trade and provide guidance and
all of that. So that's one piece that's important. I
(25:04):
think the other piece around the pharmacological treatment. I'm going
to say something that is going to surprise a lot
of people, which is that when it comes to treating HIV,
for example, we know how HIV spread, we know all
that stuff, and so we know, like, oh, hey, if
(25:26):
you want to prevent it use a conduct. Okay, so
we know that, but we still developed anti retrovirals and
that made a really big difference for a lot of people.
And those were drugs, right. So I don't have any
interest in saying that there's no room for pharmacotherapy here,
(25:48):
because if there was a medication that helped to regulate
the stress response for someone who had a disregulated stress response,
I would commit if it was healing. From my patients,
the problem that we have was what I was seeing
in my clinic, which is that we weren't accurately diagnosing
(26:13):
the problem. We'd see all these kids and be like,
you've got a d h D. Here's some rittlin. Rittlin
is a stimulant. If you have an overactive stress response,
Rittlin is likely to not help you. Okay, Okay, well
your behavior still didn't get better, so we put you
on antipsychotic. This, Charlotte is not psychotic. I'd see kids
on five different psychotropic medications, and my problem was, as
(26:37):
a field, we did not have the training to know
what we're treating, which is this disregulation of the stress response.
And the treatment is several fold. Number one is to
reduce the dose of adversity and stress. Right, when a
kid has lead poisoning, first thing is figure out where
(26:58):
the lead is coming from and get rid of it
right mitigated. So what are you gonna have some specific
things that parents can do? Oh my god, my child
has a high ASIS score? What can I do to
reduce that level of toxic stress for parents out there?
A couple of things I saw all the time in
my clinical practice. Mom's bringing in a child, right, and
(27:19):
you've got a person who maybe dad's been laying hands
on for quite some time, and mom thinks, oh, he's
hurting me, but he's not hurting my child. So I'm
not gonna separate. And I have seen so many parents
who have been willing, once they understand the harm that
(27:40):
it actually is physically damaging their child's brain and body
to witness that domestic violence, are willing to do for
their child what they were not able to do for themselves.
For example, man, I had a dad who took care
of his kids, and this dad had issues with substance dependence,
(28:02):
he had PTSD, he had, you know, a bunch of
stuff going on. And he said, you know what, I
am realizing now how all this stuff is affecting my kids,
because obviously I was this doctor, so I'm saying, hey, listen,
these things it's not you're doing your stuff and you're
it doesn't harm your kids because your your children witnessing it.
And I saw this dad go to rehab, go to therapy,
(28:27):
do his stuff, and bring his kids in for their
appointment every week. So this one of the most important
things for parents is if you're concerned about your child,
one of the first things is to look at your
own aces, look at your own mental health issues. And
(28:48):
I will tell you my you know, my own experience
was that my mom's mental health condition was untreated for many, many,
many many years. And I will tell you schizophrenia is
a treatable health condition. There is no reason she should
have gone untreated for so many years. And she finally
(29:10):
did get treatment, and again it was such a game changer.
But I think for so long the shame and the stigma, yes, right,
means that we don't acknowledge what's going on, we don't
deal with it for ourselves, and we kind of try
to sweep it under the rug. And we have to
let go of the shame and stigma. We have to
(29:30):
let go of the shaman sama around. Mental health issues
is the health issue just like anything else that is crucial, crucial, crucial.
It's time for a short break when we come back
more with our guest. Alrighty, then let's just dive right
(30:04):
back in. I want to stay it for myself as
an adult, even though I don't have a child that
I need to be there for and get myself healthy for.
How do I, as as an adult look at the
inner child inside me and say, you deserve to have
(30:27):
fewer adverse experiences. So for the people I think who
don't have kids, who are struggling, but this is an adult, Like,
what is that self compassion look like? Yeah? So one
of the pieces that I saw over and over again
when I was taking treating my patients and especially my teenagers,
I would say, oh, because of what you've experienced, your
body maybe releasing more stress mormones than it should and
(30:52):
it can look and feel like being quick to anger,
or having trouble controlling your impulses all that stuff, And
like almost every time the response I would get is, oh,
you mean I'm not crazy? And so that first step
of that self compassion is to recognize, like, oh, you
(31:12):
know what there's nothing wrong with me, Like, my body
is responding in the way that our bodies were actually
designed to respond to the types of things that I experienced,
and there's something that I couldn't do about it. Right,
So the meditation, the exercise. One of the things that
I talk a lot about is having like a green, yellow,
(31:35):
red chart. So green is like, hey, how do I
feel when I'm in the green? Right, Green is I'm
doing well, everything's going fine. And then yellow? What does
yellow look like for me? I'm having trouble sleeping, my
heart is racing, my thoughts become obsessive, my asthma is
acting up, my blood sugar seems high, and I can't
(31:57):
I'm having a hard time with managing my diet. Eaties,
you figure out what that is, and then you say, okay, well,
what's the plan. Okay, I'm gonna step up. I'm going
to go from my meditation once a day to twice
a day. I'm going to reach out to these trusted
folks in my life who I know are there and
be like, girl, let's get together, it's time, you know,
(32:18):
and get extra good on the nutrition. Cut out the
inflammatory foods. Right, We're gonna really keep it tight to
tune us back in. What if you do that and
you still go into the red? What does red look like?
Red might look like thoughts of self harm. Red might
look like, you know, really really bad asthma and being hospitalized,
(32:39):
And then what do you do with the red? Talk
to your doctor, talk to your therapist. We're hearing more
and more about people like Naomi Osaka, right tennis star,
who said, you know what, I don't know if she
was in the red or not, but she was like,
this rex my mental health. I'm not going to do
it for me, just like I'm actually doing everything I've
(33:01):
chosen everything in my life. I'm not doing something I
don't want to do. So like why am I sis stressed?
And I think for me, a lot of it is
just so hardwired, and it's just it's a habit for
forty nine years. This is how I've responded, you know,
And I've been talking about this for years as a
as a trans person, as a as a black person,
as a black trans person, Like I've never felt safe
(33:22):
walking down the street. I feel like constantly under attack. Right,
So that like that heightened you know, toxic stress thing
is the habit in my nervous system that my body
has to unlearn. So what I would say to that
is that and this is why public health is so
important and I'm so grateful to be in the role
(33:43):
of California Surgeon General, is that you can do that
individual work to unlearn that, and it's really really important
for you to do that. But this is where public
health comes in. We actually have to make it safe
for you to walk down the street. There is a
(34:04):
certain amount of when it comes to public health where
you can't just ask the individual to do better, be better,
do differently. Individual overcoming the situation, you have to change
the structure of the society. Because if we didn't sanitize
(34:28):
our water, and every time you turn on the tap
came a whole pile of E. Coli telling you to like,
oh well, just you know, see if you can get
better from another bout of Cholorado is not okay. We
as a society have an obligation to sanitize the watermen.
(34:52):
We have an obligation to reduce the sources of adversity,
and that is a PubL look health thing. No individual
is going to do that, and that's why public policy matters. Amen,
Thank you, so much for saying that, because I I'm
sitting here in all the beautiful privilege of my life,
(35:13):
just working my ass off to be psychologically and emotionally well.
But then there's still a world where it's not safe
for me, even as a celebrity, as a black trans woman,
to walk down the street and know that I can
get home safely. We have to have those public policies.
And I'm so grateful you said, And I think that's
the point of this podcast for everyone out there who's listening,
(35:34):
who is struggling, because a lot of us are struggling.
Racism is an adverse experience, adversity, sexism, misogyny, transphobia, being
poor in America, that's living in a world where people
are anti immigrants. These are adversities that affect our mental health,
that make people hyper vision and release cortisol. And injustice
(35:55):
is stressful as fuck. In justice, it's stressful as fun,
it's post stressing, it's killing keeps killing us. So so
that is actually right, And that is why I am
a science warrior, because our ability to make public policy
is determined by the strength of the science. When we
(36:16):
figured out that lead was neurotoxic, right, and caused irreversible
neurologic damage. The basis of that science was the basis
of removing lead out of gasoline, out of paint, out
of pipes. And I'll tell you none of those industries
liked it. No one was like, oh yeah, I'm thrilled
to spend more money to do something different. What for
(36:37):
public health and public safety? And this is why one
of my still to this day proudest moments was reading
the ruling from the federal court that enjoined the Trump
administration against their policy of separating children from their parents
(36:59):
at the border, when they said, you know what, that
policy is illegal. On page thirteen of that ruling, it says,
the science shows that this leads to toxic stress. And
I'm like, that's what we're talking about, right. This is
why the way that we do this, the rigor with
(37:19):
which we do this, the science that we bring to
it matters, because on the basis of science, we can
make policy. And what the science tells us is exactly
what you just said, is that trauma is damaging to
our brains and bodies, and it leads to health problems,
physical and mental and behavioral. And you know what, for
(37:41):
the people who really don't care about whether you feel
included and safe in our environment. Maybe they will care
about the trillions of dollars that we are spending on
healthcare for treating trauma related health conditions. I published a
paper last year to show for the state of California alone,
(38:03):
the cost of adverse childhood experiences from just eight health
conditions is a hundred and twelve billion dollars per year.
So this is a public health imperative and creating safe
(38:25):
and inclusive communities and environments. It's not just a matter
of liberal values or conservative values or anything. It is
a matter of public health. It is a matter of
life or death, and it is a matter of economic
(38:46):
viability for our nation. Um. I thank you so much
for your work. I probably get talk to you all day,
But do you have anything else you want to say?
Before I asked my last question just for anyone who
wants to learn more about their own aces. The powerful
thing about the number story website is that you know,
(39:09):
no two people have the same response, right. No two
people who have experienced three aces experienced it the same way.
And that's why the story is equally as important as
the number, right, And so that that's the piece that
is so beautiful. And I think that now that we
are armed with this information, we have the power to
(39:33):
write how our story turns out. I believe fundamentally that
we have the power to transform this world, and we
do it one conversation at a time. I love that
so much. The last question I was ask all my
(39:55):
guests is what else is true for you? And this
comes from my therapeutic practice community resiliency model and the
idea of both. And even though there may be anxiety
and one part of our body, another part of our
body might be neutral and positive, and we can focus
on that, then we can exist in a place of both.
And so when you know when you are struggling and
things are rough for you, Dr Nadine Vick Harris, what
(40:19):
helps you get through? What else is true for you?
I would say what else is true for me is
I think a recognition of my own vulnerability is what
makes me strong and resilience. Because then I put into
(40:43):
place very mindfully the scaffolding, the infrastructure, the supports that
will keep me going and doing this for a really
long time, which was I think a big way that
this this research and this science was very helpful in
my own life, because I think before that I was like,
I'm strong, I don't need blah blah blah, and it's
it was exacting, it was exactly the opposite. I love that.
(41:11):
As a burnet brown stand Bernet says that vulnerability is
can scarce, but it's our greatest source of strength, and
it is our The best measure of courage is our
ability to be vulnerable. Thank you so much, Dr Nadine
burg Harris. I'm deeply honored. You don't even know how
honored I am to be having this conversation with you.
I'm deeply moved by your work. Your work has really
(41:33):
changed my life in really important ways. Even though I'm
still struggling, knowing that there is a way out because
of your work, it's it gives me a lot of hope.
It's I guess my. What else is true in this
moment is that there are brilliant, incredible, empathetic, compassionate healthcare
workers who are Actually you're a certain general of our
state and you are making a difference in a beautiful way.
(41:56):
Thank you so much for spending this time with me.
Oh it's my joy. Thank you, Oh my god. Dr
Nating burg Harris. There is a sense of purpose to
the work that she does that is beyond her, which
(42:18):
I think is just all of what we should all be,
you know, working towards and if we invite in the
information and then do the work to reduce toxic stress
in our lives. This feels game changing to me because
it feels like it's deeply connected to For me personally,
(42:39):
I don't ever feel safe, and there has been incredible
improvement in my life. But the heart wiring of safety,
the heart wiring of trauma responses in my body, that's
starting when I was a child. When Dr nadin Burg
Harres said that this starts in childhood and affects the
way our brains developed, affects the ways our immune system
(42:59):
to develop, it's like I can be a lot easier
all myself. I think I'm so emotional lized with that
conversation because it's like I think I should have it
figured out, and it's okay that I don't. Oh number story,
Google number story, go to the website. It's okay to
go and take the test, and you're not crazy when
(43:23):
it feels overwhelming, like it's too much, that's just a
biological response to what's happened to you and you can
survive it. M Thank you so much for listening to
(43:50):
Laverne Cox Show. Please rate reviews, subscribe and share with
everyone you know. Join me next week for my conversation
with New York Times bestselling author, researcher, and lecturer Dr
Joe Dispenser. He uses the latest scientific studies to learn
how meditation affects the brain and body. Dr Joe has
developed a way for people to heal their bodies, make
(44:12):
significant changes in their lives, and manifest their dreams. You
can find me on Instagram and Twitter at Laverne Cox
and on Facebook at Laverne Cox for Real. Until next time,
stay in the Last. The Laverne Cox Show is a
(44:36):
production of Shonda land Audio in partnership with I Heart Radio.
For more podcasts from Shondaland Audio, visit the I Heart
Radio app, Apple podcast, or wherever you listen to your
favorite shows.
Welcome to The Laverne Cox Show, a production of Shondaland
Audio in partnership with I Heart Radio. I was seeing
kids coming in with chess pain. I was seeing kids
with autoimmune disease just off the charts, and you know,
most of these kids were black and brown kids, and
I just didn't believe the myth that somehow these people
(00:22):
are sicker, or because they're low income they're sicker. I'm like,
what if we're all the same and these kids are
not fundamentally broken, but they're showing a normal biological response
to a harmful experience. Hello, Hello, Hello everyone, and welcome
(00:50):
to the Laverne Cox Show. I'm Laverne Cox. Today I
am really excited and nervous to be talking to the
Surgeon General of California. And the reason I'm so nervous
but also excited is because this person's work has really
(01:12):
illuminated and helped explain a lot of what has been
going on with me my whole life. A few years ago,
my therapist said to me, you should go to this
website and take this quiz and find out your asist scored.
I'm like, ACES, what are you talking about? And she said,
ACES is an acronym for adverse childhood experiences. Adverse childhood
(01:35):
experiences can have effects on us throughout our lives, not
only in terms of our mental health and our behavioral capacities,
but also our physical health. Toxic stress PTSD has health consequences.
People with high ASIS scores have a higher rate of
heart disease, diabetes, and more. The person who has brought
(01:59):
the this research to the masses arguably is Surgeon General
of California, doctor Nadine Burke Harris Nading Burke Harris is
an award winning physician, researcher, and California's first ever Surgeon General.
After graduating from Stanford, she turned down multiple job offers
(02:20):
to work in the most underserved part of San Francisco,
where she found at the Center for Youth Wellness, an
organization leading the effort to advance pediatric medicine, raise public awareness,
and transform the way society responds to children exposed to
adverse childhood experiences, aces and toxic stress. Dr Burke Harris
(02:43):
is ted talk how childhood trauma affects health across the
lifetime has been viewed more than seven million times. Her
book The Deepest Dwell Healing the long term effects of
childhood adversity was called indispensable by The New York Times.
Please enjoy my conversation with Dr Nadine Burke Harris. Hello,
(03:21):
Dr Nadine Burke Harris, Welcome to the podcast. How are
you feeling today? I'm feeling very well. Thank you, Thank you.
It's a pleasure to be with you. I'm so excited
to have you here. Can you for those folks out
there who don't who aren't familiar with you and your work,
can you, dispersed of all, tell them what ACES is
and then then we can get some background on who
(03:42):
you are. But can you tell them what ACES stands
for and why it's important. Yeah. So, the term ACES,
they stand for Adverse Childhood Experiences and they refer to
ten categories of experiences of adversity that folks can have
during their childhood. And it actually comes from this groundbreaking
(04:04):
research study that was done by the CDC and Kaiser
Permanente now over two decades ago, when they asked adults
about their history of exposure to ten categories of adversity,
and those included physical, emotional or sexual abuse, physical or
emotional neglect, were growing up in a household where parent
(04:25):
was mentally ill, substance dependent, incarcerated, where there was parental
separation or divorce, or domestic violence. And what they found
in this research study was number one, these aces were
super common, right, and I think for for so many
people who have had these experiences, they feel like they're
(04:45):
the only one. And it turns out that two thirds
of Americans have experienced at least one of these ten
categories of average childhood experiences. But the second thing that
they found was that the more of these that a
person has exp varience, the more likely they are to
have not just the things that I think many of
us intuitively associate with child too trauma, so you know,
(05:09):
things like depression or anxiety, mental health conditions or behavioral
health conditions, substance dependence, suicidality, right, all of those things,
but also heart disease, right, that's the number one killer
in America. And the more aces a person has, the
more likely they are to have heart disease, stroke, asthma, diabetes,
(05:30):
all of these different health conditions. And what we now
understand from the science and the research that has happened
is that when we experience adversity and trauma as children,
because children's brains and bodies are just developing. All of
those stress hormones that are released during that adversity and
(05:54):
trauma actually changes the way our brains and bodies are
wired and can lead to an increased risk of different
types of health conditions later on down the line. Yeah,
and that is the piece that that that hits me
so hard. I was deeply triggered after I took the
(06:16):
ACES test. I was deeply triggered afterwards. For folks out there,
I encourage you to go to the website just google
um number story dot org, thank you, and take the test,
and I love the website has resources to just in
case you are triggered, which is great, and we can
talk about some of those. But for me taking the test,
I was like, well, my was my mother really mentally
(06:37):
ill when I think she had O c D And
so there was just sort of hedging on some of
the questions. Right when I've spoken about my mother and
I have my mother was emotionally abusive, and I've spoken
about this on the podcast before and we were in
a great place now and we reconciled and healed together
and it's beautiful. But they even when like no one's watching.
I feel like I'm sort of betraying my mother by
(06:57):
like telling the truth to myself on an ASIS test. Right.
So I think that's one of the things that gets
in the way because you you know, when your TED Talk,
you say that this is a public health crisis, and
I still don't feel like there's a big conversation about
adverse childhood experiences that I think a lot of it
has to do with shame. It has to do with
how difficult it is to confront this stuff. What do
(07:20):
you think about that piece of it? Oh, there's so
much in what you just said. I've been talking about
this for a long time. Obviously the TED Talk I
recorded in and it wasn't until when I wrote my
book in ten did I ever publicly say anything about
(07:43):
my own experience of growing up with a mom with
a chronic mental health condition and talk about being worried
about betraying your parents. Right, who my mom and I
My mom is defined as by so many things, right,
and she was very loving in many ways, but then
(08:05):
also there were a lot of scary moments. And the
piece of it that I find to be really important
and related to your point of what you're saying about
feeling triggered, which I think it's so good to recognize
(08:26):
that because when when we are triggered, there's something there, right, like,
there's something there where. We got to figure out what
that's about. But for me, ultimately, this work, this information
is all about healing. It's all about interrupting that intergenerational cycle.
(08:50):
Because I one of the most profound experiences that I
ever had was speaking at an onfrience for a bunch
of young women who rushed up to me and they,
you know, one young woman said to me, Dr Burke Harris,
my ACE score is a nine, but my kids are three,
(09:13):
and I'm going to make sure it stays that way, right,
And what makes that possible is our ability to have
a much broader national conversation about these topics, which requires
us to feel safe in doing that, right, It requires
(09:36):
some kind of normalizing and understanding that actually, you know,
you can go back and look at the experience you
had with whoever was the source of your ass But
then you go back and say, well, what was the
source of their aces? And you recognize there's no bad
guy here, right, There's there's no bad guy. You just
(09:58):
have a bunch of people who we're doing their best,
their best with what they can and now what we're
doing is opening up a conversation, having a dialogue and
arming people with resources so that we can maybe do
something different with what we've experienced. Right, And that's what
(10:21):
number story is all about. It's about raising awareness and
it's about arming people with resources to understand what does
their aces mean for them and how do they find
a path to healing. Absolutely, I love that. I gotta
take a tea easy break here, but I'll be fast alright.
(10:57):
Now that's all taken care of. That's get back to
our chat. So what do you think is getting in
the way of us having more protocols in place? You
talk about best practices with children, and you introduce some
of those at your clinic, and now you're a certain
(11:19):
in general, what is getting in the way of us
basically integrating mental health into you know, all of our
healthcare practices and measuring these kinds of things so that
we so we're doing asist test whenever people are going
in for a physical or whatever. Girl, do you know
that's what we're doing in California? Talk to me, tell me,
tell me I didn't know this so here in California,
(11:41):
we've launched an initiative. It's a hundred and fifty million
dollar initiative to train our healthcare clinicians on how to
screen for advertge childhood experiences, how to assess for that
toxic stress response, and how to respond with evidence based interventions.
(12:01):
And we have given over fifty million dollars in grants
to communities all over California to implement these practices. And
I will tell you we have trained almost nineteen thousand
health care clinician so far in California. Very exciting. This
(12:22):
is world leading stuff. We are the first in the nation,
first in the world to be doing something of this
scope and scale. And I will tell you some of
the difficulties that we have right Like, besides the fact
that you and I can look at each other right
now and know that there is not some amazing barrier
(12:43):
in the neck, right that separates the head from the
rest of the body, but somehow in medicine and in healthcare,
we are like, Okay, there's mental health and there's the
rest of traditional medicine, right, and they're totally separate, and
they're financed differently. It's just very very separate and that
(13:05):
doesn't make any sense because that's not actually the way
the body works. Right. The way the body works is
that this is all integrated our mood, our mental health
impacts our immune system. Think about our stress response and
the way our stress response develops. Two of the main
stress hormones that we have been most studied our adrenaline,
(13:29):
which is a short term stress hormone, and that is
the heart pounding. And then cortisol is thought of as
more of a long term stress hormone. So you can
imagine famine as something that was like a big stressor
back in the day. What cortisol does. It increases your
blood pressure, It increases your blood sugar. It tends to
(13:50):
make people more aggressive. It affects your sleep, so it
makes it hard to sleep. Right, All of these things
to help you stay awake at night so you can
hunt and eat any critters. And it um helps you
conserve fat and store belly fat, right because it's a famine, right,
you need need belly fat. And so all of these
things are adaptive in an evolutionary standpoint, but in our
(14:16):
day to day world, it's no longer a famine. Or
for example, I give the example of your walking in
a forest and you see a bear. It's not a
bear in the woods that you have to fight and
get away from. It's the bear coming home every night.
So you can imagine the way the stress response works.
It's supposed to be that almost like a thermostat, where
(14:39):
you have a set point, you experience a threat, you
activate your stress response. It goes up, up, up, up up.
When it's done its job, it turns itself off and
you go back to normal. And that is the fight
or flight response, and that's what we were designed to do.
The problem is when we experience high doses of adversity,
as specially in childhood, that stress thermostat can get a
(15:06):
little haywire, right, and so we activate our stress response
and it goes up, up, up, up up, and then
it stays there right. It doesn't turn itself off, or
or it gets triggered for teeny tiny things. So it's
either being activated much more frequently, or it has a
very hard time turning itself off. I think I'm the ladder, well,
(15:31):
the ladder, it doesn't turn it doesn't turn off, So
I'm just it's always heightened. I never feel safe, and
then I just and I give out and I'm fatigued
that I'm like, of course, I'm exhausted. That's but that's
right because that actually it takes a ton of energy
to do that, And if you were in an environment
of constant threat, that would be adaptive. But now your
(15:53):
body is wired that way, right, and it keeps going
even if there isn't an immediate threat. And this is
actually something that's really really important to me and toxic stress,
this prolonged activation of the stress response. And when I
first started talking about this, honestly, the place I got
them a lot of flak, like a surprising amount of
(16:15):
pushback was from mental health clinicians and they were like,
stay in your lane. You're a pediatrician, why are you
talking about this? What do you think that was about? Oh?
You know, I think honestly, I think a lot of
people didn't fully know and understand the science. So when
I learned about this, because what really brought me into
(16:36):
this work was I was running a clinic in Bay
View Hunters Point in San Francisco. This is one of
the hardest neighborhoods in the city, and I was seeing
child after child after child. Most of my patients were
experiencing high doses of adversity and it was impacting their health.
I was seeing it in asthma, but I was seeing
(16:59):
kids come in with chess pain. I was seeing kids
with autoimmune disease just off the charts. And you know,
most of these kids were black and brown kids. And
I just didn't believe the myth that somehow these people
are sicker or because their low income they're sicker. I'm like,
what if we're all the same, and what's happening is
that these children are being poisoned by what's happening to them, right, Like,
(17:25):
what if these kids are not fundamentally broken, but they're
showing a normal biological response to a harmful experience. I
started researching that, and then I started looking into okay,
so if we understand this and we see the a
science and we know all of this, what do we
do about it. I didn't learn this in medical school.
(17:48):
I didn't learn this in residency. I never learned how
to treat this. And so I'm like, well, good thing,
this is medicine, right, Because if doctors were like, oh, well,
we did learned it before, so we're never gonna do
anything about it, it's unsolvable. Where would we be right
now with COVID, where would we be right now with HIV?
(18:09):
Like we can respond to new challenges for stuff we
didn't know before. So that was the whole thing. I
started an organization to really do this research and find
this out this information, the Center for Youth Wellness, And
that was really how I approached this was just like, Okay,
so what is the biology behind it? Because if we
know the biology, we can treat that. And that's what
(18:32):
we started doing in my clinic and we learned a lot.
We learned a lot from other experts around the world,
and then we developed some clinical protocols for how to
screen for adverse childhood experiences and how to respond look
at the best evidence of how do you calm down
an overactive stress response, and a lot of the things
(18:52):
that you've been talking about meditation, regular exercise, nutrition and
even more like getting even more point like anti inflammatory diet.
You know, so certain pieces are really key. Now we're
seeing data coming out about experiencing nature, right like they
put e e g s on people and had them
(19:14):
walk through the city and then had them walk through nature,
and they see that being in like dense urban environments
activates the fight or flight response more and being in beautiful,
calm nature actually stimulates more the parasympathetic and it calms
down the fight or flight response. All of these things.
(19:37):
And my thing because I'm a hardcore science nerd, Like
science is mine. The story you tell about your father
is just it's so fantastic, and like Dr Nadieberg Harris
is definitely a nerd. Yeah, so I'll say my my
for those who don't know, So my dad's my dad's
a biochemist and my mom is a nurse. And even
(19:58):
though I have four brothers, none of the other of
them went into science. But when we were kids, man,
my dad, if there was something going on, my dad
would break it down into science. Like he'd see us
throwing paper airplanes at each other. And instead of your
standard parent being like stop that, you'll poke an eye out,
my dad, you know, measure the timing of the flight
(20:19):
and the wind resistance and gravity's nine point eight meters
per second squared, like what's the lift under the wings?
Like that was Basil Burke. So I definitely learned to
see everything in the world through a scientific lens. And
then when I became Surgeon General of California. When Governor
(20:40):
Newsom appointed me, one of the things that he said
is that we are looking for someone who can take
an upstream approach, someone who can tackle aces and toxic stress.
Like he said it specifically. And I just have to
tell you this because it means so much to me.
When I started, I got a ton of heat. People
(21:00):
were saying, you can't screen for aces, and you can't
do it because if there's not a therapist for every
single person who screams positive, it's irresponsible. It's all of
the above. And why were they did they say was irresponsible?
What was the logic there? People said, you shouldn't screen
for something that you cannot treat, right. People assume like, well,
(21:24):
aces happened in the past, and you can't fix what
happened in the past, So what are you doing? And
I said, okay, But the point of doing an a
screen is to understand whether that patient likely has that
prolonged activation of the stress response, because that is imminently treatable,
and that, ladies and gentlemen, is science. The National Academies
(21:45):
of Sciences, Engineering, and Medicine release the consensus report in
saying that toxic stress is treatable. The point is to
find out how their body is reacting and whether or
not that may put them at risk for a health
conditions that if we intervene and help to regulate that
stress response, we can prevent those health conditions. Right, And
(22:07):
the whole notion that this is not treatable is just ridiculous.
It's just ridiculous. And that is why I'm so excited
to bring evidence and medicine and science to bear against
something that, by the way, two thirds of Americans have
experienced at least one ACE. This has to be a
national priority, absolutely, and so what I'm so exciting about
(22:33):
what you're doing here in California is giving everyone access
to a level of care that we all deserve because
we all are thort of dealing with this toxic stress
in one way or another. And then I wonder if
there is because when I think about public health, and
I think about where we are with COVID, what's happened
(22:53):
over the past year with mask and vaccines, and you're
saying your tip talk, we know how to treat a
public health is right, and we identify it and we
know what to do. You know, people don't smoke on
airplanes anymore. But like right now people are fighting mask
on airplanes, like you know, so do you feel I
mean like there's a resistance and what would that resistance
be about? I feel like underneath it is a shame
(23:16):
around mental health. And then I wonder if there is
in the health care industry, if we are dealing with
people's stress, with with mindfulness, with meditation, with better nutrition,
than the sort of profit motives of medicating everything are diminished.
And you know that, I'm not a conspiracy theorists, but like,
I think about what gets in the way often, right, Yeah,
(23:38):
I have two answers to that. So Number one, some
of the biggest resistance doesn't come from patients, right Doctors say, oh,
I can't screen my patients will not you know, won't
like it. And the truth is, the patients all by
and large, vastly appreciate it. It's the doctors who are
terrified because they're afraid of opening Pandora's box. They're afraid
(23:59):
they don't know what to do with the information when
it comes out. And I think that's an understandable fear
and the way that we respond in medicine, and this
is why we stood up such a robust initiative in
California is because we trained doctors to do everything that
(24:19):
they do. We trained doctors to cut people open, take
out their organs, and then sew them back up again.
We can't train doctors to ask them questions safely, right
we can. We can. People are right in saying, hey,
if I'm going to do this as part of my
as part of screening in physical exams, which is what
(24:42):
we are doing in California, I need to have the training.
I need to have the resources, I need to have
the guidance. I need to have people who know what
they're doing, who have done this before, who tell me
how to do it safely. And that's what we're doing
in California. So for example, we are going to do
it really rigorously and provide trade and provide guidance and
all of that. So that's one piece that's important. I
(25:04):
think the other piece around the pharmacological treatment. I'm going
to say something that is going to surprise a lot
of people, which is that when it comes to treating HIV,
for example, we know how HIV spread, we know all
that stuff, and so we know, like, oh, hey, if
(25:26):
you want to prevent it use a conduct. Okay, so
we know that, but we still developed anti retrovirals and
that made a really big difference for a lot of people.
And those were drugs, right. So I don't have any
interest in saying that there's no room for pharmacotherapy here,
(25:48):
because if there was a medication that helped to regulate
the stress response for someone who had a disregulated stress response,
I would commit if it was healing. From my patients,
the problem that we have was what I was seeing
in my clinic, which is that we weren't accurately diagnosing
(26:13):
the problem. We'd see all these kids and be like,
you've got a d h D. Here's some rittlin. Rittlin
is a stimulant. If you have an overactive stress response,
Rittlin is likely to not help you. Okay, Okay, well
your behavior still didn't get better, so we put you
on antipsychotic. This, Charlotte is not psychotic. I'd see kids
on five different psychotropic medications, and my problem was, as
(26:37):
a field, we did not have the training to know
what we're treating, which is this disregulation of the stress response.
And the treatment is several fold. Number one is to
reduce the dose of adversity and stress. Right, when a
kid has lead poisoning, first thing is figure out where
(26:58):
the lead is coming from and get rid of it
right mitigated. So what are you gonna have some specific
things that parents can do? Oh my god, my child
has a high ASIS score? What can I do to
reduce that level of toxic stress for parents out there?
A couple of things I saw all the time in
my clinical practice. Mom's bringing in a child, right, and
(27:19):
you've got a person who maybe dad's been laying hands
on for quite some time, and mom thinks, oh, he's
hurting me, but he's not hurting my child. So I'm
not gonna separate. And I have seen so many parents
who have been willing, once they understand the harm that
(27:40):
it actually is physically damaging their child's brain and body
to witness that domestic violence, are willing to do for
their child what they were not able to do for themselves.
For example, man, I had a dad who took care
of his kids, and this dad had issues with substance dependence,
(28:02):
he had PTSD, he had, you know, a bunch of
stuff going on. And he said, you know what, I
am realizing now how all this stuff is affecting my kids,
because obviously I was this doctor, so I'm saying, hey, listen,
these things it's not you're doing your stuff and you're
it doesn't harm your kids because your your children witnessing it.
And I saw this dad go to rehab, go to therapy,
(28:27):
do his stuff, and bring his kids in for their
appointment every week. So this one of the most important
things for parents is if you're concerned about your child,
one of the first things is to look at your
own aces, look at your own mental health issues. And
(28:48):
I will tell you my you know, my own experience
was that my mom's mental health condition was untreated for many, many,
many many years. And I will tell you schizophrenia is
a treatable health condition. There is no reason she should
have gone untreated for so many years. And she finally
(29:10):
did get treatment, and again it was such a game changer.
But I think for so long the shame and the stigma, yes, right,
means that we don't acknowledge what's going on, we don't
deal with it for ourselves, and we kind of try
to sweep it under the rug. And we have to
let go of the shame and stigma. We have to
(29:30):
let go of the shaman sama around. Mental health issues
is the health issue just like anything else that is crucial, crucial, crucial.
It's time for a short break when we come back
more with our guest. Alrighty, then let's just dive right
(30:04):
back in. I want to stay it for myself as
an adult, even though I don't have a child that
I need to be there for and get myself healthy for.
How do I, as as an adult look at the
inner child inside me and say, you deserve to have
(30:27):
fewer adverse experiences. So for the people I think who
don't have kids, who are struggling, but this is an adult, Like,
what is that self compassion look like? Yeah? So one
of the pieces that I saw over and over again
when I was taking treating my patients and especially my teenagers,
I would say, oh, because of what you've experienced, your
body maybe releasing more stress mormones than it should and
(30:52):
it can look and feel like being quick to anger,
or having trouble controlling your impulses all that stuff, And
like almost every time the response I would get is, oh,
you mean I'm not crazy? And so that first step
of that self compassion is to recognize, like, oh, you
(31:12):
know what there's nothing wrong with me, Like, my body
is responding in the way that our bodies were actually
designed to respond to the types of things that I experienced,
and there's something that I couldn't do about it. Right,
So the meditation, the exercise. One of the things that
I talk a lot about is having like a green, yellow,
(31:35):
red chart. So green is like, hey, how do I
feel when I'm in the green? Right, Green is I'm
doing well, everything's going fine. And then yellow? What does
yellow look like for me? I'm having trouble sleeping, my
heart is racing, my thoughts become obsessive, my asthma is
acting up, my blood sugar seems high, and I can't
(31:57):
I'm having a hard time with managing my diet. Eaties,
you figure out what that is, and then you say, okay, well,
what's the plan. Okay, I'm gonna step up. I'm going
to go from my meditation once a day to twice
a day. I'm going to reach out to these trusted
folks in my life who I know are there and
be like, girl, let's get together, it's time, you know,
(32:18):
and get extra good on the nutrition. Cut out the
inflammatory foods. Right, We're gonna really keep it tight to
tune us back in. What if you do that and
you still go into the red? What does red look like?
Red might look like thoughts of self harm. Red might
look like, you know, really really bad asthma and being hospitalized,
(32:39):
And then what do you do with the red? Talk
to your doctor, talk to your therapist. We're hearing more
and more about people like Naomi Osaka, right tennis star,
who said, you know what, I don't know if she
was in the red or not, but she was like,
this rex my mental health. I'm not going to do
it for me, just like I'm actually doing everything I've
(33:01):
chosen everything in my life. I'm not doing something I
don't want to do. So like why am I sis stressed?
And I think for me, a lot of it is
just so hardwired, and it's just it's a habit for
forty nine years. This is how I've responded, you know,
And I've been talking about this for years as a
as a trans person, as a as a black person,
as a black trans person, Like I've never felt safe
(33:22):
walking down the street. I feel like constantly under attack. Right,
So that like that heightened you know, toxic stress thing
is the habit in my nervous system that my body
has to unlearn. So what I would say to that
is that and this is why public health is so
important and I'm so grateful to be in the role
(33:43):
of California Surgeon General, is that you can do that
individual work to unlearn that, and it's really really important
for you to do that. But this is where public
health comes in. We actually have to make it safe
for you to walk down the street. There is a
(34:04):
certain amount of when it comes to public health where
you can't just ask the individual to do better, be better,
do differently. Individual overcoming the situation, you have to change
the structure of the society. Because if we didn't sanitize
(34:28):
our water, and every time you turn on the tap
came a whole pile of E. Coli telling you to like,
oh well, just you know, see if you can get
better from another bout of Cholorado is not okay. We
as a society have an obligation to sanitize the watermen.
(34:52):
We have an obligation to reduce the sources of adversity,
and that is a PubL look health thing. No individual
is going to do that, and that's why public policy matters. Amen,
Thank you, so much for saying that, because I I'm
sitting here in all the beautiful privilege of my life,
(35:13):
just working my ass off to be psychologically and emotionally well.
But then there's still a world where it's not safe
for me, even as a celebrity, as a black trans woman,
to walk down the street and know that I can
get home safely. We have to have those public policies.
And I'm so grateful you said, And I think that's
the point of this podcast for everyone out there who's listening,
(35:34):
who is struggling, because a lot of us are struggling.
Racism is an adverse experience, adversity, sexism, misogyny, transphobia, being
poor in America, that's living in a world where people
are anti immigrants. These are adversities that affect our mental health,
that make people hyper vision and release cortisol. And injustice
(35:55):
is stressful as fuck. In justice, it's stressful as fun,
it's post stressing, it's killing keeps killing us. So so
that is actually right, And that is why I am
a science warrior, because our ability to make public policy
is determined by the strength of the science. When we
(36:16):
figured out that lead was neurotoxic, right, and caused irreversible
neurologic damage. The basis of that science was the basis
of removing lead out of gasoline, out of paint, out
of pipes. And I'll tell you none of those industries
liked it. No one was like, oh yeah, I'm thrilled
to spend more money to do something different. What for
(36:37):
public health and public safety? And this is why one
of my still to this day proudest moments was reading
the ruling from the federal court that enjoined the Trump
administration against their policy of separating children from their parents
(36:59):
at the border, when they said, you know what, that
policy is illegal. On page thirteen of that ruling, it says,
the science shows that this leads to toxic stress. And
I'm like, that's what we're talking about, right. This is
why the way that we do this, the rigor with
(37:19):
which we do this, the science that we bring to
it matters, because on the basis of science, we can
make policy. And what the science tells us is exactly
what you just said, is that trauma is damaging to
our brains and bodies, and it leads to health problems,
physical and mental and behavioral. And you know what, for
(37:41):
the people who really don't care about whether you feel
included and safe in our environment. Maybe they will care
about the trillions of dollars that we are spending on
healthcare for treating trauma related health conditions. I published a
paper last year to show for the state of California alone,
(38:03):
the cost of adverse childhood experiences from just eight health
conditions is a hundred and twelve billion dollars per year.
So this is a public health imperative and creating safe
(38:25):
and inclusive communities and environments. It's not just a matter
of liberal values or conservative values or anything. It is
a matter of public health. It is a matter of
life or death, and it is a matter of economic
(38:46):
viability for our nation. Um. I thank you so much
for your work. I probably get talk to you all day,
But do you have anything else you want to say?
Before I asked my last question just for anyone who
wants to learn more about their own aces. The powerful
thing about the number story website is that you know,
(39:09):
no two people have the same response, right. No two
people who have experienced three aces experienced it the same way.
And that's why the story is equally as important as
the number, right, And so that that's the piece that
is so beautiful. And I think that now that we
are armed with this information, we have the power to
(39:33):
write how our story turns out. I believe fundamentally that
we have the power to transform this world, and we
do it one conversation at a time. I love that
so much. The last question I was ask all my
(39:55):
guests is what else is true for you? And this
comes from my therapeutic practice community resiliency model and the
idea of both. And even though there may be anxiety
and one part of our body, another part of our
body might be neutral and positive, and we can focus
on that, then we can exist in a place of both.
And so when you know when you are struggling and
things are rough for you, Dr Nadine Vick Harris, what
(40:19):
helps you get through? What else is true for you?
I would say what else is true for me is
I think a recognition of my own vulnerability is what
makes me strong and resilience. Because then I put into
(40:43):
place very mindfully the scaffolding, the infrastructure, the supports that
will keep me going and doing this for a really
long time, which was I think a big way that
this this research and this science was very helpful in
my own life, because I think before that I was like,
I'm strong, I don't need blah blah blah, and it's
it was exacting, it was exactly the opposite. I love that.
(41:11):
As a burnet brown stand Bernet says that vulnerability is
can scarce, but it's our greatest source of strength, and
it is our The best measure of courage is our
ability to be vulnerable. Thank you so much, Dr Nadine
burg Harris. I'm deeply honored. You don't even know how
honored I am to be having this conversation with you.
I'm deeply moved by your work. Your work has really
(41:33):
changed my life in really important ways. Even though I'm
still struggling, knowing that there is a way out because
of your work, it's it gives me a lot of hope.
It's I guess my. What else is true in this
moment is that there are brilliant, incredible, empathetic, compassionate healthcare
workers who are Actually you're a certain general of our
state and you are making a difference in a beautiful way.
(41:56):
Thank you so much for spending this time with me.
Oh it's my joy. Thank you, Oh my god. Dr
Nating burg Harris. There is a sense of purpose to
the work that she does that is beyond her, which
(42:18):
I think is just all of what we should all be,
you know, working towards and if we invite in the
information and then do the work to reduce toxic stress
in our lives. This feels game changing to me because
it feels like it's deeply connected to For me personally,
(42:39):
I don't ever feel safe, and there has been incredible
improvement in my life. But the heart wiring of safety,
the heart wiring of trauma responses in my body, that's
starting when I was a child. When Dr nadin Burg
Harres said that this starts in childhood and affects the
way our brains developed, affects the ways our immune system
(42:59):
to develop, it's like I can be a lot easier
all myself. I think I'm so emotional lized with that
conversation because it's like I think I should have it
figured out, and it's okay that I don't. Oh number story,
Google number story, go to the website. It's okay to
go and take the test, and you're not crazy when
(43:23):
it feels overwhelming, like it's too much, that's just a
biological response to what's happened to you and you can
survive it. M Thank you so much for listening to
(43:50):
Laverne Cox Show. Please rate reviews, subscribe and share with
everyone you know. Join me next week for my conversation
with New York Times bestselling author, researcher, and lecturer Dr
Joe Dispenser. He uses the latest scientific studies to learn
how meditation affects the brain and body. Dr Joe has
developed a way for people to heal their bodies, make
(44:12):
significant changes in their lives, and manifest their dreams. You
can find me on Instagram and Twitter at Laverne Cox
and on Facebook at Laverne Cox for Real. Until next time,
stay in the Last. The Laverne Cox Show is a
(44:36):
production of Shonda land Audio in partnership with I Heart Radio.
For more podcasts from Shondaland Audio, visit the I Heart
Radio app, Apple podcast, or wherever you listen to your
favorite shows.
Host
Laverne Cox
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