Humans have an incredible capacity for survival. Victor Frankl wrote about his experience in a Nazi concentration camp in “Man’s Search for Meaning.” His life afterwards was rewarding and very productive despite the worst types of atrocities that could be perpetrated on humans. He found meaning. Senator John McCain found meaning after 6 brutal years in a Vietnamese POW camp. There are countless other examples of people finding meaning after a difficult life.
Yet many young people (and some older ones) find life so challenging that they choose to end it. On an annual basis, the number of suicides completed in the U.S. is extremely small (slightly over one tenth of one percent of the U.S. population). And a larger number, as many as a third, adopt or experience negative habits during their lives that help them survive, like alcohol and drug use, smoking, depression, violence and others.
Since 2008 I have been thinking very deeply about the impact of developmental trauma on our lives. I have 2 close relatives who passed away after a life full of developmental trauma and adoption of many behaviors, some negative. But they also used what I refer to as “Neutral” and “Positive” behaviors to help them cope. The negative behaviors won, unfortunately, and they left us far too early in life.
My analytical framework is referred to as “Lean Thinking.” While typically used to describe a system of management pioneered by Toyota, Lean thinking actually focuses on 2 areas-respect for people and continuous improvement. For purposes of this piece, I will only focus on a tenet of Lean Thinking-the search for the “Root Cause” of a Problem and identification of a “Countermeasure.” Humans become excited with a new idea like the issues caused by developmental trauma and propose solutions based on their experience, which is typically quite limited. When an idea get out there with credible proponents, people adopt the idea. After it spreads, it becomes difficult to challenge the idea without being shouted down. I have personal experience with being shouted down because I challenge solutions by asking why it might be considered a solution. Defenders will jump to articles written about the solution that doesn’t answer the question either. I made the mistake of challenging the assertion that we needed to talk to everyone about suicide, and to make everyone aware of it because of its frequency. It took many minutes for the crowd noise to stop. No one even considered asking why we need to talk about suicide to everyone. No one bothered to provide a cogent answer.
Well, I have asked the same question about resilience. Huge programs are being funded to promote resilience, but I cannot find research that answers why resilience is the answer to developmental trauma. (And I know there will be those of you who refer me to research discussing resilience, but even they don’t ask the right questions) All I am asking is for you to think about this. I am not discounting the benefits of resilience programs, but is what they are teaching important, or is it the social aspects of the program that achieve the results for a short term period of time. Does it promote true healing?
The questions I am trying to answer involve multiple possible inputs, similar to my analysis of suicide in Alaska. Despite over a decade of substantial funding, and extensive use of “best practices” in suicide prevention, we seem to have a stable system of suicide. When I refer to stable, all I mean is that our suicide rate does not vary from the predicted upper and lower control limits of a stable system. Nor does the control limits exhibit any trend indicating that the system is shifting. Unfortunately, when I talk facts, people get turned off. There isn’t an acceptable answer to the suicide question when you should someone down and don’t respond to the data.
With resilience, I ask a lot of questions. But I don’t ask to confront or challenge. I ask to seek answers. If we blindly accept what we read or hear, we don’t have answers. If we don’t have facts and data, how can we know what we are addressing is improving. Too often we want hope, so we create it with observation and interpretation, not facts that demonstrate real ongoing progress.
For the discussion about resilience, how can we be sure that resilience isn’t a social overlay that makes the difference. Are we reaching the right kids? What I mean by this is, are we getting the right group of kids (ones that need healing) in the program and are they impacted by the curriculum-not the social relationships being created. If only kids who would be successful without the program are invited into the program, then the results are not identifying the proper variables. Are the variables we measure the right ones.
Dr. Vincent Felitti wrote the following:
“Might heroin be used for the relief of profound anguish dating back to childhood experiences? Might its psychoactive effects be the best coping device that an individual can find? Is intravenous drug use properly viewed as a personal solution to problems that are well concealed by social niceties and taboo? If so, is intravenous drug use a public health problem or a personal solution? Is it both? How often are public health problems personal solutions? Is drug abuse self-destructive or is it a desperate attempt at self-healing, albeit while accepting a significant future risk? This is an important point because primary prevention is far more difficult than anticipated. Is this because non-recognition of the benefits of health risk behaviors leads them to be viewed as irrational and as solely having damaging consequences? Does this major oversight leave us speaking in platitudes instead of understanding the causal basis of some of our intractable public health problems?” (Turning Lean Into Gold)
Dr. Felitti focused on the use of drugs in this quote, but I believe that many behaviors viewed as negative behaviors are also “personal solutions.” For example, compliments make one feel good about themselves. A compliment generates feel good chemical production in the brain. Perhaps the subconscious brain recognizes a compliment as good and seeks more of them. It finds that being flirtatious generates more compliments and chemicals. Flirtation increases and with experience leads to an increased ability to start relationships that make one feel good until it stops feeling good. Maybe a part of the narrative is that the fantasy created about relationships cannot be sustained and the flirt enters into a series of short relationships. A pattern emerges. When your new partner says something that offends you, the fantasy starts to end and the brain ceases receiving the positive reinforcing chemicals it craves. Then it’s on to the next one. Perhaps this is the mechanism that leads to promiscuity.
If this example is accurate, then how many other behaviors produce the positive brain chemicals we need as personal solutions. Since the effect doesn’t last very long, and because developmental trauma is so enduring, I believe our brain starts to seek what provides it with relief. And I believe that the behaviors that do so are not just “Negative.” I believe that there are also “Neutral” and Positive” behaviors that our brain seeks.
A Neutral behavior is, as I define it, one that is not harmful, but is not looked upon as a positive behavior. Dr. Gabor Mate inspired this thought when he told a group of us about a buying behavior. He said that after a stressful day, he would stop at his favorite music store and buy CD’s of favored orchestral member, even to the point of buying multiple copies of CD’s he already owned. While music itself is soothing, it appears that buying music is a habit that provides pleasure to the brain. My friend girls refer to this as “Retail Therapy.” The same is true when I think of my Mother’s bingo and pull tab habits, neither was harmful They didn’t become addictions, but they provided with something positive to think about. One doesn’t need to win at bingo in order to gain the benefit of positive brain chemicals. If you get close to a bingo, the anticipation of winning gives the brain positive stimulation. Pull tabs provide the same stimulation.
A Positive behavior is one that I define to lead to outcomes that are viewed positively by others. When you exhibit some mastery of arts, sports or academics, you get praised for it. That praise then becomes something sought after by the brain.
If our brains seek Personal Solutions, and if Positive, Neutral and Negative behaviors all provide them, I postulate that all 3 types of behaviors can coexist. My observations confirm this. I know many extremely successful professionals who have a mixture of behaviors. Negative behaviors like alcohol and drug use, obesity, promiscuity, depression, purchasing status items, considerable achievement, and excellence all coexist in one person. We see only the Positive because we are taught to hide the Negative and don’t really care about the Neutral.
I have attempted to apply this hypothesis to concepts of Resilience, and it seems to fit. When we put a kid into a program designed around culture, concepts of resilience, or other strategy that we believe works, are we actually just providing them with access to Neutral or Positive stimuli but attributing the success of the program to the curriculum. In statistical terms, I ask whether we are looking at the right variables producing the positive outcomes (if they are, in fact, positive outcomes).
As a systems thinker and analyst, it’s important to seek out all potential solutions, and to analyze the total impact on a system. With Lean Thinking, the Japanese believe every analytical session should produce 7 proposed solutions. Then if one doesn’t work, you can try 2 through 7 until you find one that works. The you need to analyze whether the proposed solution negatively impacts another part of the system. The brain’s proposed solution of alcohol or drug use can negatively impact other parts of the body. But as Dr. Felitti postulates, the negative results may not happen for 4 or 5 decades. Ot they may happen overnight. Think of someone new to drinking and is involved in a fatal DUI accident. A prison sentence and financial ruin follow quickly.
The current focus on resilience may not ultimately produce results. I see programs that recommend positive parental involvement. Well, given that Kids with ACE’s have them inflicted by parents, it’s not likely that recommendation will bear fruit without healing the parent. We can support the Kid through programs when parents are not positive engaged, but what’s to say that the Negative behaviors remain hidden and the negative results might not show up for a long time.
Again, I am not trying to be obnoxious, and I am often shouted down when I pose an opposing viewpoint. I am driven by what I see from actual practice. If we spend a lot of time and money seeking the wrong solution, how much suffering will ensue as a consequence. In Alaska, years of effort and millions of dollars spent have, in my view, only stabilized a system of suicide at just slightly above 22 per 100,000. Because suicide is one of the behaviors that increases with more ACEs, perhaps decreasing the number of suicides will benefit from a general healing strategy designed to address the developmental trauma. That’s the focus of the Restoration to Health Strategy I am working on.
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