Dr. Nadine Burke Harris discusses her book, “The Deepest Well,” which explores how toxic stress created by childhood trauma leads to physical illnesses in adult life.
“Toxic stress are the long term changes that happen to the brain and body when kids are exposed to high doses of adversity,” Burke Harris says. “It’s the normal reaction that’s supposed to save our life from a mortal threat. When it’s activated too often it can change the structure and function of children’s developing brains, their hormonal system, their immune system, even the way DNA is read and transcribed.”
In her book, Burke Harris talks about how she met a 7-year-old patient named Diego over 10 years ago. He was initially referred to her because he was displaying symptoms of ADHD. He had asthma and suffered from eczema. He was small for his age, about the size of a 4-year-old. Burke Harris found out he had stopped growing after being sexually assaulted.
“When I spoke with the endocrinologist, the hormone specialist, what she told me was that this was not unprecedented,” Burke Harris says. “The impact of traumas on children’s developing brains and bodies are much more significant than many of us previously thought.”
Childhood trauma has now been linked to higher risks for asthma, infections, behavioral problems and diabetes. Burke Harris says for children who are exposed to four or more adversities, they are much more likely to suffer from heart disease, cancer, stroke and chronic lung disease.
What can Diego do to help himself when he becomes an adult? “The Deepest Well” focuses on the many things one can do to reverse or prevent the effects of childhood trauma from happening. Burke Harris says all the research has shown that safe, stable, nurturing relationships and environments are healing for both kids and adults. A blend of exercise, nutrition, mindfulness and good mental health has also been shown to have a positive effect.
“One of the most important things we can do is provide the support in a manner that we call two generation – supporting the caregiver and supporting the child,” Burke Harris says. “When we see a child with high levels of adversity, most often their parent had high levels of childhood adversity.”
Evidence-based intervention has shown to prevent the pattern of childhood adversity from being passed down, Burke Harris says of her experience. She says, in her practice, she has seen the power of early intervention and the power of detection.
The knowledge has transformed Burke Harris’s practice. Every child that comes into her practice is screened for adverse childhood experiences. At the moment, four percent of pediatricians are doing the same. Burke Harris hopes to see every pediatrician adopt screening into their offices.
TED SIMONS: THE NEGATIVE EFFECTS OF TRAUMATIC INSTANCES LIKE NEGLECT AND SUBSTANCE ABUSE ON CHILDREN. THEY ARE WELL DOCUMENTED, BUT NOW THERE’S RESEARCH THAT LINKS CHILDHOOD TRAUMA TO POOR HEALTH LATER IN LIFE. DOCTOR NADINE BURKE HARRIS IS A PEDIATRICIAN AND AUTHOR OF “THE DEEPEST WELL,” A BOOK THAT CONNECTS THE DOTS BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND ADULT ILLNESS. WELCOME TO ARIZONA HORIZON. GOOD TO HAVE YOU HERE.
NADINE BURKE HARRIS: THANKS FOR HAVING ME.
TED SIMONS: AND WE SHOULD MENTION, YOU ARE CHANGING HANDS TONIGHT? TO BOOK STORES IN PHOENIX OR TEMPE?
NADINE BURKE HARRIS: HERE IN PHOENIX.
TED SIMONS: YOU TALK ABOUT TOXIC STRESS, NOT JUST STRESS, TOXIC STRESS. WHAT IS THAT?
NADINE BURKE HARRIS: TOXIC STRESS IS THE LONG-TERM CHANGES THAT HAPPEN TO THE BRAIN AND BODY WHEN KIDS ARE EXPOSED TO HIGH DOSES OF ADVERSITY. AND ULTIMATELY IT HAS TO DO WITH OUR BODY’S BIOLOGICAL STRESS RESPONSE. IT’S THE NORMAL REACTION THAT SUPPOSEDLY TO SAVE OUR LIVES FROM A MORTAL THREAT, BUT WHEN IT'S ACTIVATED TOO OFTEN, IT CHANGES THE STRUCTURE AND FUNCTION OF CHILDREN'S DEVELOPING BRAINS, THEIR HORMONAL SYSTEM, THEIR IMMUNE SYSTEM AND EVEN THE WAY DNA IS READ AND TRANSCRIBED.
TED SIMONS: IT’S INTERESTING BECAUSE YOU WROTE WHEN THE BODIES FACE THE TOXIC STRESS, BODIES ARE LITERALLY PREPARING TO BE INJURED. THAT'S WHAT IT'S ALL ABOUT. SO WHEN YOU HAVE TOO MUCH OF THAT, DOES IT AFFECT THE DNA, WHAT HAPPENS HERE?
NADINE BURKE HARRIS: YES, IT DOES. SO WHAT WE SEE IS THAT IT ACTIVATES THE STRESS RESPONSE. WE SEE THE RELEASE OF HIGH LEVELS OF STRESS HORMONES. AND THESE STRESS HORMONES ARE DESIGNED TO PREPARE OUR BODIES FOR SURVIVAL. IF IT'S ACTIVATED TOO OFTEN, THEN WHAT WE SEE ARE THINGS LIKE CHRONIC INFLAMMATION AND EVEN CHANGES TO THE MARKERS ON OUR DNA, OUR EPIGENETIC REGENERATION. THAT CHANGES THE WAY OUR DNA IS READ.
TED SIMONS: THAT’S INTERESTING. AND WHAT’S INTERSTING IS INFLAMMATION IS ONE OF THOSE WAYS THE BODY PREPARES FOR INJURY. IS IT NOT? YOU WRITE ABOUT SOMEBODY NAMED DIEGO. WHO IS DIEGO AND HOW DID HE CHANGE YOUR ENTIRE VIEW OF THIS?
NADINE BURKE HARRIS: DIEGO IS A PATIENT THAT I FIRST SAW MORE THAN 10 YEARS AGO NOW. AND HE WAS A YOUNG BOY WHO CAME INTO SEE ME AND HE WAS INTIALLY REFERED—HIS TEACHER TOLD HIS MOM THAT SHE WAS WORRIED THAT HE HAD ADHD OR ATTENTION DEFICIT HYPERACTIVITY DISORDER. AND WHEN I EXAMINED HIM, WHAT I FOUND WAS THAT HE HAD MULTIPLE HEALTH PROBLEMS. HE HAD ASTHMA, HE HAD ECZEMA, SKIN INFLAMMATION. THE MOST STRIKING THING ABOUT HIM WAS THAT HE WAS REALLY SMALL. EVEN THOUGH WHEN I SAW HIM, HE WAS SEVEN YEARS OLD. THIS IS A LITTLE BOY WHO HAD STOPPED GROWING. AND WHAT I FOUND OUT WAS THAT AS I LOOKED AT HIS HEIGHT, HE WAS THE AVERAGE HEIGHT FOR A FOUR-YEAR-OLD. AND IT TURNS OUT THAT HE HAD STOPPED GROWING AFTER A SEXUAL ASSAULT. IT’S CERTAINLY A VERY STRIKING PRESENTATION. WHEN I SPOKE WITH THE ENDOCRINOLOGIST, THE HORMONE SPECIALIST, WHAT SHE TOLD ME WAS THAT THIS WAS NOT UNPRECEDENTED, AND IN FACT THE IMPACT OF TRAUMA ON CHILDREN'S DEVELOPING BRAINS AND BODIES ARE MUCH MORE SIGNIFICANT THAN MANY OF US PREVIOUSLY THOUGHT.
TED SIMONS: AS A FOUR-YEAR-OLD DIEGO EXPERIENCED SOMETHING TERRIBLE. HIS BODY REACTED WITHOUT HIM REALIZING IT. AS A CHILD GETS OLDER, EVEN YOUNG ADULTS, DOES THAT SAME THING HOLD THROUGH?
NADINE BURKE HARRIS: YES. SO WHAT WE CAN SEE ARE FOR KIDS WHO ARE EXPOSED TO HIGH DOSES OF ADVERSITY, CERTAINLY GROWTH IS ONE OF THE THINGS THAT CAN BE AFFECTED, BUT WHAT WE ALSO CAN SEE BE AFFECTED IS THEIR RISK OF ASTHMA, THEIR RISK OF INFECTION, RISK OF BEHAVIORAL PROBLEMS, EVEN RISKS FOR THINGS LIKE DIABETES. AS WE GET OLDER, WHAT WE SEE IS THAT INDIVIDUALS THAT HAVE BEEN EXPOSED TO FOUR OR MORE OF WHAT THE CDC LOOKED AT IN THEIR SEMINOLE RESEARCH STUDY, CALLED ADVERSE CHILD EXPERIENCES, THEY CAN HAVE DOUBLE THE RISK FOR HEART DISEASE, DOUBLE THE RISK FOR CANCER, TWO AND A HALF TIMES THE RISK OF STROKE, ALMOST FOUR TIMES THE RISK OF CHRONIC LUNG DISEASE.
TED SIMONS: THAT'S DISCOURAGING. LET’S TALK ABOUT SOMETHING ENCOURAGING. WHAT CAN—IF SOMEONE DOES EXPERIENCE THIS, WHEN DIEGO GETS TO BE 30, 40, 50 YEARS OLD, CAN HE DO ANYTHING TO REVERSE THE PROCESS?
NADINE BURKE HARRIS: THERE IS A TREMENDOUS AMOUNT THAT FOLKS CAN DO. IN THE TWO DECADES SINCE THE CDC PUBLISHED THIS LANDMARK STUDY, THERE HAVE BEEN TREMENDOUS ADVANCES IN THE SCIENCE IN HOW WE CAN ADDRESS TOXIC STRESS. AND THIS IS WHAT I TALK ABOUT IN THE DEEPEST WELL. ONE OF THE MOST IMPORTANT THINGS, WHETHER IT’S FOR KIDS OR FOR ADULTS IS RECOGNIZING THAT YOU MAY HAVE AN OVERACTIVE STRESS RESPONSE, LOOKING AT YOUR OWN ADVERSE CHILDHOOD EXPERIENCES SCORE. YOU CAN FIND THAT IN THE BOOK. THEN, GO FROM THERE DOING SOME OF THE INTERVENTIONS THAT WE KNOW MAKE A DIFFERENCE. ALL OF THE RESEARCH TELLS US THAT SAFE, STABLE AND NURTURING RELATIONSHIPS AND ENVIORNMENTS ARE HEALING BOTH FOR KIDS AND ADULTS. THINGS LIKE EXERCISE, NUTRITION, MINDFULNESS, MENTAL HEALTH, ALL OF THESE THINGS COUNTERACT THE BIOLOGY OF TOXIC STRESS.
TED SIMONS: COPING SKILLS IN OTHER WORDS?
NADINE BURKE HARRIS: WELL IN ADDITION TO COPING SKILLS IT'S REALLY ABOUT HELPING THE BODY METABOLIZE STRESS HORMONES. THINGS LIKE EXERCISE, THEY REALLY REDUCE HORMONES, REDUCE INFLAMMATION AND INHANCE NEUROPLASTICITY.
TED SIMONS: THIS KIND OF INFORMATION I WOULD ALSO IMAGINE STRESSES THE NEED FOR FAMILY COUSELING. BECAUSE YOU DON'T WANT THE DIEGOS TO GET STARTED ON THAT PATH TO BEGIN WITH.
NADINE BURKE HARRIS: THAT'S RIGHT. ONE OF THE MOST IMPORTANT THINGS THAT WE CAN DO IS PROVIDE THIS SUPPORT IN A MANNER THAT WE CALL TWO GENERATION. SUPPORTING THE CARE GIVERS AND SUPPORTING THE CHILD. BECAUSE IF THERE IS ONE THING THAT WE SEE IS THAT WHEN WE SEE A CHILD WITH HIGH LEVELS OF ADVERSITY, MOST OFTEN THEIR PARENT HAD HIGH LEVELS CHILD ADVERSE EXPERIENCES.
TED SIMONS: I WAS GOING TO ASK YOU ABOUT THAT. IF A CHILD EXPERIENCES THIS, DO THEY GRAVITATE TOWARD MORE OF THAT. I MEAN IS IT IS IT SOMETHING THAT THE BODY SAYS, I DON'T LIKE THIS, BUT I AM USED TO IT, I CAN HANDLE IT BECAUSE I HANDLED IT ONCE.
NADINE BURKE HARRIS: WITHOUT EDUCATION OR INTERVENTION, THAT'S OFTEN TIMES WHAT WE SEE. WE SEE THIS PATTERN BEING REPEATED AND HANDED DOWN FROM GENERATION TO GENERATION TO GENERATION. I WILL TELL YOU THAT EVERYDAY IN MY CLINICAL PRACTICE, WHAT I SEE IS THE POWER OF EARLY INTERVENTION, THE POWER OF DETECTION AND SUPPORTING FAMILIES DOING THE EVIDENCE BASED INTERVENTIONS THAT WE KNOW ARE EFFECTIVE, AND WE CAN BREAK THE CYCLE OF CHILDHOOD ADVERSITY.
TED SIMONS: THIS INFORMATION, WE ARE ALMOST OUT OF TIME HERE, THIS RESEARCH, WHAT YOU EXPERIENCED WITH DIEGO, HOW HAS THAT CHANGED YOUR PRACTICE?
NADINE BURKE HARRIS: IT HAS TRANSFORMED MY PRACTICE. WHAT WE HAVE DONE, WE CREATED THE CENTER FOR YOUTH WELLNESS IN SAN FRANCISCO. WE NOW SCREEN EVERY CHILD FOR ADVERSE CHILDHOOD EXPERIENCES. UNFORTUNETLY ONLY 4% OF PEDIATRICIANS ARE DOING THAT. WE NEED TO HAVE EVERY PEDIATRICIAN IN AMERICA SCREENING FOR ADVERSE CHILDHOOD EXPERIENCES. WE HAVE PUT INTO PLACE THE EVIDENCE-BASED INTERVENTIONS THAT WE KNOW ARE EFFECTIVE AT IMPROVING HEALTH OUTCOMES FOR KIDS.
TED SIMONS: ALL RIGHT. DOCTOR NADINE BURKE HARRIS. THE DEEPEST WELL. YOU’LL BE CHANGING HANDS AGAIN. IT’S FASCINATING—THE SCIENTIFIC RESEARCH IS REALLY CHANGING EVERYTHING ISN’T IT?
NADINE BURKE HARRIS: IT ABSOULETLY IS.
TED SIMONS: CONGRATULATIONS ON YOUR GREAT WORK. THANK YOU FOR JOINING US.
NADINE BURKE HARRIS: THANK YOU. IT’S AN HONOR.
TED SIMONS: TOMORROW ON "ARIZONA HORIZON," IT'S THE JOURNALIST ROUND TABLE. REPUBLICAN LAWMAKERS WANT VOTERS TO UNDUE THE STATE’S MINIMUM WAGE INCREASE. GOP LEGISLATORS ARE READY TO ASK VOTERS TO CONSIDER THE STATE’S INDEPENDENT REDISTRICTING COMMISSION. THAT'S FRIDAY HERE ON THE JOURNALIST ROUND TABLE. THAT'S IT FOR NOW. I'M TED SIMONS. THANK YOU SO MUCH FOR JOINING US. YOU HAVE A GREAT EVENING.
Dr. Nadine Burke Harris: Author, “The Deepest Well”