and the National Native Children's Trauma Center

The Organization for Economic Development and Cooperation has completed a study that shows the number of kids in single-parent families in the United States is abnormally high (one in five), compared to the rest of the developed world. This statistic is strongly linked to a couple of others, the number of children living in poverty, but also the abnormally high number of working poor in the nation. The study also points to policy in other nations that helps alleviate these burdens for kids.

The Washington Post has the story.

One of the reasons New York Times columnist Paul Krugman is so successful is he can reach across a variety of topics and not stay confined to the discipline that won him a Nobel prize, economics. In a recent column he made such a reach, and it struck a chord in our field, although he intended something more limited.

His topic was a simple word choice, and he took strong exception to the growing use of the label “consumer” when speaking of patients in the health care system. It reminded me that using the same label is becoming widespread to the point of politically correct within social services and mental health care, and the practice in these fields is, if anything, even more offensive.
In some sense, this sort of development is business as usual within social services. There is a strong and misguided subset of the field that promotes what I call the “euphemism of the month club.” The assumption is that if we simply apply less “hurtful” language to the problem at hand, the problem will go away. Thus, it is no longer okay to call a kid “retarded,” but “delayed” works, and I guess I get that. Still, a dictionary definition says these two words say the same thing, and I suspect the kids in question would just as soon have appropriate care as a new label.
Often, too, this impulse is less benign. Thus the idea of giving public money to religious organizations is politically suspect, but it is now completely acceptable to support “faith-based organizations.” This would not be the first example in all of history of a bureaucracy using euphemism to cover its tracks.
But I don’t get the preference for “consumer.” I am told the use of the term in social work arose in a reaction to the term “client,” which the language police of the day have judged to be demeaning. Somehow the word implies the therapist is in control of the client. Say what?
A lawyer has clients, but this certainly does not imply control. A client is free to fire a lawyer any time she chooses. What the word does imply is a relationship of advice and consent, in which both parties have agency, something more complex than buying an iPad. As Krugman writes in his column:

The relationship between patient and doctor used to be considered something special, almost sacred. Now politicians and supposed reformers talk about the act of receiving care as if it were no different from a commercial transaction, like buying a car — and their only complaint is that it isn’t commercial enough.

This holds doubly for the care of emotional health. How is it we have come to think of a therapist’s care as a unit of production that someone takes home to “consume,” the way we buy groceries, consume them, then go buy some more? Or think of the more extreme meaning of the word in the common language as in: “The house was consumed by fire.” If we do our work right, nothing gets consumed. Just the opposite. A relationship builds. Something that didn’t exist before appears and endures.
What goes on between a therapist or a social worker or a teacher and the people they work with is not reducible to a commodity that fits in a bag in the trunk of a car. It is a relationship, an interchange of human response, emotion and wisdom that changes everyone in the process. These people do not transact; they engage. Why on earth would we demean this process with the language of commerce?

The New York Times reports this morning on some mounting evidence about the ways meditation practice physically alters the brain.

How Meditation May Change the Brain – NYTimes.com.

Bessel van der Kolk, one of the world’s leading experts on post-traumatic stress and childhood trauma, will deliver a public lecture in Missoula on January 24. The appearance marks the beginning of van der Kolk’s formal collaboration with the Institute for Educational Research Service at the University of Montana.

Van der Kolk trained as a psychiatrist at Harvard University and began his career by working with veterans of the Vietnam War who were suffering what had been labeled “shell shock” or “battle fatigue” in earlier wars. He was instrumental in more thoroughly classifying it as post-traumatic stress disorder and led the field trials that formalized the diagnosis in the Diagnostic and Statistical Manual of the American Psychiatric Association. He subsequently became interested in a parallel problem in children, especially those who suffer the ill effects of child abuse, domestic violence and poverty.

His work was pivotal in the founding of the National Childhood Traumatic Stress Network, sanctioned by Congress in 2001. The network has since carried out research on the causes and remedies of childhood traumatic stress. The National Native Children’s Trauma Center at UM, a part of IERS, is one of seven major centers in that network.

The body of research has demonstrated that childhood traumatic stress or “developmental trauma” is surprisingly common, especially among children living in poverty, can physically affect brain development and is linked to the nation’s leading social problems, such as alcoholism, drug abuse, juvenile crime, suicide, school dropout, bullying and continuing poverty. One major study in California concluded mistreated children die, on average, twenty years earlier than other people.

Van der Kolk has agreed to directly engage major IERS projects in the state. The Missoula-based institute has partnered with the state Office of Public Instruction to reverse the fortunes of the state’s lowest performing schools and at the same time has partnered with Missoula County Public Schools to effect similar results in the District’s Region 3. Van der Kolk will be briefed on those efforts during the day of January 24 then will synthesize and embed that information into his discussion about childhood trauma at the public lecture.

Van der Kolk’s expertise is broadly interdisciplinary and relevant for professionals from psychologists, counselors and caregivers to educators, victim advocates, law enforcement officers and welfare workers. He practices a wide range of interventions in fields ranging from yoga and meditation to theater.

Exploratory Beyond Trauma, a Missoula-based network of people who treat trauma, sponsored a daylong presentation by van der Kolk in May of 2009, an event attended by more than 100 local therapists.

The January 24 lecture will begin at 7 p.m. at the Urey underground lecture hall on the University of Montana Campus. Admission is free.

Van der Kolk and his various collaborators have published extensively on the impact of trauma on development, such as dissociative problems, borderline personality and self-mutilation, cognitive development in traumatized children and adults, and the psychobiology of trauma. His current research is on how trauma affects memory processes and brain imaging studies of PTSD.

He is past President of the International Society for Traumatic Stress Studies, professor of psychiatry at Boston University Medical School, and medical director of the Trauma Center at HRI Hospital in Brookline, Massachusetts. He has taught at universities and hospitals across the United States and around the world, including Europe, Africa, Russia, Australia, Israel, and China. His latest book, co-edited with Alexander McFarlane and Lars Weisaeth, explores what we have learned in the past twenty years of the re-discovery of the role of trauma in psychiatric illness. Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society was published by Guilford Press in May, 1996.

The emerging field of social neuroscience has taken a long look at loneliness and found suppressed immune systems, heart disease and depression. Interestingly, both the neuroscience and biochemistry of this problem look very much like what we know about trauma. At the root of this are cortisol and adrenaline, the stress chemicals. Loneliness also triggers the body’s fight or flight response, which is probably evolution’s way of telling us we are in danger when we isolate ourselves from the protection of others. The findings are reported in detail in Science magazine.

Some months ago we reported the beginnings of an important project in Missoula, the renovation of a former warehouse at 825 W. Kent to house the Red Willow Learning Center, a project specifically directed at the treatment of trauma. So now the work is done and the doors are open, and the project’s backers plan an open house at the new center. Details are below:

Although conventionally trained as a psychiatrist, Bessel van der Kolk is known for exploring unconventional interventions for trauma, especially what he calls “bodywork.” He is particularly fascinated with yoga. He elaborated on this idea in detail in an interview with Integral Yoga Magazine, and we offer a link to that interview below.

Van der Kolk is scheduled to speak in Missoula on January 24 at 7 p.m. in the Urey underground lecture hall at the University of Montana. The event is free and open to the public.

Download the pdf: van der Kolk on yoga

The University of Washington has shown that the Steps to Respect program prevents bullying by preventing gossip. The research demonstrated a 72 percent reduction in gossip, but also explores the strong link between schoolyard gossip (itself a form of bullying) and physical abuse.

Anti-bullying program reduces malicious gossip on school playgrounds.

Bessel van der Kolk, one of the world’s leading experts on childhood traumatic stress and post-traumatic stress disorder, has confirmed he will speak in Missoula on January 24. The appearance will most likely be on the University of Montana campus at 7 p.m., with the exact location to be announced soon.

The appearance comes at the beginning of a direct collaboration between van der Kolk’s Trauma Center at JRI and the Institute for Educational Research and Service at UM. As part of that collaboration van der Kolk will consult with IERS and its National Native Children’s Trauma Center on a variety or projects, both in Missoula and on Native reservations around the nation.

His lecture will be free and open to the public.