Childhood Trauma and Resilience with guest Dr. Marc Hauser

Have you ever wondered why some people are more resilient to childhood trauma? Or why the same adverse experiences can impact children and teens differently depending on where they live, how they were raised, or even how they perceive the experience? On this episode, Dr. Amy and Sandy are joined by Dr. Marc Hauser, a scientist with more than 300 published papers and seven books who has worked with at-risk children to help recover from their experiences and boost resilience. Sharing both scientific research and personal experience from working with at-risk youth, Marc helps break down some of the “why” behind the effects of adverse and traumatic experiences, as well as what parents, teachers, therapists, and other caregivers of at-risk children and teens can do to best support them. Join us for this in-depth conversation that touches on everything from corporal punishment in schools and neglect in Romanian orphanages to the impact of community violence and how chronic stress impacts the immune system. 

ABOUT DR. MARC HAUSER:

Dr. Marc Hauser is a scientist with over 300 published papers and 7 books, a public intellectual, and an educator who has worked with children ages 4 and above, as well as teachers, professors, doctors, nurses, and therapists. Over the past decade plus, he has worked both nationally and internationally with vulnerable at-risk children, including those with trauma histories, helping them to recover from their experiences and build resilience. His new book, “Vulnerable Minds; The Harm of Childhood Trauma and the Hope of Resilience” came out March 12, 2024.

CONNECT WITH DR. MARC HAUSER:

• https://marcDhauser.com

• iCAN (Child Aid Network): https://mdhevolve.wixstudio.io/ican

• X: @md_hauser

• Instagram: mdhauser2020

• LinkedIn: @mdhauser

• Facebook: MarcDHauser

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Transcript

DR. AMY: Hi, smart moms and dads. Welcome to another episode of the Brainy Moms Podcast, brought to you today by LearningRx Brain Training Centers. I'm your host, Dr. DR. AMY Moore, and I am joined by my co-host, Sandy Zamalis. Sandy and I are super excited to welcome our guest today, Dr. Marc Hauser. Marc is a scientist with over 300 published papers and seven books, a public intellectual, and an educator who has worked with children ages four and above, As well as teachers, professors, doctors, nurses, and therapists over the past decade plus. He has worked both nationally and internationally with vulnerable at-risk children, including those with trauma histories, helping them to recover from their experiences and build resilience. He's here today to share insights from his new book, “Vulnerable Minds; The Harm of Childhood Trauma and the Hope of Resilience.” Welcome, Marc.

MARC: Thank you very much. Looking forward to the conversation. 

SANDY: Yeah, we're so glad to have you here. You have a really interesting background, especially with your work. So, we always like to start each episode by having our guests tell us how they got involved in their area of expertise. Would you explain for our listeners how you got interested in helping at risk kids and people with childhood trauma? 

MARC: Yeah, I'd love to. So my background is in the neurosciences and kind of more formally and kind of the basic research end of this and an interesting experience I had about 13 years ago is that my next-door neighbor on the Cape said, “Hey, you know, you should come visit this island where there's a bunch of kids who live in a school.” And there are kids who have had a really difficult time. And they have been given an opportunity to go to the school, which has about 13 boys. All have been told, you know, kind of by a judge often, because they've had a criminal record, that this is kind of their last shot. You got to give it a shot. And the idea behind the school was—brilliant idea from a man who was a Yale graduate and then a Navy Marine —that maybe kids need to get away from the fray of the city and just kind of live off the land, work to learn to work together and kind of rebuild, you know what they've lost. And so I went out and I visited and I was absolutely taken by the boys, the school, what they were trying to do. And an opportunity to help kids think more critically about what they do. And I got really pulled into kind of the at-risk population in that way. And that, in some ways, started me down the path of getting involved directly with schools. So that was really kind of the, the first taste for me of what to do. And then what really drove me passionately for it was realizing that so much was known from kind of the cognitive and neurosciences that wasn't really in the hands of people working with these kind of kids. So they were working incredibly hard. It's very, very difficult work. Both kids who have trauma histories, children with different kinds of disabilities. It's very difficult work. And I felt there was a lot that was learned or being known about the way the mind, brain and body work that could be very helpful. So I felt like an incredible opportunity to bring my knowledge in a more practical way for kids who really deserve ways of improving their own lives. And for many of them regaining childhood. 

DR. AMY: Yeah. So there's a big push right now to make sure that most of the professions that work with children and families have trauma-informed training of some sort. And so that's become a buzzword, right? Like we're trauma informed now. But what I really appreciated about your book is you made a clear distinction between how kids respond to trauma—I'm sorry —how kids respond to adverse childhood experiences with a trauma response versus those who respond with a resilient response. Can you talk a little bit about that? 

MARC: Yeah, sure. So I think one of the kind of the inspirations in the book, or the way that books are kick starts, is something that may be actually familiar to some, not maybe most of your listeners, which is that in the late Nineties, a very important paper was published by a doctor in San Diego. Dr. Vincent Felitti was a preventative medicine doctor and what he pointed out in this paper was that there were a set of adverse childhood experiences that he defined as adverse, meaning “out of the norm of sort of typical experiences,” and we should come back to that notion of typical. Childhood was defined as kind of birth to the age of 18. And experience was left kind of undefined. But the key idea was that it was about the experience. But what he did in the paper, which was really the key piece, was he linked the score of adverse childhood experiences, which you could have anywhere from 0 to 10, because there were 10 different types of adversity. Things like emotional neglect, physical neglect, physical abuse, emotional abuse, sexual abuse, mental health of a parent, incarceration of a parent, and so forth. All things that could happen within a family environment. So your score was between 0 and 10. And then for these individuals who were all adults, obviously over the age of 18, he had information on various physical and mental health issues. None? Problems with, let's say, obesity, cancer, smoking, and all these other kinds of health issues. And the short version of what he found was that the more adverse childhood experiences an individual had, the higher the level of health problems there were. In other words, adverse childhood experiences were in some ways predictive of adult health problems. Okay, so that in a nutshell is kind of the paper. And soon enough, obviously, people outside the United States got very interested in this and the World Health Organization proceeded to develop a kind of an international versions of this questionnaire. And lo and behold, and perhaps not surprising for many, adverse childhood experiences are not a U.S. phenomena. They're not a California problem. They are global problems. The World Health Organization estimates that about a billion children per year are maltreated with things like neglect and abuse. So these are massive numbers. One thing that happened with that a score was that it became in some ways interpreted as the response to the experience as opposed to the experience itself. That score is not a measure of how anybody responds to it. It's a simply a measure of the experience. Moreover, it's simply you had it or you didn't have it. Not when you had it, not how long it lasted, how severe it was or anything about your response to it. So it's really important for all of us to think about what are the experiences and who responds to those in a traumatic way. Simply meaning some kind of scarring to the body and brain, and who responds with a more resilient response. In other words, they kind of bounce back from the experience. They lose a parent and they bounce right back. Or they lose a parent and they become extremely depressed, they shut down, they don't want to be around, their relationships break apart, and so forth. We want to understand that individual, those individual differences, because that is our best chance for designing interventions to help those who respond traumatically, why do they, and why do some respond with resilience. So, that piece, so the acronyms for me are Adverse Childhood Experiences (ACEs); Traumatic responses (or TRACES) to the adversity; and then resilient responses (or RACES) and we want to understand that entire package. So, for the listeners today, the key piece is just because your child has experienced some adversity does not mean they are going to respond traumatically. Some do and some don't.

DR. AMY: Yes, and so we want to learn from those children who responded in a resilient way, so that then we can help children who respond in a traumatic way. 

MARC: That's right. And I think there's a really important piece here on both the traumatic and the resilient end. So let's imagine, just to put a little image in people's head a scale that runs from vulnerable on the left, meaning a traumatic response, to resilient on the right. So we've got a spectrum of responses right from highly vulnerable traumatic resilient to highly resilient. It's important to realize that the level of the individual, both nature and nurture are contributing to where you land on that spectrum. Nature is what you're given, and nature is kind of a starting point, but nurture is also part of that starting point, and depending on how things unfold over time, one can move along that spectrum in both directions. You might start with an incredibly resilient nature, and because of nurture, you may slide towards that vulnerable end. In the same way that you may start with a very meek, resilient nature, but because of nurture, slide yourself over towards the resilient end. And so it's important to think about that balance, both what's the starting state and how do things unfold over time. And that unfolding over time is especially important for the parents listening today, because when the adverse childhood experiences work was done, childhood was defined as a period from birth to 18. But that's a lifetime for some people. And we know from hundreds and hundreds of papers in sciences that there are these windows of opportunity in development where if certain experiences happen, those systems of development—like language, like emotion, like social behavior and relationships—if those experiences happen, those systems unfold in a species-typical way. Something as typical of human beings. If those experiences don't happen or adverse experiences happen in those windows, they may never develop or may develop with great delays. So, that birth to 18 is too big a period to understand what's happening to a child. We know, again, some broad claims here, adversities that happen in those early first few years are far more detrimental than those that happen later on. Those early periods are incredibly vulnerable to either neglect deprivation or adversity, because all the systems of the brain and body are being woven together and built. So, if you don't get the experience, you may never develop them for certain things, or you may have such significant delay that it impacts many, many aspects of thriving.

SANDY: I like the way you're describing this on a spectrum. I know one of the quotes I really picked up on in your book was that you said at the very end, when you were tying out, or kind of explaining the 6 different things you'd love to see changed. And you talked about how children who present with a resilient shell often conceal an epigenetically aged core. And I feel like that's talking, you're talking about that spectrum here and what you're saying is just because you may have a resilient response, doesn't mean that that trauma is not impacting somehow. So what do you mean by that? What kinds of things? Cause that's where you were talking about with aces to that. It really was put together with these experiences and health conditions. So what are we talking about when we see the health part of the impact of things? 

MARC: So, I think, you know, one of the examples I use in the book, and this, this may kind of just ring true for sort of visually for some of your listeners is I spoke about, you know, in some ways, the sad case of Sinead O'Connor. And she was somebody if you look on Google for Sinead O'Connor in her teenage years was this absolutely sparkling, vivacious young woman. I mean, her eyes just glistened with charm and aliveness and passion. And yet we know from her memoir that she was being abused severely by her mother. And so here is this shell that is appearing and certainly by all of her successes, incredibly successful, right? So she was a pop star at a very, very young age. You know, all the images of her looks like she's doing amazingly well. And yet she was in some ways stifling all the pain that she was living with. And we know that when Individuals are having to fight hard to suppress the stress that they're living with, that ultimately, what it does, putting it very simply, is it eats away at the immune system. It's toxic to that immune system. And, of course, that ultimately is the carrier of our health, right? So when that immune system is compromised, our health goes down. And so here's Sinead O'Connor who dies at the age of 56, right? A young age. So she was fighting that. And that's what we see over and over again. Vincent Felitti, who I mentioned earlier, who's in some ways kind of the discoverer of the ACEs work or the originator of it, had been in contact with a woman who contacted him after the original publication who was a circuit court judge. Again, by every measure of success, at least professionally, super successful. Turns out she had been pimped out by a grandfather when she was younger, at a very young age, and she was suffering from four different types of cancer. Again, completely compromised immune system. So we have over and over again, and I'm giving you individual cases, but this is backed up by much more significant evidence, that when that kind of toxic stress that build-up of the stress system is continuing chronically and importantly, this is why that notion of experience. It's not kind of a one off that's going to do this, right? It's that chronic experience of adversity with a traumatic response, that system effectively is eating away at that immune system. And as all of us know, just from personal experience, when you're stressed, your thinking doesn't go so well, right? Everything is kind of clouded up. And so I who work, for example, in schools and for parents who have young kids, if the environment is a stressful one, things like word retrieval, memory, get compromised by the stress system. And so that's really important, for example, for educators. Kid riding in on a bus who's living in a stressful environment and the first thing they get is an ELA quiz. Forget it, right? It's like game over. Like, that's just not going to work. And so the sensitivity to what's coming in from the home environment on the bus ride, right? All those things are building up into the school. And that is important because effectively that's affecting the working system going into those kinds of environments. 

DR. AMY: So, I'd like you to talk a little bit more about this immune system suppression. You know, I work in the space of, you know, teaching parents about emotion dysregulation from chronic stress, right? And how the, the whole fight, flight, or freeze and the cortisol release and all of that really impacts the ability to regulate emotions and of course, attend to anything in that hulk brain mode. But it isn't as well known that this is having an impact systemically on the body. And so can you just talk more about that? Because I think it's really important that we hear that. 

MARC: Yeah, so there was a really nice—just to pick up one example. There was a really nice study that was done in kind of the inner city of Chicago with African American kind of young adults. And what they did was they first did an assessment on their sort of self-control. How in control are they? You know, you know, are they able to, you know, keep things under wraps, you know, kind of make good decisions, evaluate, you know, pros and cons, short term, long term, a variety of measures of just self-control. So, again, and, you know, get your head in your head an image on the left-hand side is super impulsive and on the right is completely under control. And of course, they linked those with things like productivity in the job, like, you know, so high self-control often linked to better health, better wealth and so forth. But what they also measured in these individuals was they measured something that is basically our biological clock. And so imagine you've got two clocks in your system. There's how old you are. You were born on this date night. You're 33. Okay, so that's just the chronology. But then there is the kind of the wear and tear on your body. So again, sort of analogously to the rings of a tree, right? So we can look at the rings of the tree and we can age a tree. And in some ways, you can see between the distance between the rings, something about the stress on the tree. Was there enough water in this year? Was there a sort of, you know, strange temperature differences, right? And so that's kind of the aging of the tree. We have similar things in our body that can be measured, and what they found was that those individuals with the highest self-control were aging biologically more than those with less self-control. In other words, by keeping things under wraps when things get difficult, they were effectively aging themselves. Okay?

DR. AMY: Wow. 

MARC: So this is kind of the pros and cons. In some ways they've done well by that because they've got better incomes, many better jobs. Maybe they got better family life, but they're effectively aging themselves by pushing that stress down. Okay? And this is very relevant to something that's happening today that many of us are certainly a worried about and concerned about, which are the wars that are happening in places like Gaza and the Ukraine. One of the things that comes out of some of that work and strikingly, it comes out of a Israeli researcher, Ruth Feldman, who works in Gaza, is that—this is now, she's been studying the Israeli children, but my guess is that this is generalizes to any child—is that children confronting war, obviously an incredibly stressful experience, those who kind of acknowledge the horror of the experience do better in terms of recovery than those who avoid the horror. In other words, all else equal, if you go, “Nope, this has been okay, this is fine, no problem, war, nah, nothing, I don't know,” those who go, “Oh my god, this is horrible, like this is the worst nightmare of my life” actually recover better. And that's an important tell, because for recovery, and this of course is known to any therapist, it's confronting and dealing with what the experience is rather than suppressing it. And so in some ways, what you mentioned before is that kind of emotional regulation, dysregulation. Those who in some ways are better able to regulate but ignore what's causing it are less able to be successful in the long run because it's hammering the biology.

DR. AMY: Wow. Fascinates me. 

SANDY: I know my brain is spinning and just even thinking. You know, we have parents that listen to our podcast and, you know, this may seem like it's far removed from them because they're doing the best they can with their kids. But what I'm basically hearing you say is that even our own personal experience could be affecting our today. Let's talk about that a little bit and give our listeners some, some guidance on dealing with their own experiences as parents and how that maybe is manifesting with their own children. 

MARC: Yeah. So I think there's two kind of questions there. One is kind of the experience of a parent with a child. And then there's maybe, you know, maybe there's some room for discussing some potential practical strategies. And let me just make a, I'll put a little push pin on the second part, just to put a frame around this. It's absolutely the case that when many of us think about war, we think, well, that doesn't happen on our soil as Americans. Well, you know, violence, certain happens, community violence happens. You may not want to call it a war. But the stress of living in a violent community is certainly something that is a familiar experience to Americans. And one of the analogies that I make in the book is that war may seem unfamiliar to Americans who have only lived in this country, let's say, but gang violence certainly is not something that is foreign to the soil. And so I would encourage people to think about different kinds of exposure to violence as the key lens for this part of the conversation.

DR. AMY: So things like school shootings.

MARC: Yep. Absolutely. Right. Car shootings, carjacking, domestic violence, you know, aggressive drivers, right? Anything that is a potential or perceived potential threat to me, are the things that trigger our stress systems and our fear systems. And some kids are living in that. You know, because you look at the book, I start the story off with the story of LeBron James, the basketball player's life. And he was exposed to hearing sirens and gunshots as a young child. So that's what he lived with. And here's someone who's been very successful, but that was his early childhood. So that, I think that's just a good lens for people to think about. Our stress system wasn't wired necessarily for war, but for things that threaten our survival. And there's enough of those going on in our own country to be worried about.

SANDY: I think COVID probably encapsulates that as well. I mean, we all experienced that.

DR. AMY: Well, really, the early response to COVID, right, was instilling an enormous amount of fear. 

MARC: An amount of fear, and I would add an ingredient, which is it also instilled tribalism, right? There was the maskers and the non-maskers. There was those who were socially distancing and those who weren't. And so we quickly use that as a vehicle to go, “You're bad, you're good,” you know, “What are you doing in line so close to me?” Right? I mean, all of our fear systems just got triggered right up. Okay. Also, and we'll get back to this sure, COVID stripped many of our youngest from their social experiences and deprived them of what they need. Okay. So let's come back to the parents now. So, one of the things that's also very relevant about this, and your COVID example is a good one to insert here as well, is we know that for parents, their stress levels, either from their prior experience as children that they're bringing forward into their own parenting, their current stress during pregnancy, and their stress upon their child's birth will greatly impact that child's development. I want to bracket all three of those bins because they potentially affect different stages of the development. Let me just start with the stress of a pregnant mother, because some of your listeners may be mothers to be, and they're pregnant. We now know from many, many studies, but I'm going to start with one that was done with pregnant mothers during Hurricane Sandy, the hurricane that hit the southern coast of, you know, of New England, New Jersey. This was a study that looked at mothers who kind of gave birth before Hurricane Sandy, mothers who were pregnant during, and kind of mothers who were pregnant right after. Okay. And they followed their children up until the age of about 5. What they found was that mothers who were pregnant during Hurricane Sandy, those kids at the age of five had a massively higher mental health burden than other children who were born before or those who were after. Girls showed something different than boys. Typically speaking on the mental health spectrum, again, broad generalization, lots of individual differences, girls tend to internalize more and boys tend to externalize. So the boys were showing much more in the way of oppositional defiance and ADHD and the girls were showing more in the way of anxiety and depression. The numbers were through the roof. Now this is 10,000 individuals, but it was substantial and it really points to how the stress physiology of a pregnant mom is going to affect the development of her baby. That's before the baby's even born. So that's one piece. Now, take that and think about moms who may have experienced neglect or abuse when they were children and how that psychology may be carried forward to their own children. Because maybe they were never modeled how to invest in a baby, how to attach to a baby, how to engage and respond appropriately to a baby. And so the mental health that they carry forward from their own potential trauma can affect directly that baby. Let me put a little frame on this to help. One of the nice analogies or metaphors that people like to use about the nature of attachment is that to think about it like a tennis match. Baby serves up a need, parent returns that serve. Okay. So it's a serve-and-return match. Okay. Now, when it's working well, there's a synchrony between the baby serve and the mom or dad's return. Baby cries, mom or dad picks baby up, feeds baby, baby reaches their hands up to be picked up, parent picks the baby up. That's not to say that every serve from the baby needs to be returned or should be returned. If my 3-year-old says, I want an iPhone. I'm like, “Sorry, dude. You're three years old.” Excuse me. No, right? And we often have to teach them that not every need that they feel they need gets returned. But on average, the match works well, like in tennis, when serves are synchronized with returns. Timely and appropriate.

When that's not happening, here's what happens to babies. They're like, “Man, I really needed some help.” I mean, I'm the thought bubble in the baby's head, right? “I really needed to be picked up and you're not doing that.” So the world now feels unsafe and I'm not getting my needs met. And so things like being curious and exploring, the world feels too unsafe because I'm not getting basic needs met. When a parent has had their own traumatic experience as a child, may have been neglected or abused, that serve-and-return relationship wasn't form and they know that. They may not know it explicitly like I'm saying it, but they feel it. They know it in that unconscious way. And that may be how they respond to their own child. And so critically for parents, it's both coming to grips with what was experienced and really embracing this idea that strong attachment comes from that synchronized serve-and-return relationship. And that's language. It's emotion. And it's social. And all those pieces form that attachment relationship.

DR. AMY: That was a great analogy, the tennis analogy, for sure. So then talk a little bit about, middle childhood, adolescence, teenage years. What should parents be looking for? How are those early adverse childhood experiences, the response to those, manifested in the later childhood years? 

MARC: Yeah, so I think one of the things that we haven't really touched up on, but I'll this is a good chance to kind of put a point here, is it's really important for parents and educators, those working with children, to be really clear about the type of adverse childhood experience that a child encountered, because different types will often lead to different kinds of behavioral psychological manifestations. Let's make one distinction. Let's think about the difference between neglect or deprivation and abuse. We now know from many, many, many studies, many of them I discuss in the book, that those different types of experiences lead to different impact on the developing child and when they occur is really important. Let's take an example. Since you asked about kind of middle childhood, those kind of teen years, for example. One of the things that COVID did, and my youngest daughter, who at the time was a freshman in college, is that it stripped all social interactions away from them. And we often think, well, you know, they're on their phones interacting with their friends all day long. My daughter was, including things like FaceTime. That did not do it for her. And for the kids that we are now working with in schools, they lost two years of social maturation. And the impact of that is dramatic. And the best way to think about this for all the listeners is going back to this idea of a window of opportunity, or what's often called either a critical period or a sensitive period. In development for motor systems, movement, sensory systems, hearing, vision, and cognitive and emotional systems, there are different windows of opportunity when certain experiences are necessary for those systems to develop properly. Let's go back to neglect. We know from many, many studies, many of them coming out of the work from this really, really horrific period in Romania, where many children were left in these very, very impoverished orphanages, that when children are deprived of basic needs for the first few years of life, If they don't have that, the executive system of our brain, the system that really works with attention, working memory, planning, self-control, those systems fail to thrive. And it looks like, at least from the early work that's going on now, is that even if that child is put into a healthy foster care system with an adoptive parent or family, some of those systems may not recover. So those first few years, if that experience doesn't happen, all those neural connections that are needed and nurtured by the experiences, those systems fail to thrive. And you may either see no development or very, very delayed development. To make this more dramatic, so people really understand why this is so important, that's the system that underlies all learning. The best predictor of readiness for school is that executive system. Kids who are really ready for kindergarten have more developed executive systems. Depriving them of nurture, food, reading, right? All the talking that goes on during early development, right? Chattering away. That is depriving that executive system. Fast forward now to those teen years. If you're stripped away of those social experiences, you will see massive delays in the social skills domain, right? Understanding to read emotions, how to navigate the social world, how to collaborate, how to sympathize with somebody who needs something. Those systems get delayed because the experience hasn't been there, and that's what COVID did globally. So we are in some ways looking at a world that has a teenage group that has gone through a vacuum of social experience. So when, you know, the kids are like, “Yeah, I don't want to be with you, mom and dad. I want to be with my friends.” It's a real need, like language and nutrition is a need. It's no different. It's a window of opportunity where they absolutely need those social interactions. And again, social media is not doing it.

DR. AMY: So I'm hearing you say, when teens are saying, “Mom and Dad, I need to be with my friends, then Mom and Dad need to let them spend time with their friends.” 

MARC: They need to let themselves spend time with their friends. And what I would add on to this too is, here's another way of thinking about it: the teen years are really the experimental years. It's a time to try things out and they are really experimenting and they're often very impulsive. And the best way to think about that is to come back to that executive system. Here's the curve to paint in your head. Our emotional systems in the brain, often referred to as the limbic systems, are developing very quickly, and they kind of mature in those early teen years. That's not to say there's not more growth, but they're kind of maturing then. Whereas the breaking system of things that can control those emotions doesn't really mature perhaps until 23 to 25. So you've got a kind of a runaway train that doesn't have its brakes on until after college. So they're more impulsive. There's something good about that, right? I think we need to be also thinking about the goods of this. Some of the most creative people are those young people who don't care about the consequences, like,” I'm going to try this. It may not work. I don't care. I want to give it a shot.” And that's why you see the Mark Zuckerbergs and the Bill Gateses, who were totally youngsters when they developed all these things, right? Because they didn't care about the consequences. They thought, “I don't need to go to Harvard. I'm going to stop at my sophomore year. I'm going to develop Microsoft. I'm going to develop, you know, Facebook.” Because they don't care about the consequences. There's something very healthy and good about that. Because that's where the creativity comes in. They're experimenting in all different directions. It's part of who they are. It's adaptive in many ways. Of course, it comes with costs. And for the listeners, the key thing to remember is because of individual differences in that breaking mechanism, which can be hurt by lack of early experience, that delay may be even greater for some, and they may therefore have less control over the emotional eruptions that some of them are experiencing because of that traumatic response.

DR. AMY: All right, so this is a great transition speaking of executive function skills, to let Sandy read a word from our sponsor. And when we come back, I do want to be, I do want to touch on the cultural nuances in ACEs and particularly what we're seeing, whatever, we'll come back in just a minute. 

MARC: Okay, sounds good. 

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DR. AMY: Alright, I'll try to sound a little more intelligent as I ask you this next question, Marc. So, you talk about how there are differences in how … you talk about how cultural norms influence how we look at different adverse experiences in childhood. So you give a great example that in the United States, there are 19 states that still allow corporal punishment, that they allow hitting children. And not just in schools, right, but they don't have laws against physical punishment of children by families and parents. And so I would like to talk a little bit about that. 

MARC: Okay, great. So I think the context for me that this became very relevant was thinking about the ACE survey. So the ACE survey, as I kind of mentioned, is one in which you get, the original one, at least, 10 questions about different types of adverse experience. For example, were you ever hit, kicked, you know, bitten, slapped, you know, that's the question effectively, right? And there's a part of it, you know, so that it hurt. And, okay, so, I mean, children all over the place, including my brother, might say, yes, my father was totally not. But at one point, my brother went way over the limit. And when I was a child in France, the teacher had a habit of throwing a metal ruler when we got a little bit unregulated or whacking us on the knuckles. So I would have answered yes to that. And that would have counted as a one for physical abuse. And if they'd added on a time dimension, it would have been for a couple of years. Even though, you know, maybe it happened like three times to me. I wasn't that bad of a kid. So that's a little bit weird because I might not have even included that because I wouldn't have thought about a school with a ruler being physical abuse. And so the lens that comes on that is really important, both within our own country, that kind of cross cultural between states. And then, of course, for any parent coming from a country outside of our own or any teacher working with children who come outside of our own. So I mentioned a child in my own book who came from Jamaica, where when the student was not well behaved in school, his father would beat him and his father's father beat him. And that was just part of the culture. He wouldn't have thought about that as physical abuse. Just, “All right. I screwed up in school. All right. So what? My dad's gonna whack me in the head.” And he would never have conceived that, nor would it have led to, in his case, a traumatic response. This child was not traumatized from that. He was emotionally dysregulated for lots of reasons, but getting whacked by his dad wasn't one of them. Right? Never talked about, “Oh yeah, my dad, you know, hits me when I do something.” Not a traumatic response. So the lens on this is really important because for a child growing up in one of those 19 states, would never consider being hit in school as a form of physical abuse.

DR. AMY: Because it's accepted, right?

MARC: It's accepted. It's a norm. Right. It's what happens. It's a norm. It's a cultural norm. In the country of Kenya, where I work, um, up until about 2016, caning, which is using a stick to hit kids who misbehave in classroom, was legal across the country. It was legally stopped in 2016. That doesn't mean it's over. It still happens in certain areas, and it's noted in the news as inappropriate, but it happens. But many Kenyans grew up as that is. That's what happens to us in school if we misbehave. Cultural norm. So it's really important because the survey is asking about. How did you, you know, did you have this experience, but the experience has a cultural lens on it. We think about certain kinds of physical contact, sexual contact, emotional contact as being adverse, but that's kind of been pre labeled with a cultural lens. And that's why that's it's so important. I think, you know, a very relevant piece of this is what's certainly happening a lot in our country is many of the movements that we're most familiar with, like the MeToo movement, Black Lives Matter, were in some ways opening up a new lens on things that were sort of swept under the carpet, right? That certain forms of sexual commenting are a form of harassment. Certain kinds of commenting about someone's race or gender are forms of discrimination and oppression. And one of the things that wasn't on the original, a survey is discrimination and oppression. And those are clear things that are happening outside of the family. Of course, that could happen within the family. But they're happening often outside of the family. And for many, we know those are adverse and can often lead to extreme trauma for some people. And so it's really important to have a broader cultural lens when we do these surveys, because the culture in which you are embedded is going to shape how you answer that. I would add one more thing, and this is really important because the survey itself for me, and I point this out in the book, is having a disproportionate impact on policy. And I want to put a kind of a flag here for people just to consider. The ACEs survey is what's often called a retrospective survey. It's asking adults to think back about what happened during childhood. We now know there's a massive mismatch between what people report and what actually happened. That's part one. Especially when you're asking kids to think adults, some who may be 50 when they answer the survey, to think back to when they were 10 or 11 and all the distortions that may happen with what went on. That's the first thing. The second point. is that the ACEs survey was never intended by Felitti and his colleague as a screener for health for the individual. It's not like you go in and get a test and say, “Yep, you have cancer.” That's a screener. We know it well. If it says it, you know, the odds of it being incorrect are low. It's a predictor of you having cancer. The ACEs questionnaire was never meant as a screener for individuals. It's meant as a population measure that when individuals have a scores above this, the risk of individuals having health problems is high. The reason I mention that is because in certain states, like California, the ACEs score is being used in insurance policies that individuals who have an ACE score below four have one insurance tier, and those with four or more have a different one. Again, coming back to the first part of our conversation, it's about the response to the ACEs. It's not the ACEs. So you have a scores driving policy. But let me also say. We want people to be aware of ACEs. That is not the point of my comment, right? Everybody should care deeply about kids who experience adversity. 100 percent no debate. But ACEs aren't traumatic responses, they're not resilient responses. They're the experience and they have no dimensionality. There's not a distinction between the types. When they occurred, how long they occurred, how bad they were. There's nothing in the information like that. And so some of the more recent work is moving in that direction to take those distinctions importantly and to link them up to the actual health issues of the individuals. 

DR. AMY: All right, so we … First of all, like I'm so blown away by that. I had no idea that that was happening. I do know that life insurance organizations are looking at things in a similar way and it drives me nuts. But that's another story. But I feel like you left us on a cliffhanger back there about five minutes ago that I want to return to. So when you say that there is such a cultural influence on what may or may not be a traumatic response to what some cultures would consider an adverse childhood experience where other cultures would not, what I'm hearing you say then is, in the 19 states that allow physical punishment, those children think of that as normal. And so they will probably not have a traumatic response to being physically punished, where the other states where it's not considered normal, those children might have a traumatic response to physical punishment. Isn't there a moral issue here? Like, is that okay for us to go, “Well, that happened in Georgia. So those kids, you know, it's fine for them to get punished that way.” How do we reconcile those differences among cultures?

MARC: Okay, that's a that's a really, really good question. I like how you put it. One of the things I think is important—I think we all experience this to different extents—is how certain experiences become normalized. All of us, many of us, I would say, started normalizing the war between Ukraine and Russia. We were, all of us, horrified when it started and it's become kind of background news. But it's still happening and many, many children are still being horrified by that experience. But for us, it's become kind of background noise. What's happening in Gaza is slowly becoming background noise. So we're normalizing the experience. So part of it is what becomes kind of a norm of a culture. What becomes a norm of a culture doesn't necessarily mean that the child's response to it isn't traumatic. So that's a distinction I want to make. I want to distinguish between how a child responds to it and how an individual might respond to the questionnaire. A child growing up in a culture where corporal punishment was legit in schools as an adult might not tick off being slapped as an example of an ACE. Because they're thinking, “Well, my, you know, my parents never hit me, but my teacher did. But that's my teacher and that was allowed. So zero. Don't put that one down.” That doesn't mean they might not have been harmed by that. Okay? So that that's a really, I think a key distinction. What I'm saying is that how we interpret the ACE score is going to be culturally bound because how people will write “zero” or “one” is going to be affected by that culture. For example, let's now go into people living in low socioeconomic status or people living in countries with extreme poverty. What they count as neglect is not going to be the same as what my daughter counted as neglect when I didn't give her a phone when she was three years old. Right? For her that was being mean neglectful and depriving her of her need. That's so far removed from what a child growing up in the Sudan thinks about as neglect, but their bar is different. Okay? That's not defined. In these surveys, right? And it's not nor is it culturally sensitive. So a, you know, how often did you not see your parent when you came home? In a lot of cultures that might be very, very high, but that may not be neglect because there's an entire community of people who are filling in some of those pieces. Okay. So that that's a lens on the survey itself. And therefore we have to really distinguish between the traumatic response. Just a year ago when I was in Kenya, I was talking to a bunch of undergraduates in one of the biggest universities in Kenya. And, you know, many of them described being caned really, really badly. And they said, “Yeah, I, you know, that was just part of how I grew up.” But other kids said, “Yeah, I still think about those days in horror.” And so different responses to the same experience all recognized. It was part of their upbringing. It was part of what happened in the schools and they expected it to happen. So it was not unpredicted. And I think that's an important piece, right? It was part of their developmental experience. And I think that's important because in a lot of the literature on adverse childhood experiences, it's often defined in terms of what's typical. That's a really westernized view about what is typical. And so I think we just need to have a really clear lens on that because we know from, especially perhaps animal studies, non-human animal studies, that there are developmental programs that adapt to environmental changes. If a baby is born in a period of resource deprivation, let's say the fruiting trees have failed for some reason, development slows down. Okay. That is part of the development. So just slow things down. Take your time developing. If you're living in an environment with high predation, you better mature quickly because no one's going to pick you up. So the developmental system speeds up. So we have those trade-offs where the environment can tilt things developmentally. So we have to be very careful when we talk about what is development typical or needed for a human baby because there's a lot of plasticity in our system to adapt to different environments. 

DR. AMY: All right. So what do we do with all of this? What do you want to leave parents with?

MARC: So I think for me, one of the things that I'm very, very sensitive to is, in some ways, the battle that I often see schools confronting in part because of not the best relationship or coordination with parents. Okay? So one of the things that is characteristic of children living in, let's say, violent environments, threatening environments is the world feels very unsafe. And there are a lot of things that can trigger, overstimulate that system so they can maintain that sense of  lack of safety. Okay? So we know kind of neurobiologically in the brain that there's an area that is kind of on high alert when the world feels unsafe. And that's an adaptive strategy. If I live in a world where I could be eaten tomorrow, I better be vigilant. Very adaptive move. But, and going back to our earlier discussion, when that system is constantly on, it wears the body and brain down. So what schools do when they know that that is the case, is they find a variety of ways to calm the system down so that safety is what that child experiences. That includes tone of language. It may include calm environments where you try to do as much as you can calm colors of walls, not too many distractions, headphones. If the child needs to sort of zone out. Ways to zone out ways to cover the eyes to reduce the visual input. There are ways that schools try to build that safety up. Now, of course, the child gets six hours of that and goes home into unsafe, it's hard to make a lot of progress because the window of school opportunity is so small in a whole-day experience. So parents who have a child who may have been abused or living in a violent environment, giving that child skills to cope, to calm that system down, and that can include breathing techniques, it can conclude, ways of distracting, of fidgeting with things, so they can do things, manipulate things, so they can take that stress somewhere else. For some of it may be physical exercise, things they can do physically, energetically. So, finding ways to calm things down can be helpful. Here's something else, and this will link back to some of the different types of adversity we talked about. For a child who has been abused, emotionally abused, physically abused, sexually abused, because the world feels unsafe, they may not have an easy time judging the nature of the threat because they generalize everything is big and bad. 

DR. AMY: There's a tiger in every bush. 

MARC: Yeah, every tiger, every bush. And that again, it's an adaptive response. Better be safe and sorry. If it's tiger, I want to be out of here. So we see kids who they come in and this was my, literally my first experience in a school with children with traumatic experiences in their past and someone living them. I walked into the class and it's one little boy runs right out. I'm like, I literally hadn't opened my mouth yet. And I was like, she said, “Hey, don't worry about it. You just happened to look like his dad.” And his dad had physically abused him, has been physically abusing him. So, next time I came in, I walked in and I sat on the ground to make myself small. And I didn't look at him. And he then said, “How come you're not paying attention to me?” And without turning around, I said, “I am paying attention to you. What do you want to tell me?” And he walked around to me. And that began that sense of safety because now is the beginning of generalization. Not everybody who looks, smells, and sounds like your dad is bad. And so it's teaching in that generalization. But the other piece of this, and this can be very effective for the parent and the child at home, is what's often called the size of the problem. Imagine three boxes. A small box, a medium sized box, and a big box. And when the child and the parent, because this is helpful for both, is in a calm state, you say, “Hey, I want you to tell me about something that would be really, really, really bad. That would go into that big box. It's a big problem.” And I might even illustrate and say, “You know what? If my dad was really, really sick, for me, that would be a huge problem. He goes into that big box. Small problem. I'm on my way to play soccer and I stub my toe. Little problem. It hurts. You know, whatever. Move on, right? And then medium-sized problem. I'm about to give a talk somewhere and I feel really, really sick and I have to cancel it. It may be my only opportunity. It's a bummer, but it's not the end of the world.” Okay, so you create those boxes and you literally have them as visuals. What's in them? So that when they have a response, you're like, what's the size of the box? You give them a calibration. You're like, “Wait a minute. Are you sure this is as big as your dad being really sick?” Okay, maybe not. And maybe that helps them readjust the response to it. Because then you can help them say, “What's the size of the problem and what's the size of your reaction? And that's equally important for a parent, right? “This kid won't make his bed!” Little problem, right? So having parents calibrate too. It may be super fresh, stressful and frustrating, but it may be a small problem, not a big one. And for both to have that, and they can both have the visuals, put it up on the refrigerator, right? So it's always there somewhere they can see it. So they can use it. Including the reaction. “You said it was medium. Your response was big.” That's it. Not a lot of language. Very simple. Okay. So a lot of the strategies that are often used in schools can be very helpful and powerful for parents. One more piece I'll give you. There's so many. Children who are dysregulated, especially children with trauma histories, especially on the abuse end as opposed to the neglect end, the language system is often affected. And they're not going to hear you or understand you or really be listening. So, less words is better. And so, when you're communicating to a child who's dysregulated, it's first of all important to see where in the dysregulation landscape they are. If they're at a peak, forget it. Nothing's going to happen, right? Wait until they come down into a point where they can listen. And so, what often happens in the schools, but again, a strategy that's very helpful for parents, is think about where they are in that landscape curve of peak, “I'm going to hit somebody” to “I'm pretty calm.” Look at their body. Are they clenching their fists? Are they looking at you? Are they flush? What are the body cues? Wait till they're in a calmer state. Ask them, “Are you ready to talk?” Yes. “No, you're not.” Come back again. Right? And you keep trying. You keep iterating until they can tell you they really are ready. And often what that means is, “I'm going to say something to you and I want you to tell me what I said back to you. Tell me that you understand me and you're listening.” And now we go forward. And I think the other key lens, and this is one of the things why I very much appreciate kind of the title of the Bruce Perry/Oprah Winfrey book, “What Happened to You?” It's very easy for parents and teachers that when a child is doing inappropriate, unexpected, misbehaving, however you want to classify it, to say, “What's wrong with you?” Instead, ask, “What's happening? What's going on?” Right? What's going on now that this is happening, right? Because that's an invitation to, and so it's turning it around and saying, “I wonder what's causing this.” They say, “’Cause you're pissing me off!” “Okay. All right. Good. What can I do to not piss you off?” And so it's inviting that collaborative initiative. And again, schools, when they're working well with children like this, that's the lens, right? It's never, “What's wrong with you?” You know, and that includes when a kid comes and hits you. You know, just in a physical restraint today because the kid try to whack me, you know, I've got to hold them.  In the next 15 minutes, “Hey, how you doing?” You got to be right back. Like what? Why'd you hit me? Right? That's not the lens. That'll never work. But “What happened to you? What can I do to help you do? What can I help do to help you not have this happen again?” Now we're collaborating. 

DR. AMY: Yeah. I think there's a wonderful trauma informed educator book called, “How can I help?”

MARC: Yeah. Right. Absolutely. And that I think that's a great lens, you know, for all of us in some ways. It's hard, especially for again, educators and parents who are dealing potentially with aggressive kids or oppositional kids or kids who are shut down or for whatever's going on, to not have that, “What's wrong with you?” You know, it's frustrating. It's difficult. It's difficult to work with children like that. But having that collaborative lens is definitely more likely to succeed. 

DR. AMY: All right. This has been a phenomenal conversation. Marc, how can our listeners find out more about you and your work? Where can they find you? 

MARC: So probably the simplest, so my website, my author website is, Marc with a C, D. Hauser. So Marc D. H. A. U. S. E. R. dot com. That's the website that's got a link to all the books I've written and several of the papers that people are interested in it. And my, you know, I, okay, I'm not a social media, big, big blaster, but I do post things on Twitter. And my, you know, my Twitter is there to an Instagram and things like that. So the website's probably the fastest and easiest way to go. And it will also kind of show some things that are happening in the company I work with, Risk Eraser and the work I do in schools or the speaking things I have. So that's probably the best place. 

DR. AMY: Okay, fantastic. And we'll actually put the link to your website and your social media handles in our show notes. 

MARC: Great. Fantastic. 

DR. AMY: Fantastic conversation. Dr. Marc Hauser, thank you so much for taking time out of your busy schedule to share your wisdom and insights with our listeners today. Listeners, if you want more from Marc, it's marcdhauser.com. Again, we'll also put a link to his book, “Vulnerable Minds; The Harm of Childhood Trauma and Hope of Resilience.” So thank you so much for listening today. If you like us, please follow us on Instagram and Facebook at The Brainy Moms. You can find Sandy on Tik TOK at The Brain Trainer Lady. We're also on TikTok at The Brainy Moms. Do all that now before you forget. But look, this is all the smart stuff that we have for you today. So we're going to catch you next time.