Pediatrician Dr. Nadine Burke Harris

The Pediatrician explains how certain childhood experiences such as trauma, stress, and neglect can profoundly impact brain development and negatively impact a person’s health as an adult.

Dr. Nadine Burke Harris is the Founder and Chief Executive Officer of the Center for Youth Wellness (CYW). She has earned international attention for her innovative approach to addressing Adverse Childhood Experiences (ACEs) as a risk factor for health problems, such as heart disease and cancer. Her work has been profiled in Paul Tough’s best-selling book, How Children Succeed: Grit, Curiosity, and the Hidden Power of Character and the recently released documentary Resilience: Biology of Stress and Science of Hope, by James Redford. Dr. Nadine’s work has earned her the American Academy of Pediatrics’ Arnold P. Gold Foundation Humanism in Medicine Award.

TRANSCRIPT

Tavis Smiley: Good evening from Los Angeles. I’m Tavis Smiley.

Tonight, first a conversation with Dr. Nadine Burke Harris. The Bay Area physician is revolutionizing pediatric medicine. She joins us to discuss her innovative approach to addressing how childhood trauma affects over our health in our last Road to Health segment of this year.

Then we’ll revisit a conversation with astronaut Mike Massimino about his memoir, “Spaceman”.

We’re glad you’ve joined us. All of that in just a moment.

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Tavis: And by the Robert Wood Johnson Foundation working with diverse partners to build a national culture of health so that everyone in America can live productive and healthy lives.

The California Endowment. Health happens in neighborhoods. Learn more.

Announcer: And by contributions to your PBS station from viewers like you. Thank you.

Tavis: Dr. Nadine Burke Harris is a pioneer in the field of medicine and the founder and CEO of the Center for Youth Wellness. She studies how childhood exposure to trauma affects brain development as well as a person’s health as an adult.

Her recent viral TED Talk video on the subject has now reached over two million views and she joins us here tonight on PBS to talk about her groundbreaking work. Dr. Burke Harris, good to have you on the program.

Nadine Burke Harris: Thank you very much.

Tavis: Let me start by asking the obvious, I guess, which is whether or not a stressful childhood can make you sick.

Harris: And the answer is yes.

Tavis: Yes. Okay.

Harris: But there’s stress and then there’s stress, right? So what we’re talking about is stress that’s so severe, chronic or pervasive that it literally gets under your skin and changes our biology.

Tavis: Tell me how that works.

Harris: Yes. So when we think about things like abuse or neglect or growing up in a household where a parent is mentally ill or substance dependent, every time a child is exposed to a situation that is scary or terrifying, it activates their stress response. You and I are familiar with the stress response, right? You know, a dog jumps out from behind a bush, right [laugh]? Your heart starts to beat, all that kind of stuff.

And that happens because there are chemicals and hormones in our body that are released. Now in children, if that happens too frequently, if that happens over and over and over again, those hormones change the way a child’s brain and body develop and function moving forward.

Tavis: And by child, you’re talking what ages here?

Harris: So the big research study that was done by the CDC and Kaiser looked at folks 0 to 18, so asked folks about traumas that they experienced any time from the time they were 0 to 18 years old.

Tavis: Right. So I hear your point that, if this happens too frequently, it can change the way that brains develop. Is there no way to arrest that in that period or thereafter?

Harris: There is. There’s actually a lot that we can do. The most important thing that we can do is early detection, right? We all know that an ounce of prevention is worth a pound of cure, and the earlier we detect, then we have the opportunity to take advantage of the child’s developing brain and body to have that development happen in a healthy environment as opposed to an unhealthy environment.

But even if it’s detected later in life, there are six things that the research shows us are the most effective things to undo the effects of trauma on developing brain and body. Those are sleep, exercise, nutrition, mindfulness like meditation, mental health interventions, and healthy relationships.

Tavis: So two seconds ago, you introduced the word “environment” into this conversation which leads me to ask how much environment impacts the reality that you’re talking about now, and are there certain people who are more susceptible to being in environments that are more conducive, sadly, to this kind of bad development?

Harris: Yes. So we are learning about that quite a bit. And what the science shows us is that our health, our biology, is a result of both nature and nurture. Both are genetics and our environment. And, in fact, our environment changes the way that our genes are read and expressed, right?

So environment actually changes our biology through a series of mechanisms. What we now understand is that it’s possible that some folks are more susceptible. For example, we see that, you know, folks in the population, there’s lots of different heights. Some people are super tall, some people are just naturally on the shorter side.

Similarly, folks have a normal variation in stress tolerance. Some can tolerate high stress and some have very little stress, and that pushes them over the edge into disease. But there’s a lot that we can do with environment to be able to buffer stress.

So one of the coolest things about the science is that we are now demonstrating that, as humans, we have the ability to buffer each other’s stress response biologically, right?

So we know I’m a new mother and, as a mother, I know that my relationship with my baby, when he cries, I know it’s time for me to nurse him [laugh]. We have these relationships and, similarly, we have the ability to affect each other’s biology through healing and nurturing relationships.

Tavis: Tell me more. I’m fascinated now and intrigued. Tell me more about how that would work. So person A is trying to assist person B. How does the interaction, the relationship, work or benefit?

Harris: Yeah. So this is actually part of the way that humans have evolved is that when a child is in a scary environment, it activates their stress response and they release hormones like adrenalin and cortisol.

Now if they are in the presence of a caring, nurturing, buffering adult, what happens is that the adult is able to help them make meaning of the situation, help them feel safe, and those hormonal levels are able to return to normal, right? Without the presence of that buffering, caring adult, those hormone levels can actually stay elevated.

And what we see in children, for example, some children in foster care populations or children who have been exposed to chronic trauma is that we see that they’re bodies release higher spikes of adrenalin and have changes in the pattern of their cortisol regulation.

But when those children–for example, research of kids who have been adopted internationally–when those children are able to get into a safe, stable, nurturing environment over the long term, we can actually see correction of those biological changes over time.

Tavis: So that if some child in some part of the world where they’re catching hell is adopted by an American family–we see this every day, to your point. Americans adopt babies from around the world. They come here and presumably have a better life, more opportunities. Those stress factors you mentioned, we assume tend to go down for those babies.

Harris: Yes.

Tavis: But what about those babies born in this country who are–you know where I’m going with this, of course–who are living in environments where they’re not just exposed to some stress, the environment itself is the quintessential definition of stress. There are gunshots going off every night. There’s arguing. There’s fighting. There’s poverty. There’s lack. What chance does that child have?

Harris: So this is really interesting. This is the work that brought me to this science, right? I discovered this science when I came to work in the Bayview-Hunters Point community of San Francisco, which is a community that does have gunshots and violence and drug deals happening on the corner. There are a couple of things that are really critically important.

One is that, if you have a healthy and intact caregiver even in adverse circumstances, the child will do well if the caregiver is supported and does well. For example, at our center, the Center for Youth Wellness, in partnership with the clinic that we work with, the Bayview Child Health Center, when we provide services to kids, we do what we call two-generation work.

We’re not only taking care of the child, we’re also supporting and caring for the caregiver because we have to not only reduce the dose of adversity that the child is experiencing, but also support the caregiver to be an effective buffer. We also know that some communities experience greater doses of adversity than others.

So the major research studies have looked at 10 specific categories which is, you know, physical, emotional and sexual abuse, physical and emotional neglect, or having a parent who’s mentally ill, incarcerated, substance dependent, separate or divorced, or experiencing domestic violence.

But we also know that in communities where certain individuals are more likely to be targeted by the police, for example, or where folks feel like it’s simply unsafe to go outside, that those individuals experience higher what we call total dose of trauma, and that also affects their stress response system. And the biggest place we see this is in behavior and learning, right?

So I came across this work when a lot of teachers were referring kids to me for what they thought was ADHD or attention deficit hyperactivity disorder. But when I actually did a thorough physical exam, what I saw was that these kids had a dysregulated stress response.

Tavis: That does not surprise me. Sad, but it doesn’t surprise me particularly when that wrong diagnosis ends up putting them on medication…

Harris: That’s exactly right.

Tavis: That’s not treating the problem that they’re suffering from in the first place.

Harris: That’s exactly right.

Tavis: But I digress on that. I got 30 seconds to go. Very quickly, it occurred to me as you were talking that the flip side of these perhaps Black and Brown kids, shall we say, in these high stress environments who get misdiagnosed, as we said a moment ago, the flip side of that is the children of wealthy parents who might not be Black or Brown who are also enduring a different kind of stress.

The stress of expectation, the stress of–I could do this all day long. I’m out of time. What do you say to those parents? Again, it occurs to me that you don’t have to be a poor kid to be under stress.

Harris: So that’s absolutely true. The original Kaiser-CDC study was done in a population 70% Caucasian, 70% college educated.

Tavis: Okay.

Harris: This is all of us.

Tavis: I get it. Dr. Nadine Burke Harris, doing great work. Good to have you on the program. Thanks for sharing that.

Harris: Thank you.

Tavis: You got to come back because I got a lot more questions for you.

Harris: Okay [laugh].

Announcer: For more information on today’s show, visit Tavis Smiley at pbs.org.

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Tavis: And by the Robert Wood Johnson Foundation working with diverse partners to build a national culture of health so that everyone in America can live productive and healthy lives.

The California Endowment. Health happens in neighborhoods. Learn more.

Announcer: And by contributions to your PBS station from viewers like you. Thank you.

Last modified: December 16, 2016 at 1:56 pm