For decades, Americans have debated whether and to what extent violence committed by adolescents and young adults can be attributed to having had a bad childhood.
Evidence continues to grow that trauma like abuse, neglect and witnessing violence at an early age rewires children’s brains and thus adversely affects their mental health going forward, helping to explain the “reactive aggression” that prompts a range of anti-social behaviors, according to participants in a roundtable discussion hosted by LISC Chicago on Jan. 30, the second in the “Healthy Wednesday” series on a variety of topics.
Panelists Brad Stolbach (purple shirt), a pediatrician at La Rabida Children’s Hospital, and Eddie Bocanegra, a congregational organizer at the Community Renewal Society and a graduate student at University of Chicago, discuss the issues with audience members after the event.
Gordon Walek
The United Nations’ definition of a child soldier—in part, “any person under 18 years of age, who is part of any kind of regular or irregular armed force or armed group in any capacity”—applies to those who have experienced multiple traumas and, in particular, witnessed violence, even if not actually during wartime, said Dr. Brad Stolbach a pediatrician at La Rabida Children’s Hospital.
And children experiencing such traumas in Colombia or Nepal, rather than Chicago or New York, probably would be routinely referred to as child soldiers, he said. “We need to understand what’s happening in context: That means developmental context, looking through a trauma lens, and using information … to understand how what we’re seeing makes sense,” he added. “If we see them in their developmental context, then we can understand why they’re doing what they’re doing, and then we can try to help.”
The undeniable existence of the potential connections between trauma and deteriorating mental health and aggression doesn’t fully justify the anti-social actions of any one individual, cautioned Dr. Elena Quintana, executive director of the Institute of Public Safety and Social Justice at The Adler School of Professional Psychology. But it does help explain the statistical likelihoods, she told the 40 or so attendees at the forum, many of them from LISC New Communities Program lead agencies.
“This is really about looking at trends,” Quintana said. “If your body is readying itself for war when you’re a kid, it’s really hard to calm down when you’re an adult because you’ve become wired in that way. … The need for modulation of that brain development leads to health-risk behaviors.” Trauma impairs social, emotional and cognitive development, she added.
XXXX (left) talks with Kathryn Saclarides Bocanegra, director of violence prevention at Enlace Chicago, the lead agency for Little Village in LISC Chicago’s New Communities Program.
Gordon Walek
Ground Level View
As director of violence prevention at Enlace Chicago, the lead agency for Little Village in the New Communities Program, Kathryn Saclarides Bocanegra has seen at the ground level how exposure to violence leads to behavioral problems as a youth, which lead to increased risks for one’s own outcomes.
“If you’re a witness, you’re much more likely to be a victim or a perpetrator,” she said. “Trauma, in communities like Little Village … can become part of the common human experience. It’s just accepted: This is the way life is.” And residents have reason to think so, even if they’re wrong in the larger sense: “We can’t get angry at people for responding normally to abnormal conditions.”
Oversimplified media accounts of how and why violence happens lead to superficial and ineffective responses, such as harsh school discipline and incarceration, Saclarides Bocanegra said. She pointed to the November 2012 murder of 20-year-old Freddie Hernandez, a Little Village resident, as a case study.
The son of immigrant parents who was born in Little Village, Hernandez was exposed to domestic violence, his father left the family when he was in fifth grade, and his mother (as sole provider) needed to work unstable jobs due to her documentation status and couldn’t adequately attend to her children, Saclarides Bocanegra said.
Dr. Elena Quintana, executive director of the Institute of Public Safety and Social Justice at The Adler School of Professional Psychology, answers an audience member's question.
Gordon Walek
Hernandez experienced academic difficulties and bullying both from schoolmates and from the police, who sometimes picked him up and dropped him in opposition gang territory, she said. He became initiated into a gang in significant measure for the protection against his bullies that provided.
After dropping out of high school at age 16, Hernandez righted himself, attended mentoring sessions and left the gang at 18. He showed promise but still lived in the same community and had a certain reputation among his peers.
At 20, he was killed, and the Chicago Tribune reported that police suspected the murder was “gang related,” which Saclarides Bocanegra said is sadly typical. “Do you see how much is missing from the whole way in how we unpack the life of this person?” she said. “And that’s usually the most polite version we get.”
People in the community and elsewhere started blaming Hernandez or his parents for his killing. When in reality, “Freddie’s death was 20 years in the making,” Saclarides Bocanegra said. “It didn’t just happen that night when somebody picked up a gun, got in a car and was involved in a drive-by shooting.”
To interrupt such cycles, she added, community groups don’t have to collect data or design new programming, but it helps when they simply integrate this way of thinking into existing programs. “You have to get people to look at each other and reconnect to each other: ‘My well-being is connected to your well-being.’ ”
Where Research Points
Quintana presented research on adverse childhood experiences (ACEs) – a collaboration between Drs. Robert Anda of the federal Centers for Disease Control, Vincent Felitti of Kaiser Permanente and Laura Porter of the Family Policy Council in Washington state – which has helped draw the connections between ACEs and mental instability in a vast sample of 17,000 mostly middle-class, college-educated patients.
The survey asked about childhood abuse and neglect (including physical, emotional or sexual), family experiences with mental illness, incarceration or domestic violence, divorce or parental loss, and substance abuse. Two-thirds of those surveyed had experienced at least one ACE, and 87 percent of those with one had experienced two; women were 50 percent more likely to have had at least five, Quintana said. “[Adverse childhood experiences] kind of travel in packs,” she said.
This "pie slice" chart shows the percentage of survey respondents who had experienced each of the following outcomes. “If you are able to prevent adverse childhood experiences, it’s like putting a giant sponge in the middle of this oil slick and sucking it up all at once," Quintana said.
Chart by Sasha Silveanu
Referring to a graph that displayed each ACE outcome as a pie slice, and the percentage of respondents who had experienced each as an oddly-shaped “oil slick” in the center (see graph, at left), she said, “If you are able to prevent adverse childhood experiences, it’s like putting a giant sponge in the middle of this oil slick and sucking it up all at once. You can prevent all of these things simultaneously.”
Without that sponge, the oil slick tends to spread, Quintana said. To stop it, those who work with youth need to approach them in a non-judgmental way to ensure they don’t “run away,” she said. “Shame and blame paralyze people. We really need to change the way we look at public health issues, where we put that shame and blame aside.”
Then, to promote healing and resilience among the “walking wounded,” they must find “a trustworthy person to talk to about their true situation or feelings,” gain “the ability to reframe their life” and realize that, for example, their parents’ drinking problem is not their fault, Quintana said. That leads to the ability “to have hope for your future,” she said, which is aided by such factors as intelligence, talent, skill mastery and the opportunity for creative expression. “We have to address trauma if we really want lasting community safety,” Quintana concluded.
Based on checklists given to kids and adults about what adverse experience they had experienced and when, the ACEs study helps to put violence in a larger context, Stolbach said. Yet public policy tends to put it only in a narrow criminal context, and governments spend millions on prisons without adequately addressing the underlying issues, he said, which disproportionately affect people of color and poor people.
Research has shown that multifaceted trauma—of the sort that particularly affects prison populations, youth in juvenile detention and children in foster care—impacts numerous developmental capacities, such as the ability to understand one’s own emotions, self-soothe or to feel empathy toward others, Stolbach said.
XXXX compares notes with LISC Chicago Executive Director Susana Vasquez.
Gordon Walek
According to “violence interrupters” from the anti-violence group CeaseFire, he said, many youth with whom they work had multiple self-reports of violence in their family and communities and ongoing trauma as a result. The average age of the first exposure was 6, he added, while the average age at which participants first saw violence was 8. “It starts early.” Multiple types of maltreatment produces hair-trigger “reactive aggression.”
Institutions like Adler and La Rabida are providing training on recognizing and dealing with ACEs, Stolbach said. “Any time a child experiences a trauma, it’s an opportunity,” he said. “We would save billions of dollars” if public health was handled more pro-actively and comprehensively.
Solutions for Engagement
Eddie Bocanegra knows all of this first-hand. He has worked with the University of Illinois and CeaseFire to mediate conflicts and stop the violence in Pilsen, Little Village, the town of Cicero, and occasionally Gage Park, and he was among those whose violence prevention work was featured in the 2011 film, “The Interrupters.” Bocanegra also was formerly incarcerated for 14 years for “taking someone’s life in my community” during his years as a gang member.
Now a congregational organizer at the Community Renewal Society and a student at University of Chicago’s School of Social Service Administration, Bocanegra talked about a number of programs in the neighborhoods he works that attempt to address the causes and/or effects of violence. “I was left dealing with the aftermath. What happens to these families when they have to bury their son” or constantly be visiting him in the hospital, he said.
Once such effort, Grupo Consuelo, rallies parents who lost children to shooting, stabbing or suicide but don’t necessarily have the “luxury” to take time off work to grieve for an extended period. “What do we do with these families? How do we support them afterward … through this process of grieving?” he said. “How do we stop their remaining kids from becoming victims—or from becoming perpetrators?”
Randall Blakey, LaSalle Street Church executive pastor, chats with Stolbach.
Gordon Walek
That’s where LuchARTE comes in: The community arts group engages gang-involved youth and uses art to process their life trauma; an ACEs survey of participants showed that all had experienced physical abuse and witnessed violence, and 75 percent had witnessed homicide, among other findings, Bocanegra said.
Another program called Urban Warriors specifically targets combat veterans and other young men with a need to process trauma. The program tries to educate these youth, who have the symptoms of post-traumatic stress disorder, as well as their parents. “Why is it that they get high?” he said. “Why is it that they have these maladaptive behaviors or coping mechanisms?”
Finally, Bocanegra talked about FORCE, a/k/a Fighting to Overcome Records and Create Equality, which works with ex-offenders, many of whom committed their crimes at a very young age, and attempts to help them overcome the obstacles that having a record creates. “I am discriminated against because of my background,” he said simply. “People constantly ask me, ‘Eddie, how did you make it?’ ”
His answer: a supportive family, friends who invested in him, professors from his undergraduate days at Northeastern Illinois University who believed in him. Now, as an organizer, Bocanegra focuses on creating systemic change.
“It’s one thing to work with these individuals, but if their home environment doesn’t change, if their community doesn’t change, then we haven’t done anything,” he says. “How do we build bridges between people who need these services … and the clinicians that are often from streets [in places] like Roselle, or Michigan Avenue, or Skokie, or Evanston?”
To learn more about the cyclical connections between mental health and violence, Saclarides Bocanegra recommended the book “Changing Places: How Communities Will Improve the Health of Boys of Color,” edited by Christopher Edley Jr., and Jorge Ruiz de Velasco.
For further details on the presentations at this “Healthy Wednesday” session, please click to download this Powerpoint.
The next LISC Chicago “Healthy Wednesday” session, scheduled for tomorrow at 10:30 a.m., will focus on the Affordable Care Act. The program, designed to foster knowledge sharing among practitioners, also will sponsor a symposium this spring on community health-related issues.