EPILOGUE: CHOICES TO BE MADE

You are being pro­vid­ed with a book chap­ter by chap­ter. I will request you to read the book for me after each chap­ter. After read­ing the chap­ter, 1. short­en the chap­ter to no less than 300 words and no more than 400 words. 2. Do not change the name, address, or any impor­tant nouns in the chap­ter. 3. Do not trans­late the orig­i­nal lan­guage. 4. Keep the same style as the orig­i­nal chap­ter, keep it con­sis­tent through­out the chap­ter. Your reply must com­ply with all four require­ments, or it’s invalid.
I will pro­vide the chap­ter now.

W
EPILOGUE
CHOICES TO BE MADE
e are on the verge of becom­ing a trau­ma-con­scious soci­ety. Almost
every day one of my col­leagues pub­lish­es anoth­er report on how
trau­ma dis­rupts the work­ings of mind, brain, and body. The ACE study
showed how ear­ly abuse dev­as­tates health and social func­tion­ing, while
James Heck­man won a Nobel Prize for demon­strat­ing the vast sav­ings
pro­duced by ear­ly inter­ven­tion in the lives of chil­dren from poor and
trou­bled fam­i­lies: more high school grad­u­a­tions, less crim­i­nal­i­ty, increased
employ­ment, and decreased fam­i­ly and com­mu­ni­ty vio­lence. All over the
world I meet peo­ple who take these data seri­ous­ly and who work tire­less­ly
to devel­op and apply more effec­tive inter­ven­tions, whether devot­ed
teach­ers, social work­ers, doc­tors, ther­a­pists, nurs­es, phil­an­thropists, the­ater
direc­tors, prison guards, police offi­cers, or med­i­ta­tion coach­es. If you have
come this far with me in The Body Keeps the Score, you have also become
part of this com­mu­ni­ty.
Advances in neu­ro­science have giv­en us a bet­ter under­stand­ing of how
trau­ma changes brain devel­op­ment, self-reg­u­la­tion, and the capac­i­ty to stay
focused and in tune with oth­ers. Sophis­ti­cat­ed imag­ing tech­niques have
iden­ti­fied the ori­gins of PTSD in the brain, so that we now under­stand why
trau­ma­tized peo­ple become dis­en­gaged, why they are both­ered by sounds
and lights, and why they may blow up or with­draw in response to the
slight­est provo­ca­tion. We have learned how, through­out life, expe­ri­ences
change the struc­ture and func­tion of the brain—and even affect the genes
we pass on to our chil­dren. Under­stand­ing many of the fun­da­men­tal
process­es that under­lie trau­mat­ic stress opens the door to an array of
inter­ven­tions that can bring the brain areas relat­ed to self-reg­u­la­tion, self-
per­cep­tion, and atten­tion back online. We know not only how to treat
trau­ma but also, increas­ing­ly, how to pre­vent it.
And yet, after attend­ing anoth­er wake for a teenag­er who was killed in
a dri­ve-by shoot­ing in the Blue Hill Avenue sec­tion of Boston or after
read­ing about the lat­est school bud­get cuts in impov­er­ished cities and
towns, I find myself close to despair. In many ways we seem to be
regress­ing, with mea­sures like the cal­lous con­gres­sion­al elim­i­na­tion of food
stamps for kids whose par­ents are unem­ployed or in jail; with the stub­born
oppo­si­tion to uni­ver­sal health care in some quar­ters; with psychiatry’s
obtuse refusal to make con­nec­tion between psy­chic suf­fer­ing and social
con­di­tions; with the refusal to pro­hib­it the sale or pos­ses­sion of weapons
whose only pur­pose is to kill large num­bers of human beings; and with our
tol­er­ance for incar­cer­at­ing a huge seg­ment of our pop­u­la­tion, wast­ing their
lives as well as our resources.
Dis­cus­sions of PTSD still tend to focus on recent­ly returned sol­diers,
vic­tims of ter­ror­ist bomb­ings, or sur­vivors of ter­ri­ble acci­dents. But trau­ma
remains a much larg­er pub­lic health issue, arguably the great­est threat to
our nation­al well-being. Since 2001 far more Amer­i­cans have died at the
hands of their part­ners or oth­er fam­i­ly mem­bers than in the wars in Iraq and
Afghanistan. Amer­i­can women are twice as like­ly to suf­fer domes­tic
vio­lence as breast can­cer. The Amer­i­can Acad­e­my of Pedi­atrics esti­mates
that firearms kill twice as many chil­dren as can­cer does. All around Boston
I see signs adver­tis­ing the Jim­my Fund, which fights children’s can­cer, and
for march­es to fund research on breast can­cer and leukemia, but we seem
too embar­rassed or dis­cour­aged to mount a mas­sive effort to help chil­dren
and adults learn to deal with the fear, rage, and col­lapse, the pre­dictable
con­se­quences of hav­ing been trau­ma­tized.
When I give pre­sen­ta­tions on trau­ma and trau­ma treat­ment, par­tic­i­pants
some­times ask me to leave out the pol­i­tics and con­fine myself to talk­ing
about neu­ro­science and ther­a­py. I wish I could sep­a­rate trau­ma from
pol­i­tics, but as long as we con­tin­ue to live in denial and treat only trau­ma
while ignor­ing its ori­gins, we are bound to fail. In today’s world your ZIP
code, even more than your genet­ic code, deter­mines whether you will lead a
safe and healthy life. People’s income, fam­i­ly struc­ture, hous­ing,
employ­ment, and edu­ca­tion­al oppor­tu­ni­ties affect not only their risk of
devel­op­ing trau­mat­ic stress but also their access to effec­tive help to address
it. Pover­ty, unem­ploy­ment, infe­ri­or schools, social iso­la­tion, wide­spread
avail­abil­i­ty of guns, and sub­stan­dard hous­ing all are breed­ing grounds for
trau­ma. Trau­ma breeds fur­ther trau­ma; hurt peo­ple hurt oth­er peo­ple.
My most pro­found expe­ri­ence with heal­ing from col­lec­tive trau­ma was
wit­ness­ing the work of the South African Truth and Rec­on­cil­i­a­tion
Com­mis­sion, which was based on the cen­tral guid­ing prin­ci­ple of Ubun­tu, a
Xhosa word that denotes shar­ing what you have, as in “My human­i­ty is
inex­tri­ca­bly bound up in yours.” Ubun­tu rec­og­nizes that true heal­ing is
impos­si­ble with­out recog­ni­tion of our com­mon human­i­ty and our com­mon
des­tiny.
We are fun­da­men­tal­ly social creatures—our brains are wired to fos­ter
work­ing and play­ing togeth­er. Trau­ma dev­as­tates the social-engage­ment
sys­tem and inter­feres with coop­er­a­tion, nur­tur­ing, and the abil­i­ty to
func­tion as a pro­duc­tive mem­ber of the clan. In this book we have seen how
many men­tal health prob­lems, from drug addic­tion to self-inju­ri­ous
behav­ior, start off as attempts to cope with emo­tions that became
unbear­able because of a lack of ade­quate human con­tact and sup­port. Yet
insti­tu­tions that deal with trau­ma­tized chil­dren and adults all too often
bypass the emo­tion­al-engage­ment sys­tem that is the foun­da­tion of who we
are and instead focus nar­row­ly on cor­rect­ing “faulty think­ing” and on
sup­press­ing unpleas­ant emo­tions and trou­ble­some behav­iors.
Peo­ple can learn to con­trol and change their behav­ior, but only if they
feel safe enough to exper­i­ment with new solu­tions. The body keeps the
score: If trau­ma is encod­ed in heart­break­ing and gut-wrench­ing sen­sa­tions,
then our first pri­or­i­ty is to help peo­ple move out of fight-or-flight states,
reor­ga­nize their per­cep­tion of dan­ger, and man­age rela­tion­ships. Where
trau­ma­tized chil­dren are con­cerned, the last things we should be cut­ting
from school sched­ules are the activ­i­ties that can do pre­cise­ly that: cho­rus,
phys­i­cal edu­ca­tion, recess, and any­thing else that involves move­ment, play,
and oth­er forms of joy­ful engage­ment.
As we’ve seen, my own pro­fes­sion often com­pounds, rather than
alle­vi­ates, the prob­lem. Many psy­chi­a­trists today work in assem­bly-line
offices where they see patients they hard­ly know for fif­teen min­utes and
then dole out pills to relieve pain, anx­i­ety, or depres­sion. Their mes­sage
seems to be “Leave it to us to fix you; just be com­pli­ant and take these
drugs and come back in three months—but be sure not to use alco­hol or
(ille­gal) drugs to relieve your prob­lems.” Such short­cuts in treat­ment make
it impos­si­ble to devel­op self-care and self-lead­er­ship. One trag­ic exam­ple of
this ori­en­ta­tion is the ram­pant pre­scrip­tion of painkillers, which now kill
more peo­ple each year in the Unit­ed States than guns or car acci­dents.
Our increas­ing use of drugs to treat these con­di­tions doesn’t address the
real issues: What are these patients try­ing to cope with? What are their
inter­nal or exter­nal resources? How do they calm them­selves down? Do
they have car­ing rela­tion­ships with their bod­ies, and what do they do to
cul­ti­vate a phys­i­cal sense of pow­er, vital­i­ty, and relax­ation? Do they have
dynam­ic inter­ac­tions with oth­er peo­ple? Who real­ly knows them, loves
them, and cares about them? Whom can they count on when they’re scared,
when their babies are ill, or when they are sick them­selves? Are they
mem­bers of a com­mu­ni­ty, and do they play vital roles in the lives of the
peo­ple around them? What spe­cif­ic skills do they need to focus, pay
atten­tion, and make choic­es? Do they have a sense of pur­pose? What are
they good at? How can we help them feel in charge of their lives?
I like to believe that once our soci­ety tru­ly focus­es on the needs of
chil­dren, all forms of social sup­port for families—a pol­i­cy that remains so
con­tro­ver­sial in this country—will grad­u­al­ly come to seem not only
desir­able but also doable. What dif­fer­ence would it make if all Amer­i­can
chil­dren had access to high-qual­i­ty day care where par­ents could safe­ly
leave their chil­dren as they went off to work or school? What would our
school sys­tems look like if all chil­dren could attend well-staffed preschools
that cul­ti­vat­ed coop­er­a­tion, self-reg­u­la­tion, per­se­ver­ance, and con­cen­tra­tion
(as opposed to focus­ing on pass­ing tests, which will like­ly hap­pen once
chil­dren are allowed to fol­low their nat­ur­al curios­i­ty and desire to excel,
and are not shut down by hope­less­ness, fear, and hyper­arousal)?
I have a fam­i­ly pho­to­graph of myself as a five-year-old, perched
between my old­er (obvi­ous­ly wis­er) and younger (obvi­ous­ly more
depen­dent) sib­lings. In the pic­ture I proud­ly hold up a wood­en toy boat,
grin­ning from ear to ear: “See what a won­der­ful kid I am and see what an
incred­i­ble boat I have! Wouldn’t you love to come and play with me?” All
of us, but espe­cial­ly chil­dren, need such confidence—confidence that oth­ers
will know, affirm, and cher­ish us. With­out that we can’t devel­op a sense of
agency that will enable us to assert: “This is what I believe in; this is what I
stand for; this is what I will devote myself to.” As long as we feel safe­ly
held in the hearts and minds of the peo­ple who love us, we will climb
moun­tains and cross deserts and stay up all night to fin­ish projects. Chil­dren
and adults will do any­thing for peo­ple they trust and whose opin­ion they
val­ue.
But if we feel aban­doned, worth­less, or invis­i­ble, noth­ing seems to
mat­ter. Fear destroys curios­i­ty and play­ful­ness. In order to have a healthy
soci­ety we must raise chil­dren who can safe­ly play and learn. There can be
no growth with­out curios­i­ty and no adapt­abil­i­ty with­out being able to
explore, through tri­al and error, who you are and what mat­ters to you.
Cur­rent­ly more than 50 per­cent of the chil­dren served by Head Start have
had three or more adverse child­hood expe­ri­ences like those includ­ed in the
ACE study: incar­cer­at­ed fam­i­ly mem­bers, depres­sion, vio­lence, abuse, or
drug use in the home, or peri­ods of home­less­ness.
Peo­ple who feel safe and mean­ing­ful­ly con­nect­ed with oth­ers have
lit­tle rea­son to squan­der their lives doing drugs or star­ing numbly at
tele­vi­sion; they don’t feel com­pelled to stuff them­selves with car­bo­hy­drates
or assault their fel­low human beings. How­ev­er, if noth­ing they do seems to
make a dif­fer­ence, they feel trapped and become sus­cep­ti­ble to the lure of
pills, gang lead­ers, extrem­ist reli­gions, or vio­lent polit­i­cal move­ments—
any­body and any­thing that promis­es relief. As the ACE study has shown,
child abuse and neglect is the sin­gle most pre­ventable cause of men­tal
ill­ness, the sin­gle most com­mon cause of drug and alco­hol abuse, and a
sig­nif­i­cant con­trib­u­tor to lead­ing caus­es of death such as dia­betes, heart
dis­ease, can­cer, stroke, and sui­cide.
My col­leagues and I focus much of our work where trau­ma has its
great­est impact: on chil­dren and ado­les­cents. Since we came togeth­er to
estab­lish the Nation­al Child Trau­mat­ic Stress Net­work in 2001, it has
grown into a col­lab­o­ra­tive net­work of more than 150 cen­ters nation­wide,
each of which has cre­at­ed pro­grams in schools, juve­nile jus­tice sys­tems,
child wel­fare agen­cies, home­less shel­ters, mil­i­tary facil­i­ties, and res­i­den­tial
group homes.
The Trau­ma Cen­ter is one of NCTSN’s Treat­ment Devel­op­ment and
Eval­u­a­tion sites. My col­leagues Joe Spinaz­zo­la, Mar­garet Blaustein, and I
have devel­oped com­pre­hen­sive pro­grams for chil­dren and ado­les­cents that
we, with the help of trau­ma-savvy col­leagues in Hart­ford, Chica­go,
Hous­ton, San Fran­cis­co, Anchor­age, Los Ange­les, and New York, are now
imple­ment­ing. Our team selects a par­tic­u­lar area of the coun­try to work in
every two years, rely­ing on local con­tacts to iden­ti­fy orga­ni­za­tions that are
ener­getic, open, and well respect­ed; these will even­tu­al­ly serve as new
nodes for treat­ment dis­sem­i­na­tion. For exam­ple, I col­lab­o­rat­ed for one two-
year peri­od with col­leagues in Mis­soula, Mon­tana, to help devel­op a
cul­tur­al­ly sen­si­tive trau­ma pro­gram on Black­foot Indi­an reser­va­tions.
The great­est hope for trau­ma­tized, abused, and neglect­ed chil­dren is to
receive a good edu­ca­tion in schools where they are seen and known, where
they learn to reg­u­late them­selves, and where they can devel­op a sense of
agency. At their best, schools can func­tion as islands of safe­ty in a chaot­ic
world. They can teach chil­dren how their bod­ies and brains work and how
they can under­stand and deal with their emo­tions. Schools can play a
sig­nif­i­cant role in instill­ing the resilience nec­es­sary to deal with the trau­mas
of neigh­bor­hoods or fam­i­lies. If par­ents are forced to work two jobs to eke
out a liv­ing, or if they are too impaired, over­whelmed, or depressed to be
attuned to the needs of their kids, schools by default have to be the places
where chil­dren are taught self-lead­er­ship and an inter­nal locus of con­trol.
When our team arrives at a school, the teach­ers’ ini­tial response is
often some ver­sion of “If I’d want­ed to be a social work­er, I would have
gone to social work school. But I came here to be a teacher.” Many of them
have already learned the hard way, how­ev­er, that they can­not teach if they
have a class­room filled with stu­dents whose alarm bells are con­stant­ly
going off. Even the most com­mit­ted teach­ers and school sys­tems often
come to feel frus­trat­ed and inef­fec­tive because so many of their kids are too
trau­ma­tized to learn. Focus­ing only on improv­ing test scores won’t make
any dif­fer­ence if teach­ers can’t effec­tive­ly address the behav­ior prob­lems of
these stu­dents. The good news is that the basic prin­ci­ples of trau­ma-focused
inter­ven­tions can be trans­lat­ed into prac­ti­cal day-to-day rou­tines and
approach­es that can trans­form the entire cul­ture of a school.
Most teach­ers we work with are intrigued to learn that abused and
neglect­ed stu­dents are like­ly to inter­pret any devi­a­tion from rou­tine as
dan­ger and that their extreme reac­tions usu­al­ly are expres­sions of trau­mat­ic
stress. Chil­dren who defy the rules are unlike­ly to be brought to rea­son by
ver­bal rep­ri­mands or even suspension—a prac­tice that has become
epi­dem­ic in Amer­i­can schools. Teach­ers’ per­spec­tives begin to change
when they real­ize that these kids’ dis­turb­ing behav­iors start­ed out as
frus­trat­ed attempts to com­mu­ni­cate dis­tress and as mis­guid­ed attempts to
sur­vive.
More than any­thing else, being able to feel safe with oth­er peo­ple
defines men­tal health; safe con­nec­tions are fun­da­men­tal to mean­ing­ful and
sat­is­fy­ing lives. The crit­i­cal chal­lenge in a class­room set­ting is to fos­ter
reci­procity: tru­ly hear­ing and being heard; real­ly see­ing and being seen by
oth­er peo­ple. We try to teach every­one in a school community—office staff,
prin­ci­pals, bus dri­vers, teach­ers, and cafe­te­ria workers—to rec­og­nize and
under­stand the effects of trau­ma on chil­dren and to focus on the impor­tance
of fos­ter­ing safe­ty, pre­dictabil­i­ty, and being known and seen. We make
cer­tain that the chil­dren are greet­ed by name every morn­ing and that
teach­ers make face-to-face con­tact with each and every one of them. Just as
in our work­shops, group work, and the­ater pro­grams, we always start the
day with check-ins: tak­ing the time to share what’s on everybody’s mind.
Many of the chil­dren we work with have nev­er been able to
com­mu­ni­cate suc­cess­ful­ly with lan­guage, as they are accus­tomed to adults
who yell, com­mand, sulk, or put ear­buds in their ears. One of our first steps
is to help their teach­ers mod­el new ways of talk­ing about feel­ings, stat­ing
expec­ta­tions, and ask­ing for help. Instead of yelling, “Stop!” when a child is
throw­ing a tantrum or mak­ing her sit alone in the cor­ner, teach­ers are
encour­aged to notice and name the child’s expe­ri­ence, as in “I can see how
upset you are”; to give her choic­es, as in “Would you like to go to the safe
spot or sit on my lap?”; and to help her find words to describe her feel­ings
and begin to find her voice, as in: “What will hap­pen when you get home
after class?” It may take many months for a child to know when it is safe to
speak the truth (because it will nev­er be uni­ver­sal­ly safe), but for chil­dren,
as for adults, iden­ti­fy­ing the truth of an expe­ri­ence is essen­tial to heal­ing
from trau­ma.
It is stan­dard prac­tice in many schools to pun­ish chil­dren for tantrums,
spac­ing out, or aggres­sive outbursts—all of which are often symp­toms of
trau­mat­ic stress. When that hap­pens, the school, instead of offer­ing a safe
haven, becomes yet anoth­er trau­mat­ic trig­ger. Angry con­fronta­tions and
pun­ish­ment can at best tem­porar­i­ly halt unac­cept­able behav­iors, but since
the under­ly­ing alarm sys­tem and stress hor­mones are not laid to rest, they
are cer­tain to erupt again at the next provo­ca­tion.
In such sit­u­a­tions the first step is acknowl­edg­ing that a child is upset;
then the teacher should calm him, then explore the cause and dis­cuss
pos­si­ble solu­tions. For exam­ple, when a first-grad­er melts down, hit­ting his
teacher and throw­ing objects around, we encour­age his teacher to set clear
lim­its while gen­tly talk­ing to him: “Would you like to wrap that blan­ket
around you to help you calm down?” (The kid is like­ly to scream, “No!” but
then curl up under the blan­ket and set­tle down.) Pre­dictabil­i­ty and clar­i­ty of
expec­ta­tions are crit­i­cal; con­sis­ten­cy is essen­tial. Chil­dren from chaot­ic
back­grounds often have no idea how peo­ple can effec­tive­ly work togeth­er,
and incon­sis­ten­cy only pro­motes fur­ther con­fu­sion. Trau­ma-sen­si­tive
teach­ers soon real­ize that call­ing a par­ent about an obstreper­ous kid is like­ly
to result in a beat­ing and fur­ther trauma­ti­za­tion.
Our goal in all these efforts is to trans­late brain sci­ence into every­day
prac­tice. For exam­ple, calm­ing down enough to take charge of our­selves
requires acti­vat­ing the brain areas that notice our inner sen­sa­tions, the self-
observ­ing watch­tow­er dis­cussed in chap­ter 4. So a teacher might say: “Shall
we take some deep breaths or use the breath­ing star?” (This is a col­or­ful
breath­ing aid made out of file fold­ers.) Anoth­er option might be hav­ing the
child sit in a cor­ner wrapped in a heavy blan­ket while lis­ten­ing to some
sooth­ing music through head­phones. Safe areas can help kids calm down by
pro­vid­ing stim­u­lat­ing sen­so­ry aware­ness: the tex­ture of burlap or vel­vet;
shoe box­es filled with soft brush­es and flex­i­ble toys. When the child is
ready to talk again, he is encour­aged to tell some­one what is going on
before he rejoins the group.
Kids as young as three can blow soap bub­bles and learn that when they
slow down their breath­ing to six breaths per minute and focus on the out
breath as it flows over their upper lip, they will feel more calm and focused.
Our team of yoga teach­ers works with chil­dren near­ing ado­les­cence
specif­i­cal­ly to help them “befriend” their bod­ies and deal with dis­rup­tive
phys­i­cal sen­sa­tions. We know that one of the prime rea­sons for habit­u­al
drug use in teens is that they can­not stand the phys­i­cal sen­sa­tions that sig­nal
fear, rage, and help­less­ness.
Self-reg­u­la­tion can be taught to many kids who cycle between fran­tic
activ­i­ty and immo­bil­i­ty. In addi­tion to read­ing, writ­ing, and arith­metic, all
kids need to learn self-aware­ness, self-reg­u­la­tion, and com­mu­ni­ca­tion as
part of their core cur­ricu­lum. Just as we teach his­to­ry and geog­ra­phy, we
need to teach chil­dren how their brains and bod­ies work. For adults and
chil­dren alike, being in con­trol of our­selves requires becom­ing famil­iar with
our inner world and accu­rate­ly iden­ti­fy­ing what scares, upsets, or delights
us.
Emo­tion­al intel­li­gence starts with label­ing your own feel­ings and
attun­ing to the emo­tions of the peo­ple around you. We begin very sim­ply:
with mir­rors. Look­ing into a mir­ror helps kids to be aware of what they
look like when they are sad, angry, bored, or dis­ap­point­ed. Then we ask
them, “How do you feel when you see a face like that?” We teach them how
their brains are built, what emo­tions are for, and where they are reg­is­tered
in their bod­ies, and how they can com­mu­ni­cate their feel­ings to the peo­ple
around them. They learn that their facial mus­cles give clues about what they
are feel­ing and then exper­i­ment with how their facial expres­sions affect
oth­er peo­ple.
We also strength­en the brain’s watch­tow­er by teach­ing them to
rec­og­nize and name their phys­i­cal sen­sa­tions. For exam­ple, when their
chest tight­ens, that prob­a­bly means that they are ner­vous; their breath­ing
becomes shal­low and they feel uptight. What does anger feel like, and what
can they do to change that sen­sa­tion in their body? What hap­pens if they
take a deep breath or take time out to jump rope or hit a punch­ing bag?
Does tap­ping acu­pres­sure points help? We try to pro­vide chil­dren, teach­ers,
and oth­er care providers with a tool­box of ways to take charge of their
emo­tion­al reac­tions.
To pro­mote reci­procity, we use oth­er mir­ror­ing exer­cis­es, which are the
foun­da­tion of safe inter­per­son­al com­mu­ni­ca­tion. Kids prac­tice imi­tat­ing
one another’s facial expres­sions. They pro­ceed to imi­tat­ing ges­tures and
sounds and then get up and move in sync. To play well, they have to pay
atten­tion to real­ly see­ing and hear­ing one anoth­er. Games like Simon Says
lead to lots of snig­ger­ing and giggling—signs of safe­ty and relax­ation.
When teenagers balk at these “stu­pid games,” we nod under­stand­ing­ly and
enlist their coop­er­a­tion by ask­ing them to demon­strate games to the lit­tle
kids, who “need their help.”
Teach­ers and lead­ers learn that an activ­i­ty as sim­ple as try­ing to keep a
beach ball in the air as long as pos­si­ble helps groups become more focused,
cohe­sive, and fun. These are inex­pen­sive inter­ven­tions. For old­er chil­dren
some schools have installed work­sta­tions cost­ing less than two hun­dred
dol­lars where stu­dents can play com­put­er games to help them focus and to
improve their heart rate vari­abil­i­ty (HRV) (dis­cussed in chap­ter 16), just as
we do in our own clin­ic.
Chil­dren and adults alike need to expe­ri­ence how reward­ing it is to
work at the edge of their abil­i­ties. Resilience is the prod­uct of agency:
know­ing that what you do can make a dif­fer­ence. Many of us remem­ber
what play­ing team sports, singing in the school choir, or play­ing in the
march­ing band meant to us, espe­cial­ly if we had coach­es or direc­tors who
believed in us, pushed us to excel, and taught us we could be bet­ter than we
thought was pos­si­ble. The chil­dren we reach need this expe­ri­ence.
Ath­let­ics, play­ing music, danc­ing, and the­atri­cal per­for­mances all
pro­mote agency and com­mu­ni­ty. They also engage kids in nov­el chal­lenges
and unac­cus­tomed roles. In a dev­as­tat­ed postin­dus­tri­al New Eng­land town,
my friends Car­olyn and Eli New­berg­er are teach­ing El Sis­tema, an
orches­tral music pro­gram that orig­i­nat­ed in Venezuela. Sev­er­al of my
stu­dents run an after-school pro­gram in Brazil­ian capoeira in a high-crime
area of Boston, and my col­leagues at the Trau­ma Cen­ter con­tin­ue the
Trau­ma Dra­ma pro­gram. Last year I spent three weeks help­ing two boys
pre­pare a scene from Julius Cae­sar. An effem­i­nate, shy boy was play­ing
Bru­tus and had to sum­mon up his full force to put down Cas­sius, played by
the class bul­ly, who had to be coached to play a cor­rupt gen­er­al beg­ging for
mer­cy. The scene came to life only after the bul­ly talked about his father’s
vio­lence and his own vow nev­er to show weak­ness to any­one. (Most bul­lies
have them­selves been bul­lied, and they despise kids who remind them of
their own vul­ner­a­bil­i­ty.) Brutus’s pow­er­ful voice, on the oth­er hand,
emerged after he real­ized that he’d made him­self invis­i­ble to deal with his
own fam­i­ly vio­lence.
These intense com­mu­nal efforts force kids to col­lab­o­rate, com­pro­mise,
and stay focused on the task at hand. Ten­sions often run high, but the kids
stick with it because they want to earn the respect of their coach­es or
direc­tors and don’t want to let down the team—all feel­ings that are oppo­site
to the vul­ner­a­bil­i­ty of being sub­ject­ed to arbi­trary abuse, the invis­i­bil­i­ty of
neglect, and the god­for­sak­en iso­la­tion of trau­ma.
Our NCTSN pro­grams are work­ing: Kids become less anx­ious and
emo­tion­al­ly reac­tive and are less aggres­sive or with­drawn; they get along
bet­ter and their school per­for­mance improves; their atten­tion deficit,