By Richard Clark:
This article is based on an interview that Amy Goodman did with Canadian physician and best-selling author, Dr. Gabor Mate’, whose books are listed at the end of this article.
Whether it’s a shopping addiction or an addiction to opiates, and whether we know it or not, we’re all looking for more endorphins for our brains. Endorphins are the brain’s feel-good, reward, pleasure, and pain-relief chemicals. Even more amazing, they are the “love chemicals” that connect us to the universe — to God, or the “oceanic experience” as Freud called it — and to one another.
The problem for addicts is that this circuitry doesn’t function very well. The circuitry of incentive and motivation, which involves the chemical dopamine, also doesn’t function very well. Stimulant drugs like cocaine and crystal meth, nicotine and caffeine, all elevate dopamine levels in the brain, as does sexual acting out, as do extreme sports, as does workaholism, and so on.
So why do these circuits not work so well in drug addicts? After all, the so-called addictive drugs, in themselves, are not, rather surprisingly, very addictive — which is to say that most people who try most drugs never become addicted to them. And so, there has to be individual susceptibility involved, to explain those who do get addicted. And these susceptible people are of course the ones with these impaired brain circuits, and that impairment is caused by early life experience adversity, rather than by genetics.
What is meant by “early life experience adversity”?
The human brain, unlike that of any other mammal, for the most part develops under the influence of the environment. And that’s because, from an evolutionary point of view, we developed these large heads, large fore-brains. And to walk on two legs we must have a narrow pelvis. This means — large head, narrow pelvis — that compared to other mammals, we have to be born prematurely. Otherwise, we would never get born. The head is the biggest part of the newborn human body. Now, the horse can run on the first day of life. Human beings don’t get that developed for two years. This means that much of our brain development, which in other animals occurs safely in the uterus, for us has to occur out there in the environment. And so it is that which circuits develop, and which don’t, depend very much on environmental input. Thus our developing brains are exposed to the possibility of early life experience adversity.
The problem here is that when children are mistreated, stressed or abused, their brains don’t develop the way they ought to. It’s that simple. Unfortunately, however, the medical profession incorrectly puts all the emphasis on genetics rather than on the environment, which, of course, has a simple explanation: It lets everybody off the hook.
What is meant by “letting people off the hook?”
If we can pretend that people’s behaviors and dysfunctions are regulated, controlled and determined by genes, and not the social and emotional environment, we don’t have to look at child welfare policies, we don’t have to look at the kind of support that our society provides to pregnant women, and we don’t have to look at the kind of non-support that is, pitifully, extended to families. The reality is that most children in North America now have to be away from their parents from an early age, because of the dire economic situation and associated considerations that have sprung up over the past 30 years, since Reaganomics first began to take its terrible toll. Because of current welfare laws, most mothers are now forced to go find low-paying jobs far away from home, and cannot see their kids for most of the day. The tragic reality is that under these conditions, kids’ brains don’t develop the way they need to. Myriad problems result, both for the children and for the society.
However, to the extent that we can pretend that all the resulting damage is caused by genetics, we don’t have to look at the social and economic policies at the root of these misfortunes; we don’t have to look at the politics that disadvantage certain minority groups, thereby causing them more stress, causing them more pain — and more predisposition to addiction. Bottom line, we don’t have to look at economic inequalities. If it’s all genes (which of course it isn’t), we’re all innocent, and society doesn’t then have to take a hard look at its commonplace attitudes and policies. So most of us pretend, as required.
Criminalization versus harm reduction
How should addicts be treated, and how are they treated in the United States and Canada?
If people who become severe addicts (as shown by all the studies) were for the most part severely abused and neglected as children (as they certainly are), then we must realize that the war on drugs is actually being waged against people that were abused from an early age onward, throughout their childhood years. In other words, we’re punishing people for having been abused. That’s the first point.
Now imagine a situation where we really were trying to figure out how to help addicts and others who are dysfunctional. Would we come up with a system that stresses them to the max? Who on earth would design a system that ostracizes, marginalizes, impoverishes and ensures the disease of the addict — and then foolishly hope, through such a crazy system, to rehabilitate large numbers of them? It can’t be done. In other words, the so-called “war on drugs,” which, as the new drug czar points out, is really a war on people, actually entrenches addiction deeply. Furthermore, it institutionalizes people in facilities where there’s nothing in the way of the care they so desperately need. We call it a “correctional” system, but it doesn’t correct anything. In actuality it’s a punitive system that makes its victims more dysfunctional than ever. So people suffer more, and when they come out, they’re more entrenched in their addictions and dysfunctionality than they were when they went in.
The chemical control of children’s behavior
There are about half-a-million kids in this country receiving heavy-duty anti-psychotic medications — medications that are usually given to adult schizophrenics to regulate their hallucinations. But in this case, children are getting it so that adults can control their behavior. So what we have here is a massive social experiment in the chemical control of children’s behavior, with no idea of the long-term consequences of these heavy-duty anti-psychotics, on our kids. How sweet.
In the last five years, there’s been a 43% increase in the rate of dispensing of stimulant prescriptions for Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD), and most of these drugs are going to boys. In other words, what we’re seeing is an unprecedented burgeoning of this diagnosis and its corresponding drug treatment.
What we’re talking about here is nothing less than the destruction of American childhood. How so? According to a recent study published in the U.S., nearly half of American adolescents now meet some criteria for a mental health disorder. So we’re talking about a massive negative impact on our children by something in our culture that’s just not being recognized.
So what is it?
The conditions in which children develop have been so corrupted and troubled over the last several decades that the template for normal brain development is no longer present for many, many kids. Dr. Bessel Van der Kolk, a professor of psychiatry at the University of Boston, actually says that the neglect or abuse of children is now the number one public health concern in the United States. Similarly, a recent study coming out of Notre Dame by a psychologist there has shown that the conditions for child development that are optimal for brain development, are no longer present for our kids. She says that the way we raise our children today, in this country, is increasingly depriving them of the practices that lead to well-being and normalcy.
What’s really going on here now is that the developmental conditions for healthy childhood psychological and brain development are ever less available, so that the issue of ADD is only a small part of the general issue that most American children are no longer getting the support they need to properly develop.
The essential condition for the physiological development of the brain circuits that regulate human behavior, that give us empathy, that give us a social sense, that give us a connection with other people, that give us a connection with ourselves, that allow us to mature — the essential condition for those circuits, for their physiological development, is the presence of emotionally available, consistently available, non-stressed, attuned parenting caregivers. And that condition, that presence, is becoming ever scarcer in America. With tragic consequences.
But what can you expect in a country where the average maternity leave is six weeks? — as compared to, say, in Sweden, where paid leave for either or both parent(s) is 15 months!) The fact is that most American kids no longer have adequate emotional caregivers available to them throughout most of their childhood. What can you expect in a country where nearly 50% of low-income women suffer from postpartum depression and therefore can’t possibly be properly attuned to their child?
What we have to understand here is that, contrary to the “free enterprise” myth that people are competitive, individualistic, private entities, human beings are not private entities. They are not discrete, individual entities. What people actually are, are social creatures, very much dependent on one another and very much programmed to cooperate with one another whenever circumstances are conducive to such cooperation. And when such circumstances are not available, and the necessary support is not available for women, that’s when women get depressed. And when the fathers — those who have even bothered to stick around — are stressed, for lack of sufficient wages, lack of sufficient time off from work, and lack of decent employment opportunities, they’re not able to support their woman in that really important, crucial bonding role that’s particularly necessary in the beginning of a child’s life. The men then get stressed and depressed themselves. Rancor follows, as does spousal abuse and child abuse. Children, and our society, then take the toll. A very heavy toll indeed.
(Note: Compelling new evidence shows conclusively that large income inequalities within societies damage the social fabric and the quality of life for everyone. See the massive accumulation of evidence at this site.)
In summary, the child’s brain development depends on the presence of non-stressed, emotionally available parents. And in this country, over the past 30 years, such parents are ever less available to children. For that reason you’ve got burgeoning rates of autism in this country, which has risen nearly 30-fold in the last 30 years.
Autism
Autism is a whole spectrum of disorders, but the essential quality of it is emotional disconnect. These children are living in a world of their own. They don’t respond appropriately to emotional cues. They withdraw. They act out in an aggressive and sometimes unpredictable fashion. There’s no clear sense of emotional connection and no sense of peace inside them.
In general, the rates of anxiety amongst children are increasing. The numbers of kids on antidepressant medications has increased tremendously. The number of kids being diagnosed with bipolar disorder has gone up dramatically. Then too there’s the bullying, the precocious sexuality, and the teenage pregnancies. There’s now even a program on TV, a so-called “reality show,” that focuses on teenage mothers. All indications of a society that has somehow got off on the wrong track and that is spiraling downward.
Post-industrial capitalism and the disintegration of the modern American family
It never used to be that so many children grew up in a stressed nuclear family. That simply was not the normal basis for child development. The normal basis for child development has always been the clan, the tribe, the community, the neighborhood, the extended family. But post-industrial capitalism has completely destroyed those conditions. People no longer live in communities that are interconnected. They don’t work where they live. They don’t shop where they live. Often the kids don’t go to school where they live. The parents are away most of the day. For the first time in history, children are not spending most of their time around the nurturing adults in their lives. Instead, they’re spending their childhoods largely separated from the nurturing adults they absolutely need for healthy brain development.
In ADD, as already stated, there’s an essential brain chemical, necessary for incentive and motivation, that seems to be lacking. It’s called dopamine. Dopamine is an essential life chemical for all mammals. Without it, there’s no life. Mice in a laboratory, that have been chemically deprived of dopamine, will starve themselves to death. Why? Because they have no incentive to eat. Even though they’re hungry, and even though their life is in danger, they will not eat, because there’s no motivation or incentive. So, one way to look at ADD is as a massive problem of motivation, because dopamine is lacking in the brain. Now, the stimulant medications do elevate dopamine levels, and these kids do then become more motivated. They can then focus and pay attention.
However, the profoundly mistaken assumption behind giving these kids medications is that what we’re dealing with here is a genetic disorder, and that the only way to deal with it is pharmacologically. But if you actually look at how the dopamine levels in a brain develop, if you look at infant monkeys and you measure their dopamine levels, you’ll see that they are normal when they’re with their mothers, and when you separate them from their mothers, their dopamine levels go down within two or three days.
In other words, what we’re doing is trying to correct a massive socioeconomic problem, that results in disconnection and the loss of nurturing, by feeding our kids chemicals! Granted that these stimulant drugs do seem to work, and a lot of kids are, in the short run, helped by them. The question is not so much whether these drugs should be used or not; the problem is that 80% of the time a kid is prescribed a medication, that’s all that happens. Nobody talks to the family about the family environment. The school makes no attempt to change the school environment. Nobody connects with these kids emotionally. In other words, it’s seen simply as a medical or a behavioral problem, and not in any way as a problem of emotional environment and development. So our kids keep “acting out” and the total chemical dosage keeps increasing, as does their “acting out.”
What does “acting out” mean?
When you hear the phrase “acting out,” it usually means that a kid is behaving badly, that a child is being obstreperous, oppositional, violent, bullying, and/or rude. Most of us don’t have the words and concepts that are necessary to say what’s really going on. The phrase “acting out” means that you’re referring to behavior which you haven’t got the words to properly describe, within the limits of the vocabulary you possess. In a game of charades, you have to “act out” because you’re not allowed to speak. If you landed in a country where nobody spoke your language and you were hungry, you would have to literally demonstrate your hunger, through behavior, by pointing to your mouth or to your empty belly, because you don’t have the words that are required.
So yes, a lot of children are “acting out,” but it’s not just bad behavior. It’s also a manifestation of emotional losses and emotional shortages in their lives. And whether it’s bullying or a whole set of other behaviors, what we’re dealing with here is childhood-stunted emotional development. And rather than trying to control these behaviors through punishments, or exclusively through medications, we need to somehow find a way to help these kids develop normally.
But many in America are moving in exactly the opposite direction
In 1998, there was a book that the New York Times named the best book of the year and it nearly won the Pulitzer Prize. It was called The Nurture Assumption. In this book, the researcher-author argued that parents don’t really make any difference anymore! Newsweek actually had a cover article that year entitled “Do Parents Matter?” Now, if you want to get the full stupidity of that question, you have only to imagine a veterinarian magazine asking, “Does the mother cat make any difference?” or “Does the mother bear matter?” This author’s research showed that children are now being influenced — in their tastes, in their attitudes, and in their behaviors — by peers more than by parents. And this poor researcher thereby concluded that this is somehow natural! Her badly mistaken presumption was that what is the behavioral norm in North America . . is actually natural and healthy. In fact, it isn’t.
If your spouse or partner came home from work and didn’t give you the time of day and got on the phone and talked with other people all the time and spent all their time on email talking to other people, your friends wouldn’t say, “You’ve got a behavioral problem on your hands and you should try tough love.” What they’d say is that you’ve got a relationship problem. Yet when children act in these ways, the vast majority of Americans have been taught to think they have a behavioral problem, and then they try and control or reshape those “bad’ behaviors.
In fact, what our children are showing us is that we have a relationship problem with them. They weren’t/aren’t connected enough with us and were/are too connected to their peer group. That’s why they want to spend all their time with their peer group and very little with their parents. And now we’ve given kids the technology with which to do exactly that. So the terrible downside of the Internet and their cell phones is that now kids are spending way too much time with each other, and way too little with their parents.
Don’t kids have to rebel in order to separate from their parents?
No. They eventually have to separate, but they don’t have to rebel. In other words, separation is normal, yes. Individuation is a normal human developmental stage. You have to become a separate, individual person. But it doesn’t mean you must reject and be hostile to the values of adults. As a matter of fact, in traditional societies, children become adults by being initiated into the adult group by elders, like the Jewish Bar Mitzvah ceremony, or the initiation rituals of tribal cultures around the world. But American kids are initiated by other kids. And so it is that you have the gang phenomenon, which is actually a misplaced initiation and orientation ritual, where kids rebel against adult values. It happens not because they’re bad kids, but because they’ve become disconnected from adults.
Education in the United States — how does it fit in?
We first have to ask, how do children learn? Learning is an attachment dynamic, among other things. You learn when you want to be like somebody. So you copy them, so you learn from them. You learn also when you’re curious. And you learn when you’re willing to try something, and if it doesn’t work, you try something else.
However, in caring about something and in being curious about something and in recognizing that something doesn’t work, you have to have a certain degree of emotional security. You have to be able to be open and vulnerable. The problem is, children who become completely peer-oriented — because the peer world is so dangerous and so fraught with bullying and ostracization and dissing and exclusion and negative talk — have a hard time protecting themselves from all that negativity in the peer world. The harsh reality is that children are not, and cannot be, committed to each others’ unconditional loving acceptance. Far from it. Even adults have a hard time providing that. Children simply can’t do it. Ever. So those children who rely totally on their peers, and not their parents, become very insecure. And emotionally, to protect themselves, they shut down. They then become hardened, so that they can become “cool.’ Nothing matters. Cool is the ethic. You see that demonstrated amply in rock videos. It’s all about being cool. It’s all about aggression and cool and no real emotion. Detached. Now, when that happens, curiosity largely disappears. Why? Because curiosity is inherently vulnerable, because when you care about something and you’re admitting that you don’t know, you are vulnerable. When you’re “cool,’ you won’t try anything, because if you fail, your vulnerability is exposed. And that violates the ethic of “cool.’ So, you’re not willing to allow the trial and error that is essential to real learning and real education.
As long as kids were attaching to adults, they were looking to the adults to model themselves on, to learn from, and to get their cues from. Now, in America, kids are still learning from the people they’re attached to, but now it’s other kids they’re primarily attached to, not their parents. So now you have whole generations of kids that are looking to other kids to be their main cue-givers. Therefore teachers have an almost impossible problem on their hands. And unfortunately, in North America, education is seen almost exclusively as a question of academic pedagogy; hence these terrible standardized tests. And the teachers who work with the most difficult kids are the ones who are most often penalized. For if they don’t have good student test scores to show school administrators, they’re seen as bad teachers, and then they could be fired. So, to avoid being seen as “bad teachers,” they are inclined to kick out any difficult kids, so as to avoid that label and the firing that might then follow.
The difficult kids get kicked out, and teachers are afraid to teach in neighborhoods where, because of troubled family relationships, the kids are having difficulties. The kids are peer-oriented, and are not looking to the teachers. And this is seen as a reflection on the teachers, which it definitely is not. So, actually, teachers are regularly being slandered and scapegoated these days, for something that is not their fault. And the reason that teachers are being slandered and scapegoated is because of the failure of American society to produce the right environment for proper childhood development!
What this problem reflects is the loss of the community and the neighborhood. So, we have to somehow recreate those communities and those neighborhoods. The schools have to become not just places of pedagogy, but places of emotional connection. Teachers must be in the emotional connection game before they attempt to be in the pedagogy game.
Research into the effects of adverse childhood experiences
There was a number of large-scale studies in the United States, done by brilliant researchers, called the ACE studies, A-C-E, adverse childhood experiences. An adverse childhood experience stems from a child being abused, or from violence in the family, or from a parent being jailed, or from the extreme stress of poverty, or from a rancorous divorce, or from a parent being addicted, alcoholic and so on.
It turns out that if a child has a number of these adverse childhood experiences, his chance of becoming a drug addict later on, or any kind of an addict, go up exponentially. In fact, a male child with six such adverse childhood experiences sustains a 4,600% increase in the risk of becoming an injection-using substance addict, as compared to the chances of a male child with no such experiences. In other words, there is a 46-fold increase in the risk.
Interestingly enough, those adverse childhood experiences also exponentially increase the risk of cancer, high blood pressure, heart disease, and a whole range of other diseases, as well as suicide and early death. In other words, there’s a real connection between early childhood adversity and a) how a person lives their lives and b) the later appearance of addiction and diseases, both physical and mental.
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Dr. Gabor Maté is the Vancouver-based physician and bestselling author of four books:
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Original Content at http://www.opednews.com/articles/The-psychological-cultura-by-Richard-Clark-101226-354.html