Symptom Bearers

"RJ" (CC BY-NC-SA 2.0) by Don J Schulte

An individual assigned as the family “symptom bearer” is used as a scapegoat for anger, wrongdoing, or trouble within the family. Rather than parents and siblings taking a look at their own role in any issues, they deflect and blame it on the IP (Identified Patient) of the family. (Health, 2023)

There's no doubt that teachers are dealing with a high volume of complex realities in their classrooms. They're working hard to serve kids who arrive from environments that may not necessarily offer the appropriate support necessary for them to survive. This is the reality. We can let that consume us, or we can find ways to function more responsively and effectively. 

I'm always looking for a silver lining. It just seems like an objectively intelligent, albeit difficult thing to do. It involves an adjustment of our lens to see things from a different, purposeful perspective. I often say we need to glare at strengths, while glancing at weakness. Individuals who are confronted by  adverse experiences beyond their control, whether they like it or not, acquire intuitive skills that the general population typically may not because they don't have to. They do this out of necessity, likely unconsciously, but that is not to diminish the reality. 

Kids who live traumatic realities tend to develop intuitive skills in order to survive their environments. Adverse Childhood Experiences (ACE) are a set of ten identifiable environmental risk factors. 

The Adverse Childhood Experiences, or “ACEs,” quiz asks a series of 10 questions (see below) about common traumatic experiences that occur in early life. Since higher numbers of ACEs often correlate to challenges later in life, including higher risk of certain health problems, the quiz is intended as an indicator of how likely a person might be to face these challenges. (Harvard, 2013)

What’s In the ACEs Quiz?

For each “yes” answer, add 1. The total number at the end is your cumulative number of ACEs.
Before your 18th birthday:

1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
4. Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
5. Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
6. Were your parents ever separated or divorced?
7. Was your mother or stepmother:
   Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
9. Was a household member depressed or mentally ill, or did a household member attempt suicide?
10. Did a household member go to prison?

*Source: NPR, ACEsTooHigh.com. This ACEs Quiz is a variation on the questions asked in the original ACEs study conducted by CDC researchers. 

The ACEs quiz gives no insight into whether an individual child might be more or less sensitive to adversity and asks no questions about whether there may have been any protective relationships in place to help buffer the child from stress. So the ACEs quiz can only give insight into who might be at risk—not who is at risk—for certain later-life challenges. (Harvard 2013) Fair enough, however, where there's smoke, there's usually fire.

In fact, the ACE Score in any given case is an optic that excludes other possible risk factors opening the possibility that it may underestimate the adversity experienced by any given child. Missing from the assessment are: 

• Stressors outside the household (e.g., violence, poverty, racism, other forms of discrimination, isolation, chaotic environment, lack of services)
• Protective factors (e.g., supportive relationships, community services, skill-building opportunities)
• Individual differences (i.e., not all children who experience multiple ACEs will have poor outcomes and not all children who experience no ACEs will avoid poor outcomes—a high ACEs score is simply an indicator of greater risk) (Harvard 2013)

More recently, the same researchers that developed the ACE protocol realized the added-value of  complimentary research referred to as Positive Childhood Experiences. 

In September 2019, lead researcher Dr. Christina Bethell released the results of a study of 6,188 adults at Johns Hopkins seeking to identify Positive Childhood Experiences (PCEs) that could buffer against the health effects of traumatic ones. A percentage of kids with high ACE scores do nevertheless grow up to have normal development and good adult emotional health. The researchers were looking to identify the factors that created a level of resiliency in these kids that helped them to thrive despite difficult childhoods. (Positive Childhood Experiences (PCEs), n.d.)

A major principle of resiliency research asserts that reducing risk factors is a beneficial action to take on behalf of kids for at-risk environments. It stands to reason that a reciprocal effort to increase protective factors should also be made. This is where PCEs enter the process. We can't always change the conditions of a child's environment away from school, but we can support efforts to help them become antifragile; the ability to navigate, cope, and eventually thrive amidst adversity. Antifragility is a state of malleability in which an individual possesses the ability to bend, but not break so their core coping ability remains stable, albeit modified. People who possess a myriad of protective factors can adapt more routinely as they respond to their environmental condition. 

The PCEs study helps shape research moving in an additional direction: increasing positive childhood experiences to build resilience in kids who have experienced trauma, and those who may in the future. The relationship between PCEs in childhood and good mental health in adults is dose-responsive; the more PCEs a child gets, the better their adult mental health is likely to be. (Positive Childhood Experiences (PCEs), n.d.)

Children with PCEs become adults who are able to seek social and emotional support. The 7 PCEs are:

1. The ability to talk with family about feelings.
2. The sense that family is supportive during difficult times.
3. The enjoyment of participation in community traditions.
4. Feeling a sense of belonging in high school.
5. Feeling supported by friends.
6. Having at least two non-parent adults who genuinely cared.
7. Feeling safe and protected by an adult in the home.  (Positive Childhood Experiences (PCEs), n.d.)

It seems like a simple formula because it is; reduce risk, increase protection. However, and this is a big "however", caring significant others are impacted by the same uncontrolled environmental conditions that the person they care for is. This is a difficult reality. But, and this is a big "but", we do have the ability to completely control the environments we create to support them. The process of determining what that environment looks, sounds and feels like is an effort we must constantly make to authentically create emotionally, socially and psychologically supportive environments away from home and the immediate family reality. 

What's Your Truth?

 

                                            "the truth is..." (CC BY-NC-SA 2.0) by memory_collector

Those of us who work with kids from at-risk environments are challenged by the truths embedded within their trauma. How much we know about the conditions of their lives is dependent on many things, not the least of which are the protocols surrounding the appropriate disclosure of the always sensitive details. Who needs to know? Can those who perhaps want to know impactful details about the kids they work with handle the emotions surrounding the circumstances? Are there those who won't benefit from knowing these details but insist on not being kept out of the loop? 

There appears to be a fairly aggressive desire to know as "much as we can" about the kids we work with, but what if we're focusing on the wrong truths? I'm the first person to assert that we need to know as much as we can about the "story behind the story" of the kids and families we serve, but when circumstances prevent us from knowing as much as we'd hope to, I think we can totally divine a simpler construct in support our most vulnerable clients. In the very simplest of terms, there's only one truth we absolutely need to implicitly know in order to do our best work with kids from at-risk environments... our own.

I have often been involved in difficult conversations regarding the "need to know." At times when it has been necessary to disclose confidential information about a child's personal circumstances, I will typically hear teachers and other school personnel make statements like, "If I had known more about this child, I would have changed the way I interacted with him," to which I typically ask two questions in reply... why and how? 

There's one thing we implicitly need to know about kids surviving adverse childhood experiences; our personal truth in the way we feel about supporting kids no matter the type of environment they arrive from every day. Call it a philosophy, a perspective, or whatever you'd like, but the way we perceive our role as kare-givers (caring for kids from at-risk environments,) is the most important awareness we need to be clear about and one that we can never go wrong with if it emerges from the right perspective. The first part of this truth is that we can never, ever judge a child. I often find that this judgement, when it does happen, is grounded in incorrect assumptions about the child; that the behaviour they're communicating with is intentional or premeditated. It's not.

This inaccurate judgement often also manifests in damaging language (verbal and body) that gets communicated back toward the child. We act out what we're feeling, even when we don't realize we're doing it. When we feel that kids are intentional in being "bad," the tendency to take their perceived actions personally is heightened. Our best work cannot materialize when we believe kids are coming to school with deliberate intent to make our day, and their classmate's days as miserable as possible.

Kids know much more about who they're dealing with than we know about them. I often say kids are like horses; they pick up on our nuances and impressions toward them so much more skillfully than we can toward them just like a horse can feel his rider through the saddle better than the rider can feel the horse. This reality puts both the horse, and the child, at a distinct advantage with respect to the ways they respond to our actions, feelings, and words directed toward them. Kids know when we're not at ease dealing with them.

If all of us who work with kids could empathetically approach each of them with kindness and acceptance perhaps we can get by without the advantage of knowing about where they come from. We'd be expressing nothing toward them that necessarily needed to be reacted to. We would be tapping into what good solution-focused therapists know about effectively working with their clients; that you don't need to dwell on the problems to effectively set goals toward the solutions. We should harbor no animosity toward others for not disclosing details about kids we don't need to know. We could simply feel what we should feel about our role as educators; privileged and humbled to have the opportunity to support them from wherever they arrive each and every day. Defaulting to that presents very good odds that we'll build the trust and comfort necessary for kids arriving from at-risk environments not to be at risk within our classroom environments too. 

Cultural Tails (Tales) - The Story Everyone Tells

de·us ex ma·chi·na

/ˌdāəs ˌeks ˈmäkənə,ˌdāəs ˌeks ˈmäakənə/

noun

1. an unexpected power or event saving a seemingly hopeless situation, especially as a contrived plot device in a play or novel.

Our lives are a series of stories that evolve in quantum ways every second as we are affected by the realities in our environments and the decisions we make surrounding them. Much of what goes on around us is beyond our control. From the Stanford Encyclopedia of Psychology, it's phenomenological in the sense that,

the discipline of phenomenology may be defined initially as the study of structures of experience, or consciousness. Literally, phenomenology is the study of “phenomena”: appearances of things, or things as they appear in our experience, or the ways we experience things, thus the meanings things have in our experience. Phenomenology studies conscious experience as experienced from the subjective or first person point of view.

How capably we are able to engineer our own stories depends on our ability to accept that the phenomena that surround us is essentially beyond our control. Sometimes, as in literature or theatre, a deus ex machina is helpful in resolving the seemingly hopeless life situations that are ultimately beyond our control, but not beyond our personal influence and ability to internalize and accept. Partly as a response to what I wrote recently about how the path of teaching chose me, and also just because it's front of mind, this resolve is what I want to talk about today. 

Essential to the stories of our lives, recognizing deus ex manchina that have unexpected power to resolve a sense of hopelessness, or what Victor Frankl would characterize as a lack of purpose, is critical to our resilience and happiness. Viktor Frankl's (1946) Man's Search for Meaning chronicles his experiences as a concentration camp inmate and describes his psychotherapeutic method of finding a reason to live. According to Frankl, the book intends to answer the question "how was everyday life in a concentration camp reflected in the mind of the average prisoner?" He observed that prisoners who found something to do every day appeared less vulnerable to the guards, and subsequently were judged as useful in one way or another; not as expendable. I simply cannot even imagine the horror of that reality, but nonetheless, it was documented by Frankl, (perhaps that was his purpose in attempting to make any sense of the horror,) and it makes sense to me.

I took away from this book the notion that without purpose, there is nothing. I think I already knew this on some level, but not to the point where I was considering the concept as part of my minute-by-minute navigation of daily challenges. I have come to realize implicitly that purpose needs to be at the core of everything I do. Purpose is a deus ex machina that resolves nearly all hopeless situations in life. It's a very critical one and we may need help finding it sometimes, but we have to have it. Hope is an action word.

The making of a teacher...

During the COVID19 crisis I've been doing a lot of thinking and reflecting... the gift of time has been nice if I'm being honest; a silver lining if you will amidst the chaos of what's happening right now. I'm one of those who have continued to go to school every day just for myself to keep that routine present in my life and so not to go stir crazy at home. Spring break has me at home today though, and for the rest of the week so I've become reacquainted with KARE Givers, (I hadn't written anything at this blog before last week since summer of 2016,) and some other things that I haven't done in a long time. I even participated in a Twitter chat last evening, something I haven't done in 8 or 9 years. It's been at least that long since this post has been sitting in my list of drafts.

I first told this story in front of an audience in 2006 to about one hundred teachers at the Central Alberta Teacher's Convention. A few years later I used it twice as an opening to a couple of lectures I gave at the University of Alberta. Later again I used this story as a narrative to open workshop sessions for the Alberta Teacher's Association Corps of Professional Instructors during professional development sessions I wrote and offered as an instructor.

In every case the theme of my presentation, lecture, and workshop was resiliency. The topic of resiliency is largely what KARE Givers is all about in one form or another, most of the posts within this blog have some reference to resiliency as a construct.

Probably as a result of all the thinking I've been doing about life and teaching, I've been brought back to my core and I'm finding myself looking for ground as I introspectively reflect on what brought me to this place in life where I feel like in some ways I know what I'm doing, but perhaps in others, I'm still trying to figure it out. At any rate here is where I am, and I guess I just feel like finally writing this narrative down. Maybe it will help me understand better where I need to go from here.