Lovely quote from David Kundtz:
Stopping is doing nothing, as much as possible, for a definite period of time.
Many more great quotes at Stopping: How to Be Still When You Have to Keep Going.
- The gales of November come lashing. #
- Lovely train ride down to Seattle, working with my friend Teresa and following the midterm election carnage. #
- #openspace today w/ top researchers and policy people on adverse childhood experiences with an eye to making big policy changes in WA state. #
- Working at Cederbrook Lodge near SeaTac airport. Lovely space, free wifi, all the tools for a good #openspace http://bit.ly/cSeIdZ #
- Did you see the moon this morning? A thin shaving, old month fading, dying into a brilliant autumn sunrise. #
- At a Casey Foundation conference in Seattle on applying science to early childhood development. Speeches this am, #WorldCafe this pm. #
- "People come to the USA for great medical treatment, but not 4 health promotion. They get less healthy when they come here." Dr. J Shonkoff #
- "Silos aren't breaking down. But if we all work in community from the same information sources we can change things." Dr. Rob Anda #
- The Still Face Experiment: http://youtu.be/apzXGEbZht0 "Our Society is 'the still face' responding to kids in need." – Jennifer Rodriguez #
- More about Jennifer Rodriguez: http://bit.ly/b3TW2N #
- Incredible video of this years Fraser River sockeye fishery: http://bit.ly/cOLM9m #
- Rainbows over Howe Sound http://yfrog.com/n3nu4rj #
- Cool air, wood smoke, still morning, eagle calling. http://yfrog.com/j49amrj #
In Seattle yesterday I was listening to a keynote by Dr. Jack Shonkoff who is a breain researcher at Harvard with an interest in early childhood development. He said an interesting thing about American health care which kind of answers the question for me about what the US is good at.
Many Americans who are opposed to public health care use the argument that people from other countries come to the United States for the world’s best treatment, surgery and acute care. No question that if you can afford it, the USA has the best. BUT – and this was a revelation to me, to hear from a leading doctor – no one moves to the USA permanently for their health. In the case of almost every industrialized country, and several developing countries as well , the USA trails in health promotion. So while people do come for treatment, they go back home to countries that support better overall health.
And insurance based system is to blame for this. Pouring money into insurance means that treaments, including surgery and drugs are developed and widely available because there is an incentive for private companies and public institutions to develop excellent treatment, activities and products that you can charge for. Health promotion is not a profit making venture, so if you choose to put public resources in private insurance, you get private, price based solutions. Building a system that prioritizes prevention, healthy communities, health promotion and safety is the way to reduce the need for acute treatments later in life, but no one can make a profit at it, so it requires a public, social response to build that infrastructure.
So that’s kind of interesting, especially as we hear the debate in Canada clamouring for more private involvement at the treatment end of things.
Silo busting is a very interesting thing. Everyone knows that systems atrophy when they divide their work into silos. Silos entrench difference and prevent learning across sectors whether we are talking about departments in an organization, or a social system like health care or child and family services.
Silos have limited usefulness. They divide work into manageable chunks. But in general they create reductionist responses to systemic problems and they pose a massive challenge to people working nfor change. If we first have to bust the silos, and only then can we address the problems, how do we know we’ll have energy left for the real work?
So let’s be real. Dr. Rob Anda, who I met this week in Seattle, had a great line when talking about reducing the effects of adverse childhood experiences. “I don’t see silos as disappearing anytime soon, but if we work together in community from common information sources we can make change.”
Great line. Forget about the silos. Bring people together in communities of practice to learn about the information they need and that serves their common purpose, and then engage in the conversations that build network and community around learning about change and enacting solutions that make sense at the community level. Bottom up silo busting. Forget about the structural reforms first. Do the work first and then institutionalize the solutions that work across sectors, disciplines and other silos. Follow the Theory U process: concretize solutions following social prototyping.
And when the silos – the funders, the government agencies, the power brokers and decision makers – come looking for evidence and evaluation, use Developmental Evaluation to tell the story of what is going on across the system.
I’m at a Casey Family Programs conference in Seattle that is looking at applying science to early learning in kids. The people here are learning about brain science and the results of early adverse childhood experiences and what the science can tell us about how we should react in the policy sphere to create healthy kids, families and societies.
The keynote is by Jack Shonkoff, who is a leading brain researcher in this field and who has been sharing some of the basics of what we know about brain science, relationships and healthy societies. Here are some of his key points:
Experiences build brain architecture. What happens is that neural circuits develop to reinforce behaviours, emotions, motor skills and so on. Babies brains build a basic architecture by forming synapses and then a more complex architecture develops on top of that. For the first three year of life, babies’ brains form 700 synapses a second. Genes provide the template for this work, but experiences turn the genes on and off. So early life experiences are built into our bodies, encoded in our brains – for better or for worse. To promote healthy brian architecture you need language rich environments, supportive relationships and “serve and return” interactions with adults are the three things that promote health brain architecture. Prolonged stress and reduced exposure to supportive relationships – in other words, what are known as adverse childhood experiences (ACEs) – create the conditions for heart disease, diabetes, and other diseases that are a result of disrupted development of organ systems.
Toxic stress derails healthy development. In babies, stress is alleviated by contact with a caring adult. If a child is exposed to stress in large amounts, the brain loses the ability to turn off the stress responses, and the stress becomes toxic. Nurturing, stable and engaging environments are the antidote to stress. It’s interesting that in North America we don’t treat stress with much compassion – “get over it” is a common response. In the USA especially, a hyper individualistic culture diminishes the importance of stress.
Some positive stress is a good thing however – what we call in the facilitation world “The Groan Zone” which helps learning and helps healthy development. There is always stress associated with learning new things or doing things for the first time. In healthy development, adults help kids with this kind of stress and the kids learn strategies for dealing with stress, which amps up the heart rate and blodd pressure and then reduces it. Supportive relationships help children to learn adaptive and coping skills.
Tolerable stress is serious and temporary – death of a family member, natural disasters, war and violence, an experience of extreme despair and other things that can lead to post-traumatic stress disorder. This kind of stress is also buffered by supportive relationships. Families, extended families, friends, neighbours, supported programs need to step in and provide the buffering that reduces stress to baseline levels.
Toxic stress however is prolonged activation of the stress response in the absence of protective relationships. This includes living alone in violence, or with adults that neglect children or who are unable to care for children because the are sick or depressed. If you don’t have access to caring adults, the stress becomes toxic and the stress system is built into your brain architecture, placing hardship on your organs, your nervous system and your hormones. This is the kind of stress that leads to long term health and development issues.
Neglect can be as powerful as abuse. It doesn’t matter to the baby’s brain whether your lack of relationships come from neglect or abuse. It has the same effect on the brain, and it keeps the stress levels high. Seven hundred synapses a second don’t care what an adult is doing if there are no compassionate relationships. Reducing stress by reducing the numbers and severity of adverse early childhood experiences results in better outcomes. This doesn’t mean that we have to solve poverty and subsistence abuse overnight before we get better outcomes – it means we need to make policy decisions that ask the question about whether we are supporting healthy and supportive relationships. In other words, the social safety net needs to work both at the systemic level to reduce inequalities, and at the acute level to create spaces where people can learn and experience healthy supportive relationships at every age.
I’ve been listening here thinking about the implications for this in organizations and communities. To sacrifice relationships at the alter of work or learning is to not only inhibit the sustainability of what is going on, but also creates the conditions for unhealthy families, groups, communities and organizations.