Learning about Toxic Stress - a personal account

Photo by Suzer Jones on Foter.com / CC BY-NC 

During a period of almost a decade I had the opportunity to learn about toxic stress on a personal level. Not that it had me as a target, my stress levels have always remained at the tolerable threshold, and that has made me very appreciative for the wealth of opportunities I had been granted since inception. What I am about to describe took place while I worked voluntarily as a teacher of English to many groups of very low SES students from 10 to 18 years of age who were part of an NGO (non-governmental office) that catered to their various – and multiple – needs in tandem with their regular schooling (when that happened).

The case in point is about a girl, let’s call her Luisa, about 11 years old but very much underdeveloped physically and cognitively for her age bracket. Luisa was one among five siblings who lived miserably in a slum located in the south zone of São Paulo, Brazil. She had no sanitation, nor regular electricity in the patched-up cardboard shack that she used to call home. Her mother was lost – died right after the birth of her last child - and her father could not answer to any family duties – he was more dedicated to booze than to anything else. There was a step mother, that, as you will learn, made all Disney princesses’ characters pale in comparison. I met Luisa once a week, when I used to go to the NGO where she spent most of her time at and had all her meals provided. She was one among a group of 20 children, all around the age of 10-13, who had English classes in a garage – yes, that used to be the only place available at the NGO to accommodate all of us - and we were more than happy for it. It provided shelter and the rest, well, we could cater for.

One day, right after class was over, Luisa approached me. She was usually very amiable to me, that had taken me some investment of time and patience, but that was not unusual in the circumstances of the work that I carried out. Luisa had very few friends among the group, though. She was usually quick and fierce in her reactions, which were mostly angry, most of the time. That had, not surprisingly, attracted very few to her side, but she seemed to take that as part of the cards that life had dealt her with. The fact that she came to my side did not surprise me that day, it was not unusual given our comradery, but there was something more, something urgent that she wanted to share with me. Upon noticing that, I made sure that everybody else left our ‘classroom’ to give her the privacy that I felt needed. But nothing could have prepared me for what she was about to disclose. Seeing the face of toxic stress - that “extreme, frequent, or extended activation of the stress response, without the buffering presence of a supportive adult” (Johnson et al, 2012, p. 321) - has taught me that there are more real monsters in our world than any Hollywood movie could rival with.

Luisa looked me in the eye and said “Teacher (that is how she called me), today I was ‘forked’”. I did not understand what she meant so I looked at her with what she rightly took for a question-mark face. Then she lifted her t-shirt to show me her child-sized belly full of fork marks freshly imprinted on her skin. I almost fainted. It took me all my strength to be able to soothingly ask her: “oh, dear, how did you get those?”. She then answered me: “It was my stepmother, she ‘forked’ me because I was taking too long to bathe.” After that, I only managed to ask: “Did she do anything else?”. Luisa looked at me and said with a mischievous smile: “There was no time. I just ran”. No more words were exchanged, only hugs and comforting tears. After some minutes, we started talking about something else, I left her with a ‘task’ – she used to be my self-appointed helper - and we parted company. After she left, instead of going out, I asked to talk to the NGO coordinator, responsible for overseeing the children, and told her the heartbreaking story Luisa had confided me with.

As I later learned, this had not been the first time that such stepmother had abused the kids in that family physically. She was also mentally impaired, and the NGO was already looking into ways to find a foster family who could take care of all siblings. Not an easy task by any accounts. But the coordinator was happy – if such a word could be used in this situation – that Luisa had me to confide in. That, as I then learned, was not her usual way of handling the toxic stress that she had to manage daily. She used to fight and verbally abuse others in her turn. And it was begetting her more problems at the NGO that used to be her ‘safe’ haven.

If before those lessons, I already took time in safeguarding children’s emotional well being to be ready for class; after that episode, I redoubled my care. I provided children with stories, with accounts of different hardships found in some literary elements, of possible ways in which what they were learning could scaffold their path to a more hopeful scenario. By doing that – little did I know – I set in motion the shift in their reappraisal of daily hurdles and the focus of their attention in hopes for a brighter future.

The ‘shift-and-persist’ approach (Chen et al, 2012) whereby low SES individuals have a greater chance of managing the allostatic load – that crippling wear-and-tear that chronic and uncontrollable stress has in our organisms – is one of the ways that practitioners (teachers, psychologists, and medical providers) involved with children living in toxic stress could be trained to apply in their praxis. Additionally, schools and social assistance centers, i.e. places where most children spend a long time in, should repurpose curriculum, standards and assessments based on the need to provide safe and supportive environments where different neurobiologically susceptible individuals (Ellis et al, 2011) could find people that they trust in, people they build relationships with, people that could extend the net of safety that every human being should be entitled to since inception.

References

Chen, E., Miller, G. E., Lachman, M. E., Gruenewald, T. L., & Seeman, T. E. (2012). Protective factors for adults from low childhood socioeconomic circumstances: The benefits of shift-and-persist for allostatic load. Psychosomatic Medicine, 74, 178-186. doi:10.1097/PSY.0b013e31824206fd

Ellis, B. J., Boyce, W. T., Belsky, J., Bakermans-Kranenburg, M. J., & Van Ijzendoorn, M. H. (2011). Differential susceptibility to the environment: An evolutionary–neurodevelopmental theory. Development and Psychopathology, 23, 7-28. doi:10.1017/S0954579410000611

Johnson, S. B., Riley, A. W., Granger, D. A., & Riis, J. (2013). The science of early life toxic stress for pediatric practice and advocacy. Pediatrics, 131, 319-327. doi:10.1542/peds.2012-0469