• Rebecca Bryan

Toxic Stress Gets Under Your Skin

I'm sitting in my little clinic this Wednesday afternoon, watching neighborhood kids playing with "school's almost out" energy and I'm reminded of this quote: "There is only one child in all the world, and the Child's name is All Children," (Carl Sandburg). I've played with children in Haddonfield, in Camden; in Malawi and Germany, Canada and elsewhere and have found this to ring true. If only they could all grow up equitably, protected from exposure to toxic stress that will literally get under their skin.


Don't get me wrong - I view usual stress as a good thing, ever since I was introduced to Stanford's Rethinking Stress Toolkit. Our bodies are built to handle stress when it comes in reasonable doses from which we recover; in fact, substantial research shows that brief stress exposure in childhood acts like an inoculation that promotes resilience in adulthood*. We can use stress to our advantage; knowing an upcoming event will be demanding allows us to gird ourselves with a positive mindset.


Toxic stress is a different state altogether. It is what, globally, too many children grow up with - chronic, all-pervasive stress caused by poverty, racism, domestic violence, neglect, and unpredictability. Stress like this mars brain development, genetic expression, and immune/hormone systems. It shortens lifespans. Parents who love and want only the best for their children can't be emotionally or physically present because of needing to work two or more jobs, or because they're overwhelmed by not being able to meet their family's needs. Fully appreciating this, I have a new favorite definition of trauma, by Gabor Mate: "Trauma is not what happens to you. Trauma is what happens inside of you, as a result of what happens to you." And this: "Children don't get traumatized because they are hurt. They are traumatized by being left alone with their hurt." (Watch Mate's documentary, The Wisdom of Trauma).


I believe that adults experience toxic stress too. In fact, when I drive by people who are clearly mentally ill, all I can think is, "my God, what have you been through?" Because the barriers erected by systemic poverty and structural racism are all too effective at taking you down: you get a job for $15/hour. You're hired per diem so no benefits. The job's in the suburbs, so your monthly bus pass costs $190. Welfare sees you are earning money so there goes your support for food assistance. Child care is tough - because of the pandemic, your sitter takes your voucher and charges more - she's struggling financially along with the rest of the community. Rent has gone through the roof with inflation; you signed up for public housing over a year ago but when you called to check on it, you were told you're number 1,193. You are stuck in an overcrowded space with little hope of getting out; when you do go out the dogs next door even chase you. It's been suggested that the fastest way to get housing is to give in and go to a shelter, but you can't bring yourself to do it...yet.


Hard to read, right? Imagine living it. Imagine living it through a pandemic! And climate change.


This is why we must dismantle structural racism and systemic poverty through addressing social determinants of health, daunting as they are. Facilitating housing alone would begin to shift health and quality of life outcomes - I think about that too, watching the kids play outside of my little clinic - it's located in newly reconstructed public housing. These kids know what having a stable home feels like, and that gives me hope for their futures.


*Lyons, DM, Parker, KJ, and Schatzberg, AF. (2010). Animal models of early life stress: Implications for understanding resilience. Developmental Psychobiology, 52: 402-410. doi: 10.1002/dev.20429


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