1. Dr Pam Jarvis

3. In the beginning: Cortisol
Cortisol is a mammalian stress hormone, which mobilises the ‘fight or flight’ response.

5. Cortisol Rhythms
Adults have a daily cortisol rhythm, where cortisol is highest in the mornings and falls as the day goes on. Babies typically fall into this pattern quite quickly.
But constant stress will alter cortisol rhythms...

6. How high do you have to turn up the thermostat before the boiler blows- or quietly ceases to function?

7. What happens when things go wrong? ‘Toxic’ Stress
James Redford, producer of the Adverse Childhood Experiences dissemination film Resilience compared the constant stress that some children live under (for example dealing with a chronically anxious, depressed or abusive parent) as comparable to arriving home every night to find a bear in the living room
‘Day after day, those chemicals – the adrenaline, cortisol, the process of high sugar, that whole response, changes the way your brain processes information. It affects the development of the organs on a cellular level. This continual exposure to stress wears the body down’ (in Cocozza 2017, online).
Children experiencing continuous or ‘toxic’ stress typically have higher resting levels of cortisol and take longer to return to baseline after individual stressful experiences

8. Results of ‘toxic’ Stress
Fight or flight response always on stand-by
Quick to anger (dismissive)/sadness and ‘learned helplessness’ (preoccupied)
Short attention span
Problems concentrating at school
View the world as a dangerous place
Mistrustful of adults and other children
Feeling of inadequacy/ lacks confidence
Lack of self-belief/ lack of self motivation
May be over-dependent upon opinion/ support of others (preoccupied)
May reject support from others (dismissive)
‘Other people are (may not be) not loving, and I am not (may not be) lovable’

11. The Resilience Movie

13. What is the evidence?
Original study found links between early death and ACEs in US sample (Felitti et al 1998)
Recent large-scale studies in Wales and Scotland link poor mental and physical health in adulthood to childhood ACEs (Wales: Bellis et al 2016; Scotland: Couper and Mackie 2016)
Clear links drawn between ACEs, poverty and parenting stress (Steele et al 2016)
Links drawn between ‘toxic stress’ and cortisol dysfunction (Oral et al 2015)
Links drawn between adult attachment anxiety and cortisol dysfunction (Quirin et al 2008)

14. What are the Criticisms? (Edwards et al 2017)
ACEs is a deficiency model: may create a ‘self-fulfilling prophecy, individual as victim of circumstances
Could therefore lead to stereotyping and stigma
Problem of amateurs making snap diagnoses on tick box evidence
ACEs is a retrospective model based on recall
Impossible to unpick the tangle of cause and effect
Can be used to suggest a solution to poverty that lies in individual therapy and treatment rather than societal change

15. Role of the protective attachment
Tharner et al (2011, p.162) found that ‘parenting stress explained the most variance in child emotional and behaviour problems’ but that ‘in families with high parenting stress securely attached children had fewer socio-emotional problems than insecurely attached children’
Shonkoff et al (2015) found that supportive adult-child relationships in early childhood could blunt the impact of ACEs: ‘resilience requires relationships’ (p.7) and that resilience could be strengthened by relationships at any point in childhood. They list important protective factors as:
At least one stable, caring and supportive relationship
Support for children to believe that they can overcome adversity
Support for children to develop self-regulation skills (the ability to manage one’s own behaviour, emotions and attention focus)
Support for and affirmation of cultural traditions

17. So what can we do?

18. For many children growing up in poverty in families stressed by economic and other insecurities, healthy attachment and stable nurturing experiences were much more challenging Burke Harris (2018 p.187)

19. Once you understand how your body and brain are primed to react in certain situations you can start to be proactive about how you approach things. You can identify your triggers and know how to support yourself and those you love (Burke Harris p.218)
How adversity affects you is not a referendum on your character. We don’t need to play the shame game. (Burke Harris p.219)

20. How Childhood Experiences affect health across a Lifetime: Nadine Burke Harris