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The Psychological Aftermath Of The Sydney Siege

A hostage runs to armed tactical response police officers for safety after she escaped from a cafe under siege at Martin Place in Sydney, Australia, on Monday. (Rob Griffith/AP)

A hostage runs to armed tactical response police officers for safety after she escaped from a cafe under siege at Martin Place in Sydney, Australia, on Monday. (Rob Griffith/AP)

By Jessica Alpert

The images of five hostages escaping from the Lindt Chocolate Cafe in Sydney are striking. A woman runs into the arms of law enforcement, her trauma and fear palpable.

This story is still developing, but one thing is for sure: “It really doesn’t take much to instill fear,” says Max Abrahms, a professor of political science at Northeastern University and an expert on terrorism. “This one guy managed to shut down an entire city, divert many planes away from Sydney, and transfix the world in real time following this story.”

As of press time, police were reporting that the hostage taker and two people were killed. For those who survived, what lies ahead psychologically?

Dr. David Gitlin, Brigham and Women’s Hospital vice chair of clinical programs and chief of medical psychiatric services, says recent research suggests reliving or “debriefing” survivors is counterproductive and “actually may precipitate the development of PTSD.”

Instead, health professionals are encouraged to use a resilience model in the immediate aftermath of an event like this one, “helping people think about the things they need to do to feel safe and secure…to deal with things on their timetable,” says Gitlin. Of course, this may come into conflict with the needs of law enforcement, who are looking for further control of an event or preparing evidence for prosecution. As this siege has ended and it’s believed that the assailant acted alone, Gitlin hopes that those now released will not be interrogated at this time.

Gitlin, who led the Brigham’s psychiatric team after the Boston Marathon Bombings, explains that “people need to be surrounded by their loved ones, put into a safe environment, and only process this when they are ready to do so.”

Acute Stress Reaction and PTSD

There are two types of trauma, says Gitlin. Continue reading

Related:

Harvard Doc To Wikipedia: You’re Not Playing Fair On Alternative Trauma Therapy

By Dr. Eric Leskowitz, M.D.
Guest Contributor

Up until recently, I’ve thought of Wikipedia as one of the great breakthroughs of the Internet era — a gigantic encyclopedia of everything, right at our fingertips, with real-time updates in all spheres of human knowledge. I even consult it regularly for medical information as part of my work as a practicing psychiatrist.

But in the past few months, I’ve been reconsidering the venture. Why? In a nutshell, it appears that the folks at Wikipedia have a problem with a fairly new sort of therapy that I practice and find helpful for certain patients.

Here’s the backstory.

Dr. Eric Leskowitz, a Harvard psychiatrist, wonders why the founder of Wikipedia called practitioners of Energy Psychology "lunatic charlatans.'

Dr. Eric Leskowitz, a Harvard psychiatrist, wonders why the founder of Wikipedia called practitioners of Energy Psychology “lunatic charlatans.’

For several years now, I have increasingly deployed this new form of psychotherapy, called Energy Psychology (EP), in my work with chronic pain patients at Spaulding Rehabilitation Hospital’s outpatient clinic in Medford, Mass.

Energy Psychology uses a combination of exposure (intentionally re-experiencing the unpleasant emotions surrounding a stressful situation) and desensitization (affirmations of self-acceptance despite the persistence of symptoms), along with a somatic component (tapping on one’s own acupressure points) to defuse the emotional charge of those upsetting memories.

Without getting into the details of how it might work, suffice it to say that Energy Psychology has helped many of my patients make great strides, especially when Post-Traumatic Stress Disorder (PTSD) is involved. (For example, when a frightening automobile accident triggered the disorder). For some patients, full recovery is possible. I’ve seen it.

A large body of research over the last 10 years shows just how effective Energy Therapy can be for a wide range of clinical problems, as described in this review article from the American Psychological Association’s journal, Review of General Psychology.

Energy Psychology has been particularly effective in treating PTSD in combat vets. And Energy Psychology has even gotten some fairly mainstream attention, from television’s Dr. Oz to The Huffington Post.

Jimmy Wales, founder of WIkipedia (Robert Huffstutter/flickr)

Jimmy Wales, founder of WIkipedia (Robert Huffstutter/flickr)

But you’d never know about any of this from consulting Wikipedia. Their entries use a range of emotionally loaded and downright pejorative terms to describe Energy Psychology and make no mention of promising new research published in the last ten years. Their article about the related topic of Energy Medicine, for example, only includes studies conducted prior to 2004 (though more recent critical reviews are cited).

Wikipedia’s entry on the most widely used Energy Psychology protocol (Emotional Freedom Techniques, or EFT) refers to the field of Energy Psychology as “pseudoscience” and relies on judgements rendered by a non-peer-reviewed blog whose name – Quackwatch – reveals just how objective it is(n’t).

To counter what we feel are gross misrepresentations, the international Energy Psychology community and members of the national Energy Psychology organization — the Association for Comprehensive Energy Psychology (ACEP) — attempted to add new research citations to the Energy Psychology article, in accord with Wikipedia’s promise to update their entries to include scientifically validated findings.

However, new entries supporting Energy Psychology appear to be scrubbed from the site. Fortunately, many of the details of this process are stored on the “Revision History” link of any Wikipedia article, so that much of the back-and-forth process can be tracked and the inconsistencies between policy and practice become evident. (Emotional Freedom Technique’s revision history is here).

Even studies from prestigious peer-reviewed journals like the Journal of Nervous and Mental Disease whose editor-in-chief is past president of the American Psychiatric Association, have not been cited by Wikipedia, nor has it been mentioned that the American Psychological Association now allows its approved Continuing Education providers to offer Energy Psychology training for Continuing Education Units, the result of a lengthy appeals process.

Because these obstacles persisted despite several years of good-faith effort in the face of repeated “scrubbing” of Energy Psychology-favorable information from the Wikipedia website, ACEP recently initiated a petition drive through change.org, asking Wikipedia to show fairness discussing newer holistic therapies. Over 11,300 supporters have signed, and, much to our surprise (and I say “our” because I am an active member of ACEP), the founder of Wikipedia – Jimmy Wales – responded personally to the petition. Here’s what he wrote on the change.org site:

No, you have to be kidding me. Every single person who signed this petition needs to go back to check their premises and think harder about what it means to be honest, factual, truthful.

Wikipedia’s policies around this kind of thing are exactly spot-on and correct. If you can get your work published in respectable scientific journals – that is to say, if you can produce evidence through replicable scientific experiments, then Wikipedia will cover it appropriately. What we won’t do is pretend that the work of lunatic charlatans is the equivalent of “true scientific discourse”. It isn’t.

Continue reading

Instead Of Therapy, Put A Little Thanksgiving Into Regular Family Dinners

Mark's postcards from Beloit/flickr

Mark’s postcards from Beloit/flickr

Anne K. Fishel, Ph.D.
Guest Contributor

When a colleague recently told me about her Thanksgiving tradition, it got me thinking about family dinners — a topic I consider every night around 7 pm and with every patient I see in family therapy.

Indeed, as a mental health provider, I sometimes feel I’d go out of business if families had regular dinners with one another. Truly. There are dozens of research studies that show that frequent family dinners promote kids’ mental and emotional well being — by lowering rates of depression, anxiety, eating disorders and substance abuse, for starters. Family meals also strengthen children’s resilience, self-esteem and sense of connectedness to their parents. Isn’t that exactly the goal of therapy?

It’s no wonder that I often have to stifle the urge to say, ‘Stop wasting your time here. Go home and eat dinner together.’

But, I’m well aware of how hard it is for busy, harried families to find time to sit down to dinner, and I’m always looking for new ways to unlock the benefits without adding any guilt or pressure. So, that is why my colleagues remarks sparked my interest. Here’s what she said:

“My sisters and I love Thanksgiving so much that our father makes a Thanksgiving-like meal throughout the year that he dubs ‘Harvest Dinner.’ We just can’t get enough of his mashed potatoes!”

I love the idea of bringing the special quality and spirit of Thanksgiving dinner to everyday meals. Two elements could easily translate to everyday dinners: sharing the workload, and focusing on more than just food. Continue reading

Silent Wars: Helping Vets Fight Mental Health Battles At Home

By Evan Bick
Guest Contributor

The movies have it wrong. Combat, at least in my experience, was not non-stop or action-packed. Those who have experienced it know that modern warfare usually involves a lot of starting and stopping. Long stretches of quiet, even boredom, can be broken in an instant.

I was deployed to Iraq as an infantry platoon leader in 2008-2009. During that time, there may not have been constant action but there was tension — my fellow soldiers and I were on edge most of time, soldiers among civilians, going on patrols in the northwest corner of Baghdad.

Evan Bick, a veteran of the Iraq war, now works with other vets struggling with mental health problems. (Courtesy)

Evan Bick, a veteran of the Iraq war, now works with other vets struggling with mental health problems. (Courtesy)

On our first day in the city, the leaders from the unit we were replacing took us on a walk through their area of responsibility. We saw the sidelong glances from civilians as Americans walked through their streets, hidden behind rifles and sunglasses, and weighed down by cumbersome body armor. We also saw an area filled with stark contrasts — stucco houses with gated courtyards in one neighborhood, and refugee camps for Iraqis displaced by ethnic violence in the next.

Deployment is a challenging experience even when it’s boring. Whether you are patrolling ‘outside the wire’ or working behind the scenes, the sense of danger is real and omnipresent. While deployed, soldiers typically work far longer hours, and with less opportunity for relaxation than they experience at their home station. Isolation from loved ones, of course, is an important challenge both for the deployed soldier and family members back home.

Even with all those challenges, the bigger battle for many veterans begins when they return home. Without a unit that shared in your experience of war, you can feel lost — more lost than you would ever feel on patrol. It’s easy to get trapped inside your own head, and to dwell on what did not go well, and what you should have done differently. The quick reflexes and adrenaline that may have helped keep you alive overseas are probably no longer helpful.

Strategies that kept you and your fellow soldiers safe, like driving fast and straight down the middle of a road, become dangerous, and loud noises or crowds may make some part of you feel like you’re back in the desert. Continue reading

Studies: It May Be Better For Kids Who Are Overweight Not To Know It

feetonscale

According to the scale, the 18-year-old girl is severely obese. But she doesn’t think so.

“I know I’m big, but I’m not obese,” she says. “I don’t take up three seats. My weight is high, but no higher than lots of people’s. It’s no problem.”

If you’re her doctor or school nurse or parent, what do you do? Do you bombard her with Body Mass Index charts and warnings of the health risks she faces? Knowledge is power, right? Certainly, that’s the principle behind the “BMI report cards” — colloquially known as “fat letters” — that schools send home in some states.

But research just presented at ObesityWeek, a major conference on obesity, suggests that it may not be wise to persuade that young woman that she has a problem.

One study found that overweight teens who “misperceive” their weight as normal end up gaining less weight over the next decade or so than teens who are overweight and know it. Another study found that those “misperceivers” blind to their extra pounds were also less likely to become depressed in later years.

The findings are at odds with the basic assumption behind BMI report cards, that it is helpful to inform kids and their families of their weight status, says researcher Kendrin Sonneville, an assistant professor at the University of Michigan School of Public Health who is also affiliated with Harvard and the Division of Adolescent/Young Adult Medicine at Boston Children’s Hospital.

Kendrin and IdiaXXX

Dr. Kendrin Sonneville and Dr. Idia Thurston at the Obesity Week conference, where they presented studies that found that weight “report cards” may backfire. (Carey Goldberg/WBUR)

“I think we can say the jury is still out,” she says. “Weight misperception is not something we should assume is harmful, and in the spirit of doing no harm, I think we need to proceed with caution on any type of programming that involves correcting weight misperception.”

The study she led, which followed more than 2700 young people beginning in high school, found that after about a decade, the overweight teens who had perceived their weight accurately gained more than one BMI unit — very roughly about 10 pounds — more than those overweight teens who had falsely believed their weight to be normal.

Why might this be? That’s one of the next avenues of research that need to be explored, but clinical psychologist Idia Thurston, an assistant professor at the University of Memphis, says the key could be the emotional baggage that comes with being told you’re overweight or obese.

More accurate weight perception may translate into more feelings of stigma and lower satisfaction with your own body, she says, “and that could affect your ability to cope — hence, depressive symptoms or hence, engaging in harmful eating behaviors.”

“So when we think about weight report cards and telling kids, ‘This is what your weight status is,’ you really need to think about how that information is being disseminated, and what kinds of protections are put into place, rather than just sending report cards home to kids and not knowing how kids will act on that information.”

Dr. Thurston’s study, also presented at ObesityWeek, found that overweight high-school-aged boys who accurately perceived their own weight as high were significantly more likely to develop depressive symptoms over the next decade or so. (The findings in girls were not statistically significant.) Once again, a false sense of being a normal weight appeared to be protective for overweight young people.

The idea of having schools screen kids for obesity began in 2003 in Arkansas during then-Gov. Mike Huckabee’s anti-obesity efforts, Dr. Sonneville says, and spread around the country without ever having a solid research base on what its effects might actually be.

About one-fourth of states track schoolchildren’s height and weight, and last year U.S. News reported that nine sent weight “report cards” home, including Massachusetts. But last October, facing pushback from nurses, parents and others, the state’s Public Health Council voted to stop sending the letters home, though the schools still gather the information. U.S. News reported that decision under the headline “Massachusetts Schools To Stop Sending ‘Fat Letters:'” Continue reading

After A Death, Should We Get A Dog? Brain Study Signals ‘Yes’

(Greg Westfall/Flickr)

(Greg Westfall/Flickr)

Let’s be clear: I need a dog like a hole in the head.

I’m a recently widowed working mother with a small house, no trust fund and two extremely active young daughters: if it’s Thursday, it must be rock-climbing, piano and Taekwondo before track practice across town. You get the picture.

Still, lately I’ve been thinking the unthinkable: a Maltipoo, Goldendoodle or some other ridiculously named, hypoallergenic, low-maintenance (does that exist?), cute-as hell puppy for my daughters — and for me — to love.

I know full well this is a risky prospect. “There is no rational reason to get a dog,” says my Basset Hound-owner friend. “They are work, expense and add to the list of beings in your home who have needs to be attended to. It is sort of like deciding to have a kid — no rational reason to do that either but big pay off on love, general hilarity and a constant reminder of the joy in everyday small things.” Or, as another friend put it: “What have dogs done for me? They make me more human.”

“What have dogs done for me? They make me more human.”
– A dog-loving friend

It’s that truly profound, but tricky to pinpoint, human-pet bond that drives Lori Palley’s research. She’s assistant director of veterinary services at Massachusetts General Hospital’s Center for Comparative Medicine and has recently become fascinated by why people’s relationships with their dogs can be so very significant.

Her latest research, published in the medical journal PLOS ONE, involved scanning the brains of mothers while they were looking at images of their own children and their dogs. Surprise: similar areas of the brain were activated — regions involved in emotion and reward — whether it was the kids or dogs on view.

It was a small study using fMRI: only 14 mothers (dog owners) who had at least one young child. And in case you jump to some conclusion about moms loving their dogs as much as, or more than, their kids, wait: the research also found that in other areas of the brain involved in attachment and bonding, the mother’s brains were more activated when viewing their children.

In a small study, mothers viewed images of their own children and their dog. Similar areas of the brain involved in emotion and reward were activated. Source: PLOS ONE: "Brain Activation when Mothers View Their Own Child and Dog: An fMRI Study

In a small study, mothers viewed images of their own children and their dog. Similar areas of the brain involved in emotion and reward were activated. (Source: PLOS ONE: “Brain Activation when Mothers View Their Own Child and Dog: An fMRI Study”)

Continue reading

Beyond Good And Evil: New Science Casts Light On Morality In The Brain

Harvard brain scientist Joshua Buckholtz has never forgotten a convict he met back when he was an undergrad conducting psychological tests in prisons. The man had beaten another man nearly to death for stepping on his foot in a dance club.

“I wanted to ask him,” he recalls, “‘In what world was the reward of beating this person so severely, for this — to me — minor infraction, worth having terrible food and barbed wire around you?’ ”

But over the years, Buckholtz became convinced that this bad deed was a result of faulty brain processing, perhaps in a circuit called the frontostriatal dopamine system. In an impulsive person’s brain, he says, attention just gets so narrowly focused on an immediate reward that, in effect, the future disappears.

He explains: “If you had asked this person, ‘What will happen if you beat someone nearly to death?’, they will tell you, ‘Oh, I’ll be put away.’ It’s not that these people who commit crimes are dumb, but what happens is, in the moment, that information about costs and consequences can’t get in to their decision-making.”

For two decades, researchers have scanned and analyzed the brains of psychopaths and murderers, but they haven’t pinpointed any single source of evil in the brain. What they’ve found instead, as Buckholtz puts it, “is that our folk concepts of good and evil are much more complicated, and multi-faceted, and riven with uncertainty than we ever thought possible before.”

In other words, so much for the old idea that we have an angel on one shoulder and a devil on the other, and that morality is simply a battle between the two. Using new technology, brain researchers are beginning to tease apart the biology that underlies our decisions to behave badly or do good deeds. They’re even experimenting with ways to alter our judgments of what is right and wrong, and our deep gut feelings of moral conviction.

One thing is certain: We may think in simple terms of “good” and “evil,” but that’s not how it looks in the brain at all.

In past years, as neuroscientists and psychologists began to delve into morality, “Many of us were after a moral center of the brain, or a particular system or circuit that was responsible for all of morality,” says assistant professor Liane Young, who runs The Morality Lab at Boston College. But “it turns out that morality can’t be located in any one area, or even set of areas — that it’s all over, that it colors all aspects of our life, and that’s why it takes up so much space in the brain.”

So there’s no “root of all evil.” Rather, says Buckholtz, “When we do brain studies of moral decision-making, what we are led into is an understanding that there are many different paths to antisocial behavior.”

If we wanted to build antisocial offenders, he says, brain science knows some of the recipe: They’d be hyper-responsive to rewards like drugs, sex and status — and the more immediate, the better. “Another thing we would build in is an inability to maintain representations of consequences and costs,” he says. “We would certainly short-circuit their empathic response to other people. We would absolutely limit their ability to regulate their emotions, particularly negative emotions like anger and fear.”

At his Harvard lab, Buckholtz is currently studying the key ability that long-ago convict lacked — to weigh future consequence against immediate gratification. In one ongoing experiment (see the video above), he’s testing whether he can use electrical stimulation to alter people’s choices. Continue reading

‘Did You Ever Kill Anyone?’ 5 Things Not To Say To A Veteran

U.S. Soldiers depart Forward Operating Base Baylough, Afghanistan, June 16, 2010, to conduct a patrol.  (Photo: Staff Sgt. William Tremblay, U.S. Army/Released)

U.S. Soldiers depart Forward Operating Base Baylough, Afghanistan, June 16, 2010, to conduct a patrol. (Photo: Staff Sgt. William Tremblay, U.S. Army/Released)

By Tommy Furlong and Dr. Paula K. Rauch
Guest contributors

“So, did you ever kill anyone?”

It’s not a question you would ask a police officer, but it’s one that many veterans get all the time. Most people have good intentions, but that doesn’t seem to be enough to guide people in what to say and what not to say to a returning veteran. It has become commonplace to say, “Thank you for your service,” but then what?

So here, in advance of our most patriotic holiday, is a brief guide for speaking with post-9/11 veterans and their families. We begin with five things not to say, and end with five that maybe you should:

1. I can’t understand why anyone would join the military.

Oftentimes, people hear the word “military” and immediately think of warfare. In reality, that is just one of the components. The military puts a lot of its resources toward humanitarian efforts. And if you list almost any civilian job, that same position can be found in the military.

So why would someone join the military? They might enjoy the structure. The job security is alluring, as are the benefits. Many young people also choose to serve for educational or economic opportunity, family tradition, seeking a challenge or as a path out of a difficult situation.

Serving our nation is an intense and rewarding career choice. So is being a firefighter, a nurse or a surgeon. Different individuals are drawn to different vocations. Choosing military service is one choice — and it’s not a crazy one.

Family members often hear “Why did you let him (or her) enlist?” or “I would never let one of my kids join the military.” The suggestion is that loving parents don’t let their children serve in the armed forces. These types of comments leave parents and spouses of veterans feeling isolated and unappreciated because, as any military family knows, when one member serves, the entire family serves. Family members have pride in their service member, but they also live with anxiety during the years of service. But all that aside, most parents don’t get to choose their adult child’s life path — and that includes career, partner and place to live.

2. How could you leave your children? Continue reading

Falling Into The Postpartum Mood Disorder Abyss: A Personal Story

By Deb Wachenheim
Guest Contributor

Over the past two days, The New York Times published a series of articles about postpartum depression and other related mood disorders. The first article looked at the science and policy on this topic and highlights a few women’s stories.

Today’s article is about my sister, Cindy Wachenheim, who took her own life in March of 2013 after struggling for six months with postpartum mood disorders. I say mood disorders because it was not just depression (and the fact that there are other postpartum mood disorders in addition to postpartum depression was something about which I was previously completely unaware). She had extreme anxiety about, and obsession with, her baby’s health and she was depressed because she believed she caused him to have serious health problems. Also, according to what I have been told by experts, she may have been psychotic: she was so convinced that something was seriously wrong with her baby — despite doctors telling her otherwise — that she strapped him to her chest when she jumped out of her apartment window, believing, I can only assume, that this was what was best for him. Thank goodness, he survived and is thriving.

Beyond what is written in the article, I think it is important to give more detail and information on some resources and policy activities in Massachusetts, in the hope that this could possibly help others who are facing similar struggles. As is mentioned in the article, I reached out to Cindy’s son’s pediatrician after Cindy had gone to see her multiple times about her concerns.

Pediatricians are key to screening for postpartum mood disorders and making referrals for needed treatment. Most women see their OB a few weeks after giving birth and if everything seems okay at that point then they are sent on their way until the following year’s annual exam.

However, woman bring their infants to see the pediatrician many times over that first year. It is pediatricians who could notice if something seems to not be right with the mother. Continue reading

Can Brain Science Help Lift People Out Of Poverty?

Five years ago Lauretta Brennan was a single mom on welfare with a pack-a-day smoking habit, stuck in a “bad” relationship and living in the South Boston projects where she grew up.

Now, she’s still living in the projects with her young son, but the bad boyfriend is gone and Brennan’s got a job as an administrative assistant after receiving a business management degree. And she quit smoking.

Her childhood in the projects was marked by alcoholism and violence all around, Brennan said; “having no adult role model was the norm, being with a man who’s ignorant, that was the norm.”

Lauretta Brennan graduated from Bunker Hill Community College with an Associates Degree in Business Management in June 2013 (Courtesy)

Lauretta Brennan graduated from Bunker Hill Community College with an Associates Degree in Business Management in June 2013 (Courtesy)

But now, thanks to a novel program that uses the latest neuroscience research to help women dig themselves out of poverty, Brennan says: “I don’t want to live off welfare. I want to make money and be around people who work and go to school. In five years, the program got me to think more like an executive — I have goals, I’m an organizer managing my family well. I’m not scared anymore.”

This shift in thinking — from chaotic, stressed-out, oppressed and overwhelmed to purposeful and goal-oriented — may not sound like brain science. But it fits into an emerging body of research that suggests that the stress of living in poverty can profoundly change the brain: it can undermine development and erode important mental processes including executive function, working memory, impulse-control and other cognitive skills.

To fix that damage, the new thinking goes, people must engage in activities and practices that strengthen this diminished functionality and, exploiting the brain’s ability to change (plasticity in neuroscience lingo) re-train themselves to think more critically and strategically.

“Poverty whacks executive function and executive function is precisely what’s needed to move people out of poverty,” says Elisabeth Babcock, chief executive of the nonprofit Crittenton Women’s Union, a Boston-based group that draws on the latest brain research to help families achieve economic success. “What the new brain science says is that the stresses created by living in poverty often work against us, make it harder for our brains to find the best solutions to our problems. This is a part of the reason why poverty is so ‘sticky.'”

In a recent paper, “Using Brain Science To Design New Pathways Out Of Poverty,” Babcock makes the case that living in an impoverished environment “has the capacity to negatively impact the decision-making processes involved in problem-solving, goal-setting and goal attainment.” In other words, this type of stress can “hijack” the brain.

As other researchers, including Jack Shonkoff, director of the Center on the Developing Child at Harvard, have noted, this chronic vise of pressure — to pay the bills, function at work, raise the kids, and simply survive in an atmosphere rife with social bias and harsh living conditions — “places extraordinary demands on cognitive bandwidth.” Babcock writes:

“The prefrontal cortex of the brain — the area of the brain that is associated with any of the analytic processes necessary to solve problems, set goals and optimally execute chosen strategies — works in tandem with the limbic system, which processes and triggers emotional reactions to environmental stimuli…When the limbic brain is overactive and sending out too many powerful signals of desire, stress, or fear, the prefrontal brain can get swamped and the wave of emotion can drown out clear focus and judgement…”

How does this play out in real life? Chuck Carter, senior VP of research at Crittenton Women’s Union, explains:

“One of the things the brain science brings is something of an ‘aha’ in terms of why things are sometimes harder than we expect them to be. When you’re looking at a family that is struggling and making decisions that you don’t really understand, having that research helps you reassess…it adds another perspective. A lot of nonprofit organizations look at the social determinants [of poverty] but not a lot look at the science that says, ‘What else is at play?’

“I think that, on the ground, it gives us creative ways to think about the work and how we might approach it…Often families are in a lot of crises…and they feel they need to do things ‘right now.’ So, for instance, we’ve got a family, and they’re in a hallway and they’ll have to talk to the case manager ‘right now.’ And we ask whether it’s a true emergency, and if not, can we talk about this the next morning, and not in the hallway. It’s a problem with executive function and poor impulse control, but we can help them slow down and figure out the right time to figure this out and what information do they need. It’s about not responding so impulsively in other parts of their lives. So, in thinking about what to do with money, it can be a question of, ‘Do I buy cigarettes now or save the money for some new furniture when I move?'”

So how do you begin to fix all of this?

I asked Babcock a bit about the science behind her organization’s Mobility Mentoring program, in which low-income — mostly single — mothers apply to get training, professional mentoring, financial and other support for three to five years, in hopes of attaining economic independence.

Here, edited, is our discussion:

RZ: What does the research say about how poverty changes the brain? And how does a “hijacked” brain function compared to a brain not experiencing intense, chronic stress?

EB: Poverty hits what scientists call our executive functioning skills: our ability to problem-solve, set priorities and goals, juggle and multi-task, focus and stick to things. And it does this in at least two very important ways. First, the stress of dealing with new problems every day and never having enough to make ends meet overwhelms our heads and swamps us. It overloads the circuits in our brains and compromises our decision-making in the moment. Continue reading