Part 1: Stressors and “Someone I know”
In the 1990s I met a young woman, we’ll call her “C”, from St. Louis who had moved into “my” neighborhood in Los Angeles. When I initially met her, she was lounging by the pool. I had no idea at that moment, but would learn later that she had been partially paralyzed as an older child (I believe her age at the time of the incident was15 years) in a drive-by shooting. We became good friends for a while, on occasion attending the same gym or simply hanging out. Although her life had obviously been changed forever by violence she was, and I assume still is, an amazing example of determination and resilience. Her positive outcomes were directly influenced by biosocial and psychosocial “protective” factors and interactions as I will describe later.
“C” is a fair complected, “red-headed”, African-American. St. Louis is a large, metropolitan city, whose population at that time was approximately 77% “White” and nearly 20% “Black”. It has its share of urban violence – and my friend was shot in a drive by at a house party. The bullet bruised her spinal cord in her neck and she was not expected to walk again.
Psychosocial factors: “C” is the daughter if a Baptist minister. Her family has a profound faith. This faith served as a protective factor – directly, providing “C” with a strength that a “Higher Power” was there for her; but also indirectly, providing her with a social group with a shared faith and belief that were supportive of her throughout her recovery. During her recovery period, the presence of her family, was a critical psychosocial factor. “C” has an amazing family – quite generous and selfless. That her parents never gave up on her successful recovery no doubt influenced the outcomes significantly. As “C’s” condition improved, she was determined to remain independent. This determination to remain independent served as a psychosocial protective factor. She improved to the point where she walked with the help of a “quad cane”. She babysat her niece, who, as a young child famously said, “You can hide but can’t run!” She lived on her own, drove a car, went to the gym and pool therapy, and painted. She worked on occasion for the very wonderful comedian, “S”, on his Soul Music Festivals in the Caribbean. Her family was politically active and socially well-connected. All these factors served to support her outcome.
Psychosocial factor include more than family. In 1992, Dennis Byrd, of the New York Jets football team sustained a severe neck injury. Byrd received state of the art therapy and was able to walk. The comedian, “S”, encouraged her to participate in regular pool therapy. Her brother closest in age to her, “R”, regularly invited her to attend social events. Her sisters and nieces visited. Examples such as this contributed to “C” being constantly willing to work and exercise to strengthen herself and remain independent. “C”told me of a younger child, in the hospital with her, who had sustained extremely serious injuries (during a tornado I believe), who had a wonderfully positive outlook. She seemed to have taken some strength from his attitude and determination while she was in the hospital.
Biosocial factors and “tertiary prevention”: Trauma to the cervical vertebrae can be disastrous. Fortunately, advances in medicine during that time were being made. Although it wasn’t until 1990 that the use of steroid drugs in spinal cord injuries had been proven to be effective, “C” told me that she had received steroid treatment at the time of her injury, which would have been the late 1970s. As an aside, “C” told me that the steroids made her eyelashes incredibly long. In addition, rehabilitation was used effectively in her case.
Biosocial and psychosocial: The strong faith and family protective factors combined with the knowledge of rehabilitation to optimize “C’s” outcomes. Her parents constantly contributed to the physical and occupational therapy regimen. This meant that she had the advantage of extra therapy as her family joined in the process. In situations where the family is less involved, the “patient” generally receives the minimum prescribed therapy. In some families, “fear” of inducing further injury or “awe” of the medical field keep families from actively participating in the physical recovery process.
Afterthoughts: “C” benefited from the intersection of a number of biosocial and psychosocial protective factors. Not all children are as fortunate. In 2002-2003, I was a youth advocate in a restorative justice program at a Family Resource Center in Santa Cruz, California. Of the children that I worked with, 100% of them had challenging lives at some point during those 0-5 years. Parent illness, domestic violence, parent divorce or separation, poverty or homelessness, drug or alcohol abuse… these children, however, appear to have lacked “C’s” psychosocial protective factors. In addition, their exposure to stressors happened at a far earlier developmental stage of their childhood. By the time they were teens, they were already involved in “anti-social” or self-destructive behaviors, including “tagging”, alcohol and drug use, truancy and violence. One particular child, “A”, 13 at the time I met him, was on probation and was referred to our restorative justice program by his Juvenile Probation Officer. He had alcohol and drug abuse issues, yet his mother and stepfather always had alcohol in the home. We implemented a harm reduction strategy with him, tolerating his occasional cigaret use, and involving him in a youth leadership group. We attempted to establish some protective factors, encouraging his participation in skateboarding (he was quite excellent). We joined him when he went to juvenile court, took him on outings, helped him in his community service requirements – generally providing him with as many psychosocial supports as possible. A few years later, I learned from one of my colleagues in Santa Cruz, that he had had an LSD incident which had resulted in cognitive impairment. I don’t know where he is today. It was a terrible outcome for a child that had worked very hard to overcome his issues.
The two stories hopefully support our role – intervening as early as possible to mitigate the negative outcomes of childhood stressors. In addition, it serves to remind me how important those first years are – and how difficult it is to overcome stressors during those years in the absence of biosocial and psychosocial protective factors. While “C’s” injuries were far more dramatic outwardly, “A’s” “soul” had been harmed. This was apparent, because he seemed never to feel quite safe. As we (his youth advocates) had become his primary psychosocial support (he invited me to attend his parent conference) – we found that whenever he made great progress and was about to be released from juvenile probation, he would do something outrageous in order to violate his probation. Whenever he seemed poised to take on a leadership role in the youth group, he would vanish for a while. He seemed never to feel secure in facing his “potential”. (No, I don’t like the word potential either). In addition, while “C” had benefited from primary prevention for much of her life while “A” had faced constant and various primary and secondary risks.
As early educators, we must involve ourselves in advocacy that goes beyond our classroom doors.
Part 2: Stressors in Japan
As a third generation Japanese-American, I have a connection with Japan. Although neither I nor my parents have, both of my brothers have visited Japan with their families. Japan is noted for people with wonderfully long life expectancies. Its intentional homicide rate is one of the lowest in the world – approximately 1/6 that of the United States. Japan has one of the lowest accidental death rates in the world at about 29 per 100,1000 (circa 1990).
This is not to say that they are without stressors. Japan was hit recently (March 11, 2011) with a terrible combination of stressors – an earthquake, a tsunami and a nuclear power plant meltdown. Indeed, Japan is located on the most dangerous section of the “Pacific Plate”, the most active of the nine tectonic plates that cover the earth. Sometimes referred to as the “ring of fire”, the section of fault lines of the Pacific contribute to many of the world’s strongest earthquakes.
As of August, about 5 months following the earthquake, the count of dead or missing topped 20,000. By early estimates, approximately 100,000 children were displaced. This according to The Guardian, “Children we talk to say that whenever there’s a tremor they are scared that something is going to happen,” McDonald told the Guardian from Sendai, where the organisation (sic) has set up an operations base.
“They are quite stressed and bored, because at the moment there isn’t much in the way of activities for them. Boredom turns into frustration and there is the stress of what has happened to their homes and families… Young victims of the disaster have spoken of missing their friends and their desire to return to schools that now serve as makeshift evacuation shelters… About 25% of the 1,200 people sleeping on cardboard mats at one shelter in Sendai are children, many of them with disabilities.”
Japan, however, benefits from a nearly culturally monolithic value system. Following the disaster, there were almost no reports of looting or rioting. Lines for assistance were orderly. According to Global Nation Inquirer, health, repair and service providers donated services and/or materials. This was, in part, the result of a cultural enforcement of values that begins at a young age in Japan. Children are taught the importance of harmony (“wa”) and perseverance (“gaman”). Even as a Japanese-American, I was raised to “not cause a scene”, to wait my turn, and to dust myself off and try again. Despite the known danger, some workers at the Fukushima Nuclear Plant continued to work. In a discussion on ChinaSmack.com a photo of teachers protecting a toddler in Yokohama was posted. Such cultural imperatives serve as powerful psychosocial protective factors that resulted in a disaster aftermath in Japan that was not nearly as catastrophic asIt might have been.
This is not to say that psychosocial stressors do not exist in Japan. In 2006, Japan’s suicide rate was reported to be the 9th highest in the world – nearly 2 1/2 times the suicide rate in the U.S. The pressures that help to keep the society orderly, also put pressure on this who have difficulties conforming to or achieving these same cultural imperatives. Child suicide rates have increased recently. Some people ascribe these increases to economic pressures as well as Japan’s beliefs regarding mental health.
As a Japanese-American, I can say that, while the values described above may be generalizations, I was raised with similar values. I found a dissident voice somewhere along my journey, however that voice is limited in scope to matters of early education, social justice, anti-war, and anti-bias matters. I once had an observant friend, a wonderful girl from Kentucky, offer me some food three times in rapid succession. When I asked her, what that was about, she said something like this: “You never accept anything from anyone if they ask you once or twice. But sometimes you’ll accept it if they insist a third time. I just wanted to save time.” I accepted her gift.
http://www.theglobeandmail.com, March 11, 2011