Source: 9News Denver and Colorado H.B.20-1312
Read time: 2.7 minutes plus video
 
This Happened
Denver’s 9News outlet ran a story April 4, 2024 on the implementation of Colorado’s new mandate for training of teachers in trauma-informed practices (TIP). The law was passed and took effect in 2020.
 
Who Did This?
Sponsors of the bill were Rep. Dafna Michaelson Jenet (D) (now a state senator), Rep. Brianna Titone (D), Sen. Dennis Hisey (R) (served one term before losing reelection in 2022), and Sen. Nancy Todd (D) (left office in 2021 after a sixteen-year career). Titone, born a biological male, was the first openly transgender person elected to the Colorado legislature.
 
The Premise
The theory of TIP is that trauma-exposed individuals ought to be sensitively handled by professionals in many spheres to both prevent worsening through re-traumatization and promote healing through new knowledge and skills.
The mandate comes from Colorado Statute § 22-60.5-110, Section 3.f., which dictates conditions for renewal of professional teacher licenses. It includes the following:

• A minimum of ten professional development hours are required on “behavioral health training that is culturally responsive and trauma- and evidence-informed.”

The content of training may include programs such as:

• (a) mental health first aid specific to youth and teens;
• (b) staff development training modules concerning how to prevent teen suicide;
• (c) interconnected systems framework for positive behavioral interventions and supports and mental health;
• (d) training approved or provided by the school district where the teacher is employed;
• (e) training concerning students with behavioral concerns or disabilities;
• (f) and training modules concerning child traumatic stress.

 
The text of the bill did not provide a rationale as to why this type of training would facilitate teachers’ skills and competence in the delivery of academic instruction.
 
While the law covers teachers in all grades, the 9News story focused on the launch of the mandate within Colorado’s universal pre-K program. Anchor Corey Rose chatted with Dr. Rosemarie Allen, the station’s “race and equity expert.” Allen’s doctorate is in Equity and Leadership in Education; she is the president and CEO for the nonprofit Institute for Racial Equity and Excellence which licenses child care providers in Colorado.
In the 1.3-minute video below, Dr. Allen asserted that trauma impacts child development, and this new training will give teachers “amazing strategies.”

Analysis
The premise of TIP is based on several controversial assertions.
(1) It is based on the ideology that trauma permanently damages the brain and derails child development, neither of which are proven.
(2) The concept of TIP is not a clear or testable theory. TIP can be any or all of the following: train professionals, professional self-care, educate victims, teach coping skills, tweak customer service to avoid retraumatizing victims, arrange environments to make people feel safer, include trauma victims in advisory roles, track customer satisfaction outcomes, communicate between service areas, allow drop-in service, change hiring practices, create women-only environments, and, of course, direct clinical care to treat trauma symptoms. Many of these do not represent evident mechanisms or effective paths to improve victim outcomes.
(3) Besides direct clinical care, the interventions by themselves or in combination have not been shown to consistently improve mental health or learning outcomes. Nearly all the non-clinical studies on TIP have measured perceptions of professionals on whether they believe they and/or their workplace are better informed or more competent.
(4) In regards to school settings, it is controversial whether teachers ought to be assuming responsibilities that have previously belonged only to parents to intervene in social and emotional issues outside their scope of expertise.
 
The Colorado legislature estimated the cost of this program to the state to be between $8,000 to $600,000.
 
Why Is This Happening?
Despite assertions by supporters, TIP is not an empirically-driven scientific model. It is an ideological-based movement consistent with progressive leftist ideas that humans are highly malleable. Statutes like this have been adopted in a growing number of states and cities to authorize government interventions in a wide range of environments.
Direct clinical trauma care, based on evidence, and delivered with common sense of sensitive and empathic professionals, has been commonly available for over three decades. What’s new in TIP is the mandate to train non-clinical professionals and trauma victims on an ideology, embed this model into statute, and create new administrative agencies and infrastructures that will inevitably increase in size and cost over time.
 
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Written by Michael S. Scheeringa
Read time: ~2.5 minutes
 
To solve complex social problems, at least two things are needed: (1) Policy makers need information outside their areas of expertise in digestible formats, and (2) that information often must come from scientists. Scientists’ reason to exist in society is, in distilled form, to extract truth from the natural world for the rest of us. For psychological trauma, the main organization of scientists is the International Society for Traumatic Stress Studies (ISTSS). The worldview of those who contribute to ISTSS recommendations, however, does not always represent what the evidence says about trauma.
 
Since its founding in 1985 as the Society for Traumatic Stress Studies (“International” was added in 1990), the Society has done more than any other organization, by far, for the promotion of good science and competent clinical work to assess and treat trauma victims. They have published the main journal for trauma research, the Journal of Traumatic Stress, since 1988, and hold an annual conference every November.
I joined in 1994 and presented my work at nearly every annual conference for twenty-three years. I, like almost all trauma researchers, considered it my professional home. I was “sort-of famous” within the group as one member told me when seeing my name tag at a conference.
I attended my last ISTSS conference, however, in 2017. I had been dreading the conferences for several years because, in part, the presentations were increasingly uninformative lectures about events that were not traumas or theories that weren’t true. I had tried to keep it interesting for myself by going to the audience microphone in the question-and-answer periods, but if I dared question their dogmas, presenters stared back blankly as if I had just suggested killing their pets. Viewpoint diversity? No thanks.
 
Due to the nature of trauma, ISTSS had always been forced to struggle with slapdash research and dubious ideas. What’s new has been the rise of advocacy. The rise was gradual, and perhaps inevitable, as the concept of posttraumatic stress disorder (PTSD) became increasingly well-known through the 1990s and 2000s. By 2005, advocacy was on steroids.
Activist-minded researchers expanded the notion of trauma well beyond life-threatening experiences to include everyday stress experiences (e.g., neglect, emotional abuse, divorce, poverty) in order to draw attention.
Complex PTSD was tacitly accepted as a valid disorder even though there is zero validation data and it had been savaged by multiple experts [1-3].
The concept of toxic stress—that psychological trauma permanently damages the brain—was embraced as canon by invited keynote speakers and Society reports even though the only supporting human data comes from weak cross-sectional studies. Pre-trauma prospective studies fail to support it.
Climate change was endorsed as a source of trauma in an ISTSS brief even though the level of threat and the man-made theory have been debunked by many credible scientists, and, even if it were true, is more of an everyday stress than a life-threatening trauma.
The list goes on to racial trauma, historical trauma, intergenerational transmission of trauma and other unproven theories. In the 2023 conference program, nearly a third of the symposia were ideologically-based on complex PTSD, toxic stress, adverse childhood experiences, equity, race, COVID, or other non-trauma experiences.
 
Why Did This Happen?
These theories were invoked for the humanitarian project to conquer suffering at the expense of other virtues that parallels the progressive leftist agenda of the past century. ISTSS got a late start, but its evolution has tracked closely to the progressive ideological capture of academia in general, including the acceleration of more radical woke movements in the past decade. The mission of ISTSS has been impacted by trauma activists to become a diluted archive of uncritical psychology, politics, sociology, and anthropology based on emotional appeals to perfect society, presented as science.
The cost of this advocacy is high. One cannot endlessly redefine concepts to suit activist needs irrespective of data without eventually sacrificing truth, honesty, and holding the respect of others. While ISTSS still holds a seat at the table for publishing and presenting good studies, as long as they don’t contradict the canon too directly, policy makers should not mistake it for behaving with a purity of mission to find truth.

REFERENCES
[1] Shawn P. Cahill et al., "Sequential Treatment for Child Abuse-Related Posttraumatic Stress Disorder: Methodological Comment on Cloitre, Koenen, Cohen, and Han (2002)," Journal of Consulting and Clinical Psychology 72 (2004): 543-548.
[2] Dean G. Kilpatrick. "A special section on complex trauma and a few thoughts about the need for more rigorous research on treatment efficacy, effectiveness, and safety," Journal of Traumatic Stress 18 (2005): 379-384, p. 383.
[3] Patricia A. Resick et al. "A Critical Evaluation of the Complex PTSD Literature: Implications for DSM-5," Journal of Traumatic Stress 25 (2012): 241-251

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Source: Cincinnati City Council
Read time: 3.2 minutes plus a four-minute video
 
This Happened
A coalition of scientists and community activists made a lengthy presentation to a committee of the Cincinnati City Council on April 2, 2024. Their aim was to formally present the underlying science and scope of their proposed model for government action to commence large-scale systemic change by trying to address stress and trauma as underlying causes of inequity in child outcomes.
 
Who Did This?
The scientist in the coalition tasked with presenting the brain science data was pediatrician Robert Shapiro, M.D. of Cincinnati Children’s Hospital. Shapiro completed his pediatric medicine training in 1984. He has been the secondary author on twelve peer-reviewed studies that covered mostly child abuse, adverse childhood experiences, and parent coaching. He has not been the first author on a paper, been the principal investigator on a research grant, or studied brain imaging.
 
The Presentation
The 1.6 hour presentation employed the usual logic of the adverse childhood experiences (ACE) narrative that stress and trauma cause permanent brain and body damage that leads to a wide variety of mental problems, physical diseases, and social dysfunctions.

​Shapiro’s first slide was a side-by-side comparison of two MRI brain scans labeled No Maltreatment and Maltreated (see above). The number of purple circles and connecting lines is obviously fewer in the Maltreated brain. In the four minute video clip below, Shapiro initially gave a vague explanation of the figure, then the chairwoman redirected him to give a clearer explanation, which was still vague, and then another council member, still confused, asked him bluntly, “Doctor, what do the purple spots represent?”

​Analysis
Shapiro understood almost nothing accurately about the brain scans. A reference was not given for the original study that produced the brain scans. We were, however, able to locate it within a few seconds with Google Image. The original study was Teicher et al. (2014) in Biological Psychiatry.[1] The original figure is shown below for comparison.

The figure represents centrality of one brain area in relation to over one hundred other possible brain areas. Centrality was based on cortical thickness of an area, meaning, very roughly, if two areas have relatively greater thickness they are considered to be connected to a greater degree. The connecting lines and the size of the circles were based on a complex permutation of four different centrality measures. In sum, each figure is presumed to show how a network of connectivity emanates from one brain area (the green circle). Shapiro never mentioned centrality or connectivity.
Teicher et al. found significant differences in networks emanating from nine different brain areas. They made figures for only three of them, and Shapiro presented only one of the figures. Greater centrality was shown in the Not Maltreated group compared to the Maltreated group for the left anterior cingulate, which is the only figure Shapiro showed. Greater centrality was shown, however, in the Maltreated group compared to the Not Maltreated group for the right anterior insula and the right precuneus, which are the two figures Shapiro omitted, and those are reproduced below.

Obviously, if Shapiro had shown these two figures, the status of brains of the Maltreated group vis-a-vis the Not Maltreated group would have appeared much more complex.
 
Other misinformation from Dr. Shapiro:

• The data were not from functional brain scans; they were from volumetric brain scans.
• Subjects did not have an area of their brain stimulated; the subjects were at rest with no stimuli.
• The green dot does not represent an area that was stimulated; it represents the base area from which calculations of centrality were made based on cortical thicknesses.
• The scans were not able to see where brain signals are sent; they showed correlations between cortical thicknesses.
• The figure did not represent how sensory input is projected throughout the brain; the measures of connectivity could theoretically include motor actions and internal processing, not just sensory input.
• The figure said nothing about the role of the frontal lobe. The figure shows the centrality of the anterior cingulate cortex.
• The figure did not indicate anything about our primitive (limbic) brain because subcortical structures were excluded from this study.

 
When showing brains scans in this manner to legislators, it raises many concerns. For example, the legislators were not told that this represented one of several ways to measure connectivity. They did not know that this method of measuring so-called connectivity was based on cortical thickness of structures. It was not based on functional MRI that showed brains in action; it was not based on blood flow to areas or on neuronal activity.
They were not told that this research is based on a shaky assumption that increased connectivity between two brain regions somehow stimulates cortical thickness growth during brain development. The mechanism of how that stimulation might happen is mysterious.
They were not told that this study has never been replicated.
They were not told that other methods for measuring connectivity do not fully replicate these results.
They were not told that the data were limited by being cross-sectional, meaning that the connectivity patterns probably pre-existed any life events and more likely represent vulnerability or resilience factors, and are not the outcomes of life events.
They were not told that connectivity maps do not yet reliably equate with functional importance like behaviors, symptoms, or morals. Any connection between connectivity maps and real-life function is assumed.
 
The presentation obviously worked. It is clear the three council members were enthusiastic about the program.

In trying to solve complex social problems, legislators must rely on scientists for truth. When scientists become persuaders for a cause, this often corrupts the process. As Paul Cairney, a professor of politics and public policy, wrote, the danger, or perhaps the intended outcome, of effective persuasion, is that “scientists may exaggerate scientific consensus on ‘the evidence’ when they become advocates.” [2]
 
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References
[1] Martin H. Teicher, Carl M. Anderson, Kyoko Ohashi, Ann Polcari (2014). Childhood Maltreatment: Altered Network Centrality of Cingulate, Precuneus, Temporal Pole and Insula. Biological Psychiatry 76(4): 297-305, https://doi.org/10.1016/j.biopsych.2013.09.016.
[2] Paul Cairney, The Politics of Evidence-Based Policy Making   (Palgrave Macmillan, 2016).

Source: WCPO ABC 9 news
Read time: 1.7 minutes
 
This Happened
On April 2, 2024, a committee of the Cincinnati City Council hosted a presentation titled Building Equitable & Resilient Neighborhoods. This was the latest step in a process over recent years by a coalition of community leaders demanding government action for large-scale systemic change by trying to address stress and trauma as underlying causes of inequity in child outcomes.
 
Who Did This?
The coalition consists of Cincinnati Children’s Hospital, the University of Cincinnati, and George Washington University’s Center for Community Resilience. The group presentation was led by Wendy Ellis, Assistant Professor at George Washington University. Her 2019 dissertation was a model that conceptualizes adverse childhood experiences (ACEs) as outcomes of systems driven by institutional racism; and these outcomes, including racial disparities in evictions, income inequity, and economic mobility, must be addressed through public health initiatives.
 
The Premise
The coalition is trying to press city government to adopt new policies and enact reforms aimed at addressing trauma because they assert those cause inequities in child well-being outcomes. Their language tends to emphasize trauma, but their model includes everyday stress experiences—household disruption, parental incarceration, food insecurity, and poverty—that are not life-threatening trauma.
Proposed reforms include to alleviate poverty (cash assistance, child tax credits), increase entitlements (preschool and childcare), educate children on relationship skills, educate parents on how to parent, provide mentoring and after-school programs, and teach everyone about the ACEs narrative. 

Analysis
Consistent with the postmodern trauma activism of the past several decades that draws extraordinary causal interpretations from shaky science, these ACEs models claim to understand for the first time in history what drives nearly all human suffering. It cannot be overemphasized that supporters of ACE movements intend large-scale expansion of entitlements and government power. Their intent is to “transform,” as the subtitle of the presentation stated: “Vision: Transform the City of Cincinnati into a national beacon of healing, community resilience, and racial justice by centering the experiences and interests of trauma exposed children and families in organizational planning, partnerships, and policies.”
 
Philadelphia, Baltimore, New Orleans, and other cities have embarked on similar public health models based on the ACEs narrative. Each are different in details and stage of implementation, but none have achieved major success. No reports from these models have provided evidence that these strategies work. It is unlikely the programs can work because the ACE research on which they are built is controversial and unproven. 

​Another concern, besides the science, is that none of this reform for large-scale culture shift has been adequately presented to or voted on by the public, who are mostly unaware of what is happening.
 
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Source: The Trouble With Trauma
Read time: 2.5 minutes
 
This Happened
For the past two decades, a Harvard pediatrician and his university-funded center spearheaded the invention and dissemination of the term “toxic stress” and helped create an international phenomenon that has persuaded much of the world that there is a public health crisis.
 
Who Did This?
Jack Shonkoff is a highly-respected pediatrician, who, over a nearly forty-year career, has over 150 publications, and has been honored with many awards and influential positions. In 2006, he founded the Center on the Developing Child at Harvard University with the intention of using scientific knowledge to address the problems of children dealing with adversity.
 
The Premise
Shortly before founding the Center, Shonkoff created the National Scientific Council on the Developing Child. This council of experts crafted a framework around the concept of “toxic stress” on how to improve outcomes for children. The framework was distilled into a policy-guided-by-science playbook with four steps:
1) Emphasize that we’ve hit a wall. A massive list of poor outcomes— poverty, poor academic performance, crime, drug abuse, murder, domestic violence, and multigenerational racism— just will not go away with current efforts.
2) Claim that it’s nearly all due to stress and trauma. Children experience high rates of trauma, violence, poverty, neglect, racism, and rampant disparities. By assertion, any rational person can see that stress and trauma must be the causes of poor outcomes and represent the roots of social class disparities in health.
3) Super-charge the claim as permanent biological damage. To make matters more urgent, assert that these experiences of stress and trauma cause permanent damage to brains and bodies.
4) Billions must be invested in trauma-informed approaches. This situation constitutes a public health crisis, perhaps the greatest of all, and the commensurate response must be massive prevention and intervention programs in the realm of public health.

​Analysis
The National Scientific Council on the Developing Child, despite what one might infer from its name, is not a council representing the nation; it is a private group of eleven-members, four of whom are from Harvard. They were likely hand-picked for their shared vision that concurs with the toxic stress narrative.
 
Toxic stress is not a scientific term. The Council’s own literature is surprisingly candid in acknowledging that they invented the term toxic stress. The members of the Council agreed to create and disseminate the phrase toxic stress to convey their message to the public because, by their own admission, “just saying ‘stress’ more loudly wasn’t going to get them where they needed to go”[1] To fashion credibility for the concept of toxic stress, they invented two other types of stress: positive stress and tolerable stress. These types were not based on validation from science.
 
The Council’s unswerving assertion that stress and trauma cause poor outcomes and permanent brain damage is, in fact, controversial and has not held up under pre-trauma prospective studies in humans [2-4]. The Council has been shy about acknowledging that one hundred percent of the adverse child experiences studies they cite to support their assertions have been cross-sectional surveys, which have zero power to prove causative theories.
 
Prior to 2009, the phrase toxic stress had never been used, except by the pediatrician Shonkoff, in a peer-reviewed science journal to describe a cause of human psychological problems. Despite the shaky evidence base for the concept of toxic stress, it has proven highly attractive, and implementations of the playbook have become commonplace in a relatively short span of about ten years.
 
Why Is This Happening?
The idea that humans are highly malleable, such that human nature is almost completely molded by life experiences, and that individual differences in success or failure are due almost wholly to outside forces as opposed to unchanging personal traits caused by genetics, is consistent with the progressive liberal agenda of the past hundred years. As described in The Trouble With Trauma [5], one speculation to explain the driving motives of progressives can be based on moral foundations theory: This type of activism is driven by individuals with skewed moral foundations that disproportionately favor care for the disadvantaged even when it defies the evidence and may constrain other moral concerns such as individual freedom, tradition, loyalty, patriotism, and liberty.
 
Should This Be Attempted?
The toxic stress/ACEs playbook is based on a fatal conceit of believing that we possess the knowledge of what causes disparate social and behavioral outcomes for children, and that much, and perhaps all, of that cause is trauma and adversity. Attempting to guide policies with knowledge that we do not in fact possess, is likely to cause much waste and harm.
 

REFERENCES
[1] Center on the Developing Child at Harvard University. "A Decade of Science Informing Policy: The Story of the National Scientific Council on the Developing Child," (2014).
[2] Julia A. DiGangi et al. “Pretrauma risk factors for posttraumatic stress disorder: A systematic review of the literature.” Clinical Psychology Review 33 (2013):728-744.
[3] Andrea Danese et al. "The origins of cognitive deficits in victimized children: Implications for neuroscientists and clinicians," American Journal of Psychiatry 174 (2017): 349-361.
[4] Michael S. Scheeringa. "Reexamination of diathesis stress and neurotoxic stress theories: A qualitative review of pre-trauma neurobiology in relation to posttraumatic stress symptoms," International Journal of Methods in Psychiatric Research (2020).
[5] Michael S. Scheeringa (2022). The Trouble With Trauma: The Search to Discover How Beliefs Become Facts. Las Vegas: Central Recovery Press. ISBN 978-1949481563
 
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written by Michael S. Scheeringa
Read time: 2.9 minutes
 
Two people can look at the same artwork and come to different opinions. Many have hailed writer and director Todd Phillip’s Joker as a visionary commentary on society that tapped into a profound zeitgeist.  Others are less positive, and believe that its sympathetic portrayal of violence was misguided and could trigger more mass shootings. So, what really is the message of the film?
 
Movie Summary
The movie follows the origin story of how Arthur Fleck became the Joker. We are led to believe that Fleck suffered childhood trauma and this abuse helped to create the emaciated monster that he became as the Joker. Furthermore, he completely forgot his history of child abuse until he stole his hospital record and then all the memories came back to him. 
Fleck’s path to become the murderous Joker was also facilitated by a string of other misfortunes, including being bullied, fired from his job, and government defunding social programs he depended on for psychotherapy and psychiatric medications.
The movie culminates in a riot in the streets inspired by the Joker’s violence meant to symbolize a counterculture rebellion against the rich.
 
The movie inspired real-life individuals at various types of protests around the world to invoke the Joker, turned a spot in New York city where the Joker danced into a tourist spot, and it became the highest-grossing R-rated film of all time.

​Todd Phillips (right) may be best known for a string of so-called gross out comedies including Road Trip (2000), Old School (2003), Borat (2006), and the three Hangover movies (2009, 2011, and 2013).

​Analysis
Almost nothing about abuse, trauma, or posttraumatic stress disorder in the film was accurate. This origin story rests on the premise of two modern theories of trauma activists. The first theory is that trauma can create criminals, including mass killers. The second theory is that trauma memories can be totally repressed while having strong power over our behaviors. Both theories are discredited, yet many people insist they are true, seemingly unaware of the evidence to the contrary.
 
The driving plot narrative is a causal theory of human nature. The reason Fleck became a broken man and then was pushed beyond his limits to become a murderer is that he was a member of the underclass, oppressed by the wealthy through their corruptions of society. It’s another parcel of the progressive leftist reframing of human nature: individuals can’t just be born bad. There must be a societal reason killers become killers.
Mixed into the story is an overly simplistic beckoning for government intervention into the personal sphere; his plight could have been prevented if we had just invested more in social services.
As Ann Hornaday wrote in the Washington Post, “Joker is a flagrantly seedy movie, one that constantly evokes the garbage, vermin and social apathy that New York was known for at its worst. Welcome to Gotham City, where the weak are killed and eaten.”  This creates the context for an amped-up version of the wealthy stepping on the throats of the poor as the cause of their problems.
 
In the debate of nurture versus nature as driving forces of human nature, Fleck is the victim of nurture. If not for bad life experiences, he could have reached a higher level of self-actualization. To make the point comic-bookish obvious, we see his smothered nobility blossom when he dances gracefully in a bathroom to express something noble, we’re not sure what, after his first kill. 

Fleck is therefore not an unempathic deviant that can be written off to genes. He’s Locke’s blank slate and Rousseau’s noble savage; with different life experiences, he could have become anything. Fleck embodies the belief that trauma can change your essential character, which is a compelling narrative but has no basis in science.
Finally, the riot at the end of the movie seems straight out of the Communist Manifesto: Marx believed that capitalism smothers the possibility of self-actualization, leaving workers permanently stunted and alienated; eventually the proletariat rises up in a revolution to wrest the levers of production from the wealthy.
 
Why Was This Made?
I can make a good guess at the political beliefs of Phoenix, but I don’t know the politics of Phillips. When controversy arose about the film’s use of violence as a means of individual and group protest, Phillips seemed genuinely surprised. When addressing this at the Venice Film Festival, Phillips said, “It’s certainly not a political film,” which caused some laughter in the press room [1]. Taking Phillips at his word, as incredible as that seems, it appears possible that Phillips truly believes the portrayal of human nature in his film is just common sense and he has no deeper reflections or doubts about his beliefs, and that may be a fair assessment of much that comes out of Hollywood that can influence our popular culture.
 
References
[1] Nancy Tartaglione (August 31, 2019). ‘Joker’s Joaquin Phoenix & Todd Phillips On Creating DC Character Study & Finding That Laugh – Venice. Deadline.

(This is a revised version of a blog post by the author from 2020 at www.psychologytoday.com.)
 
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