Source: Center on the Developing Child, Harvard University
Read time: 2.2 minutes
 
This Happened
On July 22, 2024, Jack Shonkoff, M.D., founder of the “toxic stress” movement, posted his aims for the next phase. In May 2024, he stepped down as director of the center he founded to assume a new role as Founding Director.
 
Who Did This?
Jack Shonkoff is a pediatrician who has run an advocacy center at Harvard University for the past two decades. He has done more than anyone to advance the hypothesis that trauma and stress permanently damage brains and bodies, and to leverage that vision to influence policy.
 
The Claim
Shonkoff’s post stated his new goals for advocacy would be directed by a trilogy of three working papers produced by his Harvard-based work group he calls the National Scientific Council on the Developing Child:

1. Working Paper 15 (2020) created a new emphasis that stress from poverty and systemic racism during early childhood can permanently damage brains and bodies.
2. Working Paper 16 (2023) laid out a new emphasis that the physical environment of where children live is a key source of toxic stress, and most importantly, the hazards in these environments are caused almost wholly by systemic racism.
3. Working Paper 17 (2024) acknowledged more clearly than any of Shonkoff’s prior writings the obvious role of genes as a source of how individuals respond differently to stress. Previously, his writings focused on life experiences to the exclusion of genes. Nevertheless, the main message was still that racial discrimination borne of systemic racism was a major source of toxic stress.

 
To emphasize the major nature of this shift, Shonkoff called the Center’s past agenda Early Childhood Development 1.0 (ECD 1.0), and christened the new agenda ECD 2.0.
 
Analysis
The validity of toxic stress is lacking because it is based on weak cross-sectional studies, lacks a feasible mechanism, and stronger prospective, pre-trauma studies consistently fail to support it. Likewise, there is no good evidence that the psychological stress of racial discrimination permanently damages brains or causes physical illnesses [See here and here]
 
Another concern is that Shonkoff blended into these papers an analysis that minorities tend to have more health problems because they tend to live in environments plagued by material hazards (e.g., air pollution and lead), and that this situation was due to discriminatory policies. This, however, is not consistent with the toxic stress theory, because the mechanism of stress is material toxins that would harm any racial group. This contrasts to the theory that racial discrimination is a mechanism of psychological toxin, consistent with the toxic stress theory. Shonkoff made no effort to clarify the difference in mechanisms. When claiming that all your work is “science-based,” confusing two completely different mechanisms is indefensible. The tortured language opens a whole new area of advocacy that has no connection to the original theory of psychological stress.
 
Why Is This Happening?
The emphasis on racial discrimination is a sharp turn for the Council’s working paper series. The first fourteen papers, which spanned 2004-2018, never used the words race or racial to refer to stress.
The Council’s reason for this sudden shift was just “21st-century science,” as Working Paper 15 reminded readers five times, omitting to mention that studies on racial discrimination stress had existed since the 1980s [1]. It seems curious that Working Paper 15 appeared in the year of George Floyd and Black Lives Matter riots, when it became commonplace to frame nearly any problem in the U.S. as systemic racism.
 
Like all cultural revolutions that make progressive leftists feel exhilarated and truly alive [2] (e.g., Marxism, communism, the New Deal, the Great Society, man-made climate change, DEI, etc.), conflict, not outcomes, seems to be the point, and so they are eternal, and the revolutions need to be refreshed every now and then. Shonkoff, always a skilled wordsmith, expertly crafted the shift as being driven by new science, but, as usual, he gets the science wrong. If you’re a foot soldier for toxic stress, take note; you’re being handed a new party policy.
 
 
REFERENCES
[1] Barbarin, O. A. (1983). Coping with ecological transitions by Black families: A psychosocial model. Journal of Community Psychology, 11(4), 308–322. doi: 10.1002/1520-0629(198310)11:4<308::AID-JCOP2290110405>3.0.CO;2-Z
Jung, H. (1984). Indo-Chinese refugee services in metropolitan Boston: An impressionistic assessment. Asian American Psychological Association Journal, 16–18.
[2] Gornick, V (1977). The Romance of American Communism. Verso: London
 

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Source: Journal of Trauma and Dissociation
Read time: 1.9 minutes
 
This Happened
In July 2024, a study was published claiming to show that transgender-related experiences and the negative perceptions transgender people hold of themselves are fear-inducing enough to cause posttraumatic stress disorder (PTSD).
 
Who Did This?
Psychologist Sarah Valentine, PhD, conducted the study. Her program of research addresses care for PTSD among racial, ethnic, and sexual and gender minority populations.
 
The Claim
The study was conducted on 43 transgender and gender diverse (TGD) adults who responded to advertisements distributed at clinics and at a conference. They found that transgender-related stress experiences significantly associated with severity of PTSD symptoms.
The authors interpreted this to mean that transgender-related stress causes PTSD even though the stress is not the life-threatening type of stress that is known to cause PTSD. The revelation of this, according to the researchers, is that this conclusively explains why TGD people show PTSD at higher rates than the general population.
 
Analysis
The measure of transgender-related stress experiences was flawed at least three different ways. (1) Seventeen items measured events, such as “difficulty finding a bathroom to use,” and “heard negative statements about transgender” people, but no attempt was made to determine if these were experienced as positive or negative. The literature on stressful experiences has shown that it cannot be taken for granted how different individuals perceive events. (2) No attempt was made to date each event. The researchers did not know if reported events happened before or after development of PTSD symptoms. (3) Twenty-nine items measured perceptions (e.g., “People don’t understand me because they don’t see my gender as I do” and “When I think about my gender identity or expression, I feel unhappy”), which are not experiences. It's conceivable that participants imagined what others think about gender even if discrimination acts rarely happened to them.
These types of perceptions seem nearly identical to a character trait called neuroticism. Decades earlier, it was established that one of the best predictors of who develops psychiatric syndromes, including PTSD [1], was neuroticism, which describes excessive anger, anxiety, irritability, and emotional instability following minor frustrations, difficulty calming, and viewing situations as overwhelming [2].
An alternative explanation of the findings is that a large proportion of this self-selected TGD sample had high levels of neuroticism, and many, if not most, of the PTSD symptoms were false positives.
 
Why Is This Happening?
What’s the value to transgender people and their advocates of creating a narrative that existing as a transgender person puts them at higher risk for PTSD? It doesn’t help individuals manage distress or attain self-knowledge if it teaches them erroneously that society is the problem, behaviors are misdiagnosed, and they should not engage in introspection about their own weaknesses.
The value seems apparent when these types of flawed studies are placed in the context of historical ideologies for fighting social injustice that derive their appeal from oppression. We are witnessing an attempt to control language in academia by creating a category of “oppression-based stress” [3] that has special power to harm. The truth is that everyone faces stress, and there is no good evidence that oppression stress is any different from other stress in quantity or quality. The only difference is the valence that some advocates place on oppression as part of an ideology that fits their worldviews.
 

REFERENCES
[1] McFarlane AC (1989). The Aetiology of Post-traumatic Morbidity: Predisposing, Precipitating and Perpetuating Factors. British Journal of Psychiatry 154(2):221-228. doi:10.1192/bjp.154.2.221.
[2] Widiger TA, Oltmanns JR (2017). Neuroticism is a fundamental domain of personality with enormous public health implications. World Psychiatry 16(2):144-145. doi:10.1002/wps.20411. 
[3] Sarah Valentine and Kelly Harper (4/17/2023). Adaptation of evidence-based treatments for PTSD for sexual and gender minority youth. Grand rounds presentation for University of California, San Francisco Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry. YouTube accessed 7/30/24.


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CATEGORY: CONTROL OF LANGUAGE AND IDEAS

Source: Journal of Trauma & Dissociation
Read time: 2.1 minutes
 
This Happened
On June 21, 2024, Julian Ford, editor of the Journal of Trauma & Dissociation, announced a call for submissions for a special issue on understanding and treating dissociation in the context of intersectional inequalities.
 
Who Did This?
Julian Ford has been a researcher on psychological trauma for over four decades. He has published over 250 articles, served on editorial boards of multiple journals, and was the president of the International Society for Traumatic Stress Studies in 2018-2019.
Like the strategy of Bessel van der Kolk and Judith Herman who attack the competency of those who disagree with them, he has embraced the notion that clinicians who do not follow his beliefs do harm to trauma victims by overlooking their true problems, misdiagnosing them, and giving them the wrong treatment. Ford was an early adopter of the controversial complex PTSD diagnosis, starting with a 1998 paper with his notion that traditional psychotherapy overwhelms and retraumatizes patients who have complex PTSD, causing them to dissociate. This notion has been debunked with evidence [1].
 
He may be best known for publishing a series of studies trying to promote a theory that interpersonal and multiple traumas, what he calls polyvictimization, has special, harmful effects that other traumas do not have. Using weak, cross-sectional studies with samples of convenience, he has not proven such extraordinary causal relations. Ford attributes the high severity of patients’ symptoms wholly to their experiences of polyvictimization and makes no mention of the possibility that other factors, such as genetics or nontrauma factors, could have caused their problems [2].
 
The Claim
Intersectionality was coined in 1989 by Kimberlé Crenshaw, an attorney and law school professor who was one of the founders of the systemic racism-based critical race theory. Intersectional theory posits that multiple, overlapping forms of discrimination combine to cause damaging social and political identities. Racial groups are defined not simply by additive inequalities of gender, class, sexuality, and immigration status, but by effects that are greater than the sum of those parts.
While widely supported on the Left, the claim has been criticized, mainly by conservatives, as ambiguous, ignorant of broader social problems, focuses too much on group identities instead of individual differences, and a form of identity politics.
​
The premise of Adverse Childhood Experiences—that the number of childhood experiences has a compounding effect—is the same premise as intersectionality, except in ACEs the predictors are any stress or trauma and the outcomes are mental and physical health.
In the field of mental health, supporters of intersectionality claim that unless providers take intersectionality into account, they will somehow be providing inadequate, harmful, or wrong types of interventions for victims.
 
Analysis
“Intersectionality” is a successful ideological branding borne of the strategy that you can’t see a problem if you can’t name a problem [3], regardless of whether it is true. In the trauma world, the branding names of ACEs, toxic stress, and complex PTSD have been successful, too.
The parallels between Ford’s theory of polyvictimization and intersectional theory are striking. It seems no coincidence that they arose concurrently during the phase of increasingly popular progressive leftist theories in academia, and not coincidentally the same time that the controversial and debunked theories of complex PTSD and toxic stress arose. It’s not clear whether they influenced each other in their early stages, but Ford’s editorial signals that these trauma theories have melded seamlessly with the racial- and class-based intersectional movement.
It is noteworthy that intersectional theory is a causal theory, i.e., that oppressive life experiences borne of societal inequalities cause extraordinary human suffering and failure to flourish. ACEs, toxic stress, and complex PTSD likewise are causal theories of a similar kin. Swap discriminations, stresses, and traumas with capitalism, and they are nearly the same as Marxism, the original, enduring intellectual manifesto that attributes degradation of the human self wholly to life experiences, and which shares a skewed view of human nature that genetic differences play no role in variations of behavior and humans are highly malleable.
 

REFERENCES
[1] De Jongh A, Resick PA, Zoellner LA, et al. Critical analysis of the current treatment guidelines for Complex PTSD in adults. Depression and Anxiety. 2016;33(5):359-369. doi:10.1002/da.22469
[2] Julian D. Ford, Tobias Wasser & Daniel Connor. "Identifying and determining the symptom severity associated with polyvictimization among psychiatrically impaired children in the outpatient setting," Child Maltreatment 16 (2011): 216-226.
[3] Kimberlé Crenshaw (December 7, 2016). The urgency of intersectionality. TED Talk, https://www.youtube.com/watch?v=akOe5-UsQ2o
 
 
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Source: Newswires EIN press release
Read time: 2.0 minutes
 
This Happened
A press release on June 24, 2024 announced that the leadership of a Los Angeles-based emergency medical ambulance service had been trained in the Trauma Informed Leadership Program, hailing it as a milestone as the first EMS company in southern California to complete such a program.
 
Who Did This?
Before Operational Stress (BOS) provided the Trauma Informed Leadership Program training. Founded by psychologist Megan McElheran, they are a private company based in Calgary, Canada. Believing the world is in the midst of a mental health epidemic, BOS tailors their training products to public safety personnel and first responders. BOS provides pre-recorded videos, live presentations, and support programs for employees. The Trauma Informed Leadership Program costs $500 per person.
 
The Premise
The premise of the BOS business model is that the stress encountered by first responders and law enforcement causes mental disorders. Their website asserts that 23% of public safety personnel suffer from PTSD and 50% screen positive for at least one mental disorder.
 
The leadership program content is divided into four modules:

• The Historical and Biological Underpinnings of Trauma
• Influence on Trauma-Informed Leadership
• Empathic Leadership
• Knowledge Translation

 The premise of providing a one-time training workshop to leadership is that they will return to the workplace with their new knowledge and spread to their employees new practices to help them flourish.
 
Analysis
The Canadian government has adopted the phrase “operational stress injury” as a non-medical term for psychological problems caused by trauma exposure for military or first responders. The national Operational Stress Injury Social Support program was created in 2001. The word 'injury' was selected because it was believed a shift in language away from mental disorders— posttraumatic stress disorder, major depression, and anxiety—would persuade individuals to seek help more readily.
 
The company’s assertion on their home page that 50% of public safety personnel have mental health conditions from workplace stress is wildly higher than the normal population. This misinformation comes from a single survey with major flaws [1]. Survey respondents were a self-selected sample of less than four percent of Canada’s public safety personnel. The participants knew they were selected for being public safety personnel and they may have been motivated to register their perceptions of workplace stress.
This finding contrasts with most other literature that has found first responders to be an especially resilient population. For example, a literature review of police officers exposed to trauma events found rates of probable PTSD closer to 7% [2].
 
An analysis of their year-long program for public safety personnel was unconvincing. Only 19 participants completed measures six months after the program out of a possible 203. Small, statistically significant improvements were found in PTSD, quality of life, stigma, and perceived social support. They failed to find improvements in depression, anxiety, stress, alcohol use, emotional regulation, and resilience [3].
 
Why Is This Happening?
While the Before Operational Stress group has adopted some of the trauma-informed movements' branding language, they seem to have embraced a lite-version of the ideology: Their website is not filled with the trauma-informed misinformation that toxic stress and ACEs damages brains. It is a concern, however, that they promote the theory that humans are highly malleable to life stress. Evidence continues to mount that programs built on that notion are not very helpful for people who need help the most.

 
REFERENCES
[1] Carleton RN, Afifi TO, Turner S, Taillieu T, Duranceau S, LeBouthillier DM, et al. (2018). Mental disorder symptoms among public safety personnel in Canada. Canadian Journal of Psychiatry 63:54–64. doi: 10.1177/0706743717723825
[2] Regehr C, Carey MG, Wagner S, Alden LE, Buys N, Corneil W,  et al. (2021). A systematic review of mental health symptoms in police officers following extreme traumatic exposures. Police Practice and Research 22(1):225-239 doi: 10.1080/15614263.2019.1689129
[3] Stelnicki AM, Jamshidi L, Fletcher AJ, Carleton RN (2021). Evaluation of Before Operational Stress: A program to support mental health and proactive psychological protection in public safety personnel. Frontiers in Psychology 12:511755. doi: 10.3389/fpsyg.2021.511755


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Source: ABC News
Read time: 1.9 minutes plus brief video
 
This Happened
Two days after the attempted assassination of Donald Trump, a psychiatrist interviewed by ABC News warned viewers that you can develop PTSD by watching the video footage.
 
Who Did This?
Frank Anderson's personal website describes himself as an author, psychiatrist, therapist, speaker and “trauma specialist who’s spent the past three decades studying neuroscience and trauma treatment.” His website sells video trainings on Internal Family Systems theory—one 60-minute video for $50, three 60-minute videos for $149, and a more expensive six-video course. On the Internal Family Systems website, he is part of a team of presenters who sell twelve pre-recorded videos: This “$1,239.95 value [is] just $299.00 today.”
He published a 2017 manual on Internal Family Systems therapy, a 2021 book on how to heal complex PTSD, and a 2024 autobiographical memoir of his childhood and adult struggles with shame and abuse. His memoir explained that he suffered childhood trauma when his parents took him to a psychiatrist for play therapy because they were concerned about his sexual orientation. His memoir was endorsed by Bessell van der Kolk and Gabor Maté. He appears frequently as a trauma expert on news shows and podcasts.
 
The Claim
In the adjacent 2-minute video clip, Dr. Anderson explained that individuals can get PTSD from watching the Trump assassination attempt or other violent videos. He further explained in a confusing change of topic his belief that there is a “sweet spot” of talking about violent video (not watching the video itself)—talking about the video several times is fine, but the harm occurs when talking about it six or ten times. 

Analysis
Those claims are wrong and debunked by evidence. There are no known case reports published of an individual developing PTSD from watching video violence toward a person they do not know personally. I have conducted or supervised the evaluations of over 500 trauma-exposed individuals in clinic work and five research studies on trauma, and have never encountered such a case. If Dr. Anderson knows of such a case, he ought to write it up: it would be the first one.
 
The only known study of individuals exposed naturalistically to the same television footage of trauma and then assessed by interview involved children who witnessed the 1986 space shuttle Challenger explosion live in their classrooms [1]. None of the children had developed PTSD one year later.
Nearly all other studies of viewing violent video were based on retrospective self-report questionnaires, methodologically flawed, and no subjects could be diagnosed with PTSD [2].
 
Anderson’s description of finding a sweet spot of talking about the events to prevent PTSD is misinformation. PTSD symptoms develop immediately following the moment of fear during trauma exposure in one hundred percent of cases. There is no evidence that talking about trauma events causes PTSD.
His information about critical incident stress debriefing was mostly accurate but it’s relevant for decreasing severity of existing symptoms not causing or preventing them, and has nothing to do with watching violent videos.
The individuals he described who watch or talk repeatedly about videos on purpose are the opposite of PTSD. In fact, individuals with PTSD typically avoid reminders about their experiences. 
 
REFERENCES
[1] Terr LC, Bloch DA, Michel BA, Shi H, Reinhardt JA, Metayer S. Children's symptoms in the wake of Challenger: a field study of distant-traumatic effects and an outline of related conditions. American Journal of Psychiatry. 1999 Oct;156(10):1536-44. doi: 10.1176/ajp.156.10.1536.
[2] Just one example of many such studies: Holman EA, Garfin DR, Lubens P, Silver RC (2020). Media Exposure to Collective Trauma, Mental Health, and Functioning: Does It Matter What You See? Clinical Psychological Science 2020, Vol. 8(1) 111–124, doi: 10.1177/2167702619858300
 
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Source: Marx et al., 2024 [1]
Read time: 2.5 minutes
 
This Happened
In February 2024, the leading trauma research journal published a review article attempting to bring some clarity to the controversy about how a traumatic event ought to be defined.
 
Who Did This?
Brian P. Marx, Ph.D. is a psychologist who specializes in posttraumatic stress disorder (PTSD). His work has focused on the assessment of and effective treatment for PTSD.
 
The Premise
When making the diagnosis of PTSD, the first gatekeeper criterion is whether an individual experienced a truly traumatic event or not. In the diagnostic criteria, the event is called Criterion A. If the definition of Criterion A is too narrow, individuals with PTSD won’t get the diagnosis. If the definition is too broad, individuals will be falsely diagnosed, potentially receive the wrong treatment, and contaminate the validity of research studies.

The controversy about how to define traumatic events is as old as PTSD itself, stemming to its birth in 1980. Marx argued that a new review was needed because of current events—race-related events and the COVID-19 pandemic presented new quandaries with energetic challengers.

Marx organized the evidence by noting that there are four sides in the debate:
(1) Keep criterion A the way it is, which is restricted to life-threatening events that are either directly experienced, witnessed happening to others, or learning about events secondhand that happened to loved ones.
(2) Broaden criterion A to include non-life-threatening events, such as divorce, expected death of a loved one, financial stress, giving birth, and racial discrimination.
(3) Narrow criterion A to only events that are directly experienced and witnessed, and exclude events that are learned about secondhand.
(4) Eliminate criterion A because any attempt to comprehensively define all events will always leave some ambiguity.
 
Marx and colleagues recommended option #1—keeping criterion A the way it is—because the evidence for the other options is too weak or logically indefensible.

Analysis
The review covered the relevant issues thoroughly and without bias, and came to a sensible (mostly) conclusion supported by evidence. As review articles go in psychiatry, it's one of the better ones.
The authors respected all opinions by creating four sides to the argument, but, in reality, there are only two main sides—those who want to keep it the way it is (#1) and those who want to broaden it (#2).
 
Option #3 for narrowing criterion A probably should have been the recommendation, but it’s close to splitting hairs. The gatekeeping is implemented according to #3 in all good studies based on common sense, so it does not generate many vocal supporters.
Option #4 for eliminating criterion A comes from a small but vocal, radical group who advocate for a range of other extraordinary ideas.

What’s missing was an analysis of why this debate was stoked in the first place.
 
Why Is This Happening?
Nearly all the heat, and a swarm of weak studies, for changing criterion A comes from the efforts of those who want to broaden it to include non-life-threatening events. This effort is largely ideologically-driven, not science-driven.

The strategic benefit for non-life-threat events to gain standing within PTSD is that it gives the appearance of authenticity to the premise that human nature is highly malleable to everyday stressful events of modern society (as opposed to the less common, truly terrifying, life-threatening events). This is fundamentally a difference in how one views human nature.

This view of high malleability is key to progressive leftist advocacy movements that fighting for the care of disadvantaged and minority groups must trump other personal rights and societal obligations. The same skewed moral sentiment that drives the redistribution of wealth in the welfare state and socialism to rectify harms done to the disadvantaged is the same sentiment that attempts to elevate everyday stressors—including poverty, neglect, parental incarceration, pollution, racial discrimination, transgender discrimination, and historical treatment of minority groups—to be considered harmful, traumatic events, and sometimes even public health crises, as in the cases of COVID-19 and climate change. No good research evidence exists, however, that those types of stressors cause the harm of PTSD.

If academia can control the language and ideas of science by redefining stress as life-threatening trauma, it controls an important narrative for leveraging policy, laws, and public health mandates. The attempt to redefine trauma has almost never been about science; it’s about conflating social justice with research.

 
REFERENCES
[1] Marx, Brian P; Hall-Clark, Brittany; Friedman, Matthew J; Holtzheimer, Paul; Schnurr, Paula P (2024). The PTSD Criterion A debate: A brief history, current status, and recommendations for moving forward. Journal of Traumatic Stress 37(1):5-15, doi 10.1002/jts.23007

​
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Source: Center on the Developing Child 6/5/24 email newsletter
Read time: 2.3 minutes
 
This Happened
On June 5, 2024, a group that promotes the theory of toxic stress released a report on “human variation” that adds racism to the list of stressors.
 
Who Did This?
The eleven-member National Scientific Council on the Developing Child is a private group of academic scholars on child development. The group was formed in 2003 to advocate for the narrative of toxic stress as the keystone for reforming public health policy in the United States. Since 2006, the council has been housed within the Center on the Developing Child at Harvard University. Both the Council and the Center were founded and are run by pediatrician Jack Shonkoff. The council was formed with researchers so that their science credentials would give the council the appearance of authority. As noted in the report, their mission is to have “an evidence-based approach to science synthesis that is informed by the peer-reviewed literature and recognizes the shared opportunities for government, businesses, communities, and families to promote the well-being of all young children.”
 
The Claim
The new report released by the Council is titled “A World of Differences: The Science of Human Variation Can Drive Early Childhood Policies and Programs to Bigger Impacts. Working Paper 17.” The Council releases approximately one long working paper per year as part of the many promotional materials and infographics that the Center disseminates. These longer working papers are designed to set the intellectual framework that buttresses the Center’s advocacy efforts.
 
The main message of this working paper ostensibly was that there are individual differences in traits, or “human variations,” that make individuals vulnerable to harm and that also may limit some individuals from receiving the full benefit from childhood public health programs.
The paper did not provide details about these variations, but did mention broad group categories of parent education, family income, race, ethnicity, and community environment, and broad individual categories of temperament, aggression, and executive functions.
 
These variations that limit the effectiveness of programs should be viewed as new, crucial opportunities to reallocate funding to target certain groups.
 
Analysis
While the working paper was framed as being about a scientific issue of human variation, the emphasis was on racism. Race, racism, or systemic racism was mentioned 21 times in the 17-page report. No other type of variation received as much emphasis.
 
The paper seems to be an attempt to add racism into the framework of the toxic stress and adverse childhood experiences (ACE) movements. The conventional ACE research claims that ten ACE events can cause extraordinary damage to brains, cause physical diseases, and thereby hinder human flourishing. This paper seems to imply that racism be added to the well-known list of ten ACE stressors.
While scientist activists have been increasingly trying to link racism to neurobiological damage in recent years concurrently with efforts to promote other progressive liberal projects (i.e., critical race theory, DEI, and transgenderism), there exist no credible set of strong, reliable, or replicable evidence that racism causes permanent brain damage or physical disease. There are other more viable explanations for why certain poor health outcomes are associated with different races.
Simultaneously, the report’s recommendation that targeting certain groups based on racism can increase the impacts of childhood programs was asserted without evidence. There is no body of evidence that has shown this.
 
Why Is This Happening?
Malicious racism should, of course, be addressed in society, but this working paper takes a further step with a unique argument that racism is a toxic stress that damages brains and health. As has been noted in other Trauma Dispatch posts, both the toxic stress and ACE narratives are controversial, unproven theories that are based on weak, cross-sectional studies.
 
It was not clear in the paper why racism was suddenly emphasized after twenty years of advocating for toxic stress. As with nearly all social justice causes, as the movements drag on and the arguments become stale, advocates realize that they need to refresh the message to revitalize public interest and remain relevant. This has been called the March of Dimes syndrome after the organization that was founded in the 1930s to address polio, but was compelled to change their mission to birth defects after polio was vanquished. After twenty years of activism and sixteen previous working papers, perhaps the Council realized racism would enhance their message.
 
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Source: KSHB 41 Kansas City news
Read time: 1.5 minutes plus brief video
 
This Happened
An art installation was erected inside a popular Kansas City destination for families to raise awareness of toxic stress and how to prevent it.
 
Who Did This?
Barbara Unell, president of the Raised With Love and Limits foundation, obtained degrees in journalism and psychology, and built a long career of promoting compassion in the world. She has co-authored 17 books, including half a dozen with a child psychologist on how to discipline children. She has also been a newspaper columnist, radio host, and founder of magazines.
 
The Claim
This public health campaign is based on the toxic stress narrative that trauma permanently damages brains and causes a wide range of physical and mental problems. And the main way to prevent these problems is for children to have at least one nurturing parent relationship.
The art installation was erected inside Kansas City Union Station, which is a mixed-use railway station that houses museums, traveling exhibits, a live theater, a movie theater, and a planetarium. The 45-second video below was filmed while the installation was being erected, and includes a message from Unell. Note: The arcade activities shown in the video are not part of the art installation.

​Analysis
Unell clearly has compassion for helping others. Passion, however, does not help anybody if the intellectual framework behind it is flawed. The science behind toxic stress has been debunked. And despite many attempts over many years, simplistic public health campaigns have not been able to prevent traumatic events of abuse and violence.
 
Contrary to the many other toxic stress campaigns in the United States, instead of alarming citizens of the dangers of trauma, this one emphasizes that prevention is possible by the presence of a single nurturing adult. This aspect of the toxic stress narrative has been increasingly emphasized by activists in recent years because they realized that their message that trauma damages brains was depressing and unhopeful.

The logic of this campaign is fuzzy. It’s not clear if Unell believes a parent can prevent adverse events from happening, or prevent the harmful consequences after events happen, or both.
It’s also unclear how this activity center will create supportive parents. It seems unlikely that a brief encounter with educational material in an art installation will create lasting parenting changes.

Further, it seems that the parents who are able and willing to bring their children to the center are already loving and responsible parents. The parents who are not able or willing to bring their children are the ones most likely to need intervention.

The advice that children need nurturing parents is, of course, common sense. But there is no research study that shows trauma or stressful events can be substantially prevented. And there is no research study that shows harmful effects that might follow trauma events can be prevented by early psychological intervention [1], medication [2], or a relationship.
 
REFERENCES
[1] Rose SC, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD000560. DOI: 10.1002/14651858.CD000560. Accessed 16 June 2024
[2] Bertolini F; Robertson L; Bisson JI; Meader N; Churchill R; Ostuzzi G; Stein DJ; Williams T; Barbui C (2024). Early pharmacological interventions for prevention of post-traumatic stress disorder (PTSD) in individuals experiencing acute traumatic stress symptoms. [Review] Cochrane Database of Systematic Reviews. 5:CD013613, 2024 May 20.

 
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Source: WTRF news
Read time: 1.5 minutes plus short video
 
This Happened
On April 29, 2024, a local nonprofit charity provided a free information workshop for the community on the adverse childhood experiences (ACE) theory and how to be resilient to stress.
 
Who Did This?
The Brooke Hancock Family Resource Network is a nonprofit charity which has been led by Director Janna Gordon since 2022.  Brooke and Hancock are the two smallest counties in West Virginia, nestled in the northern panhandle sliver of West Virginia between Ohio and Pennsylvania.
  
The Premise
The workshop informed participants about the alleged harmful impact of ACEs and techniques to build resilience to stress. In the 30-second video of the workshop below, it briefly shows a participant thumbing through a deck of 52 cards which included the 10 ACEs depicted as aces found in playing cards.
 
The deck also includes 42 “resilience strategies” depicted in the suit of hearts. Some of them seem like reactions that can counter stress, such as developing self-esteem, and hope. Many of them, however, have no clear relation to dealing with stress and seem like everyday advice on how to socially cooperate, such as having clear expectations and rules, learning responsibility, experiencing success, modeling appropriate behavior, helping a friend, trust, a sense of belonging, and showing empathy.

Analysis
Workshops like these are concerning because they teach participants that they are fragile, when evidence, and empirical experience, indicates they are not. As writer Abigail Shrier emphasized in her new book Bad Therapy, industries of professions that deal with children, such as counselors and educators, treat children as if they are fragile and should be afraid of everyday stressors, which may be more likely to instill harmful anxieties rather than foster resilience and self-reliance [1]. This tends to be the philosophy of progressive leftist policies.
 
The deck of cards seems like a clever way to engage with participants, especially youths who are less disposed to self-reflect in one-on-one conversations with adult counselors. They are, however, mostly common sense that may seem patronizing to youths who already have adequate social skills. A concern is that it teaches individuals that any of their unhappiness is due to life experiences that molded their characters, instead of the more likely explanation that they were born with heritable character flaws. It teaches them to blame their problems on society or on someone else. It’s a potentially counterproductive strategy for teaching people to not look inward to truly deal with inborn limitations.
 
Why Is This Happening?
Trainings like these are held frequently across the United States by nonprofits and university centers to try to focus community efforts on ACEs to improve societal problems. These are the grassroots backbone of the ACE movement that promotes an unproven theory that physical diseases and inequities in society are caused by stressful life experiences.
 
 
REFERENCES
[1] Abigail Shrier (2024), Bad Therapy: Why the Kids Aren’t Growing Up. Sentinel: New York
 
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Source: Center on the Developing Child newsletter, April 3, 2024
Read time: 3 minutes 
 
This Happened
On April 3, 2024, the Center on the Developing Child at Harvard University announced that Jack P. Shonkoff, M.D., has decided to step down at the end of June after 18 years as Center Director.
 
Who is Jack Shonkoff?
Shonkoff’s most well-known contribution is coining and then disseminating the concept of “toxic stress,” which has been cited over 20,000 times in science articles, many more times in the media, and helped to transform the ideological debate on how to raise children. He is a pediatrician who focused most of his academic career on advocacy and social policy. He has been first or secondary author on over 50 journal publications, most of them commentaries or policy recommendations, and over 30 book chapters. He has had prominent roles in national organizations and testified to Congress about the well-being of children.
 
The Premise
Shonkoff’s advocacy has had an extraordinary influence on the field of pediatrics and shaping public perception by setting an intellectual narrative that children are far more fragile than previously thought and society must protect them from stress and adverse experiences.
 
In 1998-2000, he chaired a committee of experts on child development who published a policy monograph for the National Academy of Sciences which concluded that child development is derailed on a massive level by environmental stressors, and for the first time created the concept of “stressors that are toxic” [1].
 
Next, in 2003, while at Brandeis University, Shonkoff spearheaded the creation of the National Scientific Council on the Developing Child, which, despite the name was not a national government agency; the council was simply a private group of like-minded scholars with a stated mission to transform social policy. Their aim was to change the care of very young children from “a private, family matter” to influence national policy about children based on new neuroscience [2].
 
Then, in 2006, Shonkoff moved to Harvard University and became the founding director of the Center on the Developing Child. By then, the Council, which followed Shonkoff to Harvard, was worried that “just saying ‘stress’ more loudly wasn’t going to get them where they needed to go” [2]. The Council agreed to invent and disseminate the phrase “toxic stress.” Further, to convey their message more clearly to the public, they also invented a hierarchical taxonomy of positive stress, tolerable stress, and toxic stress. With a few years, their efforts made toxic stress widely accepted.
 
Prior to Shonkoff’s advocacy, there had never appeared a cogent connection between childhood psychological stress and derailed child development; the concept of stressors that are toxic had been used only to describe animals, mostly fish and shrimp, poisoned by pollutants. His synthesis appeared to be a stunning connection of psychological stress to major adult disease and dysfunction.
 
The concept of toxic stress is nearly identical to, and borrows heavily from, the adverse childhood experiences (ACE) movement, which claims, based on weak, cross-sectional studies, that stress and trauma in childhood permanently damages brains and causes a wide range of serious medical illnesses. The concept is also nearly identical to the claims in the 2014 best-selling book by Bessel van der Kolk, The Body Keeps the Score.
 
Analysis
The great tragedy of Science—the slaying of a beautiful hypothesis by an ugly fact.
—Thomas Henry Huxley
 
Shonkoff was a master at pulling together cherry-picked research through a wordsmith’s skill with academic rhetoric and humanitarian sentiment to convince others that he had finally found the source of nearly all childhood suffering. Toxic stress would have been a useful theory to provide levers for policy makers to pull to raise children out of chronic misery.
 
None of it, however, is true.
 
The supporters of toxic stress and ACE push back on any criticism by asserting that there is a widespread consensus and the scientific debate is over. As Shonkoff wrote in 2000, “The scientific evidence on the significant developmental impacts of early experiences, caregiving relationships, and environmental threats is incontrovertible…The overarching question of whether we can intervene successfully in young children’s lives has been answered in the affirmative and should be put to rest” [1].
 
Shonkoff omitted, however, or perhaps didn’t realize given his limited experience as a researcher, that the ACE research upon which he heavily leaned, is one-hundred percent cross-sectional in nature, which has zero power to provide causal conclusions. When individuals have been studied prospectively with assessments gathered before trauma and repeated after trauma, most studies fail to support toxic stress, and the few that do have been unreplicable [3]. A mechanism for how ACEs can cause a massive array of both mental and physical dysfunctions from psychological stress, including many that are normal, everyday stressors, has never been found.
 
What’s Next?
At age of approximately 78, it’s not clear what’s next for Shonkoff. The announcement stated that he plans “to dedicate all his time to an external, field facing agenda. Jack is not retiring…He will focus his time and energy on engaging directly with policymakers and community-based leaders who are eager to leverage scientific insights…”
 
Whether he has scientific insights is arguable. It is conceivable that his legacy will instead be a doctor who was gripped by a progressive leftist ideology that children are fragile and then found studies that fit while ignoring better science. Toxic stress is not a scientific term. It is a marketing slogan.
 
 
REFERENCES
[1] National Research Council and Institute of Medicine. "From Neurons to Neighborhoods: The Science of Early Childhood Development," National Academy Press, (2000).
[2] 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).
[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.
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.
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).
 
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