Wild Medicine, City Medicine

Cambridge, Mass.’s Healthy Children Task Force (HCTF) examined Adverse Childhood Experiences (ACES) throughout the 2012-2013 school year as its window onto child and youth wellness.

Pardon me. That lead sentence should have read:

You have deep, deep problems. But our time is up.

Let me explain.


ACES sure has that wonky ring to it—just another one of those nasty healthcare sector acronyms. It’s as if we can cure a problem faster if we can say it faster. Experiencing abuse or neglect or growing up with an imprisoned parent are the more obvious ACES, but there is fuller list. Are they the lodestone of prevention measures, or hype? Researchers at Kaiser Permanente and the CDC have indeed correlated various concatenations of early trauma experiences  with graded levels of risk behaviors and disease in adulthood, showing that the childhood end of the timeline can make or break the health of an individual years later. The study surveyed 17,000 adults.

Check your own ACE score here.

HCTF gatherings are  lunchtime meetings, both efficient and informal, punctuated with the occasional repartee and salad fork sounds. The city staff from all reaches of Cambridge together to learn about a particular concept, problem, or perspective. Interested public school parents like myself sometimes attend, but most often you’ll see school committee members, Cambridge Health Alliance staff, a random sampler of clinicians, nutritionists, early childhood education specialists, MPHs, and people whose jobs are more on the front lines of defending the mental and physical health of urban youth and kids.

It’s a bit odd to sit in that windowless room around a square of conference tables, as I do every few months, thinking to myself, “Does anyone else in the room feel like there’s no air in here—no bit  of sky to see?”

The reason I’m in that room is to understand how we could give a jumpstart to kids’ wellness with a particular prescription: Cambridge’s vast and vastly under-appreciated open spaces.  By open spaces I don’t mean the manicured parks, nor the new artificially turfed soccer fields rimmed with highly adaptable trees.  I don’t mean our city’s many beloved pocket parks, whimsical playgrounds, or the CitySprouts gardens that thrive at every public school in Cambridge. Those outdoor resources are indispensable in their own right.

I’m thinking of those areas that—whether ecologically restored and kept in shape by human labor (think Lusitania Meadow) or not (think parts of Alewife Reservation)— provide shelter to animals, old specimen trees, and serve as wildlife corridors. I’m thinking of places where a child can run, not just a few hundred yards, but perhaps a bit farther.

G. holds a squirrel's leavings.
What the squirrel left. Winter in an open space in Cambridge, Mass.

Perhaps in such places, a kid can even slip away to the secret folds of the woods where play and fantasy (as well as jeans) are smudged with dirt and broken wild berries.  I’m thinking of the abandoned farm next door to my third-grade friend’s house, the trees we climbed there, the territories we invented in its spaciousness.

We have the equivalent of such places here.  It’s good for all kids. My theory is that they offer something more to certain kids—a kind of complementary therapy for children who experience trauma, or who may do so in their future. Open spaces could be a kind of medicine—not as panacea, but as kind of pemmican for childhood’s journey. Richard Louv has recently commented

parks with the richest biodiversity appear to have a positive impact on psychological well-being and social bonding among humans. Those

While we can’t say with certainty that these influences play a direct role in early brain development, it’s fair to suggest that the presence of nature can soften the blow of toxic stress in early childhood and throughout our lives. It’s understandable that researchers have yet to explore the natural world’s impact on brain development because the topic itself is rather new. Also, scientists have a hard time coming up with an agreed-upon definition of nature – or of life itself.

via Do Early Outdoor Experiences Help Build Healthier Brains? | Psychology Today.

Brain research has also contributed to an understanding of the role of trauma in health. ACES Too High News, a blog devoted to the unfolding view of the original ACES study and its offshoots, reports:

Children with toxic stress live much of their lives in fight, flight or fright (freeze) mode. They respond to the world as a place of constant danger. With their brains overloaded with stress hormones and unable to function appropriately, they can’t focus on learning. They fall behind in school or fail to develop healthy relationships with peers or create problems with teachers and principals because they are unable to trust adults. Some kids do all three. With despair, guilt and frustration pecking away at their psyches, they often find solace in food, alcohol, tobacco, methamphetamines, inappropriate sex, high-risk sports, and/or work and over-achievement. They don’t regard these coping methods as problems. Consciously or unconsciously, they use them as solutions to escape from depression, anxiety, anger, fear and shame.

552px-Smoking_(9418449684)What all this means…is that we need to prevent adverse childhood experiences and, at the same time, change our systems – educational, criminal justice, healthcare, mental health, public health, workplace – so that we don’t further traumatize someone who’s already traumatized.

via ACES Too High News

Black's Nook, Fresh Pond Reservation, 2013
Black’s Nook, Fresh Pond Reservation, 2013

Resiliency, of course, is a factor that cuts across exposure to different levels of trauma. Arming children (and adults) with the building blocks of resiliency could be a critical corollary of  identifying the many faces of trauma. Nature alone may not lead to resiliency, but I’d be willing to bet that it could play a significant role, and without side effects.

Giving kids a chance to spend regular and sufficient time in full-fledged habitats, more wild than not, isn’t possible in many cities. Even here in Cambridge, our habitats of caliber lie mostly in the north and west of the city, with little to no functional habitat in East Cambridge, Cambridgeport, Riverside, Central Square, and adjacent areas. To Though I enjoy and value Northpoint Park myself, it doesn’t provide East Cambridge residents the equivalent of what Fresh Pond Reservation does to its neighbors. The Charles River Reservation is a critical open space for its adjacent communities, and meets the needs for respite and democratic enjoyment of nature. The more intact habitat within it, however,  is concentrated in the western part of the city.

The HCTF members have immersed themselves in the subterranean factors that make a child an unhealthy adult. These same factors make it difficult if not impossible to learn at school, particularly if the child is inadvertently re-traumatized by unaware teacher or youth workers.  Staff of agencies and departments that work with children and youth are getting an overview of the teachings of the ACES study at a November 21st event convened by the city’s Kids’ Council. The next step is titrating policies to reduce and mitigate children’s experience of trauma in the schools and other places where municipal government has a role.

Tree time is quality time.
Tree time is quality time.

There’s a bigger step I’d like people in the city to take—reframing nature (not just playground) experiences for kids as essential, not optional, as in the program launched this week by Massachusetts General Hospital and the Appalachian Mountain Club. Richard Louv prompted members of the American Academy of Pediatrics with this idea in 2010.  It’s not a new shtick by any means, but perhaps the time is ripe. Traction time for Vitamin N, you might say.

Let’s not underestimate the power of modeling an individual connection with the environment, either. Doctors, out-of-school-time programs, teachers, counselors, parents—we can all put aside our cell phones, iPads and e-readers and take the kids outside.

Deep problems, indeed, define the field of trauma,. Those deep problems may need deep, essential, but simple solutions, including, but not limited to, romping in the woods.

I hope it can happen before our time is up.

Next installment: Communities Get Serious About Nature.

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