Health Matters: Teen substance abuse and addiction

We have evolved over millions of years to deal with brief, sometimes intense, episodes of stress and trauma. Think of cavemen fighting off saber-toothed tigers. Under stress our bodies release substances, like adrenaline and cortisol, to help our nervous system respond to life threatening stresses — Fright/Flight/Fight/Freeze.
In today’s world, stress tends to be of lower intensity, but of longer duration, yet the same stress substances are released. What happens when a child’s brain is frequently flooded by these compounds?
Research has shown that these same hormones that get us out of trouble when we have brief stress, cause brain changes, behavioral problems, and long-term health problems when the exposure is prolonged. There is evidence that persistent exposure to electronic devices and multi-tasking activities that constantly require us to respond may be a form of chronic stress.
Children growing up in stressed homes, in poverty, in dangerous neighborhoods often demonstrate challenging behaviors because of chronic stress.
What can we do as parents, caregivers, relatives, friends, teachers, bus drivers, cafeteria workers — all of us — to respond when things go wrong? Timeouts, suspensions and expulsions are often ineffective and can contribute more trauma and stress, causing behaviors to escalate.
When kids act out, when their behavior pushes our buttons, it is very difficult to think creatively about how to respond. All too often we “parent from the hip,” impulsively reacting to children’s behaviors. Anger, frustration and/or resentment is not a good plan for responding.
Here’s a better idea, one that works with 4-year-olds and 18-year-olds (and even 50-year-olds). it’s called Head Start-Trauma Smart. It is based on a concept known as ARC (Attachment, Self-regulation and Competency) developed at the Justice Resource Institute of Brookline, Mass.
First, a basic principle of child development: Children’s behavior means something. It’s often difficult to figure out what that meaning is, but we can respond in ways that teach kids how to stop or reduce these behaviors in ways that respect the child and preserve our own dignity.
When children’s emotions overwhelm them, you might find the  Identify, Validate and Defuse response helpful.
1.      Identify the feeling. Instead of yelling “Stop!” give the child’s feelings a name and describe what you see them doing, i.e., “You look really mad. You’re making fists and your face is all scrunched up.”
2.      Validate the child’s feelings. “I’d be mad too if …” Strong feelings are okay, but it’s important what we do with those strong feelings.
3.      Defuse the traumatic emotional response and help the child solve the problem. For younger children having a “safe spot” may be helpful for them to go and use calming techniques, i.e., blowing on a pinwheel to the count of 3, squeezing on a stress ball, or holding textured cloth. Older kids may find wearing a bracelet to focus on right away helpful to remind them to stop and make better choices. This technique helps children feel safe and learn self-mastery over difficult feelings and control over how to respond to strong emotions.
There is no one answer, but Head Start-Trauma Smart is a strategy for helping children avoid problem behaviors and giving caregivers’ strategies to safely respond to difficult behaviors. Ultimately, this response is healing by releasing kids from damaging consequences of chronic stress and trauma.
Editor’s note: This article was contributed by pediatrician Jack Mayer, MD, MPH, of Rainbow Pediatrics in Middlebury. “Health Matters” is a series of community education articles written by members of the Porter Medical Center professional/clinical staff on health topics of general interest to our community.

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