

Broken Places
Episode 1 | 55m 6sVideo has Closed Captions
Find out why some children are damaged by adversity while others are able to thrive.
"Broken Places" explores why some children are severely damaged by early adversity while others are able to thrive. By revisiting childhood trauma victims we profiled decades ago, we learn how their experiences shaped their lives as adults.
Problems playing video? | Closed Captioning Feedback
Problems playing video? | Closed Captioning Feedback

Broken Places
Episode 1 | 55m 6sVideo has Closed Captions
"Broken Places" explores why some children are severely damaged by early adversity while others are able to thrive. By revisiting childhood trauma victims we profiled decades ago, we learn how their experiences shaped their lives as adults.
Problems playing video? | Closed Captioning Feedback
How to Watch Broken Places
Broken Places is available to stream on pbs.org and the free PBS App, available on iPhone, Apple TV, Android TV, Android smartphones, Amazon Fire TV, Amazon Fire Tablet, Roku, Samsung Smart TV, and Vizio.
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♪♪ ♪♪ -From a young age, being in foster care, I knew I had a chance of not making it.
Um, being, um, my Mom not being in my life, I knew I had a bigger chance of not making it.
My brother and myself not having fathers, bigger chances of not making it.
Nobody cared about me or him.
So, because of that, we have to protect each other.
We always say, "We all we got."
♪♪ -Raising five kids alone was very hard, stressful, sad place to be.
-I thought nobody in my family loved me.
-We are dysfunctional.
Yes, we are.
-It's mainly you.
-It's mainly you.
-No, it's not.
-Yes, it is!
-It's you.
[ Both laugh ] -I'm a teen mom.
I'm living in foster care.
I don't really have my life mapped out the way I want it to be.
I experience adversity the same way other people experience adversity.
But I make the choice to see it as an obstacle and not as a roadblock that I can't move.
Uh-oh.
The baby's sad.
-Why are some children so damaged by early adversity... -Peek-a-boo!
-...while others are able to thrive?
Ernest Hemingway had a powerful way of addressing this question in a "Farewell to Arms," where he wrote, "The world breaks everyone and afterward many are strong at the broken places."
♪♪ ♪♪ Yvonne Gross raised her five children in one of the poorest neighborhoods in Boston.
-I get that feeling all the time, giving up, but if I give up, who'll take care of my children?
Nobody.
They, um -- Sometimes I get so stressful I want to go hide underneath a rock.
-5-year-old Bobby, also known as Storm, was Yvonne's greatest concern.
-Cut it out!
-He's starting to steal.
He, um, three days ago, he got up, he was starting to hit hisself in the face and whatnot.
And I'm like, "Something's wrong here."
-Is this the -- the worst you've felt through all of this?
-The worst?
One time, I think I probably had a nervous breakdown.
One time, I just sat in the bathroom and I cried, 'cause there's no help.
-You feel like that now a little bit.
-It was rough.
Very rough.
You're always listening for bullets.
My kids learned how to... ride bikes and roller skate, jump rope in the house, because they had to learn, when your heard them guns, you had to drop to the floor.
♪♪ It was rough.
-[ Growls ] -Bobby went through a rough time growing up.
It was hard seeing him having to struggle, and me being a young mom didn't understand, because the people around me said, "Your child is bad."
So, he got punished.
I whooped his behind.
He got even badder and angrier.
-I tried hanging myself.
I broke both of my arms.
Only one got the scar.
Uh, I laid under my bed and set my bed on fire.
It's a battle wherever you go to fight, to survive out here, and I'm still doing that every day.
-Toxic stress is really the kind of adversity experienced by a child that is overwhelming, that the child cannot cope with with his or her own behavior and physiology.
-We're not talking about failing a test or losing a basketball game.
We're talking about threats that are so severe, chronic, or pervasive that they literally get under our skin and change our biology.
-In the early '70s, I was just going into college, and we just began to hear about this syndrome, uh, post traumatic stress.
Right?
And soldiers were going off to Vietnam, and they were coming home, and they were changed.
And they were ill, physically and mentally ill.
I thought, "What if the war was in your home, if it's on your streets, it was every time you went to school?
What happened to you when you couldn't get off the front lines?"
♪♪ -This clinic at Boston Children's Hospital was created by one of the nation's most renowned pediatricians, Dr. T. Berry Brazelton.
-Do you get tired?
-I get tired, very tired.
-Are you hiding behind there?
[ Laughing ] I don't think he wants me to see him.
Oh, you don't like to be touched, do you?
-No!
-No.
You don't like anybody to play with you?
-No.
-No?
Bobby is one that I would say is going to cost society a lot if one made a prediction about him, because he's not only very hyper-sensitive -- When I touched him, he jumped and moved away.
If I tried to make any advance to him, he had to guard himself and shut me out right away.
And he couldn't really let me get close.
And that mother with five children under the age of 6 is so overwhelmed, she hasn't -- hasn't the capacity, the energy, the time or anything else to pay attention to each of those children individually.
So they have to really fight to get anything out of life, and that's what he's turned into -- a fighter.
A decent self-image comes from somebody paying attention to you as a person and respecting everything you do.
If you pick up a small baby, and the baby goes "ooh" at you, and you go "ooh" back, and the baby says "ooh" a second time, you say "That's right."
And it goes "ooh" a third time, you say "Aren't you wonderful?"
That baby's face glows.
And you know that baby suddenly realizes, "Somebody loves me.
Somebody's passionately in love with me, and I know I'm worth it."
Now, these kids probably have never had much of that.
-Bobby was in a mental hospital 20 times.
Jail, I'd say seven times.
-I was a little troublemaker.
[ Chuckles ] -Bobby, I need my chair.
Could you go sit in your chair, please?
Thank you.
-Early adversity, really in many different forms, uh, fundamentally affects the growth and development of the brain.
-The basic way it works has to do with our body's fight or flight response, right?
So, imagine you're walking in the forest, and you see a bear.
Right?
Like, what, what happens in our bodies?
Immediately, the brain sends a signal to the rest of the body to release stress hormones.
So we release hormones like adrenalin and cortisol.
And these hormones are responsible for, you know, all those feelings that we have when we're terrified.
That is what is supposed to happen to allow you to either fight that bear or run from the bear.
But the problem is what happens when the bear comes home every night.
Right?
And this process is activated over and over and over again.
-I'm hoping there's a future here for him instead of gang fighting and killing people.
-I suspect that this was a mom who powerfully loved this little boy Storm, but herself had become so injured by her own life experience that her ability to give the kind of "serve and return" that Berry Brazelton was referring to was limited by her own experience.
-Thinking back on my own childhood, it was terrible.
At 6 years old, we were molested... ...constantly.
We had no one to turn to.
My biological mother didn't understand.
She didn't care.
She was told that that's what -- That's what happens.
The state put me in DSS custody, and I was molested all over again.
-If you were seriously neglected or abused or in a very violent environment or in a very tense and highly stressed home environment because of poverty as a baby, some of your brain circuitry, your metabolic systems, your cardiovascular system was affected early on in that very sensitive time in development, and there are biological memories of that.
There are traces that are helping us now to understand why what happens early leads you to more likely have illness.
-I had a stroke.
I had two strokes.
The first one left me wheelchair bound for 2 1/2 years.
Um, I had to battle cancer.
Then here comes the -- the fibromyalgia, the chronic pain disorder.
Always in pain, always crying.
Can't get out of bed, can't walk.
And then they told me that I had M.S.
for years.
When I tried to take my own life, that was the lowest.
And it was a sad, dark place.
-When you have an adult who has an overactive stress response, they're more likely, that family is more likely to be in a stressful or traumatic situation.
And the ability of the caregiver to be that buffer is compromised.
And that creates a little bit of a perfect storm for intergenerational transmission.
-Oh.
There he is.
-My son, Jeremiah, has, uh, cerebral palsy.
He can't talk.
He can barely walk.
I can't see him when I wanted to see him because his mother actually had both of our parental rights tooken away.
They basically said I did everything -- beatin' on the kids to showin' 'em porn, to this, that, and a third, and all the blame went on me.
-Families like Yvonne's family, where you see what happens to her and then you see what happens to little Bobby, and you see this -- then you see what happens to his kids.
You add up those costs, I will tell you, uh, we would have been much smarter to do an initial investment in solving that problem early on and making sure it did not go into the next generation.
-There we go.
-Yvonne and Bobby both rely on Social Security disability.
The correlation between early adversity and poor health outcomes was documented in a landmark study called the Adverse Childhood Experience or ACE Study.
-They asked 17,500 adults about their histories of 10 categories of adverse childhood experiences.
And these include physical, emotional, and sexual abuse -- physical and emotional neglect -- or growing up in a household where a parent was mentally ill, substance dependent, incarcerated, where there was parental separation or divorce, or domestic violence.
-There are 10 questions, so your ACE's score could be anywhere from zero to 10.
It's simply how many of these things actually happened to you.
So if four of these things happened to you, your ACE's score is four.
-Yvonne's ACE score is 10.
-For an individual with four or more ACEs, their risk for 7 out of 10 of the leading causes of death in the United States is dramatically increased.
7 out of 10.
So when we're talking about the $3 trillion a year in healthcare spending that the United States is spending right now, 75% of which is for treating chronic disease, right -- If we are not addressing ACEs as a root cause of chronic disease, we are missing the boat.
-There's been great value from the ACE Study that's shown how adverse experiences in childhood lead to problems in adult life.
But an ACE score alone just gives you a measure of environmental exposure.
It tells you nothing about individual differences in children.
-Children have profoundly different responses to, eh, to adversity.
So the metaphor that we have ended up using for this, which seems to work both for scientists and for laypeople is this metaphor of the orchid and the dandelion.
Uh, there are children who, like dandelions, can thrive almost in any environment in which they're reared.
They do well even in conditions of stress and adversity.
There are other children who are like orchids, who are extremely sensitive to the kind of environment that they're being reared in.
Under the right nurturing conditions, they thrive almost better than any other child.
But under conditions of adversity, under conditions of stress, they wilt, and they don't do well.
♪♪ -20-year-old Daniella Anderson moved into her first group home at age 16, after being severely abused by her father.
Since then, she moved a dozen times before ending up in a group home in Manhattan for pregnant girls in foster care.
-I was pretty much decided that I was gonna have an abortion, and I told my boyfriend, and he says, "You can't.
We're having this baby."
-19-year-old Veasna Hover came to America from Cambodia after his parents were murdered when he was still an infant.
-Why are you so anxious?
-To have a family of my own.
I know we're going to make this family work.
-Just a few hours later, their son was born.
♪♪ Shortly after the birth, Daniella was forced to move into a mother-baby foster home.
♪♪ -I've never been so unhappy.
Right now, I'm living out of garbage bags, and I don't feel like that's something I should have to do.
I shouldn't have to wake up every -- every other week in a new placement.
I've been buying my own diapers, buying my own food when foster parents are receiving money to do that for me.
♪♪ Veasna can't even come here to visit.
And he needs to spend time with his child, as well.
-You got me looking like I'm soft, baby.
-Oh, please.
-I got a little Tweety thing on my shoulder.
-Despite the turmoil in her life, Daniella continued taking classes at night at Hunter College.
-I just knew when I had Elijah, I was going back to school.
And I thought, despite the obstacles, I would make it.
-I see a lot of confusion about why... ♪♪ -No matter what, I'm getting to the other side, successful.
At the core, I'm a dandelion, because no matter what, I'm gonna to make, you know, lemonade.
Like lemons, lemonade, or lemon martini.
I don't know.
It depends on the day.
-She is a poster child for a dandelion, which means that she can grow and thrive in lots of different circumstances.
-There's something that clicks in me where it's like, "Okay, pity party over.
Time to -- Now it's time to act."
♪♪ -How do you feel when you see pictures of your father?
-I don't know.
I get angry, I guess.
♪♪ My father, he hit us with 2x4s and literally anything he could pick up.
My mother, she would sit back and allow him to do it, because he would beat on her, too.
♪♪ I used to get mad when my staff in my group homes would tell me, "Mothers, like animals in the wild, mothers protect their children," you know?
And I'd say, "Well, my mother's not a mother 'cause she never protected us."
You know?
My dad was just doing what he knew.
Like, he knew, "Okay, well, a kid's not behaving, in our culture, unfortunately, you know, it is taught, like, you know, you just beat them into submission."
The final time was when he had hit me, and I, uh, had, um, started bleeding from my head.
♪♪ That was what led to me being in foster care.
I scored a nine on the Adverse Childhood questionnaire, um, primarily because of the experiences I had with my parents, and then subsequently when I went into foster care.
So it was just a compounding of neglect, abuse, both physical, mental, sexual.
-This is a tough thing to come out of unscathed, and the question of what is it about individuals who seem to overcome that?
And there are some very clear findings that have come across all of these different contexts.
At the top of the list is always the presence of some kind of supportive relationship.
-From birth to age 5, the most important person, I would say for me, was my grandfather.
He was loving and attentive.
Gave us nicknames.
But more importantly, he always made me feel like, no matter what, he would support me.
-Sometimes is only takes one person.
It only takes one person to teach a child how to feel safe and how to regulate themselves, to make a difference in that child's entire future.
-He loved us like, you know, to the moon and back.
Like, we could tell.
You're happy, too, right?
"I'm happy, Mommy."
-Daniella and Veasna voluntarily left the foster care system and moved into their first apartment in Connecticut.
-Hi, Elijah.
Hi.
♪♪ ♪ Who needs a diaper change?
♪ ♪ I do, I do ♪ ♪♪ We're home.
♪♪ You crawling, Elijah?
♪♪ You have to pay rent in, wow, three days?
-Hope I get this job.
'Cause then we won't have to worry about bills coming and we don't have any income coming in.
-We got bills already, and we just moved in.
-I guess, my -- my only fear is that one day, that me and you are gonna get in a big argument.
You know?
I guess that's my only fear, just to not be with you.
-I think my biggest fear is repeatin' what my parent's did to me with Elijah, you know?
-It's gonna be a struggle, but we can do it, as long as we do it together.
♪♪ -This was Veasna and Daniella's wedding day.
The ceremony was supposed to have started 2 1/2 hours earlier, but Daniella had not arrived.
♪♪ There were also serious doubts about whether Veasna would make it to the wedding.
The night before at his bachelor party, Veasna got so drunk that he passed out and wound up in the emergency room on life support systems.
♪♪ -Here I am, the day before my wedding, wondering, "Am I getting into to something that I'm gonna regret?"
-By virtue of the authority invested in me by the state of Connecticut, I do pronounce them husband and wife.
You may kiss the bride.
♪♪ -After the wedding, Veasna and I happily introduced another member to our family.
So now we have two children, Elijah and Sky.
Shortly thereafter, he joined the military, and through those years, um, one of the things that happened was an abuse of alcohol, which then led to an abuse of everyone in the family.
So, there were rage-fueled pushing and fighting and shoving, and you know, um, I certainly didn't want that for me, and I definitely didn't want it for my children.
One of the last big altercations that happened was when Elijah got into a fight with Veasna, defending me.
And he had Elijah on the floor, and he was literally choking him.
And their version of child protective services on post came to the house.
And it really scared me.
The fear of my kids being put into foster care made me realize, like, "I have to go."
And I ended up going to a domestic violence shelter.
My greatest fear was repeating the same cycle, um, for my children, and when I looked at them, and I realized, like, they were going through what I saw and what I went through in my parents' dysfunctional relationship, um, it really made me wake up.
I'm not helpless.
I'm stronger than that.
I shouldn't allow anybody to treat me like that, and certainly not someone who says they love me.
-For young people growing up who have overcome these obstacles, uh, they see a world, uh, that is filled with peril.
Uh, it's, uh, you know, you might have gone through the swamp, uh, and the alligators didn't get you, uh, but you don't forget you gotta go through the swamp again.
And those alligators didn't go anywhere.
So, you're gonna think, uh, you know what, I'm still vulnerable, and I've still got, you know, this child I have to provide for, and I'm uncertain.
And there's no, uh, guarantee of success.
-The alcohol abuse got to the point where he was drinking and driving all the time.
That led to this one evening where he got a DUI, so they did an other-than-honorable discharge.
He's still the father of my children, and I still see him as a man who's experienced things that I couldn't fathom.
Experienced having my parents killed and then go to a refugee camp and then be put with this woman who was physically abusive to me, and then taken away by, you know, child protective services after making this trek across the world to a new country and not speak the language, and then be put in foster care.
And, you know, to have to go through all of that and then be brave enough to say, "Okay, alright.
I'm gonna try having a marriage.
And then have a marriage and then join the military and go to a war zone to experience killing, and -- and having to, like, literally fight to survive."
One of those situations could have made someone say, "You know what?
I'm going to be an alcoholic."
-In individuals who have experienced high doses of adversity in childhood, it affects the structure and function of the pleasure center of the brain.
And so these folks actually get less pleasure from activities that should be pleasurable, and they need higher and higher doses to get the same effect.
And what we see is that that's part of the reason why we see a dramatically increased risk for high-risk behavior and substance dependence in individuals who have high doses of childhood adversity.
-It meant him self-medicating with the alcohol and staying out and, you know, that kind of thing.
And me self-medicating with, "Well, I'm not feeling loved and attended -- attended to and -- and cared for, so I'm gonna eat."
If Veasna and I got in an argument, it would be like, "Okay.
Well, come on, kids.
Let's go to get ice cream."
I could have easily been 600 pounds.
Easy, between every adversity I've been through my whole life.
I decided, no more was I, you know, going to be, like, a victim to this.
Like I was going to, A, take off the weight and then, B, keep it off.
I lost 40 pounds in like 4 1/2 months with Weight Watchers, and my leader, she said, "I think you could help a lot of people who have been through this."
Thank you for having me here today.
My name is Daniella.
I am a leader.
I am a mother.
I'm a student, and I'll be leading a workshop for you today on group facilitating and coaching.
Do you like vegetables?
-Yes.
-Yes.
So, what kind of vegetables do you like?
-Spinach.
-Spinach.
Okay.
Can you guys see what we've created here?
Yes?
You see the shape?
-A web.
-It is a web.
Yes.
-She is like the quintessential example of a resilient person.
But here's what science would say about that.
She wasn't -- She wasn't born inevitably to be resilient, but she was born with a lot of genetic potential to be more on the resilient side of things.
Lucky for her.
-I hate the word "resilient" because I think it takes away from the effort and energy and choices someone makes to overcome an obstacle.
♪♪ -Bring him close to you.
♪♪ I'm raising a child that's going to be successful.
So, I read your essay.
Can I read you something?
-Yeah.
-I'll tell you my favorite line.
"Not respecting oneself is the worst sickness.
It feels as if your insecurities are gnawing at you, clawing its way out."
Wow!
[ Laughs ] -Thank you.
-Where did that come from?
-Again, late at night, most creative part of myself.
-I feel like as a parent, I have a charge to really nurture my children and cultivate their spirits and make them feel like they can do anything, and that they, you know, have the support from me both physically, mentally, emotionally, you know, spiritually even.
I think she's also seen me as a woman, as a mother, be tenacious, so I think her feeling comfortable to model that behavior is different than Elijah.
And when Elijah was living with me, he rebelled.
It came to the point where he wanted to drink, and he wanted to smoke cigarettes.
So it became, "Well, that's why I want to live with Dad, because Dad's gonna let me do what I wanna do."
And so now he lives with his father.
-That story is another wonderful illustration of the ways in which no two children are actually raised in the same family.
Every child in a given family has a different experience that depends upon birth order.
It depends upon genetics.
Um, it depends upon the kinds of stressors encountered by the family during that child's critical period of early life.
♪♪ -Danny and Raymond Jacob lived in Sunset Park, Brooklyn, with their grandmother, Urslena.
-Thank you.
Always know who the gentleman is around here.
-They were abandoned by their biological mother when she became addicted to drugs.
♪♪ -Me and him will be in the room, sittin' down, relaxing.
He askes me a lot.
He be like, "D, when we gonna be a family again?"
And sometimes I don't know what to say.
All I could say is, "Just pray, Ray."
♪♪ -Danny and Raymond's mother had a family reunion at her drug rehabilitation program.
-Hi, Mommy.
♪♪ -Danny and Raymond's mother left the drug rehab program sooner than the family expected.
-Where did you go when you left there?
-I went, and I got high.
♪♪ -I feel like -- I feel like everything I pray for and hope for is gone, Kitten.
-Mommy, I feel that I'm never going to be able to stop getting high.
Just being away in them programs for months is not going to change me.
And I don't want to -- I don't feel like I want to live anymore.
I wish that I was just dead, and my kids will be fine.
And that's it.
♪♪ Yeah, I start-- I have start all over again.
-When you was in the rehab, we was like, "Yeah, Grandma, my second year in high school, I'm livin' with my mother.
You won't have to worry about it."
We crack jokes and everything, our second year.
And now it's not going be no second year.
You keep saying the same thing, and nothing's happening.
All these years, that's all Grandma talks about, all the chances they gave you.
Tired of this.
♪♪ -I think it was a couple of weeks ago, it was sign-up about, like, to see if our mothers was going to come on this class trip.
And then one of my friends had said, if -- if my mother wanted to come.
And I said, "Nah, she can't make it.
She works."
Everybody else has, like, a mother, and that I have a mother, but my mother isn't being a mother.
-Imagine if your mother actually when you were a kid was expressing through her behaviors that she did not want you.
That damage, uh, that's done to a child will last with them through the rest of their life.
-[ Speaking indistinctly ] ♪♪ [ Men cheering, speaking indistinctly ] ♪♪ [ Whistle blows ] -The Underdogs basketball team been around since 2003.
[ Whistle blows ] 6 in 5 seconds.
Um, I started with just my brother, 15 kids, and now we grew into 1,050 players.
[ Men speaking indistinctly ] -When my brother offered me the assistant coach job...
I said sure, why not.
I just wanted to give back to my community and to a program that taught me so much throughout my years.
-I wish we would've ran a cut a little bit harder and finished a little bit stronger, but that's why we gonna work on our offense now.
Ready for offense?
-Let's go.
-Coach, let's get one more basketball.
Basketball saved me.
Gentlemen, let's work on our A game.
I used to shoot and throw the ball at the rim, you know, just thinkin' about my mom and trying to erase what I was feeling.
So, a lot of these guys come to me.
They just want to make it.
They want a safe place to grow at.
I try to provide that for them.
There's two type of players.
What are they?
-Trained and untrained.
-Which one are you?
-Trained.
-Good.
Let's work.
-They're coming from poor broken homes and foster care and messed-up situations.
And when you come out here on the ball court, you got guys coming from the same backgrounds that I grew up.
-You can instill something that not nobody did for me, which was give me some hope on that basketball court.
I was accepted.
No matter what I was going through, didn't matter on the basketball court.
It was when I walked off that everything started to really eat at me.
So, I just got, you know, focused and determined on my goals to become a good basketball player.
And I did that.
Got myself to college.
Got myself able to play, you know, coming from a high school that, um, they didn't think the skinny guy could make it, and he did.
♪♪ I come from nothing.
I'm coming from no -- no silver spoon, no support, no background, and I kind of want to be able to really, really change lives immediately, right off the top.
From the moment I feel like they're worthy, I want to change it.
So that's what I'm fighting for.
-Yeah, he wants a legacy.
He wants a statue and a high school named after him.
-Yeah, I'm -- -Trying to stay modest.
-Yeah, I'm on it, man.
-My brother, he was basically the father figure.
Taught me the ropes, taught me about the females and how hard work pays off, and he was definitely a role model, and he was more like a father figure for me my whole life.
-He don't listen now.
He listened -- -I'm a little bit more stubborn, 'cause, of course, I want to find my own way.
-We was each other's pillar of strength.
We didn't really -- you know, and that's what I focused on as a young man, you know, was making sure I was all my brother needed.
And as he came of age, it, thank God, he felt the same way.
He wanted to be the same way for me.
So it was always us against the world.
We kept our bond tight.
♪♪ -Urslena reported to the family court to proceed with the seemingly inevitable adoption.
♪♪ -We're going to inform the court that we're going to put in a petition to terminate the mother's rights today.
-What happens when you do that?
-Um, once the package goes in, we come back to court, and she has a right to come to court and fight for her rights.
-Okay.
The bad news is your mother didn't show up.
That's the bad news.
-Do she want us?
-Yeah, well, this is the question you gots to ask your mother.
-Raymond, I could not face them saying that they was going to take y'all from me.
I had my clothes ready and everything.
My friend woke me up this morning, but I just couldn't deal with it.
I couldn't go.
But, see, I pray God is on my side.
He's given me another chance.
Right?
-What do you mean by you couldn't get up and go?
-Yeah, I didn't go to court.
-Why?
-Because I didn't want to hear them take y'all from me.
-What you talking about, you was scared?
You were supposed to be there and tell them you don't want them to take your kids.
Here.
-Alright, now, we -- this is saying -- me and Raymond, this got us thinking, "Alright, do she want us?"
The judge is saying, "No, maybe she doesn't because she's not here."
You see what I'm saying?
-Yes.
-So, I don't know -- I don't know what else to say.
You say you do but you're not showing us.
-I do want you guys.
Don't say that.
-I have to say that.
You need to hear that.
You have no way of winning.
So, just throw in the towel.
It's over.
Game over.
♪♪ It's just that you younger than me, and you don't have your moms.
♪♪ And I don't think it's fair to you that you missed out on that.
-You said that family will always be there, and friends will come and go.
And I still feel that way.
And, you know, family go, too.
Like they do die somehow.
Everybody's gonna go, but you can always hold them in your heart.
That's the place where I'm gonna have to keep Mommy.
-Danny is just crying.
Raymond looks like he's not crying.
He looks like he's trying to say, "Well, you know, I can deal with this."
No, you can't.
You can't deal with this at 8 or 7 or 9.
Uh, this is, uh, emotionally devastating!
Uh, and if you don't get help, uh, it's liable to pay a, you know, a huge role, uh, as you move forward in life.
-On my way through my high school career, I started suffering with manic depression, bipolar disorder.
And from the ages of 14 to 19, I was hospitalized 12 times, and it just took a toll on me.
-To have something like that happen is absolutely horrible, horrible.
You know, I mean, it was, um, you can't put in words as a brother, to not be able to protect your own brother.
That was the hardest part, is just no being able to protect somebody you love.
-For the past six years, I've been receiving disability, and it's a blessing.
-I think it's interesting that it was the younger boy, Raymond, who in subsequent life went on to have far more in the way of mental disorder and difficulties than his older brother.
That may have to do with differences in genetics, but it may also have to do with the period of life, the period of development during which the stressor of their mom becoming addicted and going to a treatment program and being absent from the family occurred.
-Check it, check it, check it.
-I began to realize that the research that we were doing regarding these children who differ in susceptibility to the stress of the environment was really an echo of, uh, of my own childhood.
We grew up in a family where there was lots of conflict.
My sister, Mary, began developing a series of mental health symptoms that ultimately led to a diagnosis of schizophrenia.
And she actually ended up, um, taking her own life, uh, several years ago.
The story of the orchid and the dandelion are really the story of my sister and me.
Where as I, the older brother, and the more dandelion-ish of the two of us, uh, was able to sustain and move through those challenges to my own development in life, um, my sister was really relatively unable to do that.
There were probably genetic vulnerabilities for both Raymond and for my sister that were there and were very real but may not have expressed themselves without the impact of those early experiences.
-I'm really impressed at how great she looks and healthy.
-We have this general understanding in pediatrics that children living in very, uh, threatening environments are at greater risk for health problems, but we've had no way to screen for that.
And we're close to being able to screen for that.
-You see that?
-Yeah.
-She really wants to walk.
-We will have measures to be able to differentiate children who seem to be more sensitive to adversity and, therefore, need more attention.
And at the same time, this will be a measure of resilience, because there are a lot children living in very tough environments who are doing well and whose parents are doing a magnificent job.
That's the big breakthrough.
It's being able to measure this at an individual level.
-There she is.
-A simple EEG, a measurement of electrical activity in the brain -- put a little cap on the child's head, couple of minutes, you get an EEG tracing -- It will tell you about the electrical activity in the brain, which in cases of stress can also be decreased.
-Beautiful.
It's all good.
You look really good.
Yeah.
Alright.
So, we're interested in understanding how babies react to the different experiences that they have.
And one way we do this is by recording her brain activity by wearing this special hat.
And then while she's wearing it, she'll watch a movie, and we'll get to see what's going on in her brain.
♪♪ ♪♪ Nice job.
-This is bringing 21st century neuroscience into the community setting in a pediatric office where people can interpret this.
And it's a whole new world.
There's science of excessive stress affects, and we can measure these in simple ways.
We can look at stress hormones like cortisol.
These are things that you can collect in urine, you can collect them in saliva, so they'll be very simple to do in a community-based setting.
-So, the next thing we'll do, um, is we do a urine collection from him.
And the way we do that, we just ask you to help us with a regular diaper change, and what we're looking for in here is a marker called isoprostanes.
Um, and so that is a marker of oxidative stress and has been associated with some health issues later on.
Alright.
Fantastic.
Almost done.
-This possibility of screening, it's a game-changer, from moving from just talking about toxic stress to measuring it.
-If this becomes standard of care in pediatricians' offices, they have perhaps one of the most powerful tools ever to identify children at risk for exposure to excessive stress, to know whether or not children are living in excessively stressful circumstances, and to measure whether or not they're getting better from the interventions that we provide.
-Okay.
Ready?
-What did you wanted to be before you wanted to be a singer and a writer?
-A doctor.
-[ Laughs ] Okay.
So, take a deep breath.
-This early intervention program called HealthySteps now operates in 120 pediatric clinics in 15 states.
-The overarching goal of Healthy Steps is to take advantage of the primary care pediatric practice as a universally accessed practice and as a trusted setting.
So now when you bring your child to the pediatrician, you see the pediatrician and the HealthySteps specialist.
And that HealthySteps specialist pays extra attention to the parent-child relationship, to the attachment status between the parent and the child, to the parent's own mental health.
-So, Carmen, we've talked a lot about some of the things that you went through when you were a little girl that have made it really hard to feel like the world is a safe place.
-I was raped as a little girl, and... my mom never really did anything about it.
Um, when I was 11 years old, I was sent away to a mental institute because he repeatedly did this to me, and my mom, I guess she didn't know how to take care of me, the same way that I didn't know how to take care of my daughter.
-I think it was hard for you to trust you mommy instinct, right?
-Yes.
Absolutely.
-We try to identify families at risk as early as humanly possible.
They might still be pregnant.
We don't have to wait until the baby's here, or they might have a newborn.
And then if they want to be part of the program, what that means is that the HealthySteps specialist will co-manage every single visit to the pediatric practice.
-I became so consumed with hurt and anger and hate and frustration that when I finally had my daughter, I guess it escalated through the postpartum depression, as well, where I just felt at times even that I didn't even want to exist anymore.
And HealthySteps helped me in that sense of, you know, me knowing how to speak to my daughter, how to let her know that, "I'm not shutting you out," because I believe that's what I was doing at first.
-And with Serenity, no matter what happens to her, big or small, she knows that she can go to her mommy.
-Absolutely.
Absolutely.
-And her mommy is going to take her seriously... -Absolutely.
-...and protect her and stand up for her.
-I make sure that my daughter knows that I will always listen to her.
I feel like I am the mother I was born to be.
-The costs of inaction on early childhood are so severe.
And in the big budget that has so many zeros behind it, when I say to you that we do this for $450 per family per year, those are pennies.
-♪ We are singing, we are singing ♪ -This preschool program is part of the Harlem Children's Zone, which has been led by Geoffrey Canada for three decades.
-Today, we've got 13,000 kids in our program.
We've got more than 25,000 adults who were part of the services we provide.
Uh, we've got kids that we start with those parents when their kids are 1, 6 months, sometimes when the parent is pregnant.
And we're trying to make sure that we prevent as many of those initial challenges that parents face that end up interfering with the development of their child.
So, what happens 20 years later?
This is what we find.
95% of our kids are graduating high school.
Uh, out of that graduation rate, about 95% of those kids go on to college, that they graduate college at higher rates, both in four-year schools and two-year schools than every other ethnic group, including whites, in America.
But here are some things we don't talk about.
We have way reduced teen pregnancy rates, and -- and numbers that you would have assumed 300, 400 kids were in jail, we've had 1.
-Now we actually understand and can -- and can see and can measure how early adversity impacts risk of health and behavior problems over the lifetime.
And we can connect that to the economic cost of inaction.
Right?
So we can either pay this tremendous cost for not doing anything about the situation, or we can invest in prevention.
-Folks will come in, they say, "Geoff, but yes, you're spending $5,000 on that child.
Could we scale that?"
And I have said to folks, when you begin to calculate what we end up spending on families, uh, that we don't provide really effective interventions, we don't solve the problems early on, uh, there's incarceration costs.
The latest New York City cost to incarcerate one person in New York City for a year, $167,000.
Those costs seem to me to be, uh, really not scalable, but you know what?
We've scaled them all over America.
Then you throw on top of that all of the losses and tax revenues from folks who are not going to be able to go to work.
Their -- their work experience is going to be cut short.
If you care about national defense, have a healthy, uh, population.
Have kids who are growing up who can read, who can write, who will be able to work for their entire adult lives.
That's really to me national security.
-♪ Where is Bobby?
Where is Bobby?
♪ -♪ Here I am ♪ -The story of Storm and his family is just one little postage stamp example of the economic, uh, impact of these kinds of experiences on children and on society writ -- writ large.
-Each time a new baby is born, we are given another chance to do better and improve the likelihood of a better outcome for this child.
I mean, for a lot of people, for me, that's compelling reason enough to do it.
Um, but for some people, and I welcome a big tent on this, for some people for whom the issue is much more about the financial costs to society, every time a new baby is born, it's always another chance to save more money.
-So much of the talent that young people have is, uh, absolutely destroyed and sometimes limited because they did not get the kind of support -- uh, emotional, intellectual, educational support when they were children.
So, would Daniella have been the next Supreme Court judge if she had a stable mom?
We don't know.
I celebrate what she's done with her life, but I also recognize, uh, that there's a certain, I think, toughness, uh, determination, and grit that these folks have that if they had given -- had been given even a small amount of support, boy, uh, what they may have accomplished.
-I'm not a millionaire, and I don't, you know, plan on becoming a millionaire working where I work, but I feel fulfilled, and I feel like there's tons of people with tons of money that are unhappy.
So, if I had to trade, I wouldn't.
-I believe that we have, um, a truly ethical, moral obligation to care for, uh, those in our midst that are the most troubled, the most needy, and those are our children.
-If you look at uh, what's happening to families where you have opioid addiction and the impact that has on children, I mean, it's very clear you could see it, uh, with those two boys growing up with that mom who was on drugs.
This is just not in the inner cities with black and brown kids.
That's happening all over America right now.
This is a fairly significant group of kids in this country that without real interventions, they simply are not going to be able to reach their full potential.
-Me and my brother always jokingly say, you know, that if my mother was there, he would probably be in the NBA, and I probably would have been a doctor or lawyer.
We would have been two different people.
[ All singing indistinctly ] ♪♪ -So, at the Harlem Children's Zone, we haven't made it so these kids don't have problems.
What we've made it is that they can escape.
No matter what happens, there's a group of people here that have known you your entire life.
If something happens with the family, there's still a group of folk who become this alternative support group that believes in you, that -- that tells you, you know, that they're going to stick with you, that they're going to help you navigate.
It doesn't replace Mom.
It doesn't replace that love.
What it does is it gives you a stability that says maybe there's a way to make it out of this and still end up okay.
-♪ A, B, C, D, E, F, G ♪ -I'm optimistic, because, potentially, we finally have some hard science to support what every grandparent and kindergarten teacher has always told us -- that this is an incredibly important time, that you can make long-lasting changes for these kids.
And we can finally potentially measure it is, I think, the breakthrough that we've all been waiting for.
-I'm incredibly hopeful, because, number one, when we understand it as a public health crisis, it allows us to use the right set of tools, right?
It allows us to use public health level tools, raising awareness, doing routing screening, doing early detection, investing in systems for intervention, right?
And that is how you solve a public health crisis.
And in the U.S., we're actually pretty good at that.
But the second thing is that when we talk about 2/3 of the American population who has at least one Adverse Early Childhood experience, for me, that means that there is -- none of us are more than one degree of separation from this problem.
And that means we're all invested in finding solutions.
That is the power that we have to come together, because anyone who has experienced ACEs in their life wants to be part of easing suffering for others.
♪♪ ♪♪ ♪♪ -"Broken Places" is available on Amazon Prime Video.
♪♪ ♪♪
How Does Early Adversity Affect the Brain?
Video has Closed Captions
Clip: Ep1 | 2m 31s | How does early adversity affect the brain? Childhood screening may provide answers. (2m 31s)
"Does She Want Us?": A Family Breaks Down
Video has Closed Captions
Clip: Ep1 | 1m 43s | After their mother failed to show up to family court, two brothers are left asking "why?" (1m 43s)
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