Patients would carry soda into Dr. Gerard Clancy’s office, with cigarettes tucked away for after therapy.
Often victims of abuse or violent crime, they would seek soothing but risky behaviors to cope.
Overweight. Chronic pain. Chronic obstructive pulmonary disease. Type II diabetes. His former patients will die younger than they should, he said.
Clancy conducted therapy sessions until he became president of the University of Tulsa in 2016. At his psychiatry clinic, he saw firsthand how a lifetime of unhealthy habits wear on a person suffering post-traumatic stress disorder after a serious threat to his or her well-being.
“It dates back as much as anything to their behaviors and how they live their lives daily,” said Clancy, who remains a prominent leader in Tulsa’s mental-health network. “They walk in with the biggest QuikTrip thing of sugary Coca-Cola as possible. And as soon as they’re done seeing me, they go outside and smoke.
“Part of that is how their brain has been wired.”
Tulsa is at the forefront of revolutionary research to unlock a deeper knowledge of how social, behavioral, physical and environmental factors may affect brain development and health. Oklahoma is No. 1 in the nation in youths up to age 17 who have experienced two or more Adverse Childhood Experiences, according to the 2017 National Survey of Children’s Health conducted by the U.S. Census Bureau.
Trauma at a young age can negatively alter or stunt cognitive development, creating undesirable genetic changes that may even be passed onto future generations, some studies show.
Referred to as Adverse Childhood Experiences, ACEs include household dysfunction, neglect, abuse, poverty, crime, substance abuse and mental illness. Research is showing ACEs to be strong predictors of cognitive, behavioral and physical health, and mental wellness problems.
The initial question no longer is a superficial and judgmental, “What’s wrong with this kid?” Trauma-informed experts are nuanced, mining for answers by posing the more enlightening query, “What’s happened to him or her?”
ACEs are the common thread underlying behaviors that, from a logical standpoint, don’t make sense because they are knowingly harmful to the person, said Jennifer Hays-Grudo, director for the Center for Integrative Research on Childhood Adversity in Tulsa.
Things like smoking. Drinking to excess. Drugs.
“At the time, these behaviors were solutions to a larger problem,” Hays-Grudo said. “The larger problem is the fact that either you are a child being abused or neglected and feeling hopeless, or you’re an adult who didn’t develop the ability to soothe and regulate your emotions when you’re stressed.
“And in fact, your body didn’t develop the ability to help you do that. You might want to do that, but your body is programmed to get upset and stay upset because life is dangerous. That’s what your body learned as a child.”
Examples of long-term ramifications include premature death in adults, according to a study published in 2009 in the American Journal of Preventative Medicine.
Participants were questioned in 1996 and 1997 about potential ACEs under eight categories. People with an ACE score of 6 or higher were found to have died nearly 20 years earlier on average than those with no ACEs.
As transformative as germ theory was more than a century ago, ACEs appear poised to have a global effect.
Hays-Grudo noted how germ theory prompted wholesale changes in hospital policies and procedures to block the transmission of germs. Doctors no longer simply used the same instruments from patient to patient like during the Civil War.
The ongoing paradigm shift in how trauma affects developing brains has reverberated through scientific circles for two decades and now is beginning to filter more into public consciousness and practice.
Hence the more nuanced and illuminating question, “What’s happened to him or her?”