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PACEs in Maternal Health

Dr. Gabor Maté & Full-Potential Parenting, Even When It Is Hard

 

Note: Allison Morris had dozens of experts in her summit series through Full-Potential Parenting. I took notes only on those by Donna Jackson Nakazawa, Gabe Maté and Sebern Fisher (coming later this month). Though the audios are no longer available, for free, they can be purchased for $100. or less (depending on the year), here. Forgive me for sounding like an advertisement, I don't know Allison personally. I am a huge fan of all parent-led resources and wish I discovered this series sooner. I appreciate the parent-centered and sensitive questions and conversations she has with guests. Her content is geared towards adoptive and foster parents, but anyone interested in ACEs, developmental trauma and attachment can benefit. Much more than what I've quoted or paraphrased is available in the full interview.

Dr. Gabor Maté is an author and speaker. His work draws on current research and his decades of clinical and family practice. He speaks about childhood and parenting, in general, as well as his experiences as a child and father. He is an interesting mix of direct and warm. He was interviewed by Allison Morris as part of her Healing Our Children World Summit series.

I'm still chewing on Maté's compelling words. Over his career, one of the "astonishing" things he has realized is how virtually all diseases are “rooted in early childhood experience.” He knows those words would sound radical to his medical colleagues, but not to him. 

Dr Gabe Mate

“In a nutshell,” he said, “if kids get what they need in early childhood, they are going to be o.k, (set, in a good way). If they don’t get what they need in early childhood, for whatever reason, they are going to have great challenges.”

Morris asked him to explain what children need, specifically.

An adult who is “able to respond to the child in a way child feels seen, heard, understood, accepted, celebrated, received," he said. He mentioned the writing and work by the Center on the Developing Child at Harvard University to detail how attachment impacts the architecture of the brain. Click here to dive deeper.

So what goes wrong and why don't we, as parents, provide these things for our kids, I wondered? Being responsive sounds simple enough, but lots of us know how nearly impossible it can be.

It can be the high-stress way we live, Maté said, a current culture where kids are separated from nurturing adults and how often we, as parents, are isolated and apart from other nurturing adults, as well. We manage with little or no help from others who might help pick up the slack (Those of us with high ACEs might have absent, strained or unsafe extended family situations).

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Maté mentioned how often our kids are with their peers in real time and on screens, so instead of being with loving adults during development, they are with others who are also still developing, too.

He suggested not introducing technology to kids until they are fully attached to us. He emphasized rebuilding attachment in the time we do have, which might mean not planning play dates or scheduling activities. or us being more present when our kids are present.

Sometimes the issues are more complex. Maybe we are not able to be present and available, though, because of the trauma we carry in us and with us.

This, he said, sometimes comes out in overt ways, such as physical or sexual abuse, which we know still happens to kids. But it's not always overt. The trauma is passed on through "anger, anxiety, depression and lack of availability" as well, which has a tremendous impact on a child. Note: Many of us would not intuitively know or consider this stuff to be trauma-related. If it has been or seemed normal it doesn't seem like what others call adversity.

Morris asked how we, as parents can help our kids who have been hurt by trauma, early stress and attachment disruptions. Many of her summit listeners, like Morris, are foster and/or adoptive parents, and some feel pretty "daunted." Some worry about the future because early childhood may be over. Many of us worry, as she said, that maybe "we've missed the boat already."



"It is daunting," Maté said.

He acknowledged studies that show that stress on a mother in pregnancy causes the release of stress hormones that are passed on to the child. And when it comes to adoptive and foster parents and their birth parents, one can assume there's been a lot of stress.

"If you are giving up a child, by definition, you are stressed," he said, even if it's a choice. Even in cases where adoptive parents are present at the birth, and their child is placed in their arms as a newborn, that infant has still experienced an enormous loss, he said. Both the birth mother and the child are stressed. That baby is “attuned to mother's voice and rhythms.” He said it is an emotional memory, a “deep sense of abandonment” that creates insecurity for the child who "just lost the world that I grew up in."

And that loss is real even if there have been no other ACEs, losses, stresses and traumas. But often, that is not the case. Infants and children often go through many losses, ruptures, and transitions during the adoption process, from birth parent, hospital, orphanage, foster care situation, etc. before being adopted. 

An “adoptive parent full of nothing but good intention,” is meeting a child “already imbued with an unconscious awareness that the world is unsafe. I’m not worthy. I can’t trust because I’ll be betrayed,” he said.

Many of us don't realize this when we become parents. We may be so overjoyed at starting a family that we don't appreciate the trauma, loss, and adversity our children (and their birth family) have experienced.Dr Gabe 3

For adoptive parents, the good news is that these negative and unconscious beliefs, as well as the ways the nervous system is programmed, are not fundamental to who we are." What a child has learned about the world can change, he said. 

There are two particular things, he said, all parents need, but adoptive parents especially need: awareness and patience. We must be aware of the “sacred enormity” of what we are taking on as adoptive parents. There will be challenges. Children are not "a blank slate."

We parents are not a blank slate either, I kept thinking. But how many of us have not even known we were carrying unconscious beliefs, from trauma, with us? 

We must be "patient, very patient and very dedicated," he said, and can't be “expecting anything from the child" in regards to expecting them to take care of our needs.

Dr Gabe Mate

Though he didn't talk about ACEs and parents with ACEs, specifically, I think we have to also have this long-term view, patience, awareness, and devotion to ourselves and our kids to understand how challenging and complex it is when we have pre-existing trauma as parents.

It's hard. Sometimes it's really, really, really hard.

“Our children are never stressing us," Maté  said. They aren't responsible for the emotions in us. 

He wasn't denying that things like colic, depression, poverty, and violence don't strain, stress and impact parents, because — come on —  we know that they do. He was reminding listeners that our kids aren't responsible for us — ever. We have 100% responsibility for ourselves. We can't meet the emotional needs of our children unless we take care of our own.

We may get stressed "because we have unresolved issues", but too often we focus on fixing our kid and avoiding our own pain, he said.

In fact, parents don't even know how stressed we actually are or the impact trauma has had on us, our parents or our kids.  We might be learning about ACEs well into our parenting and while in crisis or conflict individually or as a family. For me, learning about ACEs and attachment helped my parenting and my healing, eventually and it wasn't always easy to juggling parenting with trauma recovery.

Many of us are in recovery or rebuild mode when we learn about family systems and healing. And it's hard to admit that even though we love our kids we may have hurt them with what we did or didn't do or own negative beliefs. 

He spoke as a father not just as a doctor about his own now grown children and experiences parenting.

Dr Gabe Mate

He spoke of the difference between being loved and feeling loved and how important it is for children's development to feel loved. 

Maté spoke about his earliest experiences as an infant. He was born in Hungary in 1944 to Jewish parents. He was a loved and wanted child but he had a mother who was terrified and grieving. She had a baby. Her husband was away doing forced labor and both her parents were killed at Auschwitz.

She was a “scared, unhappy woman," he said, about his mother and she loved him, which is something an adult can understand but a child cannot. A child "makes it (early experiences) about the self, because a child can’t help interpret it that way," he said. It's not even conscious.

From child’s point of view, the relationship with a parent is most important, he said. "That's the good news and the bad news," as my friend Kathy and I always say. It means, as parents we have a lot of responsibility and a lot of power.

Preventing ACEs as well as supporting our children, ourselves and others, in the present to heal from ACEs and their impact, promotes and protects health and well-being now and in the future, for decades and generations to come. 

Attachment in the early years is pretty dang important and many of us need this reminder (and support) over and over. Maté doesn't "focus on it to the exclusion of other issues," external and environment, but attachment is a primary focus because "it’s the most significant and immediate," and is "amenable to positive intervention."

Unfortunately, there is still a lot of awful advice about parenting and much of it has come from experts. Advice, he said, which is "the opposite of what kids need." Two examples he gave are timeouts for punishment and letting babies cry it out. 

He talked about how these methods manipulate a child's healthy and natural dependence on the parent. Their natural longing for closeness is used against them in a way that conveys "when you displease me I deny you of your biggest need." In essence, he said, to a kid, it says, "My acceptance of you is based on your behavior," which undermines them.

Dr Gabe Mate

These practices feel terrible to many parents. The fact that they are considered to be normal, he said, just means they are the norm, not healthy or optimal for kids.

The fact that they are considered to be normal, he said, just means they are the norm, not healthy or optimal for kids.

“Don’t be despairing,” he said, which I needed to hear. He mentioned the power of relationships in healing and the neuroplasticity of the brain - and how they are related. Good relationships support development throughout life.

Many of us have kids who have been labeled and diagnosed with things such as depression or ADHD, which he himself has struggled with, as have lots of us. These may be descriptions of traits for a certain time, he said, but “the diagnosis is not written in stone.”

In relationships, a person’s “behavior and brain will change.” 

Things like dissociation or depression or distractedness exist for all on a continuum and are just a part of human nature. Their existence doesn't mean there are different kinds of people as if, there’s the “mentally ill over there and normal here.”  

As a man in his 70’s, he still has “some days I’ll out depressive and ADHD tendencies more than others.” A diagnosis isn’t about the “nature” of a person for all time, it just describes current "coping patterns" — which can change. Relationships can help make changes. 

Dr Gabe Mate

As a person and a parent, I am part of the social context. For my kid, my role is huge and has an impact in the present and the future for generations and generations. 

Personal change and social change are sometimes one in the same. 

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