A Tale Of Two Pandemics

Will Covid19 Widen Inequality?

With Rugby & Football postponed and social gatherings replaced by social distancing-the only hope for an exhilarating weekend was a long bicycle ride. As Hudson suburbs gave way to inner city Bronx & Harlem before the more prosperous heartland of Manhattan- a simple bike ride shows how different income groups cope with Corona Virus. In prosperous neighbourhoods, cafe bars and barbers shop were half or three quarters empty. There was not a hipster to be seen. By contrast, poor migrant areas were bustling. It’s a bike ride-not a piece of scientific research. But do high rents, poor pay, insecure employment, no sick leave & “for profit” health systems prevent the poor from social distancing? Do they need to carry on as normal? Even when they are frightened of the virus?

We may all be frightened of getting sick. But the poor often fear the sickness itself less than the life consequences. One pay check away from homelessness, the potentially ruinous out of pocket hospitalisation costs or the direct relationship between todays work-shift & tonight’s family meal. Over time the secondary costs will hit the poor the most. If children are out of school, who will look after them? Online learning is a brilliant solution for social distancing, but those who already have the worse learning outcomes also have the worse connectivity: the poor. In the end, there will be job layoffs. Corona virus will break some businesses and the working poor will be the first to go.

27 million Americans don’t have health insurance. The world’s wealthiest country equals many middle and low income countries in having dramatically worse health outcomes for it’s poor. Brits shouldn’t be smug. Low income males in the UK die almost ten years earlier than the wealthy. Many of the non-communicable diseases and conditions that render Covid 19 lethal are much more prevalent for those in poverty. In the poorest countries on the planet, weak health systems may be overwhelmed by Corona Virus. This will divert resources from other child killers such as ebola, measles, cholera and pneumonia.

Child poverty is not the only driver of lifelong inequality. Adverse childhood experiences such as family violence and neglect also lead to serious inequality throughout adulthood . How do you think #StayAtHome sounds to a child who only feels safe when they are not at home? Whose only soothing & supportive relationship is with a teacher or a school deskmate. The pandemic will turn their already fragile world upside down and minimise their chances for recovery. When schools were closed during the Ebola crisis in West Africa increased rates of sexual abuse and exploitation of children were recorded.

Privileged cultures, wealth and education rightly equip children with skillsets to better navigate complex challenges in a way that often eludes the less well off. This is highly relevant in a pandemic. The ability to distill a stream of useful facts about the virus amidst an explosion of noisy fake news. The agility to regularly absorb and update ones knowledge and act up upon it. Adaptation to change and uncertainty and knowing where to seek help. When something goes wrong for a poor or high-adversity kid and they are knocked off course, it takes them much longer to get back on their feet.

In many countries including the US and UK, inequality seems to be expanding and social mobility declining. If you grow up without university educated parents, your future prospects seem to be in decline. It is rarely articulated, but deep in the sub-conscious of working class and poor people this trend has transformed voting trends. Growing inequality has created space for populist braggarts who shun science and international cooperation. The very people who now appear shrivelled and sheepish next to scientists with international networks of practice.

Covid 19 is not just a public health crisis. It will be an economic and social crisis, a jobs crisis, a housing crisis and it will certainly be a child crisis. It needs a social strategy as well as a public health strategy. Are we the Italian balcony Sopranos who celebrate our shared humanity by singing our hearts out together? Or the hysterical supermarket goers who elbow each other out the way to buy endless supplies of loo roll? I think time will show us to be more like the sopranos, but that social strategy needs to bring us together rather than build wedges to drive us even further apart.

Do the Academy Awards Point to an Awakening on Adversity?

I am unbearable company during the Oscars. Like most US-based Brits I can’t help but do football stadium style cheering every time someone from the UK wins anything. Worse still I can’t watch films like Judy or Rocketman without analysing the”underlying messages” on insecure attachment. Nor can I enjoy The Joker, Harriet or Honeyland without giving a droning commentary on how toxic stress ruins lives. The invitations are drying up.

In case you are not clued up on the lingo: Insecure attachment is the term used to describe how poor early parental attachment undermines our ability to form healthy and nourishing relationships . Toxic stress is when prolonged childhood trauma chronically activates our stress response systems. Robust recent research now shows how people with either do worse in education, employment, physical and mental health and inter-personal relations throughout life.

From a rough estimate, about a quarter of 2020 Oscar nominee productions feature a story line with the following formula: Child trauma minus healing/soothing relationships = train wreck adulthoods. Does the proliferation of these story lines in films mean our recognition of the link between early trauma and poor life outcomes ? It is not just happening in Hollywood. In the sober UK BBC Question Time a couple of weeks ago. Decorated former Police Chief Mike Barton told a studio audience that we can only reverse the London drug and crime problem if we address adverse childhood experiences (ACEs). Research in the USA shows how media coverage on the theme has dramatically increased in recent years.

Our shared narratives should never be deterministic about the pathway from childhood trauma to adult dysfunction. Sometimes those with high childhood adversity flourish. But the most recent evidence suggests those with higher levels of trauma are much more likely to have poorer life outcomes. As Mike Barton may concur, they are the ones most likely to be targeted by criminals, groomers and radicalisers alike. As the US Centre for Disease Control has shown, they are also do much worse on almost every health and wellbeing indicator. The costs are huge and quantifiable. The UK Based Overseas Development Institute modestly estimated that violence against children alone (excluding the devastating global costs of child neglect) cost 8% of GDP. Conversely Nobel Prize winning economist James Heckman argues that if we invest in prevention in the very beginning of childhood-the return on investment through life is up to 13-fold.

Film scripts don’t always end with trauma. They can also inspire us with recovery and resilience. Gus van Sant’s Good Will Hunting had nine Oscar nominations and won two and is one of America’s most popular films. It is perhaps the most compelling cinematic representation of how a young adult overcomes debilitating childhood trauma through connection with an empathetic witness . When the film was made, recovery through connection was only a common sense proposition. Now that proposition is firmly backed up by science base. Human connection and a sense of belonging in family, school or community provides a buffer against toxic stress. It calms the stress response system and helps rebuild the attachment model. It enables the child to build the resilience to navigate future shocks and see a lifeline to a better future. We call this science of resilience.

The opposite of Good Will Hunting’s story of recovery is the inter-generational emotional neglect suffered and transmitted by Elton John’s father in RocketMan. Deep in middle age he sings: “I can’t love, shot full of holes, I don’t feel nothing, I just feel cold“. At the extreme end of this spectrum is the character played by Joachim Pheonix in The Joker. Severe childhood trauma with no empathetic witness on the path to adulthood is costly for the individual, their family and society as a whole.

Film and literature critics often tell us that fine writing gives a tangible narrative to feelings the viewer or reader has, but could never put into words. The research shows that between 50 and 80% of any given population have experienced one ACE and between 10 and 20% have experienced 4 or more. Everyone, everywhere is affected by childhood adversity. We don’t talk about it easily. We could assume it has been taboo for most of human history. But if we are not affected by it directly, our spouse, neighbour or colleague is. It is often manifested in their decisions and behaviour. It’s why we identify so much with these stories. It’s one of the reasons Good Will Hunting is held in such affection and why so much of our popular culture alludes to this theme. This is our story. Our broken childhoods and our struggle to overcome them are a central theme of human existence and spirit. But a marginal theme within our national and international conversations. Could that be changing?

From an advocacy perspective I hope so. More public openness to the theme could drive the political will and public demand needed. A good public policy start would be investment in 3 things. Trauma prevention though early parent outreach and support. Recovery and resilience through trauma-informed communities and schools. Open and taboo-busting public discussion on adverse childhood experiences. These interventions could close the costly gap between what we know and the policies we do. Imagine how much trouble could have been prevented if Gotham City had had better childhood policies. In Pinner and Philadelphia too.

And that brings us back to Elton and his Oscar nominated recovery anthem: “Find the wind to fill my sails, Rise above the broken rails, Unbound by any ties that break or bend, I’m gonna love me again” How rich our world would be with an opportunity for everyone to rise above those broken rails.

Another Brick In The Wall? Transforming Global Learning

Its progress we rarely acknowledge. Today across the world, in savannah and steppe and in city and village, most children will go to school. A few decades ago, this was a pipe dream. Access to education is a hard-fought human right which makes our world a better place. It is an accelerator for every other form of progress in any society. For example, half of the global reduction in child mortality over the past 20 years is attributable to the first generation of mothers in many poor countries receiving an education. A third of the world’s poorest girls continue to be out of school with huge societal costs. In total, 9% of the world’s children still don’t go to school. By 2030 we must achieve the goal of basic access to universal education.

Now the global discourse is expanding from access to quality and relevance of what children learn. From this lens, global education is in a learning crisis. 53% of children in low and middle income countries cannot read a basic text by the time they are 10. This is a benchmark described by the World Bank as learning poverty. Education spending has increased in many low and middle countries. Yet it is not directed towards the poorest children who need it the most. In low income countries, almost half of education budgets go to the wealthiest 10%. Against a background of fast-paced technological change in the labour market, poorer children will be left behind.

We now know that brain development is most prolific before the age of 5. Primary and secondary school are hugely important, but not the most impactful institutions for social, emotional and cognitive development of the child. The family in infancy and then pre-school from 3-6 years of age yield the most influence on learning and life outcomes. Yet, the poorest families have little guidance on early stimulation and brain development. Research has shown that 3 year olds from families on welfare hear around 600 words an hour. Those from professional families hear over 2000. This gap in language acquisition is an indicator of huge inequality even before the child enters pre-school.

Such early disparity could most obviously be addressed by a pre-school education starting at 3, as the child’s brain continues to develop rapidly. But in many countries most poor children just do not go to pre-school. The gap in pre-school access between the wealthiest 20% and poorest 20% is vast. The OECD Pisa survey shows that much later at 15 you can see the outcome of this early inequality. 15 year olds who attended pre-school are on average between one and two years ahead in maths science and language. Together, these early disparities drive an intergenerational cycle of poverty. This harms the individual child, exacerbates inequity and undermines economic and social development.

Even many well-resourced primary and secondary education systems in wealthy countries struggle to keep pace in a changing world. Education reform is never a progression from one static position to another. It is an evolution constantly informed by two streams of change. The first is the changing labour markets and civic culture Education should prepare citizens contribute and gain from progress and prosperity. The second is our growing knowledge of brain development and how children learn. Systems creak and move slowly, and despite the amazing dedication of most teachers, schools are behind the curve on both counts.

All research shows the one thing that drives good education outcomes is the performance of teachers. Yet stakeholders including unions, parents and parliamentarians often focus on structural issues like class size or teaching hours rather than teaching itself. Children learn from teachers they love and who inspire a passion for their curiosity. The 20% of children affected by multiple traumas at home cannot learn at all unless the teacher provides a sense of safety, calm and belonging.

Most countries do not have a system to recruit high calibre teachers, keep them motivated and developing in step with a changing world. Many spend less than 1 % of their education budgets on in-service development. They are teaching for a moving target. A glance at todays vacancy pages shows jobs that did not exist when I started school millions of years ago. Teachers should be preparing children for jobs that don’t exist yet, and for working lives with much greater change than we have known before. Teachers need to shift from teaching kids stuff to teaching them how to think and create stuff. Children also need to learn how to learn and to be inspired to keep learning throughout the life course. For good citizenship they need media literacy too. Many countries are not adequately making these obvious changes happen. Pink Floyd railed against authoritarian teachers in the 70s. Today the threat is “authority-less” teachers with kids checking their smart phones in class to see if what the teacher is saying is up to date.

No public service institution can keep up with the pace of start-ups and tech. No country can address the learning crisis without engagement of the private sector. No private sector can flourish without a properly equipped workforce. Each needs each other, yet there is so little collaboration between them.

Both our evolving knowledge of adolescent brain development and of the labour market lead us to the same conclusion. The most relevant and rewarding way for a teenager to learn is through collaboration with peers in developing a creative solution to a problem. Yet most classrooms do not and cannot practice this.

Rutger Bremen questioned the mantra about educating children to find their place in the labour market of tomorrow. Instead he argued we should educate children to create the kind of labour market and society we would like them to live in. School informs character development, whether we intend it to or not. Inclusive moral and civic learning is a prerequisite for individual and societal flourishing. The UK-based Jubilee Centre has developed a framework for teaching integrity, respect, neighbourliness alongside core performance and intellectual competencies. The framework is being adopted in UK schools, and adapted oversees.

To address the global learning crisis we need to make sure that children are ready for three big transitions. The first is school readiness at 5 or 6. This requires narrowing the gap in early learning. All parents should receive knowledge of early stimulation through pre-existing primary health networks, at the same time they learn about vaccines and nutrition. We should pursue universal access to pre-school for 3-6 year olds as we have pursued access to primary and secondary education. Governments should invest at least 10% of their education budgets in early learning. They should also end the huge wealth disparity in pre-school attendance.

The second transition is at age 10. We need to eradicate learning poverty by ensuring that all children can read a basic text at 10. More than anything else, this will depend on the quality of teaching. We need behavioural science innovations to keep teachers motivated and systems where teaching practice can be informed by the evolving science of learning. Schools need to be trauma-informed so children affected by family or humanitarian trauma can be soothed, feel safe and make the important connections required to enable learning. Inclusion and gender-responsive school systems are also essential to end learning poverty.

The third transition is at 16 or 18 to work, training or higher education. This is about the relevance of education to both the labour marker and citizenship. We need a global commitment for teaching competencies, collaboration and character in an age of AI and fast-paced technological change..The public sector cannot achieve this alone and needs innovative financing and constructive technical collaboration with the private sector. As has happened in Finland, the teaching workforce needs to become an agile community of practice. This would enable it to adjust and develop teaching based on what it sees in the classroom and in the outside world. Creativity and collaboration needs to be at the heart of teaching.

Wherever we are, in addressing the learning crisis, our aspirations must be high. On the one hand we should work toward a world in which our children and then their children have a quality of life that is better than the one we had. On the other to ensure that they shape a society that is even fairer, kinder and a better place to live. Only a radical rethink of global education will help us get there. We owe our children nothing less.

The Networking of Trauma

Preventing Organised Crime and Other Exploitation Groups Preying on Vulnerable Children

Violent extremists, gangsters and groomers have a simple recruitment strategy. They network trauma. They can spot a vulnerable teenager from 1000 yards. It can be easy to pull them in by sating a desire for belonging or through initial kindness. But the intention eventually is always exploitation.

An Irish security expert once shared three observations about the Northern Ireland conflict. Firstly that at any given moment during the conflict, there were only ever a few dozen people who could actually kill someone. Secondly that they usually came from traumatic homes with fathers who had also killed. He concluded that it seemed political extremists and organised criminals knew exactly how to identify and recruit such people. I have seen similar recruitment strategies in lawless or conflict-affected countries from Afghanistan to Bosnia. It always has devastating consequences.

It’s not black and white. There are economic and structural determinants of violence too. Most people affected by childhood trauma do not turn to crime or violence. But the world is waking up to the impact of childhood trauma as a driver of recurring violence. It occurs in cycles. Data from Wales show that adults affected by chronic childhood trauma were respectively 14, 15 and 16 times more likely to be a victim or perpetrator of violence or use crack cocaine than others. Data on consequences of chronic childhood trauma is similar across continents

There is an underpinning neurobiology to this cycle. Children are dependent on a strong attachment with a parent. If the attachment is absent due to neglect or violence, a child will see it as a serious threat. That threat chronically activates the stress response system. It distorts the way they perceive danger, they way they see themselves as well as their attachments to others. If families, schools or communities cannot provide soothing connections to heal the trauma, the child enters adolescence and adulthood with unresolved chronic trauma. This leaves them extremely vulnerable to exploitation and with limited prospects for learning or finding a lifeline to a better future.

All of this leads to an obvious question for anyone reading this blog. In my neighbourhood are there more forces trying to exploit or trying to prevent the inter-generational cycle of violence? Prevention services, usually delivered through the health system help new parents develop a secure attachment with their child. That attachment is the best weapon against neglect and violence. it can help heal the parent at the same time as protecting the child. In an ideal world these services would be provided globally. As noted elsewhere this type of prevention provides the greatest return on investment for the public purse. No other intervention does more to prevent poor life outcomes including in mental and physical health, crime and productivity.

Response services provide a second chance to children who have already been traumatised. In Trauma-informed schools for example, the teacher creates a calming environment and a caring connection. This ensures every child in school is safe, seen, secure….and most importantly soothed. The four Ss feature in the excellent “The Whole Brained Child” by Daniel Siegel and Tina Payne Bryson. In a Trauma-informed school, the teacher makes the child feel they matter as an individual. Many who come from traumatic childhoods have been rescued by a teacher who did exactly that. Positive relationships and connections build resilience that help teenagers navigate away from poor decisions that bring bad life outcomes. And if a child is approached by a Fagin type exploitation group, they feel they can tell the teacher

A second important question is what is being done in my neighbourhood to prevent the cynical “networking of trauma” by exploitation groups.

Both in the UK and the US, Trauma-informed practice is also being adapted to policing and justice sectors. One of my favourite champions of this is Detective Superintendent Stan Gilmore of Thames Valley Police in the UK. He observed those arrested for “County-Lines” drug trafficking were almost always in their mid teens. He started to see them as much as exploited and vulnerable youngsters as offenders . Instead of pursuing a custodial sentence, the emphasis was placed upon diversion from a potential life-cycle of crime. This included curfews and supervision orders that stopped the gangsters reaching the child . It cut off their source. It also referred the child to services to help address the underlying trauma. The whole approach switches the question to the child from “What did you do?” to “What happened to you?

To me this is intelligent and effective policing. It recognises that the foundations of organised crime are built on networking trauma and vulnerability and if you prevent that networking, you can break the cycle. Childhood trauma is not an excuse for crime, but to effectively reduce crime we need to be trauma-informed.

Just imagine how societies would flourish if we not only prevented the networking of trauma by exploitation groups, but also prevented or mitigated the trauma itself. We now have enough evidence and knowledge to work towards this goal. We just need the political will and the resources

Could You Be Loved?

How the love, optimism and resilience captured in My Name is Why by Lemn Sissay adds so much to our understanding of childhood

The most magical moment of the holiday season for me was seeing A Christmas Carol at New York’s oldest functioning theatre the Lyceum on Broadway. Way up in the rafters, I couldn’t help but ponder whether everyone has a ghost of past, present and future. We all know an Ebenezer, if we are not indeed one ourself. I am not talking about his prolific miserliness. But rather how his adaption to survive an early trauma becomes a maladaption over time. And how that rigid maladaption distorts and derails his whole life course.

But like most of Dickens stories, a Christmas Carol in the end is a joyous tale. It acknowledges human trauma, which as James Baldwin once wrote is a major purpose of literature. “The suffering and struggling person finds great liberation when they realise something they thought was only happening to them, happened to Dostoevsky 100 years ago”. But A Christmas Carol then takes that trauma and shows how magical and resourceful humans can be in overcoming it. And old Ebenezer breaks through in the end because of love, optimism and resilience.

A Christmas Carol probably did more than anything to shape the modern narrative and aesthetic of a western Christmas. Dickens grew up in a rare decade when London winters were bathed in snow. Thats why we yearn for a White Christmas. The concept of a warm family hearth and a shared feast as a buffer from unresolved trauma and winter cold. But Christmas is ruthlessly painful for those with no such buffer.

No-one knows this more than poet and Manchester University Chancellor Lemn Sissay, who has created a whole national movement of volunteers across the United Kingdom providing communal Christmas dinners for young adults who have lived in care of the state.

In any given year, the list of Lemn’s accomplishments is remarkable. But this year he contributed something that may have even inspired Dickens. With astonishing dignity and courage he completed his 30 year struggle to acquire the social work files from his own childhood in care and shared them in his memoir: My Name is Why.

In addition to Dickens, Maya Angelou, Edgar Allen Poe and Maxim Gorky wrote painful stories of childhood. The general narrative on violent, neglectful or otherwise unjust childhoods has evolved over decades and centuries-faster than our political will and technical ability to address it. I think Lemn’s writing has added something profound and new to it.

When interwoven with his own memories, the social work files run through My Name Is Why like a real time set of MRI scans on a childhood struggle. They are accounts of Lemn’s interaction with the so called “care” system and the social workers who drift in and out of his life. Combined they represent the culture of that system. By sharing them he exposes a deeper level of vulnerability than most would have the courage to do. He does this from a position of strength and it serves as a powerful antidote to the toxic masculinity and superficial egocentricity of our time. He is courageous beyond belief.

I believe he shares the files to illustrate one of the most original and poignant themes in his book. The importance of memory for all of us. As we saw from Scrooge, the struggle for recovery always requires bringing the memories back into one comfortable place. For Lemn, a childhood neglectfully dispersed and disrupted by multiple carers in scattered locations eats away at the sense of self-hood and deprives you of a “valid persona”. The impact of this fragmentation is profound and: ” quietly depletes the sense of self-worth deep inside a child’s psyche. This is how a child becomes hidden in plain sight. Family is just a set of memories disputed, resolved or recalled between one group.” But what happens when the family is not there?

The care system could have been the buffer and the hearth. A loving space for recovery and a platform to build a better tomorrow. But the social service files show how the children in its care were treated with suspicion and mistrust. As a teenager Lemn wrote poetry, had a Saturday job and bought a guitar with the proceeds. A good parent would be proud of this. But rather than assets, each of these activities were viewed negatively by the care workers. He devoured Bob Marley biographies, when “there were no books and consequently no encouragement to read” in the children’s home. He described these adolescent passions as his “flagpoles on the mountainside”. They told the story of someone whose identity and self was formed without compromise. Of someone who would one day soar. I wondered how many readers laughed out loud, as I did, when the school report from the sadistic quasi-prison Wood End file said Lemn had “average intelligence”

The cruelty of these institutions and Dickens workhouses before, are the tip of a very big iceberg. Adverse childhoods are more common than we ever thought them to be and occur mostly within families-not institutions. The more we make it normal to talk about it and understand it, the better chance we have of building a society and world that lives up to the best hopes of a Charles Dickens story. That is one where we acknowledge the lasting impact of trauma-but always seek to defeat it through love, optimism and resilience. A society where every child is connected and matters on an individual level.

Lemn’s book, and much of his life’s work contributes to the understanding we all need to achieve that goal. He personifies a spirit of love, optimism and resilience, and we could all do with more of that.

Merry Christmas from New York

“What You Have Been and Still are for Me”

The Power of Teaching

I have a favourite teacher story and it goes like this. As a child, Albert Camus was asked by his impoverished single mother to quit school and start work. Camus’s teacher visited the family home and convinced her to let young Albert continue his education. The teacher’s name was Louis Germain.

Albert Camus went on to become one of the 20th centuries most important novelists. Many decades after leaving school and upon being awarded a Nobel Prize for Literature, Albert Camus wrote a letter to Mr Germain entitled “What You Have Been and Still are for Me”. He wrote “Without you, without the affectionate hand you extended to the small poor child that I was, without your teaching and example, none of all this would have happened.”

How many of us have life journeys that are profoundly enriched and transformed by the hand of a teacher? Sometimes as children we carry the weight of the world on our shoulders through poverty, abuse or neglect. In all of that fragility and wrenching pain, it often takes a teacher to make us believe we matter and to unlock the opportunities to exercise curiosity, collaboration and cultivate character

Two thirds of us have had teachers who made a difference in our lives, according to research from Harvard Graduate School of Education. Yet the research also shows that these teachers are outliers in their own school settings. Even the university professors who produce the most impactful teachers are outliers in their faculties. Our education systems do not incentivise modern-day Mr Germains at all

The research now shows what common sense should have always told us. children only learn from teachers they love. We once saw reasoning as being the opposite to emotion, but neuroscience tells us something different. It is only through a deep network of relationships, belonging and collaboration in school and life that we can have an ecosystem for learning. To motivate and organise ourselves for learning, we have to engage the emotions. Emotions are not compartmentalised in a different part of our brain while we deploy rationality and reason to absorb facts.

In any given classroom of 25 children, at least 4 or 5 may experience multiple forms of severe trauma at home. Such trauma chronically activates their stress response system. This doesn’t switch off when they enter the classroom. An attuned teacher in a trauma-informed classroom can soothe the stress response system. They can help the child to learn, trust, connect and build resilience and attachment. And here is where the healing, and therefore the ability to learn, begins. Trauma-informed schooling is potentially one of the most impactful strategies for reducing child trauma in general.

A few years ago attended a lecture by Harvard Professor Tony Wagner on outlier teachers who help kids recover from a broken start . It inspired me to track down a teacher who had transformed my life. At 15 I lived in state care in an inner-city area blighted by drugs and crime. I had been kicked out of three schools and had wound up in an education centre for those at the very end of the line. In every sense, my life prospects were incredibly bleak.

Jan Rapport was an idealistic teacher working in the most difficult of education settings. She gave me a chance. She is the only adult I could remember having a real conversation with during my entire childhood. She instilled in me a lifelong passion for learning and particularly for literature. My imagination soared and I began to see a different path forward. I now know, it was probably the calming attachment and connection, the relationship itself that made the most difference.

When I the school at 16, I lost contact with her. When I finally found Ms Rapport over 25 years later there was so much to talk about that we didn’t really know where to begin. She was now a pensioner and I was well….er…middle aged. We caught up on what we had done with our lives. Nobody expects someone from my background to have a job in the UN, though somehow she thought I would turn out okay. I needed to tell her that she saved me-that I would not be here and I wouldn’t have done all of this without her. I didn’t have any words in my vocabulary that could adequately convey how grateful I am. I was in awe to look into the eyes of this person who saw things in me that I did not see in myself and helped me beat a pathway to places I could have never imagined. A teacher. The power of a teacher.

It is often said that when you are teacher you don’t know where you legacy will end. Louis German commitment stayed with Albert Camus through his life. A part of it passed onto to others through his work, friendships and family. Imagine if we could deliver a global legacy on teaching. If we could take what inspirational, life-changing teachers have and dispense it through entire teaching workforces. Every teacher emotionally present for children. Every child made to feel like they belong and matter as an individual. Every school dedicated to learning, curiosity and trauma-informed healing. We could and we should celebrate the power of teaching and harness it to touch the lives of every child.

Ordinary People in Ordinary Places Talking about Violence and Neglect

“How can I help my child to be self confident when I do not feel self confident myself ?”
This is not an intimate conversation between friends. It is not a soul-searching parent in private counselling with a psychologist. It is one of many written questions delivered by a 400 strong audience to the stage of a provincial theatre in North Macedonia. Following dance and comedy, the audience engage with an expert panel on hirtherto taboo themes such as neglect & violence. And you can hear a pin drop.

As with most middle and low income countries, there is little public discussion on childhood adversity. Policy makers rarely prioritise investment to address its lifelong impact and costs. The “Parenting Is Always Learned” campaign has two aims. The first is to introduce the science of brain development to ordinary parents in ordinary places in simple language. The second is to break taboos on family crisis and Adverse Childhood Experiences.

We asked Sasko Kocev, a comedian and actor to moderate the event. We were amazed to the extent this created a conducive environment for discussing a taboo and difficult theme in a non-judgemental way.

It made sense later when we read research in the Power Of Moments by behavioural scientists Chip and Dan Heath. It suggests that laughter creates social bonds and synchronises audience engagement . We are all affected by Adverse Childhood Experiences. Most people have experienced them in their own childhood. Those who haven’t are likely to have their lives entwined with someone who has. Violence and neglect are not a “Them” problem, they are an “Us” problem. Comedy reminds us of our imperfections, at the very least, that we are all a bit broken.

A young dance troupe perform a powerful representation of themes such as alienation and domestic violence. The second half of the event is an interaction between the experts & the audience using anonymous questions.

Adverse Childhood Experiences are as present in North Macedonia as they are anywhere. A World health Organisation supported survey found that 64% of young adults had one adverse trauma in childhood and almost 1 in 10 had four or more. The most common was emotional neglect at 30%. I once asked the entire psychology faculty second grade if the data surprised them. It did not.

A campaign alone will not work. Parenting Is also Learned accompanies reforms of health, education and social protection systems. This includes home nursing visits that promote nurturing caregiving and universal pre-school education.

Often childhood trauma such as emotional neglect is transmitted from generation to generation. It is difficult to talk about neglect as we often have to examine our own behaviour or that of our parents. By acknowledging adversity is often transmitted unintentionally, we can discuss it without judgement. This is essential for breaking taboos and enabling consolidated action on childhood adversity.

The answer to the question posed at the beginning of the article is not easy. How do parents ensure they don’t transmit poor attachment, insecurity or anxiety on to their own children.” But senior British psychologist Peter Fonagy researched the way that being “reflective” prevents such transmission. The more parents become aware and reflective of their own feelings and the way they may impact others, the less likely they are to transmit negative models of care.

And as the name of the campaign suggests, we can learn parenting skills. As the curtains go down and we exit the stage there is a queue of parents and young people seeking to share their experience and ideas. Its 10pm, we have gone on for an hour longer than expected, yet many people don’t want to leave.

As Victor Hugo said, there is nothing more powerful than an idea whose time has come. The idea whose time has come is that we can nurture the first generation to grow without violence and neglect.

“Because I Grew Up In An Orphanage”

On Identity & Being Raised In Care of the State

I wouldn’t need a large abacus to count the number of times my experience as someone raised in care of the state has been well represented in a film. One fleeting moment in Robert Altman’s 2001 murder mystery Gosford Park, an elegant pre-cursor to Dowton Abbey, nailed it.

During a large and free-flowing dinner table conversation about family, Mr Stockbridge (played by Clive Owen) stunned fellow diners when he answered a question with a simple “because I grew up in an orphanage“. The ensuing silence told more of our story than any scripted dialogue ever could.

Anyone from state care who had to describe their background following a routine question about childhood in a polite conversation knows that silence. Until very recently and in middle age I still grimaced when such discussions arose at the diplomatic functions I attend with my job. If I am honest about it, at different stages of my life I have felt intrinsic shame, stigma and especially guilt for the discomfort it may cause to others and this has often fed into a deep, internal narrative that I am not really good enough to be here . I also felt compelled never to hide who I am or where I come from. Being from state care is as important for my identity as being a Belgan or being a Hindu may be to someone else. It is where I spent my formative years, it is what shaped me and I want to be a good role model for kids in care today. It is at my core . I just would rather not talk about it.

6% of UK 18 year olds from state care go to university compared to around 27% of the general population. When I was 18 ( a very long time ago) it felt more like 0%. We were from a minority that was more likely than any other to end up in prison, a gang, trafficked, addicted or die early and very very unlikely to go to university. Unlike other marginalised minorities, we had no underpinning culture, flags or narrative to carry a sense of pride in our identity. I am so proud of the 6% of 18 year olds from care who attend university today. It is a testimony to resilience, the odds are still stacked against them, they make it through anyway.

Like many of my generation, I left a children’s home aged 16 with a €200 leaving care allowance, a modest bag of life possessions and a complete absence of any form of love or belonging at all.

I have never complained about where I come from. This was the way my life was, it was normal to me. Coming from the bottom 1% of a society where identity was shaped by class and family, and then trying to advance though university & career etc often left me feeling unsteady on my feet and like an outsider or an imposter. I still feel like an outsider today to be honest, but I wouldn’t want to go back and change anything.

There are also things I am proud of. Because I had no parental support at all, I woke up at 4 am on weekends, when the other students were coming back from parties, to run a market stall in Camden Town. I drove a mini-cab around London late at night and did shifts in an old peoples home and a college kitchen to pay my way through university. I believed that completing a university education would help me escape the legacy of my childhood and would do anything to reach that goal. I remember going to my first day of university, buying my own pens and books with money I had earned. I couldn’t quite believe how lucky I was just to be there. It seemed that most took it all for granted. How much luckier I was to see going to university as a massive blessing. I still feel blessed and privileged today.

What about love? in state care, one often grows up with this internalised sense of being unloveable, not even by one’s parents. Biologically all children are programmed to seek loving protection and nurture from parents, when it is absent they interpret it as danger. Those from care backgrounds often have low self esteem, insecure attachment, post-traumatic stress and over-active fight or flight systems. This has a profound impact on your identity and sense of self.

You can strive to be a success on the outside as a young care leaver, inside there are all these jagged edges and broken parts that, if you are aware of them, you would like to put together again. But when you are trying to escape severe poverty without any support networks, you are just thinking about survival. Profound emotional insecurity can be a barrier to the relationships that the research now tells us are the single most important determinant of both healing from trauma and building the resilience to overcome barriers and get on in life. Often the strategy the subconscious gives us is to separate the left and the right side of the brain-to run on the gas of the cognitive: job and education and forget the oil of love, emotion and belonging. Just like a car, you will break down in the end.

Nobody politically can articulate this. The main political discourses in our society don’t do emotional. They only do economic and power.

The left often argues that a care leaver is a victim of discrimination and poverty. As Nimco Ali wrote recently about race & gender & being a refugee “The left wants to frame my life experience via the prism of helplessness and victimhood. I am meant to be consumed by all that has happened to me — to long for all that I have lost and wait to be rescued, but I have always refused to do that“. For me, it has taken me most of my adult life to feel really comfortable talking about being from care. I can be shut down in a moment if someone tries to frame my narrative as a victim, and that often comes from the left.

Economic models from the right squeeze and further disadvantage marginalised care leavers. I know this from the rock face because I left care during Thatcherism. And then they argue that if an individual care leaver (actually a tiny fraction) can progress through hard work, then anyone can. Evidently they cannot and do not because the impact of trauma and neglect is very individual and complex and based upon the interaction of experience, resilience & biology. In 2019, policy makers should really know this, we shouldn’t have to explain it. And anyway, as Colin Powell once said, “how can you ask someone to pull themselves up by the bootstraps when they don’t have boots“. Care leavers badly need support networks.

Discrimination, poverty and hard work are high stakes challenges for any care leaver. The main issue remains love, or the lack of it. There is a broader need for a politics that can talk about love, wellbeing, trauma, violence and hope. The social and emotional drivers of all of our behaviour and decisions. And this makes democratic sense because care leavers are not alone.

Until recently there was a common public perception that childhood trauma, neglect & violence were marginal issues addressed through the care, social work and juvenile justice systems dealing with maybe 1 or 2 % of a given child population. The World Health Organisation and other bodies have undertaken surveys in multiple countries on general populations which reveal that on average, around 60% of adults were affected be one serious adverse childhood experience (ACEs) and around 15% by 4 or more. The 15% with 4 or more ACEs, like care leavers are much more likely to have really bad life outcomes in health, crime, education and all aspects of wellbeing. In psychology research, 42% of adults across countries are said to have insecure attachment due to absence or inconsistency of parental love in the first two years of life. Insecure attachment severely affects their ability to have quality relationships. The common perception about the marginality of trauma must have ran counter to people’s lived experience and their ability to articulate it. That is now changing.

I was raised in care of the state. I am neither proud of it or ashamed of it. I would like to live in a world where future care leavers don’t suffer long silences & superficial victim or bootstraps narratives. Where investments are made to ensure those from public care & others affected by adversity everywhere-can reconnect, build and heal free from shame and public stigma. This would be socially just, fiscally prudent and frankly just plain easier and better for the whole of society.

NB: This is the first in a Triology. The second part can be found here and the second here. Benjamin perks can be followed on twitter

Stopping childhood adversity from becoming a life sentence

Impact Insider from UNICEF connect By Benjamin Perks20 March 2015

Even the most hard-nosed economist will now concede investment in good early childhood has the biggest return on public investment.

But what about a reverse argument that failure to invest in prevention of bad early childhood experience is the most costly oversight a government can make?

This is the subject of my recent TedX talk in Podgorica, Montenegro, on the global prevalence of Adverse Childhood Experiences (ACEs) like neglect, abuse and dysfunctional parenting, and how they drive poor public health, low productivity and other costs amongst adult populations.

Despite massive advances in addressing childhood adversity in many high-income countries – globally the issue remains largely taboo, difficult to discuss and emotive. But the field of childhood adversity has been revolutionized through the study of ACEs – here is how it began…

A couple of decades ago in San Diego, public health practitioners baffled by constant patient drop out from obesity programmes decided to probe whether there were any shared underlying factors among those affected. They were astonished to find out that those who dropped out almost all had one thing in common: sexual abuse in childhood.

This begged the question – were there other areas of poor health in adulthood or social outcomes where the people affected had largely been victims of childhood adversity?

What followed in the mid-90s was a longitudinal Adverse Childhood Experiences Study, of more than 17,000-mostly middle-aged and middle-class West-coasters in the US, through a collaboration of Kaiser Permanente clinics and the Centre for Disease Control in Atlanta.

Firstly, the findings revealed the shocking and heart-breaking prevalence of 10 classified types of Adverse Childhood Experiences which were broken down into three areas:
1) Abuse: Sexual, physical, emotional;
2) Neglect: Failure to meet basic physical needs, leaving a child uncared for, or unloved;
3) Household dysfunction: Witnessing, addiction, crime, parent-to-parent violence, mental illness etc.

Respondents were given an “Ace Score” of 1 to 10. Two-thirds of respondents had experienced at least one ACE and 12% of respondents had an Ace Score of 4 or more.

20% had been victims of child sex abuse – a number almost identical to the much later Council of Europe estimate that 1 in 5 European children suffer from sexual violence.

The statistics on all forms of violence also broadly correlate with prevalence levels that can be seen from the global UNICEF report on violence against children: Hidden in Plain Sight.

If researchers were knocked sideways by the shockingly high levels of prevalence, including in middle- and high-income households, they were also astounded to find an almost “dose-response” correlation with high adversity and poor life outcomes, in health, education, addiction and crime throughout the lifecycle.

According to a leading ACE researcher and public health practitioner, Dr Nadine Burke Harris, in California somebody who had experienced 7 of 10 forms of childhood adversity has a 20-year shorter life-expectancy than someone who has experienced none.

It took a different type of research, from the field of neurobiology, to explain why high childhood adversity converted to poor outcomes in adulthood – through the impact of what the Harvard University Centre for the Developing Child has termed ‘Toxic Stress’ upon the physical and brain development of children.

As devastating as all of this is, we now have the knowledge and the science to build a global effort to reduce the impact of childhood adversity and violence against children. If we can reduce the dose of adversity and toxic stress we are not only fulfilling our human rights obligation to protect children, but also potentially ensuring long-term reductions in poor public health, low productivity, high crime etc.

UNICEF works throughout the CEE/CIS region in Regional Knowledge Leadership areas to help governments to simultaneously do three things:
1) Build violence prevention mechanisms, from pre-natal visits and throughout a child’s life cycle;
2) Provide interlocking services of child protection, health, education and justice that will protect the child victim of adversity and help him or her recover; and
3) Break the public taboo on childhood adversity which prevails in almost all of the countries in our region.

In Montenegro in late 2013 we had the first national discussion on child sex abuse as part of a national survey on violence against children in parliament. Services are being strengthened, reporting seems to be on the increase and there is more public discussion. But we are mindful that this is just the beginning.

This way of approaching adverse childhood experiences is flowing from high-income countries where it is studied and researched, to middle income countries where there is some type of functional child protection system. However, according to Theresa Betancourt of the Harvard Centre on the Developing Child there is an obvious need to better understand and work on childhood adversity, mental health and toxic stress in low-income countries or conflict zones, where HIV/AIDS or the recruitment of children into armed conflict, can have a deep psychological and physiological impact on children’s wellbeing.

Courtesy of the wonderful fostering promotion group ReMoved, my TedX featured the story of a resilient, fictional young girl with an Ace score of 6 called Maja. She could be any child-in any corner of the world. Frightened of her own father, uncertain of when she may reach safety or if she will ever be properly loved and cared for.

We can make a massive difference in the life of Maja and millions of children like her by attacking childhood adversity, making the invisible visible and creating a world truly fit for children.

Benjamin Perks is the UNICEF Representative in Montenegro

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Why state care should not mean more childhood adversity

Insider on unicef Connect By Benjamin Perks2 April 2015Share this story:

© UNICEF/NYHQ2005-1796/PirozziA three-month-old baby lies in a crib at a hospital in Ukraine. She was abandoned by her mother in the maternity ward.

For most mothers, the first embrace and skin-on-skin contact with her newborn, moments after delivery, is one of the most precious and magical moments in the journey of parenthood. But sometimes, perhaps because of family breakdown, addiction or perceptions about a disability, a mother turns away from her baby and abandons him or her at birth.

And so begins the worst possible life-start for many of the 1.3 million children who reside in the care of the state across Central Asia and Central & Eastern Europe.

In those fragile early days of life, the pathway to state care is lonely and brutal. The child will often be taken from the maternity ward to a large-scale state residential institution adorned not with family memories, warmth and affection but rather regulated by administrators with filing cabinets, staff shifts and often even staff uniforms.

Upon arrival, the baby will be placed in a cot like this:

And they will lie and wait and wait and wait. They will wait for the communication, affection and love that a newborn is pre-programmed to expect. But this is unlikely to ever come as large scale institutions have staffing structures that rarely allow for more than a couple of hours attention for each baby each day.

And this is just not enough to enable the healthy physical, emotional or cognitive development of the child.

And as days turn into weeks, and weeks into months, the baby learns to stop crying for attention and to stop expecting affection and love; the parts of the brain that regulate emotional relationships stop flourishing. Statistically, the child is unlikely to ever recover from this early neglect and may remain vulnerable for life.

Could it be different?

For many decades now there has been a consensus across pediatrics, psychology and neuroscience that one-to-one continuous contact between an adult (it doesn’t need to be a biological parent) and a child is needed for normal emotional, physical and cognitive development.

Can we rewind the clock and review the decisions that result in a baby, like the one in the photo, having such an unfair start in life?

What if during routine prenatal visits, a community nurse had the required skills and mandate to identify the risk of abandonment prior to birth, to counsel against it, and to link the mother to family support, social protection and other support?

And what if this could be reinforced by the doctor and the nurse in the maternity ward (over 97% of births in this region take place in a health facility)?

And if all of this failed, what if the baby was delivered to a warm and caring foster care family trained and motivated to give attention, love and affection to the child, while the social worker tries to find a long term home, either within the extended family or if not possible, within a suitable adoptive home?

In my recent TEDx, I talked about the lifelong impact of adverse childhood experiences (ACEs): sexual, physical and emotional violence, living in dysfunctional households plagued by poor mental health, addiction or domestic violence. The other major type of adverse childhood experience is neglect, and the plain truth is that the decision to place a child in a large scale institution results in neglect.

Even with the best of intentions, the human resource structure of large-scale institutions prohibit healthy childhood development, resulting in the neglect of children. It is therefore harder to imagine a decision that has more of an impact on the human rights of an individual than the decision a government makes about what to do with a child placed in the care of the state.

Prenatal interventions; better equipped maternity wards; family support services including cash benefits; even expanded emergency and regular foster care, either within or beyond the extended family; are much less expensive than large-scale institutions a) because the unit cost of childcare is less and b) because long-term health, social and other costs caused by poor outcomes for vulnerable adults from institutionalised backgrounds are high.

The wonderful 19th century French historical novelist Victor Hugo said, “nothing is more powerful than an idea whose time has come”. Thankfully, institutionalisation is an idea whose time has gone.

In December 2012, 20 UN member states across the region supported a Call to Action to eradicate placement of children under 3 in large scale institutions in collaboration with the Office of the UN High Commissioner for Human Rights, UNICEF & the European Parliament. This has to be a departure point for eventually eradicating the placement of any child in a large scale institution.

Under the leadership of the Montenegrin Prime Minister, a multi-sectoral drive for family-based care has seen a 56% reduction in the number of institutionalised children; strengthened kinship (within extended family) care; and a 7-fold increase in the number of children in non-kinship foster care in Montenegro.

Fostering campaign promotion poster -UNICEF Montenegro/Duško Miljanić — Fostering campaign promotion poster – UNICEF Montenegro/Duško Miljanić

A campaign to change negative public attitudes to children with disabilities – who comprise around half of those in state care in our region – has resulted in a dramatic increase in school inclusion and community-based services, thus reducing abandonment.

A long time ago, a model of state care was designed for children who had been abandoned. Strengthened prevention mechanisms are irreversibly reducing such cases. At the same time, public awareness of family violence is increasing and reporting is on the up.

Thus, the child protection system will gradually shift from providing care to abandoned children to protecting those at risk of harm within the family. At the heart of this shift has been the principle that children always need solutions where there is a consistent and solid presence of a trusted adult who will always put their interests first.

Anything less is tantamount to child neglect.

Benjamin Perks is the UNICEF Representative in Montenegro