Prevention and Early Childhood Trauma-from a dad who could have done better

Solving the addiction crisis in America is arguably one of the most challenging crises we have ever faced, particularly in recent decades.  It is not the only one, but it is serious and wide spread.  Like many other complex problems, we face as humans, we will likely never eradicate the world of addiction.  There are cultural, biological, social, and genetic components to it which are all intertwined and which we are just now beginning to really understand.  

Yet as the problem has reached the “epidemic” proportion, it seems that there is far more focus on treating the disease and not nearly enough on prevention. One area of prevention in particular, which we do not talk a lot about, starts at home with healthy, present parents.

Treating the disease of addition, no matter how it manifests itself, is incredibly important.  Saving lives is ultimately the only thing that matters and effective, evidence-based treatment is capable of achieving amazing and proven results.  Integrated treatment centers, programs such as “A Way Out” and “Text a Tip” in Illinois, helpful medications, and drugs like Naloxone are all incredibly useful. Without effective treatment, we would undoubtedly be far worse off than we are today.  Further, evidence-based prevention programs such as “Botvin Life Skills” in schools, talks with our wiser elders, and reminders throughout our lives to avoid certain self- destructive behaviors are all incredibly helpful.

The one piece we seem to be missing is the fact that many of these issues, which come up later in life, start early on with our children as their brains are developing, particularly as they deal with loss and trauma.  The data and literature show a direct link between early childhood trauma and addiction.   Though I am not a therapist, I have zero clinical training, and have done no research myself on the effect that early childhood trauma can have on children as they grow older, I am a believer.  Many minds far more brilliant than mine have published many compelling studies on the direct correlation, and I shall leave it to them to defend their thesis in the event anyone out there does not believe it.  D.W. Winnicott (the late British child psychiatrist) defined trauma in early childhood as, “two things that can go wrong in childhood: things that happen that shouldn’t happen — that’s trauma — and things that should happen that don’t happen.” Early childhood loss is the essence of what trauma really is and when we recognize and admit that to ourselves, we realize there is so much more we can be doing (or not doing) as we raise our young children. 

For me, I never thought of my children’s early experiences as being anything close to “traumatic”.   There were no murders, no suicides, and no rapes.  We did deal with one natural disaster, but we were able to escape before it hit and fortunately nobody was injured.  My kids went to a good school when they were young, my family was always around, my kids played all sorts of extracurricular sports, had friends, we took vacations, etc.

Looking back, however, we had all sorts of trauma in our household as my two older kids were young. Some of it was avoidable and undoubtedly causing problems today, which is what keeps me awake at night on occasion and motivates me to share like I am doing today. For instance, I was, and still am in many ways, addicted to work. When I was home, much of the time I was not emotionally present for my kids.  I was on my phone, checking emails, or just generally distracted living mostly a fear based life. I was in a horrible marriage. When we were together as a family I was anything but present and the tension in the home was palpable I am an anxious person and have been for a long time – worried about work, worried about making money to feed my family, worried about just about everything.  Most people can’t see it, but my kids know it and it affected them – it still does.  My ex-wife and I had a cantankerous divorce.  We both played very aggressively, fighting for just about everything, and the kids got mixed up in it in ways that were both avoidable and unnecessary.  Their mother struggled with substance use and, for several years, she was essentially gone.  This was a huge loss to my kids and one that, to this day, they have not quite gotten ahold of.  Looking back there was lots and lots of trauma for my two older kids and today one of them is showing concerning signs which the data very clearly could have predicted.

My advice to future parents, parents of young children, and the all of us who are concerned about this epidemic of addiction:

 Be aware of the fact that early childhood trauma can increase one’s chances of becoming addicted to some form of self-destructive behavior as they get older.

Trauma is not only defined by life’s horrible events such as rape, murder, war or natural disasters.  It is much more broad that that and includes things such as unavailable, distracted, or stressed parents and events such as divorce.  In our society where many of us are stressed to the core, we have got to know that this takes us away from our kids and as they see this as a loss, therein lies a form of trauma.

What we can avoid and do better with as parents, we should. It starts with being aware of the long term consequences of our behavior. Yes, this is much easier said than done, particularly in today’s high stress, fast paced dog eat dog world.  However, the importance of creating a nurturing, safe, and stable environment where we are present and available while our kids grow and their brains develop cannot be understated.

For me, the silver lining is that Kim and I are raising our 2 ½ year old son with this awareness.  Though nothing is ever perfect, both of us do what we can to provide him with the loving and nurturing environment he and his brain need and deserve right now. Life will throw curve balls and we will inevitably have a child at some point who blames all of his troubles on his parents. Yet our hope is that we are currently living a life that is conducive to the state he needs us to be in, and we can try and live this way because we are aware. Living a trauma informed life is something we should all aspire to.  Knowing what can constitute trauma to our child’s brain is crucial if this is something we want to try to avoid.  There is currently so much focus on treating addiction once our kids get older and they find themselves addicted or in some form of self-destructive behavior pattern.  Starting earlier, I believe, is critical.  For those of us fortunate to be able to do so, we owe it to our kids to do nothing less.

-Our Research Team-
Timothy D. Brewerton, MD, DLFAPA, FAED, DFAACAP, CEDS-S
Professor Emeritus of Psychiatry and Behavioral Sciences
Dr. Christopher Womack
Medical Director, Child and Adolescent Psychiatry

Dr. Christopher Womack joins SunCloud as our Medical Director, Child and Adolescent Psychiatry.

Dr. Womack is board certified in Adult as well as Child and Adolescent Psychiatry, attending the University of Chicago Pritzker School of Medicine. Adult psychiatry residency and child fellowship training were completed at the University of Chicago Medical Center.

Dr. Womack’s treatment  philosophy hinges on strength based, evidence informed care, where collaboration is central to guiding individualized treatment.  He has experience caring for children and teens from varied backgrounds, appreciating the importance of how identity can inform treatment.

Favorite pastimes are cooking new recipes and exploring Chicago’s rich cultural diversity through its neighborhood and fine dining experiences.

Elizabeth E. Sita, MD
Medical Director of Adult Services

Dr. Elizabeth E. Sita, MD, is a Board Certified psychiatrist specializing in the care of patients with eating disorders. She completed her undergraduate training at the University of Chicago and graduated with Highest Honors. She then earned her medical degree at Northwestern University Feinberg School of Medicine and was recognized with the Chairman’s Award for Excellence in Psychiatry. She subsequently completed residency with the Department of Psychiatry and Behavioral Sciences at McGaw Medical Center of Northwestern University, where she was elected Chief Resident and received the Resident Psychiatrist Leadership & Service Award.

Upon completing her training, Dr. Sita joined the staff atAscension Alexian Brothers Behavioral Health Hospital Hospital, where she served as Assistant Medical Director of the Center for Eating Disorders and Director of Transcranial Magnetic Stimulation Services before transitioning to lead the new inpatient eating disorder unit as Medical Director of Eating Disorder Services at Ascension Saint Joseph Hospital – Chicago. In these roles, she has cared for a multitude of adolescents and adults struggling with anorexia nervosa, bulimia nervosa, binge eating disorder, and other eating disorders as well as severe, cooccurring mood, trauma, personality, and substance use disorders.

Dr. Sita has been recognized throughout her training and practice for a commitment to excellence in patient care and for her ability to engage patients in their most challenging moments. Her passions include the care of treatment-resistant eating and mood disorders as well as questions of medical capacity and end-of-life decision making.

She believes that, first and foremost, human connection is key to mental health and well-being and strives to share this philosophy in each and every patient encounter. She is excited to bring her expertise to SunCloud Health as the Medical Director of Adult Services!

 

VIDEO: Meet Elizabeth E. Sita, MD, Medical Director of Adult Services

 

Lacey Lemke, PsyD
Assistant Vice President of Clinical Services

Dr. Lacey Lemke (she/her) is a licensed clinical health psychologist with specialized expertise in the treatment of eating disorders and the practice of medical and health psychology. She completed her doctoral training in clinical psychology with a Primary Care emphasis at the Adler School of Professional Psychology. Dr. Lemke went on to complete both her predoctoral clinical internship and postdoctoral fellowship through Ascension Health, where she gained advanced training working with individuals experiencing eating disorders and self-injurious behaviors, as well as within pediatric subspecialty settings including endocrinology, neurology, and adolescent medicine.

Dr. Lemke is deeply committed to providing evidence-based, compassionate care and collaborates closely with interdisciplinary teams to ensure comprehensive treatment. Her professional mission is to support patients in achieving their fullest potential by guiding them to the most appropriate level of care and empowering them to make meaningful, sustainable progress toward improved health and well-being.

VIDEO: 2. Meet Lacey Lemke, PsyD.