There is grass atop the bunkers in Fort Worden. I hope the grass is never disturbed by anything other than people climbing up to see the view.
Fort Worden: https://fortworden.org/
For the Ragtag Daily Prompt: atop.
There is grass atop the bunkers in Fort Worden. I hope the grass is never disturbed by anything other than people climbing up to see the view.
Fort Worden: https://fortworden.org/
For the Ragtag Daily Prompt: atop.
I was thinking of old medicine bottles for today’s prompt, but I think hiking is one of the most medicinal things I do. Healing. Freeing. Feeling the changes in the air, seeing the forests and the water here, being very present. Peaceful.
For the Ragtag Daily Prompt: medicinal.
I keep reading bits about despair and about how a generation of children is being “ruined” by the pandemic.
Not so, I say. There is hope. We need to support each other to survive and then to thrive.
This generation WILL have a higher than average ACE score. If the Adverse Childhood Experience scale is from zero to eight, children in this time period will have at least one higher point than average and many will have three or four or more. Loss of a parent, a sibling, beloved grandparents during covid. Increases in domestic violence, child abuse and addiction. These are all part of the ACE score.
What does this do to children? They have survival brain wiring. They will do their best to survive what is happening. A friend and I both have high ACE scores, 5 or more, and we are both oppositional defiant. We showed this in different ways. He grew up in the same community. He escaped from home and knew all the neighbors. He walked to the local church and attended at age 3 or 4. He has lived in this community all his life.
His oppositional defiance showed up at home, where he consistently refused to obey. And in school, where he confounded and disobeyed teachers and passed anyhow.
My family moved every 1-5 years. I hated moving. I wouldn’t talk to kids in a new school for a year. It was very difficult. So my oppositional defiance was very very internal. I hid in books and in my head. In 6th grade I got in trouble for hiding novels inside the school book I’d already read. I also would just not listen and my respect for the teacher got even lower when she would be angry that I knew the answer to the question once she’d repeated it. I wasn’t listening because I was bored. She was the first teacher that I thought, well, she is not very bright. The next year they stuck me in the honors class and I stopped being bored, though I still questioned practically every opinion every teacher had. I wanted evidence and I did not believe it just because the teacher said it.
I am not saying that oppositional defiance is in every high ACE score. I don’t know that. Why oppositional defiance? Imagine you are a small child and you are beaten. There isn’t rhyme or reason. You can’t predict when the adult will be out of control. Why would you behave “well” if it makes no difference? You might as well do what you want, because nothing you do will change the adult. Or imagine you are a small child who is with one person, passed to another, then to another. You may not exactly trust adults after two or three repetitions. And you want to survive.
There is an increase in addictions, behavioral health diagnoses, and chronic illness in adults with a high ACE score. A researcher when I first heard a lecture about it said, “We think perhaps that addiction is a form of self medication.” I thought, oh, my gosh, how are we ever going to treat THIS? Well, we have to figure that out now, and we’ve had 30 years to work on it.
I was very comfortable with the oppositional defiant patients in clinic. I got very good at not arguing with them and not taking their behavior personally. They might show up all spiky and hostile and I might be a little spiky and gruff back: sometimes that was enough. I think the high ACE score people often recognize each other at some level, though not always a conscious one. With some people I might bring up ACE scores and ask about their childhood. Sometimes they wanted to discuss it. Sometimes they didn’t. Either was ok.
One thing we should NOT do is insist that everyone be “nice”. We had a temporary doctor who told us her story. Her family escaped Southeast Asia in a boat. They had run out of water and were going to die when they were found by pirates. The pirates gave them water. They made it to land and were in a refugee camp for eight years or so. She eventually made it to the US. She was deemed too “undiplomatic” for our rural hospital. I wondered if people would have said that if they knew her history and what she had been through. It’s not exactly a Leave it to Beaver childhood, is it? When she was telling us about nearly dying of thirst in the boat, my daughter left her chair and climbed on my lap. She was under ten and understood that this was a true and very frightening story.
We can support this generation of children. This has been and is still being Adverse Experiences for adults as well. Family deaths, job loss, failure of jobs to support people, inflation. Remember the 1920s, after World War I and the last pandemic, of influenza. “On October 28, 1919, Congress passed the National Prohibition Act, also known as the Volstead Act, which provided enabling legislation to implement the 18th Amendment.” (wikipedia). There were forces trying to legislate behavior, as there are now. The result in 1920s of making alcohol illegal was speakeasies, illegal alcohol, and violence. Some people acted wild after WWI and the influenza pandemic and some people tried to lock down control, by controlling other peoples’ behavior. It did not work then and it will not work now. The wildness is out of control grief, I think, grief dysfunctional and drinking and shooting and doing anything and everything, legal or not. We remember how the 1920s ended too. Let us not repeat that. Let us mourn and grieve and support each other and support each other’s decisions and autonomy.
Blessings.
I saw a meme today about gratitude. It is saying that some people look at a garden and see thorns and weeds, but others see the roses. That we need to have gratitude. I think this is simplistic and papers over the trauma and grief that some people have. If they have endured a highly traumatic childhood, who am I to say they should focus on the roses? They may have a very good reason to see if there is something like a thorn that can hurt them before enjoying the roses.
I work with many patients with high Adverse Childhood Experience scores and mine is high too. I don’t tell my patients that they should have gratitude. I tell them “You survived your childhood. You have crisis wiring. Good for you. Some of your learned crisis survival wiring may not serve you as well now as it did when you were a child.” Then we discuss whether they want to work on any aspects and the many many different approaches. One example: a man who sleeps very lightly. He said that it was lifelong. When asked about his childhood he says, “We would have to leave in the night when there was shooting in my neighborhood. It was a very dangerous area.” I said, “I am not surprised you sleep lightly. You HAD to in childhood to survive. Is this something you want to try and change?” He thought about it and decided, no. Once it was framed as learned in childhood to survive, he stopped worrying about “normal”. He was satisfied that the way he slept was “normal” for him and he wanted to wake up if he heard shooting.
I think we have to ask why a person sees thorns and weeds in a garden before we judge them. My first thought with a new and angry or hostile patient is always, oh, they have been badly hurt in the past. What happened? I don’t worry that the anger is at me. I know it’s not at me, it’s at the system or a past physician or a past event. Under the anger there are other emotions, usually fear or humiliation or grief. I have brought up Adverse Childhood Experience scores on the first visit sometimes. One person replies, “I am a 10 out of 10.” The score only goes up to 8 but I agree. He was a 10. He stated once, “The military loved me because I could go from zero to 60 in one minute.” Very very defensive and very quick to respond. The response may seem extreme and inappropriate to other people: but it may feel like the only safe way to be to my patient.
I grew up hiding any grief or fear in my family, under anger, because grief or fear would be made into a story told for laughs. In college, a boyfriend told me I was an ogre when I was angry. I started working on it then and it was difficult to tame that. The person who took the longest was my sister: she could make me explode until I was in my residency. Medical training was excellent for learning emotional control, at least, on the surface. After my mother died, I had to do the next piece of emotional work: open the Pandora’s Box of stuffed emotions, mostly fear and grief, and let them out. It was such hard work that my day where I saw the counselor for an hour was harder than my ten hour clinic day. I did the work, for two long years. Blessings on the counselors who stood by me while I worked through it.
I do not think we are ever done with that sort of work. I think, what do I need to learn next? What is this friend teaching me? Why is this behavior frustrating me and I have to look in my inner mirror. Why, why, why?
Blessing on your healing path and may you not be judged.
Link about ACE scores: https://www.cdc.gov/violenceprevention/aces/about.html
Sometimes I do feel like a fossil, now that I am middle aged. For the Ragtag Daily Prompt: fossil.
I keep seeing headlines: MENTAL HEALTH IS WORSE. TEENS ARE STRESSED. ADULTS ARE STRESSED. DRUGS AND ALCOHOL AND DOMESTIC VIOLENCE ARE UP.
Like they shouldn’t be? This isn’t news. It is expected, because we are in a pandemic, the death rate is up, people are frightened, the scientific news changes daily and now we add a war.
OF COURSE PEOPLE ARE ANXIOUS AND STRESSED. And when stress goes up, substance “overuse” goes up too. Add fenanyl to the mix and the overdose death rate is up. Should I call it the “overuse” death rate to be politically correct? I do think that it is stupid to stigmatize “overuse”. But I also do not like the term “overuse”. Addiction may be stigmatized, but to me addiction means the drug or alcohol or gambling has taken over the person’s brain and it is the addiction that is lying to the person and to me. It makes it much easier for me to watch for relapse if I think of it as the habit or substance in control. There is no stigma there: the person is deeply ill and needs help. Part of the help is recognizing relapse. I look for signs.
With behavioral health we learn to watch for signs. The latest guidelines say that we should screen for behavioral health problems at well people visits. One in ten people are depressed and the lifetime incidence is higher.
The online and news articles sound surprised that there is an increase in behavioral health problems. Why would anyone be surprised? We have evolved emotions along with logic and emotions help us to survive. If you are a child in a war zone or a family with abuse or domestic violence, your brain wires to survive the crisis as best you can. These are ACE scores, Adverse Childhood Experiences. Every child’s ACE score is going up during the pandemic. Adults can develop PTSD, depression, anxiety: of course. This is how our species survive. It isn’t FUN but it is not a disaster either. We can help each other. We can listen to each other. We may have to say “I can only listen to this for ten minutes,” and set a timer. There was a cartoon with a father with a stop watch. The daughter is complaining as fast as she can. He stops her: “There. You have had your one minute of whining today.” Limit the news if it is driving you bananas or you feel more depressed or frightened. Turn off the television: if you live in a safe place, go for a walk. I have goldfinches and pine siskins arguing with each other in my front yard. The cats are hugely entertained by this. The cats only go out with harness and leash. I may need to follow Sol Duc up trees. She leaped on top of the outdoor cat cage yesterday, four feet up. I was surprised. No wonder they can catch birds: from a stand to four feet up and she is about ten months old. And see? We are distracted by the cat and relax a little.
If you are not trying to escape a war zone or something else horrible, give yourself the gentle gifts: things that make you relax. Stupid cat videos, old music, reread a beloved book, a gentle walk outside. Yesterday I “walked” Elwha. He spent the whole walk sitting on the porch watching the birds. Two birds landed in the grass and he immediately morphed to hunter, but was still on a leash. I saw a pair of robins in the back yard. One was holding something in her beak. A gift for the other? Nest building? Nestlings already?
My other go to is the trees. I go lean on a tree when I feel overwhelmed. The trees do not seem to mind. Rocks don’t either and I am very grateful.
Blessings.

#ACE scores #behavioral health #emotion #fear #normal emotional response
For Fibbing Friday.
denise levertov writes making peace
that it is an active process
it is not the absence of war
but a process in itself: how do we make it?
Make Peace
how do we wage peace?
wage is not the word
we do not do it for money
we must be more active than hoping
engender peace?
spread peace: like a pandemic
a pandemic of peace
the comfort of peace
the joy of peace
the love of peace
the peace of the grave
the peace of sleep
the peace of heaven
peace here now
peace not distant nor below the earth
peace conscious, aware and present
peace alive, breathing, welling up in everyone
peace here now
a pandemic of peace
a river of peace
peace flowing through and around, above and below us
peace full, peace out, peaced
let us verb it
I am peaced today
I peace you
I peace Russia
I peace the soldiers
I peace the Ukraine
I peace the entire world
I peace you
please, will you peace me?
peace me now, then there will be two
and everyone else
peace the world now
a pandemic of peace
make peace
___________________
I taped a conversation with a wren one morning in Wisconsin. I never saw my wren and clearly I have not got the language down, but she kept talking to me anyhow.
I knit this lovely striped scarf. It is just brown and pink stripes. No tricks, right? Two rows of pink and two rows of brown.
For the Ragtag Daily Prompt: wool.
This was my most amazing beach find yesterday: the sight of a group of kids playing normally, no masks.
The war horrors bring us down, but we must remember hope. This gives me hope too:
Also for the Ragtag Daily Prompt: peace.
For the Ragtag Daily Prompt: peace.
BLIND WILDERNESS
in front of the garden gate - JezzieG
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Or not, depending on my mood
All those moments will be lost in time, like tears in rain!
An onion has many layers. So have I!
Exploring the great outdoors one step at a time
Some of the creative paths that escaped from my brain!
Books, reading and more ... with an Australian focus ... written on Ngunnawal Country
Engaging in some lyrical athletics whilst painting pictures with words and pounding the pavement. I run; blog; write poetry; chase after my kids & drink coffee.
spirituality / art / ethics
Coast-to-coast US bike tour
Generative AI
Climbing, Outdoors, Life!
imperfect pictures
Refugees welcome - FlΓΌchtlinge willkommen I am teaching German to refugees. Ich unterrichte geflΓΌchtete Menschen in der deutschen Sprache. I am writing this blog in English and German because my friends speak English and German. Ich schreibe auf Deutsch und Englisch, weil meine Freunde Deutsch und Englisch sprechen.
En fotoblogg
Books by author Diana Coombes
NEW FLOWERY JOURNEYS
in search of a better us
Personal Blog
Raku pottery, vases, and gifts
π πππππΎπ πΆπππ½π―ππΎππ.πΌππ ππππΎ.
Taking the camera for a walk!!!
From the Existential to the Mundane - From Poetry to Prose
1 Man and His Bloody Dog
Homepage Engaging the World, Hearing the World and speaking for the World.
Anne M Bray's art blog, and then some.
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