Trauma Education Essentials

Book Reviews

Monthly Book Reviews

Book reviews written by Dana Ross, MD, MSc, FRCPC. 


The Deepest Well by Nadine Burke Harris

Wow. Dr. Burke Harris, a paediatrician in San Francisco, has written a phenomenal book titled, “The Deepest Well: Healing the Long-term Effects of Childhood Adversity”. She has a particular focus on adverse childhood experiences (ACEs) and the link between toxic stress and health outcomes across the lifespan. Her Ted Talk on ACEs has over 3,500,000 views. I have never met her, but she is one of my new favourite people.
 
Here’s why.
 
In the book, she tells the story of her journey from doing research in medical school to current day and how she came across the landmark ACE study and why it’s important. Dr. Vincent Felitti and Dr. Robert Anda led the ACE study which involved over 17,000 patients and took place between 1995-1997 at Kaiser Permanente in San Diego. They gave each patient a questionnaire asking about childhood abuse, neglect and exposure to household dysfunction, as well as current health-risk factors and health outcomes.
 
Their results showed that ACEs are very common, and that the more ACEs a person had, the higher the likelihood of having poor health outcomes such as heart disease and cancer. The results have since been replicated in other studies numerous times.
 
Her own journey of noticing the physical and mental health impacts of toxic stress plays out in a gripping narrative full of stories about her patients, their families and the communities she has worked with. Dr. Burke Harris describes the neurobiology of the stress response in a way that feels accessible and helpful.

Importantly, she doesn’t focus just on the problem, but she clearly outlines solutions and goals: universal ACE screening, prevention, early intervention, trauma-informed approaches, and education to increase recognition of the sweeping impact of ACEs across the lifespan.
 
I was really moved and inspired by the end of the chapter titled, ‘The Rising Tide’ when she describes coming into awareness of the need to focus on adverse childhood experiences for everyone, not just special populations. Wondering why there is so much resistance to the science of adversity, she realized that some people want it to be a problem that only effects ‘those people, not us’, while others want to claim it for their community alone.
 
She argues that we need to stop ‘othering’ and come together to understand our common biology of stress and suffering. On one hand, any message about unity is welcome these days but it’s more than that. Her message is key to powering change on the level that is needed to make a real difference in people’s lives. We need our scientists, researchers, clinicians, policy makers, educators and everyone else to get on board to find solutions that aren’t fragmented. She delivers not only a message but also, if we are listening, a call to action.

Dana Ross