Thursday, March 17, 2016

Brain research and buoyancy and blacked out boxes

Every Monday evening I attend a compulsory foster training course for three hours. We're a fairly large group of people who represent a wide range of society: there are single parents, newly married couples, older couples (gay and straight), and grandparents; there are people who work in professional capacities, as full-time home makers, or who are unemployed or under-employed; some of us have post-graduate qualifications, others didn't graduate high school. We chat easily about our lives, share our commitment to fostering and offer one another support. The meetings are facilitated by the Department for Children and Families, a team of people who are, in all fairness, already stretched beyond measure by the increasing numbers of children coming into the foster care system. Together we are working through a photocopied pack of information which has been written someplace else by someone else. Using lots of bullet points and carefully worded case studies, this pack requires us to engage in pre-defined activities and to learn lots of 'facts'.

Despite doing well at school and achieving a bagful of qualifications over subsequent years, I am not a good student. There are many different learning styles - visual, kinetic, auditory etc. - but my learning style is probably best described as 'difficult'. I don't mean to be difficult, it's just that I have an aversion to 'facts'. (As an excuse for all my question-raising and belligerence, it might be worth pointing out here that the plausibility of Eugenics in the twentieth century was fuelled by 'facts' drawn from scientific research on heredity in animal and plant husbandry while Gregor Mendel's work on genetics provided the 'facts' necessary to support racial segregation in many US states). 'Facts' are dangerous things, particularly when they are borrowed from research which isn't fully understood and used without caution or self-reflection. The philosopher, Karl Popper, stressed that, 'Our knowledge can only be finite, while our ignorance must necessarily be infinite'; but times change and, rather than philosophy or sociology, contemporary childcare advice seems to draw 'facts' almost exclusively from introductory handbooks to neuroscience.

I don't know very much about neuroscience and the neuroscientists I most admire also claim to not know much about neuroscience; unfortunately, they are in the minority. Neuroscience affords a seductive language for talking about emotional responses and learning. Through the use of brightly colored scans of various brains - baby's brains, rat's brains, criminal brains etc. -  and through the development of an assortment of PowerPoint diagrams, 'experts' are able to show, for example, how children benefit from loving attention and an absence of stress in the early years of their development. To pardon the pun, this seems a no-brainer, but the fostering pack presents this as a new research finding within neuroscience. To summarize: there is a highly publicized case study of rats which apparently proves beyond doubt that rats which (who?) have been handled even once during their infancy have active neural pathways which are dormant in rats which have never been handled. Although we are talking about rats, folks, we are then encouraged to make a moral leap of faith from the claim that these particular active neural pathways are GOOD things, to their correlation with the 'arousal/relaxation attachment/bonding cycle' (shown above) which underpins contemporary understandings of early childhood care. All of this leads to a crowd-pleasing finale in which we claim, de facto, that: (a) pregnant mothers should not experience stress (because it messes with the unborn child's cortisol levels and can cause permanent changes in their neural pathways); (b) newborns should be comforted every time they cry; and (c) some of the damage experienced in early childhood can cause irreparable damage in a child's brain.

When I was pregnant with my first daughter, Gina Ford's Contented Little Baby Book was a bestseller. Ford advocated (in fact, I think she might still advocate, although her books now sell in smaller numbers) teaching children to sleep through the night by leaving them to cry, and teaching them to eat by making them adhere to a routine of structured feeding times rather than giving a child food because they had indicated they were hungry. This approach is similar to Truby King's parenting advice from the 1930; he advocated a strict regimen of building character through avoiding giving babies attention on their own terms. In the time between King and Ford, the pendulum of popular thought swung to an opposite extreme where Dr. Spock advocated a wholly 'child-centered' approach. Generally speaking, I suspect there are strengths and weaknesses to both Ford/King's routinized approach and Spock's/the contemporary 'baby-knows-best' approach; my quarrel, however, is with the use of partial evidence to suggest the superiority of one approach over another, and the attempts to limit our thinking within the boundaries of one tiny area of scientific understanding. (Incidentally, given that I dislike routines almost as much as I dislike 'facts', my daughters didn't have a routine and we muddled along on the principle of 'whatever makes the most people happy'. It worked for us, which gives me precisely no grounds from which to generalize!)

A comparison might be made with Physics. In Physics, the equation for buoyancy is, I think, Fb = ρ ρ g V. If one was designing life rafts for an ocean-going vessel, it would probably be advantageous to have a good understanding of buoyancy equations. If you're trying to evacuate a sinking vessel, having an understanding the principles of Physics is of more limited use. My grandfather spent two days in the Pacific after his ship, the HMS Exeter, was sunk. He stayed alive by sharing a floating table with another Marine. I'm fairly sure my grandfather couldn't have worked out the equation for why the table bobbed along, just below the surface of the waves, but, in that instance and at that time, it worked for him.

My main fear about the current popular use of neuroscience to explain children's behavior is the risk that it justifies dictating limited ways to respond to a child's behavior. In a teacher conference for a boy I mentored, I was told that the cortisol levels flooding this boy's brain meant there was no way to teach him right from wrong during periods of anger. The teaching staff used lots of words during this meeting which I didn't fully understand, but the basic explanation seemed to be that the boy's anger affected his brain by compromising the neurons in the hypothalamus. This school subsequently suspended the boy for unruly behavior when he threatened to kill their martial arts teacher (the boy later explained he had been speaking hypothetically about a move he had seen in a Jackie Chan movie; he is a smart boy who can use words like 'hypothetically' and talk happily about the relative merits of Jackie Chan over other martial arts experts; but he doesn't always have the wisdom to let people know when he's joking rather than when he is raging). I have seen the boy angry but never out of control, which all contributes to my sense that I don't understand the hypothalamus at all. The boy's therapist has read a different book on neuroscience and thinks his problems relate to ways in which post traumatic stress disorder have shrunk this boy's left superior parietal lobule. She might be right. When the boy gets upset, I find talking about Justin Bieber helps; that's the advantage of not being a specialist.

Because I am not a specialist, I am leery of looking too closely into neuroscience, or adopting a normative position regarding how we parent. I suspect most of us are just doing the best we can; some 'bests' are more effective than others. On Friday afternoon, I met a distraught woman and, because there was no-one else around to help her, we went out for a hot chocolate. I hoped I might be able to direct her to some person or organization who could offer some kind of proper help. We are around the same age and we were similarly dressed in sweaters and jeans. She was wearing make-up, I wasn't. She took a diary out of her bag - one of those cheap pocketbook diaries you can buy for less than a dollar in a drugstore. She opened it to March and there were lots of blank boxes marking out each day. Only two boxes were colored in: one with a fluorescent marker, the other with a black biro which had been scribbled across the box with such force the paper had torn. The woman chewed her nails, bit at a flap of skin which had worked loose around her thumb, and told me it was her son's birthday the next day. He didn't live with her. He had never lived with her. The state had taken him off her after he was born. She had had several other babies, all of whom had been raised in care. I thought of the foster sons who stay with us sometimes and the children I've mentored and the homeless youth I have worked with, and I thought of all the anger I have felt towards some of their mothers: if their mothers had been different - better, calmer, healthier - those children would have had a better life, I thought. But that anger is nothing more than a different lens through which to see the world, and the woman sat in front of me was crying into her hot chocolate.

We made a plan to post this son a birthday card after we finished our drinks. I told her I would try to find the details of a support group available for women who had had children taken into care. I didn't ask her what she'd done, as it didn't seem relevant. She pointed at the blacked out box sitting among all the empty days of March and told me one of her children had killed himself on that date. I didn't ask what he'd done, as it didn't seem relevant. I picked up a copy of the local free press and gave her the number of a hotline for Suicide Survivors so that she could talk to an expert if she wanted to; sometimes you need someone better trained to help you.

On Monday night, I tried to be a better student - less argumentative, more accepting of the evidence; it's important to learn from the experience and expertise of other people. But every time I looked at the PowerPoint diagrams of cycles and neural pathways I saw a scribbled out square on the blank page of a diary, and I haven't found a way to understand that yet.

Saturday, January 30, 2016

Rage, pathos, pity and skiing

Until recently, I have been able to treat my spinal cord as a difficult adolescent: I have lived with it, endured it, and trusted it to either bugger off at some point in the future or to start behaving better. But it's nearly 20 months since I broke my neck and the adolescent looks as though he might be here to stay. Iola has baptized him 'Diplodoscious', a name as good as any other, and he lives with us on a daily basis, an awkward and spectacularly complex mixture of electrical impulses and chemical coding which provokes rage and pathos and pity inside me in almost equal measure.


I am not going to stop doing the things I love because my broken neck makes them more difficult, but sometimes my broken neck whoops my ass. Literally. I have no clear sensation in my left foot so, more than once, I have needed to come down mountainsides on my caboose because I can't trust my left foot in the places where the path is hidden by leaves. I need x-ray vision, a walking pole, and hiking pants with reinforced patches across my bum. It didn't use to be like this.


However much money I spend on soap and however much I fiddle with the temperature of the water, it hurts when I wash my hands. It will probably always hurt when I wash my hands. I do a lot of hand-washing because my children are petri dishes of colds and flus and vomiting bugs; my chickens contain an entire poetic lexicon of potentially deadly diseases - salmonella and histoplasmosis and cryptococcosis and more; and our random menagerie of household pets share a familial desire to poop copiously in various shapes and places. That's a lot of hand-washing; that's a lot of pain. My accident has also meant my hands have grown old before the rest of me. Like a little old lady, I need to take a few extra moments when I buckle the dog's collar, or turn the key in the lock; I need to run lids of jars under hot water; light bulbs tend to shatter when I try to change them because I have no way to regulate my grip. Most of the time, I can live with this - my hands got old before me? Meh! I can still write and knit and flap them about me as I chivy the girls out of the house in the morning - but last week I cried in the check-out queue of the supermarket because I couldn't get the coins out of my purse.


I've never thought pity is a particularly useful emotion. I believe in having compassion for and empathy with those less fortunate than myself. But sometimes I pity myself. Not often. Not often at all. But sometimes.


Two weeks ago, I phoned the Smugglers' Notch Adaptive Ski Program (SNAP) and introduced myself. I explained about my neck and my nerve damage and my tendency to fall over unaided while both feet are on the ground. I told them I wanted to learn to ski.
'What level of skiing were you at before you broke your neck?' asked the administrator.
'I hadn't,' I said.
There was a long pause before the administrator said, 'So, you broke your neck and then you decided you wanted to learn to downhill ski?'
I said yes, and she said I needed to meet S-.

S- spent nearly 27 years of his adult life captaining an Atlantic fishing boat, then he became a born-again Christian and dedicated the rest of his life to helping people with disabilities to farm, during the summer months, and to ski during the winter. He's blunt as a mallet, irascible, troublesome and an absolutely fabulous teacher. He's the kind of man who'll promise candy to someone else's ski class of Kindergarten children if they promise to lie down in the snow and refuse to get up; he'll not back down when he thinks he's right but he would never ski past any incident without first checking everyone was ok. At the moment he's living through the final stages of pancreatic cancer: while he calls himself a 'dead-man walking' he also tells me he isn't quite ready to go yet. He's got a job to do - there are a few children he's been working with over the years whom he wants to spend another winter with, and he wants to make me fall in love with skiing.

As well as the skis on my feet, I now have two tiny skis attached to my arms via crutch-like contraptions. They're called outriggers. 'The thing is,' says S-, pointing to all the people under our ski lift, 'all skiing is adaptive.' He describes how each person is skiing differently, using their body differently, personalizing their equipment. Just because I have four skis doesn't mean he's not going to expect me to learn properly.

My left leg doesn't have sufficient coordination for me to be able to slow down by making a snow plow (to borrow Iola's terminology, a snowplow means making a pizza slice with my skis). S- listens, shrugs and tells me I shouldn't be snow plowing anyway. 'You should be parallel skiing,' he says. 'It looks better and it will make you a better skier.'

S- makes me use the edges of my skis to make sweeping turns down the hills, he makes me twist my body and keep my legs close together so I can slalom, he makes me practice ankle pivots and hockey stops.

At the bottom of the run, we get into the chair lift and swing out over the snow and the slope and the dark edgings of the trees, and we talk about life and living and pain and struggle and the wonders of sailing across oceans and the best ski runs he's ever had. At the top of the hill, we ski off the lift and pause for a moment, looking out towards the mountains and feeling the snow on our faces, then we chase the slope back down to the bottom.

Perhaps it is because I don't know what it's like to ski without a broken neck, or perhaps it's something more profound, but at the end of a morning's skiing, my cheeks ache from smiling. All that other stuff - my little old lady hands and the rage and the pathos and the pity - are smaller somehow, because everything else is so big.