Dr Gabor Maté is not a great orator, nor does he have a flashy speaking style. He doesn’t invoke spontaneous applause or standing ovations. He is softly spoken and understated. On the upper tier of the vast Glasgow Concert Hall, I had to lean forward to hear better, drawn in as he mixed the personal, the spiritual and the neuroscience of adversity, trauma and addiction.

 

His great skill is to direct your thoughts inward and to encourage you to reflect on your own experience. When we do so, we see the universality of his theory – one that is not about ‘us’ versus ‘them’. We will all, he argues, face adversity and trauma in our lives and it is something we collectively, as a society, must address together.

 

While this was billed as an ACEs event, to truly embrace his message, we have to take a wider view of adversity than the ACE study can capture. To begin with, ACEs themselves are not the trauma – they are the events that have caused the trauma. Trauma is not something that happens to us, he argues, it happens within us.

 

Darren McGarvey, who spoke at the beginning of the event, talked about how learning about the ACEs study was one part of his own journey to understanding himself. Yet while the ACEs survey may help answer ‘what happened to me’, this won’t help everyone, as Darren McGarvey himself acknowledged.

 

Nor do ACEs capture all of the events that cause trauma. Poverty, Dr Maté argues, should be considered an adverse childhood experience. Structural inequalities like poverty can cause stress that, in turn, lead to ill health and poor wellbeing. One study cited by Dr Maté even found an association between racism and rates of asthma amongst African-American women[1].

 

How do we explain this link between traumatic events and wellbeing? Dr Maté argues that the primary impact of unresolved trauma, particularly as a result of our childhood experiences, is alienation, from ourselves, from our work and from others.

 

In opening, Dr Maté referenced a Ted Talk by Sir Harry Burns, former Chief Medical Officer for Scotland, where he quoted Scottish trade unionist and political activist Jimmy Reid on alienation. In his famous 1975 Glasgow University rectoral address, Jimmy Reid said on the subject:

 

“Alienation is the precise and correctly applied word for describing the major social problem in Britain today.”

 

In the same speech, he identified the antidote to this problem:

 

“The challenge we face is that of rooting out anything and everything that distorts and devalues human relations.”

 

Like Jimmy Reid, Dr Gabor Maté is clear that human connection is key to healing from alienation. This isn’t just a philosophical argument but is rooted in the science of attachment.

 

But in seeking attachment we require to heal, Dr Maté argued, we can often lose our authentic self. The impact of prejudice, discrimination and stigma is illustrative here. If we live in a community or society where we are not free to express our identity, we become alienated from ourselves and others.

 

This is often true of young people who have care experience, who often tell us of the stigma they face across their life. Nor does that stigma exist alone – we live in a society where young people continue to face homophobia, transphobia, racism and misogyny.

 

Recovery, therefore, must begin with returning us to our authentic selves. For those who support young people to do that, how we intervene is often the crucial factor. Dr Maté challenges us to ask who we are being when we intervene, are we doing so from a place of compassion and without judgement?

 

As a society we often punish children for ‘bad’ behaviour through giving them ‘time out’, playing on their worst fear and removing human contact. We know that school exclusion rates for children with care experience are higher than their peers[2] so this is particularly pertinent to care-experienced young people.

 

For adults, this ‘time-out’ can often take the form of custodial sentences. The evidence on this suggests that care-experienced young people are also more likely to be involved in the justice system as an adult[3]. As Karyn McCluskey, Chief Executive of Community Justice Scotland, said during a panel discussion at the conference: our prisons are “passive receivers of the injured”.

 

So how do we change this? We must begin with the human. As Sir Harry Burns said, we need to begin by asking, ‘what matters to you?’ and ‘what can we do?’

 

Fundamentally, if we want to achieve societal change, we need to include both those who deliver services and the citizens that are supported by them from the outset. As Sir Harry Burns said: “When you want to make change happen, you have to involve those who will need to make it happen.”

 

This took me back to a question posed by Darren McGarvey at the beginning of the day: “How does this translate into policy?” Put differently, how do we take the learning from Dr Gabor Maté and translate this into change?

 

For Staf, the day reinforced our belief in the importance of relationships and connection but it has also opened our eyes to the impact of the opposite – alienation. Tackling alienation and building the relationships needed to heal from trauma will take commitment from all of us.

 

To deliver that change in the care system, we will keep working to bring together lived experience with those who will be asked to implement change. Only then will we be able to deliver a society where all young people are listened to, cared for and loved.

 

Three ways you can be part of change

1. Give your views on relationships as part of Mapping Relationships, the first stage of a new three-year project to support you to develop relationship-based practice. Find out how here. 

2. Support Youth Just Us, a project to support the participation of young people with care and justice experience. Read more here.

3. Read about Project Return, our new project to support return young people to return to a life that is not determined by their experience of trauma. Find out more here.

 

Cover image attribution - University of Fraser Valley: https://www.flickr.com/photos/ufv/36495826004/in/photolist-YEpwiV-XB1Dzo-3bMXDb 

[1] Experiences of Racism and the Incidence of Adult-Onset Asthma in the Black Women’s Health Study, Coogan et al, 2013: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941245/

[2] 169 per 1,000 looked after pupils were excluded in 2016-17, compared with 27 per 1,000 pupils across all pupils. Scottish Government, 2018: https://www.gov.scot/publications/education-outcomes-scotlands-looked-children-2016-17/pages/6/

[3] 47 per cent of adults in custody reported being looked after as a child. Scottish Prison Service, 2018: http://www.sps.gov.uk/Corporate/Publications/Publication-6087.aspx