“A heart-breaking, world-shaking, revolutionary book.”

Paul Tough, Author of How Children Succeed

“...brilliantly exposes and explores one of the most critical health issues we face today.”

Bryan Stevenson, Author of Just Mercy

“...a rousing wake-up call...”

Michelle Alexander, Author of The New Jim Crow

“Essential reading for every parent...”

Kamala D. Harris, United States Senator for California

Dr. Nadine Burke Harris MD, MPH, FAAP

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Why did you write this book?

There is hard science behind adversity and trauma that gives us new hope in breaking the cycle of childhood adversity and its physical manifestations that too often get handed down from generation to generation. And everyone should have access to this science and hope. I wrote this book for parents, stepparents, foster parents, grandparents, and caregivers who are trying to figure out the best ways to give children the best shot in this world despite the difficulties life throws their way. I wrote it for all of the young people in this world facing outsize challenges, and for adults whose health is shaped by the legacy of their childhoods. My hope is to inspire conversations—around dinner tables, in doctors’ offices, at PTA meetings, in courtrooms and at city councils. But my greatest hope is to inspire action—big and small.

Can you tell us about a patient who changed your life/work?

For a long time, I had suspected that there might be a biological connection between early adversity and health, but it was Diego, a seven-year-old boy who stopped growing after a sexual assault who really forced me to dig deeper. As a doctor, we do all of these complicated and expensive work-ups to determine the cause of our patients’ health problems, but in this case the most important thing that we had to address was the trauma.

What surprised you about your work in ACEs?

When I first started my research into toxic stress, I had no idea that childhood adversity could change the way our DNA was read and transcribed. I never learned about that in medical school. That really blew me away. I also continue to be surprised by the hopeful aspect of this issue! For me this science is incredibly hopeful. ACEs have been happening for a long time, but this science represents an amazing breakthrough in helping us interrupt the progression from early adversity to disease and early death.

Has your parenting changed as a result of your discoveries?

This research has opened my eyes to the fact that one of the most important things I can do as a mom is help my children develop a healthy stress response system. I want to give my children as many tools as I can to for a successful future and a well-regulated stress response is critical for kids’ success in school, relationships, jobs and in life.

It has also brought home for me the importance of self-care. Self-care isn’t selfish. Especially during difficult times, so many parents naturally want to put their kids first, but sometimes they put themselves last. That’s a mistake. It’s hard to nurture our kids when we are totally stressed out, worn out and exhausted. I promise, no matter what they say, kids need a parent or caregiver who can be present and nurturing a lot more than they need those silver high tops. This research really helped me understand just how powerful I am in helping my kids make it through whatever life throws in their way.

Why is it so important to understand ACEs?

In order to effectively prevent and treat serious health conditions like heart disease, cancer, diabetes, and asthma, we need to understand what is causing them. And the science around toxic stress is telling us that for many people it starts in childhood. While I believe that it is critical that pediatricians understand and screen for ACEs in a primary care setting, enough kids had been sent to my clinic by teachers requesting a diagnosis of ADHD and medications that I knew that the doctor’s office wasn’t the only place that needed fundamental understanding of toxic stress.

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