56 Toxic Stress: Safe, Stable, Nurturing Relationships are the Antidote

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Andrew Garner, MD, PhD, FAAP, is a Clinical Professor of Pediatrics at Case Western Reserve University (CWRU) School of Medicine and a Primary Care Pediatrician with University Hospitals Medical Practices in Cleveland, Ohio. Dr. Garner is a product of the Medical Scientist Training (MD, PhD) Program at CWRU and the Pediatric Residency Training Program at the Children’s Hospital of Philadelphia.

Dr. Garner is the co-author of the American Academy of Pediatrics’ (AAP) original (2012) and recently revised (2021) Policy Statements on Childhood Toxic Stress. He has also co-authored an AAP-published book entitled “Thinking Developmentally.” Dr. Garner is a past-president of the Ohio Chapter of the AAP, and he has served on several AAP Leadership Workgroups, including Early Brain and Child Development, Epigenetics, and Poverty.

Dr. Garner is passionate about promoting the safe, stable and nurturing relationships that buffer toxic stress and build the rudiments of resilience

[00:01] Dr. Andrew Garner Shares His Story With Us

• I introduce and welcome Dr. Andrew Garner
• Why pursue pediatrics?
• Andy shares his reasons

[06:00] Safe, Stable, and Nurturing Relationships

• Andy talks about the effects of adverse experiences to children
• He shares some interesting insights about biological changes due to toxic stress
• Adversity is not destiny and here’s why
• The role of relational health in resolving toxic stress and adverse children experiences
• Why relationships should only be built, but nurtured as well
• Andy explains

[17:40] Public Health Approach and Positive Experiences

• Is there a connection between adversity and positive experiences?
• The role of pediatricians in promoting positive experiences among children
• How to apply public health approach in addressing adverse experiences
• Don’t miss our exchange about the “universal prevention”
• How pediatricians think in a multi-generational manner

[29:01] Strong Emotions Are Superpowers

• Pediatricians can also support the parents, and here’s how
• Our only lever for change
• Andy breaks down the concept of bio-behavioral synchrony
• What the society can improve on in terms of handling and showing emotions
• He talks about how children can channel strong emotions into worthwhile endeavors

[39:35] Transform Pain, Not Transmit It

• How people really deal with stress
• Pain not transformed is transmitted to others
• Listen to our exchange about anti-vaccine movements
• How can healthcare providers simplify the benefits of vaccines

[48:20] Closing Segment

• Don’t miss Andy’s message for his resident self
• Final takeaways:
• AAP’s policy statements on toxic stress and trauma
• The relation between adverse childhood experiences and behavioral outcomes
• Adversity is not destiny
• Safe, stable, and nurturing relationships buffer and create positive experiences
• Building partnerships and systems to lift kids up
• The role of public health approach in promoting positive experiences among kids
• What to understand about relational health
• The social circles around the children
• Building solid therapeutic relationships with parents and patients
• How pediatricians can build their own resilience

Key Quotes:

“All kids need positive experiences to thrive.” - Dr. Andrew Garner

“What we all strive for as human beings is to