Tag Archives: adolescent girls

Big Women, Little Women, Small Oscars

The Oscars are this Sunday, and as war movies and films about repressed male feelings take center stage, I’ve been thinking about why Greta Gerwig’s Little Women had me wiping away tears during the last 30 minutes of the film – something that also happened to me while watching another Gerwig film, Lady Bird.

Gerwig is a stealth story teller. She appears, for the first half of her films, to be weaving together a tapestry: scenes of girls-becoming-women; girls lit-up by a longing to be known and seen for their own way of interpreting all that is unsaid in a scripted world, and searching to find a way to make their singular voice be heard. These tableaus unfold against a larger backdrop of sacrifices both gladly and unhappily made, in order to serve and preserve the human interconnections that sustain us, and make us who we are as we find our place in the world.

And then, two-thirds of the way in, you realize Gerwig has quietly rowed you into currents of loss and gain and joy and rage which – if you are female, and if you are anything like me (and you might not be anything like me)  – you have learned to suppress. You are stitched into Gerwig’s tapestry like Gulliver strapped into the shoals of the seashore, you can’t escape, you didn’t see it coming, and you just want to sit with these waves of old repressed female feelings washing over you for a good long time.

I’m no Louisa May Alcott and I’m no Greta Gerwig. I’m a science journalist; I tell scientific detective stories, interweaving emerging research with lived human experience. Still, my life as a writer began in many ways, with Little Women. I grew up in a family formed by historically “big” men: the Jackson in my name harkens back to Thomas J. (hence my grade-school playground nickname, “Stonewall”), and “Davey,” for whom Jackson Hole is named. Despite that legacy, my father, a newspaper editor, sailor, and quiet human rights activist, gave me Little Women and One Thousand and One Nights. Two female narrators, Jo March and Scheherazade. In his way, like Gerwig, my dad was also a covert actor.

That same year, circa 1970, I begged my dad for a tape recorder like the one he kept beside him on the front seat of our wood-paneled station wagon. I’d tuck that tape recorder under my arm and hold out the mic, asking people questions. “That pesky girl,” one male family friend said; even my own mom was horrified: “Put that away Donna! No one wants to hear what you have to say!” – she was no doubt projecting onto me her own fears (we parents do that kind of thing).

Three years later, my father died one summer day, following surgery. A few miserable years went by. I turned 17. As I thought about college, my mom begged me not to become a writer. “You’ll have frizzy hair, you’ll be a fat poet, you’ll never marry!” “I’m not getting married until I’m 40!” I yelled back at her.

In flocked my benefactors: my aunt, who once told me, “You aren’t the problem, Donna, what’s happening around you is the problem.” A teacher gave me a key to the teacher’s library. Another took me on a college tour to show me what might be possible. In college, a women’s studies teacher urged me to apply to a journalism program.

Over the next decade a lot happened. I wrote my first book. I got married. My son was born and a few weeks into being parents we discovered he had a life-threatening condition. He had surgery, and for weeks I lived in a room reserved for parents of critically ill babies on the pediatric wing at Johns Hopkins. After we brought him home, I spent a year in my bathrobe, nursing him, urging him, that beautiful boy, to health. (And so I wept (spoiler alert!) while Jo nursed Beth at the seaside.)

A few years and books later, I was the one who fell ill, with a neurological autoimmune disease which left me paralyzed. I recovered and relapsed. (My mom developed a theory around that time, that writing was killing me.) I didn’t think I’d write again. But I did; at first, I used a thick occupational therapy pen to set down words. I wrote my fourth book and fifth.

Now, as I’m half-way through a string of promotion for my sixth book, I’m thinking a lot about my voice, against the backdrop of the faces we as women can and cannot reveal to the world, if we want to be taken seriously. And more and more I find myself longing for the two selves to merge: the self I bring onto stage, or into a bookstore, and my unspoken female self who has lived the losses and joys of a Jo March while writing between the crises of living.

Over the course of three decades, I’ve been told many different things about how we should and shouldn’t tell stories. The biggest arrow strike has been that I myself have been a patient, which, for many decades, has been more or less disqualifying if one wanted to be taken seriously as a science journalist. The “right voice” has meant male voice; a voice which does not tell stories of patients and if it does, does not do so with compassion. Compassion is, well, too feminine and vulnerable a thing, and might skew one’s reporting. Still, there was always one exception to that – you could reflect on patients’ experiences if you were a man with an MD or PhD behind your name. And you could judge it. To wit: a well-known man in my field recently said he wouldn’t read my book because he wrote – in an email I wasn’t supposed to see – though the topic was worthy he found it “unlikely” that I’d ever been paralyzed twice (a fact I mentioned briefly in the book’s prologue). Perhaps, he suggested – despite knowing I see one of the world’s top neurologists – it had been a kind of emotional hysteria?

I did it differently. I knew there was a game I wasn’t physically well enough to play. I was too immersed in the life of the caregiver and patient. So, I did it a female-centric way, a patient-way, writing from hospital beds and waiting rooms, and at the kitchen table while overseeing homework, Halloween costumes, skinned knees, and broken hearts.

For a very long time, this put me in what I came to think of as the pink collar ghetto – the female patient writer we fear may be malingering on the page, or at very least skewed by her experiences and unable to be dispassionate about the subjects whose lives she’s reporting.

Right before one of my book tour talks, I called my 87-year-old mom, who I hadn’t talked to in a little while. I had a strange urge to hear her voice. “Hey mom, I’m about to give a talk at Harvard,” I said, flashing back to that moment when I was 18 and broke the news that I had secretly applied to a few colleges she didn’t know I’d applied to, and she’d been so angry she drove me to college, put my suitcase on the sidewalk, and drove away. (So now you know why I wept during Lady Bird, too.)

My mom was quiet on the phone and then said, “I remember reading your paper on Willa Cather’s My Antonia, when you were in high school. I would read something you wrote and it would send tingles down my spine. You had a way of putting words together and I thought to myself: Who is this child?” She paused. “I’m so proud of you.” It took me a moment before I could speak. It was the first compliment my mom had ever given me about my writing. My voice.

Book tour number six has been clarifying for me, my comfort level with walking that line between the presented self, versus the scripted self, even while knowing all the ways in which I might be sidelined (too female, a patient, not a scientist, non-affiliated, and now maybe not young enough (no ingenue here)).

We’re seeing women break past old fears of how they may be seen in medicine, science, sports, and journalism, moving beyond doing things in the man-made manner which we’ve inherited by those who’ve dominated our fields. And a lot of women are finding, in their own Jo March endings, that once you push back against the narrow confines of those barriers, that maybe there is a way to do things a little differently. Who says the old way is best just because that’s the way it’s always been done? You begin to create a new playing field, and the fear of “what you might think of me” is finally gone.

Male-directed films may get all the awards this Sunday at the Oscars, but when I look around, it’s women, like Greta Gerwig, who are rewriting the script for all of us, and speaking truth to the complexity of the feminine experience. There may be no award big enough for that.

 Thank you, Greta, for seeing us.

Donna Jackson Nakazawa is a science journalist and the author of six books, including her newest, “The Angel and the Assassin: The Tiny Brain Cell That Changed the Course of Medicine.” Follow her on Twitter, Instagram and Facebook

Why We Need to Talk About the Unique Biological Effects of #ToxicChildhoodStress and #FemaleAdversity on Women’s Bodies and Brains.

The Female Body and Brain on Toxic Stress

(CRUCIAL NOTE HERE BEFORE YOU READ: Boys’ immune systems become dysregulated in response to #toxicstress too, and that leads to disease and changes to the brain that we also need to talk about more openly AND compassionately. Today I’m focusing on girls’ unique immune response to #toxicstress.)

So, exactly what happens in a girl’s body, in response to #toxicstress, that leads girls to be more likely to be ill as adult women? EVERY WOMAN WAS ONCE A GIRL. So, we should figure this conundrum out, right?

(For more on the scientific link between toxic childhood stress, being female, and later developing autoimmune disease, depression and other conditions, please read PART I of this essay, Why Girls Who Face Toxic Stress are More Vulnerable to Adult Illness: The Shocking Relationship Between Being Female, #ACEs, Autoimmune Disease and Depression)

Well, it turns out that girls’ developing immune systems react differently to toxic stress than boy’s do. This is because of some basic physiological differences between women and men. Women are, generally, physically smaller than men and our hearts and lungs are much smaller in size. Yet our anatomy makes added room to carry a fetus in order to create new human life.

Our smaller heart, lungs, and organs still have to be able to do everything a human male does – pump oxygen, circulate blood, run fast, think fast, be awake 16 or 17 hours a day – and have the necessary fuel to carry a child to term. We have to do double duty, on half the machinery.

Women can do so much more on less because we also have higher baseline levels of the hormone estrogen. Estrogen acts as a kind of messenger, carrying information between groups of our cells. Say we are stressed, or catch a flu, or get a vaccine – estrogen helps us, as women, have a more robust immune response. This more robust immune response is also thanks to steroid hormones known as glucocorticoids (or GCs). Glucocorticoids are produced by the adrenal gland and are anti-inflammatory. They help regulate inflammation.

If a woman is pregnant, glucocorticoids help us to keep our baby safe and carry it to term, even if we come down with the flu, or have a physical injury. Our immune system is poised, all the time, to protect our ability to carry another life.

This heightened female immune response also means that when our immune system sets out to fight off any foreign invader, such as a virus or bacteria, as women we also produce more of what are called antibodies, or fighter immune cells. That’s good. BUT it can also be a problem. As women, when we produce more antibody fighter cells, we also produce more autoantibodies. Autoantibodies are rogue fighter immune cells that can mistakenly attack the body’s own tissue or organs, in what we refer to as friendly fire. As in #autoimmunedisease.

When women, ESPECIALLY GIRLS, repeatedly face #toxicstress during the developmental years, over time, their stress response begins to be dysregulated. Glucocorticoids, or GCs, become less able to properly regulate a healthy, appropriate immune response, which leads to more inflammation.

Now remember, in the face of threats that prick up the immune system (which includes infections, physical injury, AND social threats and stressors), girls ALSO make more antibodies AND more rogue autoantibodies – again, because we have so much more estrogen.

This leads to a double whammy. It’s a simple equation:

A (Glucocorticoids stop regulating a proper immune response in face of #toxicstress)

+ B (Estrogen leads to production of more autoantibodies, which can attack the body itself)

= C (When girls face toxic stress, rogue autoantibodies can run amok, promoting slow-brew inflammation, and later disease)

This means that, over time, a woman’s immune system is a lot more likely to begin to attack her own body. This accounts for the fact that #autoimmunediseases strike women at three times the rate of men. For some illnesses that ratio is far higher. Examples. Women develop Hashimoto’s thyroiditis at a rate of 10:1 compared with men. In lupus, that rate is 9:1. In Sjögren’s syndrome, 9:1. #AutoimmuneDisease is one of the top ten leading causes of death in women under the age of sixty-five.

Fifty million Americans have an autoimmune disease, and three-quarters of these are women.

Women are also twice as likely as men to have chronic pain syndromes. Women with an ACE score of 3 are significantly more likely to have chronic pain syndromes including headaches, back and neck problems. Women are also more likely to have “contested conditions” – meaning the medical profession is still debating whether these autoimmune conditions are real or just psychosomatic — such as #chroniclyme, #chronicfatigue and #fibromyalgia.

A heightened inflammatory stress response also affects the architecture of the #femalebrain differently than the male brain. A girl’s brain, on adversity, is a vulnerable brain in unique ways. For instance, both boys and girls who grow up with #toxicstress demonstrate, on brain scans, fewer neural connections between the pre-frontal cortex (the decision-making center of the brain) and the hippocampus (an area of the brain that helps us to make sense of our emotions and experiences). But, in girls who grow up with #toxicstress and #ACEs, another area of neural connectivity is affected. It goes offline. Synaptic connections between an area of the brain known as the amygdala (the fear-and-alert center of the brain) and the pre-frontal cortex are also weakened.

This means that girls who experience #ACEs are more likely to grow up in a chronic state of hypervigilance. Fight or flight. Feeling that life is an emergency. This contributes to the fact that girls and women are more likely to suffer from anxiety and depression as adults than are men. Stats bear this out. One third of men with an #ACE Score of 4 later develop depression—already a high and disturbing figure—while nearly 60 percent of women with 4 #ACEs develop chronic depression in adulthood.

That means that the risk that growing up with #toxicstress and #adversechildhoodexperiences will lead to neuroinflammatory diseases such as depression and anxiety disorders is, as with autoimmune disease, TWICE AS HIGH for women as it is for men.

Physical inflammation is increasingly linked to mental health disorders. Cutting-edge research shows us that our body and brain’s immune responses function in tandem. (I’m writing more about that in my next book, out in 2019, so stay tuned for The Angel and the Assassin: The Tiny Cell That Changed the Course of Medicine. I think it’s the most important book I’ve ever written.)

Still, it can take years, sometimes decades, for toxic childhood stress to translate into symptoms, much less visible physical disease. A young girl can face a lot of chronic #toxicstress at the age of 12. BUT it may take 30 years or longer for the inflammation unleashed by that chronic adversity to progress to disease symptoms. At that late date, the link between a stressed little girl and the ill woman she’s become is invisible to the patient – and her physician.

This plays into why so many doctors miss autoimmune disease in women. Recent studies show that the average woman sees five doctors over four-and-a-half years before receiving a proper diagnosis—and nearly half of women are labeled and dismissed as “chronic complainers” in the early stages of their illness.

This means that women who’ve faced #femaleadversity and who also face #autoimmunedisease often get dismissed TWICE. From early on in life, they know if they meet up with any type of #femaleadversity  or CHILDHOOD TRAUMA– sexual harassment, date rape, sexism, abuse, at home, school or work — if they report it their version of events, what they say may very well be dismissed. Disbelieved. Their self-reports are very likely to be distrusted. Years later, in a doctor’s office, when they report their PHYSICAL #auatoimmune or #chronicpain symptoms, they get dismissed or disbelieved all over again.

The past repeats itself.

(Later this week, I’ll be adding more to this thread, in PART THREE.)

If this topic interests you personally, because it speaks to your experience, or because you work with, teach, mentor, or are parenting girls, or if you work in #ACEAwareness or #trauma prevention, sign up for my blog and newsletter now. If you haven’t yet signed up for my mailing list and/or my blog, you might want to now.

(To sign up for my mailing list and newsletter, click on the link below, and see the “Mailing List” subscription box to your right. To sign up for my blog, scroll down on the right hand side of my website’s blog page to “Never Miss a Blog Post and sign up there.)

You can also find me on Facebook or @DonnaJackNak on Twitter.

Female Adversity: The Female Body and Brain on Toxic Stress

Hi All,

Three things I wanted to let you know about: later this weekend I’ll be posting a three part essay about women, toxic stress, and the female immune system — and why this topic matters now more than ever (more on that below!); an update on my next book, The Angel and the Assassin; and upcoming speaking events!

One thing readers know about the work I do and the books I write, including Childhood Disrupted, The Autoimmune Epidemic, and The Last Best Cure, is that I focus on the intersection of neuroscience, immunology and emotion – while shining a spotlight on WOMEN’s experiences. Connecting these dots is always an underlying theme in my work. Women, girls, toxic stress, the female brain and immune system, autoimmune disease and chronic physical and mental illness — if you care about any of these, keep an eye out for my upcoming three-part blog series in which I delve into the scientific links between them all.

I’ve written this upcoming blog, and am offering it up freely, because I think it’s crucial that we address the unique way in which the female brain and immune system respond to environmental influences, including #ACEs, and how, in turn, this unique female brain-immune response contributes to girls being several times more likely to later develop autoimmune diseases, depression, anxiety disorders, and so many other chronic illnesses.

I’m going to break down for you, in a way no one else has, or will, how and WHY Adverse Childhood Experiences and toxic childhood stress are a #metoo issue of the greatest magnitude. For girls and for the adult women they become.

If you haven’t yet signed up for my mailing list and/or my blog, you might want to now. (To sign up for my mailing list and newsletter, see the “Mailing List” subscription box to your right. To sign up for my blog, scroll down on the right hand side of this page to “Never Miss a Blog Post and sign up!)

I’m calling this three-part exploration:

Growing Up With Female Adversity: The Female Body and Brain on Toxic Stress. In it, I’m offering up the term — and hashtag — #FemaleAdversity — to refer to the chronic societal stress girls face growing up. Girls not only come of age with higher rates of #AdverseChildhoodExperiences, including verbal, emotional, sexual and physical abuse, girls also have to find their way to a healthy adulthood and sense of self amidst cripplingly narrow societal expectations regarding what is acceptable female beauty and behavior. All this is intensified, 24/7, by images of effortless female perfection on social media and in media in general. Meanwhile, girls are witnessing the sexual harassment and sexism so many adult women endure. Over time, this #FemaleAdversity can take a toll on girls’ and women’s immune systems, bodies, and brains in unique ways.

So, in this series I’ll be delving into:

Part One: Why Girls Who Face #ToxicStress are More Vulnerable to Adult Illness: The Shocking Relationship Between Being Female, #ACEs, #AutoimmuneDisease and #Depression.

Part Two: Every Woman Was Once a Girl: Why We Need to Talk About the Biological Effects of #FemaleAdversity on Women’s Bodies and Brains.

Part Three: #FemaleAdversity is a Unique Form of #ToxicStress — One We Haven’t Been Paying Enough Attention To — And We’d Better Start Soon.

If this topic interests you personally, because it speaks to your experience, or because you work with, teach, mentor, or are parenting girls, or if you work in #ACEAwareness or #trauma prevention, sign up for my blog and newsletter now.

2. Here, too, is a very brief update about my next book THE ANGEL AND THE ASSASSIN: The Tiny Cell That Changed the Course of Medicine, and Gives us a Radically New Way of Looking at Human Well-Being, which will be out with Ballantine Books (Random House) in Fall 2019. I’m writing as fast as I can! And what I’m researching and reporting on is as promising for human health as it is mind-blowing. I’m happy to say, I’ve already turned in the first 200 pages.

In THE ANGEL AND THE ASSASSIN, I’m on a mission to de-stigmatize brain-related health challenges, and to show how chronic conditions like depression, anxiety, learning disabilities, mood disorders, memory issues, and Alzheimer’s all involve one tiny, overlooked (and all too often, overactive) brain immune cell called microglia, which functions as the “white blood cell of the brain.” These tiny glial cells are in constant dialogue with the body’s immune system, and can be all too easily triggered by physical or emotional trauma, toxic stress, environmental toxins, infections, and inflammation in the body itself. All of these can, in turn, cause microglia to become agitated and destroy brain synapses and circuitry, generating neuroinflammation — in much the same way that rogue immune cells in the body can generate a slow brew inflammatory process that leads to the body attacking itself, as in autoimmune disease.

This truly amazing discovery – and the new understanding that the brain is an immune organ, ruled by these little reactive immune cells called glia — is one of the most revolutionary discoveries in the history of science, and it’s changing everything, including leading to exciting new avenues for treating seemingly intractable life-altering disorders.

Once again, in  The Angel and the Assassin, as in all my books, I’ll be examining what this means specifically for women and girls, who suffer disproportionately from trauma, toxic stress, autoimmune disease, depression, and so many chronic illnesses. Stay tuned!

3. Finally, for those who are interested in knowing about my upcoming events, here are a few of the venues where I’ll be lecturing over the next few months. Both of these events offer CME and CPE Credits for professionals who want to be trauma-informed, learn about ACEs Science, and the latest science on resiliency.

Keynote, Rutgers University DIS[RU]PT TRAUMA Conference, Thursday, May 31st, 9 a.m. – 12:00. I’ll also be offering a break out workshop.

Golisano Children’s Hospital 16th Annual Pediatric Conference, Saturday June 9th, 1:30, at the Sanibel Harbour Marriott Resort & Spa.

Hope to see you at one of these events!

You can also find me on Facebook or @DonnaJackNak on Twitter.

Donna