DQ - CH 12 - The Deepest Well

Discussion Questions

  1. In multiple situations, Diego took on the role of caregiver. Given what you know about toxic stress, what are the dangers of a child fulfilling that role?

  2. Respond to the following quote, specifically how it applies to you and your work: “We can’t erase Diego’s past trauma or build him a protective bubble to float through life in, but we can use what we know about his biology to mitigate the impacts of the toxic stress that will forever be a part of his world” (p. 205).

  3. What did you learn about Dr. Lister, and why was his story included in this chapter?

DQ - CH 11 - The Deepest Well

Discussion Questions

  1. How can a person’s understanding of their own ACE score be a tool for self-empowerment and advocacy?

  2. What was the relationship between the kids with the highest level of stress after 9/11 and their geographical location? What was surprising about this?

  3. What does the author mean by “stepping on the gas” and “releasing the brake” as we support learning for children?

  4. What are some of the “bear dens” near the kids you serve? What about near you?

DQ - CH 10 - The Deepest Well

Discussion Questions

  1. The author was surprised when she found fellow advocates (and sufferers) in a different social class. When have you been surprised in a similar way?

  2. \What are the two steps toward reducing toxic stress for a child (see p. 166)?

  3. Dr. Harris recommends 6 things to her patients (see p. 168). With each recommendation, rate yourself on a scale of 1-5 for how you did over this last week.

  4. What did you learn about oxytocin?

  5. Respond to the following: “ACEs and toxic stress thrive on secrecy and shame, both at the individual level and at the societal level. We can’t treat what we refuse to see” (p. 171).

DQ - CH 9 - The Deepest Well

Discussion Questions

  1. In the world of orphan care, who is your role model?

  2. What did you learn in this chapter about PKU testing?

  3. Do you ever, like Dr. Harris, walk out of your proverbial exam room, lay your head on the desk, and just cry?

  4. Many of Dr. Harris’ patients would tell her that their previous doctors didn’t know about the toxic stress in their lives because they hadn’t asked. What kinds of questions are important for you to ask about the people you serve? How can you find answers to those questions?

  5. Explain the analogy of how the brain is like a topiary bush.

DQ - CH8 - The Deepest Well

Discussion questions

  1. Is there a pattern in the histories of the people you serve? If you have seen it, does that pattern look similar to or different from the pattern observed in the people of Bayview?

  2. Do you ever feel - like the author, like Moses, like Peter - that when God put you in your role, He chose the wrong person for the job?

  3. What kinds of big dreams do you have for helping the kids you serve?

  4. Can you relate to the story of Sister J trying to get in the way of the progress being made in Bayview?

  5. The author believes that trauma becomes embedded in a community. Do you agree or disagree?

DQ - CH7 - The Deepest Well

Discussion Questions

  1. Take a few minutes to take the ACE survey for yourself.

  2. Does viewing the caregiver and child as a team lead you to realize that you need to invest in different ways than you are currently?

  3. Do the people you serve have a safe place to tell their story? Have you ever had the privilege to be the person they share their past with?

  4. What are a few of the ways that having a depressed mom affects an infant?

  5. Have you noticed any particular cues when a child you work with is trying to calm himself?

  6. What are some creative ways to incorporate exercise into the daily routine of a child who doesn’t want to be active?

  7. What are some thoughts on how to view meditation through the Christian lens?

DQ - CH6 - The Deepest Well

Discussion Questions

  1. In the story of Charlene and Nia, Dr. Harris doesn’t blame Charlene for her daughter’s failing health; instead, she tries to help them both. If you were in the doctor’s place, would you have felt the same compassion for Charlene?

  2. List some possible answers to the question, “How is it that ACEs are handed down so reliably from generation to generation?” (p. 79).

  3. Write a summary to what you learned in this chapter about “high-licker” and “low-licker” rats.

  4. Explain epigenetics in your own words.

  5. What hope do you see in the experiment in which the rat pups were switched at birth?

  6. In your own words, explain what telomeres are and how they are affected by toxic stress.

DQ - CH5 - The Deepest Well

Discussion Questions

  1. When pediatric patients needing vaccinations entered their fear brain, Dr. Harris took note of how their caregivers responded. When you see a child acting out of their fear brain, do you function as a buffer between them and stress?

  2. Does a better understanding of the observable effects of stress and trauma on the brain make a difference to you as you work in ministry?

  3. It takes time for communities to learn and understand new research. How do you see people in your community growing in their understanding of the negative effects of toxic stress?

  4. Respond to the following quote: “To treat the root of the problem I had to look at both stories my patients’ symptoms were telling me: the story on the surface and the story underneath” (p. 61).

  5. Choose 2 parts of the brain discussed in this chapter and explain how toxic stress affects them.

DQ - CH4 - The Deepest Well

Discussion Questions

  1. In your own words, explain what you can remember about how the stress response system is supposed to work (no need to use medical terminology).

  2. In your own words, explain what you remember about what happens when the stress response system becomes dysregulated.

  3. When is it a good thing for the stress response system to cut off access to the pre-frontal cortex? You can use the author’s example of the bear in the woods if it helps to have an example.

  4. What are some of the effects of cortisol?

  5. What does an activated stress response system do to the immune system?

  6. What are the key factors that shield children from the negative effects of adverse experiences?

DQ - CH3 - The Deepest Well

Discussion Questions

  1. Dr. Nadine Burke Harris writes in this chapter about finding a therapist to work with her medical patients. Initially, there was resistance from the community but after time they began to see the value in therapy. Have you seen a resistance to therapy in the children/individuals you serve? Has this changed over time?

  2. Dr. Felitti worked with obese patients and found a surprising number of cases of childhood sexual abuse. Can you relate these patients’ return to their coping mechanism (in their case, overeating) to anything you’ve seen with the people you serve?

  3. Dr. Felitti presented his research to groups of doctors, attempting to convince them about the connection between childhood abuse and obesity. His audiences were hesitant to believe him, to say the least. As you explain the link between behavior problems and childhood trauma, do you experience something similar?

  4. What did you learn from this chapter?

DQ - CH2 - The Deepest Well

Discussion Questions

  1. Based on Nadine’s work in the Hayes Lab, what did she learn about how and when can the stress response be adaptive?

  2. The author relates the community of Bayview to the stressful environment of the tadpoles. What are some of the stressers you know about in the environment where you serve?

  3. “If the stress-response system was indeed the mechanism at play...it meant that if we figured out the problem early enough in a child’s development, we could make a significant impact on his or her later life” (p. 26). How does this statement encourage you in your work? Give a specific example.

DQ - CH1 - The Deepest Well

Discussion Questions

  1. What is one thing you were made more aware of in this chapter of The Deepest Well?

  2. What does the author mean by the title of her chapter, “Something’s Just Not Right”?

  3. The title of this book is The Deepest Well. To what well is the author referring? How does she use this analogy to relate to the problems she encountered as a medical doctor?

  4. Based on what you’ve read so far, why does knowing the stories of the people we serve matter?

  5. At the end of the chapter (p. 14), the author describes her heartbreak as she thinks about the different paths that two babies will take, based solely on the circumstances they were born into. How have you struggled with similar thoughts/feelings as you work with people who have gone through very difficult things in life?