Salus Health Care Forum July 2, 2025

Bill B

Let me bring in one of the concepts that came up earlier in one of our forums.  Peter Sterling brought in allostasis. That’s the fundamental process and how much that’s related to, in this case, the child’s prediction of the environment. As Peter was saying, the child’s,(and adult’s) physiology reacts not to the reality, but to the predicted reality. I was thinking back to what Craig was talking about in terms of family chaos. I want to dust off a concept offered by a fellow named Eric Erickson. He talks about the fundamental issue of trust. What we now know is that if one has found very little trust in childhood, somewhere in our 40s and the 50s, all this comes out to haunt us. So, if we think of allostasis, then what if the child cannot predict—or even more importantly, can’t trust the predictions of what’s happening to them, given the chaos. And what would be interesting, Craig, are results from the studies that aren’t going to be done for quite a while. Even later in life, in the 40s and 50s, do you find massive crises on the part of some people that comes from a fundamental lack of trust, and what Walt has talked about as love (or is predictive caring) that occurs very early in life? So there may really be a trigger here, an explosion, or a time bomb that doesn’t occur until much later in life.

Craig

I think one of the things that may be missing from the discussion is that these things happen early in life. They happen to kids, and kids who can’t trust, who are particularly reactive to the environment, have troubled childhoods. And that affects life course development. Yes, we are talking about things that may happen well into the 40s and 50s of a person’s life. However, it was done with adults, the ACE study left out the severe consequences for kids regarding all of the problems we’ve been talking about.

Bill B

We’ve been talk about trust and love, as Walt was saying, We have focused on individual relationships. What about communities? What about the sense of trust that’s a collective? Jack, in your study of rural health, are there families that by some criteria would be considered dysfunctional, at least amenable, or vulnerable to crises for the child. But somehow in those settings the child does all right.