Toxic Stress: Fran Cronin
Draft 2: 3/22

Our flight from Moscow back to the U.S. during the summer of 1998 was long, hurtling for over nine hours across the Arctic Circle at a pressurized altitude of 35,000 feet. Like most direct flights between New York and Moscow during the years after the breakup of the Soviet Union, the passengers on the plane were voluble and restless, the background noise a chronic din of Russian and English mashed together. The seats crowded with assorted American tourists, some hard drinking Russians and their families, rows of Russian and American businessmen, and some - like my husband, daughter, and me - were families returning to the United States with an adopted child.

Just one week before we had flown an hour south from our home in Moscow to Saratov, a congested port city along a wide expanse of the Volga River. It was the middle of July and Saratov was bleached a hot white from sun reflecting off its broad water way. We had been waiting three months to make this trip. Our five-month old son, Nick, was being readied for his adoption inside the hospital where he had lived since birth, a modest single-story brick rectangle. The long corridors and small rooms darkened and kept cool by the habit of keeping unnecessary lights off. Officious hands were swaddling him, mummy style, in a brightly patterned yellow cotton cloth.

When we arrived, Nick was placed in our arms and we left, the over-sized wooden doors closing heavilly behind us. In our waiting car was a change of clothes and a ready bottle.

As we flew back to Washington D.C. with our three-year old daughter sleeping quietly, and our new son by our side, my husband and I felt complete. But we also wondered about our new baby. Despite the novelty of us, our smells and unfamiliar language, the sensation of flying, and the constant barrage of sound and light on the plane, Nick remained passive the entire flight home. He didn’t smile and he never cried. When I kissed the downy blonde hair on his head, his scalp smelled like something that had been singed, as if the internal workings of his brain were smoldering.

Nick had just turned five months, unusually young for a Russian adoptee. If my own personal survey is any indication, he remains the youngest child I know to have been adopted from Russia. Legal requirements and political posturing did then, and still do, corral children into overly long stays in institutional care. Oblast, or regional law, in 1998, required newborns to be placed on a four-month waiting list before they could be available for an international adoption. Today, the wait time is eight months. Need to verify this. But most Russians felt culturally disinclined to adopt from outside their families. A Communist hangover also contributed to the wait and see attitude. Children abandoned to state care were tested at three years to determine their intelligence and aptitude. The more poorly a child tested, the less the state would allocate to house and educate that child. With a notorious lack of resources and vested caring, children languished, months then years, eventually sinking into listless despair and poor health.

The circulating estimate in 1998 for the number of children institutionalized in Russian care ranged between 500,000 and a million. [this needs to be verified]. The number of Immigrant Visas issued to Russian orphans coming to the United States was almost 4500. The Evan B. Donaldson Adoption Institute reports these adoptions were almost one-third of all U.S. international adoptions My husband, surveying the circle of friends we had in Moscow at that time, said, “We are living in the land of adoption.”

*Not sure of the following will stay here

Letter of Relinquishment

I relinquish my male child out of wedlock...I renounce my parental rights regarding the child forever. I will not have any gradge against his prospective adoptive parents...My mother does not want the child.


Entry No. 245 on 02.24.1998

The data on the child’s father has never been confirmed by any official documents and has been indicated according to a verbal statement of of the mother c/o I.M. Klimova, a staff member of the Maternity Hospital.

Director of the Registry Department, L.S. Doroshenko


Date: 07.13.98

During the child’s stay in the hospital since 02.24.98 till 07.08.98 neither his parents nor his relatives have ever visited the child or taken any interest in him. The child was proposed as a candidate for adoption to RF citizens but failed to be adopted by any Russian family.

Head of the Medical Institution, L.D. Lavrenchuk

I, Rybchinskaya Galina, certify that I am familiar with the Russian and English languages, and that I have translated [these] documents faithfully and accurately.


At Harvard, Jack Shonkoff, founding director in 2006 of the university-wide Center on the Developing Child , has become the go-to-guy when it comes to early childhood development, particularly with children who have experienced early trauma and abuse. The trauma, which Shonkoff likens to the effects of PTSD, could occur envitro, if the mother was stressed from chronic malnutrition or abuse, or post-natally, due to the deprivations of institutional care such as in Russia or the orphanages of Romania. Children placed in foster care, who experienced abuse or exposure to abuse, Shonkoff says, can manifest the same disregulated and maladaptive traits.

Since graduating from New York University School of Medicine in 1972, Shonkoff has been making a name for himself in the neuroscience of early adaptive behavior. The prestigious academic handles that follow Shonkoff's name like a comet trail, leave little doubt as to the ferocity of thinking he has been developing. For Shonkoff - who wears an impish grin like a cat about to fess up a mouse and has short gray hair he's barely tamed - it’s all about the science.

In a forum convened this past February by Harvard’s School of Public Health in Cambridge, Mass., Shonkoff sat on a distinguished panel with Robert Block, President, of the American Academy of Pediatrics, and Roberto Rodriguez, a Special Assistant to the President for Education Policy, who was beamed in remotely on a screen from his office in Washington, D.C. The moderator opened the forum with the question “What is toxic stress?” Shonkoff was in his element. He himself had coined the phrase “toxic stress” to telegraph the complex panoply of emotional and neurological fallout that resulted from early and debilitating chronic trauma.

Sitting on a simple frame chair on small stage barely large enough to contain the panelists, Shonkoof looked out over the stolid crowd of academics. “We’re at a tipping point,” Shonkoff says, “in the development of this biological revolution we are living through in science...We are beginning to understand - in a way we never did before -how early experience literally gets into the body and effects the development of the brain, effects the development of the cardiovascular system, the immune system, metabolic systems, and provides new insights, new opportunities to ask the question: What is it about hardship that leads to more illness, that leads to more problems in learning, more problems in decreased economic productivity, and a shorter life span?”

Diary Entry - March 3, 2003 - 11:48pm

Good day. Bad night. N and I got into a terrible multi-stage escalating brawl. How can such anger and fury be generated between me and my 5-year old? Tried to take him up to his room after several bouts of spit-fire. Wouldn’t budge. Hung onto the banister for dear life. Tried to pry his fingers off. Instead we tumbled backwards; he in my arms against my body. I could feel myself start to free-fall back. Terror...panic. Somehow I managed to keep myself upright. Released him; shaking.

Stood in the dark several minutes with my face in my hands. Didn’t know what else to do.

Diary entry - March 19, 2003 - 12:41am

Tired..so tired...N had a meltdown over a tongue depressor he found in the parking garage. Cried almost until we picked D up form school. At home, the 2 started on each other. N karate chopping. D eventually started to cry. Starts silly; ends badly. Probably N’s new medication today? Funny how I initially resisted the medication and now I want anything that will make our situation better. Hard times seem worse. Is it by comparison?

Diary entry - March 30, 2003 - 1:12am

D & N cuddled up together in N’s bed. D got into his bed. Very precious. First time, I think? I’ll leave them. I think it’s good or them to feel peaceful together. We’ve had such a roller coaster all week.

Scene: Andy Garner: expl of physiologcal changes due to toxic stress

Scene: Some history in neuroscience: Ed Tronick, “Still Face video

Stephanie Shelley welcomes me into her uncluttered third floor office, in Somerville, Mass., a modest sunny spot that is far removed from the wide avenue of traffic below. At 63, Shelley is athletically trim and animated; her energy and presentation well suited to the demands of her therapy practice. During the past 20 years, Shelley has worked with over 400 children and families suffering from what she describes as complex trauma and attachment issues. Issues Shonkoff would say, result directly from toxic stress. She is also the only Dyadic Developmental Therapist in the greater Boston area.

DDP, as it is known, was first introduced into the therapeutic canon in 1991 by Dan Hughes, then a recent Ph.D. graduate in clinical psychology from Ohio University. He had moved to Maine and begun to work with a population of domestically traumatized children. Hughes soon realized his training hadn't taught him how to treat these kids. He couldn’t get through to them. They were remote and manifesting serious psychological problems. Scouring through research findings, Hughes started to incorporate new therapies he found circulating to help treat kids with attachment and trauma issues. Like a clinical quilt, Hughes started to stitch together what he found worked, and began to develop his own novel attachment-focused treatment. He knew these kids wouldn’t heal through talking. They had no language to describe what they felt. They had to be taught to feel and trust what they their environment had denied them. The only path to healing, Hughes determined, was through a trusted guide, a loving adult, who could nurture them back into accepting safety and security.

Using this relational model, Hughes placed kids in supportive foster or adoptive homes with coached parenting. Slowly, these children started to engage. Like turtles poking out from under their shells, Hughes watched these kids emerge from remote distrust, to tentativeness, to a trusting relationship. The enormity of this phenomenon was not lost on Hughes. To help these kids overcome their trauma and deeply internalized fears, he started to spread the gospel of DDP.

When Shelley met Hughes in Maine the summer of 1999, it was her “aha” moment. “I walked through a door,” she said, “looking through new lenses.” what else here?

Scene: exposition, transition?

Scene: Jan 25, northern GA, out in the field with Nick, transitioning from wilderness program to new therapeutic school

Closing reflection?