The book opens by introducing the reader to young people who are growing up in Roseland—a Chicago slum. For these individuals, the question is not if there is trauma, but rather how toxically it has been dosed. All have experienced some combination of physical violence, sexual assault, absence of a parent by death, incarceration of a family member, extreme poverty, or early parentification. The students attend a high school that despite the efforts of well-respected and well-intentioned educators, including the current Secretary of Education, not just fails to educate students but also fails to protect them from violence within the school itself.
How Children Succeed does not just present suffering among the most impoverished American children. The foil to inner-city Chicago’s Fenger High is Riverdale Country Day, an exclusive New York City private school with tuition starting at over $35,000 annually. In this setting, it is not that children have been exposed to too much to overcome, but rather not enough. The community of parents and students has come to fear that anything short of perfection and any deviation from a predictable course spells certain doom. Tough effectively communicates the anxiety of these students because of their collective supposition that everything in life must be planned for.
Rather than being deflated by the degree of emotional suffering at both ends of the socioeconomic spectrum, the psychiatrist who reads this book will come away inspired by the group of pioneering people working to make things better. The group therapist will experience validation when beauty salon owner Ms Lanita Reed gathers impoverished teenage women for Sunday night dinner parties so they can talk about all of the chaos in their lives instead of violently acting out or making other self-destructive decisions. When Tough shows how Educator David Levin working with inner-city middle-schoolers and Principal Dominic Randolph of Riverdale Country Day are including cognitive-behavioral principles in their curricula and seeing observable improvements in outcomes across many academic and social domains, the psychotherapist will experience further affirmation about the craft. Biologically minded practitioners will enjoy the clarity with which the research concerning trauma and distortions of the HPA axis is presented.
Although the book primarily examines the interplay between psychology and its application in the educational setting, Tough does not ignore the importance of clinicians. “Clinicians can have a huge role” when mental illness interferes with a young person’s education (P. Tough, oral communication, October 3, 2012). Since the book presents compelling evidence on the importance of attachment, the author says “Psychiatrists and psychologists can work with parents and children to aid in healthy relationships” and gives an example of this within the text (P. Tough, oral communication, October 3, 2012). Furthermore, Tough realizes that when even the best efforts to protect children from trauma have failed, psychiatrists can “help remediate the effects.”
While David Brooks wrote that How Children Succeed is “essential” reading simply to be an informed citizen, it is even more essential that psychiatrists familiarize themselves with this work. If it is not essential because of the up-to-date evidence on child development it disseminates, it is essential because Tough demonstrates that application of our principal treatments offers the best hope for the education of our nation’s children.
