268: Rebuilding the Brain, with Dr. Anne Light

Ending Human Trafficking Podcast

Dr. Sandie Morgan is joined by Dr. Anne Light to discuss the ways we can rebuild the brain, including meditation, cognitive and behavioral therapy, and medications.

Dr. Anne Light

Dr. Anne Light, MD Dr. Anne Light is a pediatrician specializing in childhood trauma. She earned her MD from Harvard Medical School (2005) and completed residency training in pediatrics at Massachusetts General Hospital (2008) with a focus in trauma and emergency care. Until 2015 she worked as pediatric provider within the Massachusetts General/Partners system and led several multidisciplinary collaborations to improve patient care and trauma outcomes. In addition, from 2008-2011 Dr. Light served as the Executive Director of a nonprofit to optimize early learning in children aged zero to three. In 2015 she joined the Orange County Social Services Agency, where she serves as the Medical Director and is working to create interdisciplinary programs to support children and families. She is currently leading and developing the WE CAN Coalition: Working to End Child Abuse and Neglect. This group has more than 150 members from across Orange County organized into 9 task forces in order to improve the prevention, diagnosis, and treatment of maltreatment in children, families and communities.

Key Points

• ACE, adverse childhood events, studies have highlighted the effects of neglect on child development.
• Trauma can neurologically affect brain development in youth by putting more emphasis on the fight-flight-freeze response, and less emphasis on the development of stop, think, solve.
• The neuroplasticity of the brain allows individuals to continuously grow, no matter the age.
• Meditation can help rebalance the blood flow in your brain and allow underdeveloped regions grow.
• Two great therapies for trauma:
  • Trauma–Focused Cognitive Behavioral Therapy (TF-CBT)
  • Eye Movement Desensitization and Reprocessing (EMDR)

Resources

• WE CAN Coalition
• Neuroscience of Maltreatment, Dr. Annie Light — Ensure Justice Conference 2018
• Preventing and Addressing Child Trafficking Project

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Transcript

Dave [00:00:00] You’re listening to the Ending Human Trafficking podcast, this is episode number 268, Rebuilding the Brain, with Dr. Anne Light

Production Credits [00:00:09] Produced by Innovate Learning, maximizing human potential.

Dave [00:00:28] Welcome to the Ending Human Trafficking podcast. My name is Dave Stachowiak.

Sandie [00:00:33] And my name is Sandie Morgan.

Dave [00:00:36] And this is the show where we empower you to study the issues, be a voice, and make a difference in ending human trafficking. Sandie, I’m so glad for us to have today, again, another expert with us is going to help us to really think about things so proactively and to look at things from a standpoint of research and in today’s case, of course, a bit on health care and medicine. Please join me in welcoming Dr. Anne Light to the show today. She is a pediatrician specializing in childhood trauma. She earned her M.D. from Harvard Medical School and completed residency training in pediatrics at Massachusetts General Hospital with a focus in trauma and emergency care. Until 2015, she worked as a pediatric provider within the Massachusetts General Partner System and led several multidisciplinary collaborations to improve patient care and trauma outcomes. In addition, she served as the executive director of a nonprofit to optimize early learning in children aged zero to three. In 2015, she joined the Orange County Social Services Agency, where she serves as the medical director and is working to create interdisciplinary programs to support children and families. She is currently leading and developing the WE CAN Coalition: Working to End Child Abuse and Neglect. This group has more than 150 members from across Orange County organized into nine task forces in order to improve the prevention, diagnosis, and treatment of maltreatment in children, families, and communities. Annem we’re so glad to have you on the show today.

Anne [00:02:06] I’m thrilled to be here. Thank you.

Sandie [00:02:08] I remember when I first met you at the first meeting of the WE CAN Coalition and you had my heart at the very beginning because with a background in pediatric nursing, prevention is always my preference. So I’ve been so privileged to be able to be at least on the edges of what you’re doing here in Orange County, and I appreciate you so much.

Anne [00:02:36] Well, thank you, Sandie. I’ve been thrilled to have your partnership. You’ve done some amazing work and I’ve been privileged to be a part of it.

Sandie [00:02:43] So one of the things that absolutely–you were an Ensure Justice speaker that got so much response from our attendees–as you helped us understand trauma in the brain, especially for children. And I’ll put some links back to some of those presentations in our show notes. But today we get to talk about the other side of this and the hope that comes with this. So let’s start with a quick overview of ACEs. What are ACEs and why is it important?

Anne [00:03:25] Absolutely, great question. ACEs stand for adverse childhood events. When you look at the initial ACE study, it really was about maltreatment in children and by maltreatment, I mean abuse and neglect. So there was physical, emotional, and sexual abuse, physical and emotional neglect. And then there was this category called household dysfunction, which was severe mental illness and a parent incarceration. A mother who was treated violently. Substance use. Severe substance use by a parent. And in the initial study, they did look at divorce. I always caution folks about divorce because that initial study was done in 1985 with folks who were in their mid-60s. Was really asking about the divorce rates or the divorce events in the 1920s. And as you can imagine, if you got, if your parents got divorced in the late 1920s, early 1930s, the odds that there may have been mental illness, incarceration, violence, substance abuse in that family was a lot higher. So really, I think it’s those those core ACEs, and some have been added on since then, but those core ACEs are really about abuse and neglect in the family. We know from our studies in Orange County and nationally that more than 60% of families who are coming into the child welfare system struggle with mental illness and substance use. And so the odds that that household dysfunction is impacting the child with some form of neglect, I think is very high when you look at that brain development.

Sandie [00:04:55] There’s a huge intersection with that and children who are more vulnerable to being trafficked either for labor or for sex trafficking. So let’s start talking about the brain. I am every day, everything I read about the brain just inspires my imagination and fills me with hope. And we’re right here at the beginning of 2022, lots of people are discouraged, pandemic issues, mental health concerns for our kids. And so understanding this from an image perspective, you have shown us pictures and we are on an audio interview. So we’re going to have to write a word picture for people as they listen. And you’ve shown us pictures of a healthy brain and a brain that did not develop as it was designed and its shocking because of those empty spaces. Can you describe that for us and tell us what it means?

Anne [00:06:08] Yeah, absolutely. And I would actually back it up a step, Sandie, because I think it’s I think actually the brain is phenomenal. I adore it. I’m a total total geek. And I think actually the brain is designed to give you exactly the outcome you need or exactly the outcome it thinks you need. So when those brains are developing differently in the context of trauma, it’s not necessarily maladaptive during the trauma. Right? If you’re a young child growing up in a violent household, stopping to think deeply about complex intellectual problems is going to slow you down. What you need to be able to do is rapidly assess when you hear a footstep on the stair, be alert to it, assess it quickly, figure out if there’s imminent danger and get yourself out of that imminent danger. So in fact, as the brain is growing, it is building structures and it’s building structures that it thinks are going to help you. And in fact, they do in the moment. It’s just that once you’re outside of that dangerous home environment, we wish that you had a little bit more development in some of those other, more cognitive stop, think, solve areas. So so basically, what’s happening again is, you know, the brain is fantastic. It’s really very plastic. And so when you’re born, it’s really pretty rudimentary and it’s over the course of your life that you grow these neurons and connect them, and it really happens in response to your experiences. We know from looking at your Romanian orphans who were kind of put into a room and not given a lot of interaction that if you don’t interact with the child, they will not develop these brain connections, right? It’s not an automatic development that goes off track in maltreated children. It’s actually a development that we nurture in healthy children. And some of these neglected children are not getting that nurturing or, again with violence, their brains are gearing more towards a figh-or-flight response and getting really, really good at that to protect them from danger. So what we see when we look at brain scans is actually pretty dramatic. What you see on normal, what we call normal or healthy development is that in response to stress, there’s a lot of activation in the frontal lobe. I’d like people as they’re listening to put their hand up, put your right hand up, curl your thumb in and wrap your fingers around it exactly as you would not want to throw a punch, right thumb on the inside, fingers on the outside, sort of in a fist like structure, that thumb is going to be the amygdala, the deep brain structures. And its response is really about fight, flight, or freezing, and freezing is a big one in individuals who’ve been trafficked or maltreated. And then on the outside those four areas of the brain, your four fingers are going to correlate to speak, solve, stop, and socialize. And if you if you kind of imagine speak, stop, solve, socialize for each finger and the fight on the inside, you really get a general picture of what the brain is doing. And so in cases where children are given a loving and nurturing home that’s safe and protected, those speak, solve, stop, socialize areas become very robust. And the fifth is very tight, so they wrap around that fight or flight. And when emotional triggers hit the child, they’re able to rationalize their way through it and calm that amygdala. Calm down that fight-flight-freeze response. In children who are maltreated, what we see is that the amygdala, that fight-flight was very, very large. And in fact, the neurons in the frontal lobes, which is that speak, solve, stop, socialize the fingers, those die off. So it’s almost as though your thumb is very swollen and your fingers are coming out and spread and becoming very spindly. And without the connectivity, without that closed fist, the brain can’t communicate back and forth. So even if you’re able to try to think through your predicament, you can’t biologically affect the amygdala, which means you can’t biologically slow your heart rate. You can’t slow your respiratory rate. You can’t control the dilation of your eyeballs. With a healthy, robust system, the feedback from those frontal lobes can calm the amygdala again, biologically decreasing some of the steroid secretion. But in a in a maltreated child who’s had brain development that really prioritizes that fight-or-flight response, they’re unable to put the brakes on once the emotional response gets started, and again, that’s biologically not necessarily in terms of how they’re interacting with others.

Sandie [00:10:34] And that reminds me so often of stories I’ve seen, even media representations of kids acting out and someone yelling at them, What were you thinking? And I think, what you’re saying is they aren’t able biologically to get to that thinking part of your brain.

Anne [00:10:58] Exactly. And I think that, you know, it’s all it’s all relative. I think we want to be clear that people do have agency, but I just think that what they’re working with is more limited. And so it’s a lot harder if you don’t have as much in the way of frontal lobe development and you have a lot more amygdala development, it’s going to be a lot harder to de-escalate when you become anxious, when you become stressful, when you become overwhelmed. And I do want to be clear, that happens to all of us actually, Sandie. So it’s it’s interesting, there’s something called amygdala hijack, where again, the amygdala gets triggered and it actually does burst the blood flow away from your frontal lobe. So it does this not to stop you from thinking, but because it’s decided if there is a tiger coming at you, right? Thinking isn’t going to help, what’s going to help is running away or going up a tree. And so what it’s doing is trying to pull the blood flow away from the front of your brain and send it to your heart, your lungs, your large skeletal muscles, your circulatory system so that you can react very quickly. But again, what that means is that you’re not sending as much blood flow to the frontal lobes. It’s harder for those frontal lobes to actually get the oxygen and the glucose to function as best they can. And you know, I have done talks with thousands of professionals, and when we were in person back in the day, I used to say, you know, raise your hand if you’ve had a bad day. Now raise your hand if you’ve made a bad choice on that bad day. Not something huge, but you had an extra slice of cake because you were stressed, you snapped at a loved one, right? You excuse yourself early from something, so like, I just can’t handle this, I got to go. Those little things, almost everybody’s done them. We almost all have a time when stress causes our amygdala to really secrete a lot of steroid hormones. And when that cortisol is high, we want to eat an extra piece of chocolate cake, we want to have an extra drink of alcohol. And in fact, it’s a very human reaction to do so. So I think it affects all of us. It’s just individuals who’ve been in a traumatic situation, and it’s not just children with maltreatment. My very best friend’s husband is in the military and was with the 101st Airborne for a long time. You know, any sort of traumatic situation is valuable to retrain yourself to really hone those fight-or-flight and decrease the stop, think, solve. And then the challenge is as you change your environment, how do you change your brain functioning? How do you change your reaction? The brain, while plastic, doesn’t change quite that fast, and I think that’s where you end up in trouble.

Sandie [00:13:25] Well, and a long time ago, actually not that long ago, we thought we were sort of stuck with what we have. And so we felt bad for, like some of my young people that I work with who did come from those situations where they saw violence against their mothers and all other kinds of forms of neglect and maltreatment, that now we had to help them accommodate to their trauma and PTSD. But there’s new science about brain plasticity, and I’d like to have kind of an update on how the brain recovers.

Anne [00:14:06] Absolutely. I think that’s a great, a great point. And you know, I often when I do this slide, I sort of ask people, you know what percentage of folks who have, let’s say, an ACE score of six or seven who’ve seen a lot of this maltreatment, be it neglect or abuse, or a lot of problems in the family. What are the statistical odds that their brain has been impacted? And in fact, it’s very, very high. It’s like 998 out of a thousand, right? So almost 100 percent, which is pretty crazy. Now that could be a speech delay, doesn’t have to be something that is is necessarily emotional, but oftentimes it is. And yet, with those high ACE scores, people can go on to have incredibly fulfilling lives. So I want to be really clear that this ACE score is not destiny, that the brain changes are not destiny. The brain is designed to help you. And just as, you know, my best friend’s husband who went to Afghanistan and I guess he was like twenty five had some dramatic brain changes within Afghanistan. He can come back and rewire on the back end, and it’s interesting. We always sort of expect that of veterans that they can wire and rewire. We tend not to expect that of children. And I do think you’re right, Sandie. There was this old school thought when I went to medical school, at least, that you grow up, you get you get a brain that fully grows till you’re about twenty five and then that’s it. And from there on, you just shrivel into oblivion. But thankfully, that is not the case at all. The brain, like everything else, is growing and developing your whole life, right? Those neurons are changing over. Within our whole body, we get about one billion, with a B, one billion cells per hour.

Sandie [00:15:41] Wait, wait, wait, wait. I don’t want somebody who’s driving to miss two things in here. Thats B with a billion every hour. Not once a month. Every hour. Oh my gosh. OK, go ahead. Because that is like, I want that to be a headline somewhere.

Anne [00:16:00] Yes. And in fact, you know, as it turns out, in the brain, although there are a lot of cells, it’s really about where they go. There are small regions in the brain that if you can dramatically increase the neuron density there and activity there, you can start to control that amygdala function. Calm it down. You can have huge impacts on how you feel. Again, I want to be really clear that that that folks who’ve been through maltreatment, it’s not just a social change there. Biologic changes, right? You can measure their stress hormones and they’re very high in response to very small stresses. And so any of us with that, with that size amygdala, with that kind of flooding of cortisol in our system would want to lash out or be angry. Perhaps, you know, seek something like substances or food to try to calm the the high level of cortisol in our system. And so I think understanding that there are areas particularly you can build up that will help to rebalance the brain can be really helpful in terms of seeing that optimism right and that there’s absolutely a way to use the brain plasticity to your advantage. You’re never done. You can always keep growing.

Sandie [00:17:14] So this is kind of if I try to imagine going to the gym and having a personal trainer so that I can strengthen parts of my body. This is the same idea of they will go where you use them. So how do I strengthen those weak areas and integrate them more with my amygdala and other brain structures?

Anne [00:17:44] Great question. You know, I would actually back it up a step, Sandie. I would say the first step is to start to rebalance the blood flow in your brain. Why do I say that? Well, there’s sort of two parts. Rebalancing the blood flow and getting something called brain derived neurotrophic factor. OK, so blood flow is pretty simple. Imagine you have a garden, right? And you want to grow tomatoes or thats a hard one to grow from seed, you want to grow kale. OK? And you don’t want to grow weeds, so you need to put the kale in the ground. And again, we’re already getting the the cells every hour. You know what we do with them remains to be seen, but they’re being seeded, the grounds being seeded. What you want to do is make sure those things grow, so you’ve got to water them, right? You got to prepare the soil and you’ve got to water them. And if you’re really feeling generous, maybe you put in a little bit of compost fertilizer Miracle-Gro. Okay. So it turns out that the blood flow is like the water, right? It brings the oxygen, it brings the glucose and brings the complex molecules that these cells need to grow and flourish, OK? And so as I mentioned, when you have very strong amygdala development, you can over time get less blood flow in those frontal regions of the brain and more blood flow preferentially going to the amygdala. And that’s going to be a problem because it means as you make new neurons in every part of your brain, right? The ones in the amygdala are going to stick around and grow almost like you’re you’re watering the weedy part of your yard. Instead of watering that that little kale plant you want to grow. What you want to do is shift the blood flow or shift watering to the frontal lobes. And so one of the most powerful ways to do that is actually meditation. I get a lot of questions about meditation. I kind of study it from a neurological perspective, so I don’t have a feeling about what type is best. It should feel kind of hard. It should feel like being constantly distracted and pulling yourself back to focusing on the moment. And if you’re doing that, that act of focusing is actually the act of kind of pulling yourself towards an area of your brain that focuses on redirection and awareness. And that is the area you really want to have seeing that increased blood flow kind of water or prime healthy neuron growth and development in those frontal lobes.

Sandie [00:20:00] I have been working on some of those mindfulness meditation strategies, and you are so right. I get so easily distracted, but you’re encouraging me that that’s like turning on the water faucet for the good veggies.

Anne [00:20:19] It is. And it’s and it should be. I mean, honestly, Sandie if you, you know, if you’re the kind of person that can pay attention beautifully in the moment. That’s fantastic for you. But it is much, much, much, much better to sit for five minutes, let’s say, and be constantly frustrated that you’re distracted, but recognize your distracted and bring your brain back. Each of those moments of recognition, awareness, and redirection is like a bicep curl for that frontal area of your brain that can control the amygdala. And what you’re really doing is not necessarily enjoying the meditation, because I will tell you, I personally don’t enjoy meditation. I do it, I don’t enjoy it. But what you’re doing is a bicep curl, right? It’s just like, I don’t necessarily love going to the gym and lifting weights, or now that I’m at home with the pandemic doing push ups, I don’t love doing pushups. What I like is when my daughter says, Pick me up, mom, I can toss her in the air, right? That’s why I’m doing it. And so I think for the brain, it’s the same way. You don’t have to love meditation. You have to see it as an exercise that’s going to build that frontal lobe so that when you hit a stressful situation, you can actually take a deep breath, redirect and decrease the amount of cortisol your body secretes in response to a stress. And you can see this in controlled trials, right? There’s this great trial where they take people, and for 30 hours over four days, they put them in one of two groups. One group gets stuck in a lecture hall, learning about how great meditation is. The other group actually meditates, okay. So you’re only talking four days, 30 hours. They do a stress test at the beginning and a stress test at the end, and it’s very simple. It’s something like, Oh, here’s a bunch of puzzles to solve. Each one should take you about two minutes. They’re really easy. Well, they’re unsolvable problems, right? So it’s not a horrible stressor, but it’s enough for people to get a little anxious, especially if there are other folks in the room pretending to get the answer right? Right. This is part of the stress. So what they find is that everyone has sort of more or less the same baseline of stress. But after you’ve gone through those four days of meditation, the amount of cortisol you secrete, right, so the measurable amount of stress hormone in your saliva is going to be about, it’s hard to quantify, but let’s say 30 times less than it is in the folks who just learned about how great meditation is. So again, the benefit isn’t in the meditation itself. The benefit is in changing your brain to be less reactive so that when stress hit, you don’t feel the need to go face down in the chocolate cake, right? You don’t feel the need to have an extra glass of wine to get through dinner with your in-laws. You have those tools in your holster to kind of calm your body, even in times of external stress. You don’t get as stress as fast and you respond a lot more quickly to kind of that talking yourself through the process, right? Because we are all going to encounter stressors. That’s just part of life. And so to the degree we can respond, I think we really set ourselves up for success.

Sandie [00:23:13] OK, so rebuilding the brain after trauma? Are there some best practices? We we listen to people starting nonprofits wanting to help abused children, human trafficking victims. What are some best practices for recovery from that kind of trauma? And does it also take advantage of this one billion new cells every hour?

Anne [00:23:43] Absolutely. In fact, there great studies that show the, most out of the Department of Defense, that show that just like if you go to the gym, you’re going to have to work at it for eight to 12 weeks before you start to see the muscles change and then you’re going to see functionality a little later. They have shown that when you’re doing therapy, your brain changes first and then you feel the benefit thereafter. So to a certain degree, and we don’t do it every day because it’s thousands of dollars per person to run one of these scans, you can actually do scans. You start to see changes in the brain before the participants really starts to see the positive behavioral outcomes, right. So you might feel the distress you might have, let’s say night terrors are horrible nightmares, right? Those brain changes happen before your nightmares start to decrease. And so it’s really those brain changes that are going to control and help assist you in healing. So there are a couple of different ways to do it. The two best therapies are trauma focused cognitive behavioral therapy and eye movement desensitization and reprocessing. Without going into too much of the nitty gritty of each, and Sandie, if you want me to go into the nitty gritty, just back me up. Each of them is really focused again, if we put our our right hand up, we curl our thumb in, we roll our fingers on top. Both are really focused on counteracting the effects of trauma. So really not nourishing the amygdala, letting it kind of fall back to a smaller baseline and really strengthening those fingers. So stop, speak, solve, socialize and tightening them around the amygdala so there can start to be a connection between the two and you can start to feel emotional, but but actually be able to continue to get blood flow to the frontal lobes and start to intellectually work through some of the problems as opposed to existing in the state of amygdala hijack, right, where you’re so flooded with emotion, it’s really hard to think concretely and logically about what’s in front of you.

Sandie [00:25:48] OK, so we’ll put a link in the show notes to some resources on trauma focused CBT. What about EMDR?

Anne [00:25:58] So EMDR? Oh, and let me just go back to trauma focused cognitive behavioral therapy. You know, the thing that I love most about that is, again, it’s a short term rewiring. But what they have shown with randomized controlled trial is that not only the kids get better, more quickly and more completely than controls, but the benefits last at least two years. So two years is as long as they followed it out. They didn’t have funding to do more than that. But again, if the therapy is a couple of months and the benefits two plus years to me that suggest they successfully rewired that, that brain with the therapy. Now eye movement desensitization and reprocessing is fascinating. The first time I heard about this was right when it was starting, and I said, What, are you crazy? It turns out it’s really doing the same things in the brain but what’s amazing about it is it doesn’t necessarily require the participants to describe in detail their experiences to the therapist, and that can be really helpful for someone who’s had really overwhelming trauma. It may be really hard to talk about it. Talking about it may trigger a lot. And so one of the things you can do is the therapist can engage the client and basically, you’re actually sort of following the therapist finger with your with your eyes as it goes back and forth like a metronome or the pendulum honor and an old fashioned clock. And that sounds like, well, how is that helping me? But it’s actually you’re engaging all those frontal lobe areas and also your occipital lobe where your vision is based to track that finger, moving back and forth to predict where it’s going to go, and forcing yourself to stay on track with the eye movement while the amygdala is active, again its going to force some blood flow into those frontal lobes. It’s going to change the dynamic of how the amygdala is regulating the frontal lobe blood flow, and over time, you build in more and more detail and questions and you can go a little deeper. But it’s a great way, again, we put our hand up to really shrink that thumb and tighten those fingers around. And that’s and that’s really the goal of all neurologic rewiring after trauma, whether it be childhood trauma or a PTSD from another experience.

Sandie [00:28:10] Wow. Dr. Anne Light. It is always encouraging for me to have conversations with you, and I’m going to be more intentional about inviting you back for more conversation on rebuilding the brain and how we can be very proactive in the lives of our children in our community from a prevention perspective, as well as our expectations for the future for our kids.

Anne [00:28:40] I love it. Thank you so much for having me, Sandie. It’s always a privilege. I always have so much fun talking with you. And we cover such great stuff. I love it.

Dave [00:28:49] Thank you so much, Anne and Sandie, for this conversation. Sandie, this is usually the time in the show where we talk about the resources that are going to be on the show notes, and of course they are. So if you go over to endinghumantrafficking.org, you’ll find all the resources there, not only for this episode, but every episode. And in addition to that, it’s the new year and we have something new to share with all of you that we’re beginning this year. And before we do Sandie, maybe you might give us a little bit of background on what’s leading to this new announcement.

Sandie [00:29:24] Dave, I am so honored and humbled by the people that listen to this podcast. Our goal is for people to study the issues, be a voice, and make a difference. And we started out over ten years ago, and now we’ve grown to where we have listeners in 148 countries. We’re in the U.S. Library of Congress. We have the opportunity to offer free education in places where we never dreamed we would ever be present. So as we’ve thought about that, about sustainability, how do we make sure we can maintain the quality and the long term availability? How can we expand to meet increasing numbers of questions and requests for resources? And how do we support more resources for people? And that’s where we found ourselves as we were ready for 2022.

Dave [00:30:38] Indeed, and we are pleased to announce a new opportunity that we have starting this year. We’re bringing a new way for you to actually support the work of the Ending Human Trafficking podcast and of course, the work of Sandie and her team at the Global Center for Women and Justice here at Vanguard University. We are expanding our community of advocates and we’re inviting you to become a patron. And the way you can do that is actually through a program that many of you are familiar with called Patreon. Patreon is a wonderful service that helps fans and supporters support the work of those who are doing creative work in the world and getting the message out there. And Sandie and I have begun work to actually set up really a supporting process through Patreon so you can get access to new content on the show. Early access to some of the Ending Human Trafficking podcast episodes. Some bonus episodes. And some exclusive resources and toolkits that will be available here in the future. Plus, in addition to that, it’s a great way to continue to support the work that we’ve been doing through the Ending Human Trafficking podcast and the Global Center for Women in Justice. And I should mention here that we’re not changing anything about what we’re already doing. All of the work we’re already doing with the podcast will still be available freely. We’re going to continue to work on airing episodes as we have for the last 10 years. This is for those who would like to support us in a more substantial way. Just in addition to all the things that we’re already doing, it’s pretty simple and affordable. You can become a patron for only $5 a month and get access to all the ending human trafficking patron benefits. And the easiest way to get information is to go over to endinghumantrafficking.org. You will see a link on the website to Patreon, and that will get you an opportunity to go in, see all the details and actually an invitation to join us as a patron. For those of you who may support others on Patreon already, you can go over to Patreon and also search for Ending Human Trafficking and you’ll see all the options there as well. And Sandie, we’re really excited to begin this, to continue to support our work, to continue to support the content creation. I should also mention Sandie, you know, you have been supported for years through your salary at Vanguard University through the center. I have been volunteering my time and will continue to do so for the last 10 years to support the show. So this isn’t coming to us directly. It’s really to continue to invest in the programing, the work, the content creation of the work Sandie has been doing and her team all this time. And I’m really excited to see what happens with this Sandie. So thank you so much to you and the entire team for doing the work to begin to put this together and a huge thank you in advance for those of you who decide to support us through Patreon. And even if you don’t, thank you for all that you have done to support us and passing along the show. We are grateful for however you’ve supported us and Sandie. It’s really an exciting thing to start, isn’t it?

Sandie [00:33:49] I am totally excited. I am grateful to all of our listeners, and I am especially grateful to the team you keep mentioning, Dave. We cannot do this alone. And we appreciate all of the people that come on the show to give us interviews and to spread this knowledge hub with others and share these resources so that together we can all be part of ending human trafficking.

Dave [00:34:21] And that’s the place to go if you’d like to find out, of course, more the notes and resources from our conversation today with Anne and or if you’d like to look into supporting us through Patreon as a patron. Go over to endinghumantrafficking.org. You’ll see all of the details there. And as always, we will be back in two weeks for our next conversation. Sandie always a pleasure. Have a great day.

Sandie [00:34:45] Thanks.

Dave [00:34:46] Take care, everyone.