Profound Questions for the ACEs Movement from Dr. Anda and Colleagues

David Dooley and  Craig McEwen can't you both be right? Good parents living in extremely stressful situations of poverty, neglect, and other stressors are not able to be their best selves. Attacking poverty, neglect, and other stressors will be extremely helpful for those good parents. Damaged parenting can happen in any level of socio-economic status. I grew up with a father diagnosed with paranoid-schizophrenia and a mother who was told by psychiatrists in the 1950s that schizophrenia was the result of cold mothers and cold wives. My father was a PhD research scientist making plenty of money when he was working. After my mother finally escaped with her four children, we were on welfare until she could get a job as a secretary. Either way she had very little time to be a "good" parent to us whether there was money or we struggled. All four of us are Adult Children with various levels of dysfunction.

Why can't we address stressful environments AND clinically dysfunctional families? Breaking the stigma of mental illness and the causes of poverty can be addressed. It is not pie, doing one does not diminish the other. 

Good parenting is intergenerationally-transmitted, just as trauma is.   There are a lot of us whose intergenerational transmission wasn't optimal, so we struggle to know better practices.

ACEs are survivable if you have had warm empathic parenting (aka secure attachment).  You will have resilience and resources to deal with trauma.   

What inculcates warm empathic parenting is having received it as a baby, or having had a reparative attachment experience in older life where you feel seen, loved, accepted, and understood.    We have all seen examples of wonderful, kind parents and loved children in poor circumstances, as well as frosty brittle parents in affluent circumstances.

Thank you for this. I have been reflecting deeply since reading the article last week and asking myself the same thing - in what ways have I potentially contributed to the misuse by not emphasizing it as a population-level indicator but as something that is potentially indicative of an individual's risk. These are important questions to ask ourselves as we engage in this work. 

David it seems that you are treating the quality of parenting as a foundational trait that is not affected by outside factors. Quality of parenting is strongly affected by stress which is determined by a person's perception of safety and reliability that their basic needs will be met. In the utopia community, an ineffective or harmful parent will have less stress. They will also be in a great position to heal the accumulated stresses that affect their behavior and ability to learn. As a mental health counselor, it's much easier for me to help people heal from the effects of toxic or traumatic stress if they are in a relatively safe and secure place presently in their life. 

If an effective, positive parent is in a community where basic needs and safety are unreliable, they will eventually accumulate stress and become a lower quality parent. succeeding generations will be likely to continue to degrade if basic needs and safety are at risk.

This is a generality, based on my own assumptions, I know. I just thought I'd weigh in on the discussion.

"...income, food, housing, child care, and much more."

Here's a thought.

Consider a utopia where income, food, housing, and much more is available.  Now populate that utopia with parents who engage in parenting behaviors and practices generally recognized as disrupting the healthy development of children.  Wouldn't that utopia eventually descend into chaos?

Now consider our own far from perfect communties.  Populate them with parents who engage in parenting behaviors and practices generally recognized as supporting the healthy development of children.  I suspect the generations to come will make significant changes to improve our communities.  

Great question, David. But improving parenting means improving the resources that parents have available to them, including income, food, housing, child care and much more. Parenting does not happen in isolation. So supports from communities and through public policy can do much to affect the quality of parenting. Certainly, parenting education,  home visiting, and tools such as Vroom (see https://www.vroom.org/  can help build positive parenting skills. But diminishing the stress of under-resourced families should be a central concern of public policy. The question then is why are we as a nation so reluctant to do that?

Here's what baffles me. 

Most, if not all, of the ten original adverse childhood experiences are associated with unsupportive and harmful parenting.  This begs the question,

Why aren't we working furiously to figure out ways to improve the overall quality of parenting in communities?