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The most important thing I didn’t learn in medical school is about adverse childhood experiences, also known as ACEs. To be sure, if I had understood them then the way I do now, I would have been a better and more compassionate physician. Importantly, I would have avoided lots of mistakes. What kind of mistakes, you ask? I was pretty much a failure taking care of smokers, drinkers, drug addicts, and morbidly obese people. People who were chronically depressed or in chronic pain were not...

In a 2013 study, when low- and moderate-income families with children between the ages of 17 and 30 came to H&R Block to have their taxes done, a portion of the families were also offered the chance to have someone sit with them, on the spot, to fill out their application for federal student financial aid. Importantly, they weren’t just told or shown how to do it: The advisor actually guided them through completion of the form. With this single interaction, often lasting less than 10...

Childhood trauma isn’t like an old t-shirt. It’s not something that can be tossed aside or outgrown. A woman who grew up with her father’s substance abuse, her mother’s incarceration, and the resulting physical and emotional neglect is 12 times more likely to attempt suicide. She’s at three times the risk for heart disease and cancer. If she’s also ever suffered emotional, physical, or sexual abuse, her life expectancy will be 20 years shorter. Doctors can measure a patient’s ACE (Adverse...

Sarah Long doesn’t like to dwell on her childhood memories. They are fraught with secrets and traumas. Her abusers were family members who convinced Long never to share their secrets, she said, and who abused her physically, sexually and emotionally, beginning when she was a young child. The Wisconsin Rapids woman grew up believing the abuse was normal and her feelings of shame, discomfort and anxiety were wrong. For years, she held this abuse tight, never daring to tell her parents. [For...

There’s no way for a person living in the world to truly do no harm. Take the environment. Even if you only eat vegetables that you grow in your own garden and only travel to places you can bike or walk to, if you still use electricity, or throw away garbage, you’re still somewhat contributing to the forces behind climate change. And yet, people are still enticed by paths that promise purity. This is the diet that will keep your body “clean” and “toxin-free.” (Whatever is meant by “toxins.”)...

There’s a paradox at the core of Trumpism: Many of Donald Trump’s supporters place great trust in a man who regularly tells them to trust no one: not the “dishonest” media, not the “corrupt” politicians, not the “phony” experts, not his many “crooked” enemies. No one, that is, except Donald J. Trump himself. “Believe me,” Trump likes to say. But the paradox starts to make sense when you consider the findings of a report released this week by the communications marketing firm Edelman. For 17...

Artist Shepard Fairey's "Hope" poster is, perhaps, one of the defining images from the 2008 campaign to elect President Barack Obama. The image, as ubiquitous in 2008 as Donald Trump's red "Make America Great Again" caps were in 2016, inspired optimism for a world no longer defined by political party. Red and blue, the poster signaled a desire for our politicians to work together for a common good. The global recession had just begun, and it would take teamwork from individuals across the...

Every day in our clinic at St. Christopher’s Hospital for Children in North Philadelphia, I see upwards of 25 children, ranging from newborns to teens. I spend as much time as I can talking with parents about their infants' feeding patterns, their toddlers' development and their adolescents' maturing bodies. I try to provide helpful advice, appropriate medical care and positive assurances. But as I listen to the questions and concerns of the families I care for, I know that whatever we do,...

The International Initiative for Mental Health Leadership (IIMHL) is a virtual international collaborative which aims to strengthen leadership and thereby improve services for people with mental health or addiction issues. Eight countries belong to IIMHL: Australia, Canada, England, Ireland, New Zealand, Scotland, Sweden and the US. Countries’ pay a small amount to belong and in exchange there are regular communications on innovation, research and national work plus every 16 months a...

From the time two of my three sisters, my husband and I nudged our way into a very crowded Metro car (several passed through too packed for new riders) to the Women’s March on the National Mall in Washington, D.C., to the bus ride home in the late afternoon, we encountered no “disruptors” or angry protestors, only warm, convivial women and men expressing their particular view of the post-election world and the work that needs to be done. The children were charming and the babies didn’t cry.

There are two kinds of trauma. Both are devastating to your mind, body, and soul. The trauma everyone is familiar with is “hard trauma.” That would be a natural disaster, war, or personal injury, like a car accident. This type of trauma is almost always physical. “Soft trauma” is prolonged physiological or emotional abuse. All forms of abuse fall into this category (child abuse, sexual abuse, emotional abuse, narcissistic relationships, domestic abuse, etc.). The physical evidence of soft...

Okay, we’ve got it: Not “What’s wrong with you?” but “What happened to you?” That explosive outburst? The child who cannot concentrate at school? The domestic violence survivor who is in a constant state of hyper-vigilance? Yes, most of us in family services are now able to recognize trauma-symptoms and respond with empathy… most of the time. But what does it mean to be truly trauma-informed? For a start, it means that we have patience with others and ourselves as we seek to acquire the...