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PACEs in Nursing

We’ve changed our name to PACEs Connection! 

 

The big change!

We have some very exciting news! As of today, ACEs Connection is now PACEs Connection. PACEs stands for Positive and Adverse Childhood Experiences.

Before I explain why we made that change, rest assured that while the look of the home page and the network is different, the way you use PACEs Connection remains the same. It’ll work the same way it always has.

Behind the scenes today and tomorrow (March 16 and 17, 2021), our team is diligently making the changes necessary for this transition. They began by changing our web address from www.acesconnection.com to www.pacesconnection.com. They also made sure that your bookmarks and links to any pages on ACEs Connection are automatically redirecting to the correct new web address.

The home page and the pages that link from the home page are changing today, as are the home pages of some of our larger sites, such as Parenting with PACEs, PACEs and Education, PACEs and Pediatrics. No information will be removed or altered, except to change ACEs to PACEs where appropriate, and to include additional information about positive childhood experiences.

PACEs Connection comprises more than 400 communities, so please be patient as we work with community managers to update the information on each community site. That will take at least a month, perhaps longer. On social media, you can find us now @PACEsConnection.

We may experience brief periods of downtime as the system works through the updates. Our emails will change soon, and direct to our original emails. Please pardon our stumbles as we go through this transition.

A HUGE thanks to Mindy Atwood, Val Krist, Jenna Quinn, Alison Cebulla, Carey Sipp, and Brian from Crowdstack (the platform we use for our social network). You are making a really difficult transition look easy!

If you have any questions about any of this, please don’t hesitate to reach out to any of us!

So…..Why are we doing this?

To explain this so that it makes sense, here’s a little chronology:

For the first years of ACEs Connection, we described ACEs science as including five parts:

  1. The epidemiology of adverse childhood experiences (the original CDC-Kaiser Permanente ACE Study and the hundreds of other ACE studies);
  2. The short- and long-term health consequences;
  3. The effects of toxic stress from ACEs on the brain;
  4. How toxic stress from ACEs passes from generation to generation of humans and systems;
  5. And resilience research.


We always included information about resilience, but it didn’t quite hit the mark. So, for the last few years, we’ve been talking about how to integrate positive childhood experiences into our community in a more meaningful way.

We’re one of several other major elements of this movement in which we’ve all been inching along: SAMHSA’s trauma-informed practices, CSSP’s Strengthening Families and the CDC’s Essentials for Childhood (safe, stable, nurturing relationships, and environments), and social-emotional learning (SEL). Of course, I’m simplifying wildly, because you can break all this down even further, into developmental trauma, attachment theory, etc. But where I’m going with this, is that the movement is giving people lots of pieces at a time when we need a more comprehensive framework.

For example, most trauma-informed training usually includes some brain science and sometimes generational trauma, but not ACEs epidemiology or health consequences. So, the training gives tools without providing an understanding of the science behind them. Which carries a great risk of simplifying it and/or turning it into the latest fad.

One more piece, the most important for the U.S.: Over the last year, there’s been a long overdue awakening of people wanting to learn about race, equity, and inclusion, thank goodness. But without a foundation of PACEs science, we risk losing that to the grip that racism holds on this society, and the misbegotten idea that Whites should heal Black people, Native Americans and people of color. It’s the opposite: Whites need to heal themselves by acknowledging the harm done, examining the harm still being done, and making amends — by providing reparations to Black and Indigenous people, by creating anti-racist policies and laws, by addressing inequity by providing more opportunity. By doing so, that begins to heal everyone, even though the pain of the trauma will linger for decades. We need time for people to understand this remarkable knowledge, to bake it into our hearts and bones, and to let go of “them” and “us”.

So back to our decision to change our name: Here we all are, in this movement, with me feeling as if I was stuck between a rock and a hard spot. We at ACEs Connection realized that looking only at ACEs wasn’t capturing what happens in our lives. And, although the knowledge of ACEs science liberated a lot of people by explaining their lives, it also depressed a lot of people if they weren’t provided information about resilience. And sometimes, even if they were, it wasn’t emphasized or explained sufficiently.

What popped me out from my stuck place between the rocks was the research that Dr. Christina Bethell, Jennifer Jones, Dr. Narangerel Gombojav, Dr. Jeff Linkenbach, and Dr. Robert Sege did on positive childhood experiences and published in 2019. They used data from Wisconsin’s ACE study to look at seven positive childhood experiences (PCEs) and found that positive childhood experiences show a dose-response association with depression and poor mental health, just as ACEs show a dose response. The more PCEs, the less depression; the more ACEs, the more depression. But here’s Bethell’s important conclusion: “Joint assessment of PCEs and ACEs may better target needs and interventions and enable a focus on building strengths to promote well being.”

So, my take on this is that it’s fine to talk about the ACEs and PCEs you have. Why not? It’s useful shorthand. It’s an easy way to think about this knowledge, especially if you’re new to it.

ACEs and PCEs don't work separately

HOWEVER….don’t think of them as working separately. Nor are they two sides of the same coin. In reality, adversity and positive experiences work together, all the time, throughout your life, in your body and in your brain, in your communities.

There’s a great video from the Alberta Family Wellness Initiative (funded by the Palix Foundation) — the folks that developed “The Brain Story” — that shows, very cleverly, how this works. It’s called “Brains: Journey to Resilience.”

APACES1

Here are a few images from the video that show how positive and adverse experiences work together.

APACES2

Not only can you learn to balance them on a fulcrum, but you can also move the fulcrum so that as a person heals, their tolerance for adversity increases.

APACES3

And guess how that will be useful for all of us? When climate change strengthens and throws more adversity at us, we want to be stronger to create solutions to deal with it.

We’re taking this a step further: We’re applying this same approach that’s useful for individuals and families to organizations, systems and communities. That’s VERY important for organizations and systems to develop policies that heal and to create an anti-racist society.

And a reminder from Bethell: Adversity can become a positive experience. There’s more attention being paid lately to post-traumatic growth. My life is a case in point: Without the load of ACEs that I had as a child, PACEs Connection would not have been created. Or, maybe it would have, but not by me. I’m sure many of you resonate with how your own adversity led to growth. (Of course, I sometimes wish my life had been adverse-free with more positive experiences, but that’s not life. What I can aim for is the day when there’s no need for PACEs Connection!)

I’m not saying PACEs is a perfect framework. It’s just one step on the path toward something that might be more useful.

As a movement, it’s obvious that we need to figure out how to better describe this amazing knowledge and increase the understanding of PACEs. We need to make PACEs science clear to everyone, no matter what their learning style, so that we can talk about and use this knowledge in our individual lives, our community lives, our organizational lives and our systems lives. And at all stages, we must always consider how racism, the elephant in the room, relates to the discussion.

We’re asking for your continued participation PACEs Connection and in this conversation and for your ideas about integrating PACEs into our lives and work….through your blog posts, including your personal stories; poetry and visual art; ideas for and participation in webinars, and any other way you’d like.

We’re hosting a Better Normal on March 26 with Christy Bethell to launch the conversation. At that time, we’ll also give you a teaser to the upcoming HOPE Summit, sponsored by the HOPE National Resource Center at Tufts Children's Hospital, where some of the presenters will address the interplay between positive and adverse childhood experiences. (There’s also another HOPE project at the University of Oklahoma worth exploring sometime soon….that project's focus is tangential to the Tufts University project, but not the same.)

Since it’s the beginning of a conversation, I’ll leave it there. We all want to hear from each other as we explore this new territory.

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Images (3)
  • APACES1
  • APACES2
  • APACES3

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