Trauma Wounds and the Legacy of Healing

How do childhood experiences shape our lives? And are there particular events or chronic issues that cause long-term harm? To answer those questions, a great deal of research has been poured into studying ACEs, or Adverse Childhood Experiences, over the past 25 years. ACEs are defined as traumatic events that occur before the age of 18 including, but not limited to, physical, emotional, sexual abuse, and neglect. Following the landmark Kaiser-Permanente study of 1998, where it was found that two thirds of Americans had experienced at least one ACE, there has been a steadily growing body of research that has become the backbone for a dawning era in addressing the long-term consequences of ACEs. Across the nation there are now numerous state and regional initiatives that are beginning to not only acknowledge but address these events in meaningful and constructive ways. Here in New Jersey, awareness is being raised about the prevalence of ACEs and a public-private campaign has been kicked off to begin this healing process. As of 2019, over 40% of children in the state have experienced at least one ACE; and nearly 20% have experienced multiple. In addition, 10% of children in New Jersey are food insecure, a major contributing factor in the prevalence of ACEs. These findings are significant because they can be helpful predictors in understanding the variety and incidence of downstream health consequences these future adults may face in the coming years, from developmental issues to chronic illness.

Childhood adversity, first and foremost, affects brain development. According to Nadine Burke Harris, doctor and pioneer in the field of linking ACEs to health outcomes and founder of the Center for Youth Wellness, childhood trauma “may lead to an increased risk of cognitive impairment, attention deficits, learning disabilities, hyperactivity, self-regulation, memory and attention, and anxiety” (Center for Youth Wellness, n.d.). The consequences of improper brain development show up in two ways that affect health outcomes: decision making and physiological changes throughout the body. Research shows that people with higher ACE scores are more likely to engage in using substances such as alcohol and tobacco, both of which have been linked to chronic diseases. Physiological changes often include hormones, such as adrenaline and cortisol, being produced in excess due to repeated fight or flight responses in people who have experienced childhood adversity. These hormonal factors can contribute to decreased heart and cardiovascular health, type 2 diabetes, thyroid issues, and decreases in immune function, to name a few. Mental health disorders such as depression have been shown to be caused by these unfortunate experiences, and cancer has also been linked to childhood adversity, though more evidence is needed. Now, what are some of the contributing risk factors?

People who have a higher ACE score are more likely to come from a low-income household. Research shows a clear relationship between low income and higher ACE scores, with scores going down as income increases. Households with less than $15,000 in income showed the highest average incidence of ACEs. Four New Jersey counties – Salem, Passaic, Essex and Hudson – exceed the national average of 13.8% of children living below the poverty line according to a 2019 estimate. Individuals and families with limited income are also less likely to receive the healthcare they need. A 2017 study found that, “ACEs appear to compromise an individual’s ability to access resources. This is consistent with research showing that ACEs are associated with a lower socioeconomic status”, and “…experiencing almost any adversity was associated with lower odds of being insured or having a personal provider.” (Alcala, 2017) Without the proper interventions, both physically and mentally, current or future parents may not be prepared to meet the spectrum of needs required by their children, thus contributing to a vicious cycle of transgenerational trauma.

Though it lacks a true consensus definition since it is an emerging area of study, transgenerational trauma, also known as intergenerational trauma, is explained in the New Jersey ACEs Action Plan thusly: “Intergenerational trauma occurs when the effects of trauma are transferred from one generation to the next, either through genetic adaptation or social and cultural practices.” According to a 2003 article in Psychiatric Times, “…patients with parents suffering with PTSD often describe damaged, preoccupied parents who are emotionally limited. Symptoms in parents such as traumatic reliving, emotional numbing, and dissociative phenomena do not help a child develop a reasonable sense of safety and predictability in the world.” (Charles Portney, 2003) Parents may lack the capacity to guide their children successfully through developmental phases that are mentally and emotionally challenging. Chronic illnesses may also contribute similarly to a child’s development. A 2003 Australian study found that sons and daughters of chronically ill mothers were more likely to experience developmental issues in the domains of emotion and cognition, with a higher number of chronic conditions contributing to a higher risk factor in children. Combined with potential economic factors such as limited financial resources, children of parents with ACEs are at greater risk to experience a variety of them, as well. So, what is being done in New Jersey to transform transgenerational trauma into transgenerational healing?

With its declaration to become a “Trauma-Informed, Healing- Centered State”, New Jersey is using resources to alleviate and prevent both developmental and health outcomes associated with ACEs. A total of $3 million in funds have been re-appropriated from the Department of Children and Families for this purpose and will be distributed in the form of micro-grants to those invested in raising awareness in their respective communities. Leaders and advocates were asked to submit their own innovative project ideas illustrated by the following examples:

A singing class for new mothers experiencing, or at risk for, postpartum depression, in which they can bond with their babies in a unique way and learn the importance of ritual and routine. To facilitate further social bonding and resourcing, a healthy meal will be offered to the participants following each class.

A meal kit program for families to cook and eat meals together. Families receive ingredients and a recipe at their doorstep - the same model as Blue Apron. Recipes are simple and healthy, and the box includes a family activity such as a game to play or conversation starters. The idea is for families to connect and communicate more.

An outdoor sensory garden for children with developmental challenges or who have experienced ACEs, that encourages being in nature as a form of therapy while learning gardening techniques and social skills.

A resource HUB for families who have experienced ACEs which offers produce distribution and nutrition assistance, links to free counseling and parenting programs, and classes that focus on building skills to process and mitigate anger, stress, and anxiety.

These are just a few of the numerous ideas from the Central New Jersey region. Those approved for action will have a lasting impact on our understanding of Adverse Childhood Experiences, the importance of healing, and what that process looks like for individuals and communities. In the coming weeks, select projects will be approved and funds distributed to begin this important work. The next step will be to ensure that these projects have the support they need throughout the process, and finally, data will be collected to gain an understanding of the impact these novel services have on target populations. New Jersey is well on its way to achieving its desired goal, and the legacy of this initiative will be that traumatic wounds, no matter the depth and breadth, can and do give way to transgenerational healing, especially when we do the work as a community.

Sources:

https://onlinegrad.baylor.edu/...-experiences-health/

https://centerforyouthwellness.org/the-science/

https://www.ncbi.nlm.nih.gov/p...dult%20cancer%20risk.

https://www.psychiatrictimes.c...troduction-clinician

https://jech.bmj.com/content/73/5/393

https://burkefoundation.org/re...-aces-collaborative/

https://cfbnj.org/the-problem/...hem%20are%20children.

https://www.nj.gov/dcf/news/publications/aces.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306082/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4617302/

https://acestoohigh.com/aces-101/