How Childhood Trauma Can Make You A Sick Adult [8 min - Big Think]

You know Janie...

you are correct! We spent our time caring for siblings or parents always thinking we would do better, be better in some form or another....

We were young but achieving (even if simply surviving which isn't necessarily that simple in some circumstances) it took contemplation though our young minds didn't call it that, planning as much as Bobby Fischer did for a chess match and a keen awareness to our environmental threats... Everywhere ...

Which ones to attend to when???


We are incredibly strong, even  if orchids, we have dandelion mixed in.

I just got in Detroit and  ready for the connector flight


Have some ideas to share in a bit....


T

Thank you Tina, So sweet of you. I really believe high ACEs people do have high resilience, I know that I do, and I think you do too. It is because we don't give up. We are still here, still trying and still getting back up. After reading so many posts from ACEs victims on this web site I am impressed at the compassion, dedication and accomplishments many have done to help others. Maybe this is in spite of or because of having a high ACEs score.

 

As children many of us when we fell had no one to comfort us or pick us up so we learned to do it ourselves. But is is nice when someone does comfort us. Thank you for comforting me.

And I send comfort back to you.

Janie,

I wish you the very best. It is hard having a high ACE score with no family and no people in your life to provide resilience (compassion/love/care)!! everything  is really hard!!! Keeping a job - getting a job--- having a self is hard (at least for me).  I haven't said that I support you yet and I'm not real good at doing this all the time... But I just wanted to say.... Hey we are sisters if virtually and so I just wanted to provide a little encouragement! I have to get on a plane to go to the AAP conference but wanted to say .... I'm there 4 you in the virtual world and I get how hard it is (and how easy it is to be taken advantage of even when childhood is over) seems like it is pretty hard to climb out of that deep lonely hole or find light to get out of the cave... I was talking to a new friend who was a track star in High School (state champion) and at a local university... Very smart and he told me "never look behind or down". Looking behind could be a 1/10 of a second and cost the race. Looking down could mean you fall and gotta climb back up... Been thinking about the analogy and I like it... So anyway ... Be well!!!

Tina

 

Seems like a badge of honour would be appropriate for you too, Janie!  Too bad there's no prize money in it, to help with your ongoing research!!

And I have to admit that I have not been to a medical doctor for 12 years because when I did go they put me in a very bad place because they didn't understand what was going on with me. I understand that that is their job but I didn't want drugs or medication to cover over or bury me in. I had to find my way through the internet researching and reading books. There was not a lot our there in the medical field for me. So I am happy that now that are awakening to ACEs problems and trying to help the individual.

 

"Do no harm" ?????

I was forced to get Obama care but I never used it. They don't pay for what I needed. So I had to pay for it myself. Acupuncture, massage therapy and natural herbal remedies. I wanted to get EMDR help but couldn't afford it at the time. No help out there for me! Unless I wanted to be drugged up,  put to bed and accept my lot in life.

 

But I did find my way. I will never be totally over it. But I have learned to deal with things and keep them under control. I am no longer crippled up and in pain every day. Wen I get tired and down I make myself get up, move and do something. When I was in my darkest time I made myself do a happy thing for myself. One happy thing everyday.

 

I used to be a Sign Language Interpreter and College Professor for ASL. Now I am a writer, author and avid researcher. We do need to reinvent ourselves at times and turn curses into blessings. Now all I need is to get paid for it.

 

 

I agree Resmiye. I think we're on the same page. It's all in the delivery, the listening with compassion and acceptance without judgment. And providing that empowering is critical, as you say.

Thanks so much for the clarification.

I am quoting from a previous message, I think that helps me understand we are actually on the same page: how we present the material is extremely important. using descriptive negative labels may shut down some individuals to the material whether in medical setting or in public. best.

 

Last reply! Possibly the majority of problems with giving the information and the client not handling it well, or denying its affects, could lay in the area of the delivery of the information about ACEs trauma etc. to the client.  If a therapist delivers the info in a 'disorganised attachment' mode ie with some hostility, fear, helplessness (fear of not having the skills, energy etc it takes), anxiety - frightening in some way (no matter how subtle) as opposed to 'secure attachment' mode,  the client may perceive that this is indeed a doom and gloom prognosis.

If the client is given positive empowering statements after learning about it in a low key, yes-this-is-quite normal-given-the-circumstances-and-many-people-have-gone-through-it-as-you-have, one could possibly get a radically different response.  I don't know - I'm not a research scientist!

i think, i should have provided some background information first. my clinic has already implemented trauma informed care and we are doing trauma screening, resiliency screening, family functional capacity screening and helping our clients understand the role of ACEs in their lives and health consequences, as a result of which, we have established a very good network of referral system wiht family navigation put in place to help our clients. I am the co-chair of the U of Iowa trauma informed care task force and we are in the process of expanidng our TIC practice to three more clinics/units including the Pediatric clinic. I have obtained master trainer training on ACEs interface and have been training numerous audiences in Iowa and internationally on ACEs and TIC.

 

i also agree the shame felt by individuals should be put in where it belongs, the circumstances client did not have any control over. my point is the starting point when interacting with individual clients (not those attending voluntarily an educational setting) should not be to tell clients "ACEs create sick adults" since the client may not be aware at the outset that they are "sick" or being confronted out-of-context with such, and being labeled as such my shut them down from collaborating for their own good from the outset.

 

this is a big discussion we are holding in iowa and across the nation in especially medical settings. some people even think, we shouldn't focus on ACEs and look at needs and build on strengths. I am not there: I think, obtaining trauma history of a person is important both to help providers to become trauma informed about the client and so that we can help them see the connections between their ACEs and their current functioning and physical and mental health. but beyond that focusing on resilency and needs is the core of our work.

PPS. Tina mentioned the S word: shame. Laura Kerr has written recently about it...

If your clients aren't privy to ACE etc info then your clients can never really have the chance to grow beyond the toxic shaming that appears to very much be at the CORE of every poorly operating family, no matter how great the resilience program you present.

I concur with Tina wholeheartedly when she said not being shamed by society into being quiet about ACEs etc. which I think will allow a modicum (but exponentially growing) of the possibility of freedom from shame. This is where it starts.

Surely if you watch the movie Good Will Hunting you can understand its importance?!! Half joking - but the toxic shame the main character felt is clearly portrayed. 

We can be quiet no longer, we have the job of spreading the message. Please help not hinder its progress.

You are in fact hurting the client more not less by not exposing them to the information available.

Resmiye: You may be interested in this story about pediatricians who are taking an ACEs history of parents and/or children or actually using it as a screening tool to determine services. And here's an update that focuses on the Children's Clinic, which takes ACEs and resilience histories of the parents of four-month-olds.  I'll be doing updates of the others mentioned in last year's story. RJ Gillespie did a survey of physicians and parents, and found overwhelming support for having a conversation about ACEs and resilience.

Well it was to be my last reply...

Hi Tina, I keep missing your comments as I write mine!

I only say "Badge of Honour", because gosh (!) what else can you do with the information AND no one else (or if so extremely rarely) is going to positively recognise what you've done (and been through) for you and say something positive/empowering!  You have to do it for yourself.  Having someone else say it is an added bonus.  I feel like one has no choice but to wear it as a badge of honour type thing or whatever you want to call it.  Maybe there's a better turn of phrase. One I believe has to take the positive out of such negative experiences - ie being proud of your ability to survive/thrive etc.  This would apply to all minority groups...

I would go further to say that you deserve such a badge, Tina, corny as it sounds...!

Last reply! Possibly the majority of problems with giving the information and the client not handling it well, or denying its affects, could lay in the area of the delivery of the information about ACEs trauma etc. to the client.  If a therapist delivers the info in a 'disorganised attachment' mode ie with some hostility, fear, helplessness (fear of not having the skills, energy etc it takes), anxiety - frightening in some way (no matter how subtle) as opposed to 'secure attachment' mode,  the client may perceive that this is indeed a doom and gloom prognosis.

If the client is given positive empowering statements after learning about it in a low key, yes-this-is-quite normal-given-the-circumstances-and-many-people-have-gone-through-it-as-you-have, one could possibly get a radically different response.  I don't know - I'm not a research scientist!

 

I don't think anyone with a high ace score considers this a "badge of honor." It is a reality. To get rid of "high ace score" is the same as telling someone their reality shouldn't exist or that they should just forget about the physical, sexual, emotional abuse...I see that as a huge part of the problem to heal... Resilience is working collaboratively to provide children with SSNR (safe, stable, nurturing relationships). That is best done by primary prevention something that CAC's and child protection are generally notoriously terrible at!!!!

Not trying to be rude but CAC's and child protection are after the fact interventions. Pediatrics needs to move indeed the policy statement by Schankoff,Gardner et al stresses we must address toxic stress with prevention rather that remediation as the most logical  approach...

PS Is it possible/plausible to ask your clients to check out:  What's Your ACE score website?

That's how I found out about ACE scores.  The only reason I believe I'm slightly obsessed about it, is because everyone else isn't - as in doesn't know about it.

I don't know your clientele and their needs, but perhaps you could be wrong about them not being able to handle such knowledge.  At least some of them I'm guessing could feel empowered from such information.

I am a high acer ..... have all 10 plus parents on welfare, homeless adolescent after dad stuck a deer rifle in my face, couch surfer, poverty, welfare, food stamps, child welfare exposure survivor (talk about something that will scare you away!) took the ACTs the morning after sleeping under an apple tree plus valedictorian x 2, MD from the University of Michigan, pediatrician, child advocate!!!!

We scare folks away when professionals are afraid to speak the truth and become educated about ACEs! They do make you sick mentally, physically, emotionally BUT it doesn't have to be...

When we stop keeping secrets --- the molestation and other abuse (and stop feeling shame for keeping our ACEs secret, because professionals seem to think we like secrets) and especially when we are no longer shamed by society for not keeping quiet) we can, in a supportive community, become free....

It is just that medicine isn't very supportive because medicine is afraid, judgemental and has a VERY long way to go....

Oh and the mental health system and the DSM that we will all be referred is going to call us if still kids ADHD, ODD, CD, Pediatric Bipolar or if adults Borderline or Bipolar, Sociopathic, Schizoaffective, and on and on .... Sounds like a label lacking an understanding of etiology (sorry ... struck a nerve!!!)

Just some random thoughts

Tina, MD, FAAP

Firstly, I think it's great to not have everyone who doesn't agree, speaks up about why.

Knowing about ACEs can certainly be a drawback, but only in that the rest of the world hasn't caught up with the implications of what it means, if indeed they've even heard of it.  Understanding of this field of the human experience has needed attention for a long time.  Finally there is some movement.  To me, it's like saying there's been no such thing as racism, sexism, etc etc.  Now the denial of traumaism.  Yes I did indeed make that word up!  

The group with high ACEs is not a small minority group.  If there's a problem with people wanting to understand their background, it means that all of society has still got a long way to go.  It means they don't want to know about why they think and behave as they do, without explanation.  I simply cannot believe this to be true for the vast majority of high ACEs (especially those that don't score highly on the follow up resilience screening test), IF and when it is delivered appropriately - with sensitivity and with TIC practices.

Dr Felittti didn't make up the data he found.  What he found has such enormous implications that should be screaming at people, including the media to pay attention.  Wake up world - it exists! Dr Felitti's presentation is titled: How Childhood Trauma Can Make You A Sick Adult.  It's not an absolute given.  

Without 'labels'/the concepts of ACEs, how can one even discuss what is discussed on this website, etc?  

I must say I don't like the word trauma because mainstream freaks out at the word, for all sorts of reasons. Hence I say traumaism is alive and well.  Finding a more palatable word could prove useful...The understanding and going beyond just the understanding of ACEs cannot commence without firstly everyone understanding what it is.  I believe you can't just plonk resilience practices/positive psychology etc etc onto people with high ACEs and think it will work.  It will not.

It's going to take a lot more nuanced understanding and sophistication, as well as further brain research etc to really make inroads in this field.  Humanity is so very complex.

In the meantime if you believe clients cannot handle the truth, do it ever so gently.  Withholding what you know, as mentioned numerous times, is like not letting the client know they have cancer.

My reply is less sequential than I desired, but hopefully you get the drift.  And yes, I feel so strongly about it, that I think my pre-cortex almost goes offline and my limbic system takes over! 

If you survive high ACEs etc it SHOULD be seen as a badge of honour. Let's hope that day is not too far off. You survived, possibly even thrived.  You probably stopped the intergenerational abuse and helped others. How much effort does this take?  How unacknowledged is this in our society?  

unfortunately, none of the clients in the medical community perceives ACEs score as a badge of honor. those who visit ACEs connection website or attend meetings on ACEs to me are already those who have a better understanding of ACEs, thus, may be better at also understanding that ACEs is not the end of it, resilience is what counts. we call this in the scientific community selection bias. However, in the medical community, people come for medical care not knowing anything about ACEs and trauma informed care. they require very gentle introduction of the concept without labeling, with a focus on resilience. perhaps our different perceptions are due to dealing with different populations. hence, i believe our rhetoric should be devised according to the needs of the  most sensitive populations that we are trying to reach and help. 

 

Resmiye Oral, MD

Professor of Pediatrics

Director, Child Protecton Program

University of Iowa

 

Most people who are educated about ACEs in a safe place, with a safe person, are glad to know about their ACE score. They say it explains their life. Check out Got Your ACE Score? on ACEsTooHigh, and scroll down to read the hundreds of comments. I tend to think of the ACE score as a badge of survival and resilience, and a door into deep understanding.

janie, i know that is a fact, but not everybody who has high ACEs exposure feel comfortable being labeled "sick". i am dealing with such patients day in day out and they are extremely sensitive to being assigned negative sounding labels. everybody wants to believe they are OK. i think, working with people with troubles without labeling them is much more constructive. i hope we get rid of high ACE score as well as such labeling before such labeling starts scaring people away from disclosing their troubles. all my best. resmiye 

Although I understand about not wanting to be labeled... most of us ACEs people are sick we just don't know why? And we hide it very well.

Like me... Fibromyalgia, Chronic Myofasial Pain, lower back pain, problems with bloating and digestion. The point is once we know why we are sick we can improve our condition and heal the mind body connection. And we don't have to stay crippled, sick or always on pain.

 

It makes me wonder how many people who suffer from fibromyaliga have a high ACEs score!

“How childhood trauma makes you a sick adult” is not a good title: labeling people with adjectives like “sick” is not constructive. something like “How childhood trauma is associated with life threatening conditions or illness in adults” may provoke more receptiveness in reader, who may have multiple trauma history.

Seems like a great introduction (video being a great medium I believe) into some of the what and why of ACEs, for those who are new to this.   One to keep!