• Mayday at the Bottom of the World

    November 16, 2022 By in ACE Study, Adverse childhood experiences, Positive & adverse childhood experiences, Resilience 13 Comments

    [Personal note: People often ask what prompted me to found PACEs Connection, which began as ACEs Connection in 2012. There are two parts to this answer: the professional part—how ACEs Connection grew out of my reporting on violence epidemiology. And the personal one, which I haven’t written about in great detail until now. It appears on HiddenCompass.net, a remarkable travel site that calls itself “the antidote to clickbait”.]

    Photo: Fred Olivier/Alamy

    This story contains graphic content and descriptions of sexual abuse involving a minor. Reader discretion is advised.

    In my beginning is my end. — T.S. Eliot

    Friday, July 24, 1998 / 2:29 a.m.
    Aboard The RSV AURORA AUSTRALIS
    100 miles off the Antarctic coast

    One long, ear-thrumming alarm jerks me from the edge of sleep. A fire drill? At this hour?

    I struggle from beneath the blankets of my narrow bunk, open the cabin door, and wince at the bright light of the ship’s empty companionway.

    “Is this a drill?” I ask a scientist who stumbles past. He sleepily shakes his head and shrugs.

    The alarm stops. I pause in the doorway and will the silence to settle in.

    I detest middle-of-the-night surprises. Always have.

    ~~

    The edge of the mattress tilts.

    But it’s the breathing that sets my heart to racing.

    ~~

    The alarm erupts again.

    “Attention! Attention, please! There’s a small fire in the engine room.” The captain’s voice, tense and remote, issues from the ship’s loudspeakers. “Please muster to the heli-deck.”

    My roommate, a penguin researcher, shakes herself awake and rolls out of her bunk. She steps into her “freezer” suit, designed to withstand temperatures as low as minus 4 degrees Fahrenheit (minus 20 C). I don a turtleneck sweater, pullover, jacket, long underwear, sweatpants, socks, and wool-lined boots.

    I start through the doorway and — for a reason that I will never understand — dash back into the room to grab a small flashlight. I bought it in Hobart, Tasmania, the port we’d left eight days earlier, to quiet some mind-gremlins that had been shouting at me, “Don’t go! Don’t go! Go home! Go home!”

    But my home was 9,000 miles away.

    I’m on a seven-week expedition aboard the research icebreaker RSV Aurora Australis with several dozen scientists, technicians, and crew to explore the winter sea ice around Antarctica — a journey I’m chronicling for the Discovery Channel.

    We’re exploring one of Nature’s most mysterious phenomena: Every year, starting in May, 20 square miles of sea freeze each minute in the ocean surrounding the Antarctic continent. By July, enough sea ice will form to double the size of Antarctica.

    Life abounds in this ephemeral world, but for humans, it’s one of the most isolated, forbidding places on the planet.

    I trudge with others single file toward the stern. As we emerge onto the helicopter deck, I smell smoke.

    It’s frigid outside. Thick clouds solidify the moonless night. Floodlights punch holes of illumination onto the deck, which is covered with a thin layer of snow. Lowered lifeboats crouch in shadows along the railings.

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  • Mass shootings and the news media: Catching up to the science of PACEs

    July 13, 2022 By in ACE Study, Adverse childhood experiences, Opinion (Oped), Positive & adverse childhood experiences, Solutions 8 Comments

    How do we, as a country, learn about mass shootings and gun violence? The news media. How do we learn about the best approaches to prevent mass shootings and gun violence? The answer should be “the news media”, but it’s not. Yet.

    People who know about the science of positive and adverse childhood experiences (PACEs) understand that PACEs are at the root of violence. The news media is getting there. In the last couple of years of mass shootings, more articles examined the childhood of the shooter, but more could be done, as I pointed out in essays I wrote after the Buffalo, New York, and Uvalde, Texas, shootings.

    After last week’s mass shooting in Highland Park, Illinois, two new threads appeared:

    1. A deep look at the shooter’s family (and this) to address the question: Are the parents to blame?
    2. And the growing number of online communities of mostly male youth or young men that glorify violence and are obsessed with nihilism. “I’ve described this as sort of like a mass shooter creation machine,” said Alex Newhouse, deputy director of the Center on Terrorism, Extremism and Counterterrorism at the Middlebury Institute of International Studies in an interview with NPR’s Odette Yousef. “A lot of these communities are designed to spin out mass shooters over time, over and over and over.”

    My take on examining shooter’s families: I think it’s great to report what happened in a shooter’s family…as long as a reporter takes a trauma-informed approach. That means reporting without using words of blame, shame or punishment…so a headline that says “Are the parents to blame?” would change to “What happened in that family?”

    Parents pass on ACEs—and positive childhood experiences (PCEs), for that matter—to their children. So, if they aren’t cognizant of their own ACEs, how can they possibly understand their child’s ACEs? And where did parents get their ACEs and PCEs? From their parents and environment. How to break the cycle? Educate families, organizations and communities about PACEs science, and integrate practices and policies based on PACEs science in all organizations in every community.

    My take on the online cultures of violence: At the moment, the proposed solutions are to understand the subculture and moderate the content. “It’s not hard to figure out where different violent spaces are,” Emmi Conley, an independent researcher of far-right extremist movements, digital propaganda and online subcultures told NPR. “What’s hard is what do you do once you find one, if the red flag still falls within free speech territory. Because currently we have no intervention abilities, we only have law enforcement.” I have another idea: It seems to me that these subcultures provide a perfect opportunity to reach out and help youth who are in dire need of a caring adult and counseling. That’s a project worth funding!!

    Ongoing issues: There’s the ongoing issue of the news media’s obsession with mass shootings, while mostly ignoring aggregate shootings, which receive little attention. And then the dire news of too many incidents of violence that lead news organizations to not cover important stories, and in almost every community, not cover the type of violence that costs communities the most in heartbreak and dollars—family violence. This headline in the Washington Post points out that mass shootings may be going the way of family violence coverage—too little coverage to help a community figure out how to prevent the violence. There are too many mass shootings for the U.S. media to cover: News organizations must make agonizing decisions about which shootings deserve on-the-ground reporting, and for how long.

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  • Supreme Court justices and originalism: A legacy of ACEs

    June 30, 2022 By in Adverse childhood experiences, Opinion (Oped), Positive & adverse childhood experiences 8 Comments

    Just as millions of other people over the last few days, we’re still reeling from the news of the U.S. Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade. One overpowering emotion after another hit us—we’re sad, devastated, numb, livid. So many parts of people’s lives are affected that it’s overwhelming to try to comprehend. It’s not just the 40 million women of childbearing age who live in states where access to abortion will be prohibited, but the millions of women who need an abortion because of health reasons. What happens when you live in a state where the first answer is “NO!”?? And it’s much more complicated and generational than that.

    Ingrid Cockhren, PACEs Connection’s CEO, thought about how mothers being forced into birthing children puts those children at risk in so many ways, and the historical context of women being treated as property. Carey Sipp, who is PACEs Connection’s director of strategic partnerships, noted that the most “abhorrent rolling back to the dark ages” aspect of the ruling forces women who are raped and girls who are raped by relatives or friends of family (which are most rapes) to live with the consequences of those horrors with no ability to escape the past. The criminalization of pregnant women and their caregivers. The likelihood of a 33% increase in the pregnancy-related deaths of Black women. We could go on.

    “It’s all just bad,” says Rafael Maravilla, our network manager.

    In light of the science of positive and adverse childhood experiences, my main question is: What happened to you, Justices Alito, Thomas, Kavanaugh, Barrett and Gorsuch? What happened to you in your childhoods, your formative years, that led you to blithely unleash such cruelty and incoherence? What happened to you, Justices Kavanaugh, Barrett and Gorsuch that you could nonchalantly testify that you regarded Roe v. Wade as established precedent, which meant that you weren’t going to consider overturning it? It’s obvious now that was misleading at best, a lie at worst.

    We know what happened to former President Donald Trump during his childhood, and some of what happened to Russian President Vladimir Putin. We don’t know what happened in the originalist judges’ childhoods, but I am willing to venture that they experienced some adversity, otherwise why would they support the concept of constitutional originalism? It’s not an innocent concept. It clearly harms people.

    I’ve always said that it’s not a person (with ACEs and few positive childhood experiences) with a gun or knife who does the most damage; it’s the people (with ACEs and few PCEs) who have great power who can do the most damage. And I believe that, as in the case of Trump and Putin, the originalist justices on this Supreme Court not only have great power, but are using it unwisely in a way that is causing great harm. It’s possible that by their actions they don’t mean to do great harm, but that’s a consequence of ACEs and not enough PCEs, too. (What ACEs/PCEs Do You Have?)

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  • There’s no mystery to what happened in Uvalde; there were many opportunities to prevent it .

    June 7, 2022 By in ACE Study, Adverse childhood experiences, Child trauma, Community prevention programs, Opinion (Oped), Positive & adverse childhood experiences, Solutions 13 Comments

    Thousands of parents, pediatricians, social workers, educators, community advocates, kids, judges, police, district attorneys know exactly what led to Salvador Rolando Ramos running into a school and slaughtering 19 kids and two teachers in Uvalde, Texas. And what could have derailed his path, as well as the path of all other recent mass shooters.

    To people educated about the consequences of too many childhood adversities and too few positive experiences, what happened in Uvalde is not a mystery.

    Research has established that:

    • Adverse childhood experiences (ACEs) are the root cause of most of our economic, social, physical and mental health issues.
    • People with more than four types of ACEs and few positive childhood experiences have an extraordinarily high risk of violence as both victims and perpetrators, cancer, heart disease, mental illness, alcoholism and drug use, and dying prematurely.
    • What’s an ACE? The 10 in the original CDC-Kaiser Permanente Adverse Childhood Experiences Study include physical and emotional abuse, physical and emotional neglect, sexual abuse, a parent who is addicted to alcohol or other drugs, who is depressed or mentally ill, a mother who is abused, an incarcerated family member, divorced or separated caregivers. More than 30 other ACEs have been added since the 1998 study include bullying, racism, community violence, and homelessness.
    • People who are denied economic stability, adequate housing, education and wealth because of local, state and federal policies (a.k.a., ‘being poor’) are burdened with the highest ACEs but have fewer resources to mitigate toxic stress stemming from ACEs; in the U.S., inequities are compounded by racism affecting people of color and other minorities. But as the last three weeks of shootings show, everybody has ACEs or is affected by them.

    Ramos had, at minimum, five types of childhood adversity that lasted for years. He experienced extreme bullying; an abusive relationship with his mother; his mother’s reported substance abuse; an absent father; and a disability (stuttering, lisp) for which kids taunted him mercilessly. We know little about his early childhood, where more ACEs may be lurking.

    A child that experiences toxic stress from ACEs exhibits a fight, flee or freeze response. Ongoing toxic stress damages kids’ developing brains, and leads to them to exhibit coping behaviors, such as engaging in violence. Ramos coped with his distraught feelings by harming himself (he cut his face repeatedly with a knife) and violence, including fighting often with peers.

    Of the seven positive experiences that research shows can ameliorate ACEs, Ramos apparently had only two: neighbors who cared about him and, until a while before the shooting, friends. As for the other ways that could have probably prevented him going on a shooting rampage—able to talk with his family about his feelings, feeling as if his family stood by him in tough times, participating in community, a sense of belonging in high school, and feeling safe and protected by an adult in the home—he clearly had none.

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  • To prevent mass shootings, don’t bother with motive; do a forensic ACEs investigation

    May 18, 2022 By in Adverse childhood experiences, Child trauma, Chronic disease, Community prevention programs, Positive & adverse childhood experiences, Solutions 15 Comments

    Because 18-year-old Payton Gendron provided in his 180-page diatribe a motive for shooting 10 people in Buffalo, NY, on Saturday night, police didn’t need to search for one, as they often have other in mass shootings. But using motive to prevent mass shootings will just get you a useless answer to the wrong question.

    The right question is: What happened to this person? What happened to a beautiful baby boy to turn him into an 18-year-old killer spouting racist screed?

    Steve Breen, San Diego Union Tribune

    In those questions—and looking at the answers through the lens of positive and adverse childhood experiences—lie our solutions.

    In a 2019 Los Angeles Times article, “We have studied every mass shooting since 1966. Here’s what we’ve learned about the shooters”, Jillian Peterson and James Delaney wrote: “First, the vast majority of mass shooters in our study experienced early childhood trauma and exposure to violence at a young age. The nature of their exposure included parental suicide, physical or sexual abuse, neglect, domestic violence, and/or severe bullying.”

    Research clearly shows that the road that leads from a precious infant becoming an abused or neglected child who grows up to become a distressed murderer is predictable. That was revealed in the CDC-Kaiser Permanente Adverse Childhood Experiences Study.

    The ACE Study showed a remarkable link between 10 types of childhood trauma and being violent or a victim of violence, as well as experiencing the adult onset of chronic disease and mental illness. The ten types of childhood trauma include experiencing physical and emotional abuse, neglect, living with a family member who is addicted to alcohol or who is mentally ill, and witnessing domestic violence. (For more information, see PACEs Science 101 and What ACEs/PCEs Do You Have?) Subsequent ACE surveys include experiencing bullying, racism, the foster care system, living in a dangerous community, losing a family member to deportation and being a war refugee, among other traumatic experiences.

    The point is — and the science is irrefutable now — just as a bullet rips through flesh and bone, a child experiencing ongoing encounters that cause toxic stress, without positive intervention to help the child, will suffer damage to the structure and function of their brain.

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  • The myth of survivor solidarity: Why it’s so hard for us to all just get along

    April 22, 2022 By in Opinion (Oped), Resilience, Solutions, Trauma 6 Comments

    As a Weinstein survivor, I’ve noticed that journalists love to explore the presumed solidarity among “sister survivors” – in our case, the over 100 women who came forward about Weinstein’s sexual predation. But what journalists don’t write about are the challenges in preventing any group of trauma survivors from imploding. Only when we survivors understand the impact of trauma can we overcome the underlying forces that threaten to pull us apart and stand together against injustice and abuse.
     
    Journalists often look for a “feel good” element to a story, particularly when reporting on distressing subjects. It makes sense. Why not try for a little positivity when there is enough bad news nowadays to sink us into overwhelming despair? As a Weinstein survivor, I’ve noticed that one positive spin journalists love to explore is a presumed solidarity among “sister survivors” – in our case, over 100 women who came forward publicly to recount our personal experience of Weinstein’s long reign of sexual predation.

    Trauma, anger
    Trauma, anger. Photo @Melanie Wasser for Unsplash.

    Solidarity among survivors is a value I happily embraced, the idea of us coming together to support each other as more and more victims of high-profile abusers courageously stepped forward to join the ranks of those who cried, “Me too!” For my part, I have spent the last four years talking with survivors and connecting individuals to create a network of mutual support. It felt like an act of sedition in the face of powerful men and an at-times indifferent establishment. Still, I should have known that this camaraderie would develop stress points and, in some cases, fall apart. Interpersonal trauma in particular often results in a distrust of other people and a host of other protective responses that work against cohesiveness. In the refreshingly honest words of one interviewee in an article about community trauma: “…traumatized people interacting with other traumatized people – a community can really run the risk of imploding” (1).

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  • Hysterectomy Triggers Renewal of Childhood Trauma

    April 21, 2022 By in Adverse childhood experiences, Child trauma, Trauma 4 Comments


    TRIGGER ALERT – CONTENT REFERENCING  SEXUAL ASSAULT, CHILD SEX TRAFFICKING, PHYSICAL AND EMOTIONAL ABUSE.

    April is Sexual Assault Awareness Month. I don’t think it matters which month it is—when you feel called to share a portion of your story the calendar is irrelevant. In my case, the calendar serendipitously lined up with a surgery that occurred the same month. I had a full hysterectomy because of a large fibroid tumor in the wall of my uterus and multiple tumors in and on my ovaries. The tumors were located after an MRI and then a follow up CT because I was experiencing severe abdominal pain. Doctors could not verify that the pain was due to the tumors, but the tumors needed to come out regardless. My mom had passed away at age 60 from ovarian cancer. Her cancer wasn’t diagnosed until it was stage 4. Three months after her diagnosis, she passed away. I was managing a lot of emotions going into surgery.

    Prior to my surgery, I had a few panic attacks about how this surgery was a culmination of the complete lack of power I’ve had over my body, most specifically, the parts of my body that men want to possess, use for their pleasure, or even damage—out of some warped psychological issue they might have.

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  • PACEs champion Rebeccah Ndung’u launches trauma-informed schools in Kenya

    April 6, 2022 By in ACE Study, Adverse childhood experiences, Community prevention programs, Education, Positive & adverse childhood experiences 4 Comments

    [Ed. note: This is a continuing series of articles about people who are involved and contributing in the movement to implement practices and policies based on the science of positive and adverse childhood experiences.]

    Growing up as the eldest daughter in a family of three girls and three boys in Nairobi, Kenya, Becky Ndung’u and all her siblings attended school, which is mandatory for children ages six through 14. Her parents—both farmers and her father also a lifelong government accountant—were committed to providing all their children a good education.

    Her education began in a public school, followed by a private high school. Our conversation was conducted in English, but Ndung’u is also fluent in her native languages, Kikuyu and Kiswahili.

    After graduating from high school, the young scientist earned a “higher diploma”—equivalent to a bachelor’s degree—in analytical chemistry in 2000 at what is now the Technical University of Kenya and then went on to earn a higher diploma in soil science in 2003 at what is now the Jomo Kenyatta University of Agriculture and Technology.

    Not able to find a job in her field, she opted to work in schools as a science lab assistant, organizing and teaching lessons in biology, chemistry, and physics. She also prepared students for the exams they needed to matriculate from secondary schools.

    She recounted that during this time, she was often asked to teach biology and chemistry when the teacher was absent. As a result, she says, “I learned a lot about how school systems work, their challenges in terms of teachers being overworked, discipline in learners, poor academic performances, and the struggles of parents to pay school fees.”

    From Science Assistant to Educational Psychologist

    But she had no desire to become a teacher herself. “I wanted to help the schools but not as a teacher,” she explains. “My focus was helping learners improve their academic performance and acquiring the discipline to avoid dropping out of the school. But in Kenya, there is no provision for educational psychologists in the education system.”

    After earning a diploma online in educational psychology and emotional intelligence at the University of Ireland in 2020, she started working on her own as an educational psychologist. She acquired students by word of mouth from parents. “Amazingly,” she said, “I was able to help kids with behavior problems, learning difficulties, poor academic performances, and learners with special needs.”

    Before learning about the science of adverse childhood experiences (ACEs), Ndung’u’s knowledge about emotional intelligence (EQ) opened her eyes as to why children acted out and misbehaved in the classroom.

    She recalls having to remove two sisters, ages six and eight, with severe dyslexia from the classroom because they couldn’t read at their grade levels. She used her EQ skills to get the sisters to open up and talk about their issues. She also involved their parents so that they could understand what their children were experiencing and to explain what needed to be done. She secured the students a special needs teacher, who home-schooled them for eight months. Later, they were both successfully integrated back into the schoolroom.

    Learning About ACEs

    While working with children, the trauma educator heard a talk by Dr. Angie Yonda-Maina, director of Green String Network, a nonprofit dedicated to peacebuilding through practices related to trauma, justice, spirituality, and security. Ndung’u was struck by a poster presented in the doctor’s talk that included a reference to ACEs.

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  • The Intolerable Cure

    April 6, 2022 By in Adverse childhood experiences, Positive & adverse childhood experiences, Resilience, Solutions 12 Comments

    As a survivor of interpersonal trauma, commitment and intimacy have never been easy, which is why I never did remarry after my first marriage fell apart. That is until last October, when my boyfriend who had been living at a comfortable distance (measured in thousands of miles) suggested I pack up my apartment and ride out the pandemic with him in Hawaii. Thus began an adventure that had me breathing into paper bags and him warranting a nomination for the Nobel Peace Prize.

    I get bent out of shape easily. On days when I haven’t had enough sleep, I’m particularly vulnerable to being disgruntled and snappy, finding everything about my partner annoying, right down to his very existence. I usually seek refuge in elaborate plans of escape. (No doubt on those days my husband is similarly engaged.) I dream of a light-bathed studio giving onto a beach or a small cabin perched by a lake and surrounded by pines. The scene changes, the head count doesn’t. I am on my own.

    For many trauma survivors, “avoidance”—a symptom of post-traumatic stress and driver of my escape fantasies—is the only way to make our lives feel manageable.

    The latest edition of the Diagnostic and Statistical Manual of Mental Disorders describes avoidance as “efforts to avoid distressing memories, thoughts, or feelings” and “external reminders (people, places, conversations, activities, objects, situations)” associated with traumatic events. But what if the source and reminder of the trauma is other people? And what does that mean for our relationships?

    The essential dilemma for survivors of interpersonal trauma is that, as Judith Herman has written, “recovery can take place only within the context of relationships; it cannot occur in isolation.” It makes sense that for those of us who have suffered abusive relationships, safe, stable relationships would be the cure, in the same way someone who has been poisoned might flush out toxins with pure water. However, as survivors of interpersonal trauma, getting close to people also feels inherently unsafe. In many cases, our trauma stems from the fact that the people who were supposed to love and protect us instead hurt us. We learned—sometimes at a young age—to distrust and fear the very thing we need as humans to survive. In The Boy Who Was Raised as a Dog, Bruce Perry writes:

    “Being harmed by the people who are supposed to love you, being abandoned by them, being robbed of the one-on-one relationships that allow you to feel safe and valued and to become humane—these are profoundly destructive experiences. Because humans are inescapably social beings, the worst catastrophes that can befall us inevitably involve relational loss.”

    Even more worrying, the inability to tolerate close relationships not only impedes trauma recovery but may even shorten our lifespan. A 2015 Brigham Young study reported that isolation is as bad as smoking 15 cigarettes a day in terms of the impact on our mental and physical health—and ultimately our longevity. The daily pain of social isolation is very real; it actually registers in the same region of the brain as physical pain. For some trauma survivors, isolation can be “iatrogenic”—meaning, the remedy is worse than the disease.

    Some people get around the need for emotional connection with other humans by befriending other large mammals: dogs or horses are regularly used in trauma therapy. For those of us who dare to dip a toe into the potentially tumultuous waters of relationships with other humans, the experience is probably best approached as a kind of exposure therapy, where you face the thing you most dread in small increments until your brain is rewired and you no longer sense a threat. The problem is that marriage—to go back to my own situation—does not work like that. You can’t be married for say, one day a week, until you build up a tolerance. And, quite apart from your own ability to tolerate this unaccustomed state of being close to another person, unless your partner understands trauma well—and, like my husband (thus far), has enduring patience—there is a serious risk that the relationship will end up imploding.

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  • Research shows only a tiny percentage of physicians integrating PACEs science

    March 29, 2022 By in ACE Study, Adverse childhood experiences, Positive & adverse childhood experiences 7 Comments

    Three relatively recent studies from different parts of the U.S. show that only a tiny percentage of physicians, medical school faculty and other healthcare providers are integrating practices and policies based on the science of positive and adverse childhood experiences (PACEs).

    Why it matters: For people in the PACEs community, the following is news that’s 20 years old: Adverse childhood experiences are common, preventable and linked to six out of the top ten leading causes of death in the United States.

    As one of the studies noted: “Positive and negative experiences in childhood shape our trajectory of health or illness for our entire lives, and this impact can be attributed to the brain-body physiology that results from our experiences during childhood.”

    The science is well established. Thousands of research papers have been published about the long- and short-term health effects. Every U.S. state has done an ACE survey, many more than one. Legislation addressing childhood trauma and PACEs science has been passed in 39 states. Dozens of books have been written about the topic, including two bestsellers; one of those—Bessel van der Kolk’s The Body Keeps the Score—has been on the New York Times paperback bestseller list for 178 weeks. Physicians who have been early adopters for more than a decade say they would never go back to not integrating it into their practices.

    In 2016, only eight out of 192 medical schools included content about childhood trauma, and that could be just a single lecture. Early adopters in the medical community know that if PACEs science isn’t integrated into medical schools, benefits of its knowledge will never get to patients. And people WANT their doctors to know about this. Donna Jackson Nakazawa, author of Childhood Disrupted: How Your Biography Becomes Your Biology and How You Can Heal, posted this article on ACEsTooHigh.com: Childhood trauma leads to lifelong chronic illness—so why isn’t the medical community helping patients? It’s had more than two million page views and hundreds of comments.

    Who did the studies and why? In Muskegon County, MI, Resilience Muskegon, a community organization created by mental health agency HealthWest, did a survey of county residents that showed a huge disconnect between the healthcare system, which is highly rated, and the health of people in the county. A local ACE survey showed that 31.4 percent of adults have experienced 4 or more ACEs, nearly three times the number in the original CDC-Kaiser Permanente Adverse Childhood Experiences Study, which showed 12.5 percent had an ACE score of 4 or higher. This prompted researchers to recruit 226 physicians from Mercy Health, a hospital and healthcare system that serves 85% of the county, to participate. They asked if they knew about ACEs science, if they used it in their practice, and if they had a personal history of ACEs.

    In Texas, researchers from the University of Texas and the University at Albany, NY, recruited 85 healthcare providers from Central Texas that included physicians, nurses, social workers and other staff who were at least 18 years old and providing care in a medical setting to women or children in Central Texas. Going into the study they thought that most healthcare workers would know about ACEs. They thought that most screened for traditional ACEs such as substance use or mental health issues, more often than ACEs such as bullying or community violence, and they thought that most patients would self-disclose common ACEs. They also thought that healthcare providers familiar with ACEs would implement ACE-informed strategies for patients, such as providing resources for patients or creating an ACE-informed culture in their practice. They were remarkably off target.

    In Illinois, a team comprising three medical students and four medical school faculty noticed that “very, very few of our colleagues knew anything about childhood trauma,” says Dr. Audrey Stillerman, one of the authors who is clinical assistant professor in the Department of Family and Community Medicine at the University of Illinois at Chicago. They were also interested in why this science that has existed for decades hasn’t been integrated into medical education so that it could become a part of clinical practice. What’s the rub? they wondered. Why isn’t medical education just different now? The team developed a survey to explore these questions; 81 faculty members from the University of Illinois College of Medicine and Rush Medical College in Illinois responded.

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