When U.S. Sen. Heidi Heitkamp (D-ND) arrived mid-way through a congressional briefing on the Science of Trauma last week, she delivered her remarks with passion, humor, and most of all, a sense of urgency to the room full of Capitol Hill staff and a smattering of advocates. Her message was macro as well as micro—change national policy to incorporate what the ACEs science tells us about trauma, and see and respond to the needs of those you encounter in everyday life. (Her remarks start at 27:48 and continue through 41:45.)
ACEs science refers to adverse childhood experiences. This includes the epidemiology of ACEs (the CDC-Kaiser Permanente Adverse Childhood Experiences Study and several dozen ACE surveys in U.S. states and organizations), the neurobiology of toxic stress, the effects of toxic stress on our bodies, how toxic stress is passed from one generation to the next (epigenetic consequences), and resilience research, which shows our brains are plastic and our bodies want to heal.
Reaching back to her days as the North Dakota state attorney general, from 1992 to 2000, Heitkamp told the story about the state’s prison warden who gave her early insight into trauma. The warden interviewed all new inmates and ask them about their lives. When they described the abuse they suffered as children, he wrote down two numbers by their name—the age they were when the abuse started and, in his view, the age they now were developmentally. She added that the word “trauma” was never used, but both she and the warden knew that these childhood experiences fundamentally changed who that person became.
Heitkamp urged the staff to go back to their bosses and examine how the science should inform the many issues that come before them, whether the policy relates to criminal justice, health care, social services, education, or some combination.
She also told a favorite story to illustrate the importance of responding to the everyday problems of individuals—she convinced a dentist to provide dentures to a veteran in his 90s who sorely needed them, acknowledging how difficult it was to respond to his need in light of his extreme crankiness. She concluded by saying that working on big issues is “kind of worthless” unless there is a human impact.
Heitkamp ended her remarks this way:
“I am convinced that more than anything else I can do in this town is to spread the word about making sure that children can get trauma treatment, making sure that we have trauma-informed programs, making sure that we understand this as a public health crisis—this can have huge macro results for us economically but equally as important, can change the lives of a few people in this country…which is why we are all here.”
She then turned to the panel, thanked us and said: “Keep preaching, keep preaching!”
The Campaign for Trauma-Informed Policy and Practice (CTIPP) sponsored the event. CTIPP is a new organization comprised of individuals and groups from all sectors and walks of life working together to create a better future by promoting trauma-informed policy and practice.
This briefing is intended to be the first in a series of three to provide information to congressional staff about the science of trauma, and then to explore trauma-informed practices and policy. It became evident to the founders of CTIPP that education about trauma should be a high priority when major bills relating to mental health, criminal justice reform, and education were not addressing trauma in significant ways. Exposure to this information in the U.S. Congress is growing as demonstrated by a recent hearing on mental health in the Finance Committee where Dr. Maggie Bennington-Davis devoted most of her oral testimony to the impact of adversity on health.
After my presentation providing the basics on the ACE Study and its implications, Dr. Nathan Fox, director of the University of Maryland Child Development Lab, addressed the impact of trauma on the brain and mind/body. He was followed by Dr. Zack Kaminsky, assistant professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine, who reviewed epigenetics and the intergenerational transmission of trauma.
Dr. Wendy Ellis, manager of child health policy, Office of Child Health Policy & Advocacy at Nemours Children’s Health System, moderated the program. She included a personal note about having an ACE score of 8 to make the point that the ACEs science must include resilience science and to acknowledge those who “aren’t standing in this room today.” She said she was already a young adult when the ACE Study was published but the people who raised her “knew what was going on.”
She concluded, “There is real hope and real power with the resilience part of the narrative.”