Christine Cissy White

How facing ACEs makes us happier, healthier and more hopeful

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Won’t it depress people?

Isn’t it triggering?

Aren’t the topics troubling?

Won’t it make people sad or upset?

Fear is what I often fight when talking about ACEs — adverse childhood experiences. It’s not my fear though. It’s the fear others have about all things ACEs. Adversity. Abuse. Addiction. Abandonment. Neglect. Dysfunction.

I don’t think this fear actually belongs to those of us who have lived with ACEs, who have lived through ACEs, who live with the aftermath of ACEs as adults.

When I found out about ACEs I was overwhelmed with joy. I felt radical relief. What I experienced was a profound sense of validation. It was epic.

I also felt rage because the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study and related science hadn’t been shared with me. Not my doctors, therapists, shrinks, teachers, social workers or anyone while I got ready to become a parent.

Why?

This one study and it’s 10-question survey changed my life. It changed the way I see myself and feel about myself. It changed the way I parent, prioritize parenting and self-care. It altered the way I think about my past and my parents. It didn’t just change my personal life but my professional life as a writer, health activist, and survivor.

It’s a movement and a mission and the meaning is beyond me.

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Cissy White

The ACE Study looked at 10 types of childhood trauma: physical, emotional and sexual abuse; physical and emotional neglect; living with a family member who’s addicted to alcohol or other substances or who’s depressed or has other mental illnesses; experiencing parental divorce or separation; having a family member who’s incarcerated, and witnessing a mother being abused. Other subsequent ACE surveys include racism, witnessing violence outside the home, bullying, losing a parent to deportation, living in an unsafe neighborhood, and involvement with the foster care system. Other types of childhood adversity can also include being homeless, living in a war zone, being an immigrant, moving many times, witnessing a sibling being abused, witnessing a father or other caregiver being abused, involvement with the criminal justice system, attending a zero-tolerance school, etc.

The ACE Study found that the higher someone’s ACE score – the more types of childhood adversity a person experienced – the higher their risk of chronic disease, mental illness, violence, being a victim of violence and a bunch of other consequences. The study found that most people (64%) have an ACE score of one; 12% of the population has an ACE score of 4. Having an ACE score of 4 nearly doubles the risk of heart disease and cancer. It increases the likelihood of becoming an alcoholic by 700 percent and the risk of attempted suicide by 1200 percent. (For more information, go to ACEs Science 101. To calculate your ACE and resilience scores, go to Got Your ACE Score?)

The ACE Study also found that it didn’t matter what the types of ACEs were. An ACE score of 4 that included divorce, physical abuse, an incarcerated family member and a depressed family member had the same statistical health consequences as an ACE score of 4 that included living with an alcoholic, verbal abuse, emotional neglect and physical neglect.

This one study has done more for me than decades of therapy in helping me understand the impact of post-traumatic stress.

I want that for others. This information should be shared and with people as much as possible. It’s not negative, depressing or upsetting.

Adversity is negative, depressing and upsetting. Trauma is traumatic. But understanding ACEs and their impact is amazing, incredible, medicinal, healthful and hopeful.

It’s hard to convey that deeply and emphatically enough.

I HAPPY CRIED when I saw that others my age, with my ACE score, had been prescribed anti-depressants or anti-anxiety medication.

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It’s not just me? I’m not just weak or a failure or too sensitive?

For the first time, I understood it’s not just a personal problem; it’s a social issue. It’s a cause-and-effect thing.

Mood problems are symptoms. ACEs are the problem. I’m not the problem.

I stopped looking at myself to try to figure out what’s wrong IN me and with me. I saw that thousands of other people with ACE scores suffered the same way. I saw that thousands of other people with lower ACEs scores suffered less and led healthier lives.

This changed everything.

I began hunting for what people with a lower score got that I lacked. I stopped looking for my fundamental flaw or berating myself for showing signs of wear and tear.

This is a profound shift.

  • It’s a shift that makes me feel better in me, as me and about me.
  • It’s a shift that makes me have more compassion for my parents.
  • It’s a shift that made it crystal clear that parenting is the most important thing I will likely ever do and all efforts will help my daughter now and for her lifelong future.

It has practical benefits as well.

I can talk about ACEs, in general, without having to detail my entire story every time I need to go to the doctor or therapist or psychiatrist.

For example, recently the behavioral medicine person at my HMO changed. I had to meet with a new 30-something to prescribe my generic Paxil.

She started to ask me about my life story and history.

“I have an ACE score of 8,” I said.

“What’s that mean?” she asked.

I told her about the ACE Study, the CDC website and ACEs Connection Network, which includes this site, ACEs Too High, and ACEs Connection, a social network for people who are implementing trauma-informed and resilience-building practices based on ACEs science.

She then asked again about my childhood.

“It’s in the file,” I said. “If you want to read it, you can; but knowing my ACE score is enough. Over 90% of people in my age group with my history struggle with anxiety and depression. I’m just here to manage my PTSD.”

I was polite and calm and clear that I didn’t want or need to detail my entire life story. I didn’t want to go into daddy issues or feel shame about abuse or talk about the worst things ever done to me. I’m close to 50.

“This is actually just a drug run,” I said. “I need you to fill my prescription. My PTSD is well-managed. I’m not looking to discuss or process or get feedback. I just need that prescription.”

I was polite but I’ve had PTSD about as long as she has been alive. I do not want to share the story of what caused my PTSD every three months and certainly not with a total stranger.

However, I could tell her a lot by telling her my ACE score. I could tell her a lot without revealing more than I want.

She wanted to know about my childhood and my story, but being abused is not my story. That’s the story of the person who abuses. Being neglected isn’t my story. That’s the story of the person who neglects. My story is living with post-traumatic stress. That’s what I can speak to and about.

Having the language of ACEs, for me, is empowering. I share information she needs in order to write me a prescription but in a way that doesn’t make me feel over-exposed.

I LOVE that. To me, that’s not a repetitive waste of 20 minutes that often is sad, triggering and depressing. Instead, some young, new doctor got to learn more about ACEs, which is about me and about everyone else, too.

Learning about ACEs has not “cured” my PTSD. Going to therapy hasn’t cured it either and takes a lot more time and energy, but no one ever says that shouldn’t happen.

Learning about ACEs has normalized the heck out of almost every symptom I have battled, mostly in isolation, for most of my life.

And that’s what makes me a broken record about ACEs. That isn’t happening anywhere else for people like me.

I found something that helped me go from feeling like a failure as a human being on the most fundamental level, no matter how much I tried, to just a human being, who like every other human being, is impacted by ACEs.

Most any other human with high ACEs has symptoms, issues, and impact. Most any other human with low ACEs has fewer symptoms, issues, and impact. It means the cumulative impact of trauma is the problem and not me or how I deal with it.

It means traumatic stress is caused by toxic adversity in ways that aren’t all that much of a mystery.

This, just this, all by itself and without doing anything else, is helpful and huge and hopeful.

The only thing depressing about ACEs is that this information wasn’t offered to me sooner when I was younger because it would have helped my healing, parenting and traumatic stress.

I think the ACE questionnaire and study shifts the “what’s wrong with me question?” and changes it to “what happened to me”, as well as:

  • What do I not have that I need more of?
  • What skills and resources and support did others get, that I can try to give myself now as an adult?
  • What do I need to learn so I can teach it to my kid?
  • How can I be a parent with high ACEs who has a child with lower ACEs?
  • How can I make sure my kid gets all that I lacked?

Knowing about ACEs helps me prioritize being available, patient and present as a parent because I now know it’s just as important as if my daughter gets her vaccines, to school on time, and enough to eat.

Think of all the time we worry about fast food, texting and how much sugar our kids eat. What if we talked about ACEs as much?

Why would anyone keep this information from people? I don’t understand.

Those of us with high ACE scores are not traumatized by this knowledge. We are traumatized by trauma.

And honestly, we are stigmatized by the fear of others who are so uncomfortable about what we have lived with and through that they treat us like we are broken or damaged.

I used to compare myself with others thinking I couldn’t measure up. But I realize it’s not just that they eat more kale or work out or have a more optimistic outlook. They got attachment, stability, and safety and it fortified them, sometimes for life.

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It’s not just that I’m unlucky. It’s also that they are lucky. They should write their parents thank you notes each and every day. They should realize they benefit from what their parents and community were able to provide so that they keep providing it.

So while it’s true that I can’t change my past. I can change the impact of that past with what I now know about ACEs, in the present. I can understand more why my parents were not able to do so and why it’s been hard for me. With all that, I can help change the future.

This is REALLY GOOD NEWS! Facing ACEs makes this ACE-informed face healthier, happier and a better parent.

45 comments

  2. Wow, I feel enlightened!
    I only heard about ACES the other day over lunch from the Special Educational Needs Teacher at School and decided to follow it up, when I came across your post.
    I too have an ace of 8. I know I’ve always been determined and resilient otherwise I wouldn’t have made it as a teacher.
    But I rarely talk about my past. Like you, I don’t want sympathy and as it’s the past I always know I want to leave it there. Having kids myself, I want to create a world I never had – safe, happy, caring, lovely and comfortable.
    But I have always wondered if my childhood has impacted how I deal with difficult situations, no one ever showed me. There is no blue print!
    At 42, having never seen a professional or taken meds, I wonder how much of that suppressed emotion is still inside. Now I have some guidance and you have shown me how I can touch on how difficult my childhood was without going into details and becoming tearful. Thank you for sharing. You have made a difference!

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  4. Thank you so much for this. I felt exactly the same way when I calculated my ACES score. I now work as a counselor, but there is no “cure.” I love how you say, “We are not traumatized by this knowledge, we are traumatized by the trauma.” Exactly. It is so liberating to see evidenced-based cause and effect data rather than viewing ourselves as fundamentally broken. As you say, my most important job now is parenting my young children. I am much more concerned with being attuned and nurturing than what they are eating for breakfast. You get it, my friend!

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  5. I agree with Cissy White in every way! The ACES score is a great way to describe why I suffer from depression and anxiety. It is also the stepping stone I need to heal from PTSD seeking help building RESILIENCE with my mental health as an adult!

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  7. thank you so much for sharing this with me.
    I’m 32 a divorced mother of 2 and in tears bc I have just discovered all this .

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  8. I am just learning about all of this after a friend posted another article from this site on Facebook. Very enlightening. A lightbulb went off and a huge spence of relief to get this clarity as to why I have had all these issues. Life going forward is going to be so much better.

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  9. […] How Facing ACEs makes us happier, healthier and more hopeful, by Christine Cissy White, March 16, 2017 an excellent article by a writer who found her AHA moment upon reading the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study and related science. At first wowed, referring to the experience as epic, joyful and full of relief. White claims, “This one study and it’s 10-question survey changed my life. It changed the way I see myself and feel about myself. It changed the way I parent, prioritize parenting and self-care. It altered the way I think about my past and my parents. It didn’t just change my personal life but my professional life as a writer, health activist and survivor. […]

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  11. […] I believe that most of us with chronic illnesses have experienced some form of childhood trauma even if, as I’ll describe at the end of this page and in a future post, some of us have an ACE score of “0.” This is not an easy topic, but links between adverse childhood experiences and chronic illness offers vital new resources for working with our symptoms, triggers, flare-ups and other common experiences associated with chronic illness. And for many – with chronic illnesses and with other types of symptoms that may have long gone without explanation or understanding -this research is profoundly relieving, empowering and liberating as it explains why it’s truly not your fault. […]

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  12. Hi Cissy,

    I have hugely appreciated your many recent articles and with this one had to write to tell you so.

    I didn’t know about the other ACEs surveys – which is another great resource from all that you share here about how helpful it was to know about ACEs.

    I have an ACE of zero but experienced the effects of other types of traumas that remain unrecognized but fit on the continuum as I’ve learned through research.I write about the science linking trauma to risk for chronic illness, which is what my own journey has been about (20 years with a debilitating chronic illness that is still thought to be psychological most of the time). I’ve just googled you and found some of your other work, signed up for your blog, and will be sharing this piece on my blog’s FB page :-).

    I have drafted a short form summarizing ACEs and the research for people to use with medical / mental health / office visits to educate and inform health care professionals. I will be writing a blog post about that when I get to that phase of my writing.

    Your words gave me the pieces I’d been looking for to suggest just how such a form could be used without making things worse for people with chronic rather than mental illness (ie: that wouldn’t simply trigger MD’s belief that if it’s trauma-related it must be psychological). I’m a former family doctor myself and hadn’t quite been able to figure out this particular angle until now. So thank you for that too!!

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  13. Thank you for sharing your perspective on having a high ACE score. As a high ACE score person myself I appreciated the honesty and challenge you present to us and those with low ACE scores.

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    • Thank you for writing. I’m happy to hear that. I’m always happy to hear how learning about ACEs impacts others as well, with high or low ACE scores. Please share if you feel comfortable doing so. Cissy

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  14. This is a great article Cissy! Thank you. This is such a controversial issue among many professionals I work with about how triggering teaching about ACEs may be. I very much appreciate your thoughts on this and will share your words widely.

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    • Leslie:
      Thank you for commenting and sharing. I am trying to learn more about where this fear about triggering comes from. I’ve heard it often, by people who hold this fear on behalf of others. I’ve never heard it as actually being an issue for someone with ACEs. I find it to be so validating, affirming and motivating. I don’t think to have reality acknowledged is upsetting for anyone and I don’t think it has to be done in super intense or lengthy ways. Do people detail their fears with you or what they were based on?
      I know we have to find ways to counter this perception though because it’s common. I wonder if it comes from old school talk therapy approaches and pathologizing early adversity and loss or if it is the discomfort of people who will ask or teach about ACEs? I hear about this worry as well, which I think is part silencing and shame and discomfort, which prompted me to write. Maybe those of us made exuberant, inspired and hopeful need to be more vocal? I hope it helps present another view.
      If there are other ways you have found to counter this fear of triggering in your amazing work, I’d love to learn about them. Cissy

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      • Cissy – I would love to talk to you about this – the dread of dread. Would be great to meet you, too.

        Your confidence and transparency inspire me. As a 61-year-old with an ACE Score of 8, I have done a lot of work. I like how you don’t want to blahblhablah rehash. Whew! Refreshing.

        Thanks,

        Carey

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  15. Love your article. Shared on FB. I’m most encouraged that I’m not alone in having a score of 8 and functioning. Sometimes it feels pretty lonely to be high-functioning and also have a high ACE score. Thanks so much.

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    • Stephanie:
      Thanks for commenting. I have a friend with an ACE score of 10 and to each other we sometimes refer to ourselves as “high-functioning & F’d up.” We are not beating ourselves up. We know a lot of our symptoms (overwork, overeating, compulsive busy) are a lot more socially acceptable than other symptoms and give us some power or social capital in the world. AND that they are driven entirely by the same stuff that drives other less socially acceptance symptoms. We know, that relatives who can’t function are not so different but may have symptoms that make it harder to keep a job or that can’t be hidden. Because we can “pass for normal” we may seem more like others without an ACE score (and of course, all of us have a lot in common as humans). But we also know that there are burdens and difficulties and obstacles so few understand. And that our struggles could get too much as well. That there are not safety nets for all. Not yet. it’s very similar to growing up poor or working class and being middle class as an adult. It’s living in a different place but always knowing that this place I’m in now is not the only place there is. That’s never something we don’t know. And we don’t always fit anymore, completely, in the class we’re from and the class we’re in. Thank you for reading, sharing and commenting.

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  16. Cissy, this is such a great article thank you so much for sharing. I am going to re-read it to reinforce in my brain that I do not need to go into detail about my past and it is not me that is damaged – doing a lot of work on it. I met you at Say It Survivor first workshop 🙂 I am currently doing Somatic Experience therapy with my therapist and cant believe how shut off I have kept my body my entire life. Sheila ACES = 6

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    • Hi Sheila:
      What a wonderfully small world. So glad to hear from you!

      You get to choose if, when and how you want to share and how much. I love that ACEs gives so much info. without requiring us to feel overexposed about stuff done (or not done) when we were kids. It’s empowering and just a relief. But we don’t always remember that. It seems people are asking us to share when we don’t want to and often not listening when we do want to. Hard to figure that out at times for everyone.

      I LOVE those Say It, Survivor women so much. They do the best work. And if you feel like sharing, AND ONLY IF YOU DO, I’d love to know what you think of Somatic Processing. Take care. Cis

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  17. Wow this was so empowering for me to realize that there was nothing inherently wrong with me as a child and young person but it was those who abused me horrendously. My ACE score was a 9, I only wished more therapists and psychiatrists were educated on ACE and/or cared enough to utilize it. Thanks for all you do from the bottom of my heart!!!

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    • I’m sorry for the abuse you have suffered. I’m so glad this is empowering for you as well. It’s such hopeful and helpful and validating science. I hope more and more people learn about it.

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  18. Cissy, I can relate to your feelings of validation and relief after discovering your ACE score and what it means. For me, so many pieces suddenly fell into place! Dan, ACE = 4

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    • Dan:
      Exactly! It’s like having puzzle pieces come into focus, right? I hope everyone gets that same relief and validation!

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  19. This is a life changer. I am 60. I haven’t even taken the test yet, but know my score is gonna explain some things. And to be able to “say so much without having to say so much.” Perfect! I really don’t want to explain everything, repeatedly, either!

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    • Es:
      Isn’t it nice to know you don’t have to keep explaining but can still share important info.? I think you make an excellent point, even before taking the test, many of us probably know or intuit our own scores. What we often don’t know is that there are so many others and what the scores can mean, on a bigger level. Glad that’s changing and it’s never to late for us to learn and benefit! Cis

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      • Hello,
        Love your writing. I have journaled quite a bit about how I survived a 6 ACE’s score. THE basic question I had put to myself all my life was “What’s Wrong With Me?” and I finally turned it around to “What was wrong with THEM?” It really is sad that their unresolved problems of alcoholism, anger, disappointment, depression and frustration (and probably other things I don’t even know about) caused them to inflict such trauma on their children. But…it is what it is. And like you, I’m dealing with it better every day. Thank you for your insights.

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      • Patricia:
        I hear you. When I was diagnosed with PTSD I had to fill out an insurance form and I put the names of those who abused me as my diagnosis. I was told I couldn’t do that and I said, “But if they don’t get help, things don’t change. Treating me is treating symptoms.” Plus, I didn’t revel in having a diagnosis. I think with ACEs we are understanding generational impacts of trauma and addressing ways to make lasting changes for individuals, families, and communities. That’s what energizes me. It’s not just for myself it’s for the future, too. Thank you for sharing some of your insights and experiences! Cissy

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  20. Thanks so much for this information. My husband and I adopted two girls that have an ACE score of 8 (they are now 12 and 13 – both have been diagnosed with PTSD and one has several other issues as well). I like your thought that this isn’t something that is wrong WITH them, but is from what was done TO them; I will be discussing this will them tonight. I will also be sharing this info with the therapist. We went through training to become foster/adoptive parents TWICE since 2000 and ACE was never mentioned. Neither was the fact that a young child’s brain is smaller and shaped differently due to trauma or neglect. I have made the trainers and protective services aware of this lack of information and it is supposedly now being addressed. It is blogs like yours that help get the word out.

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    • Jeanne:
      How great to get this message to your girls so early that there’s nothing wrong with them. I’m sorry for all they have already been through in their lives. It’s wonderful that you went back to help the foster care trainers learn and share more! Please consider joining the Parenting with ACEs group.
      http://www.acesconnection.com/g/Parenting-with-ACEs
      Cissy

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  22. You are so correct. Those in child welfare that push back against the reality-based documentary style videos that my organization, COPE24, produces use this excuse. “What about a student that has already been traumatized, won’t this further traumatize them?” My answer is “no, it tells them someone cares enough to get this cycle to stop.” Our students need to understand it isn’t enough to say “I’ll never do that to my child.” Helping them to understand their own trauma and then equipting them with a different and better skill set must be a part of the solution.

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    • Rene:

      “Helping them to understand their own trauma and then equipting them with a different and better skill set must be a part of the solution.”
      Yes. Yes. yes. We can use this at all ages! Cis

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  24. I’m so with you on this, Cissy – when I finally learned of the ACEs Study and how many ACEs I had – it was a lighting bolt of an “ah ha! that explains it” moment! It’s been a whole new world for me ever since. Thank you for continuing to sound the drum!!

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    • Lisa:
      It’s a drum beat that moves so much shame out of so many of us, replacing it with understanding and enthusiasm not only to help ourselves but others. I love how expansive it makes our community as well. Thanks for the work you do! Cissy

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  25. I like the idea of being able to say your ACE score and not having to go into detail — over and over again — about personal and family history. I like your emphasis here on the social — not individual — roots of some mental health issues and the destigmatizing effect of that for the individual. Thank you for writing.

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    • Dear Rebel Recovery:
      I’ve said it before but I love that name and will say so again! It’s so empowering to be able to give a number and have it say so much without having to say so much. It also keeps the narrative on adversity, as in cause and effect, instead of personalizing symptoms as though they are any more who we are, as people, as a broken bone or a stomach flu or anything else. It’s so empowering. We get to learn about others, as well, who also have similar issues and when that happens it’s hard not to become an activist. Thanks for your advocacy work, in general and for commenting. Cissy

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      • Hi Cissy, your response to my comment made my day. Thanks so much. You’re public advocacy and writing inspire me to write more publicly about some of my struggles, which I know are not mine alone. I also noticed some of your other writing, in The Elephant Journal. I, too, hope to publish something in the near future. Thanks, sincerely, for being there, for helping to pave the way. Have a great day! A.

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      • Yes, we need each other. I hope you are sharing your writing on the ACEs Connection site where there are a lot of other survivors, activists, parents, professionals, policy makers, etc. It’s a great mix of all sorts of people. No matter how much we hear “You’re not alone” it can be hard to remember/feel that until we hear from others who are different but feel similarly. Thanks again for writing and I look forward to reading your work.

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