The practice of ACEs science in the time of Trump

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As with any remarkable change, the 2016 presidential election, a swirl of intense acrimony that foreshadowed current events, actually produced a couple of major opportunities. It stripped away the ragged bandage covering a deep, festering wound of classism, racism, and economic inequality. This wound burst painfully, but it’s now open to the air and sunlight, the first step toward real healing. The second opportunity is how the election and its aftermath are engaging more Americans from many different walks of life. The election brought out people who hadn’t voted in years; its aftermath has engaged people who’d counted on someone else to do their citizenship work for them. All these people — all of us — now have an opportunity to work together to solve our most intractable problems. That knowledge is embodied in the science of adverse childhood experiences (ACEs).

In a nutshell, this ACEs science clearly shows that childhood trauma results in the adult onset of chronic physical and mental illness, violence, and being a victim of violence. It shows that most of us have experienced childhood trauma. And it shows that the systems we’ve created to change human behavior — whether criminal, unhealthy or unwanted — will actually work if we change them from blaming, shaming and punishing people to understanding, nurturing and and healing them.

The divide we start from is stark: an Electoral College that chose Donald Trump to be president by a vote of 306 to 232, and the voters who chose Hillary Clinton by a nearly three-million vote margin (65,844,610 to 62,979,636).

So, here we are with an administration, whether you agree with its policies or not, that often uses bullying to try to get its way instead of respectful negotiation, responds to decisions it doesn’t like with threats instead of respectful disagreement, describes events it doesn’t like by saying they didn’t happen, and is enacting some policies that harm children and families.

Those actions are not just a matter of being merely “politically incorrect”. ACEs science is clear: bullying, losing a parent (to divorce, separation or deportation), emotional abuse, racist or religious discrimination, physical abuse and witnessing others being hurt — along with several other types of adversity — harm children and adults.

In the case of children, these experiences damage the structure and function of their brains, which can lead to them becoming unhealthy adults who may harm themselves or other people. If their adverse experiences are unrelenting, children live much of their lives in survival mode, responding to their world by fighting, by being frozen into inaction by fear, or by fleeing. They can’t learn as well as those who haven’t been traumatized and they don’t form healthy relationships because they have trouble trusting.

Besides the damage to their brains, children’s health suffers in two other ways: The over-production of the stress hormone cortisol damages their immune response system, leading to illness and chronic diseases that can affect them immediately and/or emerge when they’re adults. These diseases include asthma, obesity, cancer, heart disease, autoimmune diseases, etc. And to cope with the anxiety, depression, frustration, anger, etc. caused by toxic stress from ACEs, children grow into adults who drink too much alcohol or become addicted to other drugs or activities such as shopping, or who overeat, rage, engage in thrill sports, and even overachieve (workaholism), all of which can also contribute to poor health.

These same behaviors — bullying, emotional abuse, racist or religious discrimination, physical abuse and/or witnessing others being hurt — can harm adults, too. Depending on the number of the ACEs they experienced, the duration and when they occurred, the nurturing they received when they were growing up, or the healing that they experienced, adults can be triggered into reliving those same experiences virtually, with the same fight, flight or freeze responses, and, in absence of healthy behaviors, the same harmful coping behaviors. Adults carry these behaviors with them to shape how they interact with their co-workers, their children, and people in their community.

And so the cycle continues.

As we progress through these next few years, this knowledge about ACEs science helps us in two ways:

First, it helps us understand that our responses of fight, flight, or fear to current bullying, threats, and/or humiliation are normal and expected if we’ve had those experiences in our childhood. And one part of ACEs science — the CDC-Kaiser Permanente Adverse Childhood Experiences Study — as well as the dozens of subsequent ACE surveys completed by 32 U.S. states and several countries — show that most of us have had those experiences. It helps us recognize that anger, though useful to motivate, will harm us if we don’t move through it to constructive – not destructive — action. Anger comes from survival brain, and we need to be in thinking brain (our prefrontal cortex), if we’re to make good decisions.

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Just one year of child abuse costs San Francisco, CA, $300 million….but it doesn’t have to

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In 2015, 5,545 children in San Francisco, CA, were reported to have experienced abuse. Of those, the reports of 753 children were substantiated. The expense to San Francisco for not preventing that abuse will cost $400,533 per child over his or her lifetime. That adds up to $301.6 million for just that one year, according to “The Economics of Child Abuse: A Study of San Francisco.”

And, because child abuse is profoundly underreported, the costs are likely to be as much as $5.6 billion for one year of children experiencing trauma, the report found.

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Pueblo, CO, clinic rewrites the book on primary medical care by asking patients about their childhood adversity

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In October 2015 in Pueblo, CO, the staff members of a primary care medical clinic – Southern Colorado Family Medicine at the St. Mary-Corwin Medical Center – start asking parents of newborn babies to kids five years old about the parents’ adverse childhood experiences and the resilience factors in their lives. They ask the same questions of pregnant women and their partners in the hospital’s high-risk obstetrics clinic.

The results are so positive after the first year that the clinic starts asking parents of kids up to 18 years old. The plans are to do the same in the hospital’s emergency room.

Why? They think it gives kids a leg up on a healthier start in life. They think it helps adults understand and manage their own health better. They think it helps physicians better understand and help their patients. Oh yeah – and it looks like it’s going to save money. Probably a lot of money.

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This EMT integrates ACEs, offers emotional first aid

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Peter Chiavetta and the handouts he gives patients

One day, when Peter Chiavetta was just out of college, he was driving down a road in Eden, NY. Before he could even give the slightest conscious thought to his actions, he swerved off the road onto the shoulder. The car that was heading straight at Chiavetta slammed into the vehicle behind him.

“I thought I was a good prepared citizen,” recalls Chiavetta. “I had road flares and a two-pound fire extinguisher in the trunk of my car. I’m standing in the middle of the road with my little fire extinguisher, while on the ground the two passengers in the car behind me had been ejected and were lying motionless. Out of nowhere a man appeared with a first-aid kit and tried to help one of the victims. The driver — covered with blood and his knees are chopped down to bone — was calling out to me for help. I had no idea how to help him.”

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Which version is your kid’s school?

This fabulous video from Atlanta Speech School shows what a trauma-informed/resilience building school looks like — and what a school looks like that hasn’t incorporated these practices.

We’ve done stories about schools that have incorporated practices based on the science of adverse childhood experiences. This science includes who suffers and the consequences (the CDC-Kaiser Permanente Adverse Childhood Experiences Study and other epidemiological studies), the effects of toxic stress that these experiences have on a child’s brain and body, how the consequences of these experiences can be passed from generation to generation, and the resilience research that shows our brains are plastic and our bodies want to heal.

Here’s a list:

Lincoln High School in Walla Walla, WA, tries a new approach to school discipline; suspensions drop 85% — This led to the making of the amazing documentary Paper Tigers, which followed six Lincoln High School students for a year.

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Violence is just one part of childhood trauma. So why are we focusing so much on childhood violence?

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Whac-A-Mole players (photo by Laura)

Many people and organizations focus on preventing violence with the belief that if our society can stop violence against children, then most childhood trauma will be eradicated.

However, research that has emerged over the last 20 years clearly shows that focusing primarily on violence prevention – physical and sexual abuse, in particular – doesn’t eliminate the trauma that children experience, and won’t even prevent further violence.

“Although violence can beget violence, it’s hardly the only cause of violence,” says Dr. Vincent Felitti, co-principal investigator of the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study), groundbreaking epidemiological research that showed a direct link between 10 types of childhood trauma and the adult onset of chronic disease, mental illness, violence and being a victim of violence, among many other consequences.

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