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. Dsyfunction.

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.

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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).

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Putting resilience and resilience surveys under the microscope

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“Resilience is a message of hope,” says Debbie Alleyne, a child welfare specialist at the Center for Resilient Children at Devereux Advanced Behavioral Health, located in Villanova, PA.“It is important for everyone to know that no matter their experience, there is always hope for a positive outcome. Risk does not define destiny.”

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The most important thing I didn’t learn about in medical school: Adverse childhood experiences

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Dr. Nancy Hardt

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The most important thing I didn’t learn in medical school is about adverse childhood experiences, also known as ACEs.

To be sure, if I had understood them then the way I do now, I would have been a better and more compassionate physician. Importantly, I would have avoided lots of mistakes.

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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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Congressional briefing addresses public policy to improve response to ACEs

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In the final weeks of the 114th Congress, Senator Heidi Heitkamp (D-ND) welcomed her colleague Senator Dick Durbin (D-IL) as a new host for the third and final briefing on addressing adverse childhood experiences (ACEs). The December 1 briefing focused on public policies to improve coordination, prevention and response to childhood trauma.

ACEs comes from the CDC-Kaiser Permanente Adverse Childhood Experiences Study and subsequent surveys that show that most people in the U.S. have at least one ACE, and that people with an accumulation of childhood adversities — including divorce, racism, living with an alcoholic parent, and physical abuse — have a higher risk of adult onset of chronic health problems such as heart disease, cancer, diabetes, suicide, and alcoholism.

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