The month of May was proclaimed National Mental Health Awareness Month back in 2013 and, as I indicated in my last Talk Therapy reflection in March, I want to share more about the research around adverse childhood experiences (ACEs), the resulting developmental trauma, and the long-term impact on body-mind health. The intention behind this reflection is to bring more awareness to the underlying causes of dis-ease and, through such awareness, expand our collective capacity for compassion for those suffering from the effects of early childhood trauma. It is only through more education and awareness that our society will move in the direction of prevention by aligning resources with ways to stop the causes and turn away from just focusing on the treatment of the symptoms.
I also want to mention right up front that it is not my intention to place blame as that would be an attempt to simplify a very complex human condition. As one of my dear colleagues once said, “We don’t know what we don’t know. However, when we know better, we do better.” Therefore, as you read this reflection and maybe read more about the research on this topic, I hope you will come to see, as I did, that our traumatic experiences are not isolated and, in fact, most likely emanate from past generations living through similar experiences without the resources that are available today.
The first ACE study that began in 1995 was conducted in collaboration between the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente, a health maintenance organization in southern California. The participants, over 17,000 patients with health insurance were asked to complete a confidential questionnaire that asked about childhood maltreatment and family dysfunction to identify any relationships between specific ACE and known risk factors, such as smoking and alcohol/drug abuse, for chronic disease. Since this first study, many studies have been done to validate the original results, using larger and more diverse population samples to assess if the exposure to ACE increases the risk of adult disease and disability. If you are interested in reading more, the CDC website (https://www.cdc.gov/violenceprevention/acestudy/journal.html) contains a listing of journal articles by topic area.
The original study included seven categories of ACE, including abuse (physical, psychological, sexual), domestic violence (violence against mother), and household dysfunction due to any members who were substance abusers, mentally ill or suicidal, or ever imprisoned. Future studies expanded the ACE categories to include family dysfunction due to divorce and to track alcohol and other drug abuse separately.
What all of these studies have come to show is that ACEs are more common than any of us would want to know. These studies have also shown that a majority of ACEs are not experienced in isolation, meaning that if children experienced one ACE they probably experienced more than one ACE, guiding future research to investigate the cumulative impact of multiple childhood traumas on the development of disease. In addition, the higher the cumulative ACE score, the greater association with many mental, physical, emotional, and social problems, including substance use and abuse.
Expanding our awareness of what constitutes an ACE and the fact that ACEs impact the neurodevelopment of children, disrupting the healthy development of the human nervous system, begins to open our minds and hearts. Deepening our understanding further that a damaged nervous system may guide children toward unhealthy coping strategies to survive the complex traumas they have lived through, opens the door to compassion, instead of judgment and punishment, by helping us all to realize that these unhealthy behaviors were not a choice these children made, but were normal, natural adaptive responses to inhumane conditions that they found themselves in by no choice of their own.
If you are interested in learning more about how ACEs are being assessed or to determine your own ACE score, click on the ACE SCORE CALCULATOR button below.
If you would like to read a summary of the ACEs study data presented by the Substance Abuse and Mental Health Services Administration (SAMHSA), including prevention efforts based upon this growing awareness and understanding of developmental trauma, click on the SAMHSA button below.