The Practice of ACEs Science in the Time of Trump

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.

It’s also important to recognize that appeasing is another a common response to threat. Think of family violence situations where spouses must protect children and thus cannot fight, freeze or flee, and so they appease the perpetrator to try to reduce his/her abusive behavior. Thus, some people are afraid to challenge authority because of economic circumstances (a family to support, health care coverage, etc.) or they are triggered because of what they experienced as children, and respond the same way.

And many people experience a dizzying confusion when the administration says that events did not occur, when evidence of those events is in front of the world’s eyes in photos or verifiable data. Confusion and frustration are normal responses, because when parents or caregivers tell children that what they experienced (sexual abuse, physical abuse, etc.) didn’t really happen to them, they are forced to live in an unreality of someone else’s lies, often for years, which is emotionally discombobulating.

ACEs aren’t just a problem for poor people

Second, this understanding about the effects of childhood adversity is also a potent reminder that ACEs are not only an issue for people living in poverty, but for people of all economic classes, something to which the ACEs movement and research hasn’t paid much attention lately. The consequences aren’t fully understood yet, but we may be experiencing them now. The original CDC-Kaiser Permanente ACE Study clearly demonstrated that ACEs are quite common in the mostly white, college-educated, middle and upper-middle class. Twelve percent of that cohort of 17,000 participants — all of whom had jobs and great health care — had 4 or more ACEs. We know that high ACE scores can result in serious physical and mental health consequences. We know that the phrase “hurt people hurt people” emerged from the realization that most people who’ve committed violent crimes have high ACE scores.

However, hurt people hurt people on many levels, including enacting policies and legislation that are just as harmful as interpersonal violence. Many people with high ACE scores in the middle and upper socio-economic classes end up as community leaders. They are judges, teachers, principals, mayors, newspaper publishers, CEOs of companies, senators, representatives, and presidents. They create zero-tolerance schools; incarcerate children for minor offenses; enact policies that wait to intervene to offer help to troubled families until abuse has occurred, then cause further trauma by removing children from parents. They incarcerate people for being addicted to drugs; deport parents who are not a threat to public safety and separate them from their children; even manufacture false threats in order to declare wars in which thousands of brave soldiers are killed or injured, and in which thousands families and hundreds of communities suffer unimaginably.

It’s not just hurt people who are creating policies that hurt people. The reality is that all of these policies were developed by people who didn’t know about ACEs science. Our systems are organized around the belief that people can only change their unhealthy, criminal or unwanted behavior if they are punished, blamed and/or shamed. However, this new knowledge provided by ACEs science clearly shows that understanding, nurturing and helping people heal themselves is more successful and save money.

There are now hundreds of trauma-informed and resilience-building schools that eliminate expulsions, and where kids’ test scores, grades and hope (because they’re continuing on with their education) increase. Trauma-informed pediatric practices and primary care clinics are helping parents learn about their own ACEs to engage them in learning how to be healthier parents, and as a result, visits to the ER drop 30 percent. There are dozens, perhaps a couple of hundred, of trauma-informed judges and courts where recidivism drops to nearly zero. There are trauma-informed businesses and self-healing communities where hospital visits decrease, juvenile crime plummet and health insurance rates drop.

In fact, name a sector, and there are ACEs science pioneers showing that this new knowledge can actually be used to create organizations and systems that nurture people to bring out the best in them, solve our most intractable problems and save hundreds of millions of dollars.

Until they learned about ACEs science, many of those ACEs pioneers themselves supported policies based on blame, shame and punishment. Understanding ACEs science often takes some time to assimilate, however. People have to apply ACEs knowledge to their own lives before they can apply it to their family, work or community lives. That can be a challenge, because many people are reluctant — some, understandably terrified — to re-examine their turbulent childhoods, even if it means that pain and discomfort is a door to healing. Until then, they may call trauma-informed and resilience-building practices based on ACEs science “mollycoddling” or “soft” or they just won’t believe the numbers or changes in people’s lives.

Although the numbers and changes are just too big and numerous to ignore now, the spread of knowledge about ACEs sciences is still in its infancy, so we’re still functioning in a world where we are guided — consciously or subconsciously — by our ACEs. It seems as if people with high ACE scores go in one of two general directions: We see the world as a place of suffering that needs healing, encourage people to work together to solve problems, and believe that the world works better without conflict than with it. Or we see the world as a dark and dangerous place where carnage is rampant, problems are everywhere, and they are solved by identifying and defeating enemies. And if enemies do not present themselves, we who see the world as a dangerous place will create them and make them larger than they are, so that their “defeat” empowers us to find more enemies to conquer.

What can the ACEs community do?

  1. We can be inclusive and listen to each other’s stories. Most of us have experienced childhood adversity. Many of us, way too much of it. We all breathe the same ACEs air; we all swim in the same ACEs ocean, no matter what our politics, cultural background, gender, place of birth, etc. Carl Sagan, the popular astronomer and astrophysicist, said: “In the way that skepticism is sometimes applied to issues of public concern, there is a tendency to belittle, to condescend, to ignore the fact that, deluded or not, supporters of superstition and pseudoscience are human beings with real feelings, who, like the skeptics, are trying to figure out how the world works and what our role in it might be. Their motives are in many cases consonant with science. If their culture has not given them all the tools they need to pursue this great quest, let us temper our criticism with kindness. None of us comes fully equipped.”
  2. Most of us don’t have the ear of a national leader, so we can throw our energies into changing our own communities to become self-healing. The kind of progress that we humans have made over the last two centuries toward ensuring universal human rights is stunning. Two hundred years ago, three out of every four people walking this Earth lived out their lives in various types of slavery, which was indigenous to every continent. Most children worked instead of attending school. Most women were regarded as the property of their husbands, fathers or brothers. The spread of trauma-informed and resilience-building practices based on ACEs science is a logical extension of this human rights movement: Practices based on ACEs science flatten barriers to people’s freedom and futures, as well as between and among people so that we can create communities in which all people thrive.But we have to make sure we’re not ignoring anyone…and our country has, on a national level and within our communities. We can build bridges that unite everyone in the community to embrace a common respect for each other and a common purpose. This includes Republicans, Democrats, Libertarians; rich, middle-class, poor; urbanites, rural residents, suburbanites; all religions; all ethnicities and races; all abilities; all genders; all ages. Living Room Conversations is a great way to start building those bridges – it has more than 50 ready-to-discuss topics with conversation ground rules and a format than ensures everyone gets a chance to speak.
  3. We can support local journalism, and encourage the reporters and editors who serve our communities to report as much about solutions as they do about problems. When they report about local problems, we can encourage them to look for communities that have figured out solutions so that they can provide information about how we might fix things locally.We can support the national media that does the heavy lifting on keeping us informed by reporting about an administration that seems, so far, to be comfortable with not providing people with accurate information. That reporting helps us so that we don’t have to live in an unreality of the administration’s choosing.And we can encourage the national media to report as much about solutions as they do problems, too. James Fallows, an editor at The Atlantic, reported that surveys consistently show that most people are optimistic about the future of the communities in which they live, but not the nation. That disconnect is partly because we’re exposed to a more even reporting of successes and failures locally, but journalism at a national level is stuck in reporting mostly about conflict and corruption. Our view of the world is shaped by what we read and hear, so if 90% of what we read and hear is about how messed up things are, well, how can we think otherwise? As Fallows noted: “Yes, residential and educational segregation are evident across the country. Yes, police violence is more visible than ever before. But people in Michigan and Mississippi and Kansas were more willing to start confronting these injustices locally than nationally. The same was true of immigration. In our travels we observed what polls also indicate: The more a community is exposed to recent immigrants and refugees, the less fearful its people are about an immigrant menace. We heard no lusty “Build a wall” cheers in California or Texas or other places where large numbers of outsiders had arrived.” This story about Garden City, Kansas, which has worked consciously for 20 years to welcome immigrants so that it could thrive economically while other Kansas communities struggle, is a good example.
  4. As my dear friend Robin reminded me last week: We can keep breathing through our hearts. In other words, we in the ACEs movement have to walk the talk. Another friend of mind said that there’s a salient metaphorical question that’s important to ask: “Who pushed Donald Trump’s face down into the snow?” We know that, no matter whether someone has grown up in poverty or wealth, experiencing ACEs can shape them into having such a dark view of the world that empathy has been constricted into a tiny part of their soul. It’s still there, and can be retrieved if they are willing, but it doesn’t frame that person’s daily interactions. Our work is to understand that, and to do our best to create healthy communities, systems and organizations that support healthy families so that children grow up to be happy, healthy and engaged in creating open and thriving communities instead of to be distrustful, belligerent and determined to build walls, virtual or otherwise. The good news is, this isn’t a utopian vision; communities integrating practices based on ACEs science are healthy, or becoming healthy.

This new knowledge about human behavior — ACEs science — is basic and revolutionary. It’s basic because it helps us understand what works and what doesn’t work to change human behavior: Blame, shame and punishment, around which our systems are organized to change human behavior, whether criminal or unsafe or unhealthy, don’t work. Understanding, nurturing and helping people help themselves do. And ACEs science is revolutionary because it offers real hope, based on some remarkable data from pioneers in the movement, that this new knowledge can help us solve our most intractable problems.

Perhaps there’s an opportunity to educate President Trump and the people who surround him, and the current leaders in Congress about ACEs science. Perhaps not. What we know we can do is to change our own communities. But we have to make sure we’re not ignoring anyone, as we have been. ACEs science teaches us that we can work together, and make sure nobody’s left out, that there are no “deplorables”, as Hillary Clinton stated, and that we can open a door to healing for everyone who needs it. Just as our real national infrastructure is in sore need of repair, so is our virtual national infrastructure. By repairing it at the community level and integrating ACEs science to create self-healing communities, we can change the nation so that it is self-healing, too, one that is led by healers.

And one more thing: ACEs science shows us very clearly that there is no “them and us”. We’re all in this together. We’re all human; our responses to ACEs are human, i.e., the same. In that way, ACEs science is apolitical and acultural. It doesn’t matter if you’re rich, poor, black, brown, white, left, right or middle, born in Asia, Africa, South America, Australia, or Europe — if you experience many types of adverse childhood experiences, and are unlucky enough to be provided few resilience factors, your brain will be damaged, and you will suffer the consequences. Only in how we express our adversities do we differ. But the good news is: ACEs science also shows that our brains are plastic and our bodies want to heal. So, if we’re all in this together, then working together to create communities that provide environments for children and adults to heal is our only path to success.

“Together” is a tough road though, and can be extraordinarily uncomfortable, even terrifying, in its strangeness. It’s so much easier to resolve conflict by taking the traditional roads of gossiping, talking trash, yelling, bullying, hitting, shooting, locking up, running away, ignoring, not getting involved, excluding …

Oh, right. None of those things work. They’re what brought us to the divided nation we’re living in  today.

This article is being republished with permission from AcesTooHigh.

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