[Cris Alarcon, El Dorado County ACEs Collaborative, and various academic sources]
-- A little-known but hard working group of people are trying to save the children of El Dorado County --
Yes, it sounds like a sensational headline, but saving the children of EDC did not seen sensational to me, to just seemed like something that should be done. Maybe because at one time, I was one of those children of El Dorado County that needed saving. What was sensational to me was the recent discovery of how an abusive/neglectful childhood results in an astronomically higher likelihood of serious physical health issues much later in life.
At age 50 I was diagnosed with epilepsy after I was hospitalized due to an extended Grand mal seizure of about a half an hour before they were able to stop it at Marshall Medical Center in Placerville. I had never had anything like that in my life! After a year of testing I discovered that I have had epilepsy most of my life and that it likely started from early childhood traumas. It went unnoticed until it worsened as I aged. Thus began my research into epilepsy and my own road to self-discovery where I discovered that most of the things I believed about myself, were wrong!
Like most physical traumas, there is an accompanying psychological companion element. In learning about my epilepsy, I discovered that I had both long-ago physical traumas, and their companion psychological traumas. Old survival reactions that hold sway over me today, even if they are now counter-productive.
Physiologically each epilepsy has its own characteristics depending on what part of the brain is effected. In my case it is epileptic activity with a focal of my right frontal lobe. This part of our brains control things like higher reasoning, emotions, logic and is expressed in short (less than a minute) seizures both while asleep and awake. Two of the better known conditions related to this area include Turrets Syndrome and "Absence seizures" where a person becomes unresponsive or "zones out" for less than a minute. For me, the most significant affect is that I easily become extremely or excessively emotional. I cry for for crushed insects and become very angry at the most insignificant irritants. It has been the inability to properly respond to my resurfacing "feelings" that has made me stop and seriously seek change.
That is how I came to find the results of the ACEs study and recognize the disturbing parallels to my own life. I also found many of the keys to understanding my "feelings." Critical for me was gaining the understanding that most of my strong emotions today were the same responses that I learned as a young child to survive, but that I had never modify into a more productive adult response. I had to understand that my behavior at 52 was directly learned responses from my early childhood. I learned to suppress my emotions as a young child to survive rough events. This passage gave me great insight:
Van der Kolk continues with the statement that grabbed me: “what makes life unbearable is not emotions but physical sensations.”
“When you have a persistent sense of heartbreak and gutwrench, the physical sensations become intolerable and we will do anything to make those feelings disappear. And that is really the origin of what happens in human pathology. People take drugs to make it disappear, and they cut themselves to make it disappear, and they starve themselves to make it disappear, and they have sex with anyone who comes along to make it disappear and once you have these horrible sensations in your body, you’ll do anything to make it go away.”
“If these sensations last long enough, your whole brain starts fighting against emotions. And what happens in the long range is that traumatized people who continuously have a state of heartbreak and gut wrenching feelings learn to shut off the sensations in their bodies. And they go through life not feeling their physical presence.”
So I asked a few close and long-time friends, "Are these different behaviors or simply Enhanced intensity of my old normal behaviors. Each had the same take, it was the same me but to a more excessive level! That meant that the long epileptic seizure had cost me the ability to bury my emotions the way I had for most of my life. They were on the surface and they were strangers to me.
I have an excellent neurologist, and maybe the best clinical counselor in the county. My neurologist explained it to me in the geek-terms she knew I would best understand: I had a bad spot on my harddrive (brain with a place of abnormal epileptic electrical activity) and we could work a software fix (psychological), we could partition the section (surgery), but we could not replace the harddrive. I was a candidate for the first option, learning how to live with my "new norm."
That is how I found ACEs. Adverse Childhood Experiences (ACEs) are traumatic events that have significant, long term impacts on children’s developing brains resulting in poor health, social and mental health conditions.
Background: The Adverse Childhood Experiences Study — the largest, most important public health study you never heard of — began in an obesity clinic.
The Center for Disease Control, in partnership with Kaiser Permanente, lead one of the largest investigations of childhood abuse and neglect and later-life health and well-being, referred to as Adverse Childhood Experiences (ACE) Study. Through this study, an ACES screening tool was developed to assess an individual’s emotional, physical and sexual abuse; household challenges such as violence, substance abuse, mental illness, divorce and incarceration; emotional and physical neglect. Overall, the greater the number of ACEs a child experiences, the increased likelihood that they will experience costly, long-term health outcomes. The best intervention is to build resiliency in children through a trauma informed approach.
The CDC’s Adverse Childhood Experiences Study (ACE Study) uncovered a stunning link between childhood trauma and the chronic diseases people develop as adults, as well as social and emotional problems. This includes heart disease, lung cancer, diabetes and many autoimmune diseases, as well as depression, violence, being a victim of violence, and suicide.
The first research results were published in 1998, followed by 57 other publications through 2011. They showed that:
-- childhood trauma was very common, even in employed white middle-class, college-educated people with great health insurance;
-- there was a direct link between childhood trauma and adult onset of chronic disease, as well as depression, suicide, being violent and a victim of violence;
-- more types of trauma increased the risk of health, social and emotional problems.
-- people usually experience more than one type of trauma – rarely is it only sex abuse or only verbal abuse.
A whopping two thirds of the 17,000 people in the ACE Study had an ACE score of at least one — 87 percent of those had more than one. Eighteen states have done their own ACE surveys; their results are similar to the CDC’s ACE Study.
Childhood trauma isn’t something you just get over as you grow up. Pediatrician Nadine Burke Harris explains that the repeated stress of abuse, neglect and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain. This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease and lung cancer.
The study’s researchers came up with an ACE score to explain a person’s risk for chronic disease. Think of it as a cholesterol score for childhood toxic stress. You get one point for each type of trauma. The higher your ACE score, the higher your risk of health and social problems. As your ACE score increases, so does the risk of disease, social and emotional problems. With an ACE score of 4 or more, things start getting serious.
The likelihood of chronic pulmonary lung disease increases 390 percent; hepatitis, 240 percent; depression 460 percent; suicide, 1,220 percent.
I ranked an eight of ten on the ACEs scale and study results read like a textbook of my life. I came to understood that the only way to deal with my emotions today, was to get to know them, what triggers them, and why. The why goes back to my childhood and the ACEs program helped me understand that even those old, established responses can be changed with thoughtful efforts. I also concur strongly with the study's fundamental conclusion that it is far better to prevent this kind of damage than it is to try to repair it afterward.
(By the way, lest you think that the ACE Study was yet another involving inner-city poor people of color, take note: The study’s participants were 17,000 mostly white, middle and upper-middle class college-educated San Diegans with good jobs and health care – they all belonged to the Kaiser Permanente health maintenance organization.)
What causes this?
At the same time that the ACE Study was being done, parallel research on kids’ brains found that toxic stress physically damages a child’s developing brain. This was determined by a group of neuroscientists and pediatricians, including neuroscientist Martin Teicher and pediatrician Jack Shonkoff, both at Harvard University, neuroscientist Bruce McEwen at Rockefeller University, and pediatrician Bruce Perry at the Child Trauma Academy.
When children are overloaded with stress hormones, they’re in flight, fright or freeze mode. They can’t learn in school. They often have difficulty trusting adults or developing healthy relationships with peers (i.e., they become loners). To relieve their anxiety, depression, guilt, shame, and/or inability to focus, they turn to easily available biochemical solutions — nicotine, alcohol, marijuana, methamphetamine — or activities in which they can escape their problems — high-risk sports, proliferation of sex partners, and work/over-achievement. (e.g. Nicotine reduces anger, increases focus and relieves depression. Alcohol relieves stress.)
Using drugs or overeating or engaging in risky behavior leads to consequences as a direct result of this behavior. For example, smoking can lead to COPD (chronic obstructive pulmonary disease) or lung cancer. Overeating can lead to obesity and diabetes. In addition, there is increasing research that shows that severe and chronic stress leads to bodily systems producing an inflammatory response that leads to disease.
For more information about that aspect: http://www.coleva.net/COLEVA-Main-2-2-2011-v2.html
Fortunately, brains and lives are somewhat plastic. The appropriate integration of resilience factors born out of ACE concepts — such as asking for help, developing trusting relationships, forming a positive attitude, listening to feelings — can help people improve their lives.
Often termed "Your Resilience Score" was not developed for research but to prompt reflection and conversation on experiences that may help protect most people with four or more ACEs from developing negative outcomes.
In Brief: What is Resilience?
Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems or workplace and financial stressors. It means "bouncing back" from difficult experiences.
Research has shown that resilience is ordinary, not extraordinary. People commonly demonstrate resilience. One example is the response of many Americans to the September 11, 2001 terrorist attacks and individuals' efforts to rebuild their lives.
Being resilient does not mean that a person doesn't experience difficulty or distress. Emotional pain and sadness are common in people who have suffered major adversity or trauma in their lives. In fact, the road to resilience is likely to involve considerable emotional distress.
Resilience is not a trait that people either have or do not have. It involves behaviors, thoughts and actions that can be learned and developed in anyone.The science of resilience can help us understand why some children do well despite serious adversity. Resilience is a combination of protective factors that enable people to adapt in the face of serious hardship, and is essential to ensuring that children who experience adversity can still become healthy, productive citizens.
In 2015, El Dorado ACEs collaborative was formed as a communitywide response to eliminate Adverse Childhood Experiences in our County, creating an awareness of the impacts of trauma and promoting prevention, early intervention and treatment for families.
Over 90 members representing agencies, community-based organizations and individuals, participate in the collaborative. Objectives are guided by the Steering Committee and achieved through Sector Work Groups that represent the communities we live in and areas of expertise: South Lake Tahoe, the Divide, Education, Health, Public Safety, Community, Social Services/Foster Care, and Behavioral Health. In the last year, the members have:
-- Developed two-year action plans for all work groups to bring attention to the long term impacts of adverse childhood experiences and implement trauma informed strategies to support families.
-- Created an awareness of the impact of trauma through educational presentations.
-- Constructed El Dorado ACEs Connection website offering information on adverse childhood experiences and resources for trauma informed care.
-- Mapped community assets to identify prevention, early intervention and treatment services.
-- Incorporated trauma informed approaches in the El Dorado County Community Health Improvement (CHIP) Plan.
Learning more about ACEs:
Find your ACE and resiliency score: www.acestoohigh.com
Discover the impacts of ACEs: www.acesconnection.com.
For more information about the CDC ACE Study: http://www.cdc.gov/ace/index.htm
Participating in local events http://www.acesconnection.com/g/el-dorado-county-ca-aces-connection
Here’s a three-part sequence about resilience. These videos provide an overview of Supportive Relationships and Active Skill-Building Strengthen the Foundations of Resilience, a working paper from the National Scientific Council on the Developing Child
Part 1- https://www.youtube.com/watch?v=cqO7YoMsccU
Part 2- https://www.youtube.com/watch?v=1r8hj72bfGo
Part 3- https://www.youtube.com/watch?v=xSf7pRpOgu8
Ten Ways to Increase Resilience- http://www.apa.org/helpcenter/road-resilience.aspx
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[I want to acknowledge that although I composed the personal parts and general observations, I lifted much of the academic work from several academic journals with few edits, and even fewer deserved credits. I did this to reduce the length of an already overly lengthy article to improve readability for a broader audience. It does not reflect the value or deserved credit of any unnamed contributors. Cris Alarcon.]
