Sonoma County ACEs Connection members
Allen Nishikawa and Lena Hoffman at California Policymaker Education Day, 2018
Allen Nishikawa, a sansei, or third-generation Japanese American, majored in political science and American history at the University of Wisconsin, Madison, where he participated in antiwar (Vietnam) marches. But it was his experience as a military brat — moving from school to school across the U.S. and even to Japan as a child — that shaped his own childhood experiences and channeled a mindset conducive to welcoming the truth of ACEs.
Nishikawa recently retired from more than 20 years with Sonoma County (CA) Health Services, where he coordinated services for people with HIV/AIDS for 15 years and then worked on special projects in maternal child health and communications. When Dr. Vincent Felitti, co-principle investigator of the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study), came to speak about ACEs at his workplace in late 2013 or early 2014, it was Nishikawa's “aha” moment. “It was really exciting,” he says.
The ACE Study links 10 types of adverse childhood experiences (ACEs) to adult onset of chronic disease, mental illness, violence, or being a victim of violence. The original 10 ACEs included experiencing physical, sexual or verbal abuse; physical or emotional neglect; living with a family member who abuses alcohol or drugs or is mentally ill; experiencing divorce; having a family member who is incarcerated and witnessing a mother being abused. Since then, more than a dozen other experiences have been added to the ACEs list, including being bullied, experiencing community violence, racism, living in a war zone, moving often, having a family member deported and being involved in the foster care, immigration or criminal justice systems.
Nishikawa ties the importance of ACEs to a popular meme — the hero’s journey described by Joseph Campbell. Campbell’s television series investigated myths and religious beliefs. “The premise being that a person is living their normal life,” explains Nishikawa, “and then they encounter something and are faced with a real decision point: Does this information tell me I have to do something different?
“The same thing happens with ACEs. This information is world-changing on a lot of levels. For anyone in human services, it reinforces everything you instinctively knew. People are doing things as a result of who they are. They are acting in ways that may not be helpful to them now but at one time worked for them.”
Nishikawa says that knowing about ACEs also impacted his personal life.
“It explains so much in my life. I have a very low ACE score, either 0 or 1, but that’s because adverse community factors like racism were not included. My father was in the military and we moved around a lot. To always be the new kid in the school was a challenge. The added complication was being Asian. When we were stationed in Japan, all the Japanese knew I was American because of the way I spoke and moved. And in America, people assumed I was Japanese. For me, I always felt a bit like an outsider, and I was drawn to populations that weren’t always welcome. That’s why I have worked with refugees, farmworkers, and people with AIDs.
“And the other thing I realized, in the military, you have to realize that for some of these people, the military is a better family than the one they came from. I knew several men and asked them, ‘Why did you join the military?’ They said, ‘Because the judge said, We can send you to jail or if you enlist, we will make this go away.’”
That led Nishikawa to realize that many people who experienced trauma are naturally drawn to certain professions: law enforcement, military, human services and health services, because of things that happened in their own lives. “This bad thing happened to me,” he explains. “If I can use it to help other people, then maybe it can become a good thing. You hear it all the time with people who do drug counseling.” And in Nishikawa’s case, he first worked helping refugees resettle because he felt he shared outsider experiences with immigrant communities.
While working with the county as a manager, Nishikawa says that although he wasn’t in a position to integrate ACEs for their clients, he focused on the staff. “We spent a lot of time talking about ACEs and thinking about it because a lot of our staff had high ACEs, and we were putting them in high-risk situations. They might hear a story that’s too close to home one day.
“A lot of our staff took the ACEs test and were surprised because we didn’t fit the normal curve. There was a higher number of people with ACEs and they had higher scores. At a training, people started freaking out the first time we took it and we had to stop. We had to call in counseling professionals to deal with the fallout.”
A big supporter of ACEs integration into community health agencies, Nishikawa also believes much needs to be done to make organizations truly trauma-informed. He advocates that health agencies need to develop standards, interagency communications and methodologies, so that “we are all talking the same language.”
Nishikawa began posting stories on ACEsConnection based on his own experiences because he thinks stories are more powerful than straight news accounts. “People remember stories,” he says. “With stories, it’s the point you realize: Maybe I should learn a different way of doing stuff. It’s the hero’s journey again. Do I just keep doing business as usual, or do I have to do something different? That’s the key issue: you have to reach a decision point. It’s true for people, for agencies, and ACEs community groups.”
Nishikawa continues to apply ACEs training into his life. As one of the first class of local graduates of mind-body medicine conducted by Dr. James Gordon, founder of the Center for Mind-Body Medicine, he is now applying the lessons of stress-reduction practices for people in Sonoma County. Because of the terrible fires in Sonoma County two years ago, Nishikawa said there was an opportunity to talk about the effects of trauma and discover that people might have encountered trauma earlier in their lives. He then offers solutions, some as small as a few minutes of meditation, to develop resilience to counter former destructive behaviors arising from ACEs. He recently completed a set of sessions with low-income seniors and plans to lead more groups in the future.