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Reading the Signs of Trauma

I lived in Kotzebue, AK, for four months. One reason I was attracted to the community was an opportunity to introduce the concept of childhood trauma and ACEs. I did that. The Northwest Arctic School District had a wonderful and compassionate superintendent, Dr. Norm Eck.

I had a few conversations with Dr. Eck about ACEs and how it affects children as they become adults. Dr. Eck accepted the information and had plans to examine it more deeply, but eventually retired and the spread of information slowed. The community did hold a session to examine the study and results. I am hopeful the work we do on the state level will help spread the message about trauma in kids and adults in more depth.

One sign I read about that signaled the depth of trauma in the Northwest Arctic was an extremely high suicide rate. Although the entire Northwest Arctic has a population of approximately 8,000 spread throughout 13 villages, from 2004-2006 the reported suicide rate was 90.9 per 100,000, according to the Alaska Suicide Follow-back Study. Programs have been implemented to deal with the high suicide rates and have claimed success reducing teen suicides. Teens are included in the group, with the highest reported rates of suicide among Alaska Natives, who comprise a large part of the Northwest Arctic Borough (NAB) population. Native men between the ages of 15-34 have the highest rate of completed suicides among Alaska Natives.

The program implemented for the NAB holds promise. But when you read about what happens there on a regular basis in the NAB, it confirms my original observations. The historical trauma perpetrated on Alaska Native people has evolved into an inter-generational transfer of trauma with considerable life long impacts. 

This story from the Anchorage Dispatch News -- Teens killed Kotzebue man over marijuana and alcohol, police say -- tells how three young men, all teenagers, allegedly murdered another man for alcohol and drugs. Two of the teens had a recent history of criminal acts. But the fact that the three used alcohol and drugs, and two had frequent interactions with the justice system, should scream out loud about the presence of adverse childhood experiences.

Because our systems—health, behavioral health, child protection and justice—are all triggered by provable, observable symptoms, we are often limited to interventions instead of prevention. Because the data I can observe about the three young men charged with murder is limited, it’s hard to say if the signs of trauma were observable earlier. I would say, with reasonable certainty, that they were. If we surveyed the young men and got honest answers, they would likely report multiple ACEs. I would be surprised if they did not.

Our level of knowledge about ACEs and the potential for healing are limited by state policy and a lack of generalized knowledge about the impact of ACEs on people. We silo our solutions and present them only on the accumulation of symptoms that start to inconvenience us. When we can't deliver a solution, the criminal justice system takes over.

As we move forward with our discussion on solutions, I continue to advocate for an ACE early warning system and quicker interventions with a more compassionate approach. Let’s not wait until serious symptoms appear. The signs of trauma are usually evident, once you know what to look for.

Let me digress a bit and comment about “chicken sexers.” OK. I am not being strange. In his book Blink: The Power of Thinking Without Thinking, Malcolm Gladwell describes how chicken sexers are trained and the amount of training and practice it takes for them to become proficient. We need people who are trained to recognize the presence of childhood trauma with a high degree of accuracy. We have lots of knowledge about ACEs, but no real action. As Gladwell notes: “The key to good decision making is not knowledge. It is understanding. We are swimming in the former. We are desperately lacking in the latter.” If we understand how ACEs progress and the signs (there are many) exhibited, we should be able to train people to recognize early enough to intervene.

I feel sad for the victims (in in one sense they are victims) in the Kotzebue murder. As you study ACEs and its impact on people, think about how we might recognize the early signs and what good and compassionate interventions might look like. After doing that myself for the past seven years, I am ready for us to start taking the next step. Think “Recognition, Compassionate Intervention, Prevention” and finally, Celebration.

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I found the work of Dr Bruce Alexander and that of Dr Gabor Mate very enlightening on the impact of ACE experiences on Native American people's.

made perfect sense to me as to the much higher rate of substance dependence, PTSD, and other mental health issues amongst this population, compared with the non-indigenous population.

the profound destruction of their discrete historical culture has been long overlooked by the self congratulatory advocates of the overwhelming benefits of "white civilised values".

Sometimes I think that the arrogance of our thinking is beyond parody!

Lets hope that your seeds bear fruit amongst the more open minded administrators.

all the best

John F.

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