The ACEs movement 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 for the ACEs movement. 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.

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 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 — damage the structure and function of children’s brains, which can lead to them becoming unhealthy adults who may harm themselves or other people, or help 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. Children’s health suffers in two ways: The over-production of cortisol damages their immune response system, leading to illness and chronic diseases that can affect them immediately 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.

Depending on the number of these ACEs, the duration and when they occurred in a child’s life, the nurturing that children who experience ACEs receive when they’re growing up, or the healing that they experience when they’re adults, these same ACEs can trigger adults. It can throw them back 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 their work, school, children, and community environments. And 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. 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. It’s important to recognize that appeasing is also a common response to threat (think family violence situations where spouses must protect children and thus cannot fight, freeze or flee, and so they appease the perpetrator to try to minimize his/her actions), and thus some people are afraid to challenge authority because of economic circumstances (a family to support, health care coverage, etc.).

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. That's normal, because parents or caregivers often tell children that what they experienced (sexual abuse, physical abuse, etc.) didn’t really happen to them, and they are forced to live in an unreality of someone else’s lies, often for years.

Second, the knowledge 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, with 12 percent of that cohort of 17,000 study participants — all of whom had jobs and great health care — having 4 or more ACEs. We know that high ACE scores can result in 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. 

Hurt people hurt people on many levels, however, including enacting policies and legislation that are contrary to the science, because many people with high ACE scores in the middle and upper socio-economic classes end up as community leaders, including 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; 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.

Most of those policies have been developed by people who didn't know about ACEs science. Our culture is based on 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. We’re seeing the creation of trauma-informed and resilience-building schools that eliminate expulsions and where kids’ test scores and grades increase, trauma-informed pediatric practices and primary care clinics where parents learn parenting skills and visits to the ER drop 30 percent, trauma-informed judges and courts where recidivism drops to nearly zero, trauma-informed businesses and self-healing communities where people are healthier, happier, hospital visits decrease, juvenile crime decreases and health insurance rates drop. In fact, name a sector, and there’s an ACEs science pioneer 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 the knowledge to change the understanding of 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 to re-examine their turbulent childhoods, even if it means that discomfort is a door to healing.

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.

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’re all breathing the same ACEs air; we’re all swimming 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.

  1. 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 four people walking this Earth lived out their lives in various types of slavery indigenous to every continent; most children worked instead of attending school; women were regarded as the property of their husbands or fathers. The ACEs movement is a logical extension to flattening 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.

  1. 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 way, we don’t have to live in an unreality of its 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 distribution of successes and failures through local events and reporting, 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.”

  1. 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.

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 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 it is self-healing, too, one that is led by healers.

And one more thing: ACEs science showed 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; only the expression is different. “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 where we are today.  

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Some think the scariest part of a horror movie is the monster. I think the scariest part is when people try to convince others that the monster exists and no one believes them. For many who have experienced ACEs, I suspect there is a big challenge in getting others to acknowledge that things even happened to you and are significant in your life. Too often, the response is, "It's not important, get over it."

As your article suggests, the current situation provides all of us with an opportunity to learn a lesson in empathy. Some of us are now experiencing what it feels like to be casually dismissed and trivialized, and perhaps we will develop a better appreciation of the folks who felt their needs and concerns were similarly overlooked for many years.

Whether it's your patient or the entire country, it helps to go past "Why are they crazy?" and get to "What is your pain?"

Matt: Thanks so much for your comment. I'm so glad you moved from the storm to being a healer.

Kathy: Thanks for posting the additional links for information about self-healing communities. We've also included a description and links in our Resources Center in the ACEs science for communities section. 

Diane -- Thanks for passing it on...it's making a difference. As I'm posting this comment, more than 4,000 people have read this. 

Lisa -- Thanks for reading this, and for your kind words!

Peter: Thank you for commenting. I'm very curious how elected officials -- at any level and from any political party -- respond to the essay. I began thinking about how the ACEs experienced by leaders affected how they governed after I read a remarkable article in 2014, "Abuse in Britain's boarding schools: why I decided to confront my demons", by Alex Renton in The Guardian, about English boarding schools attended by the children of the elite. These boarding schools were known for canings (which were legal until 1999), sexual and physical abuse. Worst of all, six- and seven-year-old boys' were separated from their families for months at a time, during which they were punished for crying or expressing any other type of "weak" emotion. Renton wrote:

And so it is interesting that so many senior politicians in government went to boarding schools, places that, by definition, practise on young children the techniques of "attachment fracture" – a psychiatrist's phrase – that are key to removing early emotional ties and building esprit de corps.

The mark of a successful school was crushing these "weak" emotions, replacing them with anger and revenge, and inculcating a distaste for weakness before students left the school. As Renton says about the country's leaders, most of whom attended these schools: 

But, as critics like to point out, this clutch of male ruling politicians embodies the grand Victorian public school virtues – or failings – more than most: suppression of emotion, devotion to the team, distrust of women and minimal empathy for the weak and ordinary. 

So, examining the childhood of a person who's running for elected office might be useful, to see how the adversities, if there were any, were balanced and healed by resilience-building, or protective, factors. 

What do you think? 

Last edited by Jane Stevens (ACEs Connection staff)

Thank you for the lyrical journey you took your readers through. It was inspiring to see the wrestling that is so prevalent as we acknowledge, embrace, and lead out of our own ACEs understanding and experiences. After I took the ACEs test for the first time, I realized I was not alone with the experiences anymore. It gave peace to the storm I had come to know. It made me realize that I didn't have to let it define me, or rule over me, but I was able to channel it to become my greatest strength. I now stand beside others in their challenges, utilizing my experiences to grow from, while learning from the different challenges others had experienced. I began to reach for the high road where only a few seemed to be walking. I recognized that ACEs wasn't new, but it brought a common language to subjects we often did not discuss. I now engage in community service, community support resources, and volunteer work as often as I can. I find that people who are honest about their ACEs are often more genuine, more personable, and more real. I make it my point to empathize and "be with" people in the moment, and find that all people just want a secure connection. Wether for a moment or a lifetime, that is what I seek. And there lies the healing from ACEs. Sincere......Intentional......Connection.

 

I am a healer. The people around me are curious. I had to figure my own road to wellness first, and now I teach others how to build a foundation that will handle the crashing waves and storms that stand the test of time. Thanks again for your beautiful insight. Matt 

Jane, thank you so much for mentioning the self-healing communities work!  

I have been working with Dr. Robert Anda and Laura Porter implementing the self-healing communities model -- a model that is inclusive of all.  The ACE Study is unifying research regarding population health and doesn't discriminate based on political party affiliation.  Communities using the self-healing model have documented reductions in the rates of seven major social problems and Adverse Childhood Experience scores among young adults.  Cost savings from caseload reductions attributable to the implementation in child welfare, juvenile justice and public medical costs associated with births to teen mothers were estimated by an independent economist to exceed $55m/biennium. 

Additional information can be found here:  

http://aceinterface.com 

http://www.rwjf.org/en/library...ing-communities.html

With much gratitude for the efforts all of you are making to prevent, reduce and mitigate the effects of ACEs while concurrently developing resilience to support the health, safety and wellbeing of all ~  Kathy

Last edited by Kathy Adams

Jane--this is fantastic and much needed. I'm a former legislator in Oregon, fairly new to the ACEs movement, and you articulate a perspective that is vital to our civic life. These are very challenging times, and your clarity and your advocacy are  powerful. And again--necessary. I'm very grateful to be part of this effort with you.

Hi Jane, Thank you for writing this! Very well done. I shared it on my Facebook page, Trauma Informed Approach to Donald Trump: Beyond Despair is Strength: https://www.facebook.com/TIA2DT, and so far its reached 59 people to help spread knowledge of ACES for individuals, families, community, nation and our shared world. Diane Kaufman, MD, Arts Medicine for Health & Healing. 

This is excellent, Jane - thank you!

I especially like your conclusion, "And one more thing: ACEs science showed 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; only the expression is different. '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 where we are today." 

And your suggestions for what the ACEs Community can do are outstanding... loved this line in #4: "We can keep breathing through our hearts." - so very true.

Jane, your eloquence and articulate wisdom captures our hearts and inspires our souls.  To quote, "ACEs science teaches us that we can work together, and make sure nobody’s left out, that there are no "deplorables", 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 it is self-healing, too, one that is led by healers."

We (our ACEs Connection family) have the power to ignite change, inspire hope and invest in co-creating self-healing communities where we foster policy/systems change and transform narratives.

Solutions journalism. Thank you Jane for leading the way...

This was excellent.  I agree that we need to discuss politics.  Since the administration changed hands, I haven't heard a word about mental health, best practice alternatives to incarceration, affordable housing, services to single parents and grandparents raising grandchildren, homeless services for ALL homeless and not just certain populations, and so much more.

Here's what's being discussed:  "Bad Hombres," travel bans, Nordstrom and Ivanka, and a weird handshake between Trump and the Japanese Prime Minister.  What a waste of time, and the trauma just grows...

Dear Jane: "Hurt people hurt people on many levels, however, including enacting policies and legislation that are contrary to the science, because many people with high ACE scores in the middle and upper socio-economic classes end up as community leaders, including judges, teachers, principals, mayors, newspaper publishers, CEOs of companies, senators, representatives, and presidents."

Thank you!  That's the Attachment Disorder segment of ACEs, which occurs conception-36 months -- before we have enough brain myelination for conscious memory function. It's only remembered in the body on a cellular level, unseen while graduating Harvard top of the class and proceeding to positions of high power. It manifests in heavily repressed terror and rage which results precisely in vengeful national and international policy.

"Nobody beat me, nobody raped me--what's wrong with me?" as I kept saying.

And I love your conclusion. “Who pushed Donald Trump’s face down into the snow?”  Maybe no one had to.  Maybe it was enough to be an unwanted pregnancy left in a back room to cry with only nannies feeding it on a schedule. Pushed or not, either way, you're of course right on: No empathy, no exit. We're most certainly all in this together! Thank you again.

Last edited by Kathy Brous

Thank you, Kalma. I'll post it on our companion site, ACEsTooHigh, which is a news site for the general public, and from there it's picked up by a couple of other places. I can also do a version for Huffington Post, but I'll have to rein in my long-winded 2600 words to 1500!

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