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The Problem with ACEs Implementation

 

The Adverse Childhood Experiences study was ground-breaking in its recognition that childhood trauma impacts individuals across their lifespan. This was the big take-away, that adults are living with unrecognized and thus untreated physical, mental and emotional consequences that have massive detrimental impacts on their quality (and quantity) of life.

And yet, when we see the research and programming that has been implemented following the ACE study, the consensus seems to be that the effort and expense involved in treating those adults is just too much to expend. The majority of efforts are focused on prevention or early childhood intervention rather than treatment of the traumatized adult. And so the conversation about ACEs revolves around children, not around the adults from whom this study originated.

Further, when the traumatized adults are referenced at all, it is as a supportive player in the child’s story, or as researchers put it, the adult’s role is to be an effective “buffer” for children. When looking at the traumatized adult, support and treatment for them is seen as valid only insofar as it relates to their child’s well-being, not as having value in and of itself.

I often read complaints by those who are working to forward the integration of ACEs science into health care that they are frustrated by the “silo” effect, with each physical and mental health specialty working separately instead of in coordination to address the impacts of trauma.

It seems to me that the missing picture here is that we are not just silo-ing our treatment, we are silo-ing those we are treating. When we are talking about Adverse Childhood Experiences, we are talking about inter-generational trauma. We are talking about families. And yet what I see in the programs that are being created, and the research that is being done, is a child-centered focus. The mother, when mentioned, only exists to “buffer” the child, and the father does not exist at all.

Where is the whole-family approach? I see glimpses of it in discussions about child-parent psychotherapy, but then I see that the goal of this therapy is “returning the child to a normal developmental trajectory”. Returning the child? What about the parent? What is the goal for the parent in this scenario? Is their development irrelevant? If we are truly engaged in creating trauma-informed systems change, we need to be engaged from a whole family framework. ALL the traumatized people matter.

Further, all the systems that perpetuate trauma matter. If we are not looking at creating change from an intersectional, social justice informed framework, we are just spouting the same bullshit that the privileged upper class have been spouting for eons, about how those poor mothers are responsible for all the evils of the world. We must acknowledge the systems of oppression that lead to inter-generational trauma. Then we must tear those systems down, and re-build. I am encouraged to see a new framework arising in this area which recognizes the Pair of Aces: Adverse Childhood Experiences, and Adverse Community Environments.

We must also acknowledge that adverse childhood experiences do not only exist in impoverished communities, they exist in all communities. The original ACEs research came from a group that was for the most part, Caucasian and middle class. What this shows us is that the systems we live in are not just harmful to the oppressed, they are harmful to all. This does not mean that we ignore systemic oppression and discrimination. It does mean we acknowledge the pair of ACEs, Adverse Childhood Experiences and Adverse Community Environments, and how they are intertwined, while still acknowledging that childhood trauma is a universal issue.

When we are creating systems to address trauma, we need to ensure that we are not profiling a certain demographic and only creating change in the systems that serve that demographic. We need to be creating change in all systems. What does this mean? This means instituting a trauma informed framework in the inner-city school and the private school. This means educating social workers and business leaders about creating trauma informed workplaces.

We need to zoom out the lens we are using to view Adverse Childhood Experiences. Firstly, to the whole family system, and then, to the systemic discrimination that perpetuate violence and oppression. We can’t solve this complex issue unless we acknowledge the universal nature of childhood trauma, and see that ACEs touch every family and every community.

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Gladys Twombly Richardson posted:
Hi Joyelle, I've read your blog with interest, as my husband and I
committed ourselves to the "Primary Prevention of ACES" on retirement in
2004. It didn't take long to discover how complex this is - so our 2nd
commitment was to avoid further harm to parents and all the while
recognizing deep and pervasive roots of ACES in homes, and public and
private spheres of our culture. We still don't have answers. In the
meantime, we've been visionary, and like a family wanting to build a new
home, are now working "on site." There's still a lot of prep work to do,
but with a decade behind us, I'm more hopeful than ever that the process
picks up momentum. I'd like to continue this conversation with you if you
are interested. Regards. Gladhys Richardson

On Mon, May 7, 2018 at 1:40 PM, ACEsConnection <
communitymanager@acesconnection.com> wrote:

Gladys:

Please share what you and you husband are doing towards to the Primary Prevention of ACEs! It's SO GOOD to hear you are also focusing on how not to further harm parents. Part of the reason so many of us trauma survivor parents have become advocates is because that can happen. Or, sometimes parents are treated as a total afterthought. Please share what you are doing, learning, creating! 

Cissy

Yes and Strategies 2.0 offers this workshop, in California, at no cost to organizations with an interest in prevention  and there are many more plus consultations.  Where are you located?  

Barbara Jones Stern posted:

I recently attended "A Pair of ACES" workshop in Sacramento in which the universality of ACES, both personal and socially determined, was addressed as was the importance of organizing one's own community for action.  As a Family Therapist, it is important to treat (or at least educate) the whole family including grandparents and other significant people in a child's life.  That is why I am focusing on prevention during the Prenatal to Five stage of Child and Family development because expectant parents are so open to "doing it better."  Also look at the Center for the Developing Child at Harvard for more community based interventions.  Good luck

Hi Barbara,

I am so encouraged to here that the pair of ACEs framework is being used to identify the larger scale issues at play. Thanks for sharing!

Gladys Twombly Richardson posted:
Hi Joyelle, I've read your blog with interest, as my husband and I
committed ourselves to the "Primary Prevention of ACES" on retirement in
2004. It didn't take long to discover how complex this is - so our 2nd
commitment was to avoid further harm to parents and all the while
recognizing deep and pervasive roots of ACES in homes, and public and
private spheres of our culture. We still don't have answers. In the
meantime, we've been visionary, and like a family wanting to build a new
home, are now working "on site." There's still a lot of prep work to do,
but with a decade behind us, I'm more hopeful than ever that the process
picks up momentum. I'd like to continue this conversation with you if you
are interested. Regards. Gladhys Richardson

On Mon, May 7, 2018 at 1:40 PM, ACEsConnection <
communitymanager@acesconnection.com> wrote:

Hi Gladys,

Your work sounds fascinating, I would love to hear more about it! You can reach me at parentingwithptsd@gmail.com

 

I recently attended "A Pair of ACES" workshop in Sacramento in which the universality of ACES, both personal and socially determined, was addressed as was the importance of organizing one's own community for action.  As a Family Therapist, it is important to treat (or at least educate) the whole family including grandparents and other significant people in a child's life.  That is why I am focusing on prevention during the Prenatal to Five stage of Child and Family development because expectant parents are so open to "doing it better."  Also look at the Center for the Developing Child at Harvard for more community based interventions.  Good luck

Hi Joyelle, I've read your blog with interest, as my husband and I
committed ourselves to the "Primary Prevention of ACES" on retirement in
2004. It didn't take long to discover how complex this is - so our 2nd
commitment was to avoid further harm to parents and all the while
recognizing deep and pervasive roots of ACES in homes, and public and
private spheres of our culture. We still don't have answers. In the
meantime, we've been visionary, and like a family wanting to build a new
home, are now working "on site." There's still a lot of prep work to do,
but with a decade behind us, I'm more hopeful than ever that the process
picks up momentum. I'd like to continue this conversation with you if you
are interested. Regards. Gladhys Richardson

On Mon, May 7, 2018 at 1:40 PM, ACEsConnection <
communitymanager@acesconnection.com> wrote:
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