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The research is very clear about the development of the brain from zero to five. Why do we as a society accept that a parent has the right to parent in what ever manner they see fit, even when that approach is causing severe issues that the infant and toddler will take with them into adulthood. We are so ready to punish on the other side of the line, but turn a blinds eye to the innocent before they go astray.Β 
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Developing acceptance and action on this issue requires a major paradigm shift which society is not ready to accept. Β Too many systems are threatened by this information. It would mean that most of us would have to admit that we have been on the wrong track most of our careers. However as I tell the CPS parents in our classes - There are no do-overs, only do-betters.

Thank you Sue. I am challenging our current way of thinking and our current void in taking care of our children. The same is true in our schools and how we approach discipline. Until we look in the mirror and owe up To our responsibility for change, then we just keep on doing the same thing as we have always done it. It doesn't matter how many different ways we mount a dead horse, we aren't going to create change. It was hard, but I had to look in the mirror and say that I was wrong, I needed to make a change. The results have surpassed my expectations. Compassion, caring relationships, and the willingness to listen and validate a person is a good start. Thanks for your response, Jim
Dear Dr. Tinelli, This is a powerful piece of writing. Thank you for sharing. Dr. Felitti's work has been a great resource for me and it has changed the manner in which I work with kids. I am eternally grateful that I implemented the compassionate model and have been able to witness the powerful impact that it has on students that have struggled with ACE's in their lives. I had the honor of meeting Dr. Felitti and it was a privilege to have had the time to learn from him. Thanks for what you are doing to advocate and reach out to those that who are wounded. God Bless, Jim Sporleder
When I was in high school I often thought about running away from home. The problem was that I was not the sort of in trouble kid you associate with this. I was a good student and wanted to finish high school and go to college. Ir was just my parents I wanted to run away from, particularly my dad. I used fantasize ways to run away from home and still stay in school like somehow finding a place to store a sleeping bag at school and finding an open room to sleep in at the school. It occurred to me years later that a boarding school would have been absolutely ideal for someone like me. My parents weren't poor, but they weren't boarding school level rich either. So I got to thinking that it might be helping for there to be some kind of boarding school scholarship program specifically for kids that need to get away from their parents. Or maybe just the possibility of lodging at the school when there are problems at home. Programs for runaways that I have seen seem to focus on getting the children home. But what if they aren't really better off at home? The advantage also of a boarding school is that my dad wasn't turn into the police bad. I wouldn't have wanted to lose all contact with my family either. The amount of contact with them if I had been at a boarding school would have been just about right.
Shelly, You have encouraging story to tell. You are correct, there are more ACE's than just the ten that are mentioned. The ten are the top most common adverse childhood experiences that came out of the study of 17,000 people. The model is built on compassion and non-judgemental principles. The risk factors are real and for many they point to a difficult path in life unless there can be some positive interventions to support and encourage individual growth. I agree that there are amazing individuals that have built their own resiliency skills and have been an inspiration to others. The model is always there to support, encourage, and to value the person's selfwoth. Many of our homeless youth couch surf, they go from house to house where they can find food and shelter. Unfortunately, many of these homes are not healthy and may enable substance abuse and other unhealthy habits. You are correct, our youth need a safe place to go where they feel safe, where they can get a healthy meal, and where they feel valued and cared for. Thanks again for sharing, Jim
Hi Shelly, I can only speak to my experience with students that are at critical risk. Unless there is abuse, by law we can't assume the liability to providing living quarters to students who are under the age of 18. If a student is 18 and in a bad situation, we can get them placed at several support agencies in our community. However, I have observed that when a student doesn't have any family structure or boundaries, it is a challenge to get them to accept the rules and responsibilities that a stable environment has to offer. They want there freedom from a structured environment. We have found housing for students and many of them end up leaving because they don't like the expectations. The Boarding schools that I am aware of are private faith-based schools. Maybe this would have been a good balance for you when you were younger. Opportunity to get away from painful issues, still having access to those in your family in which you felt supported, plus getting your education. We are seeing a strong movement to address teen homelessness. We have to many hurting kids who have been abandoned and rejected. I hope you are doing well now and that you are in a safe and loving environment.
Shelly, Wow! Five ACE's and look where you are today? Please keep sharing your story, others need to hear it and see that there is HOPE. Thank you for reminding us that there are the quiet ones out there that mask their pain differently. I appreciate your response and your resiliency. What a great example for all of us who work with our community's children to be more attentive to those that move through quietly but are in need of the same care and support. I am grateful that you have a wonderful husband that will provide the fatherly love that is so important in the development of your children. You have a beautiful story.
ACE's aren't all created equal and I had plenty of advantages that not so many have. To start my parents were very good people who were clearly trying very hard. In fact sometimes a good amount of Dad's problem was that he was trying to hard to give us everything he never had. He himself probably suffered from about 12 ACE's all 10 plus a couple not yet thought about. Ours was considered the normal family amongst my cousins on his side of the family. No substance abuse, no wife beating. One of his sisters was even shot by her husband. We didn't see his family much. He left the scene in his early 20s and moved 2000 miles away. He was a person of high intelligence and and integrity who I respected in many ways and had a lot of fun with as well. At the same time, though, he was nuts, maybe bipolar or even borderline with a few others from the DSM thrown in as well. Fun times were all tinged with never knowing what would set off a change in mood and always having to watch what you said. Crazy making reigned supreme, the kind were you were the one who seemed to be crazy while he was calm and sarcastic. Mother was little help because her childhood experiences had left her conflict avoidand. But in spite of her giving him his way most of the time, they fought constantly, mostly verbally, but from time to time it would get physical. Then she'd cry and drive away in the car. That may be where I learned the temporary run away trick. I did the same thing on foot or on bicycle when I got older. I knew it would be worse when I got back with the trouble for going away without telling where I was going, but I didn't care, because I felt I had to get away. I knew I was coming back because I didn't bring anything with me, but I could still pretend I was running away. Sometimes I'd go so far as to take an apple and some cheese in case I got hungry or at least some money for possibly buying a hamburger. I was generally back within a couple of hours, but sometimes it was longer. Usually I just took a walk around the neighborhood, but one time I managed to ride my bike all the way to the next city, but had to turn around when I couldn't find any way around the freeway. This is all long ago. I am 58, and they both died together in a car accident when I was 40. They both lived through the great depression, so were careful with money, and left me with some financial independence, another advantage not everyone has. I married late, so no children. I've never entirely found my niche in life in spite of getting a PhD, but I do some useful things and have a relatively enjoyable live. We are all works in process. I do a lot of thinking, which has both advantages and disadvantages. If you look at the big picture around the world people survive a lot. People sometimes deal with the big things better than the little ones. My sister was killed in a car accident many years before my parents were, and it was noticeable that in some ways this was easier to deal with than the ordinary family problems stuff precisely because a death in the family is something everyone expects to be upsetting, so while the grief is there, it's not complicated by doubts of whether you should be having it or not. In contrast, people don't take child sbuse seriously until there are bruises, so you tend to think it's just that you aren't good enough or that you are too sensitive. Survivors of the holocaust go on to do great things in part because because their hurt is recognized. (Which is, of course, why holocaust denial is so horrible) Somehow we still have far too much of a honor thy mother and father morality, which makes it difficult for your pain to be acknowledged. You fee like a bad person if you aren't appreciative of all they have done for you. And then there are the "You don't have children, so you don't know how difficult it is to be a parent." remarks. From this standpoint I commend what is being done here. At the same time I do worry about the impression being given that people who have ACE's are more likely to do so many horrible things. It might lead me if I were an employer to not employ them. In fact the only thing that keeps me from being too worried about using my real name here is that the Internet is such's s needle in a haystack thing. But getting back to my original suggestion, while I can understand the practical problems of letting kids spend the night at school, it would be useful of more were done to give kids safe places to escape to, and to give a little thought in the process not just to the ones in danger of ending up in jail who may be beyond help, but those for whom a little help could go a long way. I was lucky enough, for example, to have a great sanctuary at the home of a friend who lived just with her artist mother along with 6 cats, but there is always the danger with visiting friends of worrying about wearing out your welcome. And btw don't anyone tell me that single parent households and necessarily all bad. That was a cool place. They lived more like roommates than mother and daughter.
At least in comparison to the people I think you are thinking of I'm fine. I'm married to the sweetest husband in the world. I score about 5, but all except the verbal abuse were comparatively mild. Perhaps one could invent a category of invisible ACE, which more people belong to than many realize. The biggest trouble we get into is turning in homework late or forgetting our books and pencils. We are even sometimes honor students who are escaping to our studies or trying in vain to please people who can't be pleased. We are the people who succeed to an extent, because we are smart enough to make it on our own, but at university nobody understands why we are not looking forward to Christmas. But we do exist. Otherwise Harry Potter wouldn't be so popular. And in fact it was precisely Harry Potter that got me thinking about this. A faith school wouldn't have interested me, but Hogwarts would have been fantastic.

Chris, thank you for the excellent links.Β  I really appreciate you putting this together.Β  Your feedback certainly shows the need for application instead of isolation.Β  A friend of mine sent me President Obama's 2008 speech that was given on Father's day. Powerful, identified the problems that we are facing in American and the break down of the family.Β  Today 2012, how far have we come?Β  Who as addressed the specific problems that need our immediate attention if we are going to turn our nation around.Β  I think you really identified the challenges and the resistance that is before us in order to make change happen.Β  I feel we have to draw courage from one another, support one another and keep pushing forward.Β  The costs that you quote for doing nothing is significant.Β  However, if we can help one person at a time from a life of long term illness, incarceration, life of substance abuse, abusive parenting, and a lifetime of poverty, we can make a significant change for those fortunate ones that are picked out of the dark endless hole. Β Β  Thanks again Chris, this was very helpful.Β Β Β  Jim

I share your frustration. Traumatologist Sandra Bloom made this statement which helps describe this problem, in part:

β€œWe now know a great deal about the impact of trauma and despite this, training programs, degree programs, teacher preparation courses, etc., are still woefully deficient in conveying the research data to the people who need to know it,” said trauma expert Sandra Bloom, M.D. β€œTrauma training is not about the seemingly simple problem of giving people information. The real problem is that the material is challenging, threatening, and it may elicit resistance to change and denial within individuals and within entire systems. Any effort to [improve trauma services] will have to contend with this resistance if efforts are to be in any way successful,” said Bloom.” The Damaging Consequences of Violence and Trauma. (2004). National Association of State Mental Health Program Directors. http://bit.ly/JGS5QE

Welcome Chris to our group.Β  I think you make a very good point about the barriers that we face.Β  One of the biggest barriers that I am going to address is our educational system.Β  We are so quick to put a label on a student with out any consideration as to what is going on with that student in their personal lives, we don't ask the question.Β  Through Dr. Feltti's research on the ACE Study, we know that to help a person to become resilient and to trump their ace's, it is through a caring adult relationship.Β  We made the paradigm change two years ago and have seen students make some incredible transformations in their lives.Β  However, at the age that I get my kids, the damage is already done, the scars and the wounds run deep.Β  I see wonderful kids that will self destruct the closer they get to success.Β  My ASB president is sitting in county jail, lost his college scholarship, lost graduation and his diploma, and looks like he will be serving some jail time.Β  My prayer is that being locked up will help him over time get sober and that the addiction to Meth will be gone. Β  The message that I am going to be taking to my peers is; do you want a compassionate approach that holds students more accountable or do you want a punitive approach that adds to the stress and pain that the student is already experiencing?Β  We're not counselors, mental health experts, or medical professionals. However, we can build positive relationships, address the cause of the behavior rather than reacting to the infraction.Β  I appreciate your feedback and I agree that we are up against some difficult challenges, but change may come one person at a time or one school at a time.Β  Morally, I don't see how we can not keep toxic stress out of the conversation.Β  Thanks again Chris, Β  Jim Β 

Excellent points, Jim, about our educational system! I agree with and understand everything you said. So incredibly sad about your ASB president. You said you would say toΒ your peers: "or do you want a punitive approach that adds to the stress and pain that the student is already experiencing?"Β  I would add the additional talking point that the individual's suffering will spill over in some form into "the group" (our society). I like this one-page breakdown of ACE stats http://bit.ly/L70vSe. Notice the annual cost to society: $103,754,017,492. That *might* help change some minds. Also, please consider watching Tavis Smiley's: Too Important to Fail http://bit.ly/NE4FnM ? I think it's a great watch with perhaps some good ideasΒ for additional talking points for the field of education. I completely agree with you: "change may come one person at a time or one school at a time."Β  This is epidemiologist Dr. Slutkin'sΒ premise, too. We are all individual cells that affect the health of our greater body, society. Science has now proven we are biologically interconnected and that each and every one of our actions has an effect on others. I agree with you, morally we can not keep this new science out of the conversation. If we do, we are just putting continued pressure on the "self-destruct" button. Thank you for this discussion!

Let's, first, look at ourselves before looking to others.

Of people who see a psychiatrist (at any time in their lives) -- and how many of us have not? -- 70% were hurt as kids -- with profound neurobiological damage. If you doubt this, please review the epidemiologic data at bornforjoy.com. (And please, enjoy the site.)

Β The ACEs questionnaire is a research tool and has given us invaluable data about the need to address the neurobiological sequelae of childhood hurt, not only for the humanity of the thing but also to prevent serious physical illness.Β  It is not a clinical alternative to speaking with out patients -- doing a sensitive, careful evaluation of neuropsychiatic illness should the ACE Score be high.Β  Even if low, healthcare professionals need to assess patients presenting with any ACE-related medical illness for the three syndromes outlined in bornforjoy.com. Β  These are treatable syndromes -- because one can neurobiologically confirm a clinical diagnosis and because treatment is essentially without risk (look at the website).Β 

We can, each of us, get treatment ourselves and then prioritize treatment of adults thinking to become parents.Β  Treating children, clearly, depends on focusing our diagnostic and treatment efforts on their parents.

This is nobody's fault. It is a consequence of the violent roots of civilization.Β  But each of us can address the problem -- because we care and, in most cases, because we ourselves were hurt.

Enough of the talk.Β  We fear help because adapting to childhood pain, we cut ourselves off from trusting the divine unity and beauty of Life -- and of ourselves.Β  If we -- we -- don't walk the walk, how can we blame others?Β  And when we do, we see there is no blame -- just Life, sorting itself out and healing.

Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β  Sara

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The level of arrogant ignorance of many areas in our current society is staggering.Β  The two common themes I see in this is a simplistic, almost punitive approach (think our war on drugs) toward "solutions" and a lack of compassion toward suffering, the most common of human conditions.Β  I find our collective psychic numbing to suffering as understandable as repugnant.Β  The largest form of terrorism in the world is child abuse and good research on the long term economic costs of this might be one way pragmatic compassion can break through the icy numbing.Β  Felitti's decades-long work on ACEs is exactly that data we need.Β  Our work is to form networks and get this information out in as many venues as possible.

When I teach trauma education to the psychiatry residents at our Department, I always include a short piece I wrote for Milspeak, and artistic communication blog for the military and their families.

The Wound

Gene Tinelli

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Sometimes, we do best when we learn from the millions of years of adaptation of our bodies.Β  When we have physical wounds, we have an open port to the world that can be contaminated and is often painful. Our initial response is to cover or bandage it, thus protecting the wound from further harm. If someone or something attempts to touch the wound, we push or pull away and withdraw.Β  Over time our wounds weep and leak and represent a chronic source of potential infection.Β  We become sensitive to anything near the wound and avoid even the remote chance that it will be identified and further traumatized. Sometimes the wound becomes a source of chronic awareness from which we cannot escape. Sometimes the bandage becomes so much a part of us that we think it is normal, our identity.

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We start to heal when we gently remove the bandage and clean the foreign bodies from the area.Β  Removing old crusty bandages too quickly can further damage the area. Often, the bandages are first soaked in a warm, neutral liquid so that they can be removed relatively gently.Β  Cleaning a wound can involve some discomfort but our bodies tend to attenuate some of the pain.Β  Our wound then slowly heals.

Β 

Healing is natural process of a healthy body and encompasses two general principles.Β  Time heals clean wounds and wounds heal from the inside out. These processes are the same whether our injuries are physical wounds to our skin or wounds to our souls.

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Soul wounds are acquired in simply passing through life's journey. They can also be acquired via the slings and arrows of outrageous fortune. The traumas range from child abuse and neglect though loss of loved ones to war, which encompasses all known human traumas. Soul wounds are very similar to wounds on the surface of our body. They weep and allow our essence to seep away, giving us the sense emptiness and never being whole. To avoid feeling the pain of emptiness, we apply soul bandages to the wound.Β  These bandages can take many forms. We can attack others or ourselves, thus protecting the wound by temporarily displacing the pain. We can withdraw from human contact, protecting our souls from human touch and intimacy. Or we can avoid the pain and emptiness by substituting psychoactive substances and/or behaviors that dull the pain or numb the emptiness. Drugs, sex, gambling are only part of the cornucopia of potential human avoidant responses.

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In intimate human interactions, it is the sticky skin covering our souls that touches, adheres, and transfers our affects and emotions to others. Open wounds prevent this bonding, as touch in these cases can be painful, and we withdraw from human contact. But our souls, like our skin, heal via the same processes as the rest of our bodies. Our tears wash our soul wounds clean and time heals clean wounds.Β  Soaking the old crusty soul bandages requires love and compassion. Cleaning the wound requires courage. Soul wounds, like skin wounds, heal from the inside out, which is why this whole process is ultimately spiritual.

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Like our skin, our soul wounds heal to scars, tissue that holds normal skin together. We're different, marked for life. Yet, our souls stop leaking and can fill with basic human joy. They grow and can bond with other souls. When we bond and feel the scar on another soul, we know their healed soul is a testament to basic human courage and resilience.

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Healing is the source of our strength.

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