The first time I heard about Adverse Childhood Experiences, also known as ACEs, I was sitting in a hotel room on a weekend-away with my husband. He was getting dressed for us to head to dinner, and I was perched in a window overlooking St. Louis. I scrolled through social media and spotted a video a friend called “must see.” Curious, I started watching a TEDx talk by Dr. Nadine Burke Harris on the topic of Adverse Childhood Experiences and found myself intrigued. First, many people I know, including some of the children in my adoption and foster care group, have experienced at least one ACE. Second, a person’s ACE score can have a big impact on how they function physically, emotionally, and mentally as an adult.
An Adverse Childhood Experience is defined as “highly stressful” and “potentially traumatic” experiences that happen to someone who is eighteen or younger. There can be sole ACE, multiple, or an ongoing situation. ACEs inhibit a person’s ability to feel safe, to trust, and their “sense of self” which is “threatened or violated.” Adverse Childhood Experiences include sexual assault, divorce or death of parents, suicide, physical abuse, neglect, witnessing violence, mental health issues or incarceration of a family, and more.
Here’s what you need to know. “When those adverse experiences aren’t buffered by a caring adult or supportive environment — or when they’re ongoing or overwhelming — they can cause a toxic stress response.” Additionally, “that response can affect a child’s developing brain and body” resulting in “a negative ripple effect on health and life outcomes as an adult.” Picture a row of standing dominos. The ACE drops the first one, causing a cascade of impact, and leaving a mess.
If you read the list of ACEs and found yourself nodding your head, you aren’t alone. The CDC found that 61% of adults surveyed had experienced at least one ACE, while one in six adults experienced four or more ACEs. “ACEs are linked to chronic health problems, mental illness, and substance use problems in adulthood,” and “can also negatively impact education, job opportunities, and earning potential.” All this to say, your ACE score matters — but it’s not the only thing that matters.
You can find out your ACE score by taking a ten question yes or no quiz on the ACE Resource Network’s site called Number Story. Once you have your number, you might be wondering what you can do about it. Your story, as the site shares, is much more than just the number of ACEs you’ve experienced. Trauma is layered, and you can decide what you wish to do about it.
An excellent, but rather dense read, is a book called “The Body Keeps Score” (which some mental health professionals refer to as the trauma bible). In essence, the book describes how trauma changes the brain. The good news is that if the brain can be wired in response to trauma, it can also be wired to change. But it takes hard work and resources.
What exactly might those healing steps be? I talked to Dr. Sanam Hafeez, a neuropsychologist practicing in New York City and a faculty member at Columbia University, on what we can do to rewire our brains after they’ve been wired to respond to trauma.
Step one is to take the Number Story quiz online and then, Dr. Hafeez advises, share the score with your medical professional. Doing so “can normalize the conversation about adverse childhood experience and the impact it has on your life.” She also adds that when we recognize and talk about our past, “it removes the power the secrecy of these experiences so often has.” (On a personal note, reading “Daring Greatly” by Brene Brown is also helpful as you explore shame and secrecy.) Bringing the painful truth into the light has power and potential.
Step two is to begin the hard work of focusing on “unresolved issues,” addressing the hardships as an ACE survivor, and “pair negative memories with the positive experience of being seeing and heard by a therapist.” This is downright magical, because when the therapist accepts the ACE survivor’s story, the survivor can “modify circuits in their brain that deal with trust, and grow new, healthier neural connections that help build trust.” There are several types of therapy, including cognitive behavioral therapy and EMDR, the type of therapy Prince Harry recently shared that he has used.
Step three is lifestyle changes. These can be guided by professionals. Dr. Hafeez shares that “chronic stress from ACEs causes our system to continuously activate our fight or flight response, which can prevent the body from establishing homeostasis.” If an ACE survivor can “present their five senses and body with positive inputs, such as healthy foods and calming music,” they are doing their body a huge favor. These positive inputs “stimulate their own system to regulate favorably.” Though Dr. Hafeez says that therapy and lifestyle changes alone may not be enough for the ACE survivor, in which medication may also be an option.
If you acknowledge you’ve experienced an ACE (or two, or more) and are tempted to ignore it, consider that you’ve been exposed to toxic stress. This type of stress “alters how the body respond to stress and brain development” and “can also lead to health problems in adulthood such as substance misuse, infections, asthma, chronic health problems, and mental illness.” Having an Adverse Childhood Experience also increases a person’s risk for suicide, cancer, and heart disease. ACEs have been linked to teen pregnancy, OCD, sex trafficking, difficult with job-hunting or keeping a job, and more. Yes, ACEs are that serious and significant.
The good news is that though ACEs can be haunting and impact the survivor’s brain and body, all hope is not lost. By taking steps to acknowledge the ACE and its impact, the survivor can begin a healing journey.