Recovering from Adverse Childhood Experiences

IMG_3225Recently, I received a question from a parent about Adverse Childhood Experiences (ACEs) altering a child’s immune system into adulthood. The short answer to this question is yes, trauma during childhood does change adult immune response.

Altered immune systems in turn, increase skin cancer, anxiety, depression, autoimmune disorders, heart disease and shorten lifespan. The ACE (Adverse Childhood Experiences) scale quantifies stressors during childhood–domestic violence, living with alcoholic or mentally ill parents, divorce, verbal, emotional, physical and sexual abuse. It also measures whether or not the child felt loved and important. Childhood traumas can be imposed by a teacher, parent or friend but the ACE measures trauma within families.

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In 1996, two physicians gathered ACE scores on 17,000 subjects and then looked at their adult health records. The number of ACEs predicted that increased medical care would be required in adulthood.

This is because the stress we undergo as children and adolescents can alter our bodies, cells and our DNA. Shifts in our DNA are call epigenetic changes. Repeated abuse increases neurotransmitters, particularly cortisol, resetting our “fight or flight” response and promoting inflammation and illness. Recently, Yale researchers found that chronic stress not only changes stress genes but genes which influence many adult diseases.

Researchers have long known that adults diagnosed with Post Traumatic Stress Disorder have smaller hippocampuses and enlarged amygdalas. The hippocampus stores memories and the amygdala is the emotional center of the brain. Lymphatics carry inflammatory chemicals from the body to the brain via the lymphatic system connecting these two systems which were once thought to be completely separate.

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And children who have higher ACE scores have less cortical grey matter, reducing their capacity for executive function—impulse control and self-regulation. This leads them to over-react to small stressors in adulthood, igniting the neurotransmitter cascade for “fight or flight” again, creating more damage.

Repeated exposure to stress causes the brain to go “off-line” limiting its effectiveness to appropriately react to certain stimuli. Adults with PTSD cannot distinguish between angry or confused or happy expressions on faces. This puts them at a disadvantage because they may react in fear to a happy face while ignoring the warning signs of an angry face, placing themselves in danger of repeated stressful experiences.

 Steps can be made to recover from childhood stress and prevent stress in childhood. Just as bodily wounds heal, we can recover function in areas of the brain damaged by ACEs.

1)    Mindful meditation and prayer-connecting to a higher power and learning how to tune out the world’s noise while quieting the mind creates healing for the body and brain. Research shows brain changes that come with regular meditation are decreased volume in the amygdala, which is responsible for fear, anxiety, and stress. People who feel less fear perceive themselves as happier and safer.

2)    Mentor good coping skills-when you are faced with difficult problems, put them in perspective and try to concentrate on the positives in your life. Discuss adverse circumstances with your spouse after the children are in bed. Limit arguments. Use dinnertime as a gathering place for happy conversations about school and work life.

3)    Apologize for wrongdoing-demonstrate your ability to say you’re sorry if you do lose your temper. Make amends with the wronged party by offering to go for a walk or help them with homework or a chore. Make time for an activity together that you both enjoy and take a break from the problem that is causing the anger.

4)    Make efforts to remember and heal your own childhood traumas-healing occurs with remembering, telling, mourning and forgiving. Don’t rehearse past or present hurts, especially in front of your children. Children do what they see their parents doing—not what they are asked to do.

5)    Allow your children to make their own decisions-second guessing, over managing and overscheduling your child is detrimental to healthy development. It’s important to let your child or adolescent make decisions regarding their schedule and life. This does not mean they get to stay on social media or play video games non-stop. It might mean that they get to decide when they do their weekend homework as long as their grades are good.

The first step toward healing is to increase awareness of how harmful mistreatment actually is—educate parents and stop abuse. The second step is to hold family practitioners, teachers, and pediatricians accountable for identifying at risk children and referring them to existing treatment models.

Finding ways to protect children and create healthy adults is receiving much attention by the scientific community. We are paying a huge price in healthcare and adult productivity when we continue to abuse children.

Grassroots community efforts, health care centers and hospitals are developing assessment programs and using the data they collect to identify children who are at risk, while integrating services. Seamless entry points that allow access to all services—medical, legal, law enforcement and counseling show improved outcomes. Outcome measures for children and parents who enter formal interventions and treatment is being gathered and effectiveness reviewed.

 

Often, I am asked, “What can we do to prevent childhood trauma? How do we heal ourselves?”

My answer, “One child at a time. Teaching adults to love themselves so that they can love their children and helping them when they can’t.”

As one teacher in the recent study, One Path Toward a Resilient Community commented after an intervention, “If we do 20 minutes of mindfulness in my kindergarten class on the front end, then I can teach!”

(2018 by the NC Institute of Medicine and The Duke Endowment, Preventing Adverse Childhood Experiences (ACEs) — Good Parenting, Dr. Debbie Wood, Tuesday, 26 June 2018 00:00)

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