The Weight of Adverse Childhood Experiences

Adverse childhood experiences are incredibly common, and a local organization is looking to spread the word about what are commonly referred to as ACEs. 

According to a Centers for Disease Control study conducted from 1995 to 1997, ACEs can affect not only a person’s behavior and physical health later in life, but also how their offspring are wired. The study looked at more than 17,000 Californians’ childhood experiences as compared to their health and behavior as adults, and it focused on 10 adverse childhood experiences grouped into three categories: abuse, neglect and household challenges. Specifically, ACEs include emotional abuse, physical abuse, sexual abuse, seeing the mother treated violently, household substance abuse, mental illness in household, parental separation or divorce, having a household member who engages in criminal activity, emotional neglect and physical neglect. 

The study found that those who had experienced adverse childhood experiences before age 18 had a higher chance of not only developing lifestyle issues such as alcohol abuse, smoking and drug use, but also physical effects including heart disease and liver disease. Almost two-thirds of participants reported at least one adverse childhood experience, and more than 1 in 5 participants reported three or more. The more ACEs a person had experienced, the more intense the negative health outcome. 

A group called ACE Nashville has repurposed the acronym to stand for All Children Excel. The organization offers online discussion and informational resources as well as action groups, all seeking to raise awareness about adverse childhood experiences in Nashville. Ingrid Cockhren’s job as chair of parent and community education for ACE Nashville is to give presentations on ACEs to area companies, deepening understanding of ACEs and their ongoing effects. The Scene spoke with Cockhren about those ongoing effects, the possibility of reversing or preventing them and more.

Are the effects of ACEs reversible in any way?

Yes. Reversible is a strong word, but definitely. So let’s say you have ACEs — it doesn’t mean that you’re automatically going to get cancer. People can definitely heal themselves. The earlier the intervention the better. You can make changes in the brain easier the younger you are. It’s better to have interventions younger, which means that if someone has these things going on as a child, then hopefully that child gets counseling. If that child has an adult who is there for them, or a school counselor or someone of that nature who helps them, those things will help.

But if not, say you get into adulthood and you want to resolve the issues from your childhood, you can go to counseling, you can do yoga. There are lots of things you can do to help with past traumas. It is work. You would have to work at it. Lifelong, after you’ve had a traumatic childhood, then you need to make sure that you’re taking care of yourself to combat the issues that you’ve had in your childhood. If you don’t, then you might have the lifelong repercussions, which would be the health issues and the mental issues.

Are there things we should be looking for to prevent adverse childhood experiences from happening in the first place

Parent training is a good preventative. So you have a new family, or expectant mothers. If they give training around ACEs, that would be good, or how to be a responsive parent. Another example would be going into high schools, before people become parents, to talk about how to interact with children or be the best parent they can. There’s preventative measures like home visits for new families — when people first have their children, to do home visits from social workers. Home visits are the most successful interventions for families in general. Then also, prevention looks like overall awareness of ACEs in our community — everyone knowing that this is a thing. 

Are there particular signs of trauma that we should look for in ourselves or with other people to try to help them?

When it comes to little kids, what [studies have] found is a lot of kids who are diagnosed with [Attention Deficit Disorder] or have what we call “ADD-like symptoms” of being very hyper or having negative behavior — a lot of that type of behavior is actually trauma in children. It leads to a lot of misdiagnoses of ADD when they’re really just dealing with a traumatic situation at home. 

As with anything, especially when it comes to mental health, is your life going the way you want it to go? So if you are constantly sad or anxious or depressed, or you can’t handle your affairs, if you can’t keep up with yourself financially, or you can’t maintain your friendships, relationships — those kinds of things are an indicator that you may have some trauma in your background that is unresolved. It’s about quality of life. Some people have trauma, and it may not affect them in the way that it would another person. It just depends on the person. 

What else should we know about ACEs?

When it comes to ACEs, the data is pretty compelling. It’s a pretty solid study. What we’re finding is a lot of our chronic ailments in society — with heart disease being our No. 1 killer — is really deeply rooted in childhood trauma. And what does that mean? There’s lots of different ways that happens. First, the trauma itself is changing our bodies and changing our brains, so changing our physical selves. But trauma is also changing our genetics. Trauma can be passed along to future generations. It’s important to know that it’s a real thing, it’s really impacting our society. Childhood trauma is really adversely affecting people’s lives, and their health, not just whether or not they go to jail or if they live in poverty. I’m talking about actual health and also those future generations. 

Our distant ancestors learned very quickly that spiders and snakes are very dangerous, so now we still have a fear of snakes and spiders that’s innate, and it’s in our DNA. DNA has memory for the purpose of survival. Trauma changes us so that we are trying to be better suited to survive in our environment. If you have a neighborhood that’s dangerous or you’re living in a war zone or experiencing racism everyday, then you’re going to adjust to survive in that environment. And you’re going to pass that information on in your DNA to your offspring, so they’ll be more likely to survive. 

So ACEs affect both nature and nurture.

That’s exactly what it is. So when we think nature and nurture, in the past we’ve been thinking of them as two separate things. But when we think about ACEs, we learn that there is a gray area in there, that one generation’s nurture can become the next generation’s nature. 

What do you think is the biggest misconception surrounding ACEs?

First is the misconception that it cannot be changed. It’s kind of like fate, saying, “Oh, I have these ACEs, now I’m going to have these poor health outcomes, and that’s it.” You can do things to impact your health. You can change your lifestyle to eat healthier, get more sleep, things that would help you to deal with any type of childhood trauma. Counseling and therapy do work to resolve childhood trauma.