ACES: Trauma Rolls Down Hill

An ACE score represents the number of Adverse Childhood Experiences someone had before they turned eighteen. 'Adverse' refers to events that could be extremely stressful or traumatic. These experiences range from things such as exposure to instability, abuse, and neglect as a child. The score is obtained from the ACE questionnaire which was developed to see how our past influences us throughout our life.

ACES Roll Down Hill

In my job as a family therapist there were times when I had families sit down with me to make a family tree. This family tree, unlike ones you have probably seen before, intentionally included various forms of intergenerational trauma. We would look together at patterns from substance abuse, trouble with the law, abuse in relationships, and mental illness to better understand family dynamics. If someone from an older generation experienced one of these issues it was very likely to show up again in one form or another in a younger generation. These problems seem to be passed down much like hair color or freckles, but they are not always an obvious part of your inheritance.

The ‘original’ negative events that threw poison onto the proverbial family tree may have happened so many generations ago that it could be impossible to track down. Most families either do not acknowledge negative family member behaviors or may consider the behaviors so normalized that it would not come up as an issue until something happens that draws attention to it from an outside source (like if your therapist points it out). Patterns of secrecy or indifference may mean children grow up into adults who do not realize they are at greater risk for several major life altering issues - and that they can do something about it to prevent the cycle from continuing.

ACES - Adverse Childhood Experiences

The CDC-Kaiser Permanete Adverse Childhood Experiences (ACEs) study found that over 60% of adults across 25 states reported experiencing at least one type of ACE before they turned eighteen. The study also found that the higher the ACE score (or more exposure to adverse experiences) the more likely someone is to experience higher risk for chronic physical health and mental health issues. “Toxic stress from ACEs can change brain development and affect such things as attention, decision-making, learning, and response to stress. Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. These effects can also be passed on to their own children.” (2)

There is Hope

Just because you have negative experiences in your childhood does not mean that you are doomed to wander the Earth with chronic issues. That’s not the point at all. This information is here to let you know that you are at a greater risk for several things and that if you act on this information you can prevent or reduce negative effects on your well being. It is worth it to you and anyone that comes after you for you to learn how to break the cycle of intergenerational trauma.

Change is Possible

Deciding you want change is the first step. Figuring out what to change and how to do that is probably the next forty two steps after that. Recognizing what you have been through, acknowledging how it is affecting you, and then deciding to take action can make a massive difference in your quality of life. This can be both difficult and scary to accomplish. This is the part where experts are very helpful. I’m not going to say you can’t do this on your own, but if you have the option it can be invaluable to have someone who is objective assisting you as you try this new, healthy path for yourself. That extra set of eyes and ears may help prevent you from swinging from one unhealthy path to another by accident. After all, if you have few reference points for what healthy looks like it may be challenging to find the path you are looking for on your own.

Note: If you’re interested in knowing your own ACE score you can find the questionnaire online by searching for terms like ‘ACE Questionnaire.’ The questionnaire does not acknowledge or score how resilient you are after going through these experiences. Someone can have a high ACE score, but develop enough healthy coping strategies to avoid the many negative effects that could have gotten in their way. It is only one piece of data and does not encompass everything that makes you who you are.

References

(1)  https://www.cdc.gov/violenceprevention/aces/fastfact.html

https://oie.duke.edu/inter-generational-trauma-6-ways-it-affects-families

https://www.cdc.gov/violenceprevention/aces/ace-brfss.html

Vignette

Some Posts have matching Vignettes, fictitious short stories to illustrate an example related to the topic of the post. This post shares more about what Vignettes are and what they are not.

The matriarch of the family started herding family members towards the dinner table. The few women his grandmother had allowed to follow her into the kitchen were rushing to get the food laid out beautifully for the meal. Grandfather started groaning as he lifted out of his recliner. He held a hand to his lower back as he slowly shuffled toward his seat at the head of the table.

One of the aunts watched him with a frown. “Have you gone to the doctor yet about your back?” He scoffed and rolled his eyes as he sat.

Dishes were passed around. Plates were loaded up. Elijah’s new wife was overwhelmed as family members kept making suggestions about who had cooked which dish best. Her plate was so full Amelia felt a little ill just thinking about attempting to finish it all. He had already warned her they would fuss over any food left on a plate.

The meal had barely started when Elijah’s dad poured himself a beer. Amelia watched, stunned, as Grandfather then insisted on his own glass which his son provided. She had never seen anyone in her own family drink before. Elijah’s dad turned to him and held another already poured glass. She said nothing as Elijah accepted it. By ten minutes into the family meal most of the adult men had an alcoholic beverage in front of them. One of the uncles by marriage sheepishly pulled out a hidden flask. There were chuckles.

Amelia kept her eyes on the food. She had heard the stories about what Grandfather had done when Elijah’s dad was little. She could guess how often alcohol had been involved then. She had heard of families that got drunk together. It was something that happened on television shows or movies. It felt like something as foreign as growing up in a yurt or having to hunt for her own dinner. The men were getting louder as the meal progressed. Eventually, Grandfather got up and left the table. He swore. Amelia flinched. She had never heard an elder in her family say anything like it. No one said anything as he returned to his recliner and turned the television on again. The volume was so high making conversation was not an option.

On the ride home, Amelia was uncomfortably full to the point of being nauseated. She had attempted to clear her plate and was fussed at by multiple women. She attempted to protest, to point out that she was full, when comparisons to children going without and multiple mentions of the Depression were thrown about all at once. The gunshots of some western rerun in the background on top of it all made her give up. She finished the plate, assisted with the clean up, and then waited to leave.

Amelia was silent for several minutes on their drive home. “I don’t want to go back there.”

“What?” Elijah turned his head from looking at his phone.

“Did you see how he spoke to your grandmother? He said some horrible things.”

“He does that. Always has.”

“That doesn’t mean it’s okay.”

“Well, no. Isn’t that between them?”

“I don’t feel like I even had control of my own body in that home. The noise, the arguments after dinner. Being guilt-tripped to eat food that I did not choose to put on my plate. It was ridiculous. It was as if everyone but your Grandfather was being treated like a child and he was the one acting the most like one.”

“I didn’t realize you were so bothered.”

“I… how long has his back been hurting?”

“A while. He had a surgery years ago now that didn’t go well the first time. He refuses regular check-ups. He’s stubborn.”

“And how about your chest?”

“What do you mean?”

“I remember you telling me that you had chest pain last week. When are you going to get it checked?”

“I don’t see what I have…”

Amelia pulled the car over into a fast food parking lot. She stopped the car and looked at him. “I’ve heard pieces of the stories about the example that man set in your family. About how much you and your father hated his drinking and yet you join him. I’ve heard you call him stubborn and worse and yet you are copying his behavior.”

Elijah’s hand hit the car door. “Now that’s going too far.”

“Is it? I’ve overheard some of the arguments between your parents. After seeing your grandfather it looks like your father picked up some of his habits. Now, this is my marriage with you and I want to know what habits you are willing to drop.”

“Do we have to talk about this right now?”

“Your family has a whole system for acting like nothing is wrong. I know I can’t be the only one that was uncomfortable. Please don’t act like nothing's wrong when something could be very wrong. Chest pain is no joke. I love you so much and it hurts me that I can’t make you want to take care of yourself. I can only ask you to. And… I guess that is what this is. I’m asking you to get your chest pain checked out by a doctor. If it really is something simple then great. Getting diagnosed with something doesn’t make it appear. Whatever is going on is already going on. Please, let’s not get to the point that he has. Let’s not copy that pattern. Let’s not make our future kids eat to the point that they feel like throwing up. Let’s not get passive aggressive with each other.”

Elijah sighed. “I’m scared it’s something serious, Amelia. I bet he is too. It’s easier to get distracted than to deal with it.”

Amelia took in a breath as she swiped at the tears running down her face. “Easier only for one of us.”

“Will you be there when I make the call?”

“Absolutely.” She put her hand over his. “We can do this. We can break this cycle.”