Dr. Ally's Guide to Adverse Childhood Experiences and What We Do About Them

I’m sure, by now, most of you have heard of ACEs, otherwise known as adverse childhood experiences. The term was first coined by the Kaiser Permanente health care organization in Southern California and referred to any incidents in childhood that may result in trauma or any other type of difficulty. To us, with our 2022 sensibilities, this seems obvious. But into the mid-1980s, the connection between emotional experiences and health was seen as unscientific. It was downright pseudoscience. This means there were so many generations before our own that believed their emotional experiences had no impact on their health. That makes all the holiday arguments make a little more sense, right? However, now we have an almost universal understanding that our experiences can shape our emotions which can create real change in our biology. And that experiencing adversity at any point in life, particularly in childhood, can impact health outcomes long-term. 

So what exactly are ACEs? The study highlighted ten adverse childhood experiences of note: 

• physical abuse
• verbal abuse
• sexual abuse
• physical neglect
• emotional neglect
• witnessing a parent who is an alcoholic or substance abuser
• having a mother who is a victim of domestic violence
• having a family member diagnosed with a mental illness
• having a family member incarcerated
• experiencing the divorce of your parents  

You may not have experienced any of the big 10 ACEs mentioned in the Kaiser study but there are other adversities that can impact your health. Looking through the lens of the social-ecological model, we can experience ACEs on four levels: societal, community, relationship, and individual. On a societal level, we can experience racism and prejudice, or poverty. On a community level, we may experience or witness violence in our neighborhood, noise pollution, or toxins in our environment. On a relationship level, we may experience bullying or a lack of acceptance. Then, on an individual level, watching a sibling being abused, the abuse of a parent or caregiver, experiencing and recovering from severe accidents, or being involved with the foster care system or juvenile justice system.

Ultimately, the experience of trauma on any level can result in the release of stress hormones like cortisol. The chronic release of these types of hormones, which we call chronic stress, can cause negative effects on multiple physical systems. Chronic stress can impact cardiovascular function, immunity, brain development, and how we process our emotions. ACEs are specifically linked to an increase in adult alcoholism, depression, a sedentary lifestyle, difficulties with employment, cancer, heart disease, diabetes, suicide, and engaging in violence or being a victim of violence. And according to research in the field of epigenetics, we then pass down these genetic alterations to our children. So now that I’ve painted this dire and unchangeable portrait, what do we do about adverse childhood experiences?

We survive them and thrive in spite of them. Since our bodies are little adaptation machines, we can create an environment that will encourage healing and change our DNA. Firstly, develop a team that works for you. Your team has all kinds of people. A psychologist or psychiatrist, your medical doctor and medical team, your supportive friends, loving family members, and the person who just makes you laugh on social. This is all your team. None of us got here alone and we all need the support of others to get where we want to go. Then, we want to look at managing our cortisol levels so we can just decrease our experience of stress. One of my favorite ways to decrease cortisol is to engage in acts of kindness. Doing something kind for someone else increases our production of oxytocin which naturally downregulates our levels of cortisol. This means doing something nice for someone or even just chatting on the phone. There’s that old chestnut meditation, which slows down our stress response and helps us recuperate.

Then there’s my favorite: finding meaning and connecting it to your purpose. This is one thing I do with all of my coaching clients. Aligning with why you are here is one way to stay focused on creating a sustainable and hopeful future and helps you avoid focusing on an unchangeable and possibly painful past. Where you focus goes, your mood will follow.