Adverse Childhood Experiences and Their Lasting Impact on Health: A Comprehensive Guide
ฝัง
- เผยแพร่เมื่อ 4 ต.ค. 2024
- In today's powerful episode, we unravel the profound effects of Adverse Childhood Experiences (ACEs) on adult well-being. 🔍 From the CDC's definition to startling statistics, we explore how ACEs encompass various forms of childhood trauma, including abuse, neglect, and household dysfunction. Discover the critical link between ACEs and adult psychiatric diagnoses such as substance use disorders, depression, anxiety, PTSD, and more. Join us in this crucial conversation about healing, recovery, and resilience. Watch the full episode now and be part of the change!
#MentalHealthMatters #ACEs #TraumaHealing #TherapeuticAlliance #Resilience #RecoveryJourney
I had a few “thoughts” as well 😊 Here is what I would have contributed if you had invited me on to be a part of this discussion:
Life could be viewed as one big Adverse Experience. We are all thrust into this world (without consent). Shout-out #Antinatalism.
Because trauma is a nervous system state, not an event, it can be approached in a non-linear/non-sequential way (you don’t have to start from the beginning and work your way through with the client). For example, you might say to a client “When was the first time you realized you were _finally safe?_ ”
*A few related quotes* :
- “ _Negotiating the therapeutic relationship _*_is_*_ the treatment for trauma survivors_ .”
- “Being trauma-informed is not so much about what you do, but _how_ you do it”
- PTSD is a bit of a misnomer, as there is nothing “post” about it. It shows up in the present with the client in the here and now
- “ _Traumatized people make traumatized choices_ “ (trauma begets more trauma)
- “Reactions that were once _helpful_ , are now _harmful_ .” (e.g., fawning)
3:52 What he’s talking about here in terms of the different developmental pathways/trajectories that people can take in the face of ACE’s reminds me of the related concepts of _multi-finality_ (similar beginnings, but different outcomes) and _equi-finality_ (different beginnings, but similar outcomes). For example, two siblings are raised in the same traumatic household, yet one becomes a doctor, and the other a drug addict (multi-finality). Or one person grows up in a loving, supportive environment, and another person grows up with constant abuse and neglect, YET BOTH BECOME SUCCESSFUL DOCTORS (equi-finality). Multifinality limits what we can say about prognosis, while equifinality limits what we can say about causation.
10:30 Reminds me of the saying from Narrative Therapy “We don’t store experiences, we _story_ them”
13:45 The greatest _setbacks_ provide the opportunities for the greatest _comebacks_ (think Post Traumatic Growth). Analogous to a bow and arrow analogy. The more you pull back the bow, the greater it will travel once released. Or the Japanese pottery art form called Kintsugi. Kintsugi is when they take broken pieces of pottery, and then glue them back together, thus creating something arguably more significant, meaningful, and beautiful. Kintsugi _honors_ the history and past of the “broken” pieces, and finds a way to make them whole again…
14:03 Got any of dem Shedler mugs?? One Shedler mug please! 😊
16:52 Nice epiphany here David. It reminds me of Allan Wade’s Response-Based Therapy approach to trauma. Whereby it holds that people always attempt to _resist_ violence and maintain their _dignity_ in the face of violently perpetrated acts against them. Resistance here is defined as *any* effort made by the person to resist. It can help them see that they tried their best. A few examples include: the micro-movements/shifts a women makes while being sexually assaulted in bed could be viewed as micro-acts of resistance. Or a girl who wets her bed at night to keep dad out could be viewed as an act of resistance. Or the boy who wears 3 pairs of pajamas to bed to make the sexual assault more difficult. Or refuses to call his abusive uncle by the name “uncle”. Or refuses to be in photographs with him. Or refuses to eat what he makes for breakfast. Finally, it should be noted that “open defiance” (e.g., fighting back) is the *least* common form of resistance. More common forms include going elsewhere in the body (dissociation), repression, depression, etc.
Also here on the further discussion of shame, I’m reminded of Dr. Stephen Madigan’s (Vancouver School of Narrative Therapy) term “totalizing” and “privatizing” beliefs, that are a global stories of the self that can get internalized by the individual.
22:46 Thinking of “each person individually” = An _Idiographic_ case conceptualization VS a _Nomothetic_ case conceptualization
34:44 Regarding this part of the discussion about “adverse health outcomes”. This is similar to the Social Determinants of Health (also referred to as _the causes of causes_ or _distributed causation_ )
Annabel’s work with veterans reminds me of the 3 ways we can categorize any story. 1. Man VS Man. 2. Man VS Nature. 3. Man VS Self. I think veterans are often dealing with all 3 in the recounting of their trauma.
Drinking game! - take a shot every time Annabel says “like” 🤗
#bringbackShedler
#bringhimback
Shoot me a message here, introducing yourself and the cup request: www.psychiatrypodcast.com/contact
I am wondering, in regards to people numbing with drugs, alcohol, etc., does anxiety and/or depression count as an ACE? Can anxiety and depression be considered childhood trauma for those children suffering from them since childhood, or are they more likely to be considered potential by products of the ACEs you spoke about? Thank you, and great episode as always!
Dr. Puder would obviously be better situated to answer this question (and its a good one!), so take my answer with a bucket of salt. But from the little digging that I was able to do, I got the sense that most researchers consider anxiety + depression to be *outcomes* that are highly correlated/corresponding with earlier ACE's, rather than ACE's in and of themselves.
The few notable exceptions I saw (and to your question about drugs) were that if one grows up with parents who they themselves have problematic substance use issues, that could be considered an ACE. Or in the rare occasion that children are forcibly made to use drugs (it happens), that would also be an example of a substance-use related ACE.
But we shall await the wise words of the Pudster.
Cmon Dr P, drop the sode🙏🏻
Please have Otto Kernberg on!
Second this!