Understanding childhood trauma is essential for addressing its lasting effects on individuals’ lives. In Nadine Burke Harris’ enlightening book “The Deepest Well,” she delves into the profound impact of early adversity, offering valuable insights for healing and recovery.
Insights from Nadine Burke Harris
I recently read Nadine Burke Harris’ (MD) book “The Deepest Well Healing the Long-Term Effects of Childhood Adversity.” I found this an extraordinary and important book for anyone who has been affected by trauma, whether themselves, their children, or for caretakers of children who have experienced trauma.
Ms. Burke Harris is a pediatrician who opened a clinic in a low socioeconomic area of San Francisco. In her patients she began to observe a pattern between adversity and a biological connection. She was seeing a significant amount of her patients presenting with abnormal development or disease. She began to suspect that trauma was the underlying cause of these issues. In her book Ms. Burke Harris finds proof for her suspicions and lays out a treatment plan for these children and adults.
Two Different Stories
In twenty years of practice I have also noticed many commonalities in people who have untreated trauma. Johnny was a seven year old boy who was being raised by his grandfather. His mother was addicted to drugs and in the time that he had lived with her he had been witness to many things a child shouldn’t see. He was then separated from his mother at age four and has not seen her since. He was brought to see me because of behavioral issues in the home and at school. His Grandfather was at his wits end trying to manage Johnny. He was hitting, kicking, and refusing to follow instructions at both home and school. He had been kicked out of several extra-curricular activities. Bedtime was the biggest problem. He never seemed to sleep. His teacher was sure he had Attention Deficit behavior with Hyperactivity (ADHD) and wanted to refer him for medication.
Sally was a young adult who came to me when the Doctors told her they could find no medical cause for her ongoing stomach issues and panic attacks she had been having for several years. She had tried many ways to treat her issues but had not had any success.
The ACE Questionairre
The tool Ms. Burke Harris uses to assess for childhood adversity is called the Adverse Childhood Experiences Questionnaire or the ACE. This simple, ten item questionnaire, asks about stressful events of abuse and neglect that may have affected the individual’s health and well-being as a child and into adulthood. A numerical score is given. (Feel free to take the assessment yourself below.) A score of one or more indicates the probability the individual may struggle with health, behavior, stress, or difficulties with social and emotional growth into adulthood. Examples of symptoms include but are not limited to; syndromes, diseases, depression, anxiety, hair loss, growth issues, asthma, eczema, ADHD, restlessness, and difficulty sleeping.
I use this assessment with my clients, children and adults, as an indicator of the roots of their ongoing struggles for which no root cause has been identified. This serves as an illustration for the client and a road map for both of us.
Johnny’s and Sally’s Scores
I had Johnny’s grandfather complete the ACE for Johnny. Johnny had a high score, meaning, he had experienced many traumatic experiences in his young life. His behavior was a result of his traumatic and untreated experiences. I explained this to his grandfather, who was a Military Veteran with Post Traumatic Stress Disorder (PTSD). The grandfather stated, “Now I understand, he is like me!”
Sally also scored high on The ACE. I explained to her how her body and brain were holding onto the traumatic memories and converting them to issues in the body. Her trauma was being held onto and was being expressed through panic attacks and stomach issues. Sally had PTSD.
Six Critical Areas for Treatment & Self-Care
In the book six critical areas for treatment and self-care are outlined:
- Proper nutrition
- Adequate exercise
- Proper sleep
- Mental health treatment
- Healthy relationships
- Mindfulness and meditation
By paying attention to and integrating these six areas into our lives we can treat the underlying issues and reach our maximum level of health. Even without symptoms and issues this is a model for self-care and health.
I explained the six areas to Johnny, his grandfather, and Sally. We assessed for what areas they needed to better incorporate into their lives. This became the treatment plan in therapy. Johnny has done very well and has graduated from therapy with me. His grandfather keeps in touch and sticks to the six areas of self-care for both Johnny and himself. Sally is also doing well and has become significantly more aware of herself, her body, and her past.
Find your ACE Score
While you were growing up, during your first 18 years of life:
1. Did a parent or other adult in the household often…Swear at you, insult you, put you down, or humiliate you?
or
Act in a way that made you afraid that you might be physically hurt?Yes or No
If yes enter 1 ________2. Did a parent or other adult in the household often… Push, grab, slap, or throw something at you?
or
Ever hit you so hard that you had marks or were injured?Yes or No
If yes enter 1 ________3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way?
or
Try to or actually have oral, anal, or vaginal sex with you?Yes No
If yes enter 1 ________4. Did you often feel that… No one in your family loved you or thought you were important or special?
or
Your family didn’t look out for each other, feel close to each other, or support each other?Yes No
If yes enter 1 ________5. Did you often feel that… You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
or
Your parents were too drunk or high to take care of you or take you to the Doctor if you needed it?Yes No
If yes enter 1 ________6. Were your parents ever separated or divorced?
Yes No
If yes enter 1 ________7. Was your mother or stepmother often… Pushed, grabbed, slapped, or had something thrown at her?
or
Sometimes or often kicked, bitten, hit with a fist, or hit with something hard?
or
Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?Yes No
If yes enter 1 ________8. Did you live with anyone who was… A problem drinker or alcoholic or who used street drugs?
Yes No
If yes enter 1 ________9. Was a household member depressed or mentally ill
or
did a household member attempt suicide?Yes No
If yes enter 1 ________10. Did a household member go to prison?
Yes No
If yes enter 1 ________Now add up your “Yes” answers: _____
__ This is your ACE Score
The higher your child’s or your ACE score is the higher risk there is for social, emotional, behavioral, and/or physical health issues. Left untreated the problems will increase. Seeking professional help for a high ACE score is always recommended.
Conclusion
As we navigate the complexities of childhood trauma and its effects, it’s crucial to remember that healing is possible. By acknowledging the impact of adverse experiences and embracing strategies for self-care and support, we can begin to break the cycle of trauma and build healthier, more resilient lives. “The Deepest Well” serves as a beacon of hope, guiding us toward a future where understanding, compassion, and healing are the cornerstones of our approach to adversity.
If you would like to discuss your ACE score and find clarity and understanding around your childhood experiences, contact me to schedule an appointment.
In Kindness,
MM