Adding layers to the ACEs pyramid -- What do you think?

This new pyramid is quite meaningful to the work that is happening in Maine.  Many thanks for sharing and for the robust dialogue that follows.

 

I think the new pyramid is fantastic!

Please, could we consider calling the blue layer "Complex & Developmental Trauma/ACE" ?  So many human babies have their brains damaged in utero from stress to the mother. Details for "developmental trauma" at http://attachmentdisorderheali...evelopmental-trauma/

And thank you, Lou Godbold and others: "No one is raised devoid of a historical and social context." 

Like Lou, I was raised in what looked like lily-white society.  But my maternal great-grandmother was knocked up at 13 and spent her life in the belly of tramp steamers roaming the world having 13 children, half of whom died; the 12th was my grandmother who got less mothering than the luggage. She passed no mothering to my mother who gave me nothing but "Still Face Experiment," to where I couldn't even procreate.  I'm the "butt end of evolution."

This explains why our government, corporate, judicial, medical, and other leaders often act so inhumanely. Like Lou and me, they may appear accomplished, but inside, I'd estimate more than half of them have similar complex and often developmental trauma, which can remain deeply buried for a lifetime.

This is not just "me, too." This is why our society tolerates such injustice to people of color!  As Dr. Felitti says, for example, most medical professionals "resist" the ACE Study conclusions, published 1998, for fear of "looking within."

To cite Dr. Bessel van der Kolk, MD, most of Congress is "dissociated," or they'd feel the simple human compassion to know that sending youth to war brings back a flood of PTSD victims (search on "Congress" or see footnote 9 in "developmental trauma" blog, above).

I am very happy to see the new additions to the ACEs pyramid. They ground the model in social context. It is quite impossible to understand a person or persons only as individuals.

I am with Julianne on the race issue. Additional trauma. Robert Carter at Columbia University has written eloquently on race-based traumatic stress.

I am very glad to see a new pyramid that incorporates ideas of social location and historical trauma. I also like the phrase "collective trauma," because to me it describes trauma that is systemic, historical and ongoing. Such a phrase also invites ideas like "collective resilience," which I imagine as being similar to what P describes above when talking about communities and cultures as potential stabilizing forces. I don't think I could begin to heal from internalized racism until I began organizing with other people of color.

Living in a society with collective trauma (aka systemic oppression) has an impact on all of us--oppressors, victims, and bystanders, though that trauma shows up differently in each of us. And most of us play multiple roles depending on the situation. (At the very least, each of us has experienced the challenge of being a child in an adultist world. And most of us live long enough to experience the power that comes with being an adult in an adultist world.)

On the flip side, working creatively and collectively for liberation also has an impact on all of us--healers, survivors, and witnesses, though the resilience built shows up differently in each of us. And again, we can play each role at different times (and sometimes simultaneously).

I think addressing ACEs successfully requires addressing collective trauma, and I'm glad to see that represented visually.

Tina, I agree that poverty/classism is a major trauma and oppression. I also think that racism is an additional trauma and oppression, and it's valuable to acknowledge both.

For example, in the aftermath of Katrina, people of all races were resourceful in gathering the supplies they needed for their survival, but the press reported differently on white and black survivors in the same situation ("finding food" vs. "looting"):
http://m.huffpost.com/us/entry/6614

This example is just a symptom of a larger system. For more general info on this topic, written by someone white who grew up in extreme poverty, I really appreciated this article ("Explaining White Privilege to a Broke White Person" by Gina Crosley-Corcoran):
http://thefeministbreeder.com/...-broke-white-person/

I think it's important to end all oppressions, and it can be particularly useful to consider how different collective traumas are interwoven and hold each other up.

Culture and the Impact of ACES by SES -  The impact of one's culture (ethnicity, class and income) can set in motion perspectives and beliefs that impact resilience patterns which impact lives of youth - and adults.  Life in rural America is very different from urban New York City or Chicago - particularly in perceptions of pace, speed, degrees of socialization, appreciation of art and music, dietary patterns, interpersonal interactions, family and emotional pressures, competencies of adults working with children and the notion of culture impacting survival skills.  Holding someone accountable for successful interactions with different cultures implies a recognition of distinct cultures and their differences. Articulating the dynamics of a foster mother's child care management implies some degree of familiarity with them - either direct or indirect. A hypothetical question on a Scholastics Aptitude Test might be "What is the alcohol content in 'pot liquor' - 0%, 3%, 6%, 12%, 20% or 40%?  The fundamental question is "What is pot liquor?"   If you are familiar with a country way of life, you know that pot liquor is the juice is derived from cooking green vegetables - and is sometimes used as a tea or laxative. In an urban context, few people understand even what it is - unless rural behaviors were brought up from the south. There is no alcohol content in pot liquor. As such, Kanwarpal,  I am not sure how you mean to "Generational Embodiment" - perhaps as a synonym for culture.  I would submit that the healing of people who experience adverse childhood experiences depends on how they are socialized and how they are prepared and conditioned to respond to what happens to them.  Having come from a family that is six generations post slavery (USA), what is missing in the ACE structure is the role that communities and cultures can play in a stabilizing force, to balance the deprivation of disparities.  Young men and women who witness murder in their neighborhoods display Post Traumatic Stress Disorder (PTSD) - sometimes with images of hostilities and self-demise exchanged for flashbacks. We screened several groups of African American men in Men's Group settings with the ACE Score.  The responses were tri-modal - with one in the "0-1" range, one group in the "3-4" range and the third group in the "6-7" range.  Our team is looking at Re-Entry issues from correctional settings and will integrate ACE evaluations into the release assessment - both as a baseline measure for mental wellness and a motivational tool against which we will couple strategies that teach survival skills in an environment that is not welcoming.  Once we spend the next year evaluating the dynamics of ACE on different cultures, we will report out again.

 

Paul B. Simms, Vice President

San Diego Black Health Associates, Inc.

This all makes perfect sense. No one is raised devoid of a historical and social context. We know that poverty and unemployment, for example, exacerbate stress. I, for one, am delighted to see historical trauma and family legacy included. At Echo Parenting & Education we always teach parents about generational trauma because it often explains so much. I suffered as a child because my mother was raised by a father who spent 5 years in a Nazi POW camp. But the problems started earlier with his father's early death, his twin sent to live with a relative, and my poor grandfather left with a bitter and vicious mother who took in sewing to make a living. He had to leave school and sell vegetables from a push cart at the age of 12. Sounds Dickensian, doesn't it? Once I understood this legacy, so many things made sense. It wasn't just my childhood, it was generations of trauma that I was in turn visiting on my own son.

 

For this reason, I am particularly interested in epigenetics. There is not just a psychological legacy but a physical one too. The two additional layers on the pyramid captures all this and I think it is a great improvement. (Sorry about the side track on my own personal history. Feeling very connected to the ACES folk this morning and grateful for your existence!)