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More Resilience Discussion

This article from Johns Hopkins Public Health Magazine [LINK HERE] has an interesting take on the concept of resilience. I hear this phrase often, "resilience trumps ACE's." Here is what they say:

"The good news is resilience—self-regulation of emotions, optimism and hope—can trump ACEs. (In fact, regardless of ACE status, children lacking resilience fare worse.) Children with ACEs who also have resilience had one-fifth the odds of having mental or emotional problems like ADHD or depression."

I would like to believe the solution is that simple, but I have been involved in this discussion for too long, and I believe we are coalescing around an idealistic viewpoint that might prevent discussion other theories, like the one I present. 

ACE's focused on Negative Outcomes. That's a good focus because it opened our awareness to the sometimes tragic impact of childhood trauma. But many children raised with trauma appear to do well, and when that happens, we refer to their achievement as resilience. I happen to believe that we also need to look at other protocols that heal. Some traumatized adults might actually learn the healing protocols because of their achievement. 

We know that negative behaviors help us cope. Smokers feel relief from the feelings of trauma almost instantly with their first puff. Methamphetamine was actually an antidepressant in the 1930's. Other drugs and alcohol make some forget their pain for a short time and the temporary relief it brings might well be the cause of addiction. But neutral behaviors (behaviors that don't cause damage) and positive behaviors can also contribute relief.

There has to be some actions to promote that actually help people heal. This article promotes mediation and mindfulness, which I do believe can be effective if taught in a way that gradually educates sufferers about their trauma, and helps them eliminate symptoms. 

If we assume that the successful but traumatized adults among us don't need help, then they run the risk of health issues later in life. Maybe even earlier.

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I appreciate this article addressing resiliency and specifically mindfulness.  For many years I ran the Trauma Recovery Program for women Veterans who suffered from childhood traumas, military sexual trauma, and often adult interpersonal violence as well.    In the Trauma Recovery Program we used Core Mindfulness, Emotional Regulation, Distress Tolerance and Interpersonal Effectiveness Skills – the Dialectical Behavioral Therapy (DBT) framework developed by Dr. Marsha Linehan in the 1990s as core to our trauma recovery program.  Though originally developed as a treatment for BPT (which at its core is a result of trauma and adversity), DBT is a powerful skill building approach for anyone regardless of trauma history – for these are core ‘life skills’.  Trauma Informed Care holds acquiring new skills, abilities and mastery as key to resiliency.  When clients could not or were not interested in the entire program, core mindfulness was seen and utilized as the foundation of all other efforts and essential for individual health and wellness.  Often we see resiliency referenced or implied as existing as an internal mechanism quality, or strength without adequate focus on surrounding social determinants of resiliency.  Mindfulness offers every individual immediate access to tools and perspectives that are empowering, promote agency, and thus can contribute to overall health and resiliency.

In 2005 we published a peer reviewed article in the Federal Practitioner regarding our findings using this approach.  While I/we did not use the specific ACE categories but rather let women describe their experiences and then categorized them developmentally by age and type.  Some may find this information useful  and I would be happy to provide a copy to anyone interested as it is too large for attachment here.

Like many in this field, I too have survived traumas and adversity though in my youth it had no name in my vocabulary.  I have found the content of the DBT modules extremely beneficial in all stages of trauma recovery and resiliency building work regardless of other approaches that may be paired with them. 

 I appreciate ACEs Connection for the diverse perspectives it presents.  It seems as if their remains a gap between long standing work in the field of Trauma healing and recovery work and approaches, and those responding to Aces?  In fact there exist  volumes of work gleaned over the past 50 years that is trauma informed by definition, and empowerment based in practice.  Perhaps more cross pollination would be beneficial?

Marcia Hall, PhD

Thank you for your thoughtful comments. I do believe that you raise good points. I am a person who could be said to have "done well" however still face challenges with regard to "healing" Keep up the great work!  

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