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Tonier Cain Deserves an Evidence-Based Apology


Tonier Cain spoke at the Benchmarks' Partnering for Excellence  conference last month in North Carolina.  If you don't know her name you might recognize her as the woman featured in the Healing Neen documentary (which is must see). 

I am just starting to recover from her speech.


It was hard to stand after she spoke. When I did, I went right to a yoga mat in the self-care calm room for a while. I took off my high heels and curled up in a ball for a bit.

I'm still digesting her words. 

It's not that the content was intense and heavy, though it was.

It wasn't that she talked about a ton of traumatic experiences she had survived - though she did.

It's not that my own trauma was triggered, though that happened. 

It was the way she spoke about being let down so often by the social systems she was often in and how often she was re-traumatized by them.

It's the way she challenged my thinking so I can no longer think about ACEs without thinking about all of the ACEs - adverse childhood experiences and adverse community experiences and how intertwined they are.

I have to admit that when I first heard about the "pair of ACEs" I was confused and honestly, kind of annoyed. 

I thought about how hard it is to explain what ACEs are in three paragraphs for a story, how hard it is to give a PowerPoint presentation with less than 30 slides, and I thought, we can't add another thing to the discussion or we'll lose even more people. How can we add community violence, racism and all kinds of oppression to every talk or article?

That's so privileged of me, isn't it? I think so. And I'm sorry for being so dense for so long. I sat on the yoga mat going, "I get it now" and it wasn't just in my head, mind or brain but in my gut. I felt her words.

I hope you can as well. Here are some excerpts from Tonier Cain's talk. 


If you see this woman, come through your system, in your program, on your caseload back and forth, 83 arrests, 66 convictions, 19 years of drug addiction, right, even longer alcoholism, homelessness, lost all her kids, mental health consumer. 19 years. This is the history that's in your chart that you read when she walked in the door. She's sitting across the desk from you looking like that. Truthfully, I want you to be honest with yourself, I need to know would you be able to look at her and see me today?

Do we truly believe in the people that we serve? Can we see them past, their issues and their trauma?

When a paramedic is called to someone in medical distress the first thing that do is check for signs for life, even if there are no signs of life. The first thing that they do is start to work to resuscitate that person and they do it tirelessly, not willing to give up easily. Why are we sometimes willing to give up so easy on people that got breath in their body? Why don't we work hard to resuscitate their lives?

This is my belief. Nobody can change my mind. We are created in the image of the almighty God. We are worth saving. You don't have the right to deem someone hopeless. Please don't give yourself that. That is not your right.

So again, I ask, would you be able to look across the desk, after reading my chart, could you look across your desk and see her and imagine this woman on the red carpet in Hollywood ready to receive an award, constantly trying to create things that make a difference, that give hope.

tonier cain 2

Tonier Cain's talk demonstrates why being informed by trauma survivors is critical and required by anyone hoping to be trauma-informed. As we figure out how to apply ACEs science in our family and social systems, we need to be well schooled in how ACEs have been treated/mistreated in the past or we run the risk of repeating mistakes and perpetuating pain rather than supporting and creating self-healing individuals and  systems.


Now I want to talk to you about being re-traumatized with the multiple systems I've been in. Again, this is my own personal story. This is not a personal attack for anyone in their profession. Are we cool?....

I was, they called me the community crack ho. I was the person that was homeless on the street. I was the person that was never ever allowed to go in peoples house. I was the person you see, last thing at night or first thing in the morning. Waiting for a trick or waiting to get high. That was me. I was dirty. I was smelly. I was disgusting. That was me. They couldn't see anything past that.


I failed to understand what was wrong with me. People kept calling me crazy. They called me Crazy Neen on the street and they kept telling me I needed medication. So I would checked myself into our voluntary 72-hour mental health unit at our county hospital.

It would depend on when I went. If I went on a Weds., I was schizophrenic. If I went on a Monday, I was bipolar ,If I went on a Tuesday, it was borderline. It was borderline Tuesday. It was always a different diagnosis but it was the same psychiatrist.

I would ask him over and over again, 'Well how do you know this? How do you know this? 'I would explain go him again, 'I've been up for seven days straight smoking crack cocaine.' See, they never let the street narcotics out of my system before they truly gave me an assessment or evaluation.


I have been in 31 other 28 day programs and they all did the same thing. It would take them a whole week to tell us what we better not do. Around second week they would start to give drug education courses. They wanted us to know the natural names of the drugs we were putting in our system. Some programs would actually go all the way back and tell you where the drugs originated from. By the third week they show you unsafe homemade utensils that are unsafe.

Please note the word unsafe because as addicts we do care about being unsafe. You know unsafe things that people make that is unsafe. Unsafe. Unsafe.

Finally, when you graduate they tell you how it affects your brain. I don't need to know what it used to be called I need to know what it's called now because when the movie starts playing in my head (of past abuse),  if I don't go out and find what it's called now and get it I'm probably gonna blow my brains out. I need to get it before I take my life because I can't stand that movie. I know how to get (drug) in my system. That's why I'm in your drug program. And who cares how it affects my brain? Someone tell me how to live a different life, how not to come back and forth into the system.

Note: For more details about the movies that were playing in Tonier Cain's head, check out the Healing Neen documentary.


But you know with this first 28-program I was court ordered to I felt there was a glimmer of hope because I seen people talking and they was talking positive. They were looking good. I got excited, If you can help them you can help me. So they say Cain. They call me Cain, Cain. The intake worker is ready for you.

I go in to see the intake worker and this woman pulls out the file and this is what she did.

"Ms. Cain, have you ever been a victim of domestic violence?

I said, 'Lady every man I had went up side my head.'

She said, 'Is that a yes?'

And she just checked the box.

And then she said, 'Ms. Cain have you ever been a victim of sexual abuse?'

I said, "Lady, I've been beat and raped so many times I can't  even count them. She checked the box on this one page intake form, stapled it into the file, closed the file never to be seen again. It wasn't even translated into my treatment plan.

I was subjected to violence by the hands of men. And given access to a male counselor.

If you don't get anything out of my presentation please get what I'm about to tell you. You guys ready? Come on, you ready?

When we talking to your programs, to your system, to your facility, guess what? We come with the hope that you know what you are doing.

Half of us don't have the willingness or the desire to wake up every single morning but when we hobble through those doors broken in spirit and mind and body, we expect you know what you are doing so if you tell me this man is the best thing for me, who am I to argue, you? You're the expert.


So I completed this program successfully. I graduated, first time I graduated anything in my life. I felt proud. I could not wait to get back to after care even though they deposited in my drug infested neighborhood. I could not wait to get back to say I was clean. I stayed clean for the first week I couldn't believe it, went back to that second after care, I was able to get a ride there but I couldn't get a ride home.

My drug counselor who I was assigned to at this program I was court ordered to, he offered me a ride home but he made a pit stop to push me down and rape me. And when he pulled me up by my hair he said no use in telling anyone, 'You just a crack head and prostitute.  You're nothing. And he threw me to the ground."

Maybe when we understand the prevalence of trauma, up to 93% of incarcerated girls has been exposed to emotional, physical sexual abuse, given my answers to that one page intake form, maybe, just maybe a male counselor wasn't the best decision for Tonier Cain after all - and could have been prevented.


One of the worst things you can do to someone who is a victim of abuse an neglect is put them in a room, shut the door and walk away. See because my issue with my mother was always triggered and no one is helping me to identify, address or treat my trauma and so I do the only thin Tonier knows to do is to attack and go into my survival mode.

And my survival mode has always told me to fight because I didn't  know there was any other way.

So when someone came with that tray of medication or food I smacked it out of my face. Then you're on a walkie-talkie calling and talking in code and a bunch of men running towards me.

Do you truly understand what I am saying? They were running towards me to restrain me. They were restraining a rape victim - somebody  who has been held down multiple times causing more trauma. Layers and layers and layers taking me even further away from the possibility of healing or recovering, not intentionally I know, but because we don't  understand the impact of trauma we sometimes cause more harm making it impossible for people to heal.

Note: Tonier Cain gave several examples of being re-traumatized by multiple systems. These are just a few examples. She also shared what helped her heal.


I didn't think these people could help me but they said I could keep my baby with me. (I said) 'sign me up.' In my mind, if only I could hold on to this one a little longer than the last one, if I can keep this one for more than 3 hours things would be different....

So I went to this program so I talked about all the trauma I experienced in my life. The neglect. The abandonment. See, they said Tonier everything that happened to you as a child you didn't do to yourself. And I started with the first trauma in my life, the issue with my mother. I talked about it, I cried about it some sessions, I came to the realization, 'Hold up. My mother's lack of love for me is who she is. It doesn't define my character. I was able to begin healing in that area.

Then I went to one session, talked about all the times I was physically, sexually abused. 'That would be so many times I can't even count them.'

She said, 'Let's talk about the times you can.'

Now I was in a safe environment, these things no longer happening to me. SO I was able to begin healing in that area.

Then we went to one session and she said, 'Now we going to talk about your children' and I said 'No. How do you expect me to heal from something that gives me pain every day that I wake up and realize I have four kids walking this early and if I pass them in the street I would not even know it. How do you heal from that?'

She said, 'You do. You just don't do it by yourself.

She took me through a grieving process so I was able to begin to heal.


So people over the 19 years tried to give me bits and pieces of information. Look, I seen the commercial, I've seen  the photos.  Remember the 'This is your brain on drugs commercial?'

I was a homeless crack addict when I seen that commercial. I wanted the egg sandwich, I'm sorry. I was like, really, 'We're going to start running around screaming, 'My brain.! My brain. Really?'

So the bits and pieces of info. I was getting from you would only get on the surface as so much trauma. The bits and pieces you were giving me couldn't penetrate any of that. Until I  healed and could build a foundation so my belief system could change from I am nothing, to I am something, to I can be anything I want in this world.... Because when my belief system changed - my thought process changed, and I started to make the best decisions in my life.

When I listened to Tonier Cain speak and thought about her own life and about my own, I thought about how the most protective factor in my life may be that I was never in the system. Whatever normalcy, stability and sense of family I had was able to stay, somewhat in tact. Though my biologically father was physically violent and never got sober, though he had social worker supervised visits when I was very young, they stopped when he disappeared from my life. 

So, though I have an ACE score of 8,  I wasn't re-traumatized by the foster care system, the criminal justice system and the mental health system. Unlike Tonier Cain, I wasn't taken from one family and placed in another and then forced to go to school the next day as if nothing happened. I wasn't placed in lock-down or sexually assaulted by someone in authority at a program where I sought help. I didn't get several labels and totally different treatment plans. 

My father was homeless. I never was. 

So while Tonier Cain and I had absent parents and parents who failed to protect us, caregivers and relatives who sometimes abused or were the danger, our high ACE childhoods are different. I  had a home, some extended family, friends and most of all, the consistency of school which for me was a sanctuary.

There was still plenty of chaos, neglect and pain, at home, but the traumas weren't magnified and more global. They didn't replay at school. The helps I sought didn't hurt me. I got to hold on to the illusion that there would be hope and help as an adult. 

I had high ACEs with white privilege and was able to pass for "normal" and middle class. My traumatic stress symptoms were bed wetting, depression, anxiety, eating disorders and being compulsively busy. Many of those things are socially acceptable and even rewarded. I got more popular when I lost weight. Good grades helped me get good jobs and though they didn't prevent post-traumatic stress but gave me resources which made my life easier. I had a place to live and a car. I had insurance coverage. And as an adult with private insurance I at least had the luxury of having some say in the type of help I got. 

Is what we often term resilience really luck and privilege? Is resilience really the absence of all ACEs as well as the presence of one "good enough" adult in ou corner?

These are big issues. I'm not sure anyone can talk about how they intertwine better than Tonier Cain. I'm listening and I keep learning. 

I'm outraged by how mistreated Tonier Cain was by all who were supposed to keep her safe, healthy and well. But I know shame isn't healing for anything or anyone. 

So what do we do with all the truth and stuff?

I go to conferences a lot and one of the words I hear most is "evidence-based." But what does that mean? The treatments Tonier Cain received were evidence-based and insurance-covered at the time. How do we talk about the mistakes, pain and damage we sometimes do and have had done to us even though it's usually not intentional?

I keep wondering what an evidence-based apology would look and sound like to give and get. 

I wonder if Tonier Cain has ever received one?

Thank goodness she is sharing what she's been through, what's hurt and also what helps.

It's hard to think and talk about bias and mistakes and system change and it's hard to trust things will really change if we don't.

The tag line on Tonier Cain's website reads:

"Where there's breath there's hope."

We can breathe deep. We can say, "Ouch" about what hurts, and "I'm sorry," when we've been wrong and caused pain.

I'm sorry for failing to talk about community violence, race or class or oppression in all my talks about parenting with ACEs unless directly asked to at the end during Q&A.

As though it's not important, central or related to everything.

I'm sorry about that.

I can change.

People and systems can change.

Tonier Cain is passing down epigenetic joy in her own family (see below).

Her words help me do what Jane Stevens is always says, and that is to "prevent as well as stop traumatizing already traumatized people."

It's possible, as Tonier Cain describes so well. 


They treated my trauma with the hopes that I'd stay out of their system and it worked.

But I often wonder did they realize that treating my trauma was going to break the generational cycle in my family. See my daughter doesn't know what it's like to be hungry, not to be loved, not to be supported. She doesn't even know what it [s like to live in a challenging area so she'll be able to give her kids what she was given and so on and so forth. And so we're going to get a whole different generational path from here on out. In other words, the cycle has been broken.

"What if someone recognized my trauma at age 9 like they did 13 years ago when I was given the opportunity to embrace trauma treatment?"

....Do we truly believe in the people that we serve?

Let me say this, if you treat the trauma, you will get the result, I promise you that. I'm your evidence.

For more about Tonier Cain's life and work check out her website and the Healing Neen documentary.


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Jondi Whitis posted:

So deeply grateful for this post, this community, this turning of consciousness and treatment in the world as we knew it. Renewed hope is in all these pages, every day. Thank you.


What a beautiful post and I share your sentiments about our community! Warmly, Cissy

Dawn Daum posted:

So powerful. And indeed, where the hell has the "evidence" been? Trauma-informed practice is the missing link in the "person-centered" and "evidence-based" standards of the kind of care being provided. Once Neen  finally  came in contact with someone who understood that, it was life altering for her and her daughter. Great report, Cis. Looking forward to watching the doc and sharing with others.


Thank you! I think you will LOVE Healing Neen. A large portion of it is on You Tube.

So many were benefiting from yoga, for example, before it was evidence-based. The evidence was how people felt but many professionals said, way back when, "it's too dangerous for people with trauma" because who knows what the body might bring up. It hadn't been studied and verified yet but there were plenty of survivors saying, "This helps" but that was not considered basic evidence when I don't think it gets more basic. We have to make sure that what we create and hope works for people actually does work. And that when it doesn't, we hear, see and make changes as well as apologies.

Only AFTER feeling seen, heard, understood and supported could Tonier Cain let in any of those bits of wisdom or info. she was hearing. I think, especially with parents, we rush to judging and advising and shaming rather than supporting, listening or figuring out what people need.

It's great to go from, "What's wrong with you?" to "What happened to you?" But we also need to know, as parents, what didn't happen for us so we can get it and help get it in our lives and offer it for our kids. I can't wait until Parenting with PTSD is released. Please share when that happens here and in Parenting with ACEs. And share those quotes you've been sharing on Facebook as well, if you don't mind, because they are concise, powerful testimony.


Louise: Thanks for this comment! I appreciate it.  Little impacts and changes my heart and mind more than hearing stories and experiences from various survivors and advocates. Cissy

P.S. Please share anything and everything Echo Parenting is doing on the Parenting with ACEs page as well as the main blog. Some only read posts in the communities (used to be groups) so it's great to include it in both when possible. 

So powerful. And indeed, where the hell has the "evidence" been? Trauma-informed practice is the missing link in the "person-centered" and "evidence-based" standards of the kind of care being provided. Once Neen  finally  came in contact with someone who understood that, it was life altering for her and her daughter. Great report, Cis. Looking forward to watching the doc and sharing with others.

Carey S. Sipp posted:

Oh. My. Thank you. 

There is so much here. Wish all policymakers could read this/see videos.

All "deciders."

Great work.



Thank you for reading. It's long. She had so much to say. I didn't even capture half. It was amazing. Cis

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