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Sonoma County PACEs Connection (CA)

What Does an ACE Score Really Mean? Basic ACES Training for Providers, Part Two

 

Note: I was asked to repost this blog on the Sonoma County site, so if you have already read this, there is no new content.

My ancestry is 100% Japanese, but I probably could pass as Native American. I’m straight, but having worked some 20 years in HIV services, there were many times people assumed I was gay. My ACE score is zero, but I could pretend it was five or six. How would you know what is true? How will all our newly recruited “trauma informed’ workers (all those coaches, teachers and dentists we want to be on the lookout for ACES) know what is true?

One of the great American legends is that we can always reinvent ourselves. Come to this country and start all over. Move west and escape your past. We all embellish our life stories. But if you are Rachel Dolezal, claiming to be black, or Ben Carson, claiming to have been a teenage “thug”, when do you cross the line from slight exaggeration to self-delusion to outright fraud? For those of us serving persons with ACES, what does a person’s self-reported ACE score really mean?

As ACES becomes better known to the public, we are likely to see more folks claiming to have ACES in their backgrounds. Some of this may be due to increased societal acceptance. Some may be due to improved awareness. And some may be due to the “me too” attitude that arises whenever any group receives heightened attention.

A person’s ACEs story is likely a mixture of what they believe to be true, what fits their notion of self and what they are willing to disclose to you. Might they disclose more or less, depending upon the other person’s age, sex, position and relationship? Almost certainly yes. Is it all quantifiably, objectively true? Who knows? All of us are love to hear a good story, but it is another thing to take actions based on one.

Why would anybody pretend to have ACES? Well, why do people claim Native American ancestry when they have none? Why do some falsely report being victims whenever there is a major disaster like a flood or earthquake? To garner sympathy perhaps. To identify with a marginalized group. To obtain the recognition a person may feel they warrant. After all, if the ACES score accounted for factors like pervasive racism, I would have a “real” ACES number instead of zero. Why not claim the number I feel I deserve?

Understand, I am not some kind of “ACES Denialist.” ACES are very real, well documented, and many people have multiple ACES and have experienced severe negative consequences as a result. Having the chance to share one’s life story is a great gift for both the hearer and the teller. What is less clear is our ability to judge the fullness and accuracy of self-reports. Most of us must rely on our experience (and probably our ACES equivalent of “Gaydar&rdquo to determine the veracity of ACES scores.

I bring up this issue of questionable narratives not because it is a big problem. It is actually a common, rookie problem that anyone in health and human services encounters and learns to look out for. But if we are not even preparing our new “trauma informed” troops for this common issue, how can we expect them to be prepared for the far more difficult problem of genuine hurt and trauma?

We need to give all our newly recruited “trauma informed” workers the benefit of our hard won experience. Do not let your emotions overwhelm your critical thinking skills. Always ask, “Is this what is, or did I just find what I was looking for?” Can you think of other issues that need to be included in our ACES basic training for providers?

Part three will look at the sometimes precarious position faced by cultural and linguistic interpreters. It should be posted shortly

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