Promote the problem or promote the solution?

Peter Chiavetta posted:

I believe it was Dr. Anda, maybe Dr. Felitti, said just get the information out there. I just watched Resilience with 6 other EMTs and made believers out of them. One of them is a nurse just out of college. Her outrage with my practice of ACEs in the field is that there is no patient discharge plan. Lets say there are 20% of America with a score of 4+. 60+million people. Do we have to wait until all the ducks are in a row before pulling the trigger on delivering services? I'm pushing up from the bottom. I hate the idea of one more child entering into the pipeline of trauma while some are trying to reinvent the wheel. The patients I see that are receiving treatment have not been asked the ACEs survey. Young and old. So debating the age old question "What came first. The chicken or the egg" doesn't matter. 

Everyone have a good evening. It's midnight. Off to bed.

Glad you were able to see the film and introduce the idea to others, and that most can now understand some of the concepts.  Very encouraging!! Unfortunately didn't get to see it myself due to time difference.  Really wanted to, but guess I'll have to wait. Would also like to show it to others, or better still, broadcast on one of our government tv stations.

Yes you can't wait until all ducks in a row, cos I don't believe they'll ever line up perfectly.  

I have my ducks in a row, but the "experts" aren't listening. At least not in my city. It's just frustrating when a big level national collaborative is using the right words but the wrong actions. This group could do so much more simply by engaging the community they purport to serve. Listening when we say "potential harm."

Science based community engagement. Science based development of messaging materials. Science based organizational capacity building. 

This is what we know in the fire service and this exercise can be applied at this time of the movement. 

Pull the Pin at the top of the extinguisher. The pin releases a locking mechanism and will allow you to discharge the extinguisher.  Dr. Felitti stated the Ordeal of Change: The reason for change to be so difficult is it induces a crisis in self-esteem. You have to admit you have been doing it wrong. 

Aim at the base of the fire, not the flames. This is important - in order to put out the fire, you must extinguish the fuel. To even talk about the ACE questions let alone ask people, is still a taboo to most professionals. Refer above. I offer the survey in the field at some of the worse conditions. And I find it works.

Squeeze the lever slowly. This will release the extinguishing agent in the extinguisher. If the handle is released, the discharge will stop. Keep up the tough work. If you are not blurring the boundaries of your practice, you are not doing enough for your patient.

Sweep from side to side. Using a sweeping motion, move the fire extinguisher back and forth until the fire is completely out. Operate the extinguisher from a safe distance, several feet away, and then move towards the fire once it starts to diminish. Be sure to read the instructions on your fire extinguisher - different fire extinguishers recommend operating them from different distances. Remember: Aim at the base of the fire, not at the flames!!!! Baby Steps.

Rather than a broken brain, a changed brain.  If perceived as broken, the medium of delivery is poor.  It is something/a fact that you have to accept/come to grips with in order to move on. To say I can know about it but you can't handle (the truth) it, so it's better you don't know, seems to me to be somewhat over controlling/hypocritical.  Maybe it's about giving people time to digest it slowly.  But never say some people should never be exposed to it. Delivery...

I do agree with you that the question of where to once you have understood to a reasonable level the brain research, etc etc as in: where to from there?  Where are the concrete examples of the next steps to take in order to achieve a better quality of resilience, keeping in mind it's more bouncing back than mainstream resilience learning, given the brain changes etc!

Additionally, how to apply to individuals needs, as well as group and community, addressing these particular needs.  Of course one size will not fit all.

It's a challenge!  But more doable than is currently out there.

Mem, It's not, "You can't handle the truth,"

it's, "If we are spending $300 million dollars X 12 cities on a health care messaging campaign, maybe they should look at some research on health care messaging before composing the campaign."

This is one of many, many articles that show that increasing people's perception of biogenetic causation worsens outcomes. http://guilfordjournals.com/do.../psyc.65.4.313.20238

here is another that shows linking people's problems to biology actually LOWERS clinician empathy.: http://www.ncmhr.org/downloads...cal-explanations.pdf

There are scads more like them. 

Peter, I'm not doing incremental change, I'm doing disruptive innovation. I'm not trying to get the mental health providers on my side, I'm trying to make their jobs obselete and shut them down. I have learned long ago not to dicker with unreachable people. This forum is about to get the same designation.

Corinna: "I have my ducks in a row, but the "experts" aren't listening. At least not in my city. It's just frustrating when a big level national collaborative is using the right words but the wrong actions. This group could do so much more simply by engaging the community they purport to serve. Listening when we say "potential harm.""

First, thanks to all for this very direct and thought-provoking discussion. The awareness of our own triggers is important to me, as it helps me identify my triggers. I am particularly attentive to the "not in my city" comment. I have been in primary care for years and when I heard of ACEs and Resilience I was appalled (at myself) that I had not know about it sooner. 

Second, I believe ACEs and their consequences are an epidemic--tied into all the other issues of the day, heart disease, addiction, cancer to name a few. I am also aware that having ACEs affects the way that my/our brains work. But, I went to school to learn to be a provider, and I can "go to school" in ACEs/Resilience (i.e. I am here and elsewhere learning. 

Thirdly, many of my colleagues are doing good work, but they don't know about ACEs, nor do my friends who are in law enforcement, education and/or business. 

Lastly, I believe, that we must do our best to step up and encourage people to listen. I think Paper Tigers started to raise awareness, at least incrementally. I recall their are innovators, early adopters, early majorities, late majorities and laggards. I am terrified to step into the early adopter group, I am more comfortable in the late majority group. However, this is too important to wait. I am going to keep stepping in again and again, to whomever will listen to make this work in Central Pennsylvania.

Although ACEs Connection is not perfect, I believe the tools and blogs are very helpful to many, if only to make us think differently and/or to stir up controversy. It is a melting pot, not a perfect pot. 

In some states, such as Maine (Maine Resiliency Building Network, where I just spent a few months), they are doing it well! I believe Sue Andrews-Mackey, up there, stepped in a while back and they are making definite, but slow progress. I am NOT speaking for any of you, but I need to step up and do my best to get this epidemic identified and start to be part of the solution--in Central Pennsylvania. Again, thank you! 

I would tell my children when they were upset to "Reelaaaax". 

They know the science. I finally put it together for myself in relation to WNY Trauma Initiative. They are Trauma Informed Care (There is a reason). Me, I'm ACEs in your Faces. I ask for a score on those difficult questions.

Just recently I had a young female in her first stress seizure (I like to call them Trauma Seizures). Started smoking at 16 and prescribed anxiety meds by 17. According to the mother, No ACE. I know it's bull shit. But I have to be nice, so I give the mother one of my hand outs. At the emergency room I told the intake nurse that the mother stated there was no adverse childhood trauma.  Now I used the term to get a response from the nurse. A look of curiosity was in her eyes but she went in her default setting. Googled drug side effects of meds my patient is taking and guess what. Seizures are one of them. If you are taking meds for anxiety and the cause is not treated, don't you think seizures might be from ACE. So there is a long way to go. Keep learning what people are doing. Try not to look like a bull in a china shop. Because that phrase belongs to me.

Dear Peter,

I'm an ACEs fanatic. It's dangerous to get seated beside me on an airplane, because you are probably going to get an ear-full.   

I'd like to have a hand-out that I feel good about using in any situation. What hand-out do you give out?

Thanks,

Debbie

PS  My kids know the science too.  Now when I get wound up, my son (age 21) tells me to "Relaaaax."     

ACE survey on one side. Resilience survey on the back. Then there are a flyers. One for Resilience and the other side the science behind ACEs. https://www.pacesconnection.com/...ueryString=hand+outs