People have been hearing a great deal about trauma lately.
The concept is anything but new to social workers, of course. They could have told us 30 years ago that the more adverse situations a child experiences, the higher the chance of real consequences in school, health and life.
As a concept though, trauma, unfortunately, didn’t make its way into the physical health literature until the imaging and neurobiological studies caught up with the observations from front-line workers. We finally have the hard science to show the changes in a child’s brain related to accumulated traumas. PET scans and autopsy results confirm the pruning of nerves that should have been developing rapidly at this point in life.
The trauma studies done by Dr. Felitti in California started with adults and were remarkable in showing the increased risk for chronic health conditions of those accumulated traumas. He developed a set of common insults that correlated with the increased risk to health.
I had the privilege of working with uninsured patients in my previous life. I saw every day what the accumulated results of those traumas (abuse, loss of a parent, family insecurity and personal harm) led to in adult patients. I could see the increased rates of emphysema, heart disease, past suicide attempts, depression and other chronic diseases. The people I worked with were incredibly resilient and took care of their families in difficult circumstances while dealing with these health conditions. But the toll was very high.
There are many questions left to be answered. There is a body of evidence showing that we have ways to mitigate the influence of these events on the developing child brain, but how do we best integrate them into schools, courts, faith, medical care? Do we treat adults who have these accumulated traumas in a different way than the traditional medical model? How are we, in the various organizations that encounter high-risk people, careful not to add to the traumatic burden that our patients or clients bear? Many people are thinking about and working on approaches to all of these. This will consume the many systems for the next 20 years until we can answer these questions.
I think of these Adverse Childhood Events as the next germ theory of disease. It will — and should — change the way we think of certain adult diseases. It will change the way that we treat difficult health issues in the future.
As overwhelming as the burden of these issues appear, it give us an entirely new model with which to approach people.
This blog post is part of A Healthy 10.