Teach your children well

Their father’s hell did slowly go by

And you of tender years

Can’t know the fears that your elders grew by

— Crosby, Stills, and Nash

A person I know all too well, let’s call her Dana, has never been well. If there’s a condition she might acquire, she has had it. These include arthritis, autoimmune problems, depression, panic attacks, generalized pain, intestinal issues, neurodegenerative disease, cancer, and more. Each condition is chronic, resistant to treatment, and once addressed, is immediately followed by a new complaint. In the face of this lifetime of disease, disability, and misery, Dana maintains a happy face, an active faith practice, and an ability to manage her own affairs with lots of support from her medical team, social workers, nurses, faith community, and generous friends.

It didn’t take me long to realize that Dana was a victim of ACES, adverse childhood events, that have resonated down the long corridors of her life. Raped at 9 years old by a cousin, brought up in a dysfunctional family with an alcoholic father and distant mother, neglected by an aunt that took her in after parents divorced, pregnant in adolescence, and divorced three times, life has dealt Dana a series of hard blows.

Her situation, unfortunately, isn’t unique. Medical research shows ACES impact children not only emotionally, but alter their brain chemistry, development, and their ability to respond to life later on. These adverse events can be any kind of toxic social, environmental, physical event, or abuse.

A recent article in “The Journal of Family Practice” by Dr. Audrey Stillerman of the University of Illinois, shines a light on this problem, offering direction to health care providers, community and family members regarding the need to prevent, attend to, and mitigate the impacts of ACES on our children.

According to Dr. Stillerman, “at least 60 percent of Americans have had one or more experiences of childhood adversity. Toxic stress impairs and sensitizes the stress response system, causes neuroinflammation and systemic inflammation and leads to chronic illness, disability, and death.”

Solutions aren’t simple, but sometimes just asking a simple question as whether growing up was mostly OK or pretty difficult may tip a clinician, pastor, or friend to understand the root cause of chronic, frequent, and multiple illness in someone.

By becoming trauma informed and aware, we’re in a better position as health care providers, as well as community or faith-based groups and friends to be of help. We can’t change the past, but can help change how people are thinking, feeling, and behaving today.

Some practical measures include parental and community education programs about the long-term impact of abuse, trauma, and other traumatic events in children’s lives. We need to prioritize prevention by home visits, support groups, counseling, early warning systems, social service intervention, and trauma informed clinical practice. These measures can help avoid future problems such as Dana faces daily as she unwinds the neurological, biological, and psychological impacts of her adverse childhood events.

If you know someone like her, be compassionate, have empathy, and know they’re doing the best they can. They’re fighting ancient demons we cannot see.

Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB.

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