Recently, I had the opportunity to watch the documentary ‘Resilience: the biology of stress and the science of hope.’, made in 2016. It was a very powerful experience. And it had a message that needs to be spread, so I will share some of it in this blog.
The documentary is about the discovery that was made in the USA that the health crisis that was recognised in certain groups of children – having significantly higher risks of heart disease, learning disability, obesity, mental health problems and cancer – was linked to having a high number of ACEs.
ACEs are Adverse Childhood Experiences. And when the link between ACEs and a number of health and development problems and shortened life expectancy was discovered, the doctors who made the discovery, found that there was a list of 10 ACEs that were predictive for later health problems as well as things like homelessness and criminal behaviour. By getting people to indicate how many of the 10 ACEs they had experienced and adding up the number of ACEs, it was found that children and adults with 4 or more ACEs had significantly higher risks of a large variety of health and social problems, if they did not receive any help to overcome the toxic stress caused by these experiences.
The 10 ACEs are, in no particular order: 1 having experienced sexual abuse; 2 having experienced physical abuse; 3 having experienced emotional abuse; 4 having experienced physical neglect; 5 having experienced emotional neglect; 6 having witnessed domestic abuse; 7 parents divorced or separated; 8 having a parent with mental health problems; 9 growing up with an adult who misuses alcohol or substances; 10 having a parent in prison. This does not mean that these are the only adverse experiences that a child can have, things like bullying and bereavement, or being institutionalised would have similar effects. However, generally speaking the above 10 have been found to provide a good indication.
It also does not mean that having 4 or more ACEs definitely means that you will end up obese, or with a heart condition, or with a drinking or substance abuse problem. Whether or not this is the case, is mostly dependent on the kind of mitigating factors that are present, as well as what kind of support the child receives.
What it does mean is that it has been proven repeatedly that children and adults with 4 or more ACEs have a far higher risk of a long list of problematic issues. While on the plus side, now that the correlation between having many ACEs and having serious problems later on in life has been recognised, it is possible to organise intervention and support at an early stage, to help prevent the stress caused by the experience turning into toxic stress, or to reduce the time that the child experiences toxic stress, in order to prevent all the negative effects caused to their physical and mental health by this toxic stress.
Toxic stress is a prolonged activation of the stress response that is triggered by strong, frequent or prolonged adverse experiences. What separates regular stress from toxic stress is not so much the trigger, as whether the child had secure attachments and adults around her to help reassure her and help co-regulate her stress levels down. If this is absent, regular stress turns into toxic stress. And it is the prolonged exposure of various parts of the body to stress hormones that creates the higher risks of a large range of medical and social problems.
The stress response is a physiological reaction to an adverse experience. It does not matter if the child understands what is happening or if she is still able to remember what happened to her when she was very very small, the physical response is still there and it has an effect. As they put it in the documentary: ‘The child may not remember, but the body remembers.’
This is really quite a profound discovery. And having discovered it, gives real hope that more can be done to prevent the longterm negative outcomes, by taking action early on. We do, however, need to help spread the information to make sure that people are aware and that services do actually provide early support to the children who need it.
Please share this blog to help spread awareness.