Can the way you were brought up increase your risk of alcoholism, cancer, depression, diabetes, illegal drug use, heart disease, promiscuity and smoking? Growing evidence suggests the answer is yes, and a growing number of regional health and human services leaders have started to embrace this research.
Those leaders include J. Mark Robinson, executive director of the Care Management Coalition of Western New York and co-director of the new Trauma-Informed Community Initiative of Western New York.
The change in thinking comes after findings from research started in the mid-1990s by the federal Centers for Disease Control and Kaiser Permanente, a West Coast insurance company. They surveyed 17,000 mostly white, mostly middle-class San Diego residents who answered a 10-question “Adverse Childhood Experiences Study” questionnaire in which they were asked if they’d experienced various forms of toxic childhood stress.
Among the questions: Were you constantly insulted, verbally abused or feared for your physical safety as a child? Were you sexual abused? Did you live with a parent who drank heavily? A mentally ill family member? A drug abuser?
Using a statistical analysis and health insurance records, the study showed that those with the most yes answers on the so-called “ACES” test had greater rates of chronic disease and suicide, tended to be more violent, and tended to be at greater risk of becoming crime victims.
The results have forced those who treat people who are sick to take a closer look at how they do so.
“One of the best things that can come out of this is marrying physical health care with mental and emotional health,” said Robinson, a Hamburg resident who holds a degree in psychology and biology from St. John Fisher College in Rochester. “It’s always been separated. It’s always been, ‘Oh, yeah, get over it.’ But now we know we’re one body. We’ve got a head with a brain in it. Your brain changes if you’re in a state of constant stress, which you are if you’re being constantly abused or neglected.”
The brain tells your body to secrete cortisol in such circumstances, and too much of that hormone can ravage your body, Robinson said. The challenge now, he said, is to create new treatment models that take childhood trauma into greater account.
Robinson worked for 14 years as director of Mercy Flight, then headed the Erie County Medical Center Foundation before taking his care coalition job five years ago. He helped start the trauma-informed initiative earlier this year with Susan A. Green, clinical associate professor in the University at Buffalo School of Social Work.
What would you say to somebody who says, ‘Are we going a little bit overboard here? Are we a society of victims?’
This is not at all a shirking of responsibilities or passing the buck. This is the opposite. This is an awareness of what truly can be life-changing. There’s some scary stuff to this too. Every child is different, so it’s not carte blanche, but if a child goes through severe trauma, it can actually change the way their brain functions, irreparably. It can change the way their neurons fire. They’ll look at life differently for the rest of their life, and it’s not their fault. But you’ve got to realize this, and deal with it. …
Instead of saying, ‘What’s wrong with you?,’ which has become a natural reaction when someone’s acting up, if we can say, ‘What happened to you?’ – it changes everything. It changes how we address the issues. There’s even a whole new study called epigenetics, which shows that severe childhood trauma is passed on genetically. It’s staggering.
So it gets passed down?
I was taught like you were, that your genes were your genes. It gets passed down, they don’t change. They actually alter the genetic structure and you can see diseases showing up in second and third generations if there was severe abuse or neglect.
The good news for this whole thing is it’s finally, empirically showing the relationship between mental health and physical disease and it’s going to change a lot of things we do. …
There’s some organizations that are looking at their employees, too. If you’re a social worker, or you work in a jail, if you’re working every day with people who are traumatized, it literally is contagious. It rubs off on you. We’ve always called it burnout. If you know how to address it, it really is having some positive impact on (workplace) longevity.
How does the partnership with UB work on the trauma initiative?
I like to think of the coalition as boots on the ground. We’re the folks that are dealing day-to-day with the kids and the families that need services. UB is tremendous on the research side and the cutting-edge knowledge that’s out there.
Robin Karr-Morse and Meredith S. Wiley, authors of “Scared Sick: The Role of Childhood Trauma in Adult Disease,” will be featured speakers next month during a conference presented by the Trauma-Informed Community Initiative of WNY. The event runs from 9 a.m. to 4 p.m. Nov. 6 at the Buffalo Psychiatric Center Butler Wellness Clinic, 400 Forest Ave.; the cost is $30 and includes lunch. For more information or to register, call 335-7502 visit wnytrauma.org
On the Web: Take the ACES test and see what your score means at the Refresh Blog.