What and Why?

ACEs: Adverse Childhood Events Study


ACEs: Adverse Childhood Events Study shows us the need for an integrative approach (wholisitic= whole person) to therapy.

Kaiser Permanente in 1998 threw its weight behind this study, so its one of the largest, robust studies in modern times that reveals in stark terms the legacy of trauma.

The ACE Study examined the relationship between certain childhood experiences that are often traumatic (childhood is defined as 18 years or younger) and the risks associated with them throughout the lifespan, specifically health, mortality, and wellbeing. Only 10 specific types of experiences were included in the original study. Additional experiences compound your risk. Please don’t disregard experiences that aren’t on the list. It isn’t meant to be an exhaustive catalog of trauma.

These 10 experiences consisted of either personal or environmental sources of trauma. Personal includes the usual suspects: 1) physical abuse, 2) verbal abuse, 3) sexual abuse 4) physical neglect 5) emotional neglect. 6-10 are environmental, i.e. family, experiences: 6) an alcoholic parent 7) your mother experienced domestic violence in the home 8) a family member in jail 9) a mentally ill family member and 10) losing a parent through divorce, death or abandonment.

The cumulative impact of these experiences was shocking. An ACEs score of 4 and up places you at high risk for serious and chronic health conditions, as well as disability, and a score of 6 or higher actually place you at risk of dying- up to 20 years- prematurely.

1. The ACE Study revealed six main discoveries: (from ACESTOOHigh.COM)

  •  ACEs are more common than you think…nearly two-thirds (64%) of adults have at least one.

  •  They cause adult onset of chronic disease, such as cancer and heart disease, as well as mental illness, violence and being a victim of violence

  • ACEs don’t occur alone….if you have one, there’s an 87% chance that you have two or more.

  • The more ACEs you have, the greater the risk for chronic disease, mental illness, violence and being a victim of violence. People have an ACE score of 0 to 10. Each type of trauma counts as one, no matter how many times it occurs. You can think of an ACE score as a cholesterol score for childhood trauma. For example, people with an ACE score of 4 are twice as likely to be smokers and seven times more likely to be alcoholic. Having an ACE score of 4 increases the risk of emphysema or chronic bronchitis by nearly 400 percent, and attempted suicide by 1200 percent. People with high ACE scores are more likely to be violent, to have more marriages, more broken bones, more drug prescriptions, more depression, and more autoimmune diseases. People with an ACE score of 6 or higher are at risk of their lifespan being shortened by 20 years.

  • ACEs are responsible for a significant amount of workplace absenteeism, and for costs in health care, emergency response, mental health and criminal justice. So, the fifth finding from the ACE Study is that childhood adversity contributes to most of our major chronic health, mental health, economic health and social health issues.

  • On a population level, it doesn’t matter which four ACEs a person has; the harmful consequences are the same. The brain cannot distinguish one type of toxic stress from another; it’s all toxic stress, with the same impact.


Integrative Mental Health

What’s the connection to aces?

My understanding is that the majority of persons who will seek services from me can best be viewed through a lens that is trauma focused. Even diagnosis such as depression, Bipolar, ADHD, are known to be easily misdiagnosed when trauma is missed. Trauma is not an event. It is an experience. There is no definitive list of what trauma is and what it isn’t.

Therefore, trauma competent care is what I privilege the most. In 1990 what was considered to be a bit fringe in the mental health field, which were all initiatives being advocated for by the “trauma people”- mental health professionals who cared about trauma- are now mainstream and well established “evidence based” interventions.

The importance of including the body in trauma, which is to say, mental health treatment cannot be underscored. While mental health specific interventions have been developed for that end, there is still a bifurcation between what is “mental health” and what is “physical health”. Integrative mental health is one step closer to overcoming that split.

It takes at its premise that we are a part of our natural environment. It provides us with all we need to sustain life. When we fall out of balance with our natural and organic environment, symptoms will present themselves as indicators of imbalance and disease. The first step back toward health is to restore that balance, through food, herbs, exercise, movement, rest, and other sensory based interventions, as well as conscious living through meditation and breath work. A lifestyle that includes adequate nourishment and activity, stimulating work and sufficient pleasure and leisure, sufficient solitude and social contact, is far less likely to become symptomatic. In other words, psychiatric symptoms indicate an imbalanced lifestyle on multiple levels. Integrative Mental Health track focuses on these lifestyle factors, examining choices and their impacts, from dietary changes, to appropriate, manageable exercise routines, employing simple sensory tools, and living consciously, attending mindfully to your day as an antidote to mental ill-health, or dis-ease.