NOTE from Carey on 8.12.26 : The PACEs Connection social network was replaced by a splash page on August 10, 2026. Knowing this was happening, I urged leadership to let the most prolific content providers and donors know, and started saving blogs I’d written over my 13-years of knowing Jane Stevens, founder and publisher of PACEs Connection and the now disappeared ACESTooHigh.com. This history, written by Jane, is saved on my site now for posterity. Someday the history of how this movement came about, who led it, who funded it, how it grew, expanded, contracted, and more, will be told. Saving this and other information on my careysipp.com site is an attempt to capture as much of this information as possible. It’s here for use while the PACEs Connection site is revitalized, and here in case some of this information doesn’t make it to the new site. AGAIN, this is a limited selection of article I deemed most important, and is in no way a comprehensive or fair representation of the wide scope of PACEs Connection in its heyday, when we had about 20 staffers and were offering frequent “A Better Normal”, “Historical Trauma in America” (by region), “Connecting Communities One Book at a Time”, and other webinars and events. For more of the history, another separate site, https://www.pacesconnectioninfo.com/ is still up. I will try to add more content from it, hoping that if it is saved in several places, it will be available for the revitalized site and/or posterity.
Jane Stevens launched PACEs Connection in January 2012 with ACEsConnection.com, now PACEsConnection.com, a community-of-practice social network and ACEsTooHigh.com, a news site for the general public. The intent was to inform people, organizations, and communities about a new understanding of human behavior that had been emerging since 1980s. It was clear that this new knowledge had the potential to solve our most intractable problems. The network was designed to connect the pioneers who were integrating trauma-informed and resilience-building practices based on PACEs science across sectors. This included pediatricians, educators, business owners, judges, community activists, people participating in associations, people working in juvenile justice, social workers, people in the faith-based community, emergency medical technicians, etc.
In 2014, PACEs Connection received funding from the Robert Wood Johnson Foundation and The California Endowment and began operating as a nonprofit through a fiscal sponsorship with Prevention Institute. At that time, a small team of people began working with Stevens to grow PACEs Connection. In March 2016, PACEs Connection received another round of funding from the Robert Wood Johnson Foundation, which sunsets in 2021, and TSNE MissionWorks, which is a 501c3, became our fiscal sponsor. Subsequently, at the end of 2016, PACEs Connection received a second round of funding from The California Endowment. In 2017, the Lisa & John Pritzker Family Fund, and The George Sarlo Foundation provided two years of funding. Genentech’s Resilience Effect philanthropic initiative began providing funding, which mostly supports a reporter who covers pediatrics. In 2020, Blue Shield of California Foundation began providing funding for work in California.
PACEs Connection has become the hub for the PACEs movement. Between 2012-2021, PACEsConnection.com grew from 200 members and no community sites, to more than 52,000 people from every state in the U.S. and more than 40 countries, with more members joining daily. More than 400 communities representing PACEs initiatives have launched in nearly every state in the U.S. and in several countries, with more community sites launching weekly. The community sites can be thought of as mini-PACEsConnections that support PACEs initiatives in cities, counties, regions, states, and nations. The network also supports interest communities such as PACEs in Education, PACEs in Pediatrics, and Parenting with PACEs, and organizational groups such as California Essentials for Childhood.
On ACEsTooHigh.com, articles receive from a few hundred to more than two million page views. Since its inception, ACEsTooHigh.com has also grown: in 2012, it had 471,000 page views and 3,600 visitors; by 2021, it had nearly 10 million page views and six million visitors.
Since 2012, PACEs Connection has used Marshall Ganz’ five-pronged approach to grow the PACEs movement — relationship building, storytelling, structure, strategy, and action. Our initial strategy focused on educating people and organizations about PACEs science, telling stories about people and organizations in different sectors who developed practice-based evidence that inspired others to take action, connecting people who were doing similar work, and developing a networking structure to support all this.
In our next phase, we are focusing focus on systems and policy change. That means creating a national scaffolding using distributed networking technology that links the “mini-movements” taking place in thousands of geographic- and interest-based communities, providing them tools to support their work, and then scaling up that approach. To accomplish this, we launched the PACEs Connection Cooperative of Communities for communities that need advanced tools to measure progress, as well as more guidelines and services.
From these communities will emerge new healing-centered systems that integrate PACEs science from the start (for example, creating a healing-centered system that merges schools and healthcare…something that the State of Oregon is developing) and that can be replicated throughout the world. Our relationship-building and storytelling continues; we have seen those elements light a fire of participation, innovation and sea-change across the world.
Note – With PACEs Connection switching over to a splash page on August 10, 2026, I wanted to save some of the most important posts written by Jane Stevens, a couple of other staff people, and myself. I didn’t save even a 10th of what I would like to have, but I am assured that a “data dump” of all posts and the entire social networking site exists and that we will be able to access what’s needed when the need arises. AND… just in case, I am posting this and a couple of others Jane wrote — which in no way does justice to the volumes of materials she created to help people begin to grok the connection between adverse childhood experiences (ACEs) and our most intractable social ills, or how Jane said PACEs science could help us prevent perpetuating those ills with the flip side of adverse childhood experiences — positive childhood experiences — and policies supporting PCEs and more. Please know I apologize in advance for not uploading more pieces here. Jane’s beloved “ACEsTooHigh.com” site went down earlier in 2026 and I was stunned that that decade plus of work just disappeared. My hope is that the archives of the PACEs Connection social networking site will live on and we can someday create a history of this movement, as I, too, believe the answers to all of our most intractable problems are in this science. How to prevent multi-generational ACEs, how to foster “Neuro-Nurturing” to create the early relational health that is foundational to a lifetime of better health and better choices; how to leverage finding and norming the positive to create ever-widening circles of healthy communities, families, people. Thank you, Carey Sipp
A baby is born into a family where he’s ignored by his father. When he does receive his father’s attention, his father constantly yells at, criticizes or punishes him. For the first two years of his life, this child’s mother is perfunctorily attentive, but not loving, and then abandons him for a year. From the time he was born until he is an adult, he witnesses his father abuse his older brother by terrorizing him verbally. This leads to his older brother becoming an alcoholic and dying at the age of 42. He sees his parents engaged in an emotionally neglectful, if not emotionally abusive, marriage.
This is the story of the early years of President Donald J. Trump, according to the captivating book, “Too Much and Never Enough: How My Family Created the World’s Most Dangerous Man.” The book was written by the president’s niece, Mary L. Trump, the daughter of Donald Trump’s older brother. It bursts open the doors to understanding why Donald Trump behaves the way he does. It is also is a cautionary tale for how we decide who becomes a leader, whether that leader is a president, CEO, judge or school superintendent.
In Mary Trump’s words: “Child abuse is, in some sense, the experience of ‘too much’ or ‘not enough.’ Donald directly experienced the ‘not enough’ in the loss of connection to his mother at a crucial developmental stage, which was deeply traumatic. Without warning, his needs weren’t being met, and his fears and longings went unsoothed. Having been abandoned by his mother for at least a year, and having his father fail not only to meet his needs but to make him feel safe or loved, valued or mirrored, Donald suffered deprivations that would scar him for life.”
Anyone who knows about the science of adverse childhood experiences has suspected all along thatcritical aspects of the president’s formative years contributed to his behavior today.
Mary describes Fred Trump, Donald Trump’s father, as a “high-functioning sociopath.”
“In order to cope,” writes Mary, “Donald began to develop powerful but primitive defenses, marked by an increasing hostility to others and a seeming indifference to his mother’s absence and father’s neglect….In place of [his emotional needs] grew a kind of grievance and behaviors—including bullying, disrespect, and aggressiveness—that served their purpose in the moment but became more problematic over time. With appropriate care and attention, they might have been overcome.”
But Donald Trump had practically no positive childhood experiences that could buffer the abuse he endured. “Unfortunately, for Donald and everybody else on this planet,” writes Mary Trump, who has a Ph.D. in psychology, “those behaviors hardened into personality traits…”
Donald Trump didn’t have a chance. The only thing that kept him from ending up as a small-time crook with a prison record is money, and lots of it.
Most people think of child abuse as sexual abuse or the physical abuse of being beaten. But the science of adverse childhood experiences found that other types of childhood abuse—experiencing emotional abuse, emotional neglect, living with a parent who’s addicted to alcohol or other drugs or is mentally ill, having a relative who’s incarcerated or witnessing a mother being abused, witnessing a sibling being abused, bullying, racism and other traumatic experiences—can do just as much damage. That’s because the brain itself can’t distinguish between types of trauma. It’s all just trauma that a child’s brain has to adapt to in order to survive. For example, when a father’s only interactions with a child are to suddenly rage without warning, the stress hormones in the child’s brain trigger a kid to flee for his life, fight or freeze in fear. And if that kid has to protect himself from that father every day, eventually that kid’s brain is altered.
Science is very clear that babies need two important types of positive experiences to lay a solid foundation for a healthy life, notes Mary Trump. One is physical and emotional closeness: “Being held and comforted, having our feelings acknowledged and our upsets soothed are all critical for the healthy development of young children.”
The second is mirroring, “the process through which an attuned parent reflects, processes, and then gives back to the baby the baby’s own feelings,” she writes. “Without mirroring, children are denied crucial information both about how their minds work and about how to understand the world. Just as a secure attachment to a primary caregiver can lead to higher levels of emotional intelligence, mirroring is the root of empathy.”
Although the CDC-Kaiser Permanente Adverse Childhood Experiences Study still isn’t widely known, even though it’s been around for 20 years, it and the other parts of ACEs science are providing a profound shift in our understanding about why we humans behave the way we do. ACEs science also shows that to change behavior that is unhealthy, criminal or unwanted requires a very counterintuitive approach. Instead of using practices based on blaming, shaming and punishing, as we have for centuries, incorporating policies and practices on understanding, nurturing and healing have seen remarkable results in every sector in tens of thousands of organizations (but there are millions of organizations). Schools that integrate practices based on ACEs science, sometimes called trauma-informed schools, are able to eliminate suspensions and expulsions. Hospital emergency rooms see a 30% drop in visits. Suicide attempts by youth drop 98%. Recidivism rates by graduates of batterer intervention courses drop from 60% to 1%. A year after families participate in Safe Babies Courts, 99% of children suffer no further abuse.
The ACE Study found that the higher someone’s ACE score—the more types of childhood adversity a person experienced—the higher their risk of adverse social, economic, health and civic consequences. The study found that most people (64%) have at least one ACE; 12% of the population has an ACE score of 4 or higher. Having an ACE score of 4 nearly doubles the risk of heart disease and cancer. It increases the likelihood of becoming an alcoholic by 700 percent and the risk of attempted suicide by 1200 percent. It increases obesity, violence, and mental illness. Forty-three U.S. states, many countries and countless organizations have done their own ACE surveys, and the results are remarkably similar. (To calculate your ACE and resilience scores, go to: Got Your ACE/Resilience Score?)
Subsequent research links ACEs to Alzheimer’s, dementia, maternal ACEs and infant development, obesity in youth, gynecology patients with chronic pelvic pain….you name the disease or condition, and it’s likely to be exacerbated by ACEs.
By applying this rough, but insightful, way to assess the risk of childhood adversity, and based on the information in Mary Trump’s book, Donald Trump’s ACE score is a 6.
Trump’s father emotionally neglected his son when he was a baby and a toddler.
When Donald Trump was older, his father was emotionally abusive.
Trump’s mother emotionally neglected her son when he was a toddler, at a formative time for his brain development. In other words, he didn’t receive the positive experiences necessary for healthy development.
Trump watched his older brother be abused by his father for years.
Trump’s mother had mental health problems that seem to have gone undiagnosed and untreated for several years.
Trump’s parents were in a relationship that was emotionally neglectful.
Mary Trump chronicles the lives of three generations of Trumps in her book, and shows how trauma is passed from generation to generation. The Trump family considered their lives to be normal. They probably never gave a thought to how their behavior was shaped by what they experienced as children. When people—a few hundred thousand by now—with similar backgrounds have learned about ACEs science, a constant refrain is: “I didn’t know that what I experienced was abuse. I thought it was normal. This explains my life. Why did it take so long for me to hear about this?”
The participants in the ACE Study were 17,000 mostly white, middle- and upper-middle class, college-educated people with jobs and great health care. Looking at Donald Trump’s ACEs is a potent reminder that ACEs apply to people of all economic classes, something to which the ACEs movement and research hasn’t paid much attention lately because people of color and low economics bear the burden of ACEs.
We know that the phrase “hurt people hurt people” emerged from the understanding that most people who’ve committed violent crimes have high ACE scores.
However, hurt people hurt people on many levels, including enacting policies and laws that are just as harmful as interpersonal violence, and often more harmful because they affect hundreds or thousands or millions of people.
People with high ACE scores go in one of two general directions: They see the world as a place of suffering that needs healing, encourage people to work together to solve problems, and believe that the world works better without conflict than with it. Generally speaking, their positive childhood experiences have mitigated the adversity they experienced.
Or they see the world as a dark and dangerous place where carnage is rampant, problems are everywhere and are best solved by identifying and defeating enemies, building walls, and cutting off communication from people identified as “other.” And if enemies do not present themselves, they who see the world as a dangerous place will create enemies and make them larger than they really are, so that their “defeat” empowers them to find more enemies to conquer. Generally speaking, people in this group haven’t had enough protective factors in their lives, and thus favor punitive approaches to changing behavior, such as harsh prison sentences or zero-tolerance schools, even with ample evidence that they don’t work.
People who have high ACE scores and experienced few protective factors in their childhood can heal and change—ACEs aren’t destiny—but it often requires years of effort and constant reinforcement to at least ameliorate what’s been hard-wired into a baby’s brain. Mary Trump believes that her uncle Donald is very likely never to heal. She writes:
“Donald continues to exist in the dark space between the fear of indifference and the fear of failure that led to his brother’s [Fred’s] destruction. It took forty-two years for the destruction to be completed, but the foundations were laid early and played out before Donald’s eyes as he was experiencing his own trauma. The combination of those two things—what he witnessed and what he experienced—both isolated him and terrified him. The role that fear played in his childhood and the role it plays now can’t be overstated. And the fact that fear continues to be an overriding emotion for him speaks to the hell that must have existed inside the House [the Trump family home] six decades ago.
“Every time you hear Donald talking about how something is the greatest, the best, the biggest, the most tremendous (the implication being that he made them so), you have to remember that the man speaking is still, in essential ways, the same little boy who is desperately worried that he, like his older brother, is inadequate and that he, too, will be destroyed for his inadequacy.”
I don’t hate Donald Trump. I’m very sad for the things he experienced—no child should go through what happened to him. However, I hate many of the things he’s done. Authorizing ripping children out of the arms of their parents and separating them for months, years or forever, for example, sets me to writhing in helpless fury, and I wonder: Did the experience of having his mother ripped from his life so suddenly and for so long cause him such pain that it snuffed out the light of his empathy? Mary Trump thinks so.
For those of you who don’t like him, I’m not saying you have to feel sorry for him. I’m saying: You must understand him. You must understand him so that we don’t create more Donald Trumps in this world.
Jane Stevens Publisher, ACEsTooHigh.com Founder, PACEs Connection
I am a special educator for emotional/ behavior disorders. I do a lot of research on poverty and the ACE’s. I spend my time making connections and sometimes the only one believing in my students. I passionately continue my education and influence my colleagues on the importance of recognizing trauma. I am so disappointed this article was published in a forum I value and respect. President Trump has a resilience story. The poor choice to publish a politically charged article is a decision that is costing you members.
I read the book also. I was very happy to read someone who witnessed much of the abuse and dysfunction illustrating how $ can be used to paint what ever picture the possessor wishes. No matter How much $ a “family” has it can be used to make GMO people out of their children. I’ve known, felt and been saying this for decades. Most “families” just want their children to make $. It’s a very rare Family who actually raises their child to be Authentic. To be who they’re naturally meant to be THEN make $ being That. Is how I’ve been trying to live for decades with Not much luck. I never expected this country to be a SICK as it’s proven to be.
I felt it by the early 80s as I was getting older and had to “get a job”, after living with psych torture for nearly 2 decades, that my health was going One way and $ the other. I needed to focus on my health, recovery. Since I fought my abuser back for over 5 years at least,, I wasn’t like Donald, Freddy or the others,, but, I was criminalized for it and Everyone around Guilted me and made excuses For the Abuser ever since. But, I still had that part of me that was able to fight back, speak truth to “power” to hold onto that a lot of people don’t seem to have, they were indoctrinated like D.T.
I figured that if $ was real I should be able to follow the Health and the $ would follow. NOPE! I turned to Fitness because I KNEW that for anything to be Legit it needed to be aligned With Natural Law, physics, like an athlete scores a goal. It’s Clearly been the other way around even for people WITH a lot of money as it is for those “families” who don’t.
I will NEVER understand WHY so many people follow $ when it’s Clearly Illegitimate and the exact OPPOSITE of supporting health. Maybe if people realized that Health is More than just physical,, Emotional/Spiritual/Relationships,, we Might just get somewhere
I will never understand either and I guess I tend to think of things I don’t understand and spiritual questions. Why do people choose to follow a path of making the most money possible, instead of, say, becoming the most loving person they can be? That’s what you’re asking, right? I think that our work at ACEs Connection shows that childhood can be a sort of brainwashing, and that because Trump learned from his father, “your only value is as a real estate investor,” that’s what he spent his life pursuing, even though, as his numerous bankruptcies show, it’s not something that he had any sort of special talent in.
After reading Snowball, a biography about Warren Buffett, it seemed to me that pursuing money doesn’t always have evil intentions. As a kid, finding interesting ways to make money was a hobby of Buffett’s. The companies he would choose to invest in always had to make sense on paper for the long run–he was never interested in show or quick money. I don’t think billionaires need to exist in our society but he has shown to be someone who values investing in people and using his money to make the world a better place.
But back to the spiritual question…there seem to be ego callings that are false and its our work to sort them out as we grow.
I read the book also. I was very happy to read someone who witnessed much of the abuse and dysfunction illustrating how $ can be used to paint what ever picture the possessor wishes. No matter How much $ a “family” has it can be used to make GMO people out of their children. I’ve known, felt and been saying this for decades. Most “families” just want their children to make $. It’s a very rare Family who actually raises their child to be Authentic. To be who they’re naturally meant to be THEN make $ being That. Is how I’ve been trying to live for decades with Not much luck. I never expected this country to be a SICK as it’s proven to be.
I felt it by the early 80s as I was getting older and had to “get a job”, after living with psych torture for nearly 2 decades, that my health was going One way and $ the other. I needed to focus on my health, recovery. Since I fought my abuser back for over 5 years at least,, I wasn’t like Donald, Freddy or the others,, but, I was criminalized for it and Everyone around Guilted me and made excuses For the Abuser ever since. But, I still had that part of me that was able to fight back, speak truth to “power” to hold onto that a lot of people don’t seem to have, they were indoctrinated like D.T.
I figured that if $ was real I should be able to follow the Health and the $ would follow. NOPE! I turned to Fitness because I KNEW that for anything to be Legit it needed to be aligned With Natural Law, physics, like an athlete scores a goal. It’s Clearly been the other way around even for people WITH a lot of money as it is for those “families” who don’t.
I will NEVER understand WHY so many people follow $ when it’s Clearly Illegitimate and the exact OPPOSITE of supporting health. Maybe if people realized that Health is More than just physical,, Emotional/Spiritual/Relationships,, we Might just get somewhere
I think that the rules for discussing a private citizen and a powerful public figure who makes decisions that profoundly affect people’s lives is more than warranted. It is the responsibility to do so in any democracy. It is necessary to shine light on the powerful — regardless of their political party or beliefs — to better understand them, and when applicable to hold them accountable.
Jane StevensPublisher, ACEsTooHigh; founder, PACEs Connection
Thank you for your comment, Amy. And I’m sorry to see you go. The door is always open here.
FMFormer Member
Jane, you are using ACES Connection as a political platform. First I saw this article that had nothing to do with preventing ACES, healing trauma and building resilience: https://www.pacesconnection.com…s-washingtonpost-com. Now this article based on a book that was not written by the POTUS himself. Wouldn’t that be breaking a very important rule of trauma informed care? Not giving the person impacted by trauma some control, a voice for their own story? I imagine we will be seeing many, many more articles about the POTUS from you putting him in the light you choose as we are approaching 11/3/20. I will be unsubscribing.
Thanks for compiling this synopsis Jane. The more we realize the extent of pain experienced by the powerful and privileged who are making and implementing destructive policies, the faster we will reprioritize our societies. This is the focus of my work regarding ACEs. It’s not them, it’s us. And financial security or wealth, whiteness, education, or an intact family doesn’t protect most of us. That is the salient point of the original ACE Study that stands out most to me. Donald Trump is a symptom, of the pervasive problem of unresolved childhood trauma plaguing humanity from the echelons of power around the world. The blatant example we see every day of a pained human dissociated from his self, others, nature, and reality is my source of hope for our long awaited awakening to who we are as humans and our need to reset our priorities to meet our children’s needs to prevent creating any more broken men.
This is a slide from today’s ACEs Aware webinar. As you can see, interrupting intergenerational transmission is one the goals of screening for ACEs in medical practice. It’s not really about blaming, it’s about freeing people from passing these physical and mental health risks to future generations, none of whom deserve to be born into these ongoing processes. I’d like to acknowledge some other posts that have added the very important dimension of marginalized populations’ stressors, present, and historical, into the calculus. ACEs Aware was founded and supported by the California Surgeon General, Dr Burke Harris, who deserves effusive praise for her work on ACEs. Included in the today’s presentation was the epigenetic factors of trauma and how they affect every body system of those exposed.
Well written, thank you. Like a few others, I’m somewhat concerned by what I perceived as some “blame” directed toward Mr. Trump’s parents. In my view ACEs are an expression of “the biology of Karma”, and without detailed knowledge his parent’s early environments, and their parents, etc. it might be more useful to regret what he was exposed to and focus on “now what?”
I am placing my comments based on the years I spent as a PO addressing heinous crimes and tragically raised individuals who had little opportunity to address their lives and move toward developing positive change. The social part of the pre-sentence report addresses the upbringing and traumas of the criminal as well as those of their family. Regardless of their history, they received consequences that were often severe at times. The bottom line was that they faced consequences, irrespective of their ACES. Poverty and race were rarely seen as extenuating circumstances.
In all the years I worked, I can not tell you how rare it was to have a wealthy spoiled deviant person in front of me. They had the benefit of the expensive defense team against the State. I’ve read Mary Trump’s book and her warning is that Donald Trump was raised with the ability and skill to avoid consequences and surround himself with enablers. It was a warning as to how pervasive the depravity of the family and their enablers are/were. ACES is about identifying the issues where we as a society, can assist in programs and policies to facilitate positive change and understanding.
There is a fairly broad consensus that President Trump is suffering from mental health problems. I’m an a Green Party member, so I’m not trying to sway anyone’s towards VP Biden, who I serious reservations about also in the mental health area. This is one more example of a source concerning President Trump’s mental health.
“The Dangerous Case of Donald Trump is a 2017 book edited by Bandy X. Lee, a forensic psychiatrist, containing essays from 27 psychiatrists, psychologists, and other mental health professionals describing the “clear and present danger” that US President Donald Trump’s mental health poses to the “nation and individual well being.”
Although, the results of such upbringing can cause the end results, I do not think it is fair to use ACES Connection to target Donald Trump. What is Mary Trump getting out of this? ($$$$) Not comfortable with this article and seems to be more of a political platform. I will unsubscribe today.
Brilliant Jane. If only there were some professional gate keeping within professions (outside of mental health) that would allow us to intervene when a person’s personal trauma was causing them to become a danger to themselves and/or others. Cops, politicians, lawyers, cashiers, landscapers, servers…I mean really, we all need each other to help us see what we can’t see. I guess that’s why we need the trauma-informed revolution.
Excellent article! I have been both fascinated and repulsed by the idea of reading Mary Trump’s book. Reading this synopsis through a trauma-informed, ACEs lens, was powerful, informative and important. Thank you, Jane!
Hmmm…something does not sit well with me about this article. Many, myself included, have long felt that mainstream ACEs movement does not sufficiently address the intersections of race, class, geography and other socio-environmental factors. This article seems like an apologist stance for bad behavior, without taking into account the extreme privilege that paved the way for Trump to maintain class privilege and be elected president. The ACEs he experienced, while I’m sure traumatizing, should not be extricated from the race and class privilege he also experienced. This argument seems to parallel the narrative that gets played out in the media that white people who commit crimes (the Dylan Roof’s of the world) have mental health issues, when Black, Indigenous People of Color (BIPOC) folks get labeled as thugs. It glaringly leaves out the institutional and systemic racism that overwhelmingly bars BIPOC people from gaining wealth or political power and has no impact on white cisgender men who still hold disproportionate and harmful amounts of power. Honestly, it is further proof of our society’s horrifyingly entrenched white supremacy and I highly encourage you to re-think posting this article in its current form.
I agree with you completely, Molly. This essay strives to explain so that we can understand and change our systems, with the understanding that we are our systems. It’s definitely not an apology.
Jane, thank you for your fascinating article. A challenge I frequently come across in my practice as a primary care physician for adults, is how to effectively and respectfully get a person, who has certain maladaptive coping mechanisms, to see that their ways of coping are destructive. I wouldn’t expect Mr. Trump to hear Mary Trump’s assessment and respond by thanking her and asking how he can work on changing himself. Patient’s usually don’t come to me because they’ve identified their maladaptive coping as a problem, but instead focus on their headaches, insomnia, or other symptoms. When ACEs are a contributing cause to such symptoms, and we discuss ACEs science, some people have “a ha!” moments, and start on a path towards healing. However, a lot don’t see the connection, even when I’ve (gently) brought up the topic again.
I also want to comment that I appreciate the concern Anna expressed earlier, about all of us associated with ACEs Connection needing to not allow this forum to devolve into political bickering (my description, not Anna’s). However, I feel it’s appropriate to discuss Mr. Trump’s case here, as long as our goal is to advance the awareness and understanding of ACEs, as opposed to people expressing their negative feelings toward him. Many precedents have been set, in this forum, to discuss the childhood experiences of still living people (Darrell Hammond being a recent example). I realize that in most previous cases, it’s people sharing their own stories, while in this case, Mr. Trump is not doing the sharing. I believe we therefore, in a trauma-informed way, should be sensitive to the possibility the person who didn’t share their own story might have a different story to tell.
Hmmm…something does not sit well with me about this article. Many, myself included, have long felt that mainstream ACEs movement does not sufficiently address the intersections of race, class, geography and other socio-environmental factors. This article seems like an apologist stance for bad behavior, without taking into account the extreme privilege that paved the way for Trump to maintain class privilege and be elected president. The ACEs he experienced, while I’m sure traumatizing, should not be extricated from the race and class privilege he also experienced. This argument seems to parallel the narrative that gets played out in the media that white people who commit crimes (the Dylan Roof’s of the world) have mental health issues, when Black, Indigenous People of Color (BIPOC) folks get labeled as thugs. It glaringly leaves out the institutional and systemic racism that overwhelmingly bars BIPOC people from gaining wealth or political power and has no impact on white cisgender men who still hold disproportionate and harmful amounts of power. Honestly, it is further proof of our society’s horrifyingly entrenched white supremacy and I highly encourage you to re-think posting this article in its current form.
Counting ACEs = essentially a rough sorting-hat for being raised in a dysfunctional family/ by dysfunctional adults. Functional healthy families have fewer ACE-level events (though something like the death of a parent can strike even a very wholesome home).
Donald had a huge multitude of “baby ACEs” or “shadow ACEs” as I call them. You can be rich, fed, never hit, ‘privileged’ — but if your own parents do not *connect* with you, it is much worse than an isolated horrible event like a divorce. Being neglected profoundly is orders of magnitude worse than your attentive, loving parents getting a divorce. For you have no resources to deal with anything bad that happens.
Nobody TOOK PLEASURE in baby Donald. Nobody interpenetrated with him. Nobody was his safe place, his place of refuge. Nobody modeled a safe and interested, caring “other.” All the experiences by which human beings learn to attach and self-regulate were robbed from him.
When you never receive secure attachment as a baby, that’s the worst ACE that can exist. A securely attached human being can withstand something like a parental divorce in a VERY different way than a person without that ballast of relational security. A securely attached person has internalized their own worth.
I see the child separation at the border as a kind of sick theatre of DJT’s past. Being ripped away from his mother (the mom as ‘criminal’) as a kind of large scale re-enactment.
Ever since 2016 I have observed and wondered about Trump and ACEs, and have occasionally shared my view with others. My ACEs perspective is one of understanding behavior, not as an excuse for behavior.
Dearest Jane, You are a stunningly powerful and gifted writer. Thank you for continuing to use your gifts in such a profound way. I continue to be thunderously grateful.
I’m reading this book now. As an infant mental health therapist I continue to wonder: what happened to Fred Trump in his early childhood? Or Mary? How did they become the parents they were to the Trump children? How far back do we go?
Yes Karen, as a psychologist with an interest in transgenerational transmission of symptoms, I’ve wondered about our president’s family history and reflect on the concept of “undifferentiated ego mass.”
I have Mary’s book and have to admit, I haven’t read it yet. I know about the existence of the Goldwater rule concerning not diagnosing those we have not interviewed or tested. That being said, his niece does have insider, collateral information and is a professional herself. I don’t think you need years of training as a clinician to spot something is very wrong with our president at a time in which we need leadership the most. His lack of empathy and self-referented style is apparent. Thank you posting this. He is definitely a tragic man (from Kohut) and even more tragic, is imbued with power that affects us all.
Excellent article. Thank you for sharing. I have wondered many times what Trump’s childhood must have been like to produce what we see today. I also think the media played a lot into what he is today. The adoration by them in the early 90s gave him the attention he so desperately craved and fueled his narcissism that had taken root in childhood as a defense mechanism.
I’m reading this book now. As an infant mental health therapist I continue to wonder: what happened to Fred Trump in his early childhood? Or Mary? How did they become the parents they were to the Trump children? How far back do we go?
Im going to say it: I’m really uncomfortable with this, that this movement and this platform have become so political that it’s now OK to pathologize the private details of a living person’s childhood — details they did not themselves choose to disclose and in fact fought to stop (and that may not even be true).
An adult’s public actions may be fair game, but it is most definitely NOT fair to use a person’s childhood in order to diagnose them, read their mind, or make damning claims that because of trauma, they can “never heal,” they can’t feel empathy, they are destined to be a “small time crook in Jail” (unless wealthy) or that people like them should not be “created.” These kinds of statements are uncomfortably familiar from other times when “science” was used to label and marginalize others.
I hope ACEs Connection will be extra careful never to “weaponize” ACEs science against anyone, whether you like their policies or not.
This is why parenting education must be a part of the solution. Not conventional parenting education, but a new kind…one that reaches everyone, everywhere, all the time.
The Centers for Disease Control, the American Academy of Pediatrics, the National Alliance on Mental Illness, and the National Institute of Mental Health should be working furiously on this new kind of parenting education. Perhaps parenting education campaigns akin to the smoking and seat belts campaigns of the past. Perhaps multi-media messaging that teaches parenting behaviors and practices generally recognized as supporting the healthy development of children.
Visit www.advancingparenting.org. Use a computer…our website is not optimized for phones. We are all about finding interesting and perhaps more effective ways of teaching everyone about parenting.
The science of PACEs refers to the research about the stunning effects of positive and adverse childhood experiences (PACEs) and how they work together to affect our lives, as well as our organizations, systems and communities. It comprises:
The CDC-Kaiser Permanente ACE Study and subsequent surveys that show that most people in the U.S. have at least one ACE, and that people with four ACEs— including living with an alcoholic parent, racism, bullying, witnessing violence outside the home, physical abuse, and losing a parent to divorce — have a huge risk of adult onset of chronic health problems such as heart disease, cancer, diabetes, suicide, and alcoholism.
Brain science (neurobiology of toxic stress) — how toxic stress caused by ACEs damages the function and structure of kids’ developing brains.
Health consequences — how toxic stress caused by ACEs affects short- and long-term health, and can impact every part of the body, leading to autoimmune diseases, such as arthritis, as well as heart disease, breast cancer, lung cancer, etc.
Historical and generational trauma (epigenetic consequences of toxic stress) — how toxic stress caused by ACEs can alter how our DNA functions, and how that can be passed on from generation to generation.
Positive Childhood Experiences and resilience research and practice — Building on the knowledge that the brain is plastic and the body wants to heal, this part of PACEs science includes evidence-based practice, as well as practice-based evidence by people, organizations and communities that are integrating trauma-informed and resilience-building practices. This ranges from looking at how the brain of a teen with a high ACE score can be healed with cognitive behavior therapy, to how schools can integrate trauma-informed and resilience-building practices that result in an increase in students’ scores, test grades and graduation rates.
1. What are ACEs?
ACEs are adverse childhood experiences that harm children’s developing brains and lead to changing how they respond to stress and damaging their immune systems so profoundly that the effects show up decades later. ACEs cause much of our burden of chronic disease, most mental illness, and are at the root of most violence.
“ACEs” comes from the CDC-Kaiser Adverse Childhood Experiences Study, a groundbreaking public health study that discovered that childhood trauma leads to the adult onset of chronic diseases, depression and other mental illness, violence and being a victim of violence, as well as financial and social problems. The ACE Study has published about 70 research papers since 1998. Hundreds of additional research papers based on the ACE Study have also been published.
The 10 ACEs the researchers measured:
— Physical, sexual and verbal abuse.
— Physical and emotional neglect.
— A family member who is:
depressed or diagnosed with other mental illness;
addicted to alcohol or another substance;
in prison.
— Witnessing a mother being abused.
— Losing a parent to separation, divorce or other reason.
Subsequent to the ACE Study, other ACE surveys have expanded the types of ACEs to include racism, gender discrimination, witnessing a sibling being abused, witnessing violence outside the home, witnessing a father being abused by a mother, being bullied by a peer or adult, involvement with the foster care system, living in a war zone, living in an unsafe neighborhood, losing a family member to deportation, etc.
ACEs are common…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 big chunk 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.
What’s particularly startling is that the 17,000 ACE Study participants were mostly white, middle- and upper-middle class, college-educated, and all had jobs and great health care (they were all members of Kaiser Permanente).
Brain science shows that, in the absence of protective factors, toxic stress damages children’s developing brains. Stress is the body’s normal response to challenging events or environments. Positive stress — the first day of school, a big exam, a sports challenge — is part of growing up, and parents or caregivers help children prepare for and learn how to handle positive stress, which is moderate and doesn’t last long. It increases heart rate and the amount of stress hormones in the body, but they return to normal levels quickly.
But when events or the environment are threatening or harmful – we stumble across a bear in the woods – our brains instantly zap into fight, flight or freeze mode and bypass our thinking brains, which can be way too analytical to save us (Is the bear really mean? Is it more interested in berries or killing me? Should I wait until I see it charge?). With help from caring adults, children also recover from this tolerable stress.
Too much stress – toxic stress – occurs when that raging bear comes home from the bar every night, says pediatrician Nadine Burke Harris. Then a child’s brain and body will produce an overload of stress hormones — such as cortisol and adrenaline — that harm the function and structure of the brain. This can be particularly devastating in children, whose brains are developing at a galloping pace from before they are born to age three. Toxic stress is the kind of stress that can come in response to living for months or years with a screaming alcoholic father, a severely depressed and neglectful mother or a parent who takes out life’s frustrations by whipping a belt across a child’s body.
Chronic toxic stress—living in a red alert mode for months or years — can also damage our bodies. In a red alert state, the body pumps out adrenaline and cortisol continuously. Over time, the constant presence of adrenaline and cortisol keep blood pressure high, which weakens the heart and circulatory system. They also keep glucose levels high to provide enough energy for the heart and muscles to act quickly; this can lead to type 2 diabetes. Too much adrenaline and cortisol can also increase cholesterol.
Too much cortisol can lead to osteoporosis, arthritis, gastrointestinal disease, depression, anorexia nervosa, Cushing’s syndrome, hyperthyroidism and the shrinkage of lymph nodes, leading to the inability to ward off infections.
If the red alert system is always on, eventually the adrenal glands give out, and the body can’t produce enough cortisol to keep up with the demand. This may cause the immune system to attack parts of the body, which can lead to lupus, multiple sclerosis, rheumatoid arthritis, and fibromyalgia.
Cortisol is also extremely important in maintaining the body’s appropriate inflammation response. In a normal response to a bee sting or infection, the body rushes antibodies, white blood cells and other cell fighters to the site and the tissues swell while the battle rages. But too much swelling damages tissue. Cortisol controls this fine balance. So without the mediating effects of cortisol, the inflammatory response runs amok and can cause a host of diseases.
If you’re chronically stressed and then experience an additional traumatic event, your body will have trouble returning to a normal state. Over time, you will become more sensitive to trauma or stress, developing a hair-trigger response to events that other people shrug off.
Biomedical researchers say that childhood trauma is biologically embedded in our bodies: Children with adverse childhood experiences and adults who have experienced childhood trauma may respond more quickly and strongly to events or conversations that would not affect those with no ACEs, and have higher levels of indicators for inflammation than those who have not suffered childhood trauma. This wear and tear on the body is the main reason why the lifespan of people with an ACE score of six or higher is likely to be shortened by 20 years.
4. What’s epigenetics and how does that relate to historical or generational trauma?
Most people believe that the DNA we’re born with does not change and that it determines all that we are during our lifetime. That’s true, but the research from epigenetics — the study of how social and other environments turn our genes on and off — shows that toxic stress can actually change how our genes function, which can lead to long-term changes in all parts of our bodies and brains. What’s more, these changes can be transferred from generation to generation.
Epigenetics means “above the genome” and refers to changes in gene expression that are not the result of changes in the DNA sequence (or mutations).
Resources:
WhatIsEpigenetics.com — This New York-based blog and news aggregator covers the field of epigenetics and is funded by EpiGentek. It includes backgrounders, including epigenetics fundamentals.
Epigenetics — From the Genetics Science Learning Center at the University of Utah, this section includes explainers and an overview of how the social environment affects your epigenome.
5. Positive Childhood Experiences and resilience research: If you have a high ACE score, are you doomed? No!
The good news is that the brain is plastic, and the body wants to heal.
The brain is continually changing in response to the environment. If the toxic stress stops and is replaced by practices that build resilience, the brain can slowly undo many of the stress-induced changes.
There is well documented research on how individuals’ brains and bodies become healthier through mindfulness practices, exercise, good nutrition, adequate sleep, and healthy social interactions.
Here’s a good article that weaves the unified science of human development together: Scars That Don’t Fade, from Massachusetts General Hospital’s Proto Magazine.
In the last few years, researchers have started to examine the impacts of positive childhood experiences (PCEs) on children and adults. We at PACEs Connection are particularly interested in the interplay between positive and adverse childhood experiences. Here’s some of the relevant research:
In 2014, Bethell, Dr. Paul Newacheck, Dr. Eva Hawes, and Dr. Neal Halfon found that children with higher ACE scores were less likely to demonstrate resilience, live in a protective home environment, have a mother who was healthy, and live in safe and supportive neighborhoods. However, almost half of the children who had experienced ACEs also demonstrated resilience, and “resilience mitigated the impact of adverse childhood experiences on grade repetition and school engagement.” Adverse Childhood Experiences: Assessing The Impact On Health And School Engagement And The Mitigating Role Of Resilience | Health Affairs
Dr. Yui Yamaoka and Dr. David Bard reported in 2019 that “the number of adverse childhood experiences was associated with both social-emotional deficits and developmental delay risks in early childhood; however, positive parenting practices demonstrated robust protective effects independent of the number of adverse childhood experiences.” Positive Parenting Matters in the Face of Early Adversity – PubMed (nih.gov)
Among juvenile offenders, Dr. Michael Baglivio and Dr. Kevin Wolff discovered in 2020 that “high ACE scores were associated with increased reoffending, and high PCE scores were associated with decreased recidivism, as measured by both rearrest and reconviction. Further, among juveniles with four or more ACEs who have six or more PCEs, reconviction was 23% lower and rearrest 22% lower when compared to those youth with four or more ACEs and less than six PCEs, controlling for a host of demographic and criminal history measures.” Positive Childhood Experiences (PCE): Cumulative Resiliency in the Face of Adverse Childhood Experiences – Michael T. Baglivio, Kevin T. Wolff, 2021 (sagepub.com)
In 2019, Dr. AliceAnn Crandall, Dr. Jacob Miller, Dr. Aaron Cheung, Dr. Lynneth Novilla, Dr. Rozalyn Glade, Dr. M. Lelinneth Novilla, Dr. Brianna Magnusson, Dr. Barbara Leavitt, Dr. Michael Barnes, and Dr. Carl Hanson observed in a study of adults that “higher counter-ACEs scores [i.e., positive childhood experiences] were associated with improved adult health and that counter-ACEs neutralized the negative impact of ACEs on adult health.”ACEs and counter-ACEs: How positive and negative childhood experiences influence adult health – ScienceDirect
Finally, in 2016, Bethell, Gombojav, Dr. Michele Solloway, and Dr. Lawrence Wissow examined ACEs, resilience, family protective factors, and emotional, mental or behavioral conditions (EMB) in children and youth in the U.S. The authors found that children with ACEs had higher EMB than children without ACEs, but the presence of resilience was significantly associated with lower amounts of EMB for both children with and without ACEs. In addition, the prevalence of EMB was lower when family protective factors were present, even if the child had ACEs, although the presence of two or more ACEs decreased the effect. Adverse Childhood Experiences, Resilience and Mindfulness-Based Approaches: Common Denominator Issues for Children with Emotional, Mental, or Behavioral Problems (nih.gov)
Who’s using PACEs science?
Many people, organizations, agencies, systems and communities are beginning to implement trauma-informed, resilience-building practices based on PACEs science.
Many schools — including schools in San Francisco, CA, Spokane, WA, San Diego, CA, and Walla Walla, WA — have integrated healing-centered/trauma-informed practices into classrooms, playgrounds and school policies. These schools have seen 90 percent drops in suspensions after one year; after three years, the schools no longer expel students and some no longer even have the need for in-school suspensions. The grades, test scores and graduation rates increased, and the students most benefitted were those with the highest ACE scores. By the end of 2017, several hundred schools across the U.S. were integrating trauma-informed and resilience-building practices based on ACEs science.
Homeless shelters and the faith-based community are integrating practices based on PACEs research. At the heart of their approach is educating those who are homeless and people in rescue missions about PACEs science; it often changes their whole understanding of their behavior, because they realize that they weren’t born bad, that they had no control over what happened to them as children, that they coped appropriately, given what was available to them, and that they can change. Batterers intervention programs that have integrated PACEs science have reduced recidivism rates from what was accepted — 20 to 60 percent — to zero to four percent.
Cities and states are integrating practices based on PACEs science. By the end of 2017, several hundred communities around the U.S. had launched PACEs initiatives. This report on self-healing communities describes how integrating ACEs science drastically reduced youth suicide, teen pregnancy, juvenile arrests, and high-school drop-out rates — all at the same time — in communities in Washington State that integrated practices based on PACEs science.
Growing Resilient Communities provides guidelines and tools for communities to launch and grow local PACEs initiatives, and measure the progress of their work.
What does trauma-informed mean?
According to the Substance Abuse and Mental Health Services Administration (SAHMSA), part of the U.S. Department of Health and Human Services, a trauma-informed approach refers to how an organization or community thinks about and responds to children and adults who have experienced or may be at risk for experiencing trauma. In this approach, the whole community understands the prevalence and impact of ACEs, the role trauma plays in people’s lives, and the complex and varied paths for healing and recovery.
A trauma-informed approach asks: “What happened to you?” instead of “What’s wrong with you?” It is designed to avoid re-traumatizing already traumatized people, with a focus on “safety first” (including emotional safety), and a commitment to do no harm. But a trauma-informed approach is most successful when an organization or community builds policies and practices based on a foundation of ACEs science.
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach — Introduces a concept of trauma and offers a framework for how an organization, system, or service sector can become trauma-informed. Includes a definition of trauma (the three “E’s”), a definition of a trauma-informed approach (the four “R’s”), 6 key principles, and 10 implementation domains.
ACEsTooHigh.com – News site covering PACEs research and practices
PACEsConnection.com – Social network (with 60,000+ members across sectors) and more than 400 community sites that support ACEs initiatives in cities, counties, states, regions and nations.
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach — Introduces a concept of trauma and offers a framework for how an organization, system, or service sector can become trauma-informed. Includes a definition of trauma (the three “E’s”), a definition of a trauma-informed approach (the four “R’s”), 6 key principles, and 10 implementation domains.
Paper Tigers — What does it mean to be a trauma-informed school? And how do you educate teens whose childhood experiences have left them with a brain and body ill-suited to learn? This film follows six students through a year in America’s first trauma-informed high school.
Resilience — Resilience chronicles how trailblazers in pediatrics, education, and social welfare are using cutting-edge science and field-tested therapies to protect children from the insidious effects of toxic stress.
CAREgivers — How is the professional care provider affected emotionally and physically, and who helps them?
For a list of all documentaries addressing PACEs science, and how to access them, go here.
If individuals want society to be less aggressive, more calm, less reactive, and more cooperative and collaborative… For the developing brain to develop the capacity for empathy, compassion, and all that comes to mind when thinking about what it means to be human, it requires certain developmental and social experiences at crucial junctures. Drywall Installation Arlington Drywall Contractor Pros
FMFormer Member
ACE Science is woefully limited by leaving out everything about the development of the stress response system and healthy brain architecture, Resiliency is developed in infancy via a secure attachment. A secure and loving attachment in infancy develops a brain’s limbic and cortical regulation over the brainstem’s reactivity leading to control over violent, aggressive and impulsive behavior. Focusing on anything but healthy early brain development will always be radically suboptimal.
If people want the society to be less violent and more cooperative and collaborative, more relaxed and less reactive… the developing brain needs certain developmental and relational experiences at critical points in time in order for a brain to bring forth the capacity for empathy and compassion and everything one thinks of when one considers what it means to be human.
I’m presenting a talk to a group of Pastors on ACES but the slide deck on ACES that I received does not have any slides on Neuroplasticity, from either a science perspective or from a biblical perspective.
Do any of you have a few slides that you’d be willing to share with me?
May I stress the link between family trauma and poverty. Living without resources means lack of access to survival resources like food, safe shelter, medical care, behavioral health care and transport to vital services. It also means lacking the resources to thrive: family centered schools, parent support, early childhood learning programs, youth mentors and job training. ACEs prevention programs, if it is to include our most vulnerable children and families, can build into theor strategic plan and priorities the strengthening of ten key family resources. For more information on a data-driven and cross-sector approach that addresses health disparities please visit www.resilienceleaders.org
Jane, this is great! Great! I love ACES Connection; I am grateful for the resource. It is connecting me to fabulous people and fabulous efforts – thank you!
But there is one “bone of contention” that I will pick – this reference list is missing the work of Bessel Van Der Kolk, Peter Levine, Pat Ogden, Bruce Perry… we DESPERATELY NEED TO MOVE BEYOND COGNITIVE/BEHAVIORAL APPROACHES to treating trauma. As someone that has YEARS of experience working with children and teens and working with that kind of approach to treating depression, anxiety, suicidality, substance misuse, cutting, ODD – you name it, I have worked with it – it’s an epic fail. EPIC! The emerging modalities of treatment (e.g. somatic experiencing, trauma-informed yoga, trauma drama, rhythmic movement and music, etc.) make way for regulating the body’s stress response!
We are a culture OBSESSED with the mind and the power of the mind – to the detriment of the body. We must remember that when someone is struggling with anxiety, depression, rage, etc., the individual is experiencing an overwhelming visceral body experience.
I just had to share this…in all the trauma-informed training and efforts I see going on, I am thrilled. But then I get “un-thrilled” when it’s the same means of practice we have been endorsing and implementing for years (without success!). It’s time to move beyond behavioral and cognitive behavioral approaches to resolving trauma.
Thank you for this concise review of ACE’s. My senior research project looks at the use of ACE scores in serving adjudicated youth with histories of harmful sexual behaviors. Your post provides a lot of information and resources that will be helpful to my project. Much appreciated!
TraumaInformedJobs.com is a new job board for the trauma and resilience communities. PACEs Connection members can save 10% on posting with code PACES10
The desire to see other ACEs initiatives grow and flourish was evident at a recent meeting of the Resilient Columbus County (North Carolina) ACEs initiative when Mebane Boyd, executive director of the New Hanover Resiliency Task Force (also in North Carolina), shared with the Columbus County and neighboring Pender County groups how New Hanover created and works on its strategic plan.
In the spirit of sharing, Boyd agreed to let ACEs Connection post the strategic plan and the video ofthe meeting, so other new ACEs initiatives can learn from the New Hanover Resiliency Task Force’s work and experience.
“We are learning as we go,” Boyd said. “We just happen to have a couple of years’ head start on today’s beginning communities. We want to share what we’ve learned and are learning.”
In the spring of 2018, New Hanover County got a six-month planning grant from the Duke Endowment. Boyd was hired to be the six-month coordinator.
She joined a group of 10 or 15 people who were inspired by the screening of the documentary “Resilience” earlier that spring, and who wanted to get going on an initiative.
“The (New Hanover Regional) hospital, Community Care, Smart Start, Communities in Schools, the Department of Social Services, people in the court system and others saw the documentary and said, ‘Let’s stop talking and do something,’” Boyd said.
Their planning period paid off. The group started meeting regularly and opened the meetings up to anybody who wanted to come. “It was one of the best things we did,” Boyd said.
In the first phase of the plan, the group decided to engage and involve the community, agree on a timeline, and decide on which models to consider and invest in. They also looked at what data to collect on individual, organizational and systems levels. This remains an area of growth and learning.
Phase Two involves educating the community on the Pair of ACEs, the fact that there are adverse childhood experiences and adverse community experiences. ”We knew we needed to educate and be educated, to learn about what our community’s experiences were and are. We need to understand our unique adverse community environment,” Boyd said.
Phase Two also involves education about the impact of toxic stress and the Community Resiliency Model (CRM), a hands-on neurobiological training involving ACEs and brain science, to help people learn how to regulate their central nervous system and stay grounded during stressful situations.
Implementing Phase Three means helping organizations and providers become more trauma-informed and better able to deal with their own traumas and triggers.
“Most of the early (CRM) trainings centered on teachers, first responders, and health care workers. Until we are well, it is hard for us to take care of (other) people,” Boyd said.
Phase Four is training in trauma-informed and resilience-focused models for students, clients, parents, and the community.
Phase Five is implementing the trainings across all sectors of the community; this work will be ongoing.
Phase Six is community-level coaching and accountability, and work on funding strategies to continue to train and coach.
The phases look organized paper, but, Boyd said, “Nothing we do in human services is linear. If somebody new comes into the work, you have to educate them,” said Boyd, explaining that the group may have several phases of the work going on at the same time.
Quick to give credit to groups that helped develop the plan, Boyd was particularly complimentary of the New Hanover County Strategic Planning Department.
“We were able to use their expertise, and met many, many times, before coming up with the second page of the document. Some of us got frustrated. This took months. We would wonder, ‘Why are we talking about this again?’”
”Creating the plan was the work. Coming up with our common language was key to our progress. We needed to establish the community level goals, and to look at where we could make a difference.
“Racial equity runs through everything that we do,” she added. “In the last few months, we’ve realized what a challenge racial equity is, and we’ve realized that everything we do should be done through the filter of racial equity.”
Measuring success is also part of the work. Boyd said the group worked to develop Critical Success Factors, to “establish data points that can help tell us if what we are doing matters, if it is moving the needle.”
The group recently completed a steering committee retreat.
“Planning is never done and creating a strategic plan is something you are always working on,” she said. “Some of the work is immediate and some of it is long-term work that could be going on for 10 years or more.
“We are changing generational trauma. This is not work done in a short period of time. We knew we would be in it for the long haul. So we are now educating about trauma and racial disparity.”
She says a main factor in the success of this work is to keep it “trauma-informed and resiliency-focused.”
The group will know their hard work is paying off as they see more agencies looking through the trauma lens. An example? When more pediatrics practices are using ACEs screening, and more community members, having been through the trainings or hearing about them, are understanding their own biological responses to stress. Among other criteria for success are greater community understanding of ACEs science, more parents and providers being able to support children’s needs for social/emotional development and stress management, and delivery of equity training.
Boyd had these additional comments during the Q&A session:
On relationships: They are so important. If you were together and respectful and built your community, you are developing your relationships for further work. I spend a lot of my time inviting people to meetings, thanking them for coming. A lot of my time is spent on building relationships.
On the pace of the work: When you get together and convene, that is the work. Don’t be in a rush.
On who is needed to do the work: Work with the people who are there and committed. If you wait until everybody is at the table, you will never get it done.
On funding: You need money to pay a coordinator. We have received grants. The Department of Public Instruction provided money in 2018 that was used to train the trainers for the Community Resiliency Model, so about 30 people could attend the five-day training. We also have a part-time person doing all the movie screening and coordination of training. Task Force members are helping to get out the vote, and have been asked to contact legislators to ask for Medicaid expansion. We could use that (Medicaid expansion) money to help prevent ACEs, make lives better.
On the difference the work has made in the community: All 1,800 county employees have received at least a 90-minute CRM resilience training. They are not fully trained on CRM but have learned some CRM skills. County employees say staff members are now much more aware of their co-workers’ stress. They look in on each other, they know to ask, “How are you doing?” It helps to create a common language. It helps to normalize stress responses and push that message of having compassion and empathy for ourselves and our colleagues.
On subcommittees: Each subcommittee meets monthly. There are eight subcommittees for the New Hanover Resiliency Task Force:
Carey Sipp 