Building resilience, building a better life

Most of us nod our heads when we hear that we are the product of our experiences early in life. But do we really know what that means?

What would you do if you knew that you could change the likelihood that someone would experience lifelong depression, substance abuse or even unemployment? Would you take action?

Research into adversity in childhood has shown clear connections to our future health and well-being. What happens when our childhood is not the best? What happens when we are neglected or live in a household that has its challenges?

For the past 20 years, the Center for Disease Control and Prevention has been studying just that. Through two decades of research, they have found a very strong connection between early childhood trauma, known as adverse childhood experiences, and serious physical and mental health issues that happen later in that child's life.

Researchers have found a strong relationship between children experiencing trauma in their early years and then, in adulthood, being more obese, depressed, using drugs, being unemployed, missing more work, smoking, having learning or behavior problems and even attempting suicide. How do these situations in childhood become such powerful determinants of who we become as adults?

WHAT ARE ADVERSE CHILDHOOD EXPERIENCES?

When we talk about adverse childhood experiences, or ACEs, we mean children who have lived through one or more of the following situations:

' Experiencing personal abuse or neglect, including physical, emotional, or sexual abuse or physical or emotional neglect.

' Experiencing household dysfunction, which includes having a substance abuser in the home, having someone who suffers from a severe mental illness in the home, suffering parental loss through either death or a warring divorce, witnessing violence in the household, or witnessing crime in the household.

If a child has experienced any of these situations, then they are more likely to experience serious physical and/or mental health issues in their adult life. If they experience more than one, then the issues are even greater. But why is that?

CDC researchers, after two decades of studies involving over 17,000 average middle-class participants, have found that the answer is simply, stress.

We all experience stress in our lives. Some of this stress is good. Driving down I-380 after it has snowed can cause stress. Eyes are more focused on the road. Hands grip the steering wheel tighter. Less attention is paid to the music. Because of that more focused approach, I am a better driver.

Sometimes, though, we experience events that go beyond basic stress. The loss of a loved one, the stress of a big event or the stress of a car accident all are examples of stress that is beyond what our bodies normally can handle.

Luckily, though, these experiences are short-lived, and we often can recuperate from that short, stressful situation.

Children who experience adverse childhood experiences, though, experience this stress 24/7. They are constantly on their toes, wondering if they will have a home to sleep in tonight, when their next meal will happen, or if their mom and dad are going to have another bad night and they will have to take care of their little siblings.

This constant stress is called toxic stress, and it impacts how our brain develops.

Without going too far into brain science, our brains are amazing organs that adapt well to our environment, if a child is experiencing toxic stress, their brain develops to cope with this toxic stress and to survive in the harsh environment that they live in.

This, unfortunately, impacts other areas of the brain as well. An area known as the temporal lobe becomes underdeveloped, and so these children are more likely to have a harder time dealing with emotions, building close attachments, and regulating their mental health. For these children who experience ACEs, it is physically harder to put the brakes on their outbursts, to regulate their emotions, to manage fear, panic or other emotional responses. Even to notice social cues, or to regulate their own mental health is something that is harder for them to deal with. Of course these children can still manage these stressors, but it may be harder for them to do so.

Think about that for a second: these children have a more difficult time regulating their emotions, calming down, or managing fear and panic.

We have all been mad at one time or another, but we have been able to calm down internally, most of the time, before we lash out at people. Individuals who suffer these experiences cannot do that as well. Therefore, they are more likely to look outwardly for ways to calm themselves down. This may be in the form of exercise, or it may be eating, smoking, drinking or other drug use. If a person cannot calm themselves internally, they are going to look outward for ways to make it happen.

HOW MANY PEOPLE ARE AFFECTED?

The study also found that ACEs are common. Even in Iowa, only about 45 percent of our population has experienced none of the ACEs described above. This means that 55 percent have. When walking down the street, if you pass by any person, they are more likely to have experienced childhood trauma than not. The 2011/2012 National Survey of Children's Health found that 79.7 percent of low income children in Iowa had experienced two or more ACEs. That is serious. It is higher than the state and national average for the general population.

Here's what the numbers look like - it means that of the 16,054 children in United Way's five county area (Linn, Jones, Benton, Iowa, and Cedar) eligible for free and reduced price lunch, 12,795 would have experienced two or more ACEs. That is just slightly less than the number of people who live in North Liberty.

Nationally, 1 in 4 people have been exposed to two or more ACEs. One in five experienced three or more. Of those adverse childhood experiences, 22 percent of people were sexually abused as children. And 66 percent of women experienced abuse, violence, or family strife in childhood. These numbers are staggering and cannot be ignored.

WHAT ARE THE RISKS?

According to a 1995 study of adverse childhood experiences conducted by Dr. Robert Anda and Dr. Vincent Felitti, individuals who have experienced four or more ACEs are:

' 242 percent more likely to smoke

' 222 percent more likely to be obese

' 357 percent more likely to experience depression

' 1,133 percent more likely to be an IV drug user

' 1,525 percent more likely to attempt suicide

WHAT CAN WE DO ABOUT IT?

Luckily, there is hope. Research has also found that these ACEs, while tragic, do not, by themselves, determine a person's future life. Many people have experienced real and painful tragedy in their lives, but have come out stronger than before. Even individuals who have experienced all 10 of 10 ACEs have told success stories of how they thrived in their situations. One of the major reasons for that is called resilience.

Resilience is an individual's ability to bounce back from trauma and recover from hard situations either as they were before or better than when they started. This resilience is often the result of having a relationship with a caring mentor or support figure. One person who believes in the child and who can support the child even when things are not the best can do wonders for an individual's resilience.

We can also build this resilience by changing our thinking. This means a change from what is 'wrong” with 'problem” children that we know to thinking of what is 'right” with these children that survive and possibly thrive, despite the trauma that is in their lives. If we shift our thinking - changing from the idea that children misbehave because they are bad to thinking that behavior often is the result of a child's history, we can create more compassionate environments that help build resilience in children in our care.

It is a simple shift in mind-set from 'what is wrong with you” to 'what happened to you”.

HOW DO WE BUILD RESILIENCE?

Research shows that adults can build up resilience in children by creating environments where children feel safe, by helping children manage their emotions and identifying their feelings, and by creating protective factors in schools, communities, and at home.

The protective factors for young children include:

' Parental Resilience - the ability to problem-solve and build relationships

' Nurturing and attachment - caregivers that listen and respond to a child in a supportive way

' Social Connections - having family, friends, or neighbors who are willing to help or listen

' Concrete Supports - having child's basic needs met: housing, food, clothing, and health care

' Knowledge of parenting and child development - increasing parent's knowledge of development and appropriate expectations for their child's behavior

' Social and emotional competence of children - helping children to interact positively with others, manage their emotions, and communicate feelings

(Source: Spokane Regional Health District: Community & Family Services Division; Stress and Brain Development, Understanding Adverse Childhood Experiences)

You can see in this list, we have many resources in this community ready to help us build resilience in children and families. But in order to break the cycle we all need to work together to create even more compassionate and healing environments.

WHAT ARE WE DOING HERE?

United Way has teamed up with many local professionals to address ACEs in our communities. A community summit occurred in 2012, and more than a half a dozen community conversations were to increase awareness of ACEs and determine our community's capacity to address adversity. A team of experts from Linn County Public Health, the Department of Human Services, Abbe Center for Community Mental Health, Cedar Rapids Community School District, local psychologists, HACAP, Four Oaks, Linn County Prevent Child Abuse Council, Linn County Child & Youth Development Center, Partnership for Safe Families, ASAC, Grant Wood AEA, Juvenile Justice, Young Parents Network, United Way and others are working on preventing and responding to adversity and trauma in our community. Strategies include ACEs training for community members and providers, parent education and support, trauma informed care training for agencies, funding programs that address the needs of children and legislative advocacy.

WHAT CAN YOU DO?

Would you like to get involved? Reach out to any of the agencies mentioned in this article or visit this website for more information: unitedwayofeastcentraliowa.org/aces-building-resilient-community/

Have you experienced ACEs? Or do you know someone who has? Please remember, adversity happens to most of us. ACEs are not destiny. Contact 2-1-1 if you need help.

Remember, the most compassionate response is not 'What's wrong with you?” but 'What happened to you.”

' Douglas Griesenauer is senior manager for education, and Leslie Wright is vice president of community building, United Way of East Central Iowa. Comments: (319) 398-5372; doug.griesnauer@uweci.org