“I am no longer afraid of storms, for I am learning how to sail my ship.” Louisa May Alcott
If you have ever played card games, you know that the aces generally hold a lot of weight in the game! This article is about some different ACEs that we might draw in life. And, it is about resiliency. More specifically, it’s about the relationship between the ACEs and resilience. To appreciate the relationship we must first define what is meant by ACEs and resiliency. THE CONCEPTS DEFINED: ACEs is an acronym for Adverse Childhood Events. It refers to situations and circumstances faced early in life that cause stress on the human body, mind and spirit. This is also known as developmental trauma. The types of circumstances that would be considered ACEs include exposure to any of the following:
- Household dysfunction:
- living with a parent with mental illness or substance abuse
- domestic violence
- parental incarceration
In 1998 a group of researchers at Kaiser-Permanente, in collaboration with the Centers for Disease Control, conducted research looking at the effects of ACEs on health. They surveyed 17,000 subjects(!) using a questionnaire aimed at identifying how many ACEs each subject had been exposed to. Then they compared that data to physical and mental health markers for each subject. The researchers suggest that experiencing 3 or more ACEs was predictive of physical and mental health issues (cancer, heart disease, addiction, diabetes, earlier death) in adulthood. Here is a list of the 10 questions that comprise the questionnaire: While you were growing up, during your first 18 years of life:
1. Did a parent or other adult in the household often … Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt? If yes enter 1 ________
2. Did a parent or other adult in the household often … Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured? If yes enter 1 ________
3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Try to or actually have oral, anal, or vaginal sex with you? If yes enter 1 ________
4. Did you often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other? If yes enter 1 ________
5. Did you often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it? If yes enter 1 _______
6. Were your parents ever separated or divorced? If yes enter 1 ________
7. Was your mother or stepmother: Often pushed, grabbed, slapped, or had something thrown at her? or Sometimes or often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife? If yes enter 1 ________
8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs? If yes enter 1 ________
9. Was a household member depressed or mentally ill or did a household member attempt suicide? If yes enter 1 ________
10. Did a household member go to prison? If yes enter 1 ________
Now add up your “Yes” answers: _______ This is your ACE Score.
The data in that study revealed that 26% of people in the study had experienced at least 1 ACE and 12.5% had 4 or more. Subsequent studies done throughout the United States have yielded similar results. Currently this is roughly equivalent to 780,000 people in Twin Cities 7-county metro area who have experienced one ACE and equivalent to 375,000 people in Twin Cities 7-county metro area who have experienced 4 or more ACEs. So, it is highly likely that many of us who are either reading this article or writing it are reflected in these statistics. It matters to, and for, all of us!
This research helped us to appreciate the long-reaching effects of early trauma. It reinforced our awareness that early trauma impacts brain anatomy and functioning. In addition, we know that our response to trauma, which is primitive and instinctive, is deeply and persistently etched in the body. This can lead to emotional dysregulation. And, emotional dysregulation can derail our sense of well-being and present-moment awareness and contribute to the development of those physical and mental health issues mentioned above.
RESILIENCY, in this context, is defined as the capacity to respond flexibly to life annoyances and struggles. Human beings have an innate tendency to be resilient. We wouldn’t have survived this long as a species without it! When resiliency kicks in we are able to tap into our resources (both external and internal) to respond to the ACEs we encounter. But sometimes the effects of trauma can impair this natural capacity – leaving it weakened. When this happens, we may require focused-effort to effectively engage our resiliency. In essence, we have to do the work of recovering our inherent response flexibility. The good news is that research has shown that this is possible!! There are many ways to work on this – too many to cover in this short article. So, I have decided to focus on the development of somatic (body) awareness as a resilience-enhancing strategy. There is strong neuroscience evidence for the cultivation of body-based (somatic) awareness in order to develop resiliency. These strategies promote emotional stabilization in situations of stress. And, as a result, the nervous system becomes more resilient! Below are three strategies I would like to share with you.
SOMATIC PRACTICE STRATEGY#1: Cultivating a Felt Sense as a Way to Build/Enhance Your Own Resiliency
In his book, “Waking the Tiger: Healing Trauma”, psychologist Peter Levine discusses the concept of felt sense. The felt sense can be understood as “Being consciously aware of your body and its sensations…” (Levine, 1997). This includes both internal and external sensations. This concept was originally brought into the literature by Dr. Eugene Gendlin. To get a better sense of this concept, I encourage you to practice the following exercise taken from Levine’s book. It’s beneficial to read through the description prior to beginning the exercise to orient yourself. The exercise is enhanced if done with the intention to be open and mindful to all sensations that arise.
REFINING YOUR FELT SENSE:
- Make yourself comfortable as you begin the exercise (you can be sitting or lying down).
- Feel the way your body makes contact with the surface that is supporting you.
- Sense into your skin and notice the way your clothes feel.
- Sense underneath your skin – what sensations are there?
- Now, gently remembering these sensations, how do you know that you feel comfortable? What physical sensations contribute to the overall feeling of comfort?
- Does becoming more aware of these sensations make you feel more or less comfortable? Does this change over time?
- Sit for a moment and enjoy the felt sense of feeling comfortable.
SOMATIC PRACTICE STRATEGY #2: Titration To titrate means to continuously work to find a balance of physiological functions. Titration in this sense is defined as a deliberate slowing down of your distressing body sensations and your emotions. It’s similar to slowing down the tempo of music. By slowing the processing of your sensations down you send a message to your central nervous system letting it know that it now has time for each sensation to come out one at a time rather than all at once (flooding), which often happens with trauma. The net result is being less overwhelmed, which leads to more capacity to respond reflexively as your system finds its natural pendulation.
REFINING THE SKILL OF TITRATION:
1. Choose a particular physical sensation – leave the rest for later. One step at a time here!
2. Allow yourself to experience the fullness of the sensation (a true felt sense of it).
3. Limit the amount of time you spend in the felt sense of the sensation; moderate the amount of time you allow yourself to experience the full sensation.
4. Repeat this process over time, stretching the amount of time you sit with the full sensation with each practice.
SOMATIC PRACTICE STRATEGY #3: Pendulation
Pendulation can be defined as the movement between dysregulation and regulation in the nervous system. Traumatic experiences often result in dysregulation of the nervous system and can lead to an imbalance between the responses of the sympathetic (activating) and parasympathetic (calming) branches. We know this as the fight-flight-freeze response. In contrast, regulation is the stable flow of movement within the nervous system (sympathetic and parasympathetic) – operating in a state of homeostasis (balance). So, the goal is to develop your capacity to move from dysregulation (which can occur naturally in response to a stressor) to regulation. Thus, lessening the potential of holding the dysregulation state in the body long-term. This, in turn, lessens the potential of experiencing the negative effects of such a state.
REFINING THE SKILL OF PENDULATION:
1. Start by identifying an area of your body in which you are noticing some activation (tension resulting from panic, terror, anger, etc.).
2. Allow yourself to experience the felt sense of this distressed state.
3. Then move your attention to a place in your body that feels calm or neutral.
4. Allow yourself to experience the felt sense of this physical state.
5. Slowly move back and forth between these two physical states (the tension/distress and the calm/neutrality).
6. Repeat this process – building your capacity to stay with both the negative and the positive.
The exercises above can support your movement from compromised resiliency to a return to a more natural state of being resilient. This effectively can inoculate you from continuing to experience the harmful effects of the ACEs you may have drawn in your childhood! For those who were fortunate enough to have not experienced any ACEs the exercises will reinforce the stability of your resilience. I invite you to make them a part of a regular well-being practice!
Some Other Resources for Building Resiliency:
- Online Resource: ichillapp (skills practice resource)
- Book: Peter Levine: Waking the Tiger: Healing Trauma
- YouTube video: Dr. Peter Levine: Nature’s Lessons in Healing Trauma
Fran Bieganek is a Licensed Psychologist practicing holistic psychotherapy at Bhakti Wellness Center. She has been practicing for over 20 years and currently specializes in the areas of trauma, anxiety, depression, grief and loss, stress management, developmental transitions and well-being. She works with both individuals and couples. In addition to her therapy practice she has also taught Psychology courses at several colleges in Minnesota. She is currently accepting new clients and can be reached at 612-564-9947 or by emailing her at: mailto:email@example.com.