Intricacies exist in all aspects of life, and wellness is no exception. I recently took a trip to Boston to begin training to become a Trauma Center Trauma Sensitive Yoga facilitator. As I mentioned in my last post, I am new to this work and so far it’s been a fascinating journey.
While doing some required reading for the course this week, I was particularly struck by one sentence. In an article by the American Academy of Pediatrics citing the Adverse Childhood Experiences study (ACE for short) the author writes, “Questions for patients have focused on ‘What’s wrong with you?’ rather than ‘What happened to you?'”. It struck me because I see this mistake being made in the wellness industry all the time. Might addressing the underlying cause of unwanted health habits rather than jumping straight into fixing the habits themselves be more beneficial?
The ACEs study was a game changer in the field of public health. Dating back to 1998, this study from the Centers for Disease Control and Prevention and Kaiser Permanente opened the eyes of the medical community to ACEs effect on disease. It has since been cited as a crucial development in understanding how early life experience informs overall health and wellbeing.
According to the ACE study, more than 60% of Americans are effected by ACEs. It might make sense that instead of simply telling people what they need to do to be healthier we might first consider the possibility of underlying trauma. The Western medical model is fabulous for some things (if I break my arm I would take a hard pass on the integrative medicine practitioner in favor of the ER….) but getting to the root cause of most chronic diseases tends to be a bit of a cultural blind spot.
To make things even more complex, Child Traumatic Stress can look very similar to other disorders such as ADHD. According to a document by the National Childhood Traumatic Stress Network, “Trauma can have such a large impact on development that children often experience problems in many areas of their lives. The complexity of their symptoms and presentation often lead to multiple diagnoses and potential misdiagnoses, particularly when the impact of their trauma history goes unrecognized.” Misdiagnosis can lead to ineffective treatment at best and poor health outcomes (or even re-traumatization) at worst.
In the book “Treating Complex Stress Disorders” Christine A. Courtois and Julian D. Ford write, “As the research and clinical knowledge base relevant to the treatment of clients with complex trauma histories continues to evolve, we expect that the exact features characterizing complex traumatic stress disorders and the relevant assessment and treatment protocols also will change dynamically. However, the core problems of affect dysregulation, structural dissociation, somatic dysregulation, impaired self development, and disorganized attachment patterns are likely to remain the foundation for clinicians working with survivors of complex trauma, regardless of the specific diagnoses or assessment and treatment methodologies in use.”
It seems the tide is turning and more nuanced approaches, such as TCTSY, might one day be the rule rather than the exception.
Our relationship with our bodies is just as (if not more so) as complex as our bodies themselves. Since trauma inevitably complicates this relationship, considering ACEs in relation to health may not simply be useful but indeed necessary.