024. Samantha Clarke, LCSW 

 September 13, 2018

Our pasts form our present in many ways, some overt and others so subtle that we don't even make the connection. Adverse childhood experiences, or ACEs, are traumatic events likely to have long-lasting impact on our adult lives.

In 1995, the Centers for Disease Control teamed up with Kaiser Permanente for one of the largest studies how childhood trauma and later-life health and wellbeing. More than 17,000 people participated in the initial study.

Samantha Clarke, MPA, LCSW, is the clinical director of Doorways for Women and Families, which provides services for people affected by homelessness, domestic violence, and sexual assualt. 

(I'm a new volunteer in the children's program at Doorways, which means I go play with kids living in Doorways' family home (which can provide housing for up to 22 people) to give the parents a short break. This week, I spent an evening playing with seven kids, a big collection of plastic dinosaurs, and Play-Doh. Lucky me.)

I asked Sam to talk with me about ACE scores and how childhood trauma may be related to the desire to pursue a career working with animals. Last year, I read Nadine Burke Harris's book, The Deepest Well: Healing the Long-Term Effects of Childhood Adversity, and it sparked many thoughts for me. I was delighted to be able to explore them with Sam.

An ACE score is based on answers to 10 questions. Forty percent of people have an ACE score of 2 or more, 20% have a score of 3 or more, and 12% have a score of 4 or more.

The study showed that the higher a person's ACE score, the more likely they are to have challenges related to

  • Mental Health
  • Behavior
  • Relationships
  • Physical Health

On the surface, it doesn't sound right that a person with an ACE score of 4 or more is 260% more likely to have chronic obstructive pulmonary disease (COPD). What does one thing have to do with the other? But during traumatic periods, our bodies are flooded with stress hormones, which promote survival in the moment, but also cause inflammation and disease over time.

We can't rewrite history. I asked Sam what a person should do to mitigate these negative effects and move forward.

She said there's a huge value to acknowledging and "owning" your history. This can change the conversation from "What's wrong with you?" to "What happened to you?"

It's vital to form connections, to develop a support system that affirms your worth, supports your growth, and helps you know that you are not alone. 

Common trauma- and stress-related behaviors include

  • avoidance
  • trouble focusing
  • unable to identify feelings
  • low self-esteem
  • poor impulse control
  • aggression

For many people, animals can provide "sanctuary relationships," where the person feels safe from expectations, judgment, or physical harm.

In many cases, people often become impassioned protectors of animals because they know how it feels not to have someone who takes care of them. They can fill the role for animals that abusive or neglectful parents did not fill for them.

Wondering about your ACE score? The questions are below. 

Find Your ACE Score

Prior to your 18th birthday:

  1. Did a parent or other adult in the household often or very 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?
    No___ If Yes, enter 1 __
  2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
    No___ 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 Attempt or actually have oral, anal, or vaginal intercourse with you?
    No___ If Yes, enter 1 __
  4. Did you often or very 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?
    No___ If Yes, enter 1 __
  5. Did you often or very 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?
    No___ If Yes, enter 1 __
  6. Were your parents ever separated or divorced?
    No___ If Yes, enter 1 __
  7. Was your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very 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?
    No___ If Yes, enter 1 __
  8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
    No___ If Yes, enter 1 __
  9. Was a household member depressed or mentally ill, or did a household member attempt suicide?                        
    No___ If Yes, enter 1 __
  10. Did a household member go to prison?
    No___ If Yes, enter 1 __

Now add up your “Yes” answers: ______ This is your ACE score.

Sam shared these tips for supporting friends and coworkers who show signs that they're struggling:

  • Identify what you see. "You seem pulled in many directions. I have some extra time in my schedule today. Could I help you with X?”
  • Ask, "Is there anything I can do to help?"
  • Be careful not to sound accusatory. This can be tricky. When we're stressed, we often misinterpret other people's attempts to be supportive as judgments.

Thanks for Listening!

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