ACEs and Resilience

This spring, I had the opportunity to attend a screening of the documentary “Resilience: The Biology of Stress and the Science of Hope” at my daughter’s high school. It was co-sponsored by Public Schools First NC, a statewide nonpartisan, nonprofit organization focused solely on pre-K – 12 public education issues. The documentary addresses the link between toxic stress caused by Adverse Childhood Experiences (ACEs) and the increased risk it puts children at for chronic disease, homelessness, prison time, and even early death.

I was somewhat familiar with the topic of ACEs before I watched the film, but I have to admit the data and information shared was eye-opening and thought-provoking. For those not familiar, Adverse Childhood Experiences can include:

  • Physical abuse
  • Emotional abuse
  • Sexual abuse
  • Physical neglect
  • Emotional neglect
  • Mother treated violently
  • Substance abuse
  • Mental illness
  • Parental separation/divorce
  • Incarcerated relative

The more ACEs a child experiences, the more likely he or she is to suffer from things like heart disease, diabetes, poor academic achievement and substance abuse later in life. Children who experience four or more ACEs are at greatest risk for these negative health outcomes. Experiencing multiple ACEs can cause what is known as toxic stress, or excessive activation of the body’s stress-response system. This can lead to long-term wear and tear on the body and brain. One way to think about it is as if you were to rev a car engine for days or weeks at a time. Imagine what that would do to your engine.

When children experience this toxic stress, they are essentially in survival mode. Self-protection becomes the priority, thereby affecting their social skills and their ability to learn. This can lead to difficulties in school. In addition, the increase in stress hormones can suppress the immune system, leaving children susceptible to illness and poor health in general.

Although exposure to ACEs is harmful, the good news is that the damage is not irreparable – and there are ways to reduce the effects of ACEs and toxic stress. Obviously, the primary approach should be to reduce the sources of stress in children’s lives, by meeting their basic needs or providing services in the community to help avoid exposure to these adverse experiences. However, for children who have already been exposed, strategies such as professional counseling, meditation, physical exercise, and spending time in nature have been shown to counteract the effects of ACEs. In addition, studies have shown that building resilience helps reduce the effects as well. Resilience is the ability to adjust or bounce back when bad things happen, and it is a skill that can be learned – by children and adults.

I have to admit that my interest in this topic and the documentary is really two-fold: understanding how ACEs can affect youth in my community but also how they may play a role in the lives of the adult clients whom I coach. Many of the clients I work with are often overweight or obese and may also have chronic conditions such as high blood pressure, high cholesterol or diabetes. Oftentimes, these adults are struggling with anxiety and/or depression as well. It is highly possible that these physical and mental health conditions are a result of ACEs that these individuals endured in their youth.

My experience watching this documentary and learning more about ACEs has prompted me to think about how I can possibly address this topic in my work as a coach. To be honest, helping individuals heal from the trauma of ACEs and toxic stress is really more appropriate for therapy or counseling, which is outside my scope of practice. In addition, coaching differs from counseling in that it is more focused on exploring the present and the future (e.g., through goals and action steps) rather than investigating and healing the past. However, as a coach, I think it would be helpful to know if a client did experience one or more ACEs in the past. It could open the door to introducing evidence-based practices such as mindfulness and meditation, which are helpful tools for behavior change as well as building resilience. It could be a win-win for the client – helping them heal from trauma in their past while also moving them forward in the direction of their vision and goals for optimal health and wellbeing.

I plan to explore ways that I can broach this topic if a client shares information that leads me to believe they may have experienced toxic stress due to ACEs. Sometimes clients offer this information outright. Others may drop more subtle hints about their past, allowing me to test the waters for further exploration with a gentle inquiry to share more if they are willing and able. Clients may or may not wish to elaborate, but if they do, I now feel more prepared to explore the connection between ACES and current health concerns – as well as strategies to counteract the damage that may have already been done.

If you are interested in learning more about ACEs, below are some resources that may be helpful:

CDC website about ACEs

Infographic: The Truth about ACEs

Finding Your ACE Score