Our recent survey showed most adults feel that we have great control over our health: what we eat, how we move, sleep and manage stress. And we do—but new studies reveal the impact that our childhood can affect our ability to engage in health promoting behaviors and be healthy adults. For the 60% of adults with an adverse childhood experience (ACE), their brain may be so formed by and busy coping with unconscious pain of the past that the body cannot productively manage the normal stresses of the present.
Toxic stress is a root cause of disease, suffering and early death regardless of income, race or access to care. It triggers chronic inflammation and hormonal changes, affects brain development, alters DNA and increases risk for chronic conditions such as heart disease, stroke, cancer, diabetes and Alzheimer’s. Conversely, a nurturing early childhood, in which children are taught to use words and learn how to appropriately regulate emotions go on to much healthier and productive lives than those who do not gain these skills.
However, there is new hope for adults who experienced ACEs or may not have had a nurturing environment as children. Strategies for overcoming trauma are being developed and can be integrated into primary care settings.
Researcher and practitioner Audrey Stillerman, MD, ABFM, ABIHM, ABOIM, of the Office of Community Engagement and Neighborhood Health Partnerships in Chicago, IL, suggests that when we help a patient to resolve a trauma in their lifetime, we break the chain and can prevent the trauma from affecting the next generation. Just asking whether a person’s childhood was “pretty ok or mostly difficult” could help screen for adverse childhood experiences in a low-key, patient-supportive way.
We can then steer them towards evidence-based treatments like trauma-focused cognitive behavioral therapy, eye-movement desensitization, yoga, neurofeedback, and other neuromodulatory modalities.
Some practitioners feel that addressing toxic stress and adverse childhood experiences asks too much. After all, we’re not all psychologists. But the impact of trauma is seen mostly in primary care and in the community. So we need to learn how to recognize it and provide the basics of trauma-informed care if we are to make a dent in the health crises facing our patients and our nation.
Let us remember that when we want our patients to move forward, sometimes we need to help them look back and heal the ever present past.
Note: Healing childhood and adult trauma should be a cornerstone of optimal healing and integrative medicine. In the HOPE Note, I teach practitioners how to address a patient's childhood and current level of social support.