Building out from my blog of August this year, I wanted to share that The Mandt System in Chapter 4 focuses on trauma informed care training and a good deal of the chapter discusses a study that was conducted in cooperation between the Centers for Disease Control in Atlanta, GA and Kaiser Permanente (an insurance provider). The study originated in an effort to assist patients with weight loss. However, it was quickly identified that many patients were dropping out of the program despite success in the weight loss program. After conducting interviews and follow-up discussion the physicians leading this study found a staggering percentage of people who left the program had been sexually abused in their childhoods and it suggested that the weight gain may have, in fact, been a coping mechanism for anxiety, fear, depression, etc. At that time, the focus of this study changed and many more adversities in childhood were identified. Those included:
- Physical abuse
- Sexual abuse
- Emotional abuse
- Physical neglect
- Emotional neglect
- Substance abuse in the household
- Mother being treated violently (or other witnessing of violence in the household)
- Mental illness within the household
- Parental separation or divorce
- Incarceration of someone in the household
The Adverse Childhood Experiences (ACE) study (acestudy.org) results helped us to understand the link between traumatic events in our childhood and the possible life-long outcomes (e.g. higher likelihood of smoking; higher probability of using/abusing drugs and/or alcohol; obesity; and, much greater instances of suicide attempts). The ACE study specifically set a threshold of four or more adversities in childhood as resulting in the higher likelihood of the identified negative outcomes.
Probably many of you that are reading this have experienced four (or more) of these adversities in your childhood and you have not ended up smoking, or using drugs and alcohol as a coping mechanism, or attempted suicide. The most likely contributing factor? Relationships. The very core of what The Mandt System advocates.
A survey regarding resilience (developed by the early childhood service providers, pediatricians, etc. of Southern Kennebec Healthy Start in Augusta, Maine) is fourteen questions to determine if people have the capabilities of asking for help; developing trusting relationships; forming positive attitude; and, listening to their feelings. Some (but not all) of those questions are:
- I believe that my mother loved me when I was little.
- I believe that my father loved me when I was little.
- When I was little, other people helped my mother and father take care of me and they seemed to love me.
- When I was a child, there were relatives in my family who made me feel better if I was sad or worried.
- When I was a child, teachers/coaches/youth leaders/ministers were there to help me.
- We had rules in our house and were expected to keep them.
- I believe that life is what you make it.
When people are overloaded with stress hormones they are in flight, fight or freeze mode. They are elevated in their crisis cycles. They are not as likely to trust others and thus not as likely to develop healthy relationships with others (they become loners). To relieve their anxiety, depression, guilt, etc. they turn to the most easily available solutions – like nicotine, alcohol, marijuana, methamphetamine – or activities in which they can escape their problems – like risky sports, increased sexual partners, work/over-achievement.at work, over-eating. Each of those risky behaviors can lead directly to disease or disability or social problems (alcoholism, serious injury and physical trauma, obesity, sexually transmitted infections, etc.).
It’s a bit of a cycle. A crisis prevention/intervention cycle we can interrupt with healthy relationships. And drawing your attention back to the resilience survey – please notice that not all relationships from that questionnaire are specific to family relationships (child to parent; sibling to sibling; child to aunts/uncle) it includes other types of relationships that many of us as professionals would represent (teachers, ministers, social workers, coaches, etc.). It’s easy to think about just ourselves, our own children, etc. but we need to get ourselves involved in our communities and reach out to others that are in need. These adversities don’t just affect the people directly, it affects all of us as a society collectively. We must get outside our own comfort zones. We must be willing to help create environments that are inclusive to people who have significant trauma in their lives and are geared towards healing.
Let’s each of us step up and try to break that cycle.
Nikki Wince – Mandt Adjunct FacultySupervisor