Mindfulness is a meditative practice, a moment-by-moment awareness of what’s happening in our environment and within us in the present moment. By focusing wholly on the present, we avoid obsessing on events in the past or stressing about what might happen in the future.
We all have the ability to be mindful. It doesn’t take great skill or a lot of schooling to master. You can do it anywhere, anytime; at work, at home, or while walking down the street. It does not ask us to change who we are.
Anybody can do it, and there are vast bodies of evidence that suggest that it can help us overcome a lot of issues.
Wherever you go, there you are
Addiction, anxiety, and mental health conditions are things that typically take us away from the present moment. When we are in the throes of one of these disorders, we are consumed with trying to escape the present because it represents discomfort, agitation, and pain.
Paradoxically, by focusing only on the present—on the things you feel within your body and what’s going on around you—it is possible to change how you respond to the discomfort of addiction and mental health issues. Learning how to deal with these feelings can encourage a different way of behaving, too. For example, it may prevent you from reacting impulsively to a stressful situation, helping you trade neutral, non-judgmental thoughts for those that trigger addictive behavior.
This principle is the core of mindfulness.
What is mindfulness?
Mindfulness is an ancient meditation technique that goes back thousands of years. Though it is practiced in many cultures and religions, the type of mindfulness used in addiction and mental health treatment is most closely related to Buddhist practice. In this culture, it is described as “paying attention purposefully, in the present moment, and non-judgmentally.”
In terms of addiction and mental health, the non-judgmental aspect is key as much of the angst we feel is a direct result of a judgment we have made. Thoughts and sensations themselves do not have judgment attached to them. It’s how you decide to respond to those thoughts that create the judgmental aspect.
If you do not respond to those thoughts, if you choose instead just to notice the sensations without any further acknowledgment, you do not pass judgment. Without judgment, there is no need for anxiety, self-deprecating, or harmful thoughts.
What is mindfulness meditation?
Meditation is used by people from cultures all over the world to bring a sense of peace and calm and to improve various aspects of their lives.
There are meditative aspects in many of the things we do every day, from doing the dishes to enjoying your favorite music. In fact, you may already be practicing mindfulness meditation on some level, even if you don’t realize it.
There are many different types of meditation, but mindfulness meditation places a particular focus on the awareness of oneself and the immediate surroundings.
All types of meditation have a few things in common. In any case, the way you approach it is much the same:
Find a quiet, calm environment where you are unlikely to be disturbed
Settle yourself in a comfortable position, usually seated
Relax your body and mind and release stressful thoughts
Use deep breaths to oxygenate your blood
In mindfulness meditation, you are also asked to be fully present and aware of yourself and your surroundings.
You will notice your thoughts, your breath, the temperature of the cool air as it enters your nostrils and the warmth of it as you exhale.
Open your mind to accept thoughts as they come to you.
As thoughts enter your mind, as you feel the sensations on your skin and within your body, you will observe them without judging them. You will accept these thoughts, choosing not to linger on them. Your thoughts are neither good nor bad, right or wrong. They simply are.
During this meditation, you will take inventory of each part of your body and notice how it feels, the sensations as the air passes over it, the pressure of the chair beneath you. You will notice the smells and sounds of what is going on around you and, in many cases, the anxiety and worry that you typically experience will ease.
This is the essence of mindfulness.
Our mind, when left to its own devices, will instantly judge a person or situation as good or bad, fair or unfair, important or unimportant. In many cases, this happens so quickly that our responses are reactive and can sometimes lead us down a dark path.
When we practice mindfulness, we do not allow judgment. We can gain perspective on our thoughts and find the freedom to choose how we proceed.
If the concept of mindfulness meditation is new to you, it might be helpful to start with a guided meditation, like this one:
Mindfulness meditation for mental health conditions and addiction
Though mindfulness may not replace frontline therapies for some of these conditions, it can significantly improve clinical outcomes, reduce symptoms, and help to establish coping behaviors that allow other treatments such as mental health treatment, etc… to work more effectively.
One of the other benefits of mindful meditation is that it doesn’t interfere with other treatments and can actually enhance long-term results. It can be practiced at home, at work, or with your therapist. Once you have learned the techniques, you will be able to apply it to any situation, anytime you need it.
Mindfulness for substance abuse and addiction
In recent years, mindfulness training has been studied extensively as an intervention for addictions and addictive behaviors that include smoking, drinking, and various forms of substance abuse.
The outcomes of these studies show that mindful-based interventions (MBIs) can reduce cravings and substance misuse. Better still, approaches like Mindfulness-Based Relapse Prevention can also work to prevent relapse in the future. Mindfulness staves off destructive thoughts that have the potential to derail your sobriety.
By focusing on the present moment rather than allowing your mind to obsess over a craving, you will effectively, and immediately deflect your response. Continue to practice, and this could be a sustainable method of achieving your recovery goals.
Getting started with mindful meditation
When learning mindful meditation, you may work with a therapist who can guide you through the process. Whether you pick it up quickly or if it takes some time to feel a level of comfort with the process, the results are immediately noticeable. With patience, perseverance, and commitment, the rewards will come. As you become more comfortable with mindfulness, you can incorporate them into everyday life to reduce stress and help you cope with “slippery” situations.
You can begin practicing mindfulness right away simply by taking notice of where you are, what you are doing, and what’s going on around you. The key is to accept these things without judgment and without becoming overwhelmed. If you need a guide, you can find great guided meditations like the YouTube video above, and there are also great apps and podcasts available.
There’s no need to buy anything, and you don’t need a doctor to show you how. Keep in mind that your mind will wander and attempt to hijack your serenity with judgmental thoughts. When these thoughts arise, just go back to your breath; breathe in, breathe out. Just breathe.
If you would like to learn more about mindfulness for addiction and mental health, we would love to help. Reach out today to get started.
The idea of music as a healing force is not new. The ancient Greeks put Apollo, one of their gods, in charge of both music and healing, suggesting that there has long been an understood connection between the two. There are many theories as to why music therapy works. Some studies support the idea that music helps the brain make new connections between nerve cells, and helps organize the firing of nerve cells in the part of the brain responsible for higher functions. Others look at the rhythms of music and feel that we respond to rhythmic repetition, much like our heart, breathing, and brain waves.
What can music therapy do?
The healing power of music is well-documented. It has been proven to reduce anxiety and depression, and also to lessen the symptoms of Parkinson’s disease, Alzheimer’s, autism, schizophrenia, and many other psychological disorders.
Additionally, music therapy has been found to improve motor function, communication skills, emotional stability, and the ability to focus. It is considered to be an evidence-based therapeutic approach to mental health treatment, and there are plenty of mainstream studies to back it up.
For example, according to the American Psychological Institute, music therapy should not be thought of as an “alternative therapy” due to the weight of clinical studies that can back the results. These studies prove that music therapy can help patients in the areas of physical health, emotional health, mental health, and also in a social manner.
How music therapy is applied
Depending on the diagnosis and the approach decided on by your therapist, music therapy might involve singing along to music or simply meditating and relaxing as you listen. Various exercises or movements might be performed with music as the catalyst, supporting outcomes that range from improving self-image to improving memory and physical coordination.
At Roots, music therapy not just something we offer, it is woven into the fiber of our program, with several groups a week tapping into the power of music and healing. David Hickman, a UCLA-trained Music Medicine Facilitator, provides a Drumming for Healing group, in which clients are able to use Native American and African drumming rhythms to communicate internal feelings, and support for the peer group. This extremely powerful group has become one of the cornerstones of our program.
Rock to Recovery, founded by veteran guitarist, Wes Geer, employs song writing, and performing and recording as a “band”, to focus on creating a sense of belonging and increasing self-esteem. “…It was when I was in treatment that I realized how much music could help [me] get through those tough emotions that run so rampant, especially in the early days. Being totally sober and dealing with the bottom I had hit, strumming the guitar was the only thing that would bring me peace,” says Geer. The group of professional musicians, who are also in recovery, brings fun into treatment and recovery by offering a natural escape from the fear-based mind.
Music therapy for pain
Music therapy has also proven helpful in managing pain. In one study, cancer patients were split into two groups; one group received talk therapy while the other received music therapy. In the talk therapy group, there was no noticeable reduction in pain, while the music therapy group showed a “statistically significant reduction” in pain scores.
The findings supported the theory that music therapy is a safe and nonpharmacological alternative to pain reduction, even in cases of severe and chronic pain.
Music therapy for depression and anxiety
According to the American Music Therapy Association, music therapy can help patients with a wide range of psychosocial needs. In cases where patients are resistant to other treatments, it has enabled them to develop relationships, communicate emotions, and express ideas that they may not be able to address with words alone.
The stimulation that music provides tends to provoke responses that stem from familiarity, comfort, and feelings of security associated with the music itself.
Drum circle set up for the Drumming for Healing group with David Hickman.
Other mental health outcomes that have been observed through music therapy include:
Improved personal relationships
Decrease in anxiety/phobias
Increase in verbalization
Safe emotional release
Reduction in muscle tension
In conclusion, music therapy can be highly beneficial in addressing a range of disorders. It is a safe and evidence-based practice that is effective when integrated into a multidisciplinary approach and supporting other modes of healing therapy like yoga, nutrition, and art therapy.
If you would like to learn more about whether music therapy might be right for you, reach out today to get started.
EMDR, or Eye Movement Desensitization and Reprocessing, is a specialized form of integrated therapy. Over the past three decades, it has proven to be highly effective in treating PTSD and trauma disorders as well as many other types of mental health issues.
In some cases, it is used as an adjunct therapy when treating eating disorders, panic attacks, addiction, phobias, sexual dysfunction, anxiety-related issues, and psychological trauma resulting from cancer treatment.
What EMDR is like
The treatment itself is quite involved and will generally take several appointments to complete, months if done correctly. Considered an alternative therapy, it relies on your own eye movements to lessen the emotional impact of traumatic or stressful events.
As you will see from the outline of the phases of EMDR below, the first three phases are done to help you prepare for the actual therapy. A trained, or certified EMDR therapist educated in the best practices of the therapy will spend the majority of the time working with you in these three phases: Planning, Preparation and Assessment.
It is important to keep in mind that EMDR requires that you are properly “resourced”, meaning that you have the supports in place, prior to actually starting the therapy. Resourcing includes finding a support group that you feel a part of, family or loved ones who are supportive of your treatment, a hobby or passion that you enjoy, and anything else that helps you in a positive way. Only once these are in place, will your therapist begin the reprocessing.
During a session, which usually lasts about an hour and a half, your therapist will have you recall the stressful event. You will be asked to include in those memories all the physical and emotional sensations you can remember while they move their finger back and forth before your eyes. Alternative ways to create bilateral stimulation are with handheld buzzers or headphones with alternating sounds.
As the session goes on, they will gradually guide your thoughts to more pleasant memories. At the beginning and at the end of the session, you will be asked to rate your level of distress.
As it is a relatively recent approach (the initial study was first published in the Journal of Traumatic Stress in 1989), it is still gaining momentum. However, there have been many positive results in treating veterans with PTSD.
Some research shows that EMDR is helpful for 77 percent of patients accessing the treatment for PTSD. It has a lower dropout rate than other exposure therapies, and is largely more effective in addressing symptoms.
In many cases, it is more effective than supportive listening.
It does not outperform CBT on its own.
Other exposure-based treatments have seen similar results.
It is important that EMDR be integrated into a treatment program that addresses all aspects of your unique situation, as it will be much more effective than EMDR therapy on its own.
The EMDR treatment plan
EMDR therapy consists of eight separate phases, usually spread out over 12 therapy sessions, though, as we mentioned above, the first few phases may take longer depending on your unique circumstances.
Phase one: Planning
In the first phase, your therapist will go over your history. You will be asked to talk about the trauma and any traumatic memories that trigger your responses.
Phase two: Preparation
You will then learn stress management techniques, such as mindfulness and deep breathing. These methods will help you cope with traumatic memories when they come up.
Phase three: Assessment
In the third phase, you will be asked to identify specific memories and physical components of those memories that will later be used in the EMDR treatment.
Phase four – seven: Therapy
In phases four through seven, your therapist will begin using EMDR to target the memories you have identified. You will be asked to perform rapid eye movements, either following their finger or triggered by finger taps, music, or other gestures.
The therapist will ask you to recall the trauma and the feelings you have around these events. If you feel overwhelmed or if the memories cause you too much distress, your therapist will bring you back to the present before starting again.
Phase eight: Evaluation
Following each session and at the end of the cycle, you will be asked to assess your progress. Your therapist will also provide their own assessment.
If you struggle with PTSD or trauma, we can help. Reach out today to find out how to get started.
Recovering from trauma can be a lifelong process. Each situation is as unique as the person experiencing it, and while some may be able to confront their pain and suffering, others are less resilient. For this reason, there is no way to speed the healing.
What is trauma?
Trauma results from a profoundly distressing experience. It could be the result of things that happened to you or from something you witnessed. It could be a result of Adverse Childhood Experience, losing a loved one, a divorce, illness, or losing a job; or it could be the result of a catastrophic event like a hurricane, war, torture, rape, or violent crime.
What is PTSD?
Some of the traumatic events we cited above are quite extreme, some seemingly less so, but they can all have the same effects, depending on the person who struggles with it. Many go on to lead normal lives, largely unaffected by the trauma they experienced, while others may be more vulnerable to the stressors. If this situation continues without treatment, it could become post-traumatic stress disorder (PTSD).
The correlation between trauma and PTSD
It is more or less agreed that PTSD is the product of an interaction between the intensity of the trauma and the level of the individual’s personal vulnerability. However, a serious catastrophic event, like a terrorist attack or an extreme weather event, for example, might be enough to produce PTSD in anybody who experienced it – not just the vulnerable.
Symptoms and onset of PTSD
PTSD symptoms may start to manifest themselves within days or weeks of the trauma, but sometimes it takes years to become apparent. Because of its manifestations, it may be challenging to hold down a job, maintain personal relationships, or cope with social situations.
Symptoms of PTSD include:
Intrusive, unwanted memories of the event, nightmares, flashbacks, and extreme responses to situations that remind you of the trauma.
Avoidance, not wanting to talk about it, avoiding people or places that remind you.
Feeling hopeless, helpless, and having negative thoughts about others and the world.
Loss of interest in the things you love.
Tough time expressing positive emotions.
Changes in physical and emotional responses to situations, like hyper-vigilance, self-destructive behavior, irritability, rage, and often feelings of guilt or shame.
Why it’s important to get help for PTSD right away
The intensity of PTSD may change over time. They may increase with stress, or certain stressors, like if you are reminded of the event. For example, a car may backfire and take you right back to the combat zone. A news item about a violent crime may trigger memories of your experience.
If you or a loved one has been having intense feelings about a traumatic event, if it has lasted for weeks or months, or if there are suicidal thoughts present, you should seek help as soon as possible. Simply avoiding the issue is not the answer – in fact, research has shown that there is a strong correlation between avoidance and the development of PTSD. The sooner you can seek help, the sooner you will feel better.
If you are dealing with trauma or PTSD in Long Beach, reach out today, we are always here to help.
The link between trauma and negative health outcomes among adults, including chronic physical and mental illness, is well-established. What is less known are studies like this oneby Harvard Health, and other research, suggesting there is a link between trauma and chronic pain. Modern pain professionals understand that pain is a function of the brain and our processing of many inputs: our pain receptors, our environment, our culture and beliefs about pain, and our past experiences. So naturally, symptoms of trauma will have an impact on our physical well-being and how we process pain. While it is easy for one to make this connection by looking at the co-occurrence of these trauma and pain, it is not always the easiest connection to make when you’re the one suffering.
Trauma and Chronic Pain
As touched on in our discussion about “Big T” and “Little T” trauma, the lasting effects of significant trauma that triggers intense and damaging physiological responses can become clear decades later. While some trauma survivors may identify the single moment that led to their issues, others may be unaware that seemingly insignificant occurrences have actually left permanent scars.
This is particularly true for people whose chronic pain surfaces years after the person thinks they’ve “moved on” from adverse childhood experiences. Considering that the pain often manifests itself in the back, neck, and/or shoulders — areas that can be just as easily affected by stress, posture, or just the grind of daily life — people are likely to blame that pain and discomfort on a number of other factors rather than connecting their symptoms to the trauma.
PTSD and Avoidance
Aside from the devastating physiological impact of traumatic experiences, people who have been involved in an accident or have been injured as a result of abuse may push dealing these issues to their peripheral — or ignore them altogether — in order to not have to suffer the psychological consequences of addressing trauma. As we know, one of the three symptom clusters of post traumatic stress disorder (PTSD) is avoidance and when someone has trauma around an injury, avoiding certain movements or behaviors to avoid re-experiencing the trauma is an expected outcome.
However, this results in restricting movements and a host of chronic pain issues, including reduced circulation, muscle atrophy, joint issues, and “smudging the brain map” – or confusing the brain about where the pain is actually experienced. And because pain is actually a function of brain, believing you are experiencing pain means you are experiencing pain, and it can consume you.
“Pain can take over different areas of the brain when it becomes chronic. It can take over our cognitive centers, it will fire the movement areas so it will make us rigid and freeze. Pain occupies a lot of our resources,” says Dr. Michael Aquino, PT, DPT. He adds, “This is why a lot of patients will tell me that they’re fatigued and unable to think about other things”.
In addition to these types of traumatic events, people who undergo surgery for health issues are subjected to another type of trauma: medical trauma. As the National Child Traumatic Stress Network says, medical trauma, like any adverse life event, is a result of one’s subjective experience rather than the actual severity of the medical event. So identifying trauma in these cases it isn’t as easy as looking at their medical history, as a person’s experience undergoing a simple procedure like having their appendix removed could be traumatic for one person and not another.
The symptoms of a medical trauma are the same as that of childhood abuse or combat – avoidance, fear, anxiety, withdraw – so someone suffering from this type of trauma may avoid seeking medical attention even if they know they are experiencing pain or injury.
Trauma-Informed Chronic Pain Care
Understanding how trauma can contribute to chronic pain is the first step in healing from it and finding recovery from chronic pain. Rather than potentially slipping into a pattern of substance misuse and abuse by turning to medication as a means to reduce the discomfort, identifying and treating the cause — rather than the symptoms — can lead to a significantly better long-term outcome.
Programs like Roots Chronic Pain Recovery understand that the key to a better quality of life is to remove the fear around pain and movement, and address these underlying issues by reframing our pain experience. Using modalities like Cognitive Behavioral Therapy, Mindfulness Based Stress Reduction and Acceptance and Commitment Therapy, a holistic chronic pain recovery program like Roots help people shift their beliefs and understanding of pain, and take back control of their body.
For those who are already suffering from chronic pain — and possibly also using medications and other substances to treat it — turning away from what has worked in the past in favor of an entirely different method of therapy can be a scary proposition. Wrap that in with years or decades of misdiagnoses and mistreatment, and it can seem like an impossible mountain to climb at this point, which is exactly why facilities like Roots Chronic Pain Recovery are changing the way we talk about chronic pain.
With personalized and meaningful therapy, increased movement and exercise, and integrated care, even the most severe trauma and chronic pain can be worked through with time. By identifying and addressing the roots causes of pain and overcoming the co-occurring mental health and substance use issues, Roots Chronic Pain Recovery helps with every step of the journey. Whether it’s stress-related, a work place injury, or stemming from an earlier trauma, getting help for your chronic pain can not only improve your quality of life, but save it in the long run.
Call us today at (562) 473-0827, or fill out the form below to have one of our specialists contact you.
In past articles and our most recent article on trauma, we have mentioned the impact that Adverse Childhood Experiences, or ACEs, can have on an individual. While it wasn’t long ago that we figured it out, there is a great deal of research supporting the notion that one of the key contributing factors to substance abuse, mental health and other behavioral disorders is childhood trauma. Adverse Childhood Experiences, known widely as ACEs, are common and seemingly passive experiences that one may have as a child, that, when occurring repeatedly or in combination, have a devastating impact on a person’s development and long-term health.
When an Adverse Life Event takes place during one’s life in later adolescence or as an adult, the connection for the survivor to make between the traumatic experience and their future issues can be clear. Whether it’s a singular “Big T” trauma or a series of less severe “Little T” traumatic events, the link between these experiences and a person’s behaviors can often be made easily. For example, a 58-year-old man who recently went through a divorce, was laid off and then lost his house, might make the connection between these experiences and his increased drinking and isolation.
However, the link between ACEs and mental health or substance abuse issues that develop later in life can be more difficult, for a couple of reasons. For one thing, the mental health or substance abuse issues often don’t surface until years, or even decades, after the Adverse Childhood Experience occurs. What starts as general family dysfunction, divorce, neglect, or abuse may seem relatively normal through childhood and even into adulthood. The early signs and symptoms of a greater issue often manifest themselves as isolation, lack of trust, avoidance and other social and emotional issues before they ever develop into substance abuse or severe mental illness.
What are ACEs?
The notion of Adverse Childhood Experiences, or ACEs, began with the research of the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study. The study was conducted between 1995 and 1997 and studied nearly 17,000 Kaiser patients in a San Diego Health Clinic. Patient health was studied through physical exams and surveys of current health and behaviors, while they also completed surveys about childhood experiences. What this groundbreaking study was looking at was the link – which was not understood at the time – between childhood trauma and physical, mental and emotional health later in life.
The ten childhood experiences they were looking at were:
1. Emotional Abuse
2. Physical Abuse
3. Sexual Abuse
4. Physical Neglect
5. Emotional Neglect
Growing up in a household were there was:
6. Substance abuse
7. Mental Illness
8. Violent Treatment of a mother or step-mother
9. Parental Separation/divorce
10. An incarcerated household member
Participants in the study were then given an ACE Score between 0 and 10, the total sum based on how many of the 10 types of adverse experiences they reported experiencing.
The Findings of the CDC-Kaiser ACE Study
The ACE Score, from 0 to 10, is used to assess cumulative childhood stress – now sometimes referred to as “Little T” trauma or by association with this study – a person’s “ACEs”. One of the clearest and most widely understood finding of the study was that Adverse Childhood Experiences (ACEs) are more common than one might think, or thought at the time. More than half (52%) of the participants from the original CDC-Kaiser study reported having at least one ACE, and more than 1 in 5 (20%) reported exposure to 3 or more ACEs, while another 6.2% reported 4 or more exposures.
The most prevalent of the categories of childhood exposure was substance abuse in the household (25.6%); the least prevalent exposure category was evidence of criminal behavior in the household (3.4%). Another finding was that the susceptibility of a person’s exposure to multiple ACE categories, as the relationship between single categories of exposure was significant. If someone reported any single category of exposure, the probability of exposure to any additional category ranged from 65%–93%; and then not surprisingly, the probability of more than two additional exposures ranged from 40%–74%.
The key finding of the study as it related to health outcomes, and which changed the way we understood childhood trauma, was that as one’s ACE Score increases, so does the risk for serious diseases and conditions, including:
Alcoholism and alcohol abuse
Illicit drug use
Depression and other mental health issues
Health-related quality of life
Heart and liver disease
Poor academic achievement
Poor work performance and financial stress
Risk for intimate partner violence
Multiple sexual partners
STDs and unintended pregnancies
Risk for sexual violence and intimate partner violence
The increased risk for these negative health outcomes and well-being are dramatic. Compared to someone with an ACE Score of 0, a person with an ACE Score of 4 or more is:
18 times as likely to have attempted suicide
Twice as likely to have had two or more weeks of depressed mood in the past year
Nearly 5 times as likely to have ever used illicit drugs
More than 11 times as likely to have ever inject drugs
More than 5 times as likely to be an alcoholic
How are ACEs Linked to Health Issues?
There is a large and growing body of research about how childhood stress and trauma affect brain development, brain chemistry and, thus, the regulation of the body’s emotional, stress and fear response systems are impacted. Repeated stress and activation of these systems of the brain dramatically alter the formation of myelinated axons and the amygdala, the part of the brain that activates the autonomic nervous system (ANS) and releases hormones like adrenaline and cortisol into the body. If you’re walking through the woods and see a bear approaching, or you see a kid walking into oncoming traffic, the activation of this system is very effective in increasing your heart rate, opening your airways, and increasing blood flow to your organs and muscles, and away from certain parts of the brain.
However, if the stress response system is activated every night by the sound of your dad coming home, or the sight of your mom reaching for a bottle of alcohol, your body and brain are hit with the same fight-flight-freeze response. The repeated activation of this system take a toll on your vital organs as well as your brain’s ability to regulate emotions and responses to triggers. When the body produces too much of, or stops producing, the natural chemicals to sooth or excite you, it is very common for people to turn to external stimuli to compensate this: depressants like alcohol and benzodiazepines, stimulants like cocaine and methamphetamine, or even behaviors like gambling and sexual intercourse.
Exposure to abuse and neglect also impact the prefrontal cortex, the part of the brain responsible for high level cognition and controlling impulse, and the nucleus accumbens, the brain’s pleasure-reward center which releases the body’s natural dopamine. The nucleus accumbens was first discovered in 1954 by two scientists when rats became addicted to pressing a lever that activated this part of the brain. The role of the nucleus accumbens and its connection to the amygdala and hippocampus have great implications in the study of psychiatric disorders, substance abuse and addiction, obsessive compulsive disorder and Tourette’s Syndrome, and more studies are being conducted.
The CDC-Kaiser study also found a “dose-response” relationship between ACEs and negative health and well-being outcomes across a person’s lifetime. A dose-response relationship is one where as the dose or intensity of the trigger increases, so does the intensity of the maladaptive behavior or response. For example, the more a person is exposed to abuse or neglect, the more severe the negative health outcomes will be.
Dr. Nadine Burke-Harris
One of the most notable cases of these results in action was the work of Dr. Nadine Burke-Harris, a pediatrician in San Francisco who was originally unaware of the CDC-Kaiser ACE Study. She noticed when she began working in a hospital in Bayview-Hunter’s Point, a low-income area of the city riddled with addiction and violence, that there was an abnormal number of children being referred to her for Attention Deficit Hyperactivity Disorder (ADHD). One of her colleagues made her aware of the ACE Study, which led her down a path of studying her patients’ exposure to trauma and how the brain and body were impacting their health. She subsequently started the San Francisco Center for Youth Wellness, where Dr. Burke-Harris made it routine to screen children for their ACE Score to better understand the risk factors of these youth across their lifetime.
See her TED Talk on How Childhood Trauma Affects Health Across a Lifetime:
Behavioral Risk Factor Surveillance System (BRFSS)
In 2009, the CDC began collecting annual ACE data through the Behavioral Risk Factor Surveillance System (BFRSS) from voluntary respondents telephonically. It is now the longest-running phone survey in the world. The BFRSS asks questions modified from the original ACE Study, from people across 32 states, using randomly dialed numbers. The data collected from the BRFSS are:
All ACE questions refer to the respondent’s first 18 years of life.
Emotional abuse: A parent or other adult in your home ever swore at you, insulted you, or put you down.
Physical abuse: A parent or other adult in your home ever hit, beat, kicked or physically hurt you.
Sexual abuse: An adult or person at least 5 years older ever touched you in a sexual way, or tried to make you touch their body in a sexual way, or attempted to have sex with you.
Intimate partner violence:2 Parents or adults in home ever slapped, hit, kicked, punched or beat each other up.
Household substance abuse: A household member was a problem drinker or alcoholic or used street drugs or abused prescription medications.
Household mental illness: A household member was depressed or mentally ill or a household member attempted suicide.
Parental separation or divorce: Parents were ever separated or divorced.
Incarcerated household member: A household member went to prison.
The findings of the BFRSS are similar to that of the original CDC-Kaiser ACE Study:
More than two-thirds of the participants reported at least one adverse childhood experience
More than 1 in 5 reported exposure to 3 or more ACEs
Similarly, they also found a dose-response relationship with ACE Scores correlated to an increase in the following:
Lowered educational attainment
Coronary heart disease
Treatment of Childhood Trauma
Understanding the role that adverse childhood experiences (ACEs) play in brain development and prevalence of addiction, mental illness and life-threatening diseases is a pivotal precursor to addressing these issues. Identifying and acknowledging the root of the issues is an important step in the recovery process, and only once a person can work through the lasting effects of exposure to Adverse Childhood Experiences can they truly recover. Because of the way these experiences embed themselves in our brain and body, the process of resolving them can take months or even years, but even the most complex trauma can be resolved with enough time and commitment.
Despite the acceptance of this research in the medical field, behavioral health professionals have been slower to integrate the identification and treatment of trauma into practice. It is important for someone who has been exposed to these adverse childhood experiences to find help at trauma-focused treatment programs like Roots Through Recovery, who utilize evidence-based approaches like Eye Movement Desensitization and Reprocessing (EMDR), Somatic Experiencing (SE), Mindfulness-Based Stress Reduction (MBSR), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and expressive approaches like music and sound therapy, trauma-focused yoga, and art therapy.