CAUTION: Content may be upsetting to some readers.
It was a sweltering day in the summer of 1987 in Limestone County, Alabama. The air, thick with humidity, sapped what little strength remained from already heat-wearied bodies, the chittering of bush crickets rising as the sun sank.
Following 11 hours of clearing hillside with a sling blade at the Elk River State Park, I let my thoughts wander while resting my right arm on the window frame of my father’s pickup truck, grateful for the air rushing against me. He and my stepmother, Louise, were continuing a disagreement they’d begun some time earlier about the whereabouts of a frying skillet.
The combination of fatigue and stifling heat dulled my usual hypervigilance around my father, so my response to Louise’s seemingly innocent question, “Don’t you remember your Daddy using the skillet last?” was unusually honest and unfiltered.
Absentmindedly, I replied, “I think so.”
Suddenly, the lap-belt compressed against my waist as my body lurched violently forward, then quickly snapped back. My dad, trying to hit me while leaning over Louise, screamed, “You calling me a liar! I’ll f—ing kill you, boy!” Louise pleaded with him to calm down, and screamed at me to get out of the truck.
Fueled by adrenaline, I hopped over a roadside fence and ran at breakneck speed across a heavily vegetated field. I could hear my father screaming obscenities and threats as Louise begged him to stop. I heard Louise’s panicked cry, “Run! Run! Oh my sweet Jesus, he’s going to kill you! Run!” The next sound I heard was bullets flying past me.
Louise saved my life that day, of that, I have no doubt. She would lose her own life, violently, seven years later, shot twice.
This traumatic experience, and others too numerous to recall, left an indelible mark on me. Two and a half decades later, I took the Adverse Childhood Experiences1 (ACES) questionnaire and began to understand trauma’s enduring impact on my life.
The ACEs study was a self-report questionnaire administered to more than 17,000 members of Kaiser Permanente in San Diego. It asked participants if they had experienced abuse, neglect, and household dysfunction prior to their 18th birthday. Scores range from 0 (no ACEs) to 10 (each ACEs), and the results were used to determine if there was any correlation between adverse childhood experiences and adult physical and behavioral health difficulties.
My ACE score is 10.
How has that score played out in my life?
I was expelled from the fifth grade for repeated schoolyard fights. I was arrested for arson at 10 years old. I was arrested for assault at 14. I dropped out of high school at 17. I abused alcohol my first two years of college. I attempted suicide five times. I was diagnosed with major depression, bipolar disorder, borderline personality disorder, post-traumatic stress disorder, and a few other diagnoses along the way. I was hospitalized, voluntarily and involuntarily. I was placed on numerous psychiatric medications. I also underwent electroconvulsive therapy.
None of these behaviors, diagnoses, or treatments would surprise experts in the field of childhood trauma. It was, in fact, one such skilled clinician who helped me continue my long, but rewarding, journey of recovery.
How has a trauma-informed approach paved a healing path for me?
My therapist, Paula, recognized the effects of my experiences as adaptations to extreme circumstances, not symptoms of a disease. She realized these were normal responses to abnormal situations; they once served an important role in keeping me alive, but now they were preventing me from living successfully. Moreover, she recognized the tell-tale signs of ACEs by “thinking trauma” and responded to my treatment and care needs based on this understanding. Finally, she actively sought to avoid circumstances that might lead to my retraumatization.
Paula practiced the Six Principles of a Trauma-Informed Approach2
- She worked with me to establish a sense of safety in the environment, between us, and inside of me.
- She practiced transparency—sharing what she was doing and why she was doing it—which built a trusting relationship.
- She encouraged my use of peer support, connecting with others who have had similar life experiences to decrease my sense of isolation.
- She identified the cultural context and intergenerational aspects of my trauma to increase her sensitivity and deepen my understanding.
- She explicitly recognized my expertise and leadership in the healing process. From day one, she made it clear that therapy would be a collaborative process, something we did together, not something she did to me.
- Finally, she maintained a focus on empowering me to make my own choices and to express my voice in every step of the healing process.
Adverse Childhood Experiences or later-life traumas can leave a lasting impact on our lives, but they don’t have to dictate our destinies. People need to understand that we are not broken people, damaged goods, or inherently flawed. Rather, we are affected by past events not of our own choosing. Through this mindset we can begin to write a new narrative, a narrative based on empathy, compassion, acceptance, and nurturing.
This is where healing begins.
1. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. Felitti, Vincent J et al. American Journal of Preventive Medicine , Volume 14 , Issue 4, 245 – 258
2. SAMHSA Trauma and Justice Strategic Initiative. (2014 July). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. Retrieved from http://store.samhsa.gov/produc…_20141008_SMA14-4884
Written by Malcolm Aquinas