Lourdes Follins, Meliora Consulting LLC
Adverse Childhood Events And Trauma-Informed Care
Close relationships are critical to health. For children, those are relationships with parents, for adults the circle is wider—parents, partners, children and other loved ones. What happens in those relationships, the support and security that we provide for one another, and the stress and harm we do one another, are a powerful in?uence on the health of our bodies.
When I think about adverse childhood events and trauma aware practice, when it comes to African Caribbean and Black communities, and for the rest of my talk I’m just gonna say Black or ACB because it’s faster it’s quicker and I’ve only got five minutes. I think it’s really important to remember there are a few things about that study, or a couple of things about the ACE study from the mid-1990s. Right. So Robert was spot-on when he said it’s dated. So we’re talking about 1995, 1996, 1997, when for Ludie and his colleagues collected that data.
Two things stand out to me besides the datedness of it. One is that they’ve looked at incidents that occurred in the home, they disregarded the world outside, it was strictly focused on what happened to you under the age of 18 at home, also 76 percent of that sample was white. Okay. 76 percent of that sample was white and since we’re talking about Kaiser Permanente, we’re talking about a group of people who have health insurance, which in the States where I’m from, is huge. There are so many of us in the United States that don’t have health insurance. Because we don’t have it through our jobs, or we don’t have it through the federal government. So that’s important. Those are two things that I think are really important when we look at the findings.
And so when it comes to the type of adversity that Black or ACP communities in Canada, as well as the States struggle with, we can’t just look at what’s happening at home. We’ve got some colleagues in Philadelphia, Chron home for example, who published a study in 2015 that actually looked at both conventional ACEs, you know what Robert talked about, as well as expanded ACEs. And so some of these expanded ACEs are things such as experiencing racism, and racial microaggressions. Witnessing violence in one’s community, living in an unsafe neighborhood, and remember most people don’t live in unsafe neighborhood because they want to. There are no other opportunities for them. Also experiencing bullying, and having a history of either being in or being involved with the child welfare system.
And so when we’re talking about Black communities whether it’s in Canada or in the States we have to also think about the fact that these are people who are living in what I call historically white or predominantly white countries. And so having to you know deal with whatever is happening at home, and then also then leaving your home. So dealing with xenophobia, dealing with anti Black racism, dealing with Misogynoir. Who knows what Misogynoir is? I see a couple hands. What does it it mean? Okay. So you didn’t hear any of that sexiness that he just said. So I’m gonna give it to you again. Essentially. So can you say it louder. You want to say it is the racism that Black women experience. So basically, hatred or dislike of Black women. That was sexy. I just made it simple.
Also, most people use the term poverty. Once I went to Nigeria I stopped using the word poverty. Now I say financial deprivation. Because poverty infers that it’s something that you’re doing, or something you’re not doing for yourself. As opposed to looking at how your government, your country creates situations whereby you don’t have enough. Whereby you have food insecurity. And so we look at ACEs in Black communities we definitely need to look at the conventional ACEs, but we do them a disservice by not asking about okay so what happens when you leave your home? You know under the age of 18. How much racial microaggressions do you experience? Or you know. How often do you expect? Because also not just experiencing racism but also anticipating racism is very distressing.
So if you’re going to anticipate it, because you’ve experienced it, or your parents have, you know warned you about it. When you go to school, whether it’s elementary school, high school, grad school, etc… Or if you’re living in a predominately white neighborhood. And you’ve already got financial deprevation happening at home. Thank you. But then you go out into the community, to look for work. That causes undue stress which then impacts health outcomes. I’m a psychotherapist, as well as a behavioral researcher, so I have the privilege and the joy and the honor of working with people way after the fact. I wouldn’t say I come late, well I wouldn’t say late because what I do it’s trauma aware practice, and so as someone who’s trained in traditional psychoanalytic therapy as well as EMDR.
So eye movement, desensitization and reprocessing, that is a trauma aware practice, that’s strategically designed to kind of reboot the brain. As one of my clients says, Oh so we’re dismantling trauma. I said yeah, that’s what we’re doing. That’s exactly what we’re doing. So we’re helping the brain heal itself, in a way that so that when people think about the trauma or the traumatic experiences that they’ve had, they don’t have the same reaction to it. Which means the health outcomes improve. I would also do a disservice by not mentioning trauma-informed CBT. Some people also use that and find it very effective with people regardless of the ethnic racial background, but I implore you, when you work with your clients, regardless of ethnic racial background, but especially those who are from African, Caribbean, and Black communities. If you don’t ask about their entire lives, the totality of their lives.
If you act as if you are colorblind, which you know is very effective. Right. You dismiss their reality, and that’s insulting. As well as harmful. And it perpetuates what the systems have already done to them. So I implore you not to just look at the conventional ACEs, include expanded races, include conversations about xenophobia. So when you arrived in this country what kind of experiences did you have? Or let’s say your ancestors have been here since the 1800s because we know Black people have been in this country since the 1600s but did people assume you just came off a plane? You need to ask those questions because then without looking at the entire totality of their lives you won’t understand everything and that trust will not be built. So with that I wish you good luck. [applause]