The Odds Are Ever in Your Favor

Tina's life isn't a train wreck.  It's a ship wreck.  The Titanic being sunk by the Hindenburg on D-Day.  Only without the DiCaprio spreading his arms to the sky to that cloying Celine Dion power ballad part.

Tina had it rough from the start.  Her addicted parents fought violently, then divorced abruptly, ultimately leaving her prey to a pedophile neighbor who shacked up with her mom for drugs.  She went to foster care for a spell, then returned home in time for him to get out of prison and reoffend, rending her an indistinguishable pulp of truancy, alcohol abuse, noxious relationships, unplanned pregnancies and chronic physical pain.  Her children, at least one of them a product of acquaintance rape, have been taken away by the state for neglect and returned to her several times.  She loves them dearly but cannot get her head above water long enough to stop them from being taken away again.  And again.  She knows she's repeating her own mother's patterns like a script written generations before she was born, but she doesn't have the foggiest idea where to begin to piece together a more stable life.  She doesn't even know if she can keep the power company from shutting off the electricity tonight.

Tina isn't the next guest on The Jerry Springer Show.  She's a composite of dozens of mental health therapy clients I've participated in treating during my 15 years in the social services field.

Tina scored a whopping 9 on the ACE assessment, the highest score possible.  So did her currently and chronically incarcerated husband.  This is not a good thing, like getting a perfect 1600 on the SAT or a 9 in the Olympic ice skating trials.

It is, in fact, a very bad thing.  A high ACE scores portends an alarmingly poor physical and mental health prognosis.  Read: heart disease, cancer, obesity, addiction, stroke.  The saddest part of all is that the Adverse Childhood Experiences (ACE) assessment is a measure of significant health risk factors associated with early childhood neglect, abuse and other adversity.  The unfair truth is, the more bad shit you went through as a kid, the worse your adult health.  So says the ACE study.

Except that there are always exceptions, perhaps more than are given fair credit.  Many of our world's leaders and role models might themselves have had high ACE scores had they been given that assessment by a family doctor, cleric or counselor.  The late Pulitzer-nominated poet Maya Angelou's beginnings were not completely unlike Tina's, only she wrote best-selling memoirs, won several Grammys and read her verse at a presidential inauguration.  That very president might have a high ACE score and yet, despite robustly-publicized personal issues, served as leader of the free world for two terms.

I, too, have a high ACE score.  But you probably wouldn't know it from looking at me or talking to me.  Or reading my medical records.  Or my resume.  I do not believe this is because I am particularly awesome or special.  (I am certainly neither poet nor president.)  I believe it is because of the unfreakinbelievable odds that were ever in my favor.  The countless synchronicities and kindnesses, forgivenesses and generosities that have embraced me at every turn.  In the shrink biz, we call these protective factors.

According to the Centers for Disease Control, which spearheaded the initial ACE study with Kaiser Permanente from 1995-1997, "protective factors are individual or environmental characteristics, conditions, or behaviors that reduce the effects of a stressful life."  The CDC website asserts that such mitigating variables "increase an individual’s ability to avoid risks or hazards, and promote social and emotional competence to thrive in all aspects of life, now and in the future."

So, what were these emotional talismans that staid my hand from the perilous choices that would have inevitably lead to a life of certain disaster?  Let me count the ways:

There was the loving extended family that stood in for my parents while they navigated a brutal divorce when I was a baby, making sure I was fed and burped, bathed and diapered, sung to and soothed.  There was the close-knit neighborhood where families knew each other and babysat each other's kids and planned block parties and carpooled to little league, the surrogate parents I turned to time and again for shelter and solace.  There was the fact that I was as gifted at academics as I was dismal at sports and thus developed an identity as a "smart girl" at a young age, which offered me a sense of purpose and hope.  There was my natural extraversion, which fit well into the tropical urban environment where I was raised and kept me laughing when depression threatened to Gorilla Glue me to the couch with seventeen blankets pulled over my head.  There was the honest mentor who begged me never to try hard drugs because "you'll love them so fucking much you'll never want to stop."  There was my ability as a promising young writer that led to a sustainable career.  There was the false HIV positive in college that scared me straight into healthier relationships with caring partners unafraid of commitment.

All of this didn't mean that I didn't have some serious hell to go through as I worked to address each of those risk factors outlined by the ACE assessment - risk factors that include parental separation or divorce, caregiver substance abuse or mental illness, physical, emotional or sexual abuse, family member incarceration.  This is the sort of personal history that people like Tina and I are still unpacking.  After a dedicated period of time in ICU-style psychotherapy, things do settle down for many of us and we can begin rebuilding our lives.

In fact, my clinical recommendation is that people with substantial trauma or loss in their background don't wait until life returns to "normal" to actually get a life because healing is about a new normal.  (We actually don't want the old normal, or why bother to invest in getting help at all?)  Unless your emotional symptoms are so severe and disruptive that you truly can't function for a time, in which case you may require inpatient treatment, there is no reason not to keep plugging away at your degree or continue working at your job or take up a hobby or plan a nice trip somewhere special, even as you make a significant commitment of time, energy and resources at the beginning of your recovery process.  There is also no reason not to do something fun and creative every day, just to remind yourself that there is more to life than suffering.

Once that front-loaded initial investment in treatment starts to pay dividends, we might find ourselves more able to relax and trust that our lives are no longer in constant drama as we successfully self-regulate, change old negative patterns and make better choices.  And we might find that we are beginning to recover toward, and not merely from, something.  We often find ourselves more portable and socially flexible, better able to enjoy diverse experiences, places and people.  We may discover long-hidden talents and emerging interests that do more for us than just relieve our pain.  They delight us. They might even define us, perhaps more than our suffering ever did.

And then there are those times, which happen to everybody, when life rocks our world and the old feelings, perceptions and beliefs may come home to roost.  Those are the times to slow down and break life down into bite-sized pieces. They are the times to batten down the hatches and get extra high quality rest, hydration, nutrition and movement.  To reach out and strengthen our reliance on a healthy support system.  To stay in our pajamas longer and treat ourselves to massages more often and go back to therapy.  Twelve-steppers call this "getting back to basics," an approach that can be extremely effective during periods of vulnerability or reactivation.

We needn't be surprised if some of our symptoms reemerge during those periods.  As with any former injury, old aches and pains can rear their heads amid a susceptible context, the way a previously broken ankle may act up during a rainstorm.  This does not at all mean that the hard work we have done to resolve our losses has been for naught.  We and our treatment have not failed.  What we may need is a tune up, a temporary return to the therapies and other resources that helped us in the past.  How temporary is a case-by-case determination, but there is no shame in taking all the time you need to feel resilient again and no gold medal if you get there more quickly than anyone else.  This is about quality, not quantity - most importantly the quality of your life, internally and externally.

Sometimes this may be a more grueling process than others.  Sometimes what worked to ameliorate our symptoms in the past doesn't quite do the trick this time.  And sometimes there is just no way out but through, and there is just no amount of positive thinking or plan of action or spiritual practice that can exempt us from simply experiencing whatever it is we need to experience. That is no reason to give up and accept a life sentence of emotional reactivity and dysregulation.  When it comes to your recovery, don't take no for an answer.  As they say, don't give up five minutes before the miracle.

And whatever you do, don't go it alone because trauma loves to divide and conquer.  To know we are deeply loved, that we have a place in this world no matter what is happening, this makes all the difference.  My myriad protective factors have proven this to me time and again.  And, perhaps without your knowing it, so have yours.

My mother once told me that, when her family moved back to the U.S. from Hispaniola, where she grew up until age 14, she sometimes could not relate to cultural references her high school friends would make because she did not grow up with the same songs, games, books, commercials, etc. As she jokingly put it, "How can anyone be from Haiti and be normal?"

I sometimes make reference to this when a client asks me whether they will ever "get over" a significant trauma. I tell them it's kind of like growing up in a foreign country - you may sometimes not relate to certain things the way many of those without that experience do. It will always inform your perceptions, emotions and decisions in some way, even after it stops ruling your life. You may still speak with a slight accent on certain words. You can no more erase it than you could erase growing up in, say, the Caribbean.

And that's not a bad thing, as long as you can use your experience as fodder for creating something beautiful in the world.  We aren't meant to go back to the way we think we would've been had that "horrible thing" never happened. We are meant to move forward with all the wisdom we have gathered from it.