Recovery from ACEs (Adverse Childhood Experiences). Is it possible? Is it practical? Why not just let sleeping dogs lie? Many of us who suffered ACEs (myself included with seven ACEs) feel the effects of childhood trauma, neglect, and abuse in the form of increased risk of depression, anxiety, autoimmune diseases, fibromyalgia, cancers, chronic fatigue, and many others. Further, ACEs actually alter an individual’s DNA in real ways, as previously covered in my article 7 Ways Childhood Adversity Changes Your Brain (a response for HSPs). In that article I listed three main points, as outlined by author Donna Jackson Nakazawa.
- individuals with four or more ACE’s were twice as likely to be diagnosed with cancer than those with no ACE’s.
- for a person with a score of four or more ACE’s the risk of depression was 460% more likely than for those with zero ACE’s.
- an individual with six or more ACE’s might expect to have their life shortened by nearly 20 years.
If that wasn’t enough to capture our attention and demand that we focus on this issue I also covered Nakazawa’s review of ACE’s effects on the brain including:
- Epigenetic shifts in which the stress response is set to “high” for life through alterations in gene markers in the brain.
- Size and shape of the brain with a shrunken hippocampus leading to overreactions to minor stresses in life.
- Neural pruning in which chronic neuroinflammation owing to ACE’s predispose us to further issues as we face the adult world, which is often unforgiving of any individual who cannot simply “leave it at the door.” Many HSPs suffer in quiet and, in fact, may be suffering from inflammation in the systems of the body.
- Telomeres, which are the end caps of DNA strands. In those with ACEs telomeres are less able to prevent the unraveling of DNA strands, potentially leading to disease and premature aging.
- Default Mode Network in the brain experiences less connectivity leading the individual to be less capable of discerning what is relevant and what is not, often resulting in serious overreactions.
- Brain-Body Pathway – systemic, chronic inflammation from head to toe with lessened effectiveness of immune system responses.
- Brain Connectivity weakened with less connectivity between the prefrontal cortex and the hippocampus leading to greater levels of fear and anxiety in everyday situations.
Now I would like to cover a separate article by Nakazawa in lieu of publication of her followup to this article and relate it to HSPs. The article is titled 8 Ways to Recover from Post Childhood Adversity Syndrome and details a number of strategies that I think are worthy of consideration for HSPs.
Nakazawa observes “Science tells us that biology does not have to be destiny. ACEs can last a lifetime but they don’t have to. We can reboot our brains. Even if we have been set on high reactive mode for decades or a lifetime, we can still dial it down. We can respond to life’s inevitable stressors more appropriately and shift away from an overactive inflammatory response. We can become neurobiologically resilient. We can turn bad epigenetics into good epigenetics and rescue ourselves.” With this optimistic view let’s look at each of her 8 strategies and relate them to HSPs.
1. Take the ACE Questionnaire. The ACE questionnaire will tell you your ACE score and, thus your risk factor for any or all of the factors mentioned above. Vincent Felitti, co-founder of the ACE Study “When we make it okay to talk about what happened, it removes the power that secrecy so often has.” By our willingness to address our ACEs directly we are removing their emotional power over us and beginning the journey to healing. For HSPs I cannot imagine a better thing to do for ourselves if we suffered ACEs in childhood, and many did judging by my and other researcher’s statistics. It’s true that many people would rather the past stay in the past, as it were, and move on with life attempting to forget and forgive, but the aforementioned lifelong effects of ACEs may prevent our doing just that as we deal with the lingering health-related and emotional impacts of ACEs.
I, for one, have had cancer at a young age (44) and was lucky enough to catch it early. Whether the cancer was due to ACEs we will never know, but anything we can consciously do that will improve our health, including our emotional health, is certainly worthy of our time and attention. Take the ACE questionnaire if you have not and know your score.
2. Begin Writing to Heal.
“Think about writing down your story of childhood adversity, using a technique psychologists call “writing to heal.” James Pennebaker, professor of psychology at the University of Texas, Austin, developed this assignment, which demonstrates the effects of writing as a healing modality. He suggests: “Over the next four days, write down your deepest emotions and thoughts about the emotional upheaval that has been influencing your life the most. In your writing, really let go and explore the event and how it has affected you. You might tie this experience to your childhood, your relationship with your parents, people you have loved or love now…Write continuously for twenty minutes a day.”
When Pennebaker had students complete this assignment, their grades went up. When adults wrote to heal, they made fewer doctors’ visits and demonstrated changes in their immune function. The exercise of writing about your secrets, even if you destroy what you’ve written afterward, has been shown to have positive health effects (link is external).”
Keeping a journal can be a potentially useful way to practice self-therapy, while not having to divulge these intimate details to a stranger. I suggest taking Pennebaker’s advice and writing for at least 20 minutes per day detailing your ACEs. If you are middle-aged (like me) you will likely have some perspective on the event/s and greater wisdom than you might think possible. Most of us, by middle age, have raised children of our own and lived through many trying experiences and likely have a deep, rich perspective regarding how we were parented. Writing that out can be very therapeutic with real benefits. Give it a try!
“A growing body of research indicates that individuals who’ve practiced mindfulness meditation and Mindfulness-Based Stress Reduction (MBSR) show an increase in gray matter (link is external) in the same parts of the brain that are damaged by Adverse Childhood Experiences and shifts in genes (link is external) that regulate their physiological stress response. According to Trish Magyari, LCPC, a mindfulness-based psychotherapist and researcher who specializes in trauma and illness, adults suffering from PTSD due to childhood sexual abuse who took part in a “trauma-sensitive” MBSR program, had less anxiety and depression, and demonstrated fewer PTSD symptoms, even two years after taking the course.
Many meditation centers offer MBSR classes and retreats, but you can practice anytime in your own home. Choose a time and place to focus on your breath as it enters and leaves your nostrils; the rise and fall of your chest; the sensations in your hands or through the whole body; or sounds within or around you. If you get distracted, just come back to your anchor. Here (link is external) are some tips from Tara Brach, psychologist and meditation teacher, to get you started on your mindfulness journey.
There are many medications you can take that dampen the sympathetic nervous system (which ramps up your stress response when you come into contact with a stressor), but there aren’t any medications that boost the parasympathetic nervous system (which helps to calm your body down after the stressor has passed). Your breath is the best natural calming treatment—and it has no side effects.”
The practice of mindfulness has become something of a fad in the US, with good and bad press depending on its application, but the effects of developing and maintaining a contemplative practice are solid and HSPs should work assiduously to experiment with various practices to find one/s that work for them. Acknowledging that many HSPs may find it difficult to “calm the mind” due to the deep extent to which we process all experience combined with cultural conditioning to withstand a near constant stream of bombardment to our senses I suggest walking mediation or some other form of contemplative practice that serves the purpose of quieting your mind and focusing just on the most basic of life processes (the breath).
I would add to this advice that HSPs need to go beyond calming the mind to practicing a holistic self-care practice that is as deeply embedded as any spiritual practice. Very often we live far out of touch with our bodies and reside only in our minds unaware of bodily systems, until something breaks down. My advice is: address your diet, remove items like refined sugars, salt, and highly processed foods as much as practical. Get enough rest (sleep) each night, and associate with quality individuals who uplift you on a regular basis. This may be one or two close friends (probably normal and the top limit for many HSPs). Concurrent with positive associations with others work to remove negative individuals, narcissists, bullies, and other deleterious people from your life. You don’t need them if you have suffered ACEs and, frankly, life is far too short to waste our precious time on more suffering.
“When children face ACEs, they often store decades of physical tension from a fight, flight, or freeze state of mind in their bodies. PET scans (link is external) show that yoga decreases blood flow to the amygdala, the brain’s alarm center, and increases blood flow to the frontal lobe and prefrontal cortex, which help us to react to stressors with a greater sense of equanimity. Yoga has also be found to increase levels of GABA (link is external)—or gamma-aminobutyric acid—a chemical that improves brain function, promotes calm, and helps to protect us against depression and anxiety.”
Yoga, for those who do not know, is much more than the physical exercise poses so popular now. Yoga has been practiced for thousands of years and is primarily intended as a means of attaining a continuous state of peace of mind so one might truly experience oneself and unite with the universal. In Western countries Hatha yoga is primarily practiced for its physical benefits, but also for its inherent spirituality. For HSPs, developing a yoga practice might be ideal and is one that can be started at a lower level of exertion working up to more advanced poses. There have been some incredible health turnarounds in people who were formerly disabled. Too often we accept our health situation, but our bodies will only respond to as much as we demand from them.
Though yoga is one useful strategy I advocate that ANY form of exercise is going to likely yield similar results if practiced regularly. Our bodies are designed to move. There is no cure for many health issues except to get out and start moving! For those of us with ACEs the effects of physical exercise go far beyond healing our bodies and brains to improving our self-esteem, personal confidence, self-efficacy, developing an optimistic explanatory style, and improving our sex lives as our bodies become more “in tune.”
“Sometimes, the long-lasting effects of childhood trauma are just too great to tackle on our own. In these cases, says Jack Kornfield, (link is external)psychologist and meditation teacher, “meditation is not always enough.” We need to bring unresolved issues into a therapeutic relationship, and get back-up in unpacking the past. When we partner with a skilled therapist to address the adversity we may have faced decades ago, those negative memories become paired with the positive experience of being seen by someone who accepts us as we are—and a new window to healing opens.
Part of the power of therapy lies in allowing ourselves, finally, to form an attachment to a safe person. A therapist’s unconditional acceptance helps us to modify the circuits in our brain that tell us that we can’t trust anyone, and grow new, healthier neural connections. It can also help us to heal the underlying, cellular damage of traumatic stress, down to our DNA. In one study (link is external), patients who underwent therapy showed changes in the integrity of their genome—even a year after their regular sessions ended.”
Therapy with the right therapist can be very helpful, even life changing, but with the wrong therapist a total waste of time. Few psychologists/psychiatrists acknowledge or appreciate the role sensory processing sensitivity may play in the lives of HSPs. The number is increasing as awareness increases, but finding the right relationship with a trusted therapist can be a tricky, and frustrating, experience. That being said, working through ACEs with a skilled therapist can the quick way to healing. It is true we can work on ourselves through reading and researching, but a trained and experienced psychologist, or other therapist, has likely seen hundreds of people with similar issues and knows how to help you best.
Should you be on psychotropic medications? That will vary with each person. Some will benefit, while others may find the side effects to be too troubling. Are they worth experimenting with to ascertain their potential benefit? Possibly, but proceed with extreme caution as many drugs are highly addictive and difficult to monitor. My advice would be to consult with a skilled psychiatrist regarding these types of medications and, even then, to remain on them only as long as beneficial. Psychotropic medications are not meant to be utilized for a lifetime, yet many are on them for better or worse. It’s an individual decision, of course, and one that should be made in concert with the best psychologist, family doctor, and psychiatrist available. Complement that with an awareness on the part of your loved ones regarding your planned course of medication therapy so they know and understand how your behavior and demeanor might change. As with any medication you must take them as directed or they will not reach full effectiveness the way your doctor intended.
6. EEG Neurofeedback
“Electroencephalographic (EEG) Neurofeedback is a clinical approach to healing childhood trauma in which patients learn to influence their thoughts and feelings by watching their brain’s electrical activity in real-time, on a laptop screen. Someone hooked up to the computer via electrodes on his scalp might see an image of a field; when his brain is under-activated in a key area, the field, which changes in response to neural activity, may appear to be muddy and gray, the flowers wilted; but when that area of the brain reactivates, it triggers the flowers to burst into color and birds to sing. With practice, the patient learns to initiate certain thought patterns that lead to neural activity associated with pleasant images and sounds.
You might think of a licensed EEG Neurofeedback therapist as a musical conductor, who’s trying to get different parts of the orchestra to play a little more softly in some cases, and a little louder in others, in order to achieve harmony. After just one EEG Neurofeedback session, patients showed greater neural connectivity (link is external) and improved emotional resilience, making it a compelling option for those who’ve suffered the long-lasting effects of chronic, unpredictable stress in childhood.”
This option, for HSPs, may be intriguing, but the availability of EEG Neurofeedback may be an issue for many. In addition to the potentiality inherent in the EEG Neurofeedback technique I suggest that, once an individual has developed and is maintaining a strong self-care practice (including a contemplative practice) it is likely the ability to control overreactions and calm the mind will increase commensurately. Many times, for HSPs, we feel the emotion flaring as soon as we are stimulated, the difference is in our ability to quiet the intensity of the emotion, which is often anger. Through the practices outlined thus far I think it is likely a dedicated practitioner of self-care will have some ability, over and above a person who has not developed a contemplative practice or engaged in self-care to the extent I have advocated for, to moderate the intensity of a given emotion and self-sooth. Learning to observe an emotion without reacting, as often advocated in mindfulness practices, is a difficult process, but well worth the effort.
7. EMDR Therapy
“Eye Movement Desensitization and Reprocessing (EMDR) is a potent form of psychotherapy that helps individuals to remember difficult experiences safely and relate those memories in ways that no longer cause pain in the present. Here’s how it works: EMDR-certified therapists help patients to trigger painful emotions. As these emotions lead the patients to recall specific difficult experiences, they are asked to shift their gaze back and forth rapidly, often by following a pattern of lights or a wand that moves from right to left, right to left, in a movement that simulates the healing action of REM sleep.
The repetitive directing of attention in EMDR induces a neurobiological state that helps the brain to re-integrate neural connections that have been dysregulated by chronic, unpredictable stress and past experiences. This re-integration can, in turn, lead to a reduction in the episodic, traumatic memories (link is external) we store in the hippocampus, and downshift the amygdala’s activity. Other studies have shown that EMDR increases the volume of the hippocampus.
EMDR therapy has been endorsed by the World Health Organization as one of only two forms of psychotherapy for children and adults in natural disasters and war settings.”
EMDR seems to offer great promise for HSPs, though it may also prove to be quite traumatic in reliving memories the risk is likely worth the effort if we can reverse some of the damage to key area s of the brain and improve well-functioning. Again, the locating of a trusted therapist would be crucial to such an undertaking because we HSPs experience the emotions associated with ACEs more deeply and it feels very vulnerable to expose ourselves in such ways. Knowing the individual we are working with understands sensory processing sensitivity and our likely responses to therapies will help make the process/es more useful and less frustrating.
8. Rally Community Healing
‘Often, ACEs stem from bad relationships—neglectful relatives, schoolyard bullies, abusive partners—but the right kinds of relationships can help to make us whole again. When we find people who support us, when we feel “tended and befriended,” our bodies and brains have a better shot at healing. Research has found that having strong social ties (link is external) improves outcomes for women with breast cancer, multiple sclerosis, and other diseases. In part, that’s because positive interactions with others boost our production of oxytocin, a “feel-good” hormone that dials down the inflammatory stress response. If you’re at a loss for ways to connect, try a mindfulness meditation community or an MBSR class, or pass along the ACE Questionnaire to family and friends to spark important, meaningful conversations.”
Mentioned before, but the role of positive others in our lives plays a significant role that cannot be overemphasized to HSPs. Though most of us need a good deal of alone time to recharge and process we also need to be bonded to trusted others. Finding such friends is perhaps easier said than done, but the rewards are immediate in the body. Creating and nurturing healthy relationships is, and should be, a key strategy on our path to healing from ACEs.
Though this article can only hope to begin the conversation surrounding ACEs and HSPs it is at least clear that there is hope in mitigating the lingering effects of ACEs. As more strategies become available I will, of course, pass them along to all HSPs with my considered thoughts on each technique. For now, the above mentioned strategies provide us with a starting point each of us should explore as we begin our oath to healing and, eventually, to thriving.
Tracy Cooper, Ph.D. is the author of Thrive: The Highly Sensitive Person and Career. Dr. Cooper appeared in the new documentary movie Sensitive – The Untold Story and provides consulting services for HSPs on the topics of career and the sensation seeking HSP. His web site may be found at drtracycooper.com.