ACEs: Can You Heal From a Traumatic Childhood? (Part 1)

Can you truly heal from a traumatic childhood? Dr. Christina Bethell explains why your past shapes you but doesn't have to define your future. In this episode of Recoverable, we dive deep into the groundbreaking research behind Adverse Childhood Experiences (ACEs) and the "medicine" of Positive Childhood Experiences (PCEs).

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We explore the 10-question ACEs screener and why factors like emotional neglect are often the most underrated drivers of adult disease. Dr. Bethell shares her powerful personal story of growing up in the mid-60s amidst addiction and neglect, proving that even with a high trauma score, "flourishing" is possible through connection and emotional safety.

Our guest, Christina Bethell, PhD, MPH, MBA, is a Professor at Johns Hopkins University and the founding director of the Child and Adolescent Health Measurement Initiative (CAHMI). Her work has revolutionized how we view relational health as the cornerstone of well-being. Whether you are an adult seeking healing or a caregiver looking to protect a child, this conversation provides a research-based roadmap for recovery.

If this episode resonated with you, please subscribe and share it with someone who needs to hear that they matter.

⏱️ Chapters:
00:00 – Meet Dr. Christina Bethell
02:52 – What are ACEs and how do they impact us?
04:02 – Why were these 10 specific ACEs chosen?
09:51 – The long-term impact of feeling unloved
23:16 – Does the age trauma happens change the impact?
25:11 – What should you do if you have a high ACEs score?
28:23 – The Science of Positive Childhood Experiences (PCEs)
37:58 – How PCEs buffer the effects of a traumatic past
58:20 – How can we help others heal from trauma?
01:01:06 – What does "flourishing" actually look like?

❓ Questions the Video Answers:

What are Adverse Childhood Experiences (ACEs)?

How do ACEs affect long-term physical health?

What is the "positivity paradox" in trauma healing?

Can you heal from a high ACEs score as an adult?

What are the 7 Positive Childhood Experiences (PCEs)?

Why is emotional neglect as damaging as physical abuse?

How does a parent's addiction impact a child's brain?

Can one caring adult change a child's entire life trajectory?

What is "developmental trauma disorder"?

How do "mirror neurons" affect children witnessing conflict?

Why is high school belonging such a strong protective factor?

What is the neurobiology of "presence"?

How do we move from "fixing" to "connecting"?

What are the four different ways we measure flourishing?

Is a high ACEs score a guarantee of future illness?

#childhoodtrauma #resilience #mentalhealth

Transcript

SPEAKER_00 0:00

There's a lot of pain in watching suffering that you can't fix.

SPEAKER_01 0:04

Dr. Christina Bethel is a professor at Johns Hopkins University in the Bloomberg School of Public Health. Dr. Bethel's research has shaped the conversations on adverse and positive childhood experiences, advancing public health outcomes for children, families, and communities.

SPEAKER_00 0:20

Other people can tell you as much as they want. You're good, you matter, it's okay, but you have to have something inside of you that believes it for you for it to become neurobiologically true.

SPEAKER_01 0:36

Welcome to Recoverable. I'm your host, Terry McGuire. Today we're going to dive into a topic that sounds kind of clinical on the surface, but I promise you it is as human as it gets. Usually we jump right into the top searched questions, but today we're going to do things a little bit differently. We're going to take this episode to lay a real foundation for those questions and explore childhood experiences, both good and bad, that impact us into adulthood. We're here with Dr. Christina Bethel. She is the expert who helped the world realize that ACEs are adverse childhood experiences which shape us but do not have to define us. Dr. Bethel's groundbreaking research into positive childhood experiences or PCEs is a game changer. It proves that connection and emotional safety are actually the medicine that helps our brains and bodies heal. So whether you're wondering if you can heal from a traumatic childhood or if you're looking for research-based information on how to protect children in your life, this is a conversation you do not want to miss. Dr. Bethel, thank you so much for joining us. I'm very looking forward to hearing from you.

SPEAKER_00 1:37

It's absolutely amazing also to be able to talk with your audience and get the word out.

SPEAKER_01 1:42

Absolutely.

SPEAKER_00 1:42

It's important to know.

SPEAKER_01 1:44

Your credentials speak for themselves. They're amazing. I would also like to hear a bit about you as a person and whether your childhood experiences impacted the route you took and the research you've done.

SPEAKER_00 1:55

Absolutely. I mean, I think just like everyone, your childhood experiences do define you. If you haven't peered into why that might be, then you might not see it. But if we are, if we do, we'll all find it. For me, I was um partly cultural. I was born in the mid-60s in low-income housing, kind of low-income area in LA, and it was a big party town. So my childhood was filled with drug and alcohol addiction from pretty much day one and all of the outfalls of that. Um, the neglect, the abuse, the things like that. I didn't know any different. And yet I had something also, it was a very spiritual time. People were talking about love and, you know, the what was it, the Woodstock love era. I was also exposed to all that and all the music and the Beatles. All you need is love was like going in my brain all the time. And so I had this dichotomy of those exposures, but also a sense that there was something possible. And I think that really set me up to keep looking for how we could foster the good and the possible in the midst of what's hard. Very hard sometimes.

SPEAKER_01 2:56

So let's start with the definitions. What are ACEs and how do they impact us both as children and adults?

SPEAKER_00 3:02

Okay, great. So adverse childhood experiences or aces are a set of experiences that represent many other possible experiences, but they're ones that have evidence that are connecting them to biological, neurobiological impacts on childhood and adult well-being. So they their abuse, so sexual abuse, physical abuse, sexual abuse. Also, neglect is equally difficult. Emotional neglect being one of the underrated aces that is highly associated with cardiac disease, not being actively nurtured. So emotional neglect and emotional abuse, being told you're bad, you're wrong. So those are very impactful. And even some with physical abuse who didn't have emotional abuse do a lot better. So it's often the emotional neglect and abuse that doesn't get as much attention. So I just want to emphasize that. And then the other is household dysfunction that can block the safe, stable nurturing relationships we need to thrive, like mental health, um, addiction, and drug and alcohol use that keep parents from connecting with their children in the ways that we need to thrive. So it's physical abuse or abuse, neglect, and household dysfunction.

SPEAKER_01 4:12

You already talked about some of these and did a good job of explaining that, of course. But I want to go through the actual ace questionnaire so that people understand what specifically. Now, this version of it has an or. So as I start to read those, you tell me if that's the way you would like to approach this or not. Did a parent or other adult in the household, this is your first 18 years of life, often swear at you, insult you, put you down, or humiliate you, or act in a way that made you afraid you might be physically hurt. Curious as to why these specific things were chosen and why they matter. I mean, although it's pretty clear.

SPEAKER_00 4:43

So 10 aces are in the ACES questionnaire. There could be many, many other things. And when you want to create a screener, you have to make it short. And so you try to go with the things that represent the different big domains like abuse, neglect, household dysfunction, that also have evidence to them that represent lots of other things. Okay. So we have 10 things, but there could be 200. But anyone with any of those 200 have at least one of these 10 because they travel in herds. 85% of ACEs are co-occurring, meaning if you have one, you are likely to have another. So that's part why we can make it so short. But basically, when you are in a situation where your caregivers in particular, who are supposed to love and support you, puts you down, your lack of sense of belonging and safety, which is very much animalistic. We need to belong. We're helpless as children, even pretty far into our lives. And I would say, even as adults without each other, we don't do well at all. So we need each other. And the threat that occurs in the brain and the body. So the uh stress hormones go up. It affects the amygdala. You go into fight or flight. And when you stay there and get stuck there with trauma, you can get stuck there. Without buffers, then it starts to literally deteriorate brain development, identity development, a sense of safety, and those patterns stick for life. Now, the good news is we can buffer that. And, you know, we can talk about that as we go. Oh, we will. We're definitely going to get to the whole side of this equation. So it ends up being a neurobiological and psychological identity impact and hit that filters and directs many of the things that we do in life when we've had those experiences.

SPEAKER_01 6:20

The second one is did a parent or other adult in the household often push, grab, slap, or throw something at you or ever hit you so hard you had marks or were injured.

SPEAKER_00 6:29

I mean, we know that life is hard and we can all, without being regulated, act out. So I think that physical abuse that is directed at the child with the intent to harm, and the child can feel that is definitely a sense of not being cared or valued. And so if that's not restored, if it's accidental, that's different, right? Okay. So it could happen, but it's accidental or it's like one time. Um, but basically it's because it sends the signal that I'm not safe, in addition to just a shock to the body. And so again, it's how those experiences then translate into the neurobiological cascade, endocrine immune cascade in the body that impact how the body functions. And then you can stop breathing, you can get shut down, you can stop being curious to learn, you know, sort of go into protection mode. So it's getting stuck in protection that these experiences um put you in. And certainly stop trusting.

SPEAKER_01 7:25

The third of the 10 adverse childhood experiences on the questionnaire is did an adulter person at least five years older than you ever touch or fondle you, or have you touched their body in a sexual way, try to or actually have, excuse me, oral, anal, or vaginal sex with you?

SPEAKER_00 7:40

Yeah. So this is sexual abuse. It's more common than we'd like to think, um, usually within the family, but sometimes it's also a younger other person who's older than you, and it's normal for children to actually explore and um explore each other's bodies and things like that. There's a normal, healthy development of that, but that's not what this is talking about. This is talking about, you know, being violated and used um for purposes of another person who wants to, you know, use you, have control over you, or get pleasure from you. And so it's sexual abuse. And sexual abuse is a violation of your integrity and humanity. And it's also very confusing because it's painful and it's not um what you're supposed to be doing as a child. There's a lot of research on sexual abuse. These usually co-occur, though. Again, I want to say that separating them out is fine, but usually they co-occur.

SPEAKER_01 8:28

And the fourth experience is did you often feel that no one in your family loved you or thought you were important or special, or your family didn't look out for each other, feel close to each other, or support each other?

SPEAKER_00 8:39

Yeah, so this is a big one. Yeah. This might be one of the most common ones that actually does occur that people don't think of as an adversity, um, especially if your own parenting was not filled with warmth and care. Maybe parents are taught, you know, you have to be harsh with your children. But love, right? Yeah. I mean, but there's a study that started in the 50s that Harvard University did called the Harvard Mastery of Stress study. And they simply asked uh freshmen if they felt loved and cared about by one parent, both parents, or neither. And then 35 years later, looked at how they were doing physically and in their health status. And when you had both parents that you said loved and cared about you, um, 25% had illness and um health problems. And when you looked at those that said that was not the case, 85% did. And this was before we had the neurobiological research, even on healthy development, like attachment and brain development and all of that, that came later. But we've been observing for a long time that lack of sense of being cared about and seen and valued and heard and loved, which is a thing, has a lifelong impact negative on your health. And this is in some ways where it all lands. All of that abuse, all of those other things that happen culminate in feeling unloved and uncared about and unseen.

SPEAKER_01 10:01

Since that is so common, I want to ask a follow-up and just the love we don't mean trips to Disney World. We don't need a trust fund. No, we're talking about letting your child know that they have value and that you care.

SPEAKER_00 10:17

Yes. And also that life is hard. Like hard things happen. Validating, of course, that hurts. That would be hurtful. Tell me more about how you feel. And then watching the meaning children make of their experiences because life is hard. Um, and if we try to protect children from that, they don't necessarily build the awareness that yes, life is complex and hard, and I can manage that. I can turn to somebody, I can watch the conclusions I'm drawing based on it. Does that mean I'm bad, or does that mean I need to watch out for people who behave like that and not spend time with them if I'm lucky enough to choose that? So it's very important that we um are present with what is experienced and nurture children to understand themselves and what the meanings they're making and help them restore positive meaning and behavior and protection based on their experiences.

SPEAKER_01 11:07

We're already dialing in some of the positive experiences that we're going to get to because you have to. You know, we we to avoid these things, we have to know what's required. Uh the fifth one is did you often feel that you did not have enough to eat, had to wear dirty clothes, had no one to protect you, or your parents were too drunk or high to take care of you or take you to the doctor if you needed it.

SPEAKER_00 11:28

Yeah, that's a big packed one. That's what they call a triple, quadruple barreled question. Yeah.

SPEAKER_01 11:32

Um we try to keep it to 10, so we'll put five in one.

SPEAKER_00 11:35

Yeah, exactly. Um, so some of those are more intense than others. There are a lot of um children who have unstable housing or food insecurity but are in homes that are very nurturing. So that's gonna be different. Um, we want to fix those social problems, but they're not the same as what we're talking about. So if you have persistent neglect, you do get the message that your needs don't matter. And yet, if you have the buffers that we're gonna talk about that can help a lot, it doesn't take away the sense that life's not on your side or that it's not fair. And yet, again, the meaning we make out of that, there are, you know, Harvard Business Review did a study on top leaders, and almost all of them had a lot of trauma as children. So it's how do we navigate the trauma? And we want to prevent it. We want to prevent these issues. And in many ways, that's a social policy issue, right? So we'll talk about that later. But obviously, neglect of any kind sends the message that my needs don't matter, I don't matter, and plus you suffer. And suffering itself, unbuffered and uncared about and not resolved, um, creates a deep, dark hole that you can fall into that life does life's not fair, life's not good, and I don't matter.

SPEAKER_01 12:43

And when we get to the positive things, which is coming up next, you may have dirty clothes because of the environment you're in. But if the person who helped you choose them or put them on or provided them for you is caring and loving, it's a very different experience.

SPEAKER_00 12:57

No, it is. And I talk a lot about this, not because those things don't matter, obviously. Yes, but if you look at children around the world, like in India or many other countries, they're often filled with love and care. And it's not fair. We can say they don't have enough food, their clothes aren't clean. And yet it is the nurturance and love that they receive that allows them still to be able to learn, to be able to have joy amidst that. So we don't want to not solve those things at all. But if we can bring our somehow bring the adult caring and nurturance and again, watching the meaning making that children are making of their experience and help them feel safe and loved despite um that goes a long way.

SPEAKER_01 13:37

Number six on the adverse childhood experience questionnaire is were your parents ever separated or divorced?

SPEAKER_00 13:42

Yeah. I mean, this is a controversial one. People like to say, well, half families get divorced. And of course, it's again back to how it happens. It's uh it's predictive. Keep in mind that all of these things are you're more likely to have other problems if you experience these things, but actually most don't. So more likely is not most. I study why. Why is it that these things happen? And some people do better than others. We're going to talk about that. Um, but divorce itself is already usually happening after there's a lot of conflict in the home. So you're already maybe neglected or emotionally abusers think, or you're witnessing it. And when you're a child, we know the mirror neurons in the brain, when you see neglect conflict happening between your parents, it reverberates inside of you, right? It doesn't matter that it's not directed at you, it creates a sense of lack of safety and that the world's not a safe place. And of course, it's incredibly painful to have the people who are your caregivers to fight. So divorce usually comes after problems. So that's one thing. And then when it does happen, if it's not done in a way that keeps connection and restoration and the caregivers don't bond and re restore it, that persists, that sense that it's not safe. And I have to like hold and witness and manage these two adults who can't be nice to each other, um, really can take a big hit. So the research is really clear that divorce and separation are a risk factor, but they don't have to be.

SPEAKER_01 15:06

Number seven, was your mother or stepmother often pushed, grabbed, slapped, or had something thrown at her, or this one's got two oars, sometimes or often kicked, bitten, hit with a fist or hit with something hard, or ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

SPEAKER_00 15:23

Domestic violence is also more common than we think. The threat of it as well as the actual happening of it are both impactful. So if you see threats that don't materialize into actual hitting or harming, or just the or you see it, it's incredibly um stressful, obviously, but it it says I'm not safe. And it says my caregivers are are being threatened. So it's all of these things add up in a similar way to create a sense that I'm not safe, the world's not safe, I can't trust other people. And the neurobiological hit and the meaning-making about our own self, life, and others starts to get created in a way that has lifelong impacts.

SPEAKER_01 16:00

And I would imagine with that one, you may also feel guilt or uh inadequacy if you can't stop that. No, absolutely.

SPEAKER_00 16:08

I mean, I had some of that, and I can remember being young and I was too small to climb up and help. Yeah. Right. And so I do think that can happen because children don't always know their children and they don't always know they can't do things, but they want to emotionally. Their love is strong. Most of us come into the world with a lot of eagerness to connect and love and even nurture our own caregivers, right? So affection from a child is very common and starts really early in life. And when you can't um reach out and do anything, it creates a sense of helplessness, but also self-blame. Self-blame and self-hatred start to emerge in on in the context of a lot of these experiences.

SPEAKER_01 16:45

Which you wouldn't necessarily think right away because it's like, well, that was between the adults, but you're witnessing it, you're feeling it, you're affected by it as a child.

SPEAKER_00 16:54

Absolutely. And also in as a child, you are one with your caregivers. And, you know, some say we're all one anyway in the end, but basically you there's not a sense of separation. So it's happening to you in many ways.

SPEAKER_01 17:09

We only have three more. And these are hard, but that's what we're talking about. Number eight is did you live with anyone who was a problem drinker or alcoholic or who used street drugs?

SPEAKER_00 17:18

Yeah. So we know addiction is a complex thing that you can have propensity toward it biologically and not blame yourself. But if you use it, it can grab you. So sometimes these um alcohol drug addiction happens through that pattern, but lots of the time it's because of the pain and adverse childhood experiences of the adults themselves that are doing that. So that has two different impacts. One is when you're um drunk or high, you're often removed and not attentive, not present. On top of that, you can become abusive. So again, like for domestic violence, 98% of any child with a domestic violence has some of the other aces. So these we're talking about them one by one, but they travel in herds. And it's really um alcohol and drug abuse just removes the parent from the child. They can feel it. Our brains are regulating each other. So my limbic brain is regulating your limbic brain to create a sense of safety. And when there's drugs on board, that part of the brain kind of goes offline. The, you know, amygdala, the limbic brain starts to go into default mode and you act out and behave in ways, but you're not present. So it's just horrible. I mean, I grew up with that most days of my life.

SPEAKER_01 18:29

The unpredictability of it. I actually got junked up there, sorry. The unpredictability of it, the the not being able to trust anything, including the very people who are literally on this planet as your caregivers.

SPEAKER_00 18:41

Absolutely. I mean, in my case, it was there from the beginning. And so I didn't know it wasn't normal, to be honest. And it was just my mom was just sleeping, as far as I knew. It wasn't until I was older that I realized why she was not awake.

SPEAKER_01 18:56

Uh, number nine, was a household member depressed or mentally ill, or did a household member attempt suicide?

SPEAKER_00 19:02

Yeah. So this is mental health. Again, the co-occurrence across all of these is very high. It's hard to imagine that a person would abuse their child sexually if they didn't have a mental illness of their own. So again, helping kids means helping adults and going as far back as we can to restore and heal trauma so we can pay it forward and stop it in its tracks. Um, but mental illness, depression, removing the emotional connection, removing the nurturance, and creating a sense that the child doesn't matter, it's their fault, and all the things we've been talking about. So all of these sort of intersect in similar ways to impact a common denominator set of factors. But it's important that we know that our mind and bodies are not separate. So when you have that kind of experience, psychologically, people can say, well, you know, it happened in your mind, it didn't, it happened in your body. There's nothing that happens in your mind that's not happening in your body. And vice versa. What happens in your body affects your mind. And we can talk a lot about that. But sometimes it's the physical part that activates the mental health issues, not the other way around. So it's very important that we, you know, understand that the neuroendocrine immune impacts are on board and it starts to create a fight or flight, breathing goes down, heart rate variability goes down, you know, openness to learn, experience to reach out starts to close. And when we're closed systems, we start to get sick because open systems emotionally, open systems is what creates a flow of life, and life starts to get shut down when we have these experiences without buffers. Without buffers, key.

SPEAKER_01 20:34

The last one on the list is did a household member ever go to prison?

SPEAKER_00 20:37

Yeah. So this is absence from the house. Again, just like divorce and separation, usually it's preceded by trauma, right? By the time you have a parent, maybe who is incarcerated, there's been some things happening. You know, maybe not always it could happen out of the blue, but that's one thing. And the other is just the separation. And any separation from a caregiver that you're bonded to is a trauma for any reason. So death of a parent, even from cancer, is a trauma. So the death part isn't in the original ACES study, but it is included in some others of just losing a parent for any reason is a trauma because it's the absence of the nurturance that you rely on and um a sense of again, life not being on my side. It's not safe. It's not, you know, that lockdown that children can get and adults can get from reaching out to others because we don't believe that's safe itself becomes a huge part of why we can then go on to have addiction and mental health problems and that sort of thing. That's a hell of a list. It's a hell of a list. Yeah. It's not all the bad things that can happen. And we do talk a lot about adverse community experiences as well, like neighborhoods that are unsafe or being in a war torn area. What's important to know about that is that the studies that many of us have done show that when combined with the household aces of abuse, neglect. And household dysfunction, those negative neighborhood and community experiences definitely do have a hit. But if they're there and there is presence of safe, stable, nurturing relationships in the home, even with adversity, it's a huge buffer. So on their own, they're not the main driver. And it just really elevates the importance of the relational factors. So it's important, again, just like food and housing, we want to fix those problems. Yes. But fixing those problems isn't enough because most of the kids and the problems related to adverse childhood experiences in adults and children are among people who have no social determinants at all, who live in safe neighborhoods, who have plenty of food, plenty of housing, all their needs met. So at a population level, it's really important that we understand that even though those are combined risks with ACEs and can perpetuate them because of the stress involved of not having your needs met and having a difficult time and being in poverty on their own without ACEs, there is a lot of flourishing and thriving. I always say that what we need to do is get up underneath this so that we can create a population of people who will then maybe vote for and support laws that can help us have a society where people don't starve and don't not have housing. And how are we going to do that if we, you know, aren't are filled with a population, most of whom had ACEs and are sitting with a lot of trauma?

SPEAKER_01 23:26

I have two questions. Well, I have a thousand questions, but two I'm going to ask now. So if this is all during your first 18 years of life, how big of a variation is there between someone who had these happen younger in childhood versus the high end, the 16, 17, 18 end of that scale? Does it matter how old you were when these things happened?

SPEAKER_00 23:45

There is research about sensitive periods. And the most sensitive period is early. And there's a lot of research on that because the brain is developing. It's like the foundations of a house, like it's when you're building the foundation. And so early life trauma has huge hits, um, even two months, one month, really early. And yet there's a lot, if it stops there, there's a lot of opportunity for buffering and healing. If it comes in later and you've had positive experiences up until then, nurturing experiences, and you're well developed, you also may have the skills to handle it. So it's really complex. But if you didn't have safe, stable nurturing relationships and these positive experiences we're going to talk about, and then as a teen have those, you may not be resilient. You may not have the identity of mattering and belonging and having even good friends or people to reach out to. And when you don't do that and you have those events, um, it can have a tremendous negative impact. But generally speaking, the earlier it happens, the worse. But there are sensitive periods for sure.

SPEAKER_01 24:45

On like TikTok, you'll hear people comparing their trauma scores, which is what's from this. And I should have said before we read it that you score yourself a one for each of the things you experienced. So if someone listening or watching has just listened to that list and thought, oh my gosh, like the first time I heard about ACEs from one of your research partners, I was shocked. I felt like I had found the uh instruction manual to a tool that I had previously not been really familiar with. And I was like, oh, this explains so much. Yeah. So if you have just taken this test and realized, oh, I have a high score. Yeah. High being, I don't know, you tell me what high is, but I'd say six or up or something.

SPEAKER_00 25:24

What should you do? Well, let me first back up and just say the reason we do the scoring is that it's very well established that cumulative risk and cumulative positive, too, which we're going to talk about, is what matters. So we know it's not the event, it's the experience of the event. How it, how it hits you, how it impacts you. Yes. And so we need to also look at that. So you have events and then you have experiences of them, and there's buffers that can happen. So we know more likely is not most. You are more likely if you have four or more ACEs, is where it really starts to take off for adults. Our research showed two or more when you're child. So we didn't have data on ACEs occurring in childhood. Most of the studies before the last 10 years were on adults looking back at their childhood, which is valid because if you experienced it, even if a helicopter came in and said it didn't happen, it hit you. So it's again back to experience. So, you know, somebody you could say, I was sexually abused, but there's no evidence of it. It's not about the event so much as the experience of it. And so there'll be a lot of variability. So you could have four aces, but have experienced it with buffers and do really well. So you're more likely to have risks, but not necessarily will based on how you experienced it. So what you can do if you are sitting with symptoms of trauma, which we know what they are, um, and there's a lot that you can read about how to know if you are experiencing developmental trauma is a term. And it has to do with, you know, a dysregulated nervous system that can show up as issues with being able to sleep and digest and having, you know, ruminating thoughts that are really about um your value and thinking you don't matter and low self-esteem or dysregulated self-esteem, where you think you're the best and then you think you're the worst. So there's symptoms actually that you can look at about whether you have developmental trauma disorder, but not everyone does, but those are gonna translate into trauma and all kinds of cascading results. So, what you can do is begin to build awareness so that then you can start to build the self-compassion and commitment to restore whatever was um not built or built enough. And we can do a lot of things to help calm our nervous systems, restore our false identities about I don't matter, when really it was something that happened to me, it's not what's wrong with me. So a lot of people think it's what's wrong with me versus it's what happened to me. And so that restoration process is possible to do at any age, even when you're very, very old. A lot of the problems you might be, you know, ruminating, ruminating still about your childhood when you're 85. So understanding it's not what's wrong with me, it's what happened to me, and I have capacity to heal, heal, and restore myself almost always in context of community and other supports.

SPEAKER_01 28:16

I was gonna ask you about the limitations of the A study, but I'm gonna skip and I will at the end of this episode. But I I want to go to these buffers you keep talking about because my nervous system right now is feeling really sad thinking about so many people experiencing so many of these. Um Anna want uh just to get into your research about the things that mitigate all of that trauma. So let's shift our focus to positive uh childhood experiences or PCs, which is your research. Uh tell me was that when during your life and your research and your schooling and all of the absolutely amazing things you've done, did you just think ACES are not the whole story?

SPEAKER_00 28:59

Well, first of all, I want to just make sure I say so you know that it is true that about over 60% of adults in America have experienced adverse childhood experiences. And that impacts their capacity to promote the positive with their own children and in communities. And we know that every interaction creates a reaction in the brain and body of every person. So everyone matters at every moment. And we have incredible capacity to help heal, nurture, and buffer toxic stress and adverse childhood experiences by cultivating that. But when you have people who don't know that, because they don't know how much they matter, they don't realize they're not open to receiving care, that's an issue. So it is a synemic in many ways. Like a syndic is when you have risk factors that get to be so co-occurring, like chronic illness and aces are so co-occurring that it can become a storm. And to turn the tide on that storm means to remind ourselves of the capacity we have to heal and to start to pay it forward and start to prevent ACEs or mitigate them in their tracks through promoting positive childhood experiences and a positive adult experiences, right? Because in many ways, we have a child in us, all of us. Um, the parts that are not integrated and emotionally matured because they're stuck in trauma, which is for most of us, many, many parts of us, can evolve. Um, so I'm not talking only about things that can happen in childhood, but it shines a light on the importance of early life experiences and primary care prevention for kids. So for me, I had a really interesting experience of um having most all of the aces, I would say all of them, um, some of them less to some degree than others. But I was also told really young, my grandmas, you know, would pop in every four months or so and just say, you know, everything you need is inside of you. And when you're scared, go knock on a neighbor's house. Or when you're scared, go in the closet and and look inside and think of five things you're grateful for, even though it's hard. So I was sort of taught to look for the positive, to reach out for help and to know that it wasn't my fault.

SPEAKER_01 31:08

In the midst of experiencing all of what we just taught. Yes.

SPEAKER_00 31:12

And and in my case, my grandmother was a Christian scientist and very, very spiritually into non-interventionist. She sort of believed that if you were having a hard time, it's because your soul needed it. So she didn't really do anything or my grandfather to change it, but they would come in every now and then, maybe every four months. And she just would tell me that. And I was very obedient, which I don't know if it's temperament or not, but I did it. I actually did it. And it helped me. And so I think for me, I experienced the positive in the midst of the negative. I never really lost my sense of care or love for my mother, even though she was a lifelong, you know, alcoholic and attracting all kinds of abuse and men and things in the house and all of that, um, poverty and neglect and and all of it. So I sort of got stuck on the channel of possibility amidst adversity as a child. And then I was supported in that by teachers who let me stay after school because they knew that I didn't have anywhere to go except for home. And they would always, they started once they got it, to to have me come into the nursery's office for food at lunch and even sometimes to dress me because I wasn't able to dress myself very well when I was four, right? Starting kindergarten. I started early. So I think it was really the nurturance of the community and the outside and and and realizing that the world is filled with people who care, even though I'm in an environment that is um really difficult. So that's how I got started with it. And I think it just went from there that um I noticed a lot of variation. And in the science, you can see that even though you're more likely, more likely is not most. So my commitment was to, given that more likely is not most, why is it that some do well despite? And even sometimes have post-traumatic growth learn and grow and turn into you. And that's what actually has happened so much in the world. Almost anyone you can think of who is a leader had trauma. And so I was curious about that, not to blame at all, but just because I wanted to understand. And then when I looked at the data from that lens, uh, we ended up creating the way to measure ACEs in childhood. It took about 12 years to get it onto a national survey. So we had it nationally for every state. So we could start to use the data for policy influence and public health education, and found out that about half of kids had adverse childhood experiences already by the time, you know, throughout childhood. And that when they did, they were definitely more likely to have all the chronic conditions and issues with school. Uh, can give you all the data you want on that. Um, and it started to really show a big impact at two or more ACEs. So, you know, it was a really big difference between zero, one, and two just shot up with the cumulative risk. Um, but there were many children that had resilience and, you know, being able to calm your nervous system when you're under stress and things like that. And when that was on board, the mitigating impact was huge on their engagement in school or their readiness for school or their social life or their physical health. And so I got very interested in how can we promote resilience, of course, reduce ACE, which again for me is a social thing, because if we start to create a society of children who grow up to be healthier adults, then we can prevent ACEs, right? It's very hard if you don't start to do that. So, this possibility for resilience amid adversity, how can we focus on that? And that's been a lot of what I focus on.

SPEAKER_01 34:36

That it's only two is very interesting, actually. Only because they're all pretty impactful and some are just devastating.

SPEAKER_00 34:43

Well, I think that for adults who go through life, you end up picking up positive experiences, right? And developing resilience. If you've had enough aces and they've affected you as a child, you start to seek out help.

SPEAKER_02 34:54

Okay.

SPEAKER_00 34:54

You might get mental health care, you might start to develop your own resilience skills. So by the time you're an adult, it may look like it, there's more of the things that have had to have happened before it really goes skyrocketing. I mean, be keep in mind it's linear. One ACE has a big hit from zero.

SPEAKER_02 35:09

Okay.

SPEAKER_00 35:09

Even as an adult, two, three, but four or more really set to you over the top. Again, it's cumulative. It's like, you know, the water boiling, and at some point it boils. It gets warm and warm and warm. But there's a boiling point on cumulative risk. There's also a boiling point in a positive way on cumulative positive. So the more the better, the more the worse. And so it's not any one thing. There's no magic bullet. I mean, there's evidence that if you had sexual abuse one time, but none of the other aces, and people think of that as the worst for a lot of good reasons. But um, kids who had emotional neglect and, you know, were had parents who were drug, they're gonna do worse because often when you have a big physical or sexual abuse, you do get attention. And if it only happened one time, that can actually be healed better than the long burn of cumulative, you know, toxic stress throughout your whole childhood. Same thing on the positive side.

SPEAKER_01 36:03

I'm going to step through the positive things because I need to hear some right now, if that's all right with you. And this is just you did this.

SPEAKER_00 36:10

I mean, well, I mean, first of all, the original ACE study looked at family strengths, like families that, you know, connect with each other, that have needs met in the household, things like that, but they didn't study it. So it actually has for a long time been, of course, intuitively known that, you know, when you have risk, you have buffers and how those would work. But they didn't study it. They did one study on ACEs from the original ACE study and teen pregnancy, looking at family strengths, can't family cohesion and connectedness and things like that. And it was dramatic, but there weren't very many of them done. So for me, I have my lived experience, which oriented me this way, but there also was plenty of research that was showing that when you have positive nurturance amidst all kinds of adversity, good things can happen. It's just that we hadn't operationalized it in a measure and tested it. Did it work like ACEs? Is there a cumulative positive just like there's a cumulative negative? And if so, what counts as positive? So one could say, I have fun, I have, I go to, you know, theme parks and I have enjoyment. Is that what we mean by positive? Or is it more different things? And so what we found, and what was different, was it wasn't the absence of the negative. It wasn't the I have and I don't have food insecurity. I don't, it wasn't the absence of the social negative, and it wasn't the absence of all your needs being met. What positive childhood experiences are that look like they're hitting the mark in terms of their protective effect is how we meet each other when things are hard. So do you feel safe to talk with your family when things are hard for you? So it's it's the what I call the positivity paradox. It's how are you met? How do we meet ourselves when we're suffering? Do we blame ourselves, make it worse, not reach out, maybe take a drink ourselves, whatever, or do we reach out? And when we reach out, are we met with care? So when we can reach out through our pain with care, that turns out to have the biggest hit positively in your brain, restoring possibility, restoring hope, restoring trust. And it's actually really aligned with the science of healthy attachment and young babies that when a baby acts almost falls and you come and grab it, or you happen to go out of the room longer than they want and they cry and you come back. It's those moments of restoration that build like a lot of the neurobiological sense, I can trust you, like I'm not alone. So it's often the um how we are handled when things are hard. So if you look at the positive experiences, which you're gonna read, they they fall along those themes. And we did look at the others, like no food insecurity, not having health problems socially, and um, and then looked at these as well. So we looked at a lot of different things in order to hone in on what was having the effect.

SPEAKER_01 39:02

It's fascinating that there are seven and that they're, you know, so impactful. And if you think of the, you know, the the bad things, the ACES as like a terrible storm you're stuck in. These are sort of like a shelter put above you to make you still feel worthy and safe in spite of the fact that all hell's bringing loose around you. That's right. You brought up the first one, being able to talk to family about your feelings. And that implies a lot of things, right? That's feeling like trusting them to actually listen to you, hear you, do anything. Yeah. And that you matter enough to be supported.

SPEAKER_00 39:36

Yeah. And and what's important that we say here is that um again, having aces is a risk factor, but more likely is not most. There can be aces on board. And our research really ended up culminating in that of showing that at every level of ACEs, when you have these higher positive experiences, it's incredibly buffering. So we found out that if you have six to seven of the positive experiences, and again, this points to the need for very high, like six to six, three to five doesn't really do it. It's it's the higher the better. Okay. And it's almost like I don't exactly know I want to study that. There's a threshold where something in you flips and you're like, I can count on this. Sort of feeling cared about, sort of feeling like maybe usually things happen, but you can't count on it. It doesn't seem to have the big effect. So six to seven of these positive experiences, even for adults that had four or more ACEs, was um 72% less likely to have depression as an adult. Um, so 72% lower odds, which is many times lower. So if you have uh high positive experiences and um high and no ACEs, like 11, 12% have depression as an adult. If you have high ACEs and no positive experiences, it's upwards of 55 or 60. If you have high ACEs but positive childhood experiences, it goes back down into the 20s. Wow. So, and it's so it's very impactful to have the positive experiences. So the first part of our research looked at these in a cumulative risk way. And I was trying to figure out if there's a cumulative positive measure, just like a cumulative negative with ACEs, it's incredibly powerful for public health purposes because you have a simple screener you can use. It's not everything, but it sends the flag enough that you can quickly know who and how to address trauma. So, knowing both of these, if you didn't want to assess ACEs because you thought, well, that's invasive to ask people about that or it's going to trigger them, you can ask about the positive and its absence is the negative. Absence of the positive is the negative. Without any ACEs at all. If you have did not have, so that's the breakthrough.

SPEAKER_01 41:45

So if you have no ACEs, but you have no positives, that is problematic. If you have a lot of ACEs and a lot of positives, they can counteract. That's right. If you have a lot of ACEs and few, if any, positives, that's right, that's a bad situation.

SPEAKER_00 42:00

Yes. And so I have a nice diagram, if you want it, that shows this schematically. So you can see higher low ACEs, higher low PCEs, and then looking at well-being. So what was missing also from this research is not just defining health as the absence of the negative. Okay, so does anyone know somebody who has no diagnoses at all, but is not well? Not thriving. Right. So if we can keep our eye on the possibilities for thriving and well-being, which is what we want, and that's also a lived experience. So we looked at flourishing. So flourishing is a on a dual continuum to illness. So lots of people with illness can flourish or not. And when they do, they're like, you know, 60% more likely to live longer, right? So there's studies on adult flourishing. And it's things like having a sense of meaning and purpose in life, being engaged in life and seeking to be connected to others and have relationships, having a positive, optimistic view of looking for strengths and possibilities, even when things are hard. It's a habit of hope. And then also being willing to look at what you can contribute and care about others, even if you had a hard life, like seeing that even your pain can be a source of contribution to others, like an AA, right? You tell your story, like we all matter and understanding that you matter, you have self-worth no matter what you went through. So these are qualities of flourishing that we can measure in adults. So we also had to figure out how to measure flourishing in childhood, which was part of our work because it's not like you do it the same as adults. You don't expect little kids to have meaning and purpose and agency to go out and contribute and all those things like that. So we did look at flourishing in childhood and notice that many children with high ACEs still were flourishing and many weren't. And it was because of these positive experiences.

SPEAKER_01 43:50

Let's go through more of them. Uh, the second one is feeling that your family stood by you during hard times. So that's being able to say, I was bullied, something happened at school.

SPEAKER_00 43:58

Well, it's a couple of things. First of all, It's being able to share that you have a hard time.

SPEAKER_01 44:03

True.

SPEAKER_00 44:03

So a lot of kids with too many aces too soon, without it being buffered by these kind of sense that somebody cares about me may even keep a child from even saying I was bullied. And so it sits within you. And so anyone's getting up in any way around. Exactly. Anything there are many children who could get support. Like I went and knocked on a neighbor's door because my grandma told me to, but my sister didn't necessarily. So suffering becomes a sickness inside of us when we don't share it. So we need to have a risk to share it. And so it really a lot of the aces can be on board. You know, I would say my mom, who I didn't ever see, I didn't see her sober very often. But whenever I would come in the room, and especially if she she, I don't know when she was drinking or not, because I wasn't really aware, but she would always light up. Like she thought I was filled with light and she just was filled with light. No, she didn't nurture me and she was asleep most of the time. And she brought in a lot of really negative things, and we were poor and neglected and all those things. But she herself didn't put me down. She never said yes, she never said no. She wasn't involved, but she didn't tell me I was bad. And so there's something protective, even with all the aces I had. There was some message I got that I had something in me and that I mattered. And so I think that is a lot of you know what this is about. So you can have a sense that somebody's on your side. Um, it could be a teacher, it could be a bus driver, it could be everyone matters. And in my case, it was the apartment complex manager that just kind of watched out and noticed when things got really bad and we didn't have food, and he'd call my grandpa who would come and buy us a flat of tuna and I could open the can, you know, whatever. I mean, seriously, that mattered a lot. Somebody cared. So we're we're exquisitely sensitive to the positive in the midst of the negative, and that can really be very fortifying. Exquisitely sensitive to the positive. We are. We're neurobiologically sensitive to the positive. And the little bits of it, I've done lots of interviews with adults, um, many of them professionals working with kids with aces or youth with aces. And they themselves are burnt out. They're not necessarily looking at their own experiences. And I would say, well, what is it? Tell us me a time when you felt like you mattered. And many stories adults will have of, well, it was when I really felt so down and I went into a 7-Eleven and somebody looked at me like I mattered, like actually looked at me. So looking at someone is not looking at someone. It's your my own connection with my own self. And I look out at you from a connected place in me to connect with a connected place in you. And that's presence. And there's something that happens in our brains and our bodies and in our nervous systems when we do that. That power of presence is something we're exquisitely sensitive to, looking for all the time. Even if you have tons of people around you who you think you're interacting with or you're online and you're looking and taking in all kinds of information, it can give the illusion of connection. But connection is much more calm and centered and present.

SPEAKER_01 47:02

I I really hope that if somebody watching or listening learns nothing else, it's that. It's it's not it's not huge things. It is actually genuinely caring and communicating that.

SPEAKER_00 47:16

If you think about it, the like your cells right now, that your red blood cells are separating and coming together, separating and coming together. How they do that is where our health emerges from the small things. And it really is the small moments. And often you have lots of moments, but if you don't have any moments where you're really connected, you're not going to be regulated. And we can start to do that for ourselves, but need to know if we have trauma, when you become present, anything unlike that wholeness will start to come up and to not then I get identified with it, but to expect it. Like there's actually a path to healing. But it does begin with reconnecting with ourselves, giving ourselves a chance to connect with the innate goodness in us, whether we were loved or not, and start to restore, restore that sense of relatedness to ourselves and others. And then we can start the healing process and and um really, you know, thrive despite the adversity. And we can do that for each other. We can do that for each other. So I I I call it we are the medicine.

SPEAKER_02 48:19

Yeah.

SPEAKER_00 48:19

And it's really um, you know, based on this positivity paradox that it's how we are with ourselves and each other through what has been hard that creates the positive.

SPEAKER_01 48:31

I'm gonna you you you have shared in in other uh situations a story about a child, badly injured child being brought to the hospital and the EMT looking at them and saying, it's not your fault. That's that sticking with that person into adulthood. Yeah, absolutely. So that just blows my mind because we think, oh, I'll build you a house, I'll get you out of that bad environment, I'll take you in, I'll adopt you. It's not those things. It makes sense.

SPEAKER_00 48:56

Yeah, I mean, usually when you interview people about tell me about positive experiences, it's like that. It's like something was hard and then somebody looked at me, a teacher or a doctor, and it woke something up of possibility that actually, again, we're exquisitely sensitive to it. So in this child's case, I work a lot with different children and they do art and write poetry, and it there's a real healing path they can go down, but in it, but remembering the positive, not because you want to whitewash or go into toxic positivity. That is not good. You don't whitewash, and that's a lot of what our society does. Well, that happened a long time ago. It shouldn't affect you. It's not true. If it wasn't integrated, met and integrated through the portal of your own heart, loving yourself in many cases. Other people can tell you as much as they want. You're good, you matter, it's okay, but you have to have something inside of you that believes it for you for it to become neurobiologically true, right? So then you can start sleeping again and not needing to numb yourself with social media or alcohol or something like that. And so in this child's case, it was a horrible abuse situation that led to hospitalization for many months from abuse. But the memory was the ENT that was in the ambulance, um, not the ENT, sorry, the emergency technician that took this person out of the ambulance into the surgery room where they were being prepped for surgery, remembered being looked at and the person knowing how to connect, waiting almost for the felt sense moment. Like you know, it's like dialing a dial in yourself and then with the other, and you can feel it. It's a felt sense of connection. Words or no words. I see you. You're not alone. I care. And that person did that for a second. I don't know if it was because they were waiting and they had a moment or whatever, but it said it's not your fault. He had to go back to work, but he said that to the person, and um, it never left. And it became a beacon.

SPEAKER_01 50:54

The third positive experience that works as a buffer to the bad ones is enjoying community traditions.

SPEAKER_00 51:00

Yes, absolutely. So keep in mind the words enjoying. All these positive experiences are feeling that you could, feeling supported, enjoying community traditions. It doesn't mean you were drug there and you participated. It means you remembered it being good for you. You liked it. So again, we're getting back to the role of emotions and experience. The experience of your experience is what really has the hit in a positive way or a negative way. Um, again, I didn't make as much meaning out of my mom's alcoholism and not being present because I did something else with it. I thought she was sick, I guess, for the most part. So, yeah, enjoying participating in community traditions is huge. And it's very important that the community make places for children and young people to be safe and also to come without their parents because often the parents aren't going to take them. So if you're in a school or a church or a community, and there's any way you can involve a child that doesn't have a parent who's involved. I mean, in my case, I got kicked out of brownies because my mom didn't show up for things. I mean, that was bad. So our community needs to understand that many children who are in the worst situation are not going to have parents who participate, but involve them anyway and give them a job. I have this um diagram that synthesizes all the evidence-based practices for healing. There's time-in practices where we work on breathing and regulating our own selves and all the self-soothing that's possible. There's time with practices, which are learning healthy connection and relationship and learning to trust again and connect and what it feels like. But the other one is time for practices, which is really where the joy comes in, is when we feel we can contribute to others. And that is so much evidence on the I matter, I have something to contribute. Yeah. And so give kids a job, put help them participate, make them work for their keep, whatever. If you feel like they're not paying their way, like in my brownies thing, I didn't give them the 50 cents. So they, whatever. Um, so I think we want to always involve kids and make sure it's enjoyable. So we want to ask children what would be fun for you and be surprised. We don't tact kids. We do what we think they want. But if you really sat down a bunch of kids and asked them what they want, I'm not sure they would have come up with video games. They might not have. We did that. The adults created that and put that out and then it became a thing. But what would children say really they love and want? And I think it's a lot of this normal daily connection with each with others and mattering and contributing.

SPEAKER_01 53:34

This one surprised me because of the specificity of the time. Feeling a sense of belonging in high school is an important positive experience that can neutralize bad ones by high school.

SPEAKER_00 53:44

Well, I mean, that really had to do with the fact that this is actually a list that adults report on, and we were concerned about making sure that we went to a place where they would be more likely to remember, but also what they left the school experience feeling. Okay. Okay. So we know how you can have feel like you don't belong, but you can restore it. And so it was really connecting from the most recent school experience that would be more validly remembered. You might have felt that you belonged in kindergarten, but you might not be able to remember it. And then if you didn't leave school feeling like you belonged in some ways, it may not matter as much that you felt it earlier. So there's a couple of reasons why we focused on that. It's not that it doesn't matter all the time, it really does. It was just that this was an adult survey. So we need to still create the positive childhood experiences measure for children, which is what we did for ACEs. So we created the ACES measure for childhood. And we have some measures on positive experiences, say in the National Survey of Children's Health, so we can look at that population level, but we don't have as many because it's hard to we don't do the survey directly toward children. And usually if you want to see if a child's having a positive experience, is you it's observable, but you don't ask them questions. So it's a little harder to measure. Okay.

SPEAKER_01 54:58

Feeling supported by friends is another protective factor. Exactly.

SPEAKER_00 55:02

Yeah, just feeling like you had somebody who you could say, I'm suffering and I need your help, or who you didn't have to say it because they could feel it and they're proactive. And that's a lot of how it goes with young people, is they can tell. You don't necessarily have to say, Hey, I'm having a hard time. They can tell. We're built to tell. We can feel each other. You can look at a person, walk in a room, and almost not even look, and you can feel if they're okay or not. And I think for young people, they can do that for each other. And when they do, it's incredibly buffering. But again, it comes back to a sense of being seen, heard, and cared about in the midst of what's hard.

SPEAKER_01 55:35

This might be my favorite one. Number six in terms of shock absorbers or positive experiences for children, is having at least two non-parent adults who genuinely care.

SPEAKER_00 55:46

That's right. That's right. And I always like to tell the story of for me, there were two main people. One was the grocery clerk at the store, because we didn't go to the store very often because my mom wasn't up for it. And so we would go at the last minute. And um, he knew that um you could cut this out if you want, but he knew that we had food stamps and that she was, they allowed you in rural communities to buy alcohol with food stamps. So he would know when we he would always be prepared with a bag of groceries that he knew we could cook ourselves, like macaroni and cheese and canned tuna with protein and and food, and make it available and basically push it into the cart and was at the watch of making sure that alcohol wasn't part of the purchase. And he looked at us and sometimes he'd throw a candy in or something like that. So for me, when I look back on my childhood, I think of the Safeway grocery clerk. The second person I think of is the bus driver. So we had to get to the bus. The bus driver started to notice who had a lunch and who didn't, would run in after and tell the nurses or tell the school, you gotta watch out. This kid doesn't have lunch. And that was before school lunches were on board. And later when that happened, that was great. So it's everyone matters. Everyone. And so I think that having two non-parent adults who genuinely cared about you, my parents and my friends who I started to go home with, they cared about me. And I could feel it. I didn't talk a lot. It was pretty quiet. So it's not about talking, it's about caring.

SPEAKER_01 57:21

And the last of the positive experiences, positive childhood experiences, is feeling safe and protected by an adult at home.

SPEAKER_00 57:29

Yeah, I think that again, it's not to minimize that we need as much of this as we can have. I'm focusing more on when things are hard, how can we own the possibilities we have as non-parent adults to help children. So having at least one adult for me was my grandparents who came in every now and then. They didn't stay. Now that I look back on it, I'm like, well, that was a little weird. You didn't do more to help your own daughter. But they had their belief system, but they did make sure I knew that I had value. I had some sense that I could run to the neighbors or something like that. And so usually if there's not at least one adult, relative or not, like even an older brother or sister, who you can run to when you feel unsafe and you're willing to run to them, because we need to really worry when children stop reaching out, you know, because then it's already the shutdowns happening, and that's when we really need to be worried. Um, but having at least one non-parent adult is often the case. That maybe the father's difficult, but the mother's present. So all of these count.

SPEAKER_01 58:30

I think that that is what I would like to end this episode with is I would love to know how you could advise us as adults out in the world, knowing that there are hurting people all around us. What can we do that doesn't require too much because that might stop someone, but matters.

SPEAKER_00 58:49

Yeah, I mean, you really said it um without feeling like you have to fix it. There's a lot of pain in watching suffering that you can't fix. But to remember we have to go from fixing to connecting. And connecting's possible, but if you can't tolerate the facts that you're not fixing it, that suffering happens, that suffering is happening, and that you still matter and what you're doing still matters. And so this all or nothing, either I fix it or there's nothing, is very important to get over and realizing just even a moment of your own presence. Obviously, if you can act, I do think there were some medical doctors in my life who could have acted, and I don't know why they didn't earlier. Um, they eventually they did, but um, you know, they're in a position to act, right? But most of us aren't, and that we still matter. Again, every moment matters and everyone matters every moment. And it's the presence, though. It's more um the intention in your heart and in your being to see the child beyond their own suffering and beyond the pain that they have, and to somehow communicate verbally or nonverbally, that you see them, that you care, that they matter. And if there's any way to give them something to reach out to, like, you know, uh, come on by anytime you need to for a snow cone, which was something that happened to us with a guy on down the street who sold snow cones for a nickel and we didn't have a nickel, said, Hey, come by anytime. You know, so there's all there may be something you can offer um that's genuine. And just to, you know, be able to hold and tolerate our own pain about our inability to fix others' pain is actually a skill a lot of people don't have, you know, and they shut down instead. So we can't shut down and numb ourselves um in order to help uh children and each other and ourselves. And ourselves. What's very healing. You know, life is filled with difficulties, and it's how we meet it with all the magic and beauty that we have and capacities that we have that really help us thrive and flourish.

SPEAKER_01 1:00:52

It is easier to believe what you're saying because you've lived it.

SPEAKER_00 1:00:57

Yeah.

SPEAKER_01 1:00:58

You know, you've had the aces, you have had high stuff in spades and what could be seen as little kindnesses and connections. That's right. You still carry today, which is absolutely beautiful and so powerful and so hopeful.

SPEAKER_00 1:01:15

Thank you. Yeah, I mean, I talk about flourishing in four different ways. And a lot of times we measure if you go out and look at flourishing, it's like flourishing and the remembering self, which is for adults, like up until now, how much have you or how satisfied are you with your life? If you look at the global flourishing study, that's remembering back. Kids don't do that. They don't right look back. And the next is flourishing the experiencing self. In the last week, how many times did you feel happy? That's the experiencing self. There's the flourishing of the requiring self. Do you have your needs met? Did you have enough food, housing, that kind of thing? And then what I'm talking about is the flourishing of the living and relating self. How are you meeting what arises in life from a place of empowerment and possibility? That there's some resources in, and others are resources to help us move through life in a living and relating way. It's not about getting rid of things or having all the things or even having necessarily a lot of joy in that typical way. But joy can arise inside of deep connection, even in the midst of suffering.

SPEAKER_01 1:02:22

We are gonna end there, and I hope that that really sinks in. Um, it certainly is with me. We will be back next week. We'll continue this discussion with Dr. Christina Bethel, and next week we will answer the top search questions on the internet about all the childhood experiences that impact us through life and into adulthood. Thank you so much. Thank you.