I have just been to another conference and met a woman neurologist. She is studying traumatic brain injury patients. She is applying for a grant to study adverse childhood experience scores in traumatic brain injury patients because they have noted that the people with fairly awful or very awful childhoods tend to cope better than the people with a nice childhood. She wants to do a formal study to see if this observation holds up.

Why would people who have had major trauma during childhood do better after a traumatic brain injury than those with a good childhood?

The suspicion is that their brains are wired differently. The high ACE score people have "crisis" wiring. They have brain wiring for survival in difficult circumstances. They have already used this wiring in childhood and have survived something or survived many things. When they have a catastrophic injury, the wiring kicks right in: ah, back to this, well, I can survive.

The brain is especially plastic as a child. We want to see all children treated well and loved and cared for, but it may be necessary as a species to have a survival back up. What if there is a disaster or a tsunami or a war? How do we adapt? Who survives? What becomes necessary that was unthinkable previously? Children are still growing up in the midst of wars and disasters and the crisis wiring is put in place to help them survive.

Children growing to adults in difficult circumstances work hard to survive and continue to work hard as adults. Dr. Clarke, from the OHSU primary care review, says that the personality characteristics of responsibility and hard work described in the last essay* "produce a strong positive response from the world. Over time (sometimes a long time) this tends to overcome the poor self-esteem and eventually produces a major shift in how a person views him or herself. This major shift can be summarized as "I DESERVE BETTER."

a. Often the individual will decide that they deserve a better partner or a better work environment.

b. Often they will no longer tolerate being treated disrespectfully.

c. Often there is the idea that the individual deserved better treatment when they were children.

d. The first relationship with a supportive, respectful partner may occur at this time. This, too, can be stressful because it is such a change from the past.

e. Resentment or anger about how the individual was treated as a child may be generated at this time though it may not be consciously acknowledged. It is common for the anger to be suppressed because it is an unpleasant emotion, because childhood stress survivors spent years learning how to control emotion and because the anger is often directed at people about who there is still some caring. When there is enough of this anger present it can cause physical symptoms that can be mild or severe or anywhere in between. Many people are unaware of how much anger they have. Highly educated people often have the most difficulty comprehending their level of anger.

f. Imagination techniques to uncover anger: pretending that you are watching a child you care about endure the same environment you did; pretend you are overhearing a conversation between a child you don't know who suffers as you did and the child's parent.

g. Often it is during this time of significant change in self-image that physical illness occurs."**

My hope is that as we learn more about how the brain is wired in childhood and how versatile and adaptable it is, we will also gain understanding of the differences among adults. That we will grow in tolerance and in ability to support growth and healing, rather than judging and rejecting.

*Yeah, some of this is already in Adverse Childhood Experiences 4 and 1/2: Lizard Music. I am trying to sync two writing sites. Fail!

**Dr. Clarke has kindly given me permission to quote from his work. This is from his handout at the 46th Annual OHSU Primary Care Review.

Further reading, that I am looking forward to:
They can't find anything wrong!, by David Clarke, MD. See also http://www.stressillness.com/