Silence Gives Consent

Dr Allison Jackson talks about adverse childhood experiences in her 2016 TED talk, and discusses how silence enables trauma to occur to children. You can watch her talk below.

People who experience adverse childhood experiences (ACEs) have worse outcomes across all life domains - physical and mental health, life expectation, life enjoyment, socio-economic stability, parenting capacity, forensic and financial situations. The more adverse experiences, the worse the outcome, with a cumulative effective that is exponential. I think we intuitively understand this.

Common examples of ACEs include:

• physical abuse

• emotional abuse

• sexual abuse

• neglect

• feeling unloved or unwanted

• parental divorce

• parental mental illness or substance abuse

• witnessing/being exposed to domestic violence

The consequences of these traumatic events for children carry into adulthood. There is a wealth of evidence that clearly ties childhood trauma to negative health and social consequence in adulthood. So why is this so poorly managed? As a doctor I know that I need to reduce smoking in households where children live to reduce health inequity, particularly to prevent glue ear, asthma and serious respiratory illness. I know that poor diet and lack of exercise will reduce a child’s chances of getting to adulthood in a healthy weight range, without diabetes and all that goes with that. So why are we so slow to catch on that emotional trauma in childhood persists into adulthood and sets an adult up poorly for life, flowing into all aspects of their lives?

Statistically, when a person experiences more than 4 adverse childhood events the odds of negative health outcomes sky rockets, with those individuals being 1500% more likely to commit suicide and 550% more likely to become addicted to alcohol (to name only two negative health outcomes). With 6 adverse childhood events, life expectancy for an individual reduces on average 20 years (compare that with a life of smoking - which produces a similar outcome). These statistics are as shocking to me as the health disparities I see amongst different ethnic groups in NZ. The salient distinction though between ethnicity based health inequity and health inequity due to ACEs is that adverse childhood experiences, unlike ethnicity, are invisible, and it is not clear who belong to this at risk group.

The invisibility of this group of people is made all the more intense by the shame associated with belonging to it. As I understand it, Centrepoint attracted families who struggled with difficulties in life. So I think it would be safe to say, many of the children living at Centrepoint already were vulnerable, well before they got to Centrepoint. They may have had a mentally unwell or addicted parent, parental divorce, have experienced domestic violence or some kind of abuse or neglect. Add to that sexual abuse, and in my mind it is likely many children at Centrepoint would have experienced at least 3 adverse childhood experiences before they reach adolescence.

Costa Botes film ‘Angie’ is all about adverse childhood experiences. The interesting thing about Angie though is not so much the volume of harm that happened to her and her siblings, but how she has overcome it. We know children in New Zealand experience trauma. We know for some children the burden of this trauma is so severe that their chances of becoming functional, contributing, psychologically well members of society are slim. We know the prison system and the mental health system are heavily populated with adults who belong to this high risk group.

We are surprised when someone overcomes it. It should not be so surprising, but it is.

A social context where it is more normal to talk freely about these events, in safety, without criticism or negative social consequence, is the kind of society I would like to be part of. As we talk about these events we make them more normal, and our children can share more freely what is going on with adults in their lives any trauma they may be experiencing.

In the 1980s when I was at Centrepoint no one really knew about childhood sexual abuse. It still stuns me that the parents and teachers of Albany School were worried enough about what was happening at Centrepoint to be concerned that their children might contract herpes from CP kids. This exposes a 1980s ignorance of how sexually transmitted infections are spread. Allowing for that faulty understanding, it highlights that the adults of Albany community, who were watching out for CP kids, suspected something was really not right. What did they do with that concern? They protected their own. I remember clearly being a kid at Albany School and suddenly the CP kids were all gone (at this stage I was no longer living at CP, I was living back with my family in our home in Albany, yet continued to mix socially with CP kids through school). The school board, in their wisdom, felt the solution to the CP kid problem was to remove them from the school. I may have this wrong, and I would love to be educated about the chains of events so I can think with greater charity towards the school I went to as a child. But it just seems so wrong to me that the children who were already isolated socially, and many living with fear in their home, were kicked out of their school too... I think their school owed them more than that.

I like to think that NZ society 30 years later would not miss such alarm bells ringing. I like to think that Albany School now would do a better job by a cohort of children struggling to manage day to day trauma. Does anyone else share my optimism? Regardless, increased social awareness and conversations around these hard topics is what is needed to make society safer for the children we need to protect.