Assessing Your Trauma

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In the years that I have been a clinical counselor, I have come to believe based on observations of the clients I have seen and people that I know personally, that well over 90% of the American population has had some sort of trauma in their lives.

Some trauma is fairly self explanatory and easy to recognize such as physical or sexual abuse. Some trauma is not so easily defined, such as verbal or emotional abuse. But they can all inflict traumatic memories and negative beliefs on those who receive them.

When I start seeing clients I will often times give them an assessment to briefly assess their traumas. It doesn’t cover everything, but it gives a good idea of a starting place for therapy.

This assessment is called the ACES test or Adverse Childhood Experiences. This assessment does not assess stressors outside the household such as violence, poverty, isolation, etc.). Something I feel that was left off of the ACES is death or loss of loved ones. This can be a huge trauma for children. It does not take into account any protective factors and it does not differentiate meaning not all people with high ACES scores will have a poor outcome and not all people who have zero ACES will have a positive outcome. It is an indication of greater risk of a poorer outcome and trauma responses.

The following is the ACES assessment:

Prior to your 18th birthday:

  1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
    No___If Yes, enter 1 __
  2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
    No___If Yes, enter 1 __
  3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
    No___If Yes, enter 1 __
  4. Did you often or very 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?
    No___If Yes, enter 1 __
  5. Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and 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?
    No___If Yes, enter 1 __
  6. Were your parents ever separated or divorced?
    No___If Yes, enter 1 __
  7. Was your mother or stepmother:
    Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very 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?
    No___If Yes, enter 1 __
  8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
    No___If Yes, enter 1 __
  9. Was a household member depressed or mentally ill, or did a household member attempt suicide?                        No___If Yes, enter 1 __
  10. Did a household member go to prison?
    No___If Yes, enter 1 __

Now add up your “Yes” answers: _ This is your ACE Score. A higher score in multiple studies has shown links to increased negative mental and physical outcomes as well as increased negative social outcomes. The website Got Your ACE Score? has multiple links to studies and many charts that lay out the possible effects of a higher ACES score.

Resilience on the other hand may help those with higher ACES scores combat negative outcomes. A secure early childhood is helpful for future living but not always absolutely necessary if one has a higher resilience. Again, this is very individual dependent and definitely not true for everyone.

Resilience Questionnaire

1.  I believe that my mother loved me when I was little.

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

2.  I believe that my father loved me when I was little.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

3.  When I was little, other people helped my mother and father take care of me and they seemed to love me.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

4.   I’ve heard that when I was an infant someone in my family enjoyed playing with me, and I enjoyed it, too.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

5.  When I was a child, there were relatives in my family who made me feel better if I was sad or worried.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

6.   When I was a child, neighbors or my friends’ parents seemed to like me.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

7.  When I was a child, teachers, coaches, youth leaders or ministers were there to help me.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

8.  Someone in my family cared about how I was doing in school.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

9.  My family, neighbors and friends talked often about making our lives better.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

10.  We had rules in our house and were expected to keep them.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

11. When I felt really bad, I could almost always find someone I trusted to talk to.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

12.  As a youth, people noticed that I was capable and could get things done.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

13.  I was independent and a go-getter.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

14.  I believed that life is what you make it.Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

How many of these 14 protective factors did I have as a child and youth? (How many of the 14 were circled “Definitely True” or “Probably True”?)   _______Of these circled, how many are still true for me? _______

Many people have had at least one trauma in their lives and many more have had traumas that are not listed on this assessment. As stated, this is just an early assessment that can offer a lot of information about how someone has experienced trauma and if they also had any resilient factors in their lives.

Trauma, unprocessed, continues to affect us on a daily basis whether we know it or not. It affects how we think, feel, and respond in every situation of our lives because it has instilled beliefs in us about ourselves that are almost always negative. It affects how we live, love, and work. Trauma doesn’t go away because we think we ignore it. It doesn’t go away because we get older and more distance from it. We carry it around in our brains because the brain records everything and then it flings it out at us again and again.

If you have unprocessed trauma, I highly encourage you to find a counselor to talk about it and process through it. Doing so could make all the difference in your life.

Until next time be well,

Deborah

Resilience

resilience

A great many people in the world have suffered from childhood trauma. A study in 1995 by the CDC and Kaiser Permanente studied the rates of childhood trauma and the correlation of that trauma and the increase in adulthood of physical, mental, and emotional issues.

The ACEs questionnaire was developed out of this study. (Click the link to find out your ACEs score) There are 10 questions with five related to personal trauma and five related to household trauma. Of the 17,000 people in the study, 87 percent had more than one ACEs (Adverse Childhood Events). Later studies in the US showed that as many as 12% of the people in 36 states had suffered more than four ACEs.

Conversely, the resilience questionnaire was developed in 2006 an revised in 2013 in the belief that people who had a higher ACEs score and then a higher resiliency score might possibly be protected from negative outcomes later in life. Resilience is defined as the capacity to recover from difficulties; toughness.

There has been some controversy over both tests especially in the beliefs that ALL people with high ACEs scores will have adverse negative affects in adulthood or that ALL people with correlating high resiliency scores will not have adverse affects later in life.

Every person is different, every brain is different, every person’s experiences are different and outcomes will not be the same for everyone. However, there is evidence that those with high ACEs scores and low resiliency scores can experience adverse negative effects (physical illness, mental illness, and emotional trauma) in adulthood.

So what is your resiliency score? Here is the questionnaire:

RESILIENCE Questionnaire

Please choose the most accurate answer under each statement:

1. I believe that my mother loved me when I was little.

Definitely true Probably true Not sure Probably Not True Definitely Not True

2. I believe that my father loved me when I was little.

Definitely true Probably true Not sure Probably Not True Definitely Not True

3. When I was little, other people helped my mother and father take care of me and they seemed to love me.

Definitely true Probably true Not sure Probably Not True Definitely Not True

4. I’ve heard that when I was an infant someone in my family enjoyed playing with me, and I enjoyed it, too.

Definitely true Probably true Not sure Probably Not True Definitely Not True

5. When I was a child, there were relatives in my family who made me feel better if I was sad or worried.

Definitely true Probably true Not sure Probably Not True Definitely Not True

6. When I was a child, neighbors or my friends’ parents seemed to like me.
Definitely true Probably true Not sure Probably Not True Definitely Not True

7. When I was a child, teachers, coaches, youth leaders or ministers were there to help me.

Definitely true Probably true Not sure Probably Not True Definitely Not True

8. Someone in my family cared about how I was doing in school.

Definitely true Probably true Not sure Probably Not True Definitely Not True

9. My family, neighbors and friends talked often about making our lives better.

Definitely true Probably true Not sure Probably Not True Definitely Not True

10. We had rules in our house and were expected to keep them.

Definitely true Probably true Not sure Probably Not True Definitely Not True

11. When I felt really bad, I could almost always find someone I trusted to talk to.

Definitely true Probably true Not sure Probably Not True Definitely Not True

12. As a youth, people noticed that I was capable and could get things done.

Definitely true Probably true Not sure Probably Not True Definitely Not True

13. I was independent and a go-getter.

Definitely true Probably true Not sure Probably Not True Definitely Not True

14. I believed that life is what you make it.

Definitely true Probably true Not sure Probably Not True Definitely Not True

Again, both the ACEs and the resilience questionnaire are guidelines for further exploration and conversation. Both can be used in therapy to help address past trauma and strengthening resilience.

If you have a higher ACEs score it may be helpful to seek out and work with a trauma-informed trained therapist to process your childhood trauma to reduce adverse negative affects they may be having in your life now.

Remember, there is always help, hope, and healing available.

Until next time,
Deborah