Trauma-Informed Care and Adverse Childhood Experiences (ACEs)

“May all brings be peaceful. May all beings be happy. May all beings be safe. May all beings awaken to the Light of their true nature. May all beings be free.”

— Buddhist Metta Prayer

We have followed closely the ongoing immigration crisis taking place at the US-Mexico border. As a trauma-informed clinic, we are well aware of the long-term effects this policy will likely have on the children and families that are enduring painful separation. The images are disturbing at best and despite mass public outcry, lawmakers have made little to no impact in reuniting separated parents and children.

As this continues to unfold, we as community acu-punks and health advocates are feeling angry and sad. Community acupuncture, by its very nature, is committed to battling oppression on a daily basis, bringing acupuncture to the working-class, and creating a safe place for all peoples to thrive, heal, and coexist. We recognize that this itself is a radical act. As POCA Co-Founder Lisa Rohleder states: "...society doesn't treat poor people or working-class people well, or women and children, or immigrants or people with mental illness....[ Acupuncture Points Are Holes: A Case Study in Social Entrepreneurship, pg. 169]. 

As part of this movement, we are compelled to change that narrative. We want to share an important study that highlights the potential long-term effects of today's immigration policy that is deeply affecting families and children. The Adverse Childhood Experiences study (ACEs) is summarized by the Centers for Disease Control and Prevention as follows: "Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. As such, early experiences are an important public health issue."

To flesh this out further, the ACEs study has shown that long-term exposure to traumatic events (such as sexual, physical or verbal abuse; physical or emotional neglect; a family member who is in prison; the loss of a parent through abandonment or divorce; and household dysfunction), can greatly increase the risk of mental health problems and substance abuse, as well as physical health problems later on in life.

In essence, no matter what side of the immigration platform you stand on, detained children are being setup for high ACEs scores and long-term health consequences. As this continues, they're at greater risk for:

• risky health behaviors,
• chronic health conditions in adulthood (such as pain due to arthritis, headache or chronic back or neck pain)
• low life potential, and
• early death (due to cardiovascular disease, liver disease, chronic lung disease, and cancer)

That isn't to say that these outcomes are set in stone. The study also recognizes the role that resiliency has in early development and the key role that close relationships have in building resiliency in a person. But, as is the case with detained children, they have been separated from the very people that might help them recover from these experiences. More than likely, their lives, liberty, and ability to find happiness, will be a challenge that lingers far beyond the moment if/when they find their families.

As we process this information and the news in the coming days, weeks, and months, we can allow ourselves the space to acknowledge, talk about, and do what we can to provide relief.  In talking with a patient about this crisis, we agreed it is not something to simply "get over" or ignore.  The full effects of these policies are unknown but clearly they are harmful to people now and they will likely have significant, long-term effects.

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If you would like to learn more about the ACES study, visit the CDC's website or read this NPR article, the latter of which includes an ACEs test you can take to see if the research outcomes ring true for you.

There is also a wonderful graphic zine, Trauma is Really Strange, that recognizes how "stress and trauma [change] how our brains work"; how if you "squeeze any human hard enough, [they] will be overwhelmed"; how "the best way to reset the old parts of our brains is to slowly wake up the body"; and how "healing trauma is not about remembering, it is about self-regulating to turn down intense reactions in the body." It adds that "being in a body, without chronic tension patterns and a sensitized brain, will lead us to being happier and healthier."

Given the widespread effect of trauma, we offer trauma-informed acupuncture to help you process these experiences. Acupuncture is no panacea, but it can help calm the nervous system, treat many of the symptoms and diseases brought on by chronic stress and trauma, and help manage PTSD symptoms. To quote Lisa again: "...many, many people are suffering from stress, injuries, or emotional problems that make it difficult for them to work. If acupuncture can help people recover and return to work, acupuncturists have a social responsibility to help them, particularly at a time of economic difficulty for the entire country. (Acupuncture is Like Noodles)". We welcome anyone to our clinic who is feeling like they need a safe space to heal. We (and all of our affiliated POCA clinics) will hold space for you. 

Healing. It takes a village.

If you’ve worked with me before, then I’m sure you’ve heard me say the words, "healing takes a village".  It’s a light-hearted phrase I use to remind folks of the simultaneous strengths and limitations of acupuncture.  Personally, I believe that acupuncture is a powerful medicine--a belief that has been reaffirmed daily in my work with many of you!  It has been effective for such a variety of conditions, such as stress, infertility, allergies, digestive disorders, autoimmune disease, organ dysfunction, anxiety, and the common cold.  But, like any other medicine, it would be a folly to assume that acupuncture is all-encompassing.

Despite acupuncture’s wide-ranging benefits, certain conditions and injuries may require a little extra help from another modality.  Researchers have found, for example, that yoga and acupuncture can effectively treat back pain. In other cases, for those experiencing depression or anxiety, a combination of acupuncture, talk therapy, yoga, and/or emotional freedom technique might offer greater benefits. 

Sometimes, however, it’s necessary to consult a physician.  Eastern and Western medicine are so often placed at odds with each other, but they can create a beautiful synergy when used together.  I often encourage patients to return to their medical doctor for further review when it’s appropriate to do so.  This has, in some cases, led to a significant diagnosis and medicine that has helped the patient avoid major illness.  

In one case, I was working with a patient who complained of GERD.  Acupuncture successfully treats GERD using needles and herbs most of the time.  However, after working with this patient for over a month, their condition remained unchanged.  They took my advice and a local GI doctor diagnosed them with advanced esophageal damage after performing an endoscopy.  With that knowledge, the patient agreed to take the prescribed medication and returned for biweekly acupuncture. In a few months their esophageal damage had fully healed.

As we continue our work together let’s discuss what options may best suit you.  If you need a referral please ask us the next time you come in.  We have a great list of practitioners from a variety of modalities.  In the end, as your health care provider, it is our goal to ensure that you're receiving the best set of options to heal.

How Did you Hear About Us?

This post is dedicated to the remarkable life and legacy of community member, S.B..

On our intake forms, we ask new patients how they were referred to us simply to see where people are finding out about Long Beach Community Acupuncture (LBCA). It’s always fun to read a familiar name that answers the question. Sometimes people simply write “a friend” and often the name of some social media platform. Recently, a new person had written in the name of one of our patients who died earlier this year. When I read her name in the referral, it made me smile because that patient had a wonderful smile, an infectious laugh, and a life perspective that was unique and uplifting.

It made me glad that I had had the opportunity to treat her during a terminal illness and while I cannot pretend to have known her very well, I know I will never forget her. She brought light to many and when I remembered the network of referrals, a gallery of faces hung in my thoughts. At least three other LBCA patients had all been touched by her life.

When community acupuncturists get together, we often talk about how heart-opening our work is. This is not just an emotional response; it’s visceral, in the solar plexus. I felt that feeling when I first heard about community acupuncture in my last semester of school. I read an article in CJOM (California Journal of Oriental Medicine) by a woman who had opened her community clinic in San Francisco. From the description of her practice, I knew deep down that I just HAD to practice this way--it was a feeling beyond words.

Every business wants word-of-mouth advertising--it’s free and it’s the best. When patients come in, I remember how they got here and remember the ones who have sent in others over and over again. It is a map of connection among friends, family, and community.

I know referrals happen in private practice for people too, but there is really something unique and special about the way community clinics work that facilitate relationships. Often couples come in to nap together and certainly friends do too. Just the other day, a patient came in only to find her boss and boss’s husband sleeping in the chairs next to the one she picked! It was a happy realization.

It is easy to feel isolated in our culture and that’s one of the best things about the community treatment room. You don’t have to nap next to your spouse, lover, co-worker, or friend. It is salutary to know that you are not alone in this world. And it is a beautiful way of remembering others, if they’ve passed on or moved away.

Over and over again, I am filled up by working in this clinic; it keeps my heart wide open to human beings, how complicated we all our, how deep our needs and wounds.

Embracing Uncertainty and Finishing Well

…the three noble principles: good in the beginning, good in the middle, good in the end. They can be used in all the activities of our lives. We can begin anything we do--start our day, eat a meal, or walk into a meeting--with the intention to be open, flexible, and kind.
   Pema Chödrön, The Places That Scare You: A Guide to Fearlessness in Difficult Times

I don’t know about you, but 2017 has proven to be one of the most challenging years for me. My father passed away in February and that event alone pushed me up against discomfort, sadness, and fear in ways that nothing else has.

Like everyone else, I’ve watched daily as our nation struggles to comprehend and adjust to our new political administration. I’ve read the bios of people who have been murdered in mass killings, seen devastating photos of fires, floods, and earthquakes, and often just can’t believe that something else horrific is happening---again--this year.

I’ve treated people who are experiencing nothing short of shock and trauma from these and other personal experiences--some remembering harassment and assault, some mourning their own lost loved ones.

Throughout the year though, LBCA has held me steady and I know that it has been a source of stability for others. My colleague, Nirva, wrote eloquently of the radical acts that take place in our clinic every single day. Indeed, the wonderful moments we experience with patients are a salve, a balm countering the troubles and fears that exist beyond our concrete walls.

2017 has been a year of uncertainty. No one knew what to expect after the January inauguration and we don’t know what 2018 will bring. These are difficult times to be sure. Chödrön is clear: “we can never avoid uncertainty. This not knowing is part of the adventure, and it's also what makes us afraid” (6). I would like to be less afraid, learn to work with discomfort, and enjoy the adventure of not knowing.

As the year winds down, I am thinking about how to finish it well. In any part of a process, it’s important to be mindful at each stage though we tend to gravitate toward beginnings, ignore middles, and rush through or avoid the endings. How will you finish this year well? Being “open, flexible, and kind,” seems like a good starting place.

The Radical Act of Community Healing

As I reflect on this year working with you, I’m not sure I expected to see a space for healing as an integral part of community.  But that’s what Long Beach Community Acupuncture has become for me.  This space on its own is a combination of chairs and concrete.  But everyday, we come to this building and we talk about our pain, joy, sadness, fears, and the desire for balance or release.  These rich conversations breathe life into this old building.  And for these reasons we all have a stake in this community. 

This was most apparent to me in the first month I spent with many of you.  You welcomed me so warmly over and over again.  And you all said the same thing “welcome to our community.”  And it floored me.  Looking at this moment through the lens of my previous career as an urban planner, I know that creating community is not an easy thing to do.  So it has been profoundly important to me to honor and respect that sense of community and commitment you all feel in connection to your health and this space. 

Community acupuncture is so wonderful and it has provided me the environment to extend the values I cultivated in my previous career into this work.  As acu-punks we are committed to providing affordable and accessible care that cuts across race, gender, ethnicity, language, and sexuality.  In this way, we come together to uphold the values of unity, equity, and justice—a radical act. This is what brought me to your community and to this type of practice.

On any given day, I am treating people of all walks of life, from women of color, to immigrants, to men, and limited English speakers, as well as people of differing ability, income, and class.  It is beautiful to see you all lying there in your chairs side by side unified in your healing.  And that is such a significant way for communities to heal.  

Personally it has been such a joy and honor sharing space with all of you over this past year.  I am so happy to be your community acu-punk.  Cheers to the clinic and cheers to another year working together!