ACE in the Hole

CW: Discussions of childhood ACES. Mentions of alcohol use and verbal abuse during childhood. Read safely!

Partner (on phone): “‘Always,’ ‘Never,’ ‘I don’t know how to answer that. It was ‘Always’ when we still lived there, but ‘Never’ now because we have public transportation? Well, okay, not ‘Never.’ Public transportation isn’t perfect out here, and we have sometimes have to rent ZipCars. We were not able to access the only available source of covid testing when we had it because we didn’t own a vehicle, which is what I think you are really asking about? So, I’ll say, ‘Sometimes?'”

Lavender: “Who was that?”

Partner: “CA Department of Health. Coronavirus attitudes health survey.”

Lavender: “But we no longer live in CA…?”

Partner: “Yup. And I give credit to their public health team. In between those death threats they are getting they were still able to build a surprisingly competent survey that manages to account for the fact that randomization of cell phone numbers will lead to at least 10% of their time getting a CA cell phone number that belongs to a former resident who now lives out of state. They put me in their non-resident comparison group.”

Lavender: “Oh, would that the 9th Circle of Hell would ever be competent enough to even do a coronavirus health survey, much less be competent enough to have a non-resident control group for former residents. I would love to participate in that survey given my sibling is one of those who are twice as likely to die from covid in the meatpacking-linked outbreak in [The One-Horse Town that Gave the One-Horse Townhouse its Name]. [Largest City in that Multi-County Geographical Hospital Designation] voted against requiring masks yesterday because they wanted to ‘preserve a sense of normalcy.’ Well, this resident of one of the only four states that are now controlling their outbreak absolutely has some opinions on how that underfunded rural health designation is going to cope with ‘normalcy.'”

Partner: “Speaking of Hell, they asked me ACES questions. Verbatim from the 1998 questionnaire. Including all the ridiculous artifacts of that now twenty-year-old set of questions like the fact that it doesn’t ‘count’ as CSA unless the perpetrator was at least five years older. What is up with that one? It’s not like they don’t have updated versions that simply ask about sexual trauma without making assumptions about the ages involved. Having now had each question read out to me one at a time, I am even more angry that I know that there are perfectly valid updated childhood trauma inventories that acknowledge abusers could have been siblings or neighbors or teachers or coaches or whomever else, yet they still chose to use the original wording instead. It is really dangerous to give a group of people prone to dissociating their horrors away a questionnaire that reinforces that their own trauma doesn’t ‘count’ as trauma because the particular power dynamics of their particular horror didn’t fit the original narrow definition. That is how you reinforce trauma survivors further isolating, shutting down and never confronting it. Because even among their ‘peers’ they still feel like they have less right to be there. Because the questionnaire said so.”

Lavender: “Yup. I started a blog post at one point about all the ways a person could have each and every one of those ACES as originally written, yet still technically answer that they had zero. I wasn’t really sure where to go with it.”

Partner: “Because you re-remembered how much you were drawing from your own personal experiences and you panicked and became too afraid to write them out in detail, I assume? You don’t have to use your own examples. It’s pretty easy to come up with multiple examples of ways survivors can fall through the cracks just as a thought exercise. I’ll give you at least one edge case that you probably won’t think of because you would fit the survey as read to me. They updated the language on the domestic violence question to be gender neutral. I assume that’s because CA doesn’t discriminate in official state agency correspondence about the genders of their residents’ parents. The question needed to be able to be read out to those who may have had LGBTQ parents. I’m glad they updated the language about the presumed gender of the impacted parent, but the fact that they went ahead and updated that females can be abusive and that males can experience DV makes it all the more glaring that they didn’t bother to even finish the update on that one question.”

Lavender (trying to remember the exact wording): “What else did they miss?”

Partner (heatedly): “They explicitly only asked about witnessing physical violence between parents. How is a person supposed to answer that if their parents spent years screaming at each other to the point one parent was a functional alcoholic because going out to drink at his friend’s place to get away from it all was his only relief from what, in hindsight, had to be reminding him of his own abusive childhood? Even if things never got physically violent, watching all those years of constant belittling and humiliation has to do something to a kid! Even if the parents more or less stopped being at each other’s throats over all the external stressors as their finances improved, it has to do something if the worst of it was while they were younger! And, while we’re at it, why is using alcohol only considered problematic if the parents were unable to keep the kid fed because of it? I mean, what if they gave the kid the twenty bucks to call for a pizza in advance because they knew they’d be drunk and sleeping it off at their friend’s house? Just because the kid was a latchkey kid known to be responsible enough to order food doesn’t mean the kid didn’t notice why they were being given the twenty bucks in the first place!”

Lavender (stunned): “That…no longer sounds like a purely hypothetical example?”

Partner: “Well, I mean you know it’s not a current example. They’ve gotten way more stable and, I think, worked through the worst of the damage to each other in their own very [Partner’s State of Origin] way. (Partner’s State of Origin, is, btw, of course also one of the current covid-19 red alert spots because of course it is!) It’s pretty clear from talking to them as an adult, even if they won’t speak the mental health language, that the leaving before it could ever escalate beyond screaming was a very deliberate attempt on both their parts not to perpetuate to me what was done to them. You know there was a lot of stuff in their own childhoods. You know I told you how my dad ‘lectured’ at me for hours on end when he was upset with me explicitly because his dad would get physical and he didn’t want to be that kind of dad? And my mom could never be wrong? Ever? They wanted to shield us from their childhoods – especially me since it was just me and them for such a long time – but they didn’t really get that only verbal ‘stuff’ was still ‘stuff.’ I’m not going to say that the way we fought in our household was okay. I’m also not going to say they both didn’t earnestly try to shield me from what they went through, and I’m not going to hold the verbal abuse in the family against them because I know they did the best they could. But, I’m not going to say it hasn’t had any repercussions either. I think verbal abuse should be counted as an equal form of abuse on the DV question. There was a cost to it. And that cost was dad being a functional alcoholic because that was better to him than becoming his dad.”

Lavender: “So, uh, under the most domain-general interpretation of an ACES questionnaire, how many ACES do you have?”

Partner: “I didn’t count. I know you need labels to prove to you that your experiences are real. I know you still half believe that the fact that you can come up with technicalities for your ACES means that at least a part of you doesn’t believe that those experiences happened at all. You deserve the right to claim your neurodiverse and disabled identities and your ACE count as shields against the alternative things you’d otherwise call their impacts. But, I’m different. Claiming a diagnostic label always feels like a sword to me, never a shield. It always feels less safe to be Partner the Label rather than just Partner the Weirdo Introvert. I had a much easier time masking my neurodiversity than you, so labeling me neurodiverse actually feels less safe than just being known for being ‘a weirdo’ in public. I figured out how to get along in the world as a weirdo. I don’t know how things would change if I let people know there was a reason for that weirdness. It seems like something that, at least in my case, would be used against me. In your case, what was done to you because you were weird was so bad that having the label can only make it better. You already had a target on your head from day one. In my case, I masked well enough and coped well enough as a kid that claiming labels as an adult feels like painting new targets on my head. I know that as long as I never overtly mention the mental health terms they have to be against on principle because of their own cultural background, that my parents will try and accommodate my mental health issues. I know my mom is self-aware enough to worry about whether she was a good mom to me as a kid, and she cares enough to have wanted to be one. And, I know that both my parents have enough internal brakes to stop before things go too far in an argument. Those brakes were weaker when I was younger – hence my story – but they have progressively gotten stronger as my parents have aged. You were surprised to hear that story only knowing them as they are now, so you know that’s true. I even know how to mask better than you because when I originally had the same issues with volume control and interrupting that you did as a child, they just taught me what the norms were instead of abusing me for it. And, they gave me outlets were I could not have to fit the norm for awhile and it was okay. Your brain just slides off the fact that anything was ever wrong in your childhood, so you need those labels. I know both what was wrong and what wasn’t, so I don’t.”

Lavender (thinking to self): “You mean my brain slides off of talking about the impact of my own ACES just like yours just slid off of giving me the number? Because you didn’t literally grow up in the 9th Circle of Hell, and your parents did the best they could? So it isn’t worth counting? Methinks thou protests too much…”

Lavender (out loud): Can I write about this on my blog?

Partner: “Absolutely! It was a really irritating way of asking what should be broad questions to a wide swathe of the public who might be triggered by what those questions bring up without adequate warning or aftercare. And, it invalidated a lot of survivors’ experiences because they didn’t fit outdated boxes. Oh! You should mention that why does it have to be only alcohol or street drugs that even count? As a result of the deliberate over-pushing of dangerously addictive drugs like fentanyl for temporary pain conditions that didn’t require them for the past decade, prescription drug abuse is now just as real. And, that’s even before you also get the chronic pain survivors who can’t get their needed meds because amoral big pharma deliberately pushed opioid misuse among the general public and engineered an addiction epidemic. And, there was that question on -“

Lavender: “That’s not what I meant. I meant can I write about this conversation on my blog?”

Partner: “You are more worried about anonymity than I am. And, I think it’s a pretty common story. I wouldn’t worry about it. Also, at some point I think your level of preserving anonymity over true things goes beyond just protecting [Sibling] and starts to get into me worrying about whether you are still conditioned to not speak of ‘shameful’ things. So, yeah, I absolutely want you to talk about this and become more comfortable with admitting how many ACES you have. And, I want others to know that not perfectly fitting into the narrow conception of abuse that one obesity doctor in 1998 from a white, upper-class American background could conceive of as ‘abuse’ in his time doesn’t mean the person wasn’t abused. Even if we perfectly update the ten ACES to be as inclusive as possible, there are still a whole lot of adverse childhood experiences missing from that list. Those ten aren’t exhaustive by any means. Add that, too.”

Lavender: “No, I mean can I write about your story on my blog?”

Partner: “I’ve said that’s okay before with the Psalm 91:10 stuff. My parents aren’t going to find your blog. Even if they did, they won’t recognize any of your stuff to connect the parts about them to us.”

Lavender (fumbling): “No, I mean this isn’t about them. It’s about you… *trails off*”

I could actually write that post about how our continuing focus on the original 1998 language of the ACES as a form of quantifying trauma risks us continuously invalidating survivors whose abuse experiences were even the slightest bit different from the narrow strictures of two-decade-old ideas. I could actually write about how the new fad of shoving ACES screeners at a person at every doctor’s visit or health attitudes survey without any preemptive warning about the nature of the material risks being very destabilizing for survivors.

I could do either of those things this week.

But I won’t.

Because I think I have heard once or twice that the key to good writing is to “show, not tell” whenever possible?

Need a recap of anything I’m talking about in any post? Check out my Glossary of Terms


10 thoughts on “ACE in the Hole

  1. I didn’t even know there are other, better childhood trauma questionnaires around because the old, badly worded ACEs one is so prevalent. There’s the ACE IQ but I’m sure it misses out on bullying, abuse by multiple caregivers among other things.

    Wow, I do totally invalidate some of my traumas due to the bad phrasing.

    I think it’s really good you and your partner can have these conversations. My partner has his own abuse history too.

    Liked by 2 people

  2. If you don’t mind what’s a good questionnaire? Somehow being able to read what counts as trauma and having some kind of score helps me validate myself with “yes it was trauma, yes it was that bad”.

    Liked by 2 people

    1. The Center for Youth Wellness of Nadine Burke Harris in the U.S. has a version that rewrites the classic ten ACES to have fewer weird loopholes. Instead of the original 1998 ACES requiring sexual abuse to have the perpetrator do specific acts or be “at least five years older” (because why does age even matter?!), it just asks whether “someone” ever touched you “in a sexual way that was unwanted, against your will, or made you feel uncomfortable.” You have to register your email to get it, so maybe ask your therapist to do so if you feel concerned about giving personal identification out around your trauma history? And, for the DV question, it asks instead whether “you saw or heard household members hurt or threaten to hurt each other,” which starts to get at verbal abuse. It also adds nine questions around experiencing deportation/detainment, bullying for personal identities, serious health complications, other household members being threatened with the above, neighborhood violence, death of a caregiver, out of home placements, and abuse by romantic partners while still under age 18.

      The WHO update of the ACES also is a bit better in that it brings in some more international cultural experiences (such as caning, which I know is part of your story), and it also at least breaks up DV into emotional and physical as “both bad” and is more gender-neutral. I like that it also defines the “not taking care of you” as including “not understanding your problems or worries.” It also adds threats of abandonment or throwing the child out of the house.

      The Juvenile Victimization Questionnaire is pretty explicit that being abused by a sibling is a form of abuse, which I feel might be a loophole that would make you question whether PerpBro’s actions were really “bad” if you just took the original 1998 ACES screener? It also screens for overly sexualizing a child in the language used to describe them or their intentions and for witnessing the abuse of siblings. (Evangelical Christians have some very weird conceptions of how sexually preoccupied children are and how that influences their supposed “immoral” behavior requiring punishment, from what I’ve noticed from how Partner’s extended family speaks.) It also gets at the idea of social isolation exacerbating the trauma. If no one else knew about an event, or the child had no “safe person” to counterbalance, that in and of itself is additionally traumatizing.

      The Traumatic Events Screening Inventory has a version that is self-report, though I can only find the interview version freely available online. I kind of like that it recognizes that trauma is in how the child feels. I’ve been in natural disasters that could easily be traumatic, but I had them as a special interest. My understanding of its scoring is that natural disasters wouldn’t count in *my* trauma tally, because I didn’t show a stress response to them, but they would count for a child who had nightmares as a result. However, continually threatening to institutionalize me – which doesn’t really have a direct place on a lot of screeners because it was an oddly specific type of threat to silence me that worked particularly well because of my unrecognized neurodiversity and the broader threat to my family from the system itself in the 9th Circle of Hell – cannot be as easily discounted as “only” verbal abuse because it really was “the scariest thing ever” to me as a child. In my weirdly personal trauma ranking scale, it was actually more frightening than being physically hurt or the earlier threat of actual loss of life (to a kid who was passively suicidal her entire childhood.) I also like that recognition within the instrument that trauma is traumatic because of the impact it has on the child and thus all trauma is valid.

      I also like that the newer re-writes ask the participant to endorse how many times a given experience happened, but then score that experience as an “ACE” if it happened even *once.* It means that a participant who starts to loophole themselves by going “well, it didn’t happen *all* the time, doesn’t that mean it was no big deal?” trips themselves up. They answer “demurely” – and then on the back end the interviewer ignores that weaseling out of facing the experience and counts it the same as if they *had* said “all the time.”

      In general, what I’ve found is that most screeners get too weirdly detailed about specific questions while all roughly touching more or less upon about twenty(ish) domains of abuse and trauma to varying degrees. I’m a master at loopholes, so for any given screener I would be capable of dismissing why its *particular* language probably didn’t fit my situation. However, after I had taken multiple versions, I found I wasn’t able to *keep* loopholing my way out of *all* of their descriptions of those same relevant abuse domains. You might be oddly comforted by having that same experience. Some descriptions of physical abuse you will be able to convince yourself don’t apply to you as it was just “punishment for what I did.” However, *at least one* of the written descriptions of the broad concept of excessive physical abuse as a form of punishment will hit directly enough upon your experience that you will have to grudgingly endorse it. And, that will make it harder to rules lawyer your own experience enough to convince yourself all those other descriptions of the same basic concept of a type of abuse somehow “didn’t count.” Repeat as necessary for each relevant abuse domain.

      Taking all of these eventually makes it a little easier to start grouping experiences into categories (physical, emotional, verbal, sexual, financial abuse, bullying, discrimination, etc.) and just endorse which broad categories your particular trauma(s) fit into without forever doubting whether your particular flavor of that type of abuse experiences really “counts” for the domain.

      Liked by 1 person

      1. Yessss, nodding my head because I, too, am great at loopholes! I’ll probably check out everything! It was weird when a Singaporean social worker described my abuse from parents as “severe” because I didn’t get around to telling her about all the other adult caregiver and sibling perpetrators, and because I’ve extra loopholes around “well to people in the West, it’s abuse but it’s common in Singapore, in Asia you know?”

        I generally shy away from forums and Reddit now because sometimes there’s this… Thing white people do where they say “well that wouldn’t fly in the USA/UK but it’s common in your Asian culture so I can’t tell you if it’s abuse or not”, which is great loophole fodder. To the point where Asians in Asia will add qualifiers that they don’t know if it’s abuse because it’s so common!

        Liked by 1 person

      2. I’ve noticed a trend. Go to a thread for ASD, and at some point someone will respond to a post asking “do you think I might be autistic” with “I can’t say for sure, but all I will say is neurotypicals don’t worry so much about whether they might not be that they seek out a support group to ask about it.” LGBTQ spaces and advocates will often say the same thing: that cis-gendered heterosexual heteroromantic folks don’t typically need to invest the mental effort to question being the default. If you are questioning, let that in itself be a guide. I don’t see why abuse isn’t similar. If what happened to the person in childhood was sufficiently upsetting and long-lasting for their psyche that they as an adult seek support to process it, it was most likely abuse. I’ve lived and spent time in Southern and Midwestern states where corporeal punishment with a paddle is considered ordinary discipline, including in states that still allow it in schools and have school districts that still practice it. I’ve met adults from these cultures who seem (as best I can tell) to have no trauma responses, who willingly seek out family gatherings without dread, and who are close with family despite having the means to not be if they so desired. We never know what’s going on beneath the surface, so I’m not quite willing to say that means that kind of punishment is “fine.” I’d certainly never choose it for my hypothetical future child. But, since trauma is trauma by definition when it overwhelms the person’s ability to cope, I’ll at least entertain the possibility that those adults really were only briefly punished, then loved, held and contained emotionally by their parents such that they processed those experiences without longer-term trauma. In that same vein, I can imagine that there could be Asian parents who practice Asian cultural discipline, but they manage to hold and contain their children such that their children learn to emotionally self-regulate, and develop healthy self-worth and a sense of foundational safety. Your childhood clearly didn’t provide that sense of safety. Neither did mine. I’d venture to guess that those Asians who are seeking support on forums didn’t receive that foundation either. Else why would they need to devote so many mental resources to seeking reassurance? Maybe it’s possible in some cases that certain Asian cultural practices – like certain Western ones because what flies on the more liberal coasts isn’t as homogeneous with what always flies in the heartland as forum contributors might think – aren’t always abusive. Maybe they only became abusive because of the abusive intent of the parents behind it. But, in the hands of abusive parents – and especially with added psychologically abusive justifications behind it – those practices became abusive. Paddles or canes are much more overtly conducive tools for abuse than, for instance, plastic cups because of what they were explicitly designed to do. But, I have no doubt that an abusive parent from any culture would be perfectly capable of turning a plastic cup into a tool of abuse if that was all they had to hand when they wanted to be abusive. It seems really invalidating to claim any experience upsetting enough to send a person to a support group for help in processing it years later wasn’t abuse just because it was “commonplace” where they came from. If it was dysregulating enough as a child for the person to be on an abuse forum as an adult, it was probably abuse. And, if the OP responding dug deep enough into the names that were called, the shame that was inflicted over and over, or just how much harder those parents probably hit than what was even considered culturally “normal,” it would probably become pretty clear pretty quickly. Abusers rarely ever only practice one form of abuse. Their verbal, emotional and psychological abuse matters just as much (if not more) than their physical when it comes to how traumatizing they were to their children.

        Liked by 1 person

  3. The questionnaire bothers me on several levels. They have the results, why do we keep putting people through it. What’s not quantifiable, in my opinion, is the outcome. Every brain is different. Every person handles life’s misfortunes differently. Just because my Aces score is what is and I got sick doesn’t tell one thing about who I was before I got sick. Quite frankly it’s unfair to ask people to dredge up trauma to someone they’ll never meet so that the answers can be used in their research. It’s inhumane. Your partner was able to answer no to the physical violence but what if it was yes, and what if that pondering triggered PTSD? Who gets to clean that up? The sufferer? Can we treat people a little more like we give a darn? Ugh. Hot button. 🤍

    Liked by 1 person

  4. It took me until recently to acknowledge my father had an untreated mental illness. That is an ACE but you are right, that they are not the best questions and you can easily answer no and have had childhood trauma. And, my children have a parent with mental illness and their upbringing was so much more “normal” than mine. I am taking a course on mental health peer support and we were just discussing trauma informed care and the ACE test. I am going to re-read the material now.

    Liked by 1 person

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