How Trauma Is Killing Us: Understanding Adverse Childhood Experiences (ACES)

“If we do not transform our pain, we will most assuredly transmit it.” ~ Richard Rohr

Another tragic mass shooting resulted in the deaths of ten people at Santa Fe High School near Houston on Friday, May 19, 2018. There have been 22 school shootings so far this year where someone was injured or died.

It is hard to comprehend.  There has been more than one shooting each week. What is going on? Our children are killing each other in a very public forum at the places where nurturing, learning and growing into good citizens should be happening for them all.

Instead, the threat and fear of death and violence is following them into every classroom.  Why do we adults seem powerless to put measures into effect that would change the situation immediately? We seem to be passively accepting that this is the new normal…that nobody is safe anywhere.  Of course, this is not true. My sense is that we are overwhelmed and don’t understand that unimaginable pain, mental illness and trauma are culprits behind all the violence.

I have learned a lot about (and from) kids through my professional involvement over the past four decades. Even though I would love to pour all of my experiences and wisdom shared by mentors and the kids themselves regarding childhood trauma into these pages, there would never be enough room.  So allow me to synthesize some of what I know about violent children and relate it to school shootings.

1. Childhood trauma is an underpinning of the rage which creates horrific violence.
2. Traumatized kids cannot imagine a future without more pain. Usually, they lead lives filled with current conditions of chaos and unpredictability leaving them continually re-damaged.
3. Aggressive behavior is the last survival behavior a kid uses. He has already tried to find relief in every other way.
4. No hopeful kid ever picked up guns or explosives, took them to school, and started a killing spree. Only hopelessness can create it.
5. No kid ever thought that killing his classmates and teachers would bring him attention and fame. He just wanted to die.

"The status quo is only interested in incessant judging, comparisons, measuring, scapegoating and competition." ~ Gregory Boyle

In each case, experts have lined up to offer all kinds of solutions.  Mostly they involve gun control of one kind or another on one side and the arming/hardening of schools on the other.  We seem to be stuck in debates which lead to very little action.  Unfortunately, almost all of the proposals are reactive.  Rather than putting our efforts into primary prevention, we seem bent on expending massive resources fighting a losing battle against the NRA or by turning schools into impenetrable fortresses.  I wrote a column several weeks ago about the folly of these tertiary interventions as they apply to our addiction epidemic.  The same applies when it comes to this problem.

Since childhood trauma, Adverse Childhood Experiences (ACEs), seem to have a causal relationship to violence and school shootings, I believe that we can develop screening and assessment protocols to identify at-risk people and circumstances.  We will then be able to change our modus operandi from blaming, shaming and punishing people to understanding, encouraging and healing them.

What are ACEs?

ACEs are Adverse Childhood Experiences.  These are events which occur before age 18 (most damaging are those which happen prior to age 6) and are beyond a young person’s control.  A lifetime of hardship and adversity can follow which could be passed on from generation to generation.

The principal types of ACEs are:

• Emotional, physical or sexual abuse
• Emotional and physical neglect
• Living in seriously troubled households (homes that have domestic violence, or mental and/or substance (alcohol or drug) disorders, or parental separation or divorce, or a family member who is incarcerated.

As the number of ACEs a youth experiences increase, so too does the risk for these health and mental health problems – often before they depart their teen years. The greater the number of ACEs a youth experiences, the greater is the likelihood of multiple problems. ACEs science clearly shows that childhood trauma results in adolescent and adult-onset of chronic physical and mental illness, violence, and being a victim of violence.

ACEs and the Extreme State

Most of us have been exposed to at least one ACE in our lives.  But very few of us can relate to the impact of real-life, hardcore trauma experiences which cause the ‘survival brain’ to take control of our behavior. Children who have suffered cigarette burns at the hands of parents or those who are abused sexually every night endure torture which most of us cannot imagine.   These events or series of events have been referred to as the extreme state by Dr. Corinne Gerwe.

Sigmund Freud theorized survival as a predominant driving factor in human behavior.  When trauma is experienced it is followed by an intense feeling such as fear or anger.  Physical symptoms follow like a racing heart or nausea.  The survival brain goes into high gear, virtually closing down the ‘learning brain’ sensing an emergency situation.  The behavior(s) which are enacted and relieve the intensity of the feeling is logged in the memory and become intrinsically linked to emotional survival.  They will be continually reactivated by their inter-related feeling/physical symptom states whenever the intense feeling shows up.  They can develop into persistent and often obsessive patterns that are not grounded in rational thinking or intention.  They can be described as behaviors that a person will swear never to do again and yet repeat despite attempts to resist.  These behaviors can be difficult to explain and even a mystery to the person enacting them as noted by Gerald M. Edelman in his 2003 study of neuronal consciousness.

Understanding ACEs and the extreme state should allow us to stop wasting time looking for scapegoats, endlessly searching for motives, slapping the dismissive labels of evil, loser, or bad guy on a person who has inflicted terrible damage.  It will enable our communities to own their part in violence when little has been done to prevent it.  Healing only occurs when we recognize the true nature of a problem, understand its defeating nature, and apply steps to change the way we deal with it.  Prevention is the only long term solution.

“Denial is perfectly beneficial until it’s not anymore.  Then we need to find a safe place to peel back the layers of our own pain.” ~ Gregory Boyle

Primary Prevention and Intervention Using ACEs

We have a golden opportunity to solve this most intractable school shooting problem as well as other less dramatic consequences of ACEs.  One community where systems are in place to change the dynamic is Memphis, Tennessee.  Their ACE Awareness Foundation takes a three-step approach.

1. Universal Parenting Places (UPP sites) ~ UPP sites are judgment-free zones where parents can go for help. They can talk with counselors, explore their own ACEs and learn how to alter their behaviors in their homes. Counseling is offered at no cost to the consumer. Research has shown that being able to trust another adult and “just let it out” helps people work through their experiences and take control. For some adults with a high ACE score, finding out that there may be a scientific reason their minds and bodies react in certain ways can also be liberating.
2. Parent Support Warm Line ~ At home, caregivers can call a free phone line (844-UPP-WARM) administered by Le Bonheur Children’s Hospital for guidance and support with parenting issues in real-time. It’s manned by licensed therapists who have trauma training. ACEs are more likely to occur during peak hours of parenting — late afternoon to bedtime — so the Warm Line is available for parents who need to talk through something or who just need a timeout.
3. Community Outreach ~ Healthcare providers, organizations and civic leaders attend workshops focused on creating trauma-informed citizens. The State of Tennessee has also held statewide summits and created task forces to combat the issue, creating ACE Awareness Partners.

“We envision a Memphis where everyone knows where to get the help they need. Every adult and child should be able to take control of their own destiny.” ~ Ellen Rolfes

The more we can do to prevent ACEs, the closer we will come to ending school violence, bullying, and even mass shootings.  With this in mind, I propose that every student in every school and every parent or caretaker should complete an ACEs assessment.  Those who are deemed at risk would receive immediate referral and help.  This is a full system change from intervention to prevention that won’t come easy. But we need to create a critical mass of people who understand ACEs, can speak that language and can take action.

The Work Has Already Begun

There are now 38 states and the District of Columbia who has done their own ACE surveys through the Behavioral Risk Factor Surveillance System (BRFSS) since 2009.  The BRFSS is an ongoing data collection program designed to measure behavioral risk factors for the adult population (18 years of age or older) living in households.  The original Kaiser-CDC ACE Study began in 1995 and completed in 1997, but participants were followed for 20 years. New data on the more than 17,000 participants continue to be collected.

ACEs assessments and questionnaires are being used in education, healthcare, parenting programs, and juvenile justice systems around the country.  A group called ACEs Connection describes themselves as “a social network that accelerates the global movement toward recognizing the impact of adverse childhood experiences in shaping adult behavior and health, and reforming all communities and institutions -- from schools to prisons to hospitals and churches -- to help heal and develop resilience rather than to continue to traumatize already traumatized people.”  They have organized concise methods for communities to start up local ACEs Networks.

Below you will find pdf downloadable tools from my Google Drive that can be used to determine ACEs risk for adults, children, and teens. Start by finding your own ACE score. Let’s join the effort to bring about some real, long-lasting change.

ACEs Toolbox; Questionnaires and User Guide

ACEs User Guide

Finding Your (Adult) ACE Score

ACEs Child Questionnaire

ACEs Teen Questionnaire

ACEs Teen Self Report

Robert Kenneth Jones is an innovator in the treatment of addiction and childhood abuse.

In a career spanning over four decades, his work helping people recover from childhood abuse and addiction has earned him the respect of his peers.

His blog, An Elephant for Breakfast, testifies to the power of the human spirit to overcome the worst of life’s difficulties. We encourage you to visit and share this rich source of healing, inspiration, and meditation.

Contact Bob Jones on Linkedin

Bob Jones’ blog An Elephant for Breakfast

The Addiction Epidemic: Re-ordering Strategies for Substance Abuse Disorders from Intervention to Prevention

More than 64,000 Americans died from drug overdoses in 2016, including illicit drugs and prescription opioids…nearly double in a decade. An estimated 88,000 people (approximately 62,000 men and 26,000 women) died from alcohol abuse in the same year. We lost 152,000 people.  This makes alcohol and drug abuse/addiction the third leading preventable cause of death in the United States. Only heart disease and cancer took more lives.Congress approved and the President signed a bill funding $7.4 billion for addiction in 2018.  But are we allocating our resources well? Are we addressing this health crisis in new and effective ways? It is a good and meaningful try to be sure.  The problem is that we continue to allocate much more money and effort into putting out fires as opposed to preventing them.

Chattooga River

Are We Focused on the Real Problem? Insights from the Chattooga River

In my role as an addiction professional, I used to speak before groups of mental health, substance abuse and adolescent treatment providers on a fairly regular basis. One of the stories I liked to tell is that of a hiker in the Blue Ridge Mountains who had wandered onto an active emergency situation at a Class IV rapid on the Chattooga River.

There were ambulances, EMT’s, police officers, a coroner and lots of onlookers trying desperately to pull the dead and dying from still-treacherous waters below the rapids.  The victims were young people who were beaten by rocks, lungs full of river, no longer able to help themselves.  Knowing that he would only get in the way, the hiker hustled upstream.  There he found another frantic situation indeed.

The whitewater of Bull Sluice was enveloping kayaks, canoes and swimmers. Specially trained First Responders and Experienced Whitewater Guides were using all of their skills in efforts to get people out of harm’s way to little avail.  So the hiker went around the bend and up to a point where he heard cries for help and found several river guides and volunteers throwing floating devices on ropes, wading into swift water, hauling kids and boats up to shore from an area just above the Class IV treachery.   Many were being rescued but some were swept away.

There was still little room for him to be of any use, so the hiker ran along the bank to find a group of youngsters swimming in the river.  Some neighbors and volunteers from the down river site were trying to talk them into getting out of the water…warning of the perils downstream.

Several of them paid attention and followed the urgings of their warnings and headed in for dry land.  Finally, a few hundred yards further on, the hiker found a bend in the river where it seemed to be warm and inviting.  A group of kids were changing into swim wear and heading toward the water with rafts and inner tubes.  There were no adults supervising, warning or rescuing.  The situation was so ostensibly innocent.

He approached the young people, told them of all he had witnessed and talked about finding another way to enjoy the afternoon that might not be so life-threatening.  He showed them the way to a little private cove where still water, a diving well and nice beach waited.  Everyone took him up on the offer and enjoyed a safe day of adventure.

From the Intensive Care to Early Screening:

Our Inverted Focus (or Looking for Cures in All the Wrong Places)

I think my subtitle is a little cutesier than it should be. It makes me think of the 1980 Country song “Lookin’ for Love” by Johnny Lee making it hard to resist.  Anyway, my story about the Blue Ridge Hiker is what I believe is an upside-down pyramid of attention, emphasis, funding and research in dealing with the opioid/addiction epidemic.  The following are the categories of treatment intervention as I have experienced them in decades of direct service in the field of Substance Abuse Disorders (SUDs).Tertiary Intervention: Most of our precious time and resources has been given to what I call tertiary intervention.  Like the hiker approaching the chaotic rescue efforts downriver, we have spent most of our time giving CPR to the dying and burying the others. Tertiary Interventions include;

• Emergency Response Teams (First Responders, LEO’s, Emergency Rooms, Hospitals, Intensive Care)
• 24 hour hospital based Short Term Medical Detox Centers
• Criminal Justice System
• Universal availability of naloxone

Secondary Intervention: These are Medically Managed Services for adolescents and adults.  In my story, it is the discovery of direct whitewater rescue.  Secondary Interventions include;

• Hospital based 24-hour nursing care and daily physician care for severe, unstable patients who cannot manage life without these intensive services.
• 24 hour Intensive Inpatient Services Withdrawal Management centers with counseling, physician, nursing and medication management services.
• Residential treatment centers with flexible programs to meet individual treatment needs depending on severity of illness.

Primary Intervention: Services at this level help those who do not require round-the-clock care.  The hiker in the little tale finds swimmers and adventurers above the rapids but in some degree of real trouble.  Primary Interventions include;

• Partial Hospitalization Services for adolescents and adults, this level of care typically provides 20 or more hours of service a week.
• Intensive Outpatient Services for adolescents and adults, this level of care typically consists of 9 or more hours of service a week.
• Outpatient Services for adolescents and adults, this level of care typically consists of less than 9 hours of service a week.
• Opioid Treatment Programs. (OTP) utilizes methadone or buprenorphine formulations in an organized, ambulatory, addiction treatment clinic for clients with severe Opioid-Use Disorders to establish a maintenance state of addiction recovery
• Drug Courts

Primary Prevention: Early Intervention for Adults and Adolescents, this level of care constitutes a service for individuals who, for a known reason, are at risk of developing substance-related problems, or a service for those for whom there is not yet sufficient information to document a diagnosable substance use disorder. This represents the final stop for our hiker.  Primary Preventions include;

• Adverse Childhood Experience Screening (ACE’s)
• Classroom based substance abuse education programs
• Strategic Prevention Framework by SAMHSA
• Recovery Community Services Programs. Organizations that are grassroots, separate from the government run programs, separate from treatment services i.e., Faces and Voices of Recovery (FAVOR)
• Prescription Drug Monitoring Programs (PDMP). An electronic database that tracks controlled substance prescriptions in a state. PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate a nimble and targeted response.

There is practically universal accord that our methods of dealing with drug and alcohol abuse have failed to achieve the desired results.  The efforts to stem the tide of addiction by declaring a war on drugs (which was really a war on people engaged in it) proved almost fruitless.The problem is that despite good intentions, and an allocation of massive funding, we are continuing to pour resources into the least effective means of turning the tables on our nationwide epidemic. Policy makers and leaders have decided to ignore the facts and double down on a status quo method of dealing with a healthcare crisis which has been raging for almost 20 years. And the status quo has made virtually zero impact (statistically speaking) on outcomes.The Comprehensive Addiction and Recovery Act (CARA) of 2018 heralds a new era which will “Expand prevention and educational efforts—particularly aimed at teens, parents and other caretakers, and aging populations—to prevent the abuse of methamphetamines, opioids and heroin, and to promote treatment and recovery.  However, it authorizes funding at the roughly the following levels nationwide;

• Inpatient, outpatient and OTP treatment at $4.1 billion
• Criminal Justice at $1.59 billion
• Prevention at $221 million (4.4 million per state)
• Recovery Support Services (FAVOR, recovery high schools, recovery housing) at $7 million or $140 thousand per state (not even enough to fund services in Upstate South Carolina for example)

There is a place on the planet which has used effective local initiatives in the form of policies to discourage drug use while offering solid alternative programs. Iceland built an anti-drug plan that focuses largely on providing kids with after-school activities, from music and the arts to sports like soccer and indoor skating to many other clubs and activities.They coupled this approach with banning alcohol and tobacco advertising, enforcing curfews for teenagers, and getting parents more involved in their kids’ schools to further discourage drug use.Researcher Harvey Milkman says of Iceland’s approach, that it’s “a social movement around natural highs: around people getting high on their own brain chemistry … without the deleterious effects of drugs.”As a result, Iceland, which had one of the worst drug problems in Europe, has seen adolescent consumption fall. The number of 15 and 16 year-olds who got drunk in the previous month fell from 42 percent in 1998 to just 5 percent in 2016, and the number who ever smoked marijuana dropped from 17 percent to 7 percent in the same time frame. In a similar time period, from 1997 to 2012, the percentage of 15 and 16 year-olds who participated in sports at least four times a week almost doubled — from 24 to 42 percent — and the number of kids who said they often or almost always spent time with their parents on weekdays doubled, from 23 to 46 percent.[/et_pb_tab][et_pb_tab title="The Vermont Approach" _builder_version="3.0.101"]In another approach, the State of Vermont has developed a comprehensive health care policy which has changed the outcomes for opioid disorders dramatically using medication assisted treatment programs.It is called the “hub and spoke model” which was developed by the American Society of Addiction Medicine. The results have been encouraging. Vermont is doing much better than nearby states.It was the only state in New England that in 2015 was below the national average (of 16.3 per 100,000 people) for drug overdose deaths.[/et_pb_tab][et_pb_tab title="The Los Angeles Approach" _builder_version="3.0.101"]One of the most dramatic approaches to dealing with the Drug Crisis can be found at Homeboy Industries in Los Angeles. Here, and in a multitude of spin-off organizations, comprehensive employment and life redirection strategies have been used to help gang members, previously incarcerated individuals and families to overcome violence and addiction.They are unconventional.  Established by Rev. Gregory Boyle, they tell that at Homeboys, hope has an address.  He tells us that, “Homeboy Industries has been the tipping point to change the metaphors around gangs and how we deal with them in Los Angeles County.This organization has engaged the imagination of 120,000 gang members and helped them to envision an exit ramp off the "freeway" of violence, addiction and incarceration. And the country has taken notice. We have helped more than 40 other organizations replicate elements of our service delivery model, broadening further the understanding that community trumps gang -- every time.”Every member of Homeboys must test clean on drug screens to be a part of the community service.  Their unusual program is based on a spiritual model of unconditional love.[/et_pb_tab][et_pb_tab title="The Memphis Approach" _builder_version="3.0.101"]Memphis is using ACE’s.The Adverse Childhood Experiences (ACE) Awareness Foundation of Memphis “informs the community about the role of emotional trauma in mental, physical, and behavioral health, and implements innovative models that provide preventable and sustainable solutions to reducing toxic stress in family systems.The Foundation launched and provides strategic oversight to the ACE Task Force of Shelby County, the Universal Parenting Places, and the Parenting Support Warm Line.” Although not an addiction or substance abuse disorder specific program, ACE’s used in the comprehensive way Memphis is developing will stem the tide through screening and direct services.  The fact is that pain drives addiction and SUDS. Drugs and alcohol are abused by people who have childhood experiences and trauma that the rest of us cannot imagine.They are seeking relief and a hiding place.  When a community like Memphis gathers its schools, juvenile justice system, LEO’s, pediatricians, colleges, churches, other human service providers, parents and families together, you can be sure that something incredible will happen.There is new research telling us incredible things about the way addicted brains work.  Drugs have been found to hijack dopamine systems making ‘getting high’ an almost unavoidable consequence.  Also, the adolescent brain, when exposed to drug use has little chance to form good cognitive processes. The idea that addiction is a moral failing has been practically eliminated.  With that in mind, it is even more important that we begin thinking outside of the box.[/et_pb_tab][/et_pb_tabs][et_pb_text _builder_version="3.0.101"]

It’s Up to Us…Here and Now:

Just think…152,000 people lost from this preventable disease or disorder.  People in our lives will die.  We have a lot of work to do.  Funding and programs will only go so far.  Certainly, we have to encourage a change in the way budgets are allocated.Prevention first…at the very top priority…is the best and most worthwhile model to embrace. We cannot keep repeating mistakes of the past and expect different outcomes.  But there is a spiritual, community reality that we must embrace as a foundation for how we deal with the problem of addiction and substance abuse disorders.The one who suffers is not someone else but is each and every one of us.  If we are going to get beyond all of this, there is no other way to look at it.  Our wounds are shared.  We are all in this together.  Here and now, and in each and every moment, we should be asking the question ‘What can I do to help’.Then we will find an answer._________________________________Robert Kenneth Jones is an innovator in the treatment of addiction and childhood abuse.In a career spanning over four decades, his work helping people recover from childhood abuse and addiction has earned him the respect of his peers.His blog, An Elephant for Breakfast, testifies to the power of the human spirit to overcome the worst of life’s difficulties. We encourage you to visit and share this rich source of healing, inspiration and meditation.Contact Bob Jones on LinkedinBob Jones’ blog An Elephant for Breakfast[/et_pb_team_member][/et_pb_column][/et_pb_row][/et_pb_section]

Suicide Prevention (1-800-273-8255): A Way to Prevent, Understand and React to Suicide Death

by Robert Kenneth Jones

This is the truth. We are experiencing a dramatic rise in suicide in The United States.

While other causes of death are on the decline, suicide is climbing…and it's doing so for every age group under 75. Suicide is the second-highest cause of death for 15 to 34 year-olds with the phenomenon of ‘suicide contagion’ or copycat suicide ever-increasing among teens.  The suicide rate in the United States has grown by 24 percent over the last 15 years. Don’t you wish this was fake news?  But it’s not.Music and Youth Culture Raise Suicide AwarenessLogic, the American rapper, singer, songwriter, and record producer has released a track on his most recent and third studio album called Everybody with the title, “1-800-273-8255” featuring Alessia Cara and Khalid in an effort to increase awareness and put a personal face on suicide.  The song offers up the 800 number to guide people, especially his young audience, to the National Suicide Prevention Lifeline. The hit song turned out to have an incredible impact in 2017. The National Suicide Prevention Lifeline (NSPL) says they received a 50 percent surge in calls last year after the April release of his new track.  Logic performed the record at the 2018 Grammys.  The NSPL revealed that in the two hours following Logic's performance of the track counselors received three times the number of calls they usually receive in that time period.It Feels Like It's My FaultI am no stranger to suicide.  My work as a human services provider has all too often brought me to the broken hearts of those who are contemplating suicide as well as those that have loved a person who ended their own life. It’s hard to find anyone who is untouched by this.  My own family has suffered through several. Each one has left us in a state of confusion and self-blame. I can never forget the awful notifications.  I can never forget having to then break the news to loved ones. The memories are so vivid.  I can never forget.Along with the fact that suicide is devastating and painful, it is also highly stigmatized. Its illusion of shame elicits a code of silence creating an even deeper misery.  By ending this code of silence and destigmatizing suicide (and other mental health issues) the desolation they cause will be diminished. John Nieuwenburg is an award-winning business coach who addresses the way that we might move beyond silence and shame. His TEDx Talk is a must-see for those who suffer, family members, friends, human service providers, and Chaplains.New Trends in Suicide Prevention: Brain Science and ACESPrevention is possible.  It is important to understand the risk and to know the facts. We are beginning to better understand the suicidal brain through new scanning techniques.  Studying differences in the brains of suicide attempters and depressed individuals who never attempt suicide may help in developing better treatments. The incredible work being done with adverse childhood experiences (ACES) is leading us to believe that cumulative trauma in children increases suicide ideation in adults.  A whole new treatment protocol is being established in communities like Memphis where schools, parents, hospitals, physicians, and other human service providers are being trained to recognize, screen for, and deal with trauma with its long term consequences. We have learned that 50 percent of lifetime mental illnesses like depression, anxiety, personality disorders, suicide ideation, and PTSD begin by age 14. Do you want to be the one to help?  Here is a useful hashtag tool that might lead you in the right direction. #BeThe1ToThe Startling Truth of Blue SuicideThere is an alarming increase in police officer suicide that escapes national attention.  ‘Blue Lives Matter’ is more than a slogan. These men and women who bravely serve and protect us face trauma or the threat of trauma every day they go to work.  Like veterans of war, they are likely to think about suicide and act on those thoughts much more frequently than the average adult.  Dr. David J. Fair, President, and C.E.O. Homeland Crisis Institute Crisis Intervention, Training, Consulting, and Response wrote recently that; “Police officers must deal with  Traumatic Stress Disorder (PTSD) daily. With officers being killed on almost a daily basis PTSD is raging. Not just for the officers where the shooting happened but on a national basis with something called Secondary PTSD. You can't work in law enforcement and not be affected by a police officer being injured or killed.”  The Action Alliance for Suicide Prevention has created a study guide for Chaplains and other counselors.  We are told that more law enforcement officers in The United States die by their own hand than are killed by felons. We must help break the silence and elevate suicide prevention efforts for the sake of our dedicated public servants, their families, and communities.Creating Suicide Programs and Ending the SilenceThere is so much more to be said.  Worldwide, 350 million people (that’s 5 percent of the population) struggling with depression every day. They are suffering and sometimes dying in silence because we can’t seem to talk openly about it. We must push the conversation forward. Middle and high school health classes would be a perfect place to begin the dialogue. But precious few programs exist. Instead, remain silent or we continue to put most of our efforts into postvention.Let’s get out of our cycle of denial by admitting openly that these issues are real and lethal.  Perhaps then, a Power Greater Than Ourselves can restore us to sanity.

Burned Out: What Happens When Too Much is Too Much?

by Robert Kenneth JonesCertainly, being a human service provider, a pastor, a chaplain, a police officer, healthcare worker, teacher, first responder, parent, caregiver, or some other servant leader can lead to burnout.You Are Not Alone: Hitting the Wall and So Many StressorsYou seem to hit a wall. It is a place of feeling overwhelmed, tired, pressured and crowded.  All of the promises made and things that must be done are just too much. To live up to the expectations of others and those that are self-imposed becomes impossible.If you are experiencing (or have ever experienced) burnout, you are not alone.  I sure have. It even led me to quit one job.  I have also used excessive amounts of alcohol to relieve those pressures.  The World Health Organization found that 96% of all mental health care workers experienced some level of burnout while a full half of their other study respondents experienced very high-levels.Am I Burning Out...Or Just Overly Tired?The Mayo Clinic has developed some questions, symptoms, and solutions to help us with ‘burnout syndrome’.  I have found them helpful because it is often too late when my denial is finally overcome by exasperation and exhaustion.  The consequences are never good.  Physical, emotional and spiritual health can become so compromised that simple self-care is not enough. Professional help is all that will do. Not that seeking counseling is bad (it’s what I do for a living), but there are also things we can do and ways to recognize burnout before it gets too serious.Steven Covey described good methods for finding balance before burnout in his classic book, The 7 Habits of Highly Effective People with Habit 7, ‘Sharpening The Saw’.  He tells us that there are four areas of “saw-sharpening” (or preserving and enhancing the greatest asset we have which is ourselves). He suggested having a balanced program for self-renewal in physical, social/emotional, mental, and spiritual areas of our lives.Physical:     Beneficial eating, exercising, and restingSocial/Emotional: Making social and meaningful connections with othersMental:      Learning, reading, writing, and teachingSpiritual:    Spending time in nature, expanding spiritual self through meditation, music, art, prayer, or service”Oh by the way, if this book is not in your library you are missing a treasure.It is an absolute necessity that we care for ourselves in these four areas. The choices are rather simple.  We can take time for regular renewal or we can burnout by overdoing, We can hit the wall or we can continue to serve. Feeling good doesn't just happen. We must live a life in balance by taking the necessary time to renew and refresh.Blue Burnout for LEO's and ChaplainsPolice officers experience a high rate of burnout syndrome and plateauing as described by the National Criminal Justice Reference Service (NCJRS).These men and women are protectors of justice, civil rights, and of the public who depend upon them. They give us long hours of service which are filled with continual stress.  It is no wonder they are highly susceptible to overwhelming fatigue. Their heavy responsibilities often cause them to become hypervigilant and angry.  There is far too little time for taking care of themselves. Blue Silence can become the rule of the day resulting in isolation, depression and suicide ideation. There are ways to deal with LEO burnout just as with other professions.  One of the most important things to do is to reach out to Chaplains and other trusted people in the department.  These are the folks who will understand. Nobody can handle this alone.Chaplains burnout too.  Dealing with trauma and loss on a regular basis can lead to a skewed perspective and hypersensitivity. I always think of the verse in Mark 5:24-34 when the woman touches Jesus’ cloak while seeking healing.  He is being pressed by the crowd yet feels a draining effect and turns around to see who touched his clothes.Talk about being sensitive! It is critically important for Chaplains to engage in regular mental health days away from their duties. When work is also a ‘calling’ there is an obligation which exceeds other professions. There are specific ways that are somewhat unique to Chaplains in recognizing and dealing with burnout.  It is important to remember that little healing or spiritual guidance for others can be offered by a pastor who is chronically overwhelmed. Here is a helpful verse for reflection:The grace of God means something like:Here is your life.You might never have been, but you are,because the party wouldn’t have been complete without you.Here is the world.Beautiful and terrible things will happen.Don’t be afraid.I am with you.~ Frederick BuechnerA Case for Understanding Burnout and Help from The A Familiar NeighborThere is a novel I read a long time ago by Graham Greene called “A Burnt-Out Case.”  It is a good resource for all of us.  As the incidence of burnout rises it might be essential.  The 2016 General Social Survey conducted byThe University of Chicago found that 50 percent of its respondents were consistently exhausted because of work, compared with 18 percent two decades ago. So we are all subject to burnout.  There are no exceptions in any work-related field.  This major health concern is far too pervasive to ignore or deny.Perhaps we need a bit of Mister Rogers wisdom in our hectic work-a-day world. He reminded us that while no one is perfect, it's our individual imperfections that make each one of us so special. We need to remember his gentle words; "I like you just the way you are" as we take the time to be as good to ourselves as we are to others. The only requirement is that we do the best we can.  No more.We are not meant to be in high-stress situations all of the time despite living in an age where stress seems to be glorified…and where giving in is a sign of being a wimp.  I have finally come to the conclusion that if being a ‘wimpy kid’ means taking care of myself and avoiding burnout…then let wimpdom be my home. I, for one, intend to live life fully. How about you?

Try A Little Nudge; How to change habits and manage life using simple positive influence

by Robert Kenneth JonesCan we parents, family members, friends, supervisors, teachers, pastors or human service providers get the people in our sphere of influence to do things that are good for them when they seem to be going in the wrong direction or even on a collision course with disaster?Why Do Good People Make Bad Choices?When presented with seemingly good options they choose a path of least resistance, the easy way out…or even pursue repetitious behaviors that fail every single time. It is frustrating to watch as life batters the people we care about.  It feels like no matter what we do to force compliance or how much nagging, pleading and threatening is exerted, minimal change occurs. Far too often we end up exasperated with it all and just cut the person loose in the name self-preservation, detachment or tough love. It’s time to take another look. Perhaps all we need to do is provide a little nudge or to ‘catch them being good’.It's hard to change habits, but often a gentle push rather than a big shove can direct us in the right way. My own discovery of this truth happened at The Children’s Home of Vermilion County in Danville, Illinois where I was a child care worker in the early 1970s.  There were eight boys, age 6-12 who were placed in my residential unit.  My work with The Child Care Institute and with some innovative professors at The University of Illinois led me to believe that disadvantaged, abused and neglected children could achieve at the same level as their societal counterparts who had not experienced the rough edges of life.  My boys were poor students who were disruptive at school and at our home.  I decided to employ punishment techniques used throughout the institution for several weeks using consistent consequences for negative behavior.  Nothing much changed. The boys generally complied but didn’t thrive.  When I altered my methods to match discoveries about positive reinforcement or ‘catching them being good’ the change in our living environment was dramatic.  The kids began to work harder to achieve goals.  They became curious, grades improved and the atmosphere in the cottage became fun, spontaneous and controlled. You might wonder how and why this shift was so successful.  It all started with the work of Dr. B. F. Skinner.How To Shape Behavior in Positive WaysSkinner developed and refined his theory of operant conditioning way back in 1948.  He wanted to shape behavior in ways that were pleasant rather than punishing.  He found by rewarding small behavioral steps toward a goal that responses changed rather easily and desired targets were reached quickly. His research led to enormous changes in classroom teaching developed by Dr. Wesley C. Becker at The University of Illinois. Becker discovered that instead of pairing misbehavior and attention more effective learning occurred when teachers paired desired behavior and attention. Paying positive attention to incremental successes greatly improved and accelerated learning. Becker went on to write a book called Parents Are Teachers which gave tools developed in classrooms to everyday Moms and Dads. Skinner and Becker became my mentors and the Children’s Home became my lab. The great discovery revealed that ‘catching them being good’ worked more effectively than other techniques.So how can we use this information here and now? Well, it’s become all about The Nudge! Richard Thaler won the 2017 Nobel Prize in economics for his Nudge Theory.  He co-authored a book called Nudge: Improving Decisions About Health, Wealth, and Happiness with Cass R. Sunstein which generated a lot of enthusiasm. It is interesting to me that this approach to behavior change comes from Thaler, a professor of economics at the University of Chicago and Sunstein, a legal scholar.  Their simple wisdom for us all is this; “If you want to encourage people to do things…make it easy.”  The theory teaches that “nudges” will help us manage our kids, our co-workers, our health and our aspirations.A nudge makes it more likely that an individual will make a choice, or behave in a particular way so that automatic cognitive processes are triggered to favor the desired outcome. Just like Skinner and Becker, Thaler proposes that positive reinforcement and arranging the work, school or home environment will achieve non-forced compliance to influence the motives, incentives and decision making of groups and individuals. The results have been astounding.Police Departments And A Nudge In The Right DirectionIt has been suggested that police departments use Nudge Theory to reduce repeated criminal behavior.  John H. Laub of the University of Maryland and Jim Bueermann of the Police Foundation presented their sweeping plan for the use of Nudge at the 2013 Jerry Lee Symposium and some departments have embraced Nudge Theory successfully.I have become interested in how we might use The Nudge to help LEO’s get support services after trauma at work.  Forcing them to be compliant with departmental policies and procedures to attend individual or group therapy sessions have proven to be only marginally effective. Nudge thinking is a stark departure from our traditional “carrots and sticks” approach. It relies on the idea that small changes to the “choice environment” can encourage large changes in people’s actions. Part of the appeal of nudges for both those seeking change and those who are being asked to change is that instead of mandating behavior, nudges offer people the ability to make their own decisions. There is substantial information and data which lead me to believe that a small tweak in the way we frame our internal systems will result in the desirable behaviors we want and healthier outcomes for everyone.Measures such as on-the-clock 20-30 minute didactic support groups every two to four weeks put on by local mental health providers, counselors, and in-house Chaplains would reduce the stigma associated with mandatory ‘head shrinking’. Completion of course work related to the groups could enable merit increases and/or affect chances for promotion. Using nudges to improve program adherence could promote better outcomes while limiting program costs. There are a plethora of possible benefits to utilizing The Nudge for law enforcement. As Richard Thaler tells us, we just need to make it easier.Using A Simple Nudge Toward SuccessThere is a huge opportunity to influence behavior in positive ways by employing nudge thinking.  Remember that the beauty lies in its simplicity.  From protecting the environment to encouraging kids to succeed and stay in school, from the efficacy of health services to reducing criminal behavior and from an opioid epidemic to new pathways for freedom from addiction, we have a means for change by applying the insights of operant conditioning and behavioral economics. So, why not get started with a small step at home or at work?  See what happens when you catch someone being good.  We could be at the beginning of a journey with unbelievable outcomes.After all…It just takes a little nudge.