Symptom Bearers

"RJ" (CC BY-NC-SA 2.0) by Don J Schulte

An individual assigned as the family “symptom bearer” is used as a scapegoat for anger, wrongdoing, or trouble within the family. Rather than parents and siblings taking a look at their own role in any issues, they deflect and blame it on the IP (Identified Patient) of the family. (Health, 2023)

There's no doubt that teachers are dealing with a high volume of complex realities in their classrooms. They're working hard to serve kids who arrive from environments that may not necessarily offer the appropriate support necessary for them to survive. This is the reality. We can let that consume us, or we can find ways to function more responsively and effectively. 

I'm always looking for a silver lining. It just seems like an objectively intelligent, albeit difficult thing to do. It involves an adjustment of our lens to see things from a different, purposeful perspective. I often say we need to glare at strengths, while glancing at weakness. Individuals who are confronted by  adverse experiences beyond their control, whether they like it or not, acquire intuitive skills that the general population typically may not because they don't have to. They do this out of necessity, likely unconsciously, but that is not to diminish the reality. 

Kids who live traumatic realities tend to develop intuitive skills in order to survive their environments. Adverse Childhood Experiences (ACE) are a set of ten identifiable environmental risk factors. 

The Adverse Childhood Experiences, or “ACEs,” quiz asks a series of 10 questions (see below) about common traumatic experiences that occur in early life. Since higher numbers of ACEs often correlate to challenges later in life, including higher risk of certain health problems, the quiz is intended as an indicator of how likely a person might be to face these challenges. (Harvard, 2013)

What’s In the ACEs Quiz?

For each “yes” answer, add 1. The total number at the end is your cumulative number of ACEs.
Before 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?
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?
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?
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?
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?
6. Were your parents ever separated or divorced?
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?
8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
9. Was a household member depressed or mentally ill, or did a household member attempt suicide?
10. Did a household member go to prison?

*Source: NPR, ACEsTooHigh.com. This ACEs Quiz is a variation on the questions asked in the original ACEs study conducted by CDC researchers. 

The ACEs quiz gives no insight into whether an individual child might be more or less sensitive to adversity and asks no questions about whether there may have been any protective relationships in place to help buffer the child from stress. So the ACEs quiz can only give insight into who might be at risk—not who is at risk—for certain later-life challenges. (Harvard 2013) Fair enough, however, where there's smoke, there's usually fire.

In fact, the ACE Score in any given case is an optic that excludes other possible risk factors opening the possibility that it may underestimate the adversity experienced by any given child. Missing from the assessment are: 

• Stressors outside the household (e.g., violence, poverty, racism, other forms of discrimination, isolation, chaotic environment, lack of services)
• Protective factors (e.g., supportive relationships, community services, skill-building opportunities)
• Individual differences (i.e., not all children who experience multiple ACEs will have poor outcomes and not all children who experience no ACEs will avoid poor outcomes—a high ACEs score is simply an indicator of greater risk) (Harvard 2013)

More recently, the same researchers that developed the ACE protocol realized the added-value of  complimentary research referred to as Positive Childhood Experiences. 

In September 2019, lead researcher Dr. Christina Bethell released the results of a study of 6,188 adults at Johns Hopkins seeking to identify Positive Childhood Experiences (PCEs) that could buffer against the health effects of traumatic ones. A percentage of kids with high ACE scores do nevertheless grow up to have normal development and good adult emotional health. The researchers were looking to identify the factors that created a level of resiliency in these kids that helped them to thrive despite difficult childhoods. (Positive Childhood Experiences (PCEs), n.d.)

A major principle of resiliency research asserts that reducing risk factors is a beneficial action to take on behalf of kids for at-risk environments. It stands to reason that a reciprocal effort to increase protective factors should also be made. This is where PCEs enter the process. We can't always change the conditions of a child's environment away from school, but we can support efforts to help them become antifragile; the ability to navigate, cope, and eventually thrive amidst adversity. Antifragility is a state of malleability in which an individual possesses the ability to bend, but not break so their core coping ability remains stable, albeit modified. People who possess a myriad of protective factors can adapt more routinely as they respond to their environmental condition. 

The PCEs study helps shape research moving in an additional direction: increasing positive childhood experiences to build resilience in kids who have experienced trauma, and those who may in the future. The relationship between PCEs in childhood and good mental health in adults is dose-responsive; the more PCEs a child gets, the better their adult mental health is likely to be. (Positive Childhood Experiences (PCEs), n.d.)

Children with PCEs become adults who are able to seek social and emotional support. The 7 PCEs are:

1. The ability to talk with family about feelings.
2. The sense that family is supportive during difficult times.
3. The enjoyment of participation in community traditions.
4. Feeling a sense of belonging in high school.
5. Feeling supported by friends.
6. Having at least two non-parent adults who genuinely cared.
7. Feeling safe and protected by an adult in the home.  (Positive Childhood Experiences (PCEs), n.d.)

It seems like a simple formula because it is; reduce risk, increase protection. However, and this is a big "however", caring significant others are impacted by the same uncontrolled environmental conditions that the person they care for is. This is a difficult reality. But, and this is a big "but", we do have the ability to completely control the environments we create to support them. The process of determining what that environment looks, sounds and feels like is an effort we must constantly make to authentically create emotionally, socially and psychologically supportive environments away from home and the immediate family reality.