There are empowering, encouraging things about understanding the role of adversity and trauma as risk factors for chronic illness. Among the most important are that it provides opportunities. Opportunities for making sense of symptoms. Opportunities for removing blame. And opportunities for planting seeds for healing.
The thing about planting seeds for healing?
Eventually, they sprout.
My understanding of chronic illness and trauma becomes a little more detailed and coherent every year. Here, after blogging for over 8 years, is what I’ve learned on how trauma affects risk for all kinds of chronic illnesses. It includes 8 categories of adversity, which I’ve also been working with on my own healing journey. I’ll give you a brief summary of each category with links to resources, posts, ebooks and more that support healing for each one.
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Accessing Health-Based Pathways
We know from the research that effects of adversity can add up over time to strengthen cell danger responses and nervous system survival pathways. These are pathways that can get stuck in states of fight, flight and freeze to eventually lead to symptoms of chronic illnesses of all kinds.
It’s less well known that every tool we incorporate into our lives – ways of eating, exercise of any kind, trauma therapies, supportive emotional connections, mindfulness, mind body practices and more – plants seeds that counteract effects of adversity. Seeds that strengthen our health-based pathways. That access the health our bodies inherently have underneath what they’ve had to learn to survive. Seeds that also weaken threat response pathways.
Planting seeds for healing starts to even out the imbalances and to support our bodies’ natural abilities to heal.
Planting Seeds can Influence Gene Function
These 8 categories of adversity are among the most important environmental risk factors for chronic illness that I’ve come across over the past 20 years. They are still commonly overlooked even though we now know that genes typically carry less than 50% of risk for chronic illness (1)Rappaport SM. Genetic Factors Are Not the Major Causes of Chronic Diseases. PLoS One. 2016;11(4):e0154387.
Indeed, adversity is an exposure that may be NECESSARY for chronic illness to develop because it can switch genes on that would otherwise stay silent. Healing the effects of trauma can help turn these genes off (2)Yehuda R, et al. Epigenetic biomarkers as predictors and correlates of symptom improvement following psychotherapy in combat veterans with PTSD. Front Psychiatry. 2013;4:118.
Why Tools That Seem So Simple Can Help
Given the enormity of what it can mean to have a life altering or disabling chronic illness, the tools that help heal can seem very small and insignificant indeed.
They tend to take time, often provide little overt evidence of success at any given moment, and can feel as if we are spitting into the wind. This is because they are chipping away at survival pathways that have most likely been developing in our bodies for decades. And very often for generations.
It’s not psychological. It’s because our nervous systems are plastic and changeable.
While we don’t know the full extent to which survival pathways and chronic illnesses can reverse and heal, we do know that trauma therapies and other tools can reverse epigenetic changes.
Here’s some encouragement to keep plugging away with all kinds of tools wherever and however we can.
My Journey and Ways of Healing Adversity
All of the tools I mention have helped me gradually start to shift out of disabling chronic fatigue syndrome (ME/CFS) over the past 20 years. Yes it’s been a long haul, but to have improved so significantly when I was once mostly bedridden is an almost unimaginable and precious gift. Although most of you really CAN imagine how precious this is or would be like too.
These tools help countless others as well. They have also helped me heal my from 6 years of low back pain; and asthma, which no longer gives me symptoms even when I catch a cold. It may remain a sensitive point in my system, but I have much more protection from it now. The seeds I’ve planted have also helped me find a deep, meaningful and loving relationship with David that is also helping me heal in all kinds of ways such as with the daunting effects of ACREs.
They can help on your healing journey too
Resource Posts for Healing Adversity
The posts below have been among the most popular on my blog. I share tips, metaphors and examples from how I am learning to incorporate trauma healing into my every day life. You’ll find these resource posts all in one place or check them out below.
Planting Seeds for Healing – My Most Popular Resource Posts
- How Understanding Trauma is Helping Me Heal: My Story – Updated 2021
- The 16 Tools that Best Support Healing
- My Overcoming Food Intolerances Story
- A Science-y Guide: 19 Characteristics of Trauma and Chronic Illness
- 16 Clues About Triggers and Flares
- Making Time for Resources (with “Little Stream”)
- Healing IBS Using Art Therapy
- Healing by Listening to Your Inner Voice
- What to Do When Nothing Else Works
- Using Intuition
8 Categories of Adversity
1. Adverse Pre-Onset Experiences (APOEs)
Onset of a chronic illness often begins after one or more triggering events. We especially remember triggers if the onset was sudden. These triggers tend to involve some form of threat (psychological or physical trauma, infection, exposure to toxins and the like). It doesn’t have to be big. When addressing the trigger does not cure a chronic illness, consider the possibility that the event was a last straw in a line of exposures, rather than the cause.
Planting Seeds for Healing APOEs
- The 16 Tools most recommended to support healing
- Injuries can trigger onset of Parkinson’s disease
- Adverse Pre-Onset Experiences in chronic illness
- Posts on tips for working with symptoms with stories of how they helped me
- Types of adverse events that can trigger onset of chronic illness
- Summary of the science on how adversity affects risk for chronic illness
- Triggering events can stimulate the cell danger response
2. Adverse Adult Experiences (AAEs)
Don’t know of anything that triggered the onset of your chronic illness? Did it start gradually as it did for me and 40% of people with chronic fatigue syndrome (ME/CFS)?
This new category is for stressors that happen after your 18th birthday and in the 3, 5, 10 or more years before the onset of illness. I’ve just started to wonder if having a gradual onset is part of what can make it impossible to identify a single trigger.
When we start to explore whether adversity may have played a role in our getting sick, we often recognize we’ve had a number of stressors or traumas in the preceding years or decade. Divorce. Accidents. Surgery. Caregiving for a loved one. The loss of a loved one …
The years before my first intermittent symptoms and the period during which my symptoms gradually increased were very stressful ones. For me it was being in medical training and then becoming a full time teacher in addition. I witnessed a lot of suffering and trauma as a doctor. Was in a few car accidents (even though I was physically unscathed) among other things. For me the trauma therapies and 11 tools have been key parts of my healing and recovery.
Planting Seeds for Healing AAEs
- The 11 Tools I recommend for healing, which include trauma therapies
- Examples of how I’ve made art and used art therapy to support healing
- The science of brain plasticity explains that our bodies are not “broken”
- Here’s how adversity affects the nervous system
- Here’s how epigenetics work and why it’s not “in your head”
3. Adverse Childhood Relationship Experiences (ACREs)
Even when parents deeply love their children they may have difficulty connecting or supporting them with insightful attention, kindness, and thoughtful listening. It’s not that parents have to be perfect but about their being able to repair with their children after inevitable mistakes. This fosters resilience.
Planting Seeds for Healing ACREs
- How healing ACREs helped resolve my severe food intolerances
- The science of ACREs (which is now eBook 6)
- Examples of ACREs and memoirs
- Therapies for ACREs
- Books for healing ACREs
- Documentary “Wrestling Ghosts” (gentle, compassionate, very spacious)
4. Adverse Childhood Experiences (ACEs)
This is the category of adversity that is teaching the world about the effects of trauma and how it’s not psychological. It comes from one of the most important studies published in 1998. Hundreds more studies have since been conducted since with the same results.
Planting Seeds for Healing ACEs
- Pediatrician and California’s first Surgeon General, Dr. Nadine-Burke Harris’ book on ACEs “The Deepest Well“
- Therapies (look at the table of contents for Healing General Trauma and ACEs; ACEs+)
- Updates on my ACEs (My score is not the Zero as I once thought)
- ACEs and ME/CFS
- ACEs and Type 1 Diabetes
- ACEs and Type 2 Diabetes
- ACEs and Rheumatoid Arthritis
- Intro and Overview on ACEs and chronic illness with the science
- Free ACE Fact Sheets to educate your doctor (Oprah and others on ACEs)
- Free eBook 5 with multiple blog posts on ACEs
5. Adverse Childhood Experiences Plus (ACEs +)
The main limitation of ACEs is that they only include 10 narrow categories of adversity. ACEs Plus incorporates question #11 that Dr. Felitti proposed I add to the ACEs questionnaire in the spring of 2018: “Are there any adverse childhood experiences in your life that should be added to the list?.”
We have enough research to know that all types of adversity influence long-term health. Includes spanking, covert incest, being bullied, growing up in poverty or in an unsafe neighbourhood, losing a loved one for any reason, witnessing any type of covert or overt violence and more. I’ll write a blog post introducing ACEs+ at some point.
Planting Seeds for Healing ACEs +
I’ve added a new section to My Story with my ACEs+
Other resources are the same as for Healing ACEs (above)
6. Adverse Babyhood Experiences (ABEs)
Adversity in our parents’ lives before conception, during pregnancy with us, and in our birth and first 2 years of life has an impact on our long term health. I have worked through ABEs in 7 or 8 small group multi day workshops, as part of a 3 year training, and through art to heal effects of twin loss and more.
In July 2020 I published my first journal article introducing ABEs concept. It was very encouraging to have gained the brain capacity to write an article. The ability to write at this level is one of those clues that the seeds I keep planting are making a difference. Some, in fact, are sprouting :-).
Planting Seeds for Healing ABEs
- ABEs in my history
- Intro to ABEs and autoimmune disease (type 1 diabetes)
- ABEs and type 2 diabetes
- ABEs and ME/CFS
- ABEs and rheumatoid arthritis
- ABEs affects epigenetics and beyond
- My free eBook 4 will help you learn about ABEs in your own life
- ABE Survey Results showing patterns for mothers and babies
- How healing ABEs can cure asthma (a true story and set of studies)
- Comprehensive Guide to ABEs
- ABEs Resources includes free ebook, fact sheet to educate your doctor, and the best free downloadable journal articles
7. Adverse Multigenerational Experiences (AMEs)
A history of your chronic illness in the family may not mean it is entirely or even mostly genetic. Adversity in our parents’ and grandparents’ lives may initiate risk for chronic illness and and can increase risk for ABEs and ACEs. This is because parental trauma affects their ability to regulate their emotions, biology, behaviors and more and can therefore make it harder to support these types of regulation in their children. AMEs can affect epigenetics.
Planting Seeds for Healing AMEs
- My own AMEs in my personal story
- How I am chipping away at healing AMEs
- AMEs and type 2 diabetes
- Therapies for healing AMEs
- AMEs, my grandfather’s rheumatoid arthritis, and a family secret
8. Adverse Institutional Experiences (AIEs)
In the past few years we have had opportunities to recognize how pervasive historical trauma and discrimination is in our culture. AIEs increase risk for chronic illness and are important factors, including here in the United States with our history of slavery, genocide, colonizing of other cultures and countries, and hundreds of years of immigrants who have come to escape trauma of all kinds in their homelands.
This history affects us all, whether it’s from the privilege those of us have who are white, the trauma that leads to oppression, from being on the receiving end of oppression, or from experiencing the ongoing effects of inequality, systemic and systematic oppression, and beyond.
Planting Seeds for Healing AIEs (updated November 2023)
- See Harvard sociologist Dr David Williams’ research showing that racism – major events and everyday minor events – negatively impact health (blood pressure, heart disease and more). See also this article that includes his TEDMed talk.
- My post on AIEs and type 2 diabetes
- My blog post Introduction to AIEs and chronic illness
These are some of the readings helpful for educating ourselves:
- Resmaa Menakem: Book My Grandmother’s Hands (compassionate, nonjudgmental, with exercises); Video: conversation with Tara Brach October 2020; Interview On Being; Free Short Course: Intro and Course
- Colleague Nkem Ndefo’s Lumos Transforms Services and Calendar of Events
- Video: Gwyneth Paltro and Dr. Nadine Burke Harris
- Civil Rights Lawyer Bryan Stevenson’s “Just Mercy: A Story of Justice and Redemption” and National Memorial for Peace and Justice
- Tiffany Jewell’s This Book Is Anti-Racist: 20 Lessons on How to Wake Up, Take Action, and Do The Work (Volume 1) – for children, great for adults too
- Juleus Ghunta’s children’s book Rohan Bullkin and the Shadows—A Story about ACEs and Hope and my book review
- Books: Gabor Mate’s The Myth of Normal, Robin DiAngelo’s White Fragility, and Inflamed by Rupa Marya and Raj Patel.
Take the HALE Surveys
Your responses to the Health and Adverse Life Events (HALE) surveys help refine the chronic illness and trauma model and better understand links between dose of adversity, specific chronic illnesses and health conditions, and types of adversity.
You’ll find all the Surveys on this page, including:
- List your Health conditions – so we can learn more about risk & about potential prevention
- ACEs – 10 Childhood Events
- ACEs Plus – Additional Childhood Events
- ACREs – Attachment Wounds
- ABEs – Adversity in Babyhood
Additional Resources
Chrillogs: Your Chronic Illness Stories
Chronic illness weblogs or “Chrillogs” are what I call our personal stories as seen through a nervous system and trauma lens.
See all Chrillogs.
Do you make sense of or work with your chronic illness from trauma perspectives? Does it help? Want to share your story? Email me to explore.
1:1 Consults with Me
I offer 1:1 Virtual Consults worldwide. Explore whether trauma might be affecting your health. Refine how you think about trauma and chronic illness as a health professional. Learn more about how to work with your health or with clients and patients using non-pathologizing, trauma-informed, nervous system based perspectives. Tips and insights for working with triggers and flares, validation from the research, and strategizing next steps, Learn more about Consults here.
Self-Paced Course: Roadmap to Support Healing Chronic Illness
An online course to support healing chronic illness through a trauma lens. Tips, core tools, exercises you can use as a regular practice backed by personal examples from my own journey improving disabling fatigue, and a summary of the emerging science that expands on conventional views.
- 16 video lessons also in audio format (mp3)
- 7 audio lessons for exercises
- Transcript
- Manual
- Master Guide of Resources
The following 3 Free Guides summarize (almost) everything on my blog. Each one has a slightly different focus.
References
What a treasure trove. Thank you.
Hurray! You are so welcome Marva!!
Thank You Veronique for sharing your journey.
My ME/CFS/FMS IBS etc too was a gradual process involving very many factors.
In the last 26 years members of my family have had strokes and cancers, but it was their recollections that they shared as they were being nursed at the end that revealed some information about generational adversity that shaped their lives and subsequently that of their subsequent generations, of which their are two more beyond myself.
I am following your blog with all this in mind, all the AEs at whatever age and generation affect our resilience. I am also exploring brain spotting and EMDR before engaging with a therapist. As well as polyvagal theory as it develops, and the 4 brains. We are one , brains, gut, immune system inextricably linked, So what we require to heal is a holistic approach to all, as you are investigating and sharing!
Hi Jantilly,
It is never too late to learn something important is it? And there are so many really good tools, sounds like you are doing some great exploring to see what will be a good next step and fit for you. We really ARE one. Thanks for writing and sharing xoxo
Veronique,
You are AMAZING! Thank you for putting your mind, heart and soul into this vast compilation of resources around trauma and chronic illness. I always LEARN something new and get to add to my HEALING. Thank you for the difference you make in my life and I am sure in so many others.
Peace & Love,
Pam
Oh Pam, Thank you! What you say is EXACTLY why I feel so passionate about all of this – thanks for letting me know! xoxo