In an ideal world, childhood is meant to be a haven; a place full of trust, love, nurturance, and support. But the ideal is very often not the reality. For some, this ideal is very far from ever being reached, and they live their reality within the continual shadows of neglect, abuse, pain and fear. Such experiences can have a pervasive impact on the way they view themselves as well as their lives, thus shaping their overall perspective. These early wounds leave a relatively permanent mark on their lives; they carry that pain throughout life. They may also impact the individuals’ feelings, relationships, and health well into adulthood. Adverse childhood experiences deprive children of the safety, emotional stability, and secure attachment necessary to shape their lives positively.
Even though trauma can feel like a really heavy load to carry, survivors tend to have remarkable resilience. They often display extraordinary amounts of strength and have an amazing ability and capacity to grow and find ways to adapt, heal, and rebuild while still navigating through trauma. But, this resilience can sometimes have deep suffering and pain covered behind it, and therefore it is important to recognise it and continue to build and strengthen the resilience. And to make that happen, several psychological interventions can help offer the survivors not just recovery, but the opportunity to thrive and reclaim their sense of purpose and hope in life.
Understanding ACEs and Their Impact
Adverse Childhood Experiences (ACES) are negative experiences that occur in one’s childhood, i.e., one or more negative experiences occur between the ages of 0 – 17 years. ACEs present a disruption in the safe and nurturing environment that children need to develop positively. It can take the form of many traumatic experiences, such as abuse (physical, emotional, or sexual), neglect, witnessing a violent incident at home, having parents who have a mental illness or abuse substances, having a family member attempt or die by suicide, bullying, and natural disasters. ACEs typically directly impact the child’s emotional well-being, cognitive development, and/or social relationships – often well into adulthood.
Not every child reacts to trauma in the same way; so if two children experience the same trauma, only one of them may develop long-term stress. There could be many reasons for the same, one of which could be the age of the child, which affects the way they perceive and make sense of that event, another reason could be the frequency of experiencing any such event(s).
Read More: How Childhood Experiences Affect Mental Health
1. Prevalence of ACEs Across the Globe
Concerningly, the prevalence of ACEs is remarkably high across different populations. Researchers in the United States have found that three in four students (76.1%) experienced one or more ACEs. One in five students (18.5%) experienced four or more ACEs (Swedo et al., 2024). Whereas, researchers in the United Kingdom found that 47.1% of adults experienced at least 1 ACE, while 15.6% experienced three or more ACES (Bellis et al., 2013).
There are very few studies in India to accurately understand the prevalence of ACEs in India. However, a 2018 study in the state of Kerala suggests that 91% of their youth had experienced at least one ACE, and about 50% of them had experienced three or more ACES (Damodaran & Paul, 2018). This highlights the importance of further studying ACEs and also the need to intervene as early as possible.
Read More: Prevalence of Mental Health Disorders in Delhi Teenagers at Their Peak
2. Recognising the Signs of ACEs in Children
Whether or not someone has experienced, or is experiencing, ACEs can be recognised, because after experiencing ACEs, children tend to show signs of distress or trauma, some of which could be:
- Difficulty sleeping or having nightmares frequently,
- Trust issues and fearing other people (especially strangers),
- Mood swings, i.e., difficulty regulating emotions,
- Difficulty in showing affection or other positive emotions,
- Hypervigilance and chronic anxiety,
- Avoiding situations, events, or people related to the traumatic experience, etc. (Professional, 2025).
Read More: Are Positive Emotions Just Fleeting Joy or Do They Have Lasting Benefits?
3. Long-Term Effects of ACEs on Health and Well-being
Going through ACEs can impact an individual’s health and well-being well into adulthood. Some of these effects are:
- Physical health issues: There is an increased risk of chronic physical health issues, such as cancer, diabetes, and heart disease, in adulthood for those who experience ACEs (Friemoth, 2014).
- Mental health difficulties: Being subjected to ACEs can increase the susceptibility of developing mental health challenges such as anxiety, depression, PTSD (post-traumatic stress disorder), and aggression (Gondek et al., 2021). Such individuals often tend to have difficulty regulating their emotions.
- Engagement in high-risk behaviours: Exposure to ACEs is also linked to engagement in high-risk behaviours such as smoking, heavy drinking, substance abuse (and later addiction), petty theft, and unprotected sex (Monnat & Chandler, 2015).
- A decrease in personal achievements: ACEs also contributed to poor academic performance, which would in the future impact their employment opportunities and thereby socioeconomic status (Webster, 2022).
- Problems with social relations: Children who faced ACES while growing up often faced great difficulty in forming and maintaining healthy relationships. They were also at a greater risk of rejecting social norms and had lower socioeconomic success (Monnat & Chandler, 2015).
Apart from the above-mentioned effects, ACEs can have many other impacts on different individuals as well.
Core Psychological Interventions for Building Resilience
Although ACEs can have negative effects, those who possess them can build resilience and have potentially good long-term outcomes using the right psychological interventions and resources. Resilience is an individual’s psychological ability to adapt to, recover from, and potentially flourish amidst adversity, trauma, or challenging experiences during their life using psychological, emotional, and behavioural changes.
Resilience is both a process and an outcome: it refers to the ongoing skills and strategies an individual uses to deal with life’s adversities and the positive changes, development, and healing resulting from overcoming the adversities (APA Dictionary of Psychology). Thus, resilience can be built despite the past. Family, friends, peers, an individual’s personality, their community or social group, etc., everything can either support the development of resilience or hamper it, so people should be a little cautious and surround themselves with a strong support system to help them heal and grow.
Read More: Five Pillars of Resilience, According to Psychology
Resilience can be fostered through many psychological interventions. Some of which are:
1. Cognitive Behavioural Therapy (CBT)
CBT helps survivors understand and recognise their dysfunctional thinking and behavioural styles, followed by reframing and readjusting them. This helps them to create healthier coping mechanisms for themselves with the help of a professional. It has the strongest evidence as an intervention for individuals exposed to ACES, particularly in cases of abuse (Lorenc et al., 2020). In addition to this, there is a type of CBT – Trauma Focused Cognitive Behavioural Therapy (TF-CBT).
It helps people process trauma and then work through it. TF-CBT helps people by allowing them to figure out the nature of the trauma first. They do this by systematically exposing the traumatised individual to their memories of trauma while providing them with appropriate levels of support. After which, they are also taught effective coping skills. Research has found that TF-CNT is particularly effective with children and adolescents. (Cohen & Mannarino, 2015).
Read More: Behavioural Disorders in Children
2. Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR helps individuals process and heal from the ACEs. It uses bilateral stimulation to process the traumatic memories; it is done by guiding an individual’s eye movement by making them focus on an external stimulus, while simultaneously recalling distressing images, thoughts, and emotions related to the traumatic event(s). This helps reduce emotional intensity over time. Through EMDR, individuals can better manage their feelings and regain a stronger sense of control in their lives (Gainer et al., 2020).
3. Parent Child Interaction Therapy (PCIT)
PCIT helps in strengthening the relationship between parents and children, while improving the child’s emotional and behavioural regulation. This therapy involves two phases: the first is the child-directed interaction, where the goal is to create warmth, increase responsiveness, and build a secure bond between the parent and the child, and the second phase is the parent-directed interaction, where the aim is to equip parents with effective and consistent discipline strategies. PCIT helps the survivors of ACEs through promoting resilience in children by creating a safe, stable, and nurturing home environment (Warren et al., 2022).
4. STAIR Narrative Therapy
Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy is a treatment that involves a combination of traditional PTSD focused narrative therapy and skills training that offers solutions for several problems in daily functioning. Through this approach, individuals essentially restructure their way of understanding and relating to their life events. The first step is to teach people skills to build and/or restore their psychological and social resources that are crucial to healing from trauma. This fosters self-efficacy, resulting in improved functioning (Cloitre & Schmidt, 2015).
This is followed by narrative therapy, where those who were exposed to ACEs are encouraged to reorganise their traumatic experience. This is done by asking them to externalise the problem and rephrase the way they talk about the event. This helps them “re-author” their identities from ‘victim’ to ‘survivor’ and fosters self-compassion and hope (Hassija & Cloitre, 2015).
Early Interventions & Preventive Measures
Adverse childhood experiences (ACES) can be prevented. The best way to do so is to educate families about what ACEs are. It is very important to recognise risk factors and attempt to prevent them. Safe, stable, supportive, nurturing, and trusting environments can greatly decrease the risks of exposing children to any trauma. And by forming a relationship of trust with them. Children should also be cared for and supported, thus building a healthy bond or relationship between parents and them.
All these will create positive childhood experiences and help children reach their potential. Additionally, people should ensure that they have strong support systems to do so. Yet, if children do end up experiencing ACEs, parents or others around them should look out for and recognise the signs. And thus provide children with the help they require, as early as possible.
Read More: Study: Adverse childhood relations with increased risk of chronic pain during adulthood
Conclusion
While many people are buried in the weight of the past of their adverse childhood experiences, hope is not all lost. Healing is possible. Change can be fostered by support and help from family and friends, with the additional help from psychological interventions. Adverse childhood experiences can be endured and surpassed, and this process always starts with awareness. People need to be made aware of the existence of the issue and its high prevalence rates.
A strong support system can help the survivors grow and heal. It is also crucial for parents and other elders in society to keep a lookout and check if they see anyone around them with signs of ACEs, because early measures are always better. And this becomes more possible through psychological interventions like cognitive behavioural therapy (CBT), eye movement desensitisation and reprocessing (EMDR), parent child interaction therapy (PCIT), and STAIR narrative therapy, among many others. Therefore, don’t give up, trust in yourself, and ask for help.
FAQs
1. What are Adverse Childhood Experiences (ACEs)?
Adverse Childhood Experiences (ACEs) are negative experiences that occur in one’s childhood, i.e., between the ages of 0 and 17 years. These experiences are disruptions in the safe and nurturing environment that children need for healthy development.
2. What are the effects of ACEs?
ACEs can impact an individual’s health and well-being well into adulthood. These effects include an increased risk of chronic physical health issues, increased risk of mental health conditions, engagement in high-risk behaviours, etc.
3. Which psychological interventions can be used to build resilience in people who were exposed to ACEs?
Resilience can be fostered through many psychological interventions, some of which are cognitive behavioural therapy (CBT), eye movement desensitisation and reprocessing (EMDR), parent child interaction therapy (PCIT), and STAIR narrative therapy, among many others. Additionally, children who were exposed to ACES should be provided with help as early as possible.
References +
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