Dear Rep. Geran Tarr,
I attended the Tlingit &Haida Native Issues Forum on Thursday, and was grateful for your presentation and clear commitment to focusing on the correlation between adverse childhood experiences and a host of psychosocial wellness issues among Alaskans. However, I do want to gently notice a dangerous tendency present in both your written materials and your discourse, which can be summarized in the following statement: You seem to often mistake correlation for causation, and if we fail to distinguish the two, we will undermine our advocacy efforts and perhaps say or do things which can lead to victimization of the most vulnerable people among us.
As a concrete example, I notice this sentence in your summary paper for public consumption entitled Respond to Adverse Childhood Experiences: “In Alaska, we are seeing that ACEs are synonymous with asthma, depression, teen pregnancy, suicide, drug abuse, employment difficulties, and intimate partner violence.” Of course this cannot be true — and I believe that many people at the microphone at the Native Issues Forum were in some way testifying to its falsehood. ACEs have proven to be correlated to such things, but they are not (and could not possibly be) directly causative. If they were causative, everyone with an ACE score would be an asthmatic, drug-abusing, pregnant, suicidal, unemployed partner-abuser. We know that this is not the case, and many of the people at the microphone in fact exemplified what we must call resilience to childhood adversity, in that they have experienced great adversity in childhood but have nevertheless survived and have in many cases developed strengths even from the midst of early devastation.
Responses to adversity are always complex, and always include an element of individuality that defies prediction.
Lest I be dismissed as simply a picky or semantic person, let me suggest two ways in which this danger can actually harm our cause. First, it is clear that all survivors of adversity resent statements of reckless causality. When we tell resilient people that they are hopelessly damaged by their childhood adversities — even when, of course, they do have some real difficulties — they will either dismiss us or fight us, because they have real strengths, also. Secondly, when we tell less-than-resilient people that they are hopelessly damaged, they may very well identify with their adversity in a way that cuts them off from what resources they still have to survive and flourish. This is a type of victimization that often occurs unintentionally, in cases where a person who has been a victim of some terrible act is aided by his or her social environment to more fully identify with a state of victimhood, learning to define his or her entire self with that terrible act. This is socially, psychologically and emotionally dangerous for obvious reasons.
Forgive me — I do not want to be so hard on you! Your passion is admirable, and in fact I admire your work in many ways. Also, the fact that ACEs are correlated with a number of difficulties in adolescence and adulthood is important and can help us to generate greater attention and commitment to ending child abuse. However, this issue with language demonstrates a truth in both care and advocacy to vulnerable people: “doing no harm” in the act of helping is often much more difficult than we think. Fuzzy-headed generalizations and reckless terminology can be a caregiver/advocate’s downfall in many, many situations.
Yours respectfully,
Fr. David Alexander, PhD
St. Nicholas Russian Orthodox Church
Correction: An earlier version of this letter misspelled the first name of Rep. Geran Tarr, due to an editing error. It’s Geran, not Garan. The Empire regrets the error.
