 And I want to introduce you to one of my best friends, Kimberly Pierce. And so Kimberly Pierce has been a medical provider in the same primary care practice since 1987. So she's been a medical provider for 37 years. That's amazing. That's amazing. Well, I'm sure you'll be there two more years. So she's been taking care of generations of families. And over the last decade on her own, she sought out and received extensive trainings on traumatic stress. And she was increasingly frustrated with the current Western medical systems in ability to address this important issue. So in 2018, she created a system on her own for educating screening and empowering her patients about trauma. And so she integrates this skills such as tapping yoga, breathing and mindfulness into the exam room. The impact was so profound she was inspired to create a documentary that we will watch today called the faces of aces. So, and I've seen it a couple times and it's pretty monumental so be prepared. Kimberly has shown this film around Vermont to a wide variety of audiences, including the first showings in her living room, local libraries, Vermont, the Vermont State House, the UVM Medical Center, the central Vermont hospital and the local Savoy Theater. So this film has gained so much traction. It's also going to be featured at the 2023 International Trauma Conference in Boston. Please welcome Kimberly Pierce. I'm just curious quick raise of hands. As soon as she gets the slide up she'll help but I'm just curious how many people in this room know a lot about adverse childhood experiences and epigenetics. Awesome. How many people don't know anything. Wow. Not much good. And some people may be in the middle. I hope that at the end of this I have an hour and the film is about a half an hour so I'm going to be talking a little bit and then we'll watch a short trailer. But I just hope at the end everybody has a little more knowledge about about this topic which is my favorite topic to talk about. And I hope that you also understand why I've devoted the last seven years to this topic. The first thing I want to do is watch a quick trailer. This is a trailer for the film Resilience. Anybody seen the film Resilience? A few people. It's a very high end film, multimillion dollar film that was put out a few years ago. It's very well done and I think in two minutes it'll give people a little flavor of what we'll talk about next. We all like to think of childhood as this time of joy and innocence. But for many of us it's just not true. When you grow up in these type of situations it's not something you talk about. I know I did it. The first thing that we found is that adverse childhood experiences are common. You know kids are young. They don't know what's going on. They won't remember anyway. Well, the child may not remember but the body remembers. There was this incredible G-Wiz effect. You mean adverse childhood experiences cause heart disease and lung disease and liver and cancer? Exposure to trauma affects children's developing brains. The impact is on your behavior. It's on your heart. It's on your DNA. How do you deal with that? Don't reach out cause I'm not used to that. So I'm going to try to do this quickly because we're going to try to get back on target. But basically what I'm going to be speaking about is the economic equivalent of shaking up the medical system. That's what I've been trying to do and I became a medical rebel probably about five years ago. And that's why I'm standing here today. Quick sort of personal story cause we're trying to tell our stories. I was born in early sixties. My mom was 17 when she was pregnant in high school. And my father was basically a really rough kid had been in and out of foster care and he was pumping gas in order to have enough money for, you know, to go to college. First one in his family to go to college. But I was actually really loved and I had, I had a pretty easy life. But my family always worried about me. And they couldn't figure out what was wrong with me because I had sleepwalking and nightmares and anxiety and fainting fainting fainting fainting. I think I have the world's record on fainting. And I'm not kidding, hundreds of times for every possible reason. And every time I'd end up on the floor, whether it was seventh grade science class or whatever it was, I would wake up and people would be saying, What is wrong with her. And so I knew that something must have been wrong with me. And I accepted that I was damaged that, you know, that I, that I was deficient in some way, and that I was not really worthy. And I continued to have that narrative throughout PA school. But I was drawn into the medical field because I want to try to figure out what was wrong with me. And I actually fainted my way through PA school. I'm not kidding you. But in 1987, I graduated from Northeastern University and I began working in the same clinic where I still am today, which is a long time. And if you can just imagine 1987 in Vermont, okay, this is like hallmark cards, you know, like before cell phones, there's no, there was no internet. There was no cyber bullying. It was like everything was just like mountain views and Pollock suppers and rainbows. I swear to God. And it was and I love my work and I love taking care of my patients. I was seeing farmers and plumbers and teachers and trash collectors. And I really felt like I was part of the community. And in fact, I get my own health care at the same place where I provide it. All of that came crashing down about 15 years ago when the opiate crisis hit. And what happened is all of a sudden these patients that I was deeply connected to that I love dearly were coming in with drug use overdose suicides homicides jail time. DUIs DCF referrals sexual abuse teen pregnancy. And I, I wasn't prepared for this. I wasn't trained for this. What was I supposed to do as a primary care person. And yet I felt like I had to do something. And I began to get really dragged down. I was feeling hopeless and helpless. And then one day in 2000. 2016. I was invited to stowe. There was a conference in stowe or Dr. Vince Folletti, who is the author of the adverse child experiences study or the aces study. He was speaking and and that day changed my life. Was anybody there by chance? No. Heard about it. Yeah. I knew nothing going in. I knew nothing about the topic. And I literally felt like I've been struck by lightning in the room because I felt. That Dr. Folletti was talking about his research was such emotion. He was crying about this data because not only is trauma really common, but it was also he was crying because the medical system was not listening to him. And it was as if I was like in the back of the room and there was this beach ball coming across, you know, in the air and I just felt like I had to catch it or it was going to knock me over. And I caught it. And I knew that this was the answer. This was the reason why I'd been seeing so much, you know, devastation in my patients, all of the drug use, all of that stuff was related to stress and childhood. So I put, you know, I put I connected the dots, but I also didn't know how do you take a medical research? And what do you do with that? How do you put that into into action? But that day I set out to to do everything I could for as long as I could and and I felt like this was my calling. But what I didn't know is I, you know, I set out to help my patients. But what I wasn't prepared for was that actually in my in my desire to help my patients that I would actually heal myself. And I'll tell you a little about that. But what did I learn that day? And I'm going to tell this really pretty briefly for people that don't know anything about it. The A study or adverse child experiences study was in the mid 1990s. It's still one of the biggest public health studies that's ever been done. It was 17,000 people that were that were queried. And the interesting thing is they were mostly all white, mostly well educated and very well insured. So not your typical population. And what they found was shocking. And I'll tell you about that in a minute. But they basically asked these 17,000 people about it's okay about 10 questions with 10 questions and they involved a couple different categories about childhood sexual abuse, emotional abuse, physical abuse and neglect. And it came up with a scoring system. So an ace score in my mind, if you just kind of imagine it's almost like a lead level, right. And it's very similar in a lot of ways because a lead level is an environmental toxin that can actually change, change your body. And so is aces or adverse child experiences. And the data was astounding that in terms of not only was it incredibly common, but there was a very high chance that if you'd had a lot of stress as a kid that you had a much higher risk of virtually every chronic disease that we know. So why is that in very basic quick terms. It's because of what we've been talking about being in fight or flight. When our bodies are in fight or flight that can save our asses in that moment because we can you know leap over the tall building. But if you're in that state for a long time, we have a surge. What happens is we have these cascade of neuro chemicals that are adrenaline and cortisol and other things that actually increase something called inflammation. Everybody's heard of inflammation probably inflammation is now seen to be the leading cause of virtually all chronic disease and disability and even mental mental health conditions. So all the sounds like really down right like why would I why would I be so excited about this. Okay, there's this is the downside I'm going to tell you there's a very light side which is what really gets me excited. The other thing I just want to say is that if you can identify, acknowledge, explain tell your story, then then you have the ability I find for people to start the process of healing. But the biggest thing is removing the shame that comes with having experienced childhood trauma. And even though you know, maybe that it wasn't your fault. It's a very sort of common mechanism to help keep us kind of mentally okay because as a kid, if you are in a really bad situation. And you're, you know, maybe your, your dad's hitting your mom. If you if you actually as a child if you think wow, my dad is actually he's kind of a monster like this is not a good situation. That is a lot scarier. So it's easier if you just say, if I was just a better kid, if I just tried harder, if I just did a better job, then none of this would be happening. And that's a lot safer. So that that's the thinking that really I think is the biggest thing and I what I try to tell my patients is I'm trying to do shamectomies in the room. Okay, like literally remove your shame. And it works. Take some take some doing. But if there's anything you you know come away with today is just that that whatever did happen to us in as a child is not your fault we have no control over our environment as a kid. But so losing the shame will possibly help, you know, create some some healing potential. And trauma can actually be measured now that the, the, the, the science of epigenetics which is basically stress and you know nurture nature, you know, and how it interacts we used to think oh if you have a gene for something then you're going to get the disease. Well it's not that simple. Now we actually know that you can have the gene for a disease. But if you give it a good happy safe environment with low levels of stress hormones. Actually, you can turn off the gene that would have caused that disease. So it's really kind of exciting. I want to, I want to just for a second take a minute to explain something that I explained in the exam room to my patients believe it or not. And by the way, since I started doing this, I had I've been swimming upstream within the medical system. It's not reimbursed. I'm not acknowledged. I have to take the time to do this, aside from all the other things that I have to do because I know it's the right thing to do. But one of the things that helps I think, understand this concept of how trauma gets carried from one generation to another is a rat study. And this when I learned this rat study. This was another like, boom, you know, like my whole life changed. But basically, I want to also give a little trigger warning because it does involve a shock to a baby rat but if you can just kind of wrap your head around this for a minute there's two parts to the study. The first part is that there were a litter of baby rats, and they were exposed to two things at the same time, a shock and the smell of a cherry blossom. So as you can imagine, we all took biology 101 we know that, you know, when they're when they're confronted with that shock and that, you know, that that smell, they all of the, all of the rats go into the corner, they shake, you know, and they just stay there together until everything settles down. And so we know this. And then when you take away what they did is they took away the shock. So then they would just simply giving the rats the smell of the cherry blossom and every single time they gave the rats the smell, they would all go into the corner and shake right. And we kind of all know this is like Pavlovian kind of stuff right. But what is incredible was the second part of this study. The second part of the study, basically, was that these rats that this first letter litter of baby rats grew up. They knew that the cherry blossom was bad news. They had their own litter. So litter number two, litter number two had a perfect little rat life, zero stress, like nothing, everything they needed was was taken care of. But at one point, in their growing up, I think they were like teen rats, they gave them all the smell of a cherry blossom. Guess what happened? They all went into fight or flight, they were all huddling as if something had just happened to them. And they had no idea why. So our bodies have a lot of wisdom. Our bodies remember. And I when I finally realized this study, I realized that actually by fainting wasn't my fault. It was my father's stress and my mother being bathed in stress hormones from from having to stop high school when she was 17. I can't imagine that. And I saw the connection. And I was able to just like, let go of this like notion that I was just a wimp, you know, there was something really wrong with me. And I at that moment, all of a sudden, I also imagine here's my little life and my father's life. So it's maybe like this big, right? What must it feel like to be a person of color, or to be someone with Native American descent or possibly, you know, a descendant of concentration camp. And all of a sudden I started thinking about here's my little life. What about hundreds of years. I can't even imagine what that must feel like. And that was the day I literally I started sobbing, and I just said I got to become an activist, I got to do something about this. And Sean and I met up and we started the Vermont kindness project. I just wanted to give a shout out to Bezel van der Kolk's book, The Body Keeps the Score. This is a great resource for people. And the title says it all. Even if you don't read it, remember the title, The Body Keeps the Score, The Body Knows, The Body, These Baby Rats Know. They don't know what happened, but their body reacts. And the other book that has been incredibly important to me is My Grandmother's Hands, which honestly I think is brilliant in tying together this concept and the science of trauma with also systemic racism and also just the oppression and Abby Jaffe has been such an important help with me, like understanding and taking these courses that are still ongoing and I highly recommend them. I thought I'm certainly not expert in trauma, but I thought I knew a lot until I read this book. But I was had always been afraid of public speaking. And I knew that I kind of was like, okay, well, if I'm going to try to be an activist and I might have to do some public speaking but I'm really afraid of public speaking so I don't know what I'm going to do. So I decided maybe I would start singing and I also ended up going to the choir with the hope of kind of helping me get over my anxiety and it worked. Yes, and I can tell you, I don't faint anymore. I mean, how cool is that, right? And I can tell you it was it was it was gospel choir. It was gospel singing that got me to that place. And what if, you know, Vermont could be a model for changing the health care system from the bottom up and starting with instead of the shame and blame how about love and compassion and understanding. And it's not that hard, but I'm going to show you the film that the 2016 conference in Stowe was started by the two very smart women you'll meet in the film who brought this whole concept of Vermont. If it wasn't for them, I still probably wouldn't be, I wouldn't have known about this. The last thing I just want to say before I start this film is that I have so much respect and admiration for my patients, but especially the ones in this film who are real patients who who actually offered to come and talk on film about their stuff. And they agreed to be interviewed. And the very last man, the gentleman in the film had seen me for sore throat and I talked to him about aces and kind of got a sense of he'd been through a lot. And he ended up coming back to me two days later. And, and he he's obviously okay with me telling you this now because he's in the film. But he came back two days later and he said, I really want some some help stopping doing opiates. And he'd never told anybody that he'd been doing opiates because he had so much shame and he said I want to be a better parent to my baby that was just born. So this film is for them. It's all for all of my patients. And we have any time at the end I might want to just talk about just quickly some thoughts on trauma informed language and the different language we can use. And I just want to read one roomy quote, it's just three lines put you in the right frame of mind, and get up and take care of yourself during the film. It's, it's real, it's very low budget. But I'm proud to say that it does capture a lot of like real raw emotion, and, and also hope, I hope is how you'll come out of it. So the quote is, don't turn away. Keep your gaze on the on the bandage place. That's where the light enters you and just the connection between us staying quiet and not talking about this stuff, whether it's economics or it's our health or it's our childhood trauma. That's, that's what we can do today is just break the silence and, and, and join together. So I know we've gone over time here but thanks for staying. We're going to do a quick, a quick zoom some embodied somatic work.