Ngaba uxinzelelo loMntwana kunye nokuGula okungapheliyo kuDibene?

Umxholo

• Ukujongwa ngokusondeleyo kwii-ACE
• Uthini uphando
• Kufutshane nasekhaya
• Izithintelo kwiikhrayitheriya ze-ACE
• Ukujongana ne-ACE kwimeko yezonyango
• Yintoni elandelayo?

Eli nqaku lenziwe ngokubambisana nomxhasi wethu. Umxholo uyinjongo, ichanekile ngokwezonyango, kwaye unamathela kwimigangatho yemigaqo-nkqubo kunye nemigaqo-nkqubo yeHealthline.

Siyazi ukuba amava abuhlungu anokubangela imiba yezempilo yengqondo kunye neyasemzimbeni ebudaleni. Umzekelo, ingozi yemoto okanye uhlaselo olunobundlobongela kunokubangela ukudakumba, unxunguphalo, kunye noxinzelelo lwasemva koxinzelelo (PTSD) ukongeza kwengozi yomzimba.

Kodwa kuthekani ngoxinzelelo lwengqondo ebuntwaneni?

Uphando olwenziwe kule minyaka ilishumi idlulileyo lukhanyisa indlela iziganeko zobuntwana ezibi (ACEs) ezinokuthi zichaphazele ngayo izifo ezahlukeneyo ebomini.

Ukujongwa ngokusondeleyo kwii-ACE

Ii-ACE ngamava amabi awenzeka kwiminyaka eli-18 yokuqala yobomi. Banokubandakanya iminyhadala eyahlukeneyo njengokufumana okanye ukungqina ukuxhatshazwa, ukungahoywa, kunye neendlela ezahlukeneyo zokungasebenzi kakuhle ekhaya.

Isifundo sikaKaiser esapapashwa ngo-1998 sifumanise ukuba, njengoko inani le-ACE kubomi bomntwana linyuka, nawo ngokunjalo amathuba okuba “nemingcipheko emininzi yezizathu ezibangela ukufa kwabantu abadala,” ezinjengesifo sentliziyo, umhlaza, umphunga ongapheliyo isifo, kunye nesifo sesibindi.

Olunye uphononongo lokhathalelo olunolwazi olwenzekileyo kumaxhoba okonzakala ebuntwaneni lufumanise ukuba abo banamanqaku aphezulu e-ACE banokuba semngciphekweni omkhulu wezifo ezizimela njenge-rheumatoid arthritis, kunye nentloko ebuhlungu, ukungalali, ukudakumba noxinzelelo, phakathi kwabanye. Kukwakho nobungqina bokuba ukungakhuseleki kuxinzelelo olunobungozi kunokubangela utshintsho kwinkqubo yomzimba yokuzikhusela.

Ithiyori kukuba uxinzelelo lweemvakalelo olugqithisileyo luyinto enokubangela utshintsho oluninzi emzimbeni.

I-PTSD ngumzekelo olungileyo walethiyori isebenza. Izizathu eziqhelekileyo ze-PTSD zihlala zizinye zezehlo ezifanayo ezamkelweyo kwiphepha lemibuzo le-ACE-ukuxhatshazwa, ukungahoywa, iingozi okanye ezinye iintlekele, imfazwe nokunye. Iindawo zokutshintsha kwengqondo, kokubini kulwakhiwo kunye nokusebenza. Iinxalenye zengqondo ezichaphazeleke kakhulu kwi-PTSD zibandakanya i-amygdala, i-hippocampus, kunye ne-ventromedial preortal cortex. Ezi ndawo zilawula iinkumbulo, iimvakalelo, uxinzelelo kunye noloyiko. Xa zingasebenzi kakuhle, oku kuyonyusa ukubakho kwe-flashbacks kunye ne-hypervigilance, ukubeka ingqondo yakho kwisilumkiso esiphezulu ukuqonda ingozi.

Kubantwana, uxinzelelo lokufumana umothuko lubangela utshintsho olufanayo kakhulu kwezo zibonwe kwi-PTSD. Umothuko unokutshintsha inkqubo yokuphendula koxinzelelo lomzimba kwigiye eziphezulu kubomi bonke bomntwana.

Kwelinye icala, ukwanda kokudumba okuvela kwiimpendulo zoxinzelelo eziphakamileyo kunye nezinye iimeko.

Ukusuka kwimbono yokuziphatha, abantwana, ulutsha, kunye nabantu abadala abanamava okonzakala ngokomzimba nangokwengqondo banokubakho ngakumbi ekusebenziseni iindlela ezingafunekiyo zokuziphatha ezinje ngokutshaya, ukusebenzisa iziyobisi gwenxa, ukutya kakhulu nokuziphatha kakubi ngokwesini. Ezi ndlela zokuziphatha, ukongeza kwimpendulo yokuvuvukala, zingazibeka emngciphekweni omkhulu wokukhula kweemeko ezithile.

Uthini uphando

Uphando lwamva nje ngaphandle kwesifundo se-CDC-Kaiser luphonononge iziphumo zolunye uhlobo lomothuko ebomini bokuqala, kunye nezinto ezinokukhokelela kwiziphumo ezingcono kwabo bavelele umothuko. Ngelixa uphando oluninzi lujolise kuxinzelelo lwasemzimbeni kunye neemeko zempilo ezingapheliyo, izifundo ezininzi ngakumbi ziphonononga unxibelelwano phakathi koxinzelelo lwengqondo njengento yokuxela ukugula okungapheliyo kamva ebomini.

Umzekelo, uphononongo olupapashwe kwiphephancwadi leKlinikhi kunye noVavanyo lweRheumatology ngo-2010 luvavanye amaxabiso e-fibromyalgia kwi-Holocaust abasindileyo, ngokuthelekisa ukuba bangakanani abasindileyo abanokuba kwimeko yokulawula iqela loontanga babo. Abasindileyo kwi-Holocaust, abachazwe kolu phononongo njengabantu ababehlala eYurophu ngexesha lokuthinjwa kwamaNazi, babedlula amathuba aphindwe kabini okuba babe ne-fibromyalgia njengoontanga babo.

Zeziphi iimeko ezinokubangelwa kukukhathazeka komntwana? Oko akucaci kancinci ngoku. Uninzi lweemeko-ngakumbi ukuphazamiseka kwemithambo-luvo kunye nokuzenzekelayo-azinasizathu sinye saziwayo, kodwa ubungqina obuninzi ngakumbi bubonisa ii-ACEs njengokuba zidlala indima ebalulekileyo kuphuhliso lwazo.

Okwangoku, kukho amakhonkco aqinisekileyo kwi-PTSD kunye ne-fibromyalgia. Ezinye iimeko ezinxulunyaniswe ne-ACEs zinokubandakanya isifo sentliziyo, intloko ebuhlungu kunye ne-migraines, umhlaza wemiphunga, isifo esinganyangekiyo semiphunga (COPD), isifo sesibindi, uxinzelelo, unxunguphalo, kunye nokuphazamiseka kokulala.

Kufutshane nasekhaya

Kum, olu hlobo lophando lunomdla ngokukodwa kwaye lunobuqu. Njengomsindisi woxhatshazo nokungakhathalelwa ebuntwaneni, ndinamanqaku aphezulu kakhulu e-ACE - 8 kwinto enokwenzeka 10. Ndiphila ngeendlela ezahlukeneyo zezempilo, kubandakanya i-fibromyalgia, isifo senkqubo yamathambo yabantwana, kunye nesifuba, ukubala nje ezimbalwa. , enokuthi okanye ingadibani nengozi endikhe ndayifumana ekukhuleni kwam. Ndihlala ne-PTSD ngenxa yokuxhatshazwa, kwaye inokubandakanya konke.

Nditsho nanjengomntu omdala, kwaye kwiminyaka emininzi emva kokuyeka ukunxibelelana nomxhaphazi wam (umama wam), bendihlala ndisokola ukungakhathali. Ndilumke kakhulu kwindawo endingqongileyo, ndihlala ndiqinisekisa ukuba ndiyazi apho kuphuma khona. Ndithatha iinkcukacha ezincinci abanye abanokungazenzi, njengamathambo okanye amanxeba.

Emva koko kukho ukubuyela umva. Izinto ezibangela ukwahluka zinokwahluka, kwaye yintoni enokubangela ukuba ndibekho ngelinye ixesha isenokungandibangeli elandelayo, kunganzima ukuba uyilindele. Inxalenye esengqiqweni yengqondo yam ithatha umzuzwana ukuvavanya imeko kwaye yamkela ukuba akukho sisongelo sisondeleyo. Amalungu achaphazelekayo e-PTSD engqondo yam athatha ixesha elide ukufumanisa oko.

Okwangoku, ndizikhumbula ngokucacileyo iimeko zoxhatshazo, ukuya kuthi ga kwinqanaba lokuba ndikwazi ukunuka ivumba elivela kwigumbi apho kwenzeka khona uxinzelelo okanye uve ifuthe lokubethwa. Umzimba wam uphela ukhumbula yonke into malunga nendlela ezadlala ngayo ngelixa ingqondo yam indenza ndiphinde ndiphinde ndibuyele. Uhlaselo lunokuthatha iintsuku okanye iiyure ukubuya kwakhona.

Ukujonga loo mpendulo yomzimba opheleleyo kwisiganeko sokwasengqondweni, akukho nzima kum ukuba ndiqonde ukuba ukuphila ngokwenzakala kunokuchaphazela njani ngaphezulu kwempilo yakho yengqondo.

Izithintelo kwiikhrayitheriya ze-ACE

Isikhalazo esinye seenqobo ze-ACE kukuba iphepha lemibuzo lincinci kakhulu. Umzekelo, kwicandelo elimalunga nokuxhatshazwa ngokwesini kunye nokuhlaselwa ngokwesondo, ukuze uphendule ewe, umxhaphazi kufuneka ukuba abe neminyaka emihlanu ubuncinci kuwe kwaye kufuneka ukuba wazama okanye wadibana naye ngokwasemzimbeni. Umcimbi apha kukuba iindlela ezininzi zokuxhatshazwa kwabantwana ngokwesondo zenzeka ngaphandle kwale mida.

Zininzi iindidi zamava amabi ngoku angabhalwanga kwiphepha lemibuzo le-ACE, ezinje ngeengcinezelo zenkqubo (umzekelo, ubuhlanga), ubuhlwempu, kunye nokuhlala unesifo esinganyangekiyo okanye esityhafisayo njengomntwana.

Ngaphandle koko, uvavanyo lwe-ACE alubeki amava amabi ebuntwaneni kwimeko entle. Ngaphandle kokuchaphazeleka kukonzakala, ibonakalisile ukuba ukufikelela kunxibelelwano oluxhasayo kwezentlalo kunye noluntu kunokuba nefuthe elihle elihlala lihleli kwimpilo yengqondo neyasemzimbeni.

Ndizibona ndilungelelene, nangona ndinobuntwana obunzima. Ndikhule ndihlukanisiwe kwaye ndingenalo noluntu ngaphandle kosapho lwam. Into endandinayo, nangona kunjalo, yayingumakhulu omkhulu owayekhathala kakhulu ngam. UKatie Mae wasweleka xa ndandineminyaka eli-11 ubudala ngenxa yeengxaki zokuqinelwa yimithambo. Kude kube lelo xesha, nangona kunjalo, wayengumntu wam.

Kudala ngaphambi kokuba ndigule ngenxa yeemeko zempilo ezingapheliyo, uKatie Mae wayehlala engoyena mntu kusapho lwam endandijonge phambili ukumbona. Xa ndaye ndagula, yayingathi sobabini sasiqondana kwinqanaba ekungekho namnye onokuliqonda. Ukhuthaze ukukhula kwam, wandinika indawo ekhuselekileyo, kwaye wakhuthaza umdla wobomi bonke wokufunda oqhubeka ukundinceda namhla.

Ngaphandle kwemiceli mngeni endijongene nayo, ngaphandle kukamakhulu wam omkhulu, andithandabuzi ukuba indlela endibona kwaye ndibone ngayo umhlaba iyakwahluka kakhulu-kwaye ibe mbi kakhulu.

Ukujongana ne-ACE kwimeko yezonyango

Ngelixa uphando oluninzi luyafuneka ukuze kuchazwe ngokupheleleyo ubudlelwane phakathi kwe-ACEs kunye nesifo esinganyangekiyo, kukho amanyathelo anokuthathwa ngoogqirha nabantu ngabanye ukuphonononga ngcono iimbali zezempilo ngendlela ebanzi.

Kubaqalayo, ababoneleli ngezempilo banokuqala ukubuza imibuzo malunga nokwenzakala okudlulileyo ngokwasemzimbeni nangokweemvakalelo ngexesha lotyelelo ngalunye- okanye, nangcono, ngalo naluphi na utyelelo.

"Akukho ngqwalaselo yaneleyo ihlawulwa eklinikhi kwiziganeko zobuntwana kunye nendlela eziyichaphazela ngayo impilo," utshilo uCyrena Gawuga, PhD, owabhala isifundo ngo-2012 malunga nobudlelwane phakathi koxinzelelo lobomi bokuqala kunye neempawu zentlungu engapheliyo.

Izikali ezisisiseko ezifana ne-ACE okanye kanye ukubuza Ingenza umahluko obalulekileyo- singasathethi ke ngomsebenzi wokuthintela ngokusekelwe kwimbali kunye neempawu zomothuko. ” UGawuga ukwathe kusafuneka uphando olongezelelekileyo lokufunda ngendlela imeko yezoqoqosho kunye nenani labantu elinokuthi linyuse ezinye iindidi ze-ACE.

Nangona kunjalo, oku kukwathetha ukuba ababoneleli kufuneka babe nolwazi ngokwenzakala ukuze bancede ngcono abo baveza amava obuntwana.

Kubantu abanjengam, oku kuthetha ukungafihli nto malunga nezinto esidlule kuzo njengabantwana kunye nolutsha, ezinokuba ngumceli mngeni.

Njengabasindileyo, sihlala siziva sineentloni malunga nokuphathwa gadalala esiye sakufumana okanye nangendlela esiye sasabela ngayo kukonzakala. Ndivulekile kakhulu malunga nokuxhatshazwa kwam ngaphakathi koluntu lwam, kodwa kufuneka ndivume ukuba andiyichazanga into eninzi kunye nabanikezeli bam bezempilo ngaphandle kwonyango. Ukuthetha ngala mava kunokuvula isithuba seminye imibuzo, kwaye ezo kunokuba nzima ukuzisingatha.

Umzekelo, kuqeshwa i-neurology kutshanje ndacelwa ukuba kungabakho monakalo kumqolo wam nakweyiphi na imicimbi. Ndaphendula ngokunyanisekileyo ewe, emva koko kwafuneka ndicacise malunga noku. Ukucacisa okwenzekileyo kundithathile ndafika kwindawo enzima ekunzima ukuba kuyo, ngakumbi xa ndifuna ukuziva ndinamandla kwigumbi lokubhalela.

Ndafumanisa ukuba iindlela zokucinga zinokundinceda ndilawule iimvakalelo ezinzima. Ukucamngca ngakumbi kuluncedo kwaye kubonisiwe kwaye kukunceda ulawule ngcono iimvakalelo. Iiapps zam endizithandayo koku yiBuddhify, Headspace, kunye neCalm - nganye inokukhetha okuhle kwabaqalayo okanye abasebenzisi abaphambili. I-Buddhify ikwanazo neempawu zentlungu kunye nesifo esinganyangekiyo endisifumana ngokobuqu siluncedo olukhulu.

Yintoni elandelayo?

Ngaphandle kwezikhewu kwiikhrayitheriya ezisetyenziselwa ukulinganisa ii-ACEs, zimele umba obalulekileyo wezempilo yoluntu. Iindaba ezimnandi zezokuba, ubukhulu becala, ii-ACEs zinokuthintelwa ikakhulu.

icebisa ngeendlela ngeendlela ezibandakanya iiarhente zikarhulumente nezasekhaya zokuthintela ubundlobongela, izikolo kunye nabantu ukuba bancede baqwalasele kwaye bathintele ukuxhatshazwa nokungakhathalelwa ebuntwaneni.

Njengokuba ukwakha iindawo ezikhuselekileyo nezixhasayo zabantwana kubalulekile ekuthinteleni ii-ACE, ukujongana nemiba yokufikelela kukhathalelo lwempilo yomzimba kunye nengqondo kubalulekile ekujonganeni nayo.

Olona tshintsho lukhulu ekufuneka lwenzekile? Izigulana kunye nababoneleli kufuneka bathathe amava abuhlungu ebuntwaneni ngokungathí sina. Nje ukuba senze njalo, siya kuba nakho ukuqonda unxibelelwano phakathi kokugula kunye nokwenzakala ngcono-kwaye mhlawumbi sithintele imiba yezempilo yabantwana bethu kwixa elizayo.

UKirsten Schultz ngumbhali ovela eWisconsin ocela umngeni kwimilinganiselo yesini kunye neyesini. Ngomsebenzi wakhe njengesigulo esinganyangekiyo kunye nelitshantliziyo lokukhubazeka, unedumela lokudiliza izithintelo ngelixa ngengqondo ebangela ingxaki eyakhayo. Kutshanje usungule isini esingapheliyo, esixoxa ngokuphandle ukuba ukugula kunye nokukhubazeka kubuchaphazela njani ubudlelwane bethu nathi kunye nabanye, kubandakanya-ubuyithelekelela-isondo! Uyakwazi ukufumana okungakumbi malunga neKirsten kunye neSondo esingapheliyo kwi yamagazini.org kwaye ulandele kuye Twitter.