The Adverse Childhood Experience Study – and how it impacts how we think about trauma.

Photo by Luis Galvez on Unsplash

The groundbreaking Adverse Childhood Experience study was a major study of more than 17,000 people to find out if there is a correlation between traumatic events in childhood and adult health.

ACE’s are events during childhood that happened either to you or to a parent. Traumatic events include: sexual abuse, physical abuse, verbal abuse, emotional neglect and physical neglect.

Traumatic events that relate to a parent but will affect you indirectly include; a parent who was an alcoholic, a mother who was a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment.

The study was originally triggered by findings from an obesity clinic in the mid 1980’s. The clinic had a large dropout rate; despite the participants losing weight. Upon being interviewed it was discovered that a large majority of the participants had suffered childhood abuse before the onset of their obesity. The outcome of this was the discovery that obesity wasn’t the problem, it was a defence mechanism; a way to cope with what had happened to them during childhood.

One participant claimed that if she was overweight then no man would look at her. This woman had been abused by her grandfather during childhood. This was her way of surviving as an adult; if she made herself unattractive (in her eyes) then she would never be abused again. Obesity kept her safe from harm.

The clinic was run by Dr Felitti, Chief of Kaiser Permanente’s Department of Preventative Medicine. In partnership with Dr Ande from the Centre for Disease Control and Prevention they spent a year carefully developing a questionnaire which then became the ACE study. This study revolutionised the way we viewed trauma and addiction, as well as mental health issues and physical health.

Findings from the ACE study have shown that there is a graded relationship between the main causes of death in the US, health and social problems such as smoking, illicit drug use, unintended pregnancies and attempted suicides.

Information from neuroscience has discovered that early exposure to ACE’s, such as recurrent abuse or witnessing domestic violence, has an impact on the development of the child’s nervous system. This may impact on their ability to cope with future negative and emotional traumatic events. A way of coping in adults may become self regulating through the use of illegal substances.

The ACE study found that most of the population have a score of one; one traumatic experience happened to most us during childhood; parental divorce or death, or a family member being an alcoholic. Combine this though with 3 more ACE’s giving a score of 4 means an increase in risk of heart disease and other diseases, and affects health across a lifetime.

People who have an ACE score 5 or more are 7 to 10 times more likely to use illicit drugs.

Photo by Matthew T Rader on Unsplash

Dr. Daniel Sumrok, director of the Center for Addiction Sciences at the University of Tennessee Health Science Center’s College of Medicine has an approach to treating addicts that are in line with trauma specialists such as Bessel Van Der KolkDr Sumrok states that ‘addiction’ should be renamed “ritualised compulsive comfort-seeking” and, he claims, is a normal response to people who suffered Adverse Childhood Experiences.

Dr Sumrok also agrees with Van Der Kolk in that Post Traumatic Stress Disorder is NOT a Disorder; it’s a very real, very normal response to fear and our bodies hold onto that fear long after the traumatic event has passed.

In, The Body Keeps the Score, Van Der Kolk states,

“The lives of many trauma survivors come to revolve around bracing against and neutralising unwanted sensory experiences, and most people I see in my practice have become experts on self numbing….AT least half of all traumatised people try to dull their intolerable inner world with drugs or alcohol.”

So what does all of this mean for us?

The ACE study showed that a child who has spent their childhood in fear, and in traumatic circumstances, will carry the trauma in their bodies into adulthood. As children we have no way of processing what is happening to us unless guided by a caring, empathic, loving adult who we can trust. Many of the people with ACE scores of more than 5 will have struggled to find such an adult.

Dr Gabor Mate, addiction specialist and author of In the Realm of Hungry Ghosts, works with North America’s most concentrated population of addicts in Downtown Eastside.

I worked with hundreds of female patients, and every one had been sexually abused as a child. Men were physically, sexually and emotionally abused, suffered neglect, were in foster care.”

Dr Mate claims that all addiction; drugs, alcoholism, shopping, gambling, is an attempt to self regulate our emotions stemming from what happened to us during childhood.

The physical effects of being in a state of fight, flight or freeze response during traumatic experiences in childhood takes it’s toll on the body. When adrenaline is constantly being released and we are under stress this gradually can cause inflammation in the body. Inflammation has been associated with cardiovascular disease and autoimmune diseases.

What we can do as adults is to begin processing the trauma that we may not have talked about to anyone at all. Working with a therapist allows us to understand what is happening to our minds and bodies. Many people do not understand why they feel depressed, anxious or stressed in adulthood. Many people do not realise that they are suffering from PTSD symptoms brought on by their childhood trauma. The first step towards healing is understanding.

The therapist can become the safe, secure, empathic and caring adult that we needed in our childhood. In this way, we can begin to heal.

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