The significance of the famous ACE study
The lingering impact of childhood trauma on adult well-being has become widely accepted in medical and psychology circles in recent years.
The evidence was first published in a now famous study by Dr. Vincent Felitti and his colleagues in a paper entitled Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. It is now simply called the ACE (Adverse Childhood Experiences) study.
The conclusion:
“We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.”
Dr. V Felitti et. al.
The Centre for Disease Control (CDC) in the US has taken the results of this study, which is now ongoing, very seriously and has several dedicated web pages outlining the magnitude of the problem, the specific risk factors, and a heavy emphasis on prevention. Our Canadian context is sure to be very similar.
Here is an infographic of known increased risks for adults:
This includes increased risk for accidents, mental illness, unwanted pregnancy, sexually transmitted infections, cancer, diabetes, substance abuse, and more limited educational and occupational opportunities. In fact, earlier death as shown by this famous ACE pyramid:
Several general press books have subsequently been published and widely circulated. Perhaps Dr. Bessel van der Kolk’s book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, is best known and widely quoted by mental health professionals.
Childhood Disrupted by Donna Jackson Nakazawa is a deep journalistic dive in the results of the ACE study and full of great self-help advice for dis-ease sufferers.
And Oprah Winfrey with co-author Dr. Bruce Perry have recently added to the discussion in their recent book, What Happened to You?
There is additional published evidence in the occupational medicine literature that employees, particularly those in high risk first responder positions, and who have a history of childhood trauma, are more likely to burn out or develop work related mental illness such as posttraumatic stress disorder (PTSD).
Why does childhood trauma affect adult health?
Because the infant and childhood brain is undergoing rapid development and learning, it is particularly vulnerable to an unpredictable or threatening environment. Not knowing if an approaching parent or adult will “hug or slug” causes the nervous system to become highly vigilant (sensitive). In particular, this involves changes in the amygdala and limbic system that are likely to result in prolonged states of anxiety and “fight or flight.” This in turn leads to elevated cortisol levels and its known ill-effects.
Another pathway to adult ill-health is suppressed emotions. Here the iceberg word picture is apropos.
Unprocessed, suppressed, emotions don’t die. They show up above the water line with anger issues, depression, and countless physical conditions.
Without the adult ability to interpret their abuse, children almost always assign self-blame and assume faulty thinking about their experience and their self-worth. This leaves them feeling unworthy and unlovable.
We also know from advanced functional MRI studies that children with significant abuse or neglect fail to develop integrated brain connections. And they remain disconnected from their bodies and develop thwarted views and opinions about their body.
But there is hope and healing
Because of the recent discovery of neuroplasticity, we now know that the brain changes that resulted from childhood trauma can be reversed. Faulty thinking can be corrected. Suppressed emotions can be processed and released. Self-mastery skills can be learned to overcome an overly vigilant nervous system.
Here is a simple outline of steps to healing:
- Admit your need – overcoming denial and unhealthy coping mechanisms takes resolve and strength from Above
- Find a therapist – the healing journey is never a solo one; in order to visit a painful past there is an huge need safety & soothing
- Become self-aware of your emotions & journal them – “explore the iceberg”
- Revisit the trauma to re-establish a new narrative – this requires a calm, soothed, nervous system in the safety of a trusted therapist or significant others; here a faith-based approach is especially powerful as it engages the more spiritual intuitive right brain
- Develop compassion and forgiveness – for self & perpetrator(s) – this is hard but it has been said that unforgiveness is “drinking poison, hoping the other person will die”
- Befriend your body & its sensations – this involves sitting and being present to your bodily sensations and working with exercise routines that help recover the missing healthy mind-body connections
- Rediscover play & a recover a lost childhood – many traumatized children never experienced happy childhood play and no matter the adult age, must be recovered.
The single biggest step is the first one – to admit one’s need and to be willing to do the work. So many people are afraid to open the “jack-in-the-box” for fear of uncontrolled emotions, worsening pain, and an inability to “shut” it down again.
But in my clinical experience, and that of therapists and counsellors everywhere, it is never not worth it! And I have seen too many residents in nursing homes who never did deal with their trauma, and who then in a demented state, take out their suppressed anger and frustration on the staff (then repeating the cycle not only in their own family, but that of the caregiver’s family as well).
Help for the journey
For many, a crisis becomes the impetus to deal with the past. Maybe a health crisis, a relational or marriage failure, a lost job, burnout, or just too much stress to go on.
If you are at the “end of your rope,” let it be your sign to start your healing journey. Tell a close person that you need help. Talk to your pastor, priest, or spiritual advisor. Call a counsellor or your doctor. And we at IHTC are here to help and between us have decades of experience in serving and providing resources.
Here are a couple of upcoming courses offered by our partners that we can endorse:
- Life’s Healing Choices with Rick Warren and John Baker – a DVD-based, 8-week study and workbook that focuses on one of the 8 Celebrate Recovery Principles for 8 weeks
- Emotionally Healthy Spirituality by Peter Scazzero – specifically, two lessons in this course are “Going Back in Order to Go Forward,” and “Journey through the Wall.”
Because we are mostly wounded in community, we also heal best in community. Being part of a healthy faith community, especially in a safe small group setting, is extremely helpful on one’s healing journey.
Compassionately,
