ACE study findings show that seventeen
and a half thousand middle-class adults have traumatic life experiences in
childhood that are lost in time and then further protected by shame and by
secrecy and by social taboos against inquiry into certain realms of human
experience—that those life experiences play out powerfully and proportionately
a half century later, in terms of emotional state, in terms of biomedical
disease, in terms of life expectancy.
There is a case study of a lady, she said that in 1985, she
became interested in obesity program in early childhood really by accident.
Another young woman came into the program. She was twenty-eight years old, and
weighed 408 pounds, and asked us if we could help her with her problem. And in
fifty-one weeks, we took her from 408 to 132. She maintained her weight at 132
for several weeks, and then in one three-week period regained 37 pounds in
three weeks, which I had not previously conceived as being physiologically
possible. That was triggered by being sexually propositioned at work by a much
older man, as she described him. And in short order, she was back over 400
pounds faster than she had lost the weight. I remember asking her why the
extreme response. After initially claiming not to have any understanding of why
the extreme response, ultimately she told me of a lengthy incest history with
her grandfather, from age 10 to age 21. Ultimately it turned out that
fifty-five percent of the people in our obesity program acknowledged a history
of childhood sexual abuse.
It mean, that
obviously is not the only issue going on, but it was where we began. And as we
went down that trail, then we discovered other forms of abuse, also growing up
in massively dysfunctional households.
The ACE study was really designed to see whether these things
existed at all in the general population, and if so, how did they play out over
time?
We studied 10
categories of adverse life experience that were chosen because of their
prevalence in the weight program: childhood sexual abuse, heavy-duty childhood
physical abuse, major emotional abuse, recurrent humiliation, two categories of
neglect, growing up in a home where, one of the members of the household, was
chronically depressed, suicidal, mentally ill, or in the state hospital; growing
up in a home without both biological parents; growing up in a home where, one
of the members of your household was alcoholic or a drug user; growing up in a
home where mother was beaten; growing up in a home where one of the members of
your household was imprisoned during your childhood or adolescence. Those were
the 10 categories. In a middle-class population, one in 11 people has
experienced six or more of those adverse life experiences in childhood.
So this is very common. Totally unrecognized. It was
difficult for us to accept their commonness. But on the other hand, these are
issues that most people never touch. And so who would know without routinely
asking? But at a so-called ACE score of six, experiencing any six of the ten
categories that we studied, that person was 4,600% more likely to become an IV
drug user than a person who had experienced none of those ten categories. Now,
you know, you think, you read the newspaper, the latest cancer scare of the
week, prostate cancer or breast cancer increases 30%, and everyone goes nuts.
I’m talking 4,600% increase. The same ACE score of six produces a likelihood of
attempting suicide that is between 3,100% and 5,000% greater than the
likelihood of suicide attempts in someone with none of those life experiences.
So the power of this relationship is enormous. So ultimately the question
arises:
How life experiences in childhood end up with disease do states a half
century later?
There are at least two big categories to account for that.
One is through the use of various coping devices. One smokes to feel better;
one overeats to feel better; one drinks to relax. And those things carried out
in heavy amounts have major destructive patterns, even though they may be
immediately beneficial. The other broad category has to do with the effect of
chronic major unrelieved stress on the workings of one’s brain and central
nervous system. In recent years, this is relatively new, it’s become clear that
chronic major unrelieved stress can produce the release of pro-inflammatory
chemicals in a person’s body, and also can suppress immune system function. Of
the ten categories that we studied, any six of them produces a shortening in
life expectancy of almost twenty years. The magnitude of this problem is so
huge, and the complexity of dealing with it after the fact is so huge, that
realistically, the only serious approach is going to have to involve primary
prevention. No one knows how to do that, but it’s the right question to focus
on.
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