ACE (Adverse Childhood Events): The Most Important Trauma Study You’ve Never Heard About

In order to understand why his obesity patients were dropping out of a successful weight loss program, Dr. Vincent Felitti dived into their medical records and interviews for clues. What he found launched a several year study that has enrolled more than 17,000 people. These patients were talking about incest, abuse and neglect, extreme adversity in their childhoods.

The Centers for Disease Control and Dr. Felitti with Kaiser Permanente launched a study to look at adverse childhood events and their effect on health and longevity over the lifespan.

What is an adverse childhood event? For the purposes of the study it is:

- sexual abuse
- physical abuse
- emotional abuse
- physical neglect
- emotional neglect
- a home where the mother was treated violently
- substance abuse in the home
- mental illness in the home
- parental separation or divorce
- one or more parents imprisoned

Count up the categories that apply to you. That gives you your ACE score. Anything above 4 predisposes people to substance abuse, dysfunction and health issues among other things. People with the highest scores died on average 20 years earlier than people with low ACE scores. (For more information about the mechanisms of these effects see my earlier blog posts on the HPA Axis.)

You can check out more information about the study here. Highly recommended reading for everyone: those of us who suffered difficult childhoods, caregivers, treaters and public policy setters.

This can feel overwhelming as we delve into the truth. The good news is that we are beginning to finally come to terms with the widespread effects of trauma and PTSD and the need to heal from it!

Trauma and Attachment

Here’s a little known fact about trauma: an experience of extreme stress or trauma always ruptures a sense of connection and secure attachment in the world.

What do I mean by that?

The world and our sense of safety and connection in it profoundly altered by the sense of disconnection. This makes healing from trauma a doubly hard endeavor.

Here are some examples of common traumas and the ruptured attachment:

Rape: strangers, your own judgment, even a whole gender (men, usually).

War: commanding officers, countries, your own country, people of other races

Child Abuse: authority figures, intimate relationships, justice system, sense of self

Natural Disaster: God, nature, government (if inadequate response)

Car Accidents: other drivers, own judgment, motor vehicles

Major Medical Illness: body, medical system (if inadequate), society (if not able to get insurance or help due to finances)

There are, of course, many other kinds of trauma and endless variations on disrupted attachment and connection depending on the experience involved.

All victims of traumas naturally experience a questioning of and sense of separation from self. Most end up having some sort of spiritual crisis in that their attachment to a higher power is called into question.

Without feeling secure in the world it’s easy to become lost and not know where to turn to for help when you need it the most. Therapists often underestimate the damage done by rupture of secure attachment in the midst of crisis, and patients often end up feeling angry, guilty and paralyzed.

It is important to not pathologize these responses but to see them as a normal conditioned response to trauma and extreme stress.

So, easy does it. When you are ready, sit down and think about areas of mistrust that result directly from your trauma. Be good to yourself today!