How Childhood Adversity Affects Health

I remember my first experience working with someone with trauma. She was a middle-aged woman with back pain who was quite rigid and despite us just meeting had mentioned a few negative-sounding comments about her husband. I didn't think much of it as a new clinician but some bells went off when I went to palpate her abdomen and she got very defensive despite giving me permission to do so. I felt completely unprepared to help her deal with this at the time.

​Subsequent patients came and went and they had the same vibe of behaving in a self-preserving way, some more aggressive than others. Many, when they did volunteer information, described difficult childhoods. Unsurprisingly, they now presented to me with physical pain, tension, and chronic stress. 

You don't have to be a combat veteran or survivor of terrorism to experience or encounter trauma. It's all around us.

"One in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being hit."  Bessel van der Kolk, MD. 

Trauma pulls at the very fabric of our reality and disrupts the ability to feel safe in our bodies, homes, and social settings. Regardless if you are currently in danger or not. Often this insecurity stems from adversity from ages 0-5 the most fertile time for developing attachment strategies for the child.

"Children who don't feel safe in infancy have trouble regulating their moods and emotional responses as they grow older. By kindergarten, many disorganized infants are either aggressive or spaced out and disengaged, and they go on to develop a range of psychiatric problems. They also show more physiological stress, as expressed in heart rate, heart rate variability, stress hormone responses, and lowered immune factors. Does this kind of biological dysregulation automatically reset to normal as a child matures or is moved to a safe environment? So far as we know, it does not." van der Kolk

This is staggering and if you consider how just interacting with two people can connect you with  up to a million, it affects us all. And domestic killing sprees speak to the profound affect of abuse on behavior - both the victims and likely many of the perpetrators, given the numbers.

How does this adversity early in life affect your health? The Adverse Childhood Experiences (ACE) scale, a ten question survey on negative childhood events (linked here), has been extensively studied. Scored from 0-10 with a higher number indicating more trauma, for those with a score of 4 or more depression prevalence is 66% higher in females, 35% higher in males compared to 12% in those with a score of zero. Antidepressant and pain-killer use also rises exponentially with ACE score.  There is a 5000% increase in suicide attempts when going from zero to six on the scale. ACE scores above six have a 15% or greater chance of suffering from one or more of the ten leading causes of death in the US.

"What one sees, the presenting problem, is often only the marker for the real problem, which lies buried in time, concealed by patient shame, secrecy and sometimes amnesia - and frequently clinician discomfort." Vincent Felitti, MD (ACE investigator)

So I encourage you to take the ACE survey yourself. I give it to nearly all my clients and have them report only the number to me so that I am better able to help them feel safe in their body and also help them find the proper mental health professional to co-treat the client.

If you scored high, particularly above a 3, please seek help with a qualified professional. I look for those trained in Somatic Experiencing when referring and use many of their principles myself with clients. It is important to find practitioners knowledgeable about the body, not just what is going on between your ears.

Until we solve this trauma epidemic by being compassionate and creating safe places for the people in our lives we will repeatedly and unknowingly create more trauma and violence.

And if you are a clinician, wake up. People with trauma are walking in your door every day, even if you only work with athletes. You owe it to that person to understand the basics of trauma and behavior so as to avoid triggering more stress. I recommend reading The Body Keeps the Score, In an Unspoken Voice, and Behave as a start. 

"If the structures of the human mind remain unchanged, we will always end up re-creating the same world, the same evils, the same dysfunction.”  Tolle
​- Seth