How Childhood Trauma Can Make You A Sick Adult Video Lecture | Big Thinkers on Mental Health - Health & Fitness

What we found in the ACE study involving seventeen
and a half thousand middle-class adults was
that 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.
In 1985, I first became interested
in developmental life experiences in early
childhood really by accident. In the major
obesity program we were running, a 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. And we thought, well my god, we’ve
got this problem licked. This is going to
be a world-famous department here! 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. I 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, et cetera. 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—I’m
not talking spanking—um, major emotional
abuse, recurrent humiliation, two categories
of neglect, growing up in a home where, one
of the members of the household, uh, 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, um, 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. Okay? 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 do
life experiences in childhood end up with
disease 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, et cetera. 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.