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Lifelong Impacts of Childhood Trauma
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.
A Surprising Discovery
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.
我们想 谢天谢地 终于解决这个大麻烦了
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.
很快 她就就增肥到400磅 比她减重快多了
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,
后来 她告诉了我 祖父对她漫长的乱伦经历–
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, etc.
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?
A Common Condition
We studied 10 categories of adverse life experiences
that were chosen because of their prevalence in the weight program–
childhood sexual abuse, heavy-duty childhood physical abuse
I’m not talking spanking—
还有严重的情感伤害 经常性的精神羞辱 以及两类忽视
um, major emotional abuse, recurrent humiliation, two categories of neglect
growing up in a home
where one of the members of the household,
长期抑郁 自杀 患精神疾病 或长期住院的家庭环境中
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
A Clear Correlation
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.
好吧 现在 你知道了
Okay? Now, you know,
你想 你看报纸 本周最新的癌症恐慌
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
So the power of this relationship is enormous.
Why and What To Do About It
那么 最后 问题来了 童年的阴影是如何
So ultimately the question arises: how do life experiences in childhood end up with
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;
通过暴食 喝酒 等等
one overeats to feel better; one drinks to relax, etc..
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.