What is the ‘ACEs Too High’ Study?
We all know that children who experience trauma will endure a ripple-effect of short and long-term outcomes. But, did you know that the this is just the tip of the iceberg in terms of what we can now understand about the impact of trauma on the lifespan?
Thankfully, Dr. Robert Anda, the Centre for Disease Control (CDC), and Kaiser Permanente (KP) conducted the ‘ACEs Too High’ study back in the 90’s, which took a deep-dive into trying to understand how childhood trauma impacts the individual as they enter adulthood. ((As an important side note, ‘ACEs’ refers to ‘Adverse Childhood Experiences’, and is an umbrella term for potentially traumatic events that can occur in childhood.)) Essentially, in this study, they interviewed over 17,000 adults to determine their ‘ACE score’–that is how many types of childhood trauma they experienced as a child–and compared that to their current health status as adults.
For the purposes of this study, they encompassed 10 types of ACEs such as: childhood abuse/neglect, experiencing violence within the home, growing up with family members who suffer from mental illness or abuse substances, and several more. For each ‘ACE’ an individual experienced, they add 1 point to their overall score. For every point a child scores on the assessment, they found that the risk of developing the following increases:
-having a heart attack or stroke,
-developing cancer and diabetes,
-falling into addiction and high-risk behaviours,
-getting diagnosed with depression,
-attempting suicide,
-contracting an STD,
-developing asthma, and so much more…
If an individual scored a 4 or more on the ACEs test, the study noted that is where things get very serious. In these cases, according to the CDC, “the likelihood of chronic pulmonary lung disease increases 390 percent; hepatitis, 240 percent; depression 460 percent; attempted suicide, 1,220 percent” (CDC, 2021). Essentially, if an individual scored a 4 or more, their risks of developing any (or several) of these complications mentioned above climbs substantially. If you are interested in learning more about this study, or in completing the ACEs Too High assessment yourself or with a loved one, you can access it here.
Because of the dramatic connections made in this study between childhood trauma and negative medical, psychological, and even economical outcomes for the individual, interpreters of this work use the analogy of ‘smoke and fire’ to illustrate what is going on here. Visibly, we see ‘smoke’: heart disease, depression, asthma, etc. and we often aim to treat these glaring health issues. But, according to this study, we should instead by looking for the hidden ‘fire’: childhood trauma.
A “Textbook Case”: Why ACEs Matter to Me
When I was first introduced to this study, it was by way of a TEDTalk by the brilliant Dr. Nadine Burke Harris. Dr. Burke Harris very eloquently explains the study “in a nutshell” as well as how her learnings from this study impacted her community health practice in California (If you are going to watch anything today, I highly recommend checking it out here!). The first time I viewed her talk, I saw myself. I was what Dr. Anda might call a ‘textbook case’ of the effects of childhood trauma on the lifespan.
In completing the original test myself, I score a solid ‘5’. In more recent versions of the test, I score a ‘6’. Suffice to say, as a child, I would have fallen into the category of being at significant risk of experiencing an array of health and personal issues in the years to come. As a child who experienced chronic economic instability, varying forms of neglect and emotional (and, mild physical) abuse, a caregiver diagnosed with several forms of mental illness, bouts of abandonment amidst parental divorce and affairs, and loved ones battling multiple kinds of addiction–I certainly look back and see my little nervous system was in overdrive just trying to cope. As a result of the trauma, I developed chronic stress which triggered the release of stress-hormones on an ongoing basis. Over all of those years, my body and mind were polluted and overrun by this physiological stress-hormone response, which in large quantities, we now know is quite toxic.
With the backdrop of this trauma, the landscape of my adult life began to take form…and the picture wasn’t looking pretty. By age 10, I was experiencing depressive symptoms and had suicidal ideations. To this day, I still remember my most vivid plans to end my life. In my mid-teens, I developed bulimia, a serious eating disorder. In my mid-to-late teens, I continued to battle bulimia and was also formally diagnosed (and treated) with depression and anxiety. And then, probably one of the most alarming manifestations of my trauma rose to the surface: at age 20, I developed a very rare auto-immune disease called Mastocytosis. Mastocytosis, if this is a new term to you, is basically when your body either develops too many mast cells, or, the mast cells you currently have are over-active. Due to this disease, which is ‘systemic’ (impacts the whole ‘body’ or ‘system’), I frequently develop hives, permanent skin scars or ‘spotting’, I have chronic gastro-intestinal issues, I experience brain-fog and memory loss, I have very limited energy levels, and the list goes on. Many folks who develop this disease sum all of it up as “being allergic to life”, because it almost seems as though the smallest influence can send you into a full-blown allergic response throughout the many systems of the body. At age 30, I was still experiencing varying degrees of all of these things: suicidal ideation, depression, anxiety, bulimia, and mastocytosis (and related issues).
So, you can see why this study resonates with me. But on top of this, I was also a Kindergarten Educator for several years, and observed many children in my care experiencing chronic stress as a result of trauma. I saw their little nervous systems on ‘high-alert’, and couldn’t help but wonder what the future held for them? In them, I saw versions of myself, and recognized the importance of sharing the findings of this study.
For me, in facing my own story of trauma and the impact it has on my life, I began to untangle myself from it’s web. This study was also “my story” and it didnot tell a promising tale: childhood trauma=chronic/toxic stress=negative health outcomes in adulthood and beyond. I began to wonder: what if I could interrupt that cycle…and change this gloomy trajectory for my life?
Re-Writing the “Textbook”: Reversing the Impacts of Childhood Trauma in My Life
Carrying around my trauma, diseases, mental health issues, and bleak future began to get very tiresome. Eventually, by age 33, I hit the ‘uncompromising wall’ of a nervous breakdown, and it was from that shattered place that I began to rebuild. So I began a radical search for healing (a journey that I will talk about in-detail in future blog posts).
For me, the hope for rebuilding and changing my trajectory came from a couple of powerful learnings. First, I began to hear about a thing called ‘Neuroplasticity‘–which is essentially the brain’s ability to re-wire itself by creating new neural pathways, and basically change the way our brains and bodies respond to the world. This told me that instead of feeling ‘doomed’ to reside in a toxic, stress-response state forever–I could find ways to re-organize my brain and learn to relax. In learning to respond more gently to the world, I could create new patterns of thinking and begin to calm my limbic system (the part of my brain that reacts to stress).
Interestingly enough, while I was learning about neuroplasticity, I was also doing some deep soul-searching in hopes of securing some measure of inner-peace. As I mentioned, I was experiencing a full-blown nervous breakdown, and as I ‘hit rock bottom’, I was desperately trying to find a way to heal. It was around that time when I was introduced to the work of Byron Katie. In highly encourage people to investigate her work if you seeking inner peace, because that is the gift it has given many others–and also gives me. Her wisdoms basically teach you how to identify your troublesome thoughts, and through a process of inquiry, detach from them. It is a loss of ego, which causes all suffering.
Byron Katie’s work, along with regular meditation, yoga, and spiritual exploration has allowed me to experience peace and begin my brain’s re-wiring process. Now, almost three years later, I can say that I experience levels of freedom from all of the things my childhood trauma triggered in me. With daily practice in these areas, I am gifted daily liberation from my eating disorder, anxiety, depression, and all of my symptoms of my mastocytosis are improved (some have disappeared altogether!). My relationships have improved, including the most important one: the relationship with myself.
Understanding the theory of neuroplasticity helped me to see hope in what felt like a hopeless future, but it was in my relentless search for healing–and reaping the effects of that healing–that this theory became reality. On a daily basis, I continue to uncover what brings me healing, and I don’t assume to know anyone else’s answers for their own recovery. All I can say is that I know it is possible, and share what has worked (and continues to work) for me. Everyday, I wake up in need of re-alignment, and I am learning to make peace with that, too. I am so grateful that I now have the tools to rebuild my future…and it’s looking brighter each day.
References:
Felitti, Vincent J. “The Relation between Adverse Childhood Experiences and Adult Health: Turning Gold into Lead.” The Permanente Journal, U.S. National Library of Medicine, 2002, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220625/.
Harris, Nadine Burke. “How Childhood Trauma Affects Health across a Lifetime.” Nadine Burke Harris: How Childhood Trauma Affects Health across a Lifetime | TED Talk, https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime.
Stevens, Jane Ellen, et al. “Aces Too High.” ACEs Too High, 16 Nov. 2022, https://acestoohigh.com/.
“What Is Neuroplasticity? the Power to Change Your Mind.” What Is Neuroplasticity? The Power to Change Your Mind, 29 Sept. 2021, https://www.betterup.com/blog/what-is-neuroplasticity.
