Four Aces: a terrible hand?

They say, “lucky in cards, unlucky in love,” but when it comes to “ACEs” (or “adverse childhood experiences” such as abuse, neglect and family dysfunction in childhood) those unlucky in childhood are also unlucky in adulthood—particularly unlucky about getting sick and dying. 

We’ll take a look at the details in a moment, but the key point here is that when we as parents, and as a society, allow kids to be abused, neglected or exposed to stressors such as parental alcoholism or witnessing a parent being abused we are also setting them up for significant increases in likelihood of serious illness and premature death.  This is the epitome of “unfair” and must inform both our parenting and our social policy.

The ACE Study explores the question of why risk-factors for serious illnesses are not randomly scattered throughout a population and instead cluster together amongst unfortunate sub-groups, and why it might be that if you have one illness you are more likely to have others as well.  What could contribute to this beyond unlucky genes?  To study this, a joint effort of a large health-care provider and the CDC (Center for Disease Control), looked at the health and backgrounds of over 17,000 people and then tracked their health moving forward.  The study is ongoing (and will continue to provide information on risk-factors and outcomes), but so far what has emerged is that just as early exposure to certain toxins might later lead to cancer, it turns out that early experiences of abuse and neglect not only mess with our later psychology, but also strongly contribute to our getting physically sick.

Firstly, when it comes to abuse, neglect and serious stressors in childhood, it is striking how many people experience at least some.  For example one in ten people report emotional abuse, two in ten report being sexually abused while nearly three in ten report physical abuse.  With regard to neglect, nearly ten percent of people report emotional neglect and fifteen percent say they were physically neglected.  Finally, when looking at general dysfunction in the household, five percent of people had a family member incarcerated, twelve percent say their mom was treated violently, one in five had serious mental illness in the family, twenty three percent report separation or divorce of parents, and twenty-six percent (more than one in four) report substance abuse being an issue in their house growing up.

While thirty-six percent of folks report coming through childhood unscathed by abuse, neglect and dysfunction (and they are rather lucky, it turns out, physically as well as psychologically), a quarter of people report one harmful factor, fifteen percent say two, another ten percent say three and over twelve percent report four or more ACE factors.  Now the higher the number of ACE factors that a person endures in his or her childhood, the more likely that person is to now be dealing with a serious illness as an adult.  In fact these experiences appear to be “major risk factors for the leading causes of illness and death as well as poor quality of life in the United States.  Progress in preventing and recovering from the nation’s worst health and social problems is likely to benefit from the understanding that many of these problems arise as a consequence of adverse childhood experiences.”  (To learn more about the ACE study see: http://tiny.cc/fUBkL).

The big picture:  when we hurt a kid it’s a gift that keeps on giving… major problems.

While it makes intuitive sense that being emotionally hurt and/or physically or sexually traumatized could make a person get sick over time, the fact that these findings come from the largest study of its kind, (17,000 subjects give the validity of the data a lot of heft), means that the science demands that we address these issues or deliberately turn a blind eye on the health and well being of millions of people.  The ACE Study has implications not just about how we should parent, but also with regard to how we should spend our resources of time, money and attention as a culture.  As we debate “end of life” issues, we would be well-served to think about how many health care dollars might be saved (not to mention quality of life enhanced) via early intervention to protect kids from abuse and neglect.

Now the tricky thing is to not shame, blame and criticize “bad” parents, but rather to understand that abuse and neglect are a cycle that we might help stop—not only by protecting kids, but by supporting parents to heal, develop better self-esteem and anger management skills.  If we truly hope to help people grow and improve in the care of their children, we must start by understanding the wounds and limitations of parents—deepening compassion for how emotionally and physically sick any given parent may feel depending on how many ACEs they’ve been dealt in their own childhoods.

When we contemplate abuse in parenting it makes sense to take another look in the mirror.  How much do we shout?  How much do we drink?  How much abuse do our kids watch us accept?  Could there be subtle gradations in “abuse” and subtle ripples for long-term health (i.e. is an environment of shame or our parental depression a potential cause of later illness in our children?  If so, could this be impetus for us to seek therapy for ourselves in the service of our children?).

As grown-ups we might also look at the ACE factors and be thinking, “Wow, I have quite a few of these factors myself…” And if this is the case we are also more likely as teens to have smoked, been promiscuous sexually and had an unwanted pregnancy.  The hope in recognizing the effects of abuse, in ourselves and on our kids, is that if we can be more conscious of our past wounds perhaps we can do a better job and stop the cycle of abuse and illness.  If mama’s not happy nobody’s happy… or healthy; ditto for dad.

So let’s dedicate today to looking at our own ACEs in the spirit of forgiveness of the past; and let’s look at our parenting weak spots (be it yelling, disengaging or abusing substances) and strive to make improvements as best as we can.  And let’s place our consciousness, compassion, efforts and our productive suffering in the service of all our collective children—and the grown-ups who care for them.

Namaste, Bruce