The results of the study were astoundingly clear: The more childhood trauma someone had suffered, the worse their health outcomes were in adulthood. And their risk for contracting diseases didn’t go up just a few percentage points. People with high ACE scores were about three times as likely to develop liver disease, twice as likely to develop cancer or heart disease, four times as likely to develop emphysema.[2] They were seven and a half times more likely to become alcoholics, four and a half times more likely to suffer from depression, and a whopping twelve times more likely to attempt suicide.[3]
Scientists have learned that stress is literally toxic. Stress chemicals like cortisol and adrenaline surging through our bodies are healthy in moderation—you wouldn’t be able to get up in the morning without a good dose of cortisol. But in overwhelming quantities, they become toxic and can change the structure of our brains. Stress and depression wear our bodies out. And childhood trauma affects our telomeres.
Telomeres are like little caps on the ends of our strands of DNA that keep them from unraveling. As we get older, those telomeres get shorter and shorter. When they’ve finally disappeared, our DNA itself begins to unravel, increasing our chances of getting cancer and making us especially susceptible to disease. Because of this tendency, telomeres are linked to human lifespan. And studies have shown that people who suffered from childhood trauma have significantly shortened telomeres.[4]
In the end, these studies claimed that having an ACE score of 6 or higher takes twenty years off your life expectancy. The average life expectancy for someone with 6 or more ACEs is sixty years.[5]
My score is 6.
At thirty, I was halfway to the end.
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I embarked on this research in 2018. It’s important to understand that two years later, in 2020, Robert F. Anda, the co–principal investigator of the initial ACE study, came out with an article and a YouTube video stating that ACEs were a relatively crude way of measuring childhood trauma.[6] The scores are remarkably helpful epidemiologically—for people to understand the overall significance of childhood trauma on public health. But Anda underlined that ACEs are not a good measure of an individual’s life span or health outcomes. There is a wide level of variation for each score. For example, a person with an ACE score of 1 who had extremely frequent instances of their trauma might be just as traumatized as someone with a score of 6 who witnessed a broader breadth of events but experienced them on a much rarer basis. As the following chart shows, there is a lot of overlap. Clearly, people with higher scores do face genuinely larger risks. But the scores are not hard-and-fast determinants.
ACE scores also don’t account for whether a child had good resources, such as adults who provided them with safe and loving relationships or therapists who taught them to manage their stress better. They don’t account for gender variation, as PTSD manifests differently in men and women. In his article, Anda cautioned that using ACE scores as an individual screening tool has several risks, including that ACEs “may stigmatize or lead to discrimination…generate client anxiety about toxic-stress physiology, or misclassify individual risk.”[7]
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I was incredibly relieved to read this in 2020, but in 2018, without any of this context, I felt anxious and stigmatized as hell. I became obsessed with my imminent demise, and like anyone who has been handed a death sentence, I underwent a mini existential crisis. I felt rushed, frightened, and angry—furious. Years of future life had been stolen from me. Years I could have spent hiking Machu Picchu or taking care of grandkids or painting cubist renditions of chickens.
And it wasn’t just the ACE score that seemed to tell me my body was shattered and sick. My grief kept growing with every progressive study I read about the biological effects of trauma, all the charts and graphs and diagrams that told me I’d sustained brain damage.
Brain scans prove that patients who’ve sustained significant childhood trauma have brains that look different from those of people who haven’t.[8] Traumatized brains tend to have an enlarged amygdala—a part of the brain that is generally associated with producing feelings of fear. Which makes sense. But it goes further than that: For survivors of emotional abuse, the part of their brain that is associated with self-awareness and self-evaluation is shrunken and thin.
Women who’ve suffered childhood sexual abuse have smaller somatosensory cortices—the part of the brain that registers sensation in our bodies. Victims who were screamed at might have an altered response to sound. Trauma can result in reductions in the parts of the brain that process semantics, emotion and memory retrieval, perceiving emotions in others, and attention and speech. Not getting enough sleep at night potentially affects developing brains’ plasticity and attention and increases the risk of emotional problems later in life. And the scariest factoid, for me anyway: Child abuse is often associated with reduced thickness in the prefrontal cortex, the part of the brain associated with moderation, decision-making, complex thought, and logical reasoning.
Brains do have workarounds. There are people without amygdalae who don’t feel fear. There are people who have reduced prefrontal cortices who are very logical. And other parts of the brain can compensate, make up for the lost parts in other ways. But overall, when I looked at the breadth of evidence, the results felt crushing.
The fact that the brain’s cortical thickness is directly related to IQ was particularly threatening to me. Even if I wasn’t cool, or kind, or personable, I enjoyed the narrative that I was at least effective. Intelligent. What these papers seemed to tell me is that however smart I am, I’m not as smart as I could have been had this not happened to me. The questions arose again: Is this why my pitches didn’t go through? Is this why my boss never respected me? Is this why I was pushed to do grunt work in the back room?
Being my parents’ caretaker imbued me with an illusion of control—a belief that I could prevent disaster if only I was vigilant enough. But these health outcomes proved I was wrong. If anything, it was vigilance itself that destroyed me.
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