The mother of all blind spots: How a study revealing the prevalence of abuse in childhood shows us the damage that comes from our collective denial.

A landmark study has uncovered how adverse childhood experiences (ACE) such as physical, emotional and sexual abuse are directly related to future physical and mental health. The results suggests that the prevalence of abuse during childhood is the root of many of the intractable social problems we now face. It is only when we are willing replace our denial with honesty and  our judgment with compassion, can we start to heal this massive body of pain that’s buried beneath all of us.

By E.F Nicholson 

A number of years ago, a unique study was conducted, which followed a large sample of the US population. Over a twenty year period it measured the relationship between adverse childhood experiences (ACE) and physical and mental health outcomes later in adult life. The Centers for Disease Control and Prevention in the US provides a simple breakdown of what the study entailed and its conclusions.

The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. The study is a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego.

More than 17,000 Health Maintenance Organization (HMO) members undergoing a comprehensive physical examination chose to provide detailed information about their childhood experience of abuse, neglect, and family dysfunction. To date, more than 50 scientific articles have been published and more than 100 conference and workshop presentations have been made.

The ACE Study findings suggest that certain experiences are major risk factors for the leading causes of illness and death as well as poor quality of life in the United States. It is critical to understand how some of the worst health and social problems in our nation can arise as a consequence of adverse childhood experiences. Realizing these connections is likely to improve efforts towards prevention and recovery.

The result of the study revealed two shocking and far-reaching truths. The first was the measurable relationship between the severity of abuse experienced by children and future mental and physical health. It revealed the higher an ACE score a child has, the greater the likelihood that a plethora of mental and physical illnesses may await them. Although there had been prior studies linking certain aspects of abuse to specific outcomes, this was the first study to categorically, over a long period of time, show this intrinsic connection been ACE and health. The second truth to be revealed was the extent of abuse in what are considered “normal” stable homes, as the participants in the study were from a predominantly white, middle-class, and well-educated segment of the population. Although to many social workers and education professionals it came as no surprise, for many in the medical field there was a complete a lack of awareness of both the health impacts and the prevalence of ACE in families across America.

One reviewer of a book that explores these findings aptly sums up the cultural context from which this study arises:

This is pivotal in the historic battle to verify that early life trauma exists and is a hidden underworld that manifests itself in all phases of life. It gives an explanation for many intractable social problems that cause expenditures in the billions of dollars to treat. It will be like a hydrogen bomb in the medical world where many practitioners like to divide body and mind and are thus conquered in their attempts at effective treatments. Bravo to the brave and brilliant editors and writers for taking on this taboo subject legitimizing the suffering of untold number of children and adults.

What many had felt intuitively, namely a link between one’s emotional life and one’s physical health, has now been confirmed through this solid scientific study. What this gives us, as a society, is a real opportunity to make a difference, by being honest and confronting the reality of what really goes on in our homes. Many social and health problems originate within the trauma and abuse children experience, and there is now a mountain of evidence showing that toxic and stressful experiences throughout childhood have direct consequences on both brain development and one’s future ability to cope with stress.

With the ACE Study being replicated across many US states, it has been revealed to no longer be a far-flung theory, but a legitimate fact: childhood abuse isn’t limited to dysfunctional families on the outer fringes of society’s underclass. It is happening in respectable, so-called normal families, who aren’t suffering economic hardships or any obvious stressful circumstances thought to increase the likelihood of this type of trauma. If this is what society looks like when everything is “ok,” shouldn’t we consider whether everything really is ok? We know the majority of parents who inflict this abuse have themselves been subject to the same or more serve abuse. This doesn’t excuse their responsibility of these destructive actions, but rather increases understanding of a wider inter-generational cycle that has been left unacknowledged, and therefore untreated, allowing the cycle of destruction to repeat itself over and over.

Yet we also need to remember that, putting science and cultural context aside, this was a study about people’s pain: how it is born, how it grows and how it can spread its destructive power across the landscape of a person’s life. Given its implications that the sample could be replicated in any part of the population, it appears adverse childhood experiences are leaving a legacy of untreated pain and silent suffering in the lives of millions. So much pain is really a sad fact. I think about all the people out there either suppressing that pain or needing to melt it away with the many means our society provides. The kinds of trauma measured in the study are traumas that illicit deep shame, guilt and anxiety. The nature of childhood is such that we don’t have the cognitive capacity to differentiate between who we are and our environments. So when the situation at home is violent, scary and bad, for children it becomes internalised as “I am scary, I am bad, something is wrong with me.” For most, not equipped with the understanding or support to tackle these wounds, they tend to become buried and suppressed. Often they only come to the surface by manifesting as psychical ill health or some kind of mental breakdown.

ACE are not isolated phenomena occurring in odd families here and there; rather they appear to be a widespread problem, meaning the problem can’t be solved by scrutinising each individual family. It is more effective to see the environment that these ACE occur within as what, in fact, is widespread, as the prevalence of abuse and trauma isn’t a natural condition of being human. These aberrations of behaviour come into effect when people and environments have become unbalanced. The origin and fundamental cause of the abuse can be hard to pinpoint, and we know it just keeps getting carried over from generation to generation. What enables it to continue is the silence, shame and lack of understanding of what is really going on. It’s here that the ACE study can have its most powerful impact in its ability to show, without a shadow of doubt, exactly “what is happening” and “this is exactly what impact it has.” Then to add to the difficulty of these traumas, we live in a society that isn’t set up to understand, acknowledge or really deal with this unspoken legacy. The media that surrounds us is there to distract and fool us into thinking we can shop our way through our problems. The education system we rely on is geared toward instilling conformity and obedience to hierarchical authority. The financial system we are involuntary caught up in often enslaves us or keeps many in a permanent state of survival mode. Our judicial system is extremely harsh and punitive regarding the poorest in society, yet conveniently understanding and forgiving when dealing with those who are well off. The paradigm of healthcare we refer to is often impersonal, mechanical and lacking warmth and insight. In all of these, and many other variables within society, there is not established support to help people heal what has been wounded. Rather, structures are set up to fulfill functions of production, output and wider economic objectives. All this often means traumatised people are either ignored or are just getting re-traumatised over and over, deepening the problem even further.

So what we see is that this abuse, and all the negative outcomes that accompany it, are a human problem. It’s not due to lack of money, status or achievement. I think the issue the ACE study reveals can only be dealt with when we take in the wider ramifications and the societal context of these problems emerges. Much like a rash can be a symptom of something else going on in the body, this extent of childhood trauma is a symptom of something more fundamental in society. It’s a symptom of the sickness of living lives disconnected from each other, the breakdown of community and close family bonds. It arises from severed links to nature,feeling stressed and powerless, and work environments that leave us feeling alienated. It is enlarged by poverty, but not limited to poverty. Although some may argue that, compared to the level of abuse and trauma in the 18^th century, things are quite good (which is not wholly untrue), I don’t think as a society our sights should be aiming to be just “not as bad.”

A childhood in which children feel loved, supported and understood is something for which all societies need to take responsibility. It’s something we should aim for and work toward. We require a large paradigm shift from the mind-set that “other families’ problems are not my family’s problem.” This assumes that the problems created within a family stays within the dysfunctional walls, yet they don’t. They show up at a massive healthcare cost; they impact people’s ability to work, enjoy life, and contribute to society, and if they remain unaddressed they will then be repeated into the next generation. We need to reconnect with the maxim “I am my brother’s keeper.” What happens to others also happens to me. This isn’t about the “state” intruding into private lives, rather it’s about making families aware that they are not in it alone, that others care, and that they have support: for them to feel there are friendships and resources to help them through difficult times. Once upon a time, this was called “community.” If it takes a village to raise a child, it must take an entire town to raise a family. Some of these understandings are already impacting how certain institutions have used the findings of the ACE study in how they approach children and families. These organisations are becoming “trauma-informed,” meaning they are awakening a better understanding of the root causes of why people behave in certain ways. To do this requires another paradigm shift from a moral judgement that decrees either reward and punishment, to mindset of compassion and understanding. We must comprehend that many people’s addictions and anti-social, destructive and violent behaviour is ultimately the impact of the toxic stress they have experienced remaining hidden and unresolved. This means we must move from a simplistic model of good and bad to one of wounded or unwounded, healed or unhealed. If you think this is just namby pamby waffle that doesn’t apply to the “Real World” look at any school in the US that has become “trauma-informed” to see the impact this has on reducing a whole range of problems within the school. This example is just the tip of the iceberg regarding what actually can be done.

So we need to see that all the abuse and trauma is a problem that belongs to all of us as a society, to own it and work toward healing. For this we need to get a better understanding of our societal identity. We need to see that we are more than just single, individual units; we are part of a wider entity in which we belong and contribute all the time, even if we are not aware of it. Jung saw this in his understanding of the collective unconscious. We each have our own unconscious, but it is ultimately wed and connected to a larger collective state. This collective unconscious will shape and direct our lives, as much as our personal unconscious, yet the impact may be more harmful if we don’t acknowledge it’s there. We need to recognise that the reality of humanity is interconnected, not separate, and this isn’t something that has really sunk into people’s minds. Our lack of awareness of our collective unconscious also allows it to be hijacked, infiltrated and poisoned by larger far-reaching media. This media is constantly projecting into our unconscious stories and themes designed solely to undermine us and direct us to be thoughtless consumers. There is a reason billions of dollars are spent on advertising, as they are well aware it works.

The ACE study reveals that the kind of experiences we have in childhood follow us all through our lives. This study shows, beyond a shadow of a doubt, that being human means being deeply sensitive and inherently vulnerable. We are like delicate buds rising from the soil: if properly nurtured with love, support, security and meaningful connections we thrive and become creative, caring contributors to the greater whole. However, we see how easily those tender moments of our beginning can be damaged, harmed and traumatised in such a profound way to impact a life so that everything else after just becomes a reverberation of that pain. We also need to break free of the illusion that the sensitivity and vulnerability ends when we move from childhood to adulthood. Although it’s not there in the most obvious of ways, it is still a fundamental aspect of what it is to be human. Our need for love, connection, closeness and belonging never leaves us. If denied, it will be to our detriment, but if acknowledged, it will support us to our betterment.

So we need to start seeing all that pain and suffering that comes from dysfunctional childhood environments as something of which we all must claim ownership. It’s a wound in the collective self that can be healed and transformed into something profound and meaningful. As we start to identify with our own pain it becomes impossible not to identify with all the pain that cries out through the world. As burdensome as that may first appear, when we become willing to carry that load, we will see that pain cannot only be handled, but it can be healed. This is what we need now in society. We need global acknowledgement of what it really means to be human and what really matters most in being human. As we focus on those most simple of questions the answers will become obvious, and the solution effortless. Our happiness and well-being must always be measured against that of everyone else. When a father witnesses his child in pain, that pain becomes his own pain, and will not be healed until the pain of the child they love has gone. Here we see the marvel and beauty of love that radiates when we acknowledge our connections. As we start to accept the inescapableness of our connectedness and the concrete reality that we are in this together, we will start to live our lives with that truth at the helm of what we do and how we do it. A society built and shaped around these values and priorities is a society that has the potential not just to be better, but to be something else altogether.

Below is a 3 minute video that is  a summary of the ACE study

To answer the 10 questions to get your ACE score click here 

Also if your’re looking for a great resource to find out more about ACE for personal or professional reasons this is great site http://acestoohigh.com/