How Childhood Trauma Can Make You A Sick Adult

The Adverse Childhood Study found that survivors of childhood trauma are up to 5,000 percent more likely to attempt suicide, have eating disorders, or become IV drug users. Dr. Vincent Felitti, the study's founder, details this remarkable and powerful connection.

Vincent Felitti: 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. 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 28 years old, and weighed 408 pounds, and asked us if we could help her with her problem. And in 51 weeks, we took her from 408 to 132. 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. 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, ultimately she told me of a lengthy incest history with her grandfather, from age 10 to age 21. Ultimately it turned out that 55 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, et cetera. 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?

We studied 10 categories of adverse life experience that were chosen because of their prevalence in the weight program: childhood sexual abuse; heavy-duty childhood physical abuse — I’m not talking spanking — um; major emotional abuse (recurrent humiliation); two categories of neglect; growing up in a home where one of the members of the household, 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. Totally unrecognized. 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 10 categories that we studied, that person was 4,600 percent more likely to become an IV drug user than a person who had experienced none of those 10 categories. Okay? Now, you know, you think, you read the newspaper, the latest cancer scare of the week, prostate cancer or breast cancer increases 30 percent, and everyone goes nuts. I’m talking 4,600 percent increase. The same ACE score of six produces a likelihood of attempting suicide that is between 3,100 percent and 5,000 percent greater than the likelihood of suicide attempts in someone with none of those life experiences. So the power of this relationship is enormous.

So ultimately the question arises: How do life experiences in childhood end up 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; one overeats to feel better; one drinks to relax, et cetera. 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 10 categories that we studied, any six of them produces a shortening in life expectancy of almost 20 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.

The Adverse Childhood Study found that survivors of childhood trauma are up to 5,000 percent more likely to attempt suicide, have eating disorders, or become IV drug users. Dr. Vincent Felitti, the study's founder, details this remarkable and powerful connection.

Are we really addicted to technology?

Fear that new technologies are addictive isn't a modern phenomenon.

Credit: Rodion Kutsaev via Unsplash
Technology & Innovation

This article was originally published on our sister site, Freethink, which has partnered with the Build for Tomorrow podcast to go inside new episodes each month. Subscribe here to learn more about the crazy, curious things from history that shaped us, and how we can shape the future.

In many ways, technology has made our lives better. Through smartphones, apps, and social media platforms we can now work more efficiently and connect in ways that would have been unimaginable just decades ago.

But as we've grown to rely on technology for a lot of our professional and personal needs, most of us are asking tough questions about the role technology plays in our own lives. Are we becoming too dependent on technology to the point that it's actually harming us?

In the latest episode of Build for Tomorrow, host and Entrepreneur Editor-in-Chief Jason Feifer takes on the thorny question: is technology addictive?

Popularizing medical language

What makes something addictive rather than just engaging? It's a meaningful distinction because if technology is addictive, the next question could be: are the creators of popular digital technologies, like smartphones and social media apps, intentionally creating things that are addictive? If so, should they be held responsible?

To answer those questions, we've first got to agree on a definition of "addiction." As it turns out, that's not quite as easy as it sounds.

If we don't have a good definition of what we're talking about, then we can't properly help people.

LIAM SATCHELL UNIVERSITY OF WINCHESTER

"Over the past few decades, a lot of effort has gone into destigmatizing conversations about mental health, which of course is a very good thing," Feifer explains. It also means that medical language has entered into our vernacular —we're now more comfortable using clinical words outside of a specific diagnosis.

"We've all got that one friend who says, 'Oh, I'm a little bit OCD' or that friend who says, 'Oh, this is my big PTSD moment,'" Liam Satchell, a lecturer in psychology at the University of Winchester and guest on the podcast, says. He's concerned about how the word "addiction" gets tossed around by people with no background in mental health. An increased concern surrounding "tech addiction" isn't actually being driven by concern among psychiatric professionals, he says.

"These sorts of concerns about things like internet use or social media use haven't come from the psychiatric community as much," Satchell says. "They've come from people who are interested in technology first."

The casual use of medical language can lead to confusion about what is actually a mental health concern. We need a reliable standard for recognizing, discussing, and ultimately treating psychological conditions.

"If we don't have a good definition of what we're talking about, then we can't properly help people," Satchell says. That's why, according to Satchell, the psychiatric definition of addiction being based around experiencing distress or significant family, social, or occupational disruption needs to be included in any definition of addiction we may use.

Too much reading causes... heat rashes?

But as Feifer points out in his podcast, both popularizing medical language and the fear that new technologies are addictive aren't totally modern phenomena.

Take, for instance, the concept of "reading mania."

In the 18th Century, an author named J. G. Heinzmann claimed that people who read too many novels could experience something called "reading mania." This condition, Heinzmann explained, could cause many symptoms, including: "weakening of the eyes, heat rashes, gout, arthritis, hemorrhoids, asthma, apoplexy, pulmonary disease, indigestion, blocking of the bowels, nervous disorder, migraines, epilepsy, hypochondria, and melancholy."

"That is all very specific! But really, even the term 'reading mania' is medical," Feifer says.

"Manic episodes are not a joke, folks. But this didn't stop people a century later from applying the same term to wristwatches."

Indeed, an 1889 piece in the Newcastle Weekly Courant declared: "The watch mania, as it is called, is certainly excessive; indeed it becomes rabid."

Similar concerns have echoed throughout history about the radio, telephone, TV, and video games.

"It may sound comical in our modern context, but back then, when those new technologies were the latest distraction, they were probably really engaging. People spent too much time doing them," Feifer says. "And what can we say about that now, having seen it play out over and over and over again? We can say it's common. It's a common behavior. Doesn't mean it's the healthiest one. It's just not a medical problem."

Few today would argue that novels are in-and-of-themselves addictive — regardless of how voraciously you may have consumed your last favorite novel. So, what happened? Were these things ever addictive — and if not, what was happening in these moments of concern?

People are complicated, our relationship with new technology is complicated, and addiction is complicated — and our efforts to simplify very complex things, and make generalizations across broad portions of the population, can lead to real harm.

JASON FEIFER HOST OF BUILD FOR TOMORROW

There's a risk of pathologizing normal behavior, says Joel Billieux, professor of clinical psychology and psychological assessment at the University of Lausanne in Switzerland, and guest on the podcast. He's on a mission to understand how we can suss out what is truly addictive behavior versus what is normal behavior that we're calling addictive.

For Billieux and other professionals, this isn't just a rhetorical game. He uses the example of gaming addiction, which has come under increased scrutiny over the past half-decade. The language used around the subject of gaming addiction will determine how behaviors of potential patients are analyzed — and ultimately what treatment is recommended.

"For a lot of people you can realize that the gaming is actually a coping (mechanism for) social anxiety or trauma or depression," says Billieux.

"Those cases, of course, you will not necessarily target gaming per se. You will target what caused depression. And then as a result, If you succeed, gaming will diminish."

In some instances, a person might legitimately be addicted to gaming or technology, and require the corresponding treatment — but that treatment might be the wrong answer for another person.

"None of this is to discount that for some people, technology is a factor in a mental health problem," says Feifer.

"I am also not discounting that individual people can use technology such as smartphones or social media to a degree where it has a genuine negative impact on their lives. But the point here to understand is that people are complicated, our relationship with new technology is complicated, and addiction is complicated — and our efforts to simplify very complex things, and make generalizations across broad portions of the population, can lead to real harm."

Behavioral addiction is a notoriously complex thing for professionals to diagnose — even more so since the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the book professionals use to classify mental disorders, introduced a new idea about addiction in 2013.

"The DSM-5 grouped substance addiction with gambling addiction — this is the first time that substance addiction was directly categorized with any kind of behavioral addiction," Feifer says.

"And then, the DSM-5 went a tiny bit further — and proposed that other potentially addictive behaviors require further study."

This might not sound like that big of a deal to laypeople, but its effect was massive in medicine.

"Researchers started launching studies — not to see if a behavior like social media use can be addictive, but rather, to start with the assumption that social media use is addictive, and then to see how many people have the addiction," says Feifer.

Learned helplessness

The assumption that a lot of us are addicted to technology may itself be harming us by undermining our autonomy and belief that we have agency to create change in our own lives. That's what Nir Eyal, author of the books Hooked and Indistractable, calls 'learned helplessness.'

"The price of living in a world with so many good things in it is that sometimes we have to learn these new skills, these new behaviors to moderate our use," Eyal says. "One surefire way to not do anything is to believe you are powerless. That's what learned helplessness is all about."

So if it's not an addiction that most of us are experiencing when we check our phones 90 times a day or are wondering about what our followers are saying on Twitter — then what is it?

"A choice, a willful choice, and perhaps some people would not agree or would criticize your choices. But I think we cannot consider that as something that is pathological in the clinical sense," says Billieux.

Of course, for some people technology can be addictive.

"If something is genuinely interfering with your social or occupational life, and you have no ability to control it, then please seek help," says Feifer.

But for the vast majority of people, thinking about our use of technology as a choice — albeit not always a healthy one — can be the first step to overcoming unwanted habits.

For more, be sure to check out the Build for Tomorrow episode here.

Why the U.S. and Belgium are culture buddies

The Inglehart-Welzel World Cultural map replaces geographic accuracy with closeness in terms of values.

Credit: World Values Survey, public domain.
Strange Maps
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Evolution proves to be just about as ingenious as Nikola Tesla

Credit: Gerald Schömbs / Unsplash
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Michael C. Crair et al, Science, 2021.
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