by Patrice Rancour
How does childhood trauma affect our health and well-being during adulthood? To what extent do abuse, neglect and dysfunction result in medical and psychological issues later in life? The Centers for Disease Control & Prevention (CDCP) and Kaiser Permanente’s Health Appraisal Clinic are jointly studying these associations by tracking the health of 17,000 individuals in the Adverse Childhood Experience (ACE) study, begun in 1998. The principal investigator of the study, Vincent Felitti, MD, sought to identify a link between childhood trauma and the major health issues encountered in the United States today, including heart and lung disease, depression, obesity, smoking, alcohol abuse and drug addiction. Not surprisingly, the findings of the study so far seem to confirm that link.
As part of the ACE, the 10-part ACE Questionnaire employs a participant survey to identify and measure different types of childhood trauma, including emotional and physical abuse, substance abuse or mental illness in the family. A review of the findings has revealed a clear link between the ACE score measuring childhood trauma and the probability that the traumatized individual will develop major adult diseases and psychological issues. The study also noted that participants with higher ACE scores might die up to two decades earlier than lower-scoring participants would.
Noted cardiologist Dean Ornish once observed, “What most heart patients need is not a ‘heart by-pass,’ but a ‘heart through-pass.’” In order to survive trauma from childhood, people develop a variety of defense mechanisms and coping strategies to handle their chronic distress, including Post-Traumatic Stress Disorder Complex. While many of these strategies are potentially unhealthy, they may be the only means by which these individuals are able to survive toxic situations. Psychotherapist Pete Walker, M.A., MFT, has identified four broad categories for coping with childhood trauma: narcissism, obsessive-compulsive disorder, dissociative disorders and substance abuse. He developed a management worksheet used with patients to identify emotional flashbacks resulting from childhood trauma, as well as coping mechanisms for managing the ongoing stress associated with these flashback experiences.
People make unhealthy lifestyle choices when they seek to ease the pain of a traumatic childhood. It is clear that these choices contribute to the development of adult diseases later in life. It was also found, however, that the effect of chronic stress itself exacts a toll by relentlessly circulating stress hormones and disrupting systems that regulate health and well-being in the body.
When a patient demonstrates problems related to blood pressure, obesity, low blood sugar and other symptoms, it is tempting for medical practitioners to address the most obvious issues only while leaving underlying issues unaddressed. While modifying diet and developing a fitness program are both part of a balanced effort to reverse the effects of heart and other chronic stress diseases, these are just short-term solutions to a very complex problem. If the original trauma is not addressed, such lifestyle work can go into relapse as the traumatized adult continues to make choices based on what has eased stress in the past without learning healthier, self-soothing approaches to calm both body and mind.
Incorporating the ACE questionnaire into a comprehensive assessment can help practitioners identify childhood traumas and assess the resulting impact to adult health. The compelling experience of being heard and accepted while sharing a life-long secret can exert a powerful healing effect for a patient. Since these individuals often arrive with existing post-traumatic stress disorders, trauma-informed care can help reduce stress and normalize bodily functions using mind-body approaches to healing. These techniques can actually begin to reverse harmful processes caused by prolonged exposure to high stress hormone levels in the body. Such approaches then become an authentic ‘heart through-pass,’ and initiate the very real prospect of people healing their hearts from the inside out.
Patrice Rancour, MS, RN,PMHCNS-BC, is a mental health clinical nurse specialist and Reiki therapist at the OSU Clinic for Integrative Medicine. Connect at Patrice.Rancour@osumc.edu. Also visit MedicalCenter.osu.edu/go/integrative.