What Every Practitioner Needs To Know About the Link between Childhood Trauma and Chronic Disease

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Why the Most Significant Factor
Predicting Chronic Disease
May Be Childhood Trauma

The Back Story

When a monumental study connects two previously unrelated factors and puts them together with astounding results, the implications are too compelling to ignore.

Almost by accident, this is exactly what happened in a study that began in the early 1990s.

Taking two fundamental factors of mind-body medicine, childhood trauma and chronic disease, two physicians, Vincent Felitti, MD along with Robert Anda, MD designed a study based on a clinical hunch.

Noticing that so many of their patients presented with symptoms of chronic disease, they also observed that these same patients were very often survivors of multiple and repeated childhood traumas.

Could there be a link between childhood trauma and chronic disease?

And beyond that, if there were a link, what would it mean to the prediction and healing of chronic disease?

With those questions in mind, the Adverse Childhood Experience (ACE) Study was born.

Acting on their observation of a dominant theme that emerged in the intake stories of thousands of patients, they now give us a benchmark study uncovering the impact of childhood trauma on chronic conditions.

So, how exactly was this remarkable study envisioned, what did they find, and why are the results so compelling?

In short, let's look at the Adverse Childhood Experiences (ACE) Study to see why it has become the major research bridging the gap between trauma and the chronic conditions that plague so many of our patients later in life.

Adverse Childhood Experiences: How the Study Was Conducted

This study is perhaps the largest ongoing scientific research collaboration of its kind (between Kaiser Permanente and the Centers for Disease Control and Prevention).

Analyzing the relationship between multiple categories of childhood trauma and health outcomes later in life, researchers defined nine Adverse Childhood Experiences that can occur in the household prior to age 18:

  • Recurrent physical abuse
  • Recurrent emotional abuse
  • Contact sexual abuse
  • An alcohol and/or drug abuser in the household
  • An incarcerated household member
  • Someone who is chronically depressed, mentally ill, institutionalized, or suicidal
  • Mother is treated violently
  • One or no parents
  • Emotional or physical neglect

The ACE Study used a simple scoring method to determine the extent of each participant's exposure to childhood trauma. Exposure to one category (not incident), qualifies as one point. Points are then added up to derive an ACE Score.

An ACE Score of 0 (zero) would mean that the person reported no exposure to any of the listed categories of trauma. An ACE Score of 9 would mean that all these categories of trauma were reported.

With those definitions and parameters in place, let's get to the questions and the findings.

  • The Prevalence of Adverse Childhood Experiences
  • From Life Experiences in Childhood to Structural Diseases in Adulthood
  • Coping Mechanisms and Chronic Stress: Their Relationship to Adverse Childhood Experiences
  • Surprising Discoveries
  • Applying What Was Learned: Where Do We Go From Here?

Excerpted Interview: Vincent Felitti, MD with Ruth Buczynski, PhD

The Prevalence of Adverse Childhood Experiences

Dr. Felitti: We used an ACE score of zero as the reference point. In other words, zero meant no exposure to any of the other ten categories. So, for instance, with an ACE score of six or higher, there is a forty-six-fold - a four thousand six hundred percent increase - in the likelihood of that individual becoming an intravenous drug user later in life as compared to an ACE score zero individual.

With an ACE score of six, there is between a thirty-one and a fifty-fold - a three thousand one hundred to five thousand percent - increase in the likelihood of that individual attempting suicide later in life, as compared to an ACE score zero individual.

"With an ACE score of six, there is...a three thousand one hundred to five thousand percent increase in the likelihood of...suicide later in life."

Dr. Buczynski: And how about other slightly less dramatic kinds of diseases, such as irritable bowel, hypertension, or myocardial infarction?

Dr. Felitti: Indeed, with myocardial infarction and with the presence of coronary artery disease there was an increase. It was in the hundreds of percent. Similarly, with liver disease, with an ACE score of four and higher I believe there was approximately a two-hundred-and-fifty percent increase in the likelihood of liver disease later in life.

"We saw distinctly proportionate increases in the likelihood of cigarette smoking later in life as well as alcoholism..."

Similarly, we saw distinctly proportionate increases in the likelihood of cigarette smoking later in life, as well as in the likelihood of self-acknowledged alcoholism. An individual with an ACE score of four or higher had a five-hundred-and-fifty percent increase in the likelihood of being a self-acknowledged alcoholic later in life, as compared to ACE score zero self-acknowledge alcoholic.

Dr. Buczynski: After that, what was the most highly significant?

"Ultimately, the real question is, "How does this come about?"

Dr. Felitti: Well I can't rate them numerically, but after that there were innumerable categories, in the hundreds of percents' increase, with the reference points of ACE score zero being the comparison. Ultimately, the real question of course is, "How does this come about?"

Dr. Buczynski: First of all, we need to say that correlation does not prove causation. And you are not implying that it did. What would you hypothesize might be the connection?

"...in all of these instances there was a step-wise proportionate increase..."

Dr. Felitti: Well, before we get to that, since you brought up the "correlation does not equal causation," let me point out that in all of these instances there was a step-wise proportionate increase so that when you move from ACE score zero to ACE score one, to ACE score two, to ACE score three, etc., there was a step-wise increase in the likelihood of that particular outcome. That is of enormous importance.

Dr. Buczynski: So you have interval data.

Dr. Felitti: We have a very clear dose response effect. Perhaps most important was simply talking with patients and having them explain the causality. We have many lengthy videotaped interviews with patients where it is perfectly clear to them what the explanation is between all of this. If people would like an easy way of accessing this, they can go to the website, www.ACEStudy.org.

"...the patients themselves are willing and capable of explaining the relationships quite clearly...ordinarily they are never given the opportunity."

Two key pieces were: a) the fact that there is a dose response effect with all of this - not merely some general correlation, and b) the fact that, in many instances, the patients themselves are willing and capable of explaining the relationships quite clearly. It is just that ordinarily they are never given the opportunity.

From Life Experiences in Childhood to Structural Diseases Later in Life

Dr. Buczynski: So how does one get from life experience in childhood to structural disease later in life?

Dr. Felitti: The easy pathway for understanding is through various coping mechanisms - overeating being one.

"The issue with obesity, based on our experience in successfully and unsuccessfully treating about thirty thousand obese patients, includes two core problems."

The issue with obesity, based on our experience in successfully and unsuccessfully treating about thirty thousand obese patients, includes two core problems. One is the use of food for psychoactive benefits. This is even built into the English language: "Sit down; have something to eat. You'll feel better." Secondly are the psychoactive "benefits" - the benefits of obesity per se.

But isn't it bad for you? Of course it's bad for you. The point I'm raising is whether it is not good for you.

If you talk to patients about this, it is quite remarkable what you learn. Every week in our obesity program here, for instance, we have about thirty or so people who show up at a meeting to learn more about the program. Rather than describing the program to them, I tell people that we are going to give them a free sample to show them what would be typical of the program. I explain that the program consists of the same dozen or so people meeting every week for two hours for five months with the same counselor, working on addressing questions that we have found to be important.

"Tell me why, not how you think people get fat."

The first question is this: "Tell me why you think people get fat." We're not asking "how" - "how" is obvious.

Last week the first answer was from a man with depression. I don't remember the second answer but I do remember the third answer - and that was from a woman, and she said, "People leave you alone." We then write all of these answers down.

It has been a couple of months since anyone has proposed, "My metabolism is ruined" or "Must be genetic" or "It runs in the family." To this I will usually respond, "Really? How interesting. Tell me, does everyone in your family speak English? I see - so speaking English runs in the family as well." The titters of laughter from the rest of the group pretty much kill that one right there.

"...probably the single most important question in understanding obesity: 'How old were you when you first began putting on weight?'"

One of the things that we have found, which is also useful for subjects other than obesity, is probably the single most important question in understanding obesity: "How old were you when you first began putting on weight?" Not finished the job; but first began. Whatever the cause, obviously it had to be then or before. Amongst people who have begun gaining in childhood, the number of times that those ages approximates parental loss through divorce is quite striking.

I have seen nothing in the literature about this, probably because so many of us have been divorced and it is not a comfortable subject to think about.

The second question that we pose to people in the weight program is: "We all know that there are many people who lose a lot of weight, only to regain it all, if not more. For example, they will lose 100 and then regain 120. Why does that happen?"

People always answer, "Because if you don't deal with the underlying issues it will be back." This is a rather remarkable insight. About sixty percent of the time somebody will propose, "Because major weight loss is threatening."

"Tell me the advantages of being fat."

The third question is: "Tell me the advantages of being fat." Not the disadvantages - that's obvious. You can get a government pamphlet to tell you that. The advantages, however, always break down into three categories.

First, it is sexually protective. Anyone who has been molested or raped will quickly understand that. Those are common experiences, however it is uncommon for anyone ever to bring it up or inquire. We did routinely and we learned, in this very middle-class population of seventeen-and-a-half thousand adults in Kaiser Permanente, that twenty-eight percent of women acknowledged a history of childhood sexual abuse, as did sixteen percent of the men.

That was a big surprise, but understandable. No one would have a basis for knowing because no patient brings it up spontaneously and the rest of us have all been taught that it would be impolite to inquire.

"What are the advantages of being fat?" The first category is always: "It is sexually protective." The second category is "physically protective," as suggested in the expression, "throwing your weight around."

In the early days of the Program we had two men who were guards at the state prison downtown. They lost between 100 and 150 pounds each. They did not feel comfortable going into the prison without the extra weight. They felt a lot safer looking as big as a refrigerator.

The third category is "People expect less of you." This is a commonplace observation.

"...things which are referred to as "public health problems" are...protected by shame, secrecy, and the social taboos of inquiring into certain areas of human experience."

All of these were of enormous importance in realizing that things which are referred to as "public health problems" are oftentimes also unconsciously attempted solutions to personal problems that are lost in time and then further protected by shame, secrecy, and the social taboos against routinely inquiring into certain areas of human experience.

Dr. Buczynski: So, what you're implying is that these may well be efforts at coping or compensating.

Dr. Felitti:Without question. No one smokes to get lung cancer or heart disease. People smoke because of the major psychoactive benefits of nicotine. People ask, "Isn't it risky?" Absolutely! In fifteen or twenty years it is seriously detrimental.

In fifteen or twenty seconds of inhalation, it has very clear benefits. Those are the major activities of nicotine, in terms of anti-anxiety activity, in terms of antidepressant activity, in terms of appetite suppressant activity, and in terms of anger suppressant activity. This has been spelled out in medical literature for decades.

Coping Mechanisms and Chronic Stress: Their Relationship to Adverse Childhood Experiences

Dr. Felitti: This is a separate yet important issue. I would like to stick with the first one, the coping mechanisms. The common ones are eating, smoking, drinking, and drugging. Alcohol is simple: "Sit down, have a drink - relax." You don't need to think a great deal about that. Street drugs are somewhat more complex. The resistance to understanding it is interesting because anybody my age or older should remember this. Almost everyone knows the demonized street drug crystal meth is a big problem

It is interesting that no one seems to remember that the first prescription antidepressant medication introduced for sale in the United States in 1940 was methamphetamine. It was introduced by Burroughs Wellcome, and the brand name was Methedrine. If anyone has any doubt about this, they can go to any major university library and pull out a bound volume of the Journal of the American Medical Association from 1940 or '41. There they will see full-page ads for Methedrine.

"...does it mean anything that the first prescription antidepressant medication is exactly the same chemical as crystal meth?"

The question therefore becomes; does it mean anything that the first prescription antidepressant medication is exactly the same chemical as crystal meth? Is that just an irrelevant happenstance, or are people unwittingly buying antidepressants on the street? If so, isn't it dangerous? It is equally as dangerous as having Digitalis sold on the street in an unknown dose and impure form. If you don't know what you are doing dosage-wise, Aspirin is quite reliably fatal. Just take fifty.

That is one broad category of some of the most common coping devices leading to a huge array of structural disease: coronary artery disease, diabetes and its sequelae etc., lung disease, and chronic obstructive pulmonary disease. That is fairly easy but somewhat unpleasant to understand.

"...some of the most common coping devices lead to...coronary artery disease, diabetes, lung disease, and chronic obstructive pulmonary disease."

The more subtle second category is the one previously mentioned. I will back up a little bit earlier, to the idea of the effects of chronic major unrelieved stress over prolonged periods of time, and what that does in terms of flooding a person's body with high levels of circulating cortisone and related stress chemicals.

Everyone has heard that if you take cortisone, to treat rheumatoid arthritis for example, that there are major side effects. There are certainly major benefits, but also major side effects.

"It doesn't matter whether you get the cortisone from a prescription bottle or from your own adrenal glands - there is a price to be paid for having unusually high, chronic levels of high circulating cortisol levels."

It doesn't matter whether you get the cortisone from a prescription bottle or from your own adrenal glands - there is a price to be paid for having unusually high, chronic levels of high circulating cortisol levels.

Often in this situation people's immune systems are suppressed. Sometimes it goes into total disarray. Bruce McEwen of the Rockefeller Institute in New York has written extensively on this subject.

There are so-called "pro-inflammatory cytokines," internally-produced chemicals that are released within one's body. These set up inflammatory reactions in the lining of very small blood vessels, causing them to close down and causing the scarification of whatever piece of organ they had been supplying.

The second big pathway deals with dysregulation. The chronic major stress pathway is responsible for a number of diseases we are beginning to get an understanding of now. Many people believe that if you are the recipient of an organ transplant, for example, you have to be on lifetime immunosuppression. Some people also know that if you are on lifetime immunosuppression, one of the side effects is an increased rate of malignancy in those individuals.

We are all producing low levels of malignant cells at all times. They are readily processed out by our immune systems and we never know the difference. Therefore, getting cancer means one of two things: either you are producing malignant cells at an accelerated rate as might occur from being a heavy smoker or from exposure to dangerous amounts of radiation, etc.; or your body's ability to recognize and process out those cells is impaired. One form of impairment comes from the damage to your immune system while taking immunosuppressant drugs after organ transplantation. Another form comes from chronic major stress over prolonged periods of time.

"We are all producing low levels of malignant cells at all times."

This would appear to be the second major pathway and it has obvious relevance to our finding of increased rates of cancer in high ACE score patients as well as the fact that we found increased rates of autoimmune diseases in high ACE score patients...

Dr. Buczynski: Which ones?

Dr. Felitti: We have a paper out where we studied twenty-one different autoimmune diseases. Without referring to the paper, I can't quote you reliably off-hand. Rheumatoid arthritis was one. Another interesting illness is the disease primary pulmonary fibrosis. Ten years ago that would have been a rock-solid example of a hardcore structural biomedical disease.

"...we find increased rates of cancer in high ACE score patients..."

Now it is clear that at least some portion of those cases is due to the release of these so-called pro-inflammatory cytokines causing microscopic blood vessels to become inflamed, to scarify and then cause the destruction of whatever piece of lung tissue that they are supplying by converting it into scar tissue. This is known as primary pulmonary fibrosis.

The breadth of this was quite remarkable, as well as unexpected. We kept stumbling into things, some of which were fairly easy to understand and others of which were much more complex.

Surprising Discoveries

We had an interesting experience which led to some interesting insights into this. After several years of the ACE Study it became obvious what we were learning. Then it became clear that we needed to expand our information base so that we were routinely gathering information on everyone.

Our medical questionnaire was already quite comprehensive. It's important that this information, for practical purposes, needs to initially be gathered by questionnaire and this kind of questionnaire should always be filled out at home, not in the doctor's waiting room.

"We needed to ask a lot of trauma-oriented questions, 'Have you ever lived in a war zone? Have you ever been a combat soldier? Who in your family has committed suicide?'"

It became evident that we needed to ask a lot of trauma-oriented questions. So, we routinely asked questions like, "Have you ever lived in a war zone? Have you ever been a combat soldier? Who in your family has committed suicide? Who in your family has been murdered? Have you ever been held prisoner, tortured, raped, molested as a child?" etc. So those were some examples. And we added a good dose of those to the questionnaire.

Needless to say, the staff was not exactly thrilled because they correctly realized that this raised the performance bar. Impressively, however, they all became quite capable of dealing with this.

After doing this for a couple of years, a friend of mine introduced me to some people that owned a big data mining company here in San Diego. They used a technique called neural net analysis. Neural net analysis is a rather sophisticated, heavy-duty computer approach to data mining.

Ordinarily, when data mining, you have to have some sense of what question you want answered. In neural net analysis, you absolutely do not. This approach sorts, and repeatedly re-sorts through mountains of data, looking for anything that has a relationship to anything else. Most of the relationships that turn up are simply statistical phenomena and of no interest or relevance whatsoever. The beauty of the technique is that occasionally you discover intense relationships that you never would have thought to look for.

"...they found that, coincident with the use of the new questionnaire, there was a thirty-five percent reduction in doctor office visits..."

They analyzed the results of over one hundred thousand patient visits using the new questionnaire which included the new trauma-oriented questions. This was about two-and-a-half years' work for the department. To my absolute amazement and embarrassment actually, they found that, coincident with the use of the new questionnaire, there was a thirty-five percent reduction in doctor office visits in the year subsequent, compared to the antecedent year, for a population of over one hundred thousand adult patients.

Dr. Buczynski: What did they make of that?

Dr. Felitti:There was also an eleven percent reduction in emergency room visits. People have said to me, "You sent everyone for therapy, right?" "And that was rare, essentially never." So how did this work? That is a very meaningful question because a thirty-five percent reduction in doctor office visits has extraordinary cost and theoretical implications, even if it lasts for only a year.

"I slowly came to see that...asking, listening and accepting was doing."

As near as we can figure out, we believe we illustrated the profound importance of helping people talk about the worst secrets in their lives and enabling them to go home feeling still accepted afterwards. I slowly came to see that what we had done showed that asking and listening and accepting was doing. That was rather a profound realization.

Dr. Buczynski: How long did it last?

Dr. Felitti: Two years later everything reverted back to the prior base line. One might ask, "Well why was that?" Our best understanding is our use of unified medical records here, which we have used for years. Everything is in one folder; in the early days paper and now electronically. In the folders there are our notes printed literally with laser-like clarity. They might just as well have been printed with invisible ink because no one wanted to go near that information with a pole.

Dr. Buczynski: Did you find any correlation between ACE score and visits to primary physicians or to emergency rooms?

Dr. Felitti: Yes. There is a very distinct relationship, but that is simply made clear from my own experience of talking with large numbers of high ACE score people. I don't believe, however, that we studied that in the ACE Study.

Dr. Buczynski: What are you finding about mortality?

"With an ACE score of six and higher, there is almost a twenty-year shortening of lifespan."

Dr. Felitti: With an ACE score of six and higher, there is almost a twenty-year shortening of lifespan. That was published in October or November last year. Anyone that goes to the www.ACEStudy.org website can find their way quickly to detailed iterations of all the publications and abstractions.

Applying What Was Learned: Where Do We Go From Here?

Dr. Buczynski: What would you like to see people do with it?

Dr. Felitti: It will be important to take what we learned here and use it to bring about a change in primary care medical practice: to move it from its current symptom reactive mode to the more comprehensive style that it was originally conceived for.

There is a lot of understandable opposition to that. People complain that there is no time, which is true. On the other hand, there are mechanisms for circumventing that.

"It will be important to take what we learned here and use it to bring about a change in primary care medical practice..."

The information can be obtained, as we did, by a lengthy questionnaire filled out at home. Then it is read quickly, as we did, or you feed it into a digital scanner that sucks up all the "yes" answers and reformats them into a review of systems output. This would give you a highly legible and highly structured two or three page printout that would take two or three minutes to look at and read.

While we were teaching the staff, as examiners, we would give them a real printout and give them two questions. First, how well do you understand this intellectually? Here are two or three pages of highly detailed information; how do you put all this together? Secondly, what is the first thing you are going to say after you say "Hello?" How do you walk into a room, introduce yourself to a stranger and then move from brief social nicety to talking about the things that nice people don't talk about?

"How do you walk into a room, introduce yourself to a stranger and then move from brief social nicety to talking about the things that nice people don't talk about?"

That was an interesting experience. Ultimately everybody became proficient at doing that, but it did require some thinking.

This would be one approach to make comprehensive information (biomedical, psychological, social, family, and in particular trauma-oriented) routinely available in a very organized structure, covering all patients at the very outset of ongoing care. That would be one huge goal.

The other approach would improve parenting skills across the nation, because that is really where this all begins. One cannot simply address the issue: "How are we going to fix this after the fact?" The problems are too numerous. They are too complex.

Sending people for therapy is a nice illusion. It is certainly an act of great kindness and it will be available for a very small number of people. You can turn yourself into the next Mother Teresa and make yourself extremely busy doing that, but you will never notice that you are leaving the great bulk of the problems unrecognized and unaddressed.

"If ever there were a need for true primary prevention, improving parenting skills is the area..."

If ever there were a need for true primary prevention, this is the area. A primary prevention example would be the polio vaccine. It is a good thing that during the March of Dimes days some money was put aside for vaccine development or we would still be collecting money to build the "bigger and better" Sister Kenny Institutes and to buy digitally-controlled iron lungs for patients.

Primary prevention needs to involve improving parenting skills. I am not speaking about the people with monstrous problems that are going to murder or otherwise destroy their children, for that is too complex to take on currently.

Instead I am speaking about the huge number of people who never had any experience with supportive parenting themselves. How many of them, if they simply saw or understood what it looked like, might be capable and willing to do some of that themselves?

"The vehicle for carrying out this improvement would be soap operas..."

The vehicle for carrying out this improvement would be broadcast television. The technique would be theatre, specifically soap opera. We should weave these ideas into the storyline of soap operas with illustrations of what destructive parenting looks like and how it plays out over time, and contrasting that with illustrations of supportive parenting and how that plays out over time.

The audiences are huge. The bill is paid for; one doesn't need to seek funding from a legislator or from a granting foundation. The material is sufficiently lurid that in the hands of capable writers it is not going to bore anyone.

The use of broadcast television has a demonstrable background. For instance, in Africa, where condom use has been pushed for years to try to reduce the transmission of AIDS, conventional public health approaches got absolutely nowhere. The approach that worked was weaving those ideas into the storyline of soap operas. There have been a couple of books written about that, actually.

Dr. Buczynski: That is a fascinatingly interesting idea...thank you for giving your time for sharing the information with us. I think this is really important for people to know and discuss these ideas. Through discussion we can come up with even more thoughts. One of the things we did not discuss is the neurological theory or hypotheses that trauma might lead to some impairment neurologically, which would then lead to different factors that would affect chronic disease.



-- Add Your Comment Below --

Julie Begg
Melbourne, Australia

July 21, 2011, 4:48 am
I am a Kinesiologist / Clinical hypnothereapist... Fabulous questions! ACE Score is fascinating and I will include this in my Client History. I would perhaps include accidents and operations in early childhood also. Thankyou this report has got me thinking!
Margaret Main
Glenburn, Victoria, Australia

July 21, 2011, 6:15 am
The subject matter of your interview is relevant to Psychosomatic Therapy. In a two hour session of Psychosomatic Therapy, we discover where the problems exist in the body, and then use the emotional trigger points to enable the patient to release the emotional pain. The body never lies. The problem may show from a previous generation, but still has to be released. Sometimes the patient is forthcoming regarding the history, but usually they wait for you to discover the existing imbalance, before they will clarify the body information. A mind/body approach sees some remarkable releases/changes. I love working in this field.
Paula Swanson
Petaluma, California

July 21, 2011, 7:35 am
Sadly, This gives me insight into people I have known. Thank you.
Shivam Rachana
Melbourne, Victoria

July 21, 2011, 7:38 am
First the trauma then the tumor. I have found that generational trauma lives in the cells and can be accessed. eg: a woman with ovarian cancer connects with the generational memory and trauma of her great grand mother giving birth to a dead baby. Fractals reveal events with the same energetic signature and as the energy is released emotionally and the accompanying belief identified there is a change in the physical condition. I think that the denial of our basic mammalian needs early in life in the pre and perinatal time with birth trauma and the denial of breastfeeding and the in-arms time of being held and nurtured which we have endured for generations explains many of the dis-eases and relationship difficulties that prevail today. The organism is freaked out and we live inside it. Bert Hellinger's work with 'Family Constellations' is excellent in dealing with generational trauma. Thank you for your work.
Harold Lane
Dornoch, Sutherland

July 21, 2011, 7:59 am
As a writer concerned with social issues relating especially to the future I found the article of high interest rating. I would have wished for more information about pschological factors. I also have a friend I wish to advise. I have sent this information form to Germany therefore.
Carmen Oberoi
Social Work
Sarasota, FL

July 21, 2011, 7:59 am
Amazing new information
Phil Baum
Valley Center, California

July 21, 2011, 8:18 am
There's no arguing with the results of these studies and the ACE inventory however the behaviors and conditions they cite are also attributed, to a considerable extent, to income inequality which is tied to a lack of educational opportunity which is linked, in part, to entrenched racism and class membership which is a product of our capitalist culture which itself is driven by insatiable greed, a nationally sanctioned form of addiction. When it comes to health and longevity, class membership counts.. Babies born into impoverished, high stress households are predisposed to developing self-soothing strategies which lay the neural groundwork for later substance abuse especially if their parents, themselves victims of protracted low level trauma, have modeled that behavior. For example, children living in low-income neighborhoods where there is high unemployment (30 to 50%) and serious environmental degradation related to industrial pollution are more likely than their suburban middle class counterparts to develop asthma. And the working classes, especially if they are people of color, are more likely, at some point in their lives, to be incarcerated as are their parents. It's not surprising to learn that their health is adversely affected by their situation. Prisons aren't health spas. For instance, some 30% of elementary school age children living in the Bronx, N.Y. have asthma. These same kids are more likely to breathe contaminated air and to consume, at an early age, factory foods and addictive fast foods which are deliberately laced with fats, salt and sugar, a sure-fire recipe for obesity and lifelong unhealthful food preferences. As we know, protracted stress, what some call a form of torture (now in vogue and institutionalized), often leads to substance abuse of one sort or another which in turn drives the development of degenerative disease which in turn impacts morbidity, longevity and mental health. As we speak, our national safety net is being dismantled by corporate affiliated, some say legally "bribed", heavily lobbied political entities who favor the needs and interests of the well-to-do (the few) over the pressing needs of the poor (the many). There are sixty million Americans living in poverty. Thanks to the economic meltdown brought about by our elite monied classes, along with the transfer of tens of millions of jobs abroad, many people have lost jobs and homes and hope. For the most part, our much lauded "way of life" has a hand in manufacturing the illnesses which Big Pharma, Big Medicine, Big Prison and our professional therapy community, each in their own way, "treat"; a condition I liken to mowing the lawn while leaving the root causes in place. .
Kimberly Brenner
El Paso, Texas

July 21, 2011, 8:31 am
Another very good preventative reason to strenthen family.
Catherine Mendoza LPC Mendoza
Woodstock, VA

July 21, 2011, 8:32 am
Could you give us a print button? This is something I would like to share with patients. Thanks. Catherine
Aviva Bock
Newton, MA

July 21, 2011, 8:39 am
BIG IRON LUNGS What an interesting analogy which of course makes us all shudder and yet that is exactly what we are doing with all the plush new cancer centers that are being built. Big iron lungs. This report is so timely. Those of us who are trained in trauma have long recognized the connection between childhood events and chronic pain distress in adulthood whether it manifests in physical symptoms or in mental ones. Sadly because of the prevailing medical models doctors are not trained to make the link between mind and body, never mind take a social history that would trace the path between adverse childhood events and disease later in life. We look for fix it answers and solutions and the complexity of the data that you present is much more challenging. I think your idea of using the media is an excellent one I would also like to point out that some of us who have trained in EMDR and in the other energy therapies are fully aware of these linkages. When our clientele is open to understanding how even apparently small events from childhood can become blockages to a healthy immune system, we use these tools and others to help clear a way for them to set out on a path to health and healing.
Dr. Jody Iodice
Atlanta, Georgia

July 21, 2011, 8:46 am
The field of psychoneuroimmunologgy has bred researching the phenomenon of thought, emotion, and belief effects the immune and neuroendocrine system for well over 40 years. Clearly psychological trauma causes a floodtide of emotions and neuroendocrine stress on the body. Many of us who have worked in the clinical field for a number of years certainly can attest to the propensity of autoimmune disease presentd by those patients we see in our practices who ptesent w/ histories of physical, sexual, and/or verbsl abuse. Yet, it is always validating to continue to read current research that continues to confirm this. In my own research I looked at certain activities that raised white blood cell production. What I called "Immunoenhancing activities", e.g., easternhealth care practices, music, humor, etc. Likewise, the work of Dr. Paul Pearsaul has substantiated "emotions" effect cardioimmunological" factors. There are many other researches in the clinical fields of psychology, mirobiology, and medicine who have substantiated the mind-body consequences of psychological trauma-violent victimization on the individual whether this occurred during childhood or as an adult. Many of our veterans are returning w/ autoimmune conditions a year or two after their deployment period. Thanks for update. The research should simply continue to confirm what those of us in Psychoneuroimmunology for well over the past 40 years. Dr. Jody Iodice Cancer Wellness @ Piedmont-ATL Cancer Center Piedmont Hospital-ATL
Leigh Scott
Westport, CT

July 21, 2011, 9:45 am
All fascinating stuff!
Jerry Wesch
Harker Hts., Texas

July 21, 2011, 9:52 am
This relationship between trauma and health has been surmised in the Health Psychology literature for a long time. In individuals with any chronic disease process, it is worth exploring this kind of history. Great study!
Kelly Kane
Agawam, MA

July 21, 2011, 9:58 am
This research is fascinating and very sobering. I believe the hopeful question is: As/If trauma is healed does the degree of chronic illness degree or life expectancy increase?
Ron Dyck
Steinbach, manitoba

July 21, 2011, 10:24 am
Thank you
Marlene I Shapiro
Social Work
Baltimore, Maryland

July 21, 2011, 10:31 am
Amazing study of ideas that folks in social work have been talking about for decades. The design of the study and the numbers of subjects make this very compelling. If anything comes of it, it ought to be to have primary care providers be much more psychologically sophisticated in assessing their patients. I agree, herein lies the difficulty.
Victoria Lauder
Etobicoke, Ontario

July 21, 2011, 10:33 am
I noticed the generational truama handed down while working as a statistician with the Children's Aid Society. There would be families creating the same scenario two and three generations back. I look forward to using this information to understand the many blockages of energy in the body.
Seth-Deborah Roth FNBCCH,CCHt,CI
Castro Valley, CA

July 21, 2011, 10:48 am
This is no surprise to me! I am a Registered Nurse Anesthetist and Advanced Practice Nurse as well as a Clinical Hypnotherapists. I find in my Medical Hypnosis practice, where I use regression to cause, that, indeed, medical issues can be traced back to childhood experiences. As a medical professional, this was at first surprising to me. Now, it is almost what is to be expected. I find that when you clear up emotional issues from childhood the symptoms and, yes, sometimes the disease itself clears up.
Ronelle Moehrke
Hogansville, GA

July 21, 2011, 11:04 am
I know someone who has a horrible background in abuse as a child - she has attempted suicide ten times (!!!)...she also has fibromyalgia and is in a wheelchair most of the time - she's about 53 years old.
Anna Cox
Social Work
Maumelle, Arkansas

July 21, 2011, 11:17 am
I work with those in maximum security prisons and again and again the horrific theme is that early trauma causes a wide range of chronic illness including massive psychological wounds that perpetuate violence
Bette M. Morris
Topeka, Kansas

July 21, 2011, 11:32 am
Dr. Buczynski, This interview is interesting, but I followed this link to confirm that I want to receive a copy of the original study. Other than the opportunity to post a comment, I am not finding a way to confirm that I want tyou to send me the study. At the very least, I want to receive a reference. I would also appreciate your e-mailing me a telephone number where I could call and talk with you. Dr. Bette M. Morris
Joan Faier-Routman, Ph.D.

July 21, 2011, 12:05 pm
I am thinking of a former client who has at least two of these risk factors and multiple chronic illnesses. How to work with the anger this person may feel realizing that the explanation for her health problems rests in her early childhood environment? Without this hypothesis she is left with the uncertainty of not knowing whether it is her genes, her lifestyle, environmental toxins, etc.
Julia Tupper CPC, CSC
Vancouver, WA

July 21, 2011, 12:42 pm
I am a Life and Spiritual Direction Coach. I work with people in the enhancement of Right-Relationship (authentic, intentional living.) In my work and study, I have seen this linked relationship, and it has captured my attention. In fact, I have written a paper on the subject that is currently being used as a part of a Women's Study program at a local university. I am so pleased to see this subject being addressed and especially in the helping professions community. As healing professionals, I feel that while we may have a great deal to learn in this area, we are on the front lines of helping clients/patients to understand the long term implications of trauma on children. Praise to you for laying down the bricks on the pathway to enlightenment about this most important link in our psychological past, present, and future!
Maria Gallo
Marriage/Family Therapy
Los Angles, CA

July 21, 2011, 12:57 pm
I am working with Cancer patients and Victimes of Crime... I believe that intense trauma correlates to chronic illness...
Helani Davison
salt spring island, british columbia canada

July 21, 2011, 1:25 pm
I am an addiction counselor, researcher, writer on social/environmental issues, addiction, causes and recovery. This info is invaluable. thank you.
Mary Ellen Gray
Phoenix, Arizona

July 21, 2011, 1:35 pm
As I read this, I couldn't help but see the obvious correlation between this study and the definite benefits of EFT (Emotional Freedom Technique). EFT is an amazingly rapid resolution to past traumas and experiences that have an adverse effect on our bodies and lives. Mary Ellen Gray
Tom Kavanaugh
Riverside, California

July 21, 2011, 1:48 pm
In my research work, as I utilize The R.E.L.E.A.S.E. Technique which is highly successful for releasing P.T.S.D. from the neurology of returning war veterans, the book by Dr. Clancy McKenzie has been instrumental in the success of the process. To this end, Dr. McKenzie has pioneered studying the correlation of childhood, and adolescent trauma to the onset of Adult P.T.S.D. His book, DELAYED POSTTRAUMATIC STRESS DISORDERS FROM INFANCY, has been an invaluable resource in identifying the starting point for personal change work with the individuals I've been privileged to help. The ACE Study questions will now be a part of all incoming questionnaires. Thank you for providing the information in this report!
Cathy Hockin
Social Work

July 21, 2011, 4:08 pm
Would be much more helpful if this report could be printed. Please resend with "print" button included. Thanks.
Barbara Altman Bruno
Social Work
Pleasantville, NY

July 21, 2011, 4:12 pm
Drs. Felitti and Anda have done some very helpful and creative work. I think there is much of value in considering people's childhood trauma and adult ailments. I heard years ago that more than half of doctor visits are due to psychological conditions, and Felitti and Anda's work makes more sense of that. I am a clinical social worker who has worked with people with weight-related problems for many decades. I appreciate people's ability to cope however they can. Using food is a legal and often available way to self-soothe. Certainly some people use excess food to cope, just as some use fatness to cope with other hardship. Like many physicians and others who seem to consider fatness as a personal lifestyle choice, however, Drs. Felitti and Anda are ignoring much research indicating that weight is highly influenced by genetics, fat people as a group eat no more than thin people as a group, and that dieting leads to weight gain. Useful references can be found in Linda Bacon's book, Health at Every Size, or Glenn Gaesser's Big Fat Lies. There is also evidence that chemicals in our environment are making people and animals fatter. I caution the doctors against overpsychologizing weight, as I would caution them against overpsychologizing height. Looking at when people start putting on weight in childhood, please also remember that many children put on weight in advance of growth spurts. Unfortunately, their and our culture's treatment of people considered not thin enough, constitutes emotional abuse (score one on the ACE, right there in Dr. Felitti's description of"titters of laughter" when people in his group mention genetics and ruined metabolisms in connection with larger body size). Fat children are abused by medical, educational, nutrition, and fitness personnel, among others, who think that all fat people are slothful gluttons, and also by those who think that stigma is a useful tool for psychological growth--whether from the aforementioned professionals, parents and other relatives, strangers, or even our first lady. Harvard doctors are suggesting removing fat children from their homes to somehow get them thin. It's been done; it hasn't worked and has done harm. Score another point on the ACE scale. It appears that because of such mistreatment, our war on obesity will create vast numbers of unhealthier people whose ACE scores are raised by the constant stress of stigma. Add to that the growing numbers of children with eating disorders and, probably, failure-to-thrive. So I hope that we listen to our clients/patients with respect, ask useful questions, and approach them in weight-neutral ways. I love the idea of using broadcasting to send a message that people of all sizes have value and deserve kindness and respect.
Lubby Martinson
Boulder, Colorado

July 21, 2011, 4:15 pm
As a Somatic Experiencing Practitioner and bodyworker, I have known this for a long time. I am glad that they have done the research so that it can become mainstream knowledge. There are so many good protocols that deal with this out there. Hopefully this will encourage more of a whole body approach to treating trauma in general. Bravo!
Diana Cable

July 21, 2011, 4:44 pm
Ruth, I found this fascinating. I was waiting for the relationship of trauma on the neurological system however....and at the end you addressed that it wasn't addressed. I wonder if possible to have him back and talk about that. I have for a long time understood about cellular memory and I also believe that our thoughts create our beliefs create our world. It does give me some previously left out questions to add to my questionnaires and insight into always going back to the beginning with people. Thank you.
Jana Pochop
CONCORD, California

July 21, 2011, 5:02 pm
This is absolutely fascinating. I have also noticed that some clients feel huge relieve after being able to verbalize the story of their trauma. I hope the scientists will find a medication to counter pro-inflammatory cytokines soon. It would be interesting to see a research about what influence meditation may have on them (cytokines).
Kathleen Patton
Redding , California

July 21, 2011, 5:48 pm
Thank you for this valuable information.
Sandra Pinkham
Columbus, Ohio

July 21, 2011, 5:57 pm
An emotional or physical stress can result in inflammation and a stress response that breaks down protein. When the protein metallothionein is broken down it can release cadmium, a mediator of the stress response which is able to have an effect at extremely low levels in the cells. It can play a role in all chronic disease. The genetic make up of the patient, nutritional status, sleep, bacterial flora in the gut , exercise, and stress coping mechanisms would greatly affect outcome. Cadmium is linked to cancer, heart disease, and chronic illness. Exposure can come from tobacco smoke but also from combustion of fuels and eposure to plants fertilized with phosphate fertilizers. In other words, it is ubiquitous.
Andrew Rossetti
New York, New York

July 21, 2011, 5:59 pm
Fascinating concept. I would welcome hearing more. It would be useful and informative to see the study itself.
Lesley Tran
werribee, vic

July 21, 2011, 6:55 pm
I found this very informative. This is a timely report with what most of us I imagine already knew or suspected but did not have great scientific evidence that this report provides.I like the idea of using free media to model healthy parenting.The media is responsible for so many useless and damaging role models, it's good to countercat that. Reality, always outsensationalizes fantasy so I agree that content would be certainly, 'lurid' enough to be interesting. I'd be interested in exploring the neurobioly of these outcomes further.
Maria Doig
Goomboorian, Queensland/Australia

July 21, 2011, 7:27 pm
As a sufferer of chronic illness for 28 years, I have always suspected a link in my own life. Also my husband , a cancer sufferer has been traumatised in early and later life.I notice that people who work with flower essences base their success with health on healing childhood trauma.
MaryLinda Hoes
West Bloomfield, MI

July 21, 2011, 8:03 pm
You don't have Nurse Practitioner as a choice profession. I am a PhD prepared advanced practice Psychiatric NP, Board certified. Not the same as BSN prepared nurses. I wonder what profession those responders who listed" other" classify their practice. I teach in the graduate school of a major University here and own my own practice. I have found your interviews to be very useful in my teaching and also practice. Also would like to have a printable version and references to articles/books.
Joan Marshall

July 21, 2011, 8:49 pm
So clearly put. Many of the points are known but little supporting figures easily to hand when we want people to hear these messages. Thank you
Gail Furlan
Sarasota, Fl

July 21, 2011, 8:57 pm
Looking forwardvto receiving the full article/research report.
Larry Kessler
Long Beach, CA

July 21, 2011, 9:12 pm
It is always good to get some hard facts that support what we find in our practices with traumatized people. Being a Psychosomatic Therapist, I found this particularly relevant. Thank you.
Beth Wheeling
Miami, Florida

July 21, 2011, 9:32 pm
Dr. Filleti makes some unfounded assumptions and seems to want to really simplfy matters. His statement about people who say that being obese runs in their families is absurd. His comment that the whole family speaks English and that doesn't make their family fat is truly insulting to his patients. Language is learned. How you learn to communicate and what you learn that you cannot communicate about is a far more important question in terms of obesity, but he cannot argue that genetics influence weight. I did not find him empathic. I believe he is stating the obvious. People who live in a state of chronic anxiety (like those in traumatic family situations) are constantly aroused. Of course they are going to feel pain moreI I think that his story of embarrassing newcomers in front of the group says more about him than his resesarch. It seems rather sadistic to me.
Tania McGregor
Stress Management
Adelaide, Sth Australia

July 22, 2011, 1:02 am
I am an Educational Kinesiologist and know that the body has often revealed information as it is ready to release and move into a better life. The importance of parents being supported is critical and I think the idea of the 'soapie' is great. Australia has two that you could approach 'Neighbours' and 'Home and Away' whilst I do not watch them the odd promo I have seen shows that they already handle some of the topics and it would be great to have some positive modelling on our TV to bring some kind of balance. The ACE Score is a very valuable guide and I will certainly be taking it into deeper consideration. Thank goodness that this information has been discovered and it is up to everyone who reads this interview to make sure that it does not get "lost" because it seems to difficult to handle. Goodness lets talk to politicians on every continent until we find those who genuinely want to reduce health costs an d who are willing to improve the quality of life through meaningful parental support. Thank you
Scott Daniels
Chatham, MA

July 22, 2011, 4:20 am
My wife was the victim of repeated abuse from father by cat-of-nine-tails and has already had major cancer surgery. We pray that it does not return. She has been unable to work on this trauma in therapy.
Diane Guidici
Marriage/Family Therapy
Kapaa,, HI

July 22, 2011, 4:25 am
Thank you for sharing this report. I am both a victim and a therapist/minister. There is no question about the correlations.
Mana Lawrence
Lahaina, Hawaii

July 22, 2011, 5:11 am
Hello and thank you for this. I am a firm believer that trauma sets the body up for disease. If we can just get the message to those who say, "toughen up".
Mariateresa Molo
Torino, Italy

July 22, 2011, 5:55 am
The huge data of the study confirm the need of emotional well being for physical health also. Interesting the idea of soap operas. I'll spread this report among my colleagues. Thanks so much. Mariateresa
Nancy Harper
Marriage/Family Therapy
Muncie, Indiana

July 22, 2011, 7:15 am
Great insight and very usable information. Thank you Ruth.
Carol Gardner RN MS
wynantskill , NY

July 22, 2011, 8:04 am
doing work with women and can use this research ! TX wwwwomenshealthandhealing.com
Carolyn Walker
Ottawa, Ontario

July 22, 2011, 8:04 am
I am a Physician psychotherapist and find this information both startling and fascinating, from both a personal and professional point of view. This information is definitely going to help me in my practice. Thank you!
Linda Kracht
Health Education

July 22, 2011, 8:10 am
thank you
Sheldon Weinstock

July 22, 2011, 9:52 am
Marita Pilcher
Social Work
Fayetteville, AR

July 22, 2011, 10:33 am
As a clinical social worker for 25 + yrs. I worked mostly with women who had a diagnosis of cancer. An incidental observation was that a high percentage of those women were survivors of childhood sexual trauma. Research to identify if there is a correlation between the experience of finally talking about the trauma and gaining some degree of psychological resolution and disease recurrence would be interesting.
Adele Baras, M.s. Lpc

July 22, 2011, 10:36 am
Chellie Morrison
Portland, Maine

July 22, 2011, 11:39 am
Where is the link to the full report?
Judy Steele
Minneapolis, MN

July 22, 2011, 11:58 am
Where is the report? I don't see a link. Thanks.
Judy Steele
Minneapolis, MN

July 22, 2011, 12:02 pm
All right, I've found it in the scroll box, but it's pretty hard to read that way. Can we have a way to print it? Thanks.
David Hodgson
Marriage/Family Therapy
Fullerton, CA

July 22, 2011, 12:02 pm
I appreciate your educational contributions.
Rev. Sudhamma
Greenville, SC

July 22, 2011, 12:16 pm
"You're only as sick as your secrets." Many times I have passed along this adage commonly quoted among members of 12 Step recovery groups, the idea being that silently harboring old painful information will sabotage emotional well-being and sobriety. Now it seems relevant to physical wellness too.
Rev. Sudhamma
Greenville, SC

July 22, 2011, 12:16 pm
"You're only as sick as your secrets." Many times I have passed along this adage commonly quoted among members of 12 Step recovery groups, the idea being that silently harboring old painful information will sabotage emotional well-being and sobriety. Now it seems relevant to physical wellness too.
Holly Eckert
Seattle, WA

July 22, 2011, 12:23 pm
As a middle-age woman who lives with chronic illness and lived through a lot of childhood trauma, I am sure that the two are experiences are intricately linked.
Dr. Jacob Jaffe
Bronx, New York

July 22, 2011, 12:27 pm
An interesting and helpful interview which will be useful in evaluating patients. The postings of others are also interesting
Marion Mccarley

July 22, 2011, 1:05 pm
Thank you for the information.
Timothy Deslippe
Ottawa, Ontario

July 22, 2011, 1:14 pm
I'm always pleased when research catches up and confirms what we see and know in our clinical work. How trrauma impacts the body and sets up patterns of reaction seems to be something that we see all the time. I look forward to reading the research and giving people the knowledge that this is a very real phenomenon and not a ficticious construct that they use to get attention. It seems that the link is real and reality seems best fed by research.
Moria Collett

July 22, 2011, 1:19 pm
Will you email me the report?
Paul Kalaj
miami, fl

July 22, 2011, 1:59 pm
Verry Interesting
Charles Horowitz, Ph.D.
Boulder, CO

July 22, 2011, 3:10 pm
There is a huge stigma against this truth. I do behavioral medicine in Boulder, CO, and after meeting in the past year w/ 31 physicians and 10 psychiatrists here, I get mostly the same response: "You're great and needed, so glad you're here! We know that more than 50% of what we see is psychological. And: 9 of 10 patients we refer to a psychologist don't call them. They want a pill, procedure, surgery, or injection." I'm very surprised in this day and age, in this liberal city, to get that response! Suggestions welcome. It's interesting to note that really there were no pills or injections in existence before 1850! Charles Horowitz, Ph.D.
Hilary Adele
Stress Management
England, UK

July 22, 2011, 4:18 pm
This is so true, recently I am analyzing myself and having just re-entered the family enviroment after 25 years, created past existing patterns to reimerge,,, also the patterns were copied with in other relationships. your concepts are exact however the doing has to come about with breaking the existing behaviou oc, idientified.. from my observations a strong desire to want change to occur for better life standard is core.... all therapies assisting these process's ar beneficial... what is also paramountly powerfully important is the spiritual aspect of what life brings to the souls human experience and how it handles them, which again goes into levels unsurmontable spiritually, Karmically. we are all experiencing a wonderful time for the healing of humanity. Thank you for all your wonderful contributions.
Susan Varhely
Alamosa, CO

July 22, 2011, 4:40 pm
Important information.
Lisa Moore
Marriage/Family Therapy

July 22, 2011, 5:13 pm
Trauma may not be a sufficient condition to cause chronic disease; poor parenting and trauma existed way before the epidemic of the diseases listed in the above study (obesity, diabetes, autoimmune, vascular, heart disease, cancer). And these diseases show up in the non-traumatized. The prevalence of these diseases appear and increase directly with the degree that a population relies on the industrialized diet, which is highly processed, and high in sugar, fat, salt, dairy, and animal protein. Many studies show causal connection between this diet and the recent epidemic of the chronic diseases mentioned (see studies by J. McDougall, T. Campbell, Ornish, Esselstyn, and others). Interestingly, these diseases are often completely reversed in patients who switch to a low calorie, high nutrition whole foods vegan diet. It would be an interesting study to see if changing the diets of high scoring ACE folks would heal their chronic disease. Changing diet just might be sufficient to increase longevity and decrease chronic disease, even in traumatized folks. (Maybe it could even lessen the addictive process?) I vote for a change to a whole foods, plant based, nutrionally dense diet, AND big improvements in parenting! Let the show begin.
Suzannah Wonser
Olympia, WA

July 22, 2011, 5:56 pm
As a counselor, family therapist, and former massage therapist, I do not find the results of this study unexpected. A few minutes of relaxation or deep tissue therapy, can reveal how many childhood traumas we still carry in our bodies as adults. Please make this information available for printing. It would be nice to have the comments included as an option. Thank you.
Day Piercy
Tarrytown, NY

July 22, 2011, 6:40 pm
Fascinating findings. Thanks so much for sharing this, Ruth. I'm interested in knowing if there are studies of acupuncture as treatment for trauma-connected chronic conditions. An advantage of this treatment is that it offers a whole body, integrated physical-emotional approach and a methodology for diagnosis that fits people with trauma related chronic conditions
Brenda Wilmarth
Social Work
Portland, OR

July 22, 2011, 6:43 pm
Can you give us a print button? Where can I find the original research article?
Halowine Coelho
dubai, uae

July 22, 2011, 7:02 pm
Homeopathic physician
Halowine Coelho
dubai, uae

July 22, 2011, 7:38 pm
Relevant information in this day and age
Joseph Skwish

July 22, 2011, 8:11 pm
It's not surprising that trauma would lead to chronic disease. The immune system is undoubtedly affected by trauma. Will you provide the reference to the original, published research article?
R. Oconnor
chicago, il

July 22, 2011, 8:55 pm
For some reason the report is has not opened up to me,please advise.thank you
Sadye Reddick
Vacaville, CA

July 22, 2011, 9:45 pm
Your idea about using Soap Operas to convey visually and auditorily the messages of better parenting and coping behaviors and the recognition of poor behaviors and distorted concepts is excellent and The Telenovelas out of Mexico are doing an excellent job at this. There is an excellent one right now that comes on at 12:00am on Univision titled: Para Volver a Amar. They can be excellent educational media. Also short documentaries can be quite successful. I appreciate the importance you presented about the questenaires. Thank you for the report.
Dee Cocoros Cocoroa
New York,

July 22, 2011, 10:58 pm
What is / are the solutons? Thank you for the info
Stan Willson
Edmonton, Alberta

July 22, 2011, 11:00 pm
Let me know how I can get this info.
Barbara Belger (Clegg)
New Zealand,

July 23, 2011, 1:55 am
Thank you Ruth for this wonderful programme on trauma (and I would like to get in the queue for a 'print button' for this article please). I work as NLP Master Coach, Meta Medicine Integrative Health Coach and use various other modalities in my work with clients. In our recent earthquakes (to date 7500+ since Sept 2010) we experience a huge number of the various stages of trauma and I'm excited to share that NLP and TimeLine tm (as well as EFT as well as possibly other energy psychology techniques) are showing wonderful results. As far as illness is concerned I've found the precise 'mapping' with Meta Medicine to define the original conflict shock to be almost as precise as clockwork (in one particular client of mine it ended her 13 yrs of fibromyalgia, constant pain medication. that was 1.5 yrs ago, pain free to this date. There is an intro weekend in Ontario in September and I'd recommend every health professional to take a look at Richard Flook's 'why am I sick' website. As for some of the other comments (I scanned, and did not read them all thoroughly) the link between 'manifesting an immense traumatic response' and parenting being far from Jean Liedloff's idea of a 'continuum concept' in the many people I've seen since Sept is apparent and I would definitely integrate the parenting factor into any trauma workshops/seminars that I'll hopefully run soon. With gratitude to your work and with firm belief that we all in the right place at the right time, warm regards, Barbara
Michelle Hansel Hansel
Los Angeles, Ca

July 23, 2011, 2:10 am
Thank you. Are there any studies published in Journals regarding this subject that you are aware of ?
Marion Goertz
Marriage/Family Therapy
Toronto, Ontario

July 23, 2011, 7:39 am
Thank you for the exceptional materials on client care! Please keep them coming!
Dr. John Breen, PhD
Pennsylvania, USA

July 23, 2011, 7:51 am
Thanks Ruth, for making this important information available to us. I too would like to hear more about trauma and the neurological theory. For those who commented requesting a print button, just copy and paste the content to a blank document and print that. As a School Psychologist, it seems that the time to "improve parenting skills across the nation" should begin with young teenagers BEFORE they become parents. Some teens watch soap operas, but a more ubiquitous teen media connection may be MTV, music videos, and YouTube.
Margaret Zandder
Buda, Texas

July 23, 2011, 7:57 am
So nice to have the big figures but I found myself wondering about a few more details. Pretty important to try to enhance early life experiences of our children.
A Lewis

July 23, 2011, 11:01 am
I would like to print it off as I find it hard to read copy on screen because of an eye condition. Is there a way to do this please? A.L otherwise I am excited by the very thought of this update.
Suzannah Wonser
Olympia, WA

July 23, 2011, 11:07 am
I have already commented, so I am completing this again just to get a printed copy of this presentation. Thank you for making this information available to us.
Linda Goranson
Evanston, IL

July 23, 2011, 11:53 am
This is an amazing report that should receive more notice--i.e., 60 minutes or Neweek magazine. As an energy psych practitioner what I deal with is clearing early childhood trauma--the exact trauma that leads to psycho/social/physical impairment. I really like the idea of a soap opera or TV series where people are aware of these connections. I would love to be a part of a creative team that addresses this important issue. Indeed, if we could reach parents, we could transform society in a way that is unimaginable. Let's do it!
Wendy Fredricks
Toronto, ON

July 23, 2011, 12:43 pm
I don't seem to have the link to the report.
Kathy Pauley
Irvine, CA

July 23, 2011, 1:38 pm
Yes, I believe there is definitely a connection here. Everything is connected to our over-all health, even our experiences through-out life.
Neil Penn
Marriage/Family Therapy
Palo Alto, Ca

July 23, 2011, 3:14 pm
I am a Family Therapist who worked with youth-at-risk for over 20 years. The correlation in this body of research is disturbing, However the recommended social policies are both well thought out and hopeful. I passionately agree that getting client's buy-in for developing a positive and effective parenting style is incredibly important.
Barbara Belton
Cortez, CO

July 23, 2011, 3:40 pm
I too am interested to know the answer to the question posed below about "As/If trauma is healed" does the picture change? Very personal for me as I continue to heal from serious hx of childhood abuse and complex pts. Have been doing the work of healing for many, many years now. Interestingly I am still at 62yo and always have been remarkably healthy physically. Have spent the last 40 years since first entering therapy/recovery groups working hard developing healthy habits~~~food, exercise, relationships,work et al. Always room for improvement, tho'. Have long felt blessed by this reality and believe that it has aided my emotional healing. I cannot be the only one this is true for....are they studying folks like us who are healing? We could definitely use the good news! Thank so much once again!
Julisa Adams
Boulder, Co

July 23, 2011, 4:14 pm
I'm very glad to see this obvious connection is being supported by solid research and that there is a logical suggestion on the table about prevention. This has been a foundational peice of my work for almost twenty years. I think the connection between shame and imflamation (and emotional pain in general) is a really important area to research. I also think that Bob Scaer has made a huge contribution here with his connection between helplessness (dependency), the freeze responce, and long-term overactivation of the sympathetic nervous system. My clinical experience is that people with auto-immune issues have a significant history of freeze and dissociation. Further, I've found that this can be repaired through techniques like hypnotherapy, EMDR and Brainspotting, and that this does lead to an improvement in physical symptoms, including addictions.
Dianne Greyerbiehl
Greenville, SC

July 23, 2011, 5:35 pm
As a counselor and life coach I have had a feeling for a long time that childhood trauma's effect was pervasive just from what I've seen in my practice. But it's incredible about the link between trauma and chronic disease! This is really important information. Thanks for making it available! I will include questions like this is my intake form from now on.
Joanne Koralesky
Portland, Maine

July 23, 2011, 5:58 pm
Please send a copy of the transcript offered; there doesn't seem to be a separate place on this page to request it....thank you!
Ann Pike
Jasper, Georgia

July 23, 2011, 6:18 pm
Very interesting and extremely relevant. I really like his ideas about more widely promoting the practices of good parenting. We should be able to do this without high expenses or getting the politicians involved, which would undoubtedly halt any constructive movement forward. What a great idea!
Pamela Seawell

July 23, 2011, 9:01 pm
As a Rosen Method Bodywork Practitioner, I work with the impact of trauma as it shows up in the client's body, attitudes and emotions. Thank you
Terrance Dushenko
Los Angeles, CA

July 23, 2011, 9:26 pm
Physicists have been leading the way for some time, as they refer to the vibrational levels of the cells and the typical format of psychological distress predating physiological. Simply watch "What the Bleep..." for much more in this same direction.
Thomas Villiger
CH-2502 Biel, CH

July 24, 2011, 2:24 am
Thanks for the new interesting information to you all.
Ange Puig
cherry hill, nj

July 24, 2011, 8:23 am
I use the ace study information in my graduate trauma psycholog course how to use trauma theory to design effective interventions in under & in served communities You would be shocked to learn how many psychologis never knew about the ace study so like the best students you get an "A"
Judi Goodman Goodman
lexington, ma

July 24, 2011, 10:30 am
Did you send me this article?
Maureen Atkins
Marriage/Family Therapy
San Lorenzo, CA

July 24, 2011, 7:05 pm
In graduate school I took a trauma class and found an article on the ACE Study. I was facinated by it and saw how much sense it made. I am now getting my hours at a agency that serves people with AOD issues and would like this additional article to add to my library. Thanks.
June Gibb

July 24, 2011, 8:17 pm
I so enjoy reading your reports, and appreciate your sharing them with us. However, I don't like scrolling while I read (call me old fashioned). Would you please put this in a form that we can print? Thank you very much.
Lucille Barish Barish

July 24, 2011, 10:12 pm
i have been a psychotherapist for over 40 years and have seen clearly the connection between trauma, and I would add, neglect from not good enough parents, and how this has caused a multitude of chronic diseases. I have worked often with people with CFS/Fibromyalga - and in every case there has been trauma, untuned- in parents, neglect and lack of help with children born with genetics which could lead to chronic disease without the help of parents to mirror them and help them patiently to become more resilient - which had turned into my job as a "good-enough" therapist. Therefore, no surprise to me!
Lucille Barish Barish

July 24, 2011, 10:21 pm
In over 40 years of practice, i have seen what trauma and narcissitic neglect can lead to Chronic illnesses. One in particular\ ": CFS and /fibromyalgia, whether from years of stress or a pinpointed illness had lead to it's symptoms.It is very sad for children who have been traumatized not to have "good enough" parents, who can help even genetically predisposed children to develop resilience. I must take on the role of "good enough" therapist, postulated by the wonderful D.W. Winnicot, Balint and self-psychologists.
Vina Miller

July 24, 2011, 10:59 pm
Great insights and such far reaching consequences if we can start listening to each other...not just once but ongoing. Parenting is such an important skill yet so few have ever been taught. Montessori teachers and the How to talk so kids will listen and listen so kids will talk" series by Faber and Mazlish showed us how to be respectful, and creative. Soap operas are a Fabulous idea! Easy to reach the masses who would benefit.
Robyn Miller
Melbourne, Victoria

July 24, 2011, 11:46 pm
Thank you
Dr. Dorita Berger
Norwalk, CT

July 25, 2011, 7:49 am
While it is valuable to suggest more and better parenting training, abusive parents are themselves victims of various traumas, many are on drugs, or felons, etc. They're not likely to sit in front of soap operas or other media. Also, they are not likely to "learn" from role-modeling or other educational approaches. So it's more than just "parenting" that needs to be looked at. And, childhood trauma covers a much wider areas than abuse. Trauma of experiencing war or natural disasters, death of a parent or sibling, relocation, and much more. So this information, while interesting, seems a bit simplistic.
Tim Deslippe
Social Work
Ottawa, Ontario

July 25, 2011, 11:59 am
Already left a comment and didn't get the report.... Please, I really want to see the study results.
Sandra Chatelain
Social Work
delray beach, florida

July 25, 2011, 12:59 pm
Currently reading Robert Scaer, MD, The Trauma Spectrum, which is a beautifully written description of the physiological/neurological sequallae of childhood trauma in relation to chronic disease, particularly those difficult to diagnose and treat...reflext sympathetic dystropy, fibromyalgia, etc. It is wonderful that this connection is becoming clearer and clearer and that the connection between talking about it and a decrease in office or emergency room visits was statistically demonstrated. No surprise to me after working in the addictions field for many years. Will be making use of ACE. Thank you so much, Ruth.
Peggy Verret
Sludell, LA

July 25, 2011, 1:40 pm
Send report
Suzi Io Babb
Health Education
las vegas, nv

July 25, 2011, 1:49 pm
Great food for thought. Always great to hear new explanations that somehow also feel like commonsense. Parenting skills definitely need to be improved. So sad for so many individuals. I always like your topics, and have participated in other webinars from you before. Thanks again.
M. Kelly Sutton MD
Fair Oaks, CA

July 25, 2011, 1:54 pm
Can I get a copy of the questionnaire to use in my practice? Thank you for this important work!
Erin O'Meara
Minneapolis, MN

July 25, 2011, 1:56 pm
Absolutely critical and fascinating study. I was led to believe I would have access to the report, not just an interview. How do I access the research article? Thanks.
Rebecca Weiss
Devon, PA

July 25, 2011, 2:24 pm
I am an acupuncturist and have been in interested in this and studied for a long time.
Evans Hermon Hermon
Health Education
Sechelt,, B.C.

July 25, 2011, 3:26 pm
Being an Holistic Health Practitioner, none of this surprises me. But none if this could be found out in a 15 minute office visit which is just time to prescribe another drug.
Patricia Robinett
Eugene, OR

July 25, 2011, 4:48 pm
As a hypnotherapist, past ives and regression therapist, this makes all the sense in the world to me. Thank you for saying it so well. I do not believe there is an illness without trauma - whether physical or mental illness... My continuing concern is that a vast majority of our males in the US have been traumatized at birth due to circumcision. Few healers realize the impact this trauma has, but as a circumcised female, I can see correlations in my life (and the lives of other circumcised females I've met since I wrote my book) and circumcised men - that intact people of both genders do not experience, specifically, 1) night terrors and nightmares, 2) suicidal ideation in childhood. The circumcision 'distress disease' could very well be heart problems, vascular problems and 'disheartenment' - suicide, as four times as many men commit suicide as women. *A Course in Miracles* says that "All healing is essentially the release of fear." I have used that hint very successfully in my work with others and also in my self-healing. As far as I can tell, it's what healing is all about.
Gulie Molkenthin
kimmell, indiana

July 25, 2011, 4:54 pm
I really would like to see the report.
Harriette Orelup
Dallas, TX

July 25, 2011, 6:13 pm
I am eager to see the report. Please send, and then I will have something to report on.
M Conlon

July 25, 2011, 7:09 pm
Wonderful vital Info Thank you
Ella -
Stockholm, Sweden

July 25, 2011, 7:21 pm
Trauma is frozen fear that eats the person from inside, in one way or the other. Thank you for this report, it is very signinficant.
Barbara Lee

July 25, 2011, 7:21 pm
I am a teacher and work with at-risk youth I like the pre view please send me the report by e-mail.
Emily Easler

July 25, 2011, 7:42 pm
Please send report asap. My studies indicate that this is true. thanks
Suzanne Kilkus
Marriage/Family Therapy
Madison, Wi

July 25, 2011, 8:20 pm
Thanks so much for this report, for the time, energy, and dedication this interview required. The information is invaluable and has me thinking of so many clients past and present who match the descriptions. I'm glad to again see that the research is catching up with what many of us have observed and known for many years - that there is a link between trauma and chronic illness. And I wasn't surprised at the report that many clients and patients know what the roots of their symptoms are. When I've asked the kind of questions that these researchers ask, I generally find that most people have a good idea - they just have never been asked before. It's a good reminder to trust and value the experience and wisdom of the client in showing us where we need to go for healing and transformation.
Ralph Satterlee
El Dorado Springs, MO

July 25, 2011, 8:35 pm
Roberta McKay
Kitchener, Ontario

July 25, 2011, 9:27 pm
Very valuable information. Thank you.
Roberta McKay
Kitchener, Ontario

July 25, 2011, 9:27 pm
Very valuable information. Thank you. I would like to be able to read the rest of the article.
Elizabeth Ocean
Coppell, TX

July 25, 2011, 9:37 pm
Great report and comments from so many dedicated professionals and others with insights into their own traumas. The report is not surprising to me. I have seen this many times over the years, trauma and toxic parenting in relation to physical, emotional, psychological, and spiritual disease. This also goes beyond toxic parenting into one's entire ancestral line. It is no longer necessary for people to attend therapy for years. There are a number of energy modalities introduced through energy psychology and energy medicine that work well to release these behavioral and cognitive patterns of abuse. One can learn these techniques from their therapist and spend a minimal amount of time in therapy. The therapist teaches the client how to use these energy techniques themselves which then become available to them for use any time. Of course, there is definitely a holistic approach needed for any type of disease process and the patient/client has to make a decision to seek wellness.
Petras Vainius
malvern, pa.

July 25, 2011, 10:05 pm
Took my breath away. Would like to read the balance of report. Where may I find it?
Dolores T. Morgan
Occupational Therapy
Claremont, Ca.

July 25, 2011, 10:23 pm
I am a retired O.T.R. who almost died from a form of abuse as a toddler. I spent years researching and in therapy to heal from this trauma & the residuals still affecting me. I look forward to your report. DTM
Meredith Kerrigan
King City, Ontario

July 25, 2011, 10:25 pm
I am a Certified Bowen Health Therapist and have based my practice upon this premise of linkage between Childhood experience and subsequent response. This is not new to me. It just requires exposure and acknowledgement.. This is pretty basic as a causitive contributor to adult issues. I wish that more practitioners would look at the root cause and respect it.
Petras Vainius
malvern, pa.

July 25, 2011, 10:37 pm
Any reasonable way to get back the 20 years that might have lost their way in my life?
John Irving
St. Louis, MO

July 26, 2011, 12:13 am
Very interesting presentation; however, there could be individuals with high ACE scores that are not affected by chronic disease. Moreover, some people thrived in the midst of terrible adversary. Look at the Jews who survived the horror of WWII...Many lived into advanced old age. Look at Nelson Mandela. Thank you for presenting your findings.
Lynda Andrews
Doonside, NSW

July 26, 2011, 12:13 am
This study should have been done long ago, one only needs to look at child protection systems to understand this content as commonplace. They were great questions on both the childhood sexual assault and also the obesity questions. I see this everyday in my workplace and am surprised this study was not done sooner. Well done for capturing what many in our field of work would see as a universal truth across all cultures and societies... great work
Terri Mitchell
West Stockholm, New York

July 26, 2011, 10:58 am
Thank you so much for sharing this valuable information. Working in a school as a Teaching Assistant I see many children of all ages who go through all kinds of traumas and this information certainly does help.
Christine Ragusa
Marriage/Family Therapy
Marlborough, CT

July 26, 2011, 11:47 am
I am a marriage and family therapist and a registered dietitian. The ACE Score has my attention. I would very much like to this information when obtaining client histories. What a great idea to get preventive information out to the public through soap operas.
Marlene Cohen
modesto, ca

July 26, 2011, 2:40 pm
amazing indeed. keep sending out the great material. We're getting there!
Margaret Hart
Columbia, MD

July 26, 2011, 5:59 pm
A seminal study with profound implications for the physical mental and spiritual health of children & their life time. I have come to believe that child abuse not only has long term effects but actually have a life time of psychological and spiritual distress. The connection of childhood trauma with major physical illness is a call for change. What is the next step? Also I would like to print this study for future use. Is this possible Dr. Margaret Hart
Jacquie Wise
Melbourne, Victoria

July 27, 2011, 3:10 am
I am an integrative counsellor, and have seen many examples of the relationship between trauma and stress and illness. Student doctors at Monash University in melbourne, where I tutor, are learning this as part of a more preventative approach to medicine. This article will make interesting reading for some of my clients. I too would like an easier way to print it out. Many thanks for sharing this.
Stan Willson
Edmonton, Alberta

August 10, 2011, 5:49 pm
Noris Maldonado
Marriage/Family Therapy
La Coruña, SPAIN

August 12, 2011, 2:33 pm
Very curious and interested in getting acquainted with the findings of your study. Keep on... Noris Maldonado
Noris Maldonado
Marriage/Family Therapy
La Coruña,, SPAIN (country)

August 12, 2011, 2:39 pm
Very much interested in reding your study findings. Thanks in advance for sharing such information. Thanks in advance. Noris Maldonado
Carolyn Marion
Marriage/Family Therapy
Fishersville, VA

September 7, 2011, 10:36 pm
Very helpful information. It is affirming that focusing on doing it "right from the start" or at least early intervention was given foundation in this research. I would like to see some further research to address the concerns raised by some responders with regard to stigma and obesity and looking closer at those who are resilient and seem to rise above the trauma, then go on to be happy, successful, healthy adults. CM, LPC
Henriette Hazard
Health Education
Prince George, B.C., Canada

September 8, 2011, 2:07 pm
I'm a Natural Health Consultant, I truly enjoyed all the info. I find that many get cancer as well as self destruction from trauma, I am excited for this info. I believe it will help many of my clients. Thank you kindly for sharing.
Joan M Berry
Portland, OR

October 7, 2011, 2:46 am
As a therapist who has treated adults severely abused as children for over 30 years, this parallels my clinical experience. The majority of my clients had auto-immune disorders of some sort and had relatively early diagnoses.