Yesterday we explored alcoholic systems, citing examples from my own family of origin. Today we’re going to talk about some of the reasons people head down the path of alcoholic behavior. A number of years ago, an accidental discovery was made. An organization in San Diego was doing some research to help doctors understand eating disorders and obesity. The organization asked obese clients about their weight at different times in their lives. The questions were along the lines of “How much did you weigh in the first grade?” “How much did you weigh when you began high school?” “How much did you weigh when you were in the fifth grade?” The questionnaire also asked about other milestones in people’s lives. “How old were you when you had your first job?” “How old were you when you got married?” And purely by accident, the survey asked the question that shed some real light on the obesity epidemic. The question contained a serendipitous typographical error. Instead of asking the intended question: “How old were you when you had your first sexual experience?” the question asked, “How much did you weigh when you had your first sexual experience?” Many of the obese patients (respondents were severely obese, upward of 500 pounds), reported age-appropriate weights when this experience occurred. When one woman said she was 40 pounds at the time of her first encounter, it caught the organization’s attention. When the person doing the survey asked for clarification, and again asked the same wrong question, the patient began to weep and again said she was 40 pounds. Her first sexual experience, she said, was a case of child molestation.
The findings with this patient turned out to be more common than anyone would have guessed. Time and time again, while reviewing the survey results, the patients had answered the wrong question. And the information shone a bright light on a common theme affecting people who would later become very obese. The patients reported “normal” weights prior to their first sexual experiences, sexual encounters that were not wanted and not consensual. Their weight problems began, the survey seemed to suggest, after a very traumatic life experience. With all their newly discovered data, people within the organization developed some hypotheses. They wondered if a similar survey question would provide some insight as to when someone began participating in what might be called “self-destructive behaviors.” Behaviors such as smoking, heavy drinking, promiscuous, unprotected sexual encounters with many partners, riding motorcycles without helmets, and other risky activities. The results of further questioning with other populations seemed to suggest that childhood trauma of some kind made people prone to throw caution into the wind and live dangerous lifestyles. Interestingly enough, the number of people completing the surveys seemed to taper off as the patients’ ages increased. While there was abundant information about people in their 30s and younger, there were fewer and fewer responses from people in their 40s, 50s, 60s, and older. Why was this? Sadly, it was recognized that as the population of risk-takers aged, they also died off. Their risky behaviors eventually got the better of them and they died prematurely of causes such as cancer, overdose, accidents, obesity-related conditions, sexually transmitted diseases and infections, etc. People were literally drinking, smoking, drugging, and harming themselves to death. But why? Why didn’t they stop before it got to that point? Why couldn’t people recognize that their health was suffering and take corrective actions? Anti-smoking campaigns have been all over television and radio for decades. And we all remember the Just Say No campaigns in the 80s. And what about “This is your brain on drugs” commercials? Didn’t people know they were harming themselves, maybe even killing themselves? The survey results indicated that yes, these people did know they were harming themselves. But what was more alarming was that they simply did not care.
Eventually this collection of data became helpful to organizations like the Centesr for Disease Control and other healthcare operations. After discovering that greater instances of childhood trauma led to higher risk of participating in self-destructive behaviors, they determined that these causes could be identified as Adverse Childhood Experiences or ACEs. In fact, the more ACEs someone reported, the more likely they were to participate in risky behaviors. The people with the highest ACE scores were far more likely to live shorter lives.
So what is an ACE? It’s hard to say exactly, because people have different levels of resiliency. Essentially, an ACE is something that happens in someone’s life before the age of 18 that causes some kind of emotional harm to that person. Things like being the victim of violence, abuse, or neglect. Things like witnessing violence, or a traumatic accident. Things like the death of one or both parents, the incarceration of one or both parents, or the death of a loved one by violence or suicide. Things like having parents participate in risky behaviors of their own, drug or alcohol use, etc. Anything that affects a child’s mental or emotional wellbeing is a potential ACE. People with higher ACE scores, meaning that person experienced more ACEs, are more likely to have chronic health problems, substance abuse problems, difficulty holding a job, decreased lifetime earning potential, difficulties in future romantic relationships and familial relationships, difficulties maintaining friendships, and even early death. As you can see, ACEs are a big deal.
Why do I know so much about ACEs? Because I was responsible for providing pastoral care to hospital patients who were suffering because of their self-destructive behaviors. It’s understandable on the surface level, but sad when you dig deeper, that nurses and physicians don’t like to treat people who have harmed themselves. They’d often rather save lives of people who had conditions that were not caused by the patients themselves. They would ask questions like, “Why would I go out of my way to care for a smoker with lung cancer when I can spend my energy on this other person who got lung cancer because of an unknown environmental factor?” I found that asking questions about patients’ ACEs got them to recognize the reason for their self-destructive behaviors. Questions like, “What was going on in your life when you started smoking?” were more effective than “why did you start smoking?” If you ask someone why they started smoking, they’ll almost always say something like, “I was hanging out with the wrong crowd.” Yes, probably so. But why were you hanging out with that crowd. Although they might say, “I was hanging out with the wrong crowd,” there is very often a deep sigh. And after the sigh, the ACE rears its ugly head. “My dad died when I was 12,” someone might say. “My mom used to hit me with the belt when I was a kid.” “My parents used to fight a lot and when they finally got divorced I felt like it was my fault.” ACEs affect people so much that it isn’t that they don’t know they’re killing themselves. They truly are in so much pain that they not only don’t care if they die, but they sometimes hope for the relief of death to arrive soon.
I think it’s safe to say that no one gets out of life completely free from ACEs. Our brains are not fully developed when we’re children and things affect us as children differently than they’d affect us if those same things happen later in life. If you’ve ever given a child the wrong color cup at breakfast, and saw that child throw a tantrum, then you know that kids think pretty well anything can be “a disaster.” Some kids are more sensitive than others. Some kids become numb to ACEs because they’ve experienced so many of them. Some kids are affected greatly by ACEs that don’t seem too severe to others. It isn’t an exact science. But it’s helpful to know about ourselves and about others in our lives. The challenge here is getting to know ourselves well enough to recognize the ACEs we’ve experienced and how they affect us today. We can ask ourselves questions like, do I drink too much? Do I eat too much of the wrong things, sabotaging my diet in the process? Do I smoke? Do I use drugs? Do I engage in promiscuous sex without protection? If so, what was going on in my life when I noticed this behavior begin? I’m happy to make myself available if you need someone to talk to about your ACEs. I have a lot of experience with recognizing them and their aftermath. It can also be helpful to talk to a therapist or other professional. I can also make myself available if you need to talk about the ACEs your children or other loved ones may have experienced. Our ACEs and the ACEs of our loved ones are NOT our fault. However, we can always contribute to the healing. When we talk about things, they lose their power over us and the healing can begin. I have my own ACEs and I’m sure you have yours. How we manage them and talk about them can give us tremendous relief, and maybe even quite literally save lives in the process.