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Adverse Childhood Experiences (ACEs) — 10 things you need to know

29 September, 2021

Adverse Childhood Experiences (ACEs) can have a huge impact on adult life. Find out what they are and how you can move past them...

A young girl sat in a field with her head on her knees

‘Children’s exposure to Adverse Childhood Experiences is the greatest unaddressed public health threat of our time.’ Dr. Robert W. Block



Most of us would agree that a difficult or painful childhood experience can have an impact in adulthood. But what many of us don’t realise is just how much Adverse Childhood Experiences (ACEs) can affect every single aspect of adult life — not just mental health but physical health as well, plus academic achievement and even how we cope at work. 


In fact, challenges faced when young can have a massive impact on our overall happiness and life expectancy. For this reason, they can’t be underestimated. But what exactly is an Adverse Childhood Experience? Usually, it is defined as a potentially traumatic childhood event that happens to a person before the age of 18. And research has found that the higher your ‘ACE score’ (basically, the tally of different types of challenges that you faced in childhood), the bigger the potential impact on your health and wellbeing in adulthood.


But what kind of issues count as ACEs? And what are their effects? And, most importantly, what can we do to manage those effects so that we can still thrive, despite our backgrounds? 


To answer these questions and more, here are 10 facts about ACEs and why they matter:


1. ACEs are really common


In fact, studies have found that an astonishing two thirds of people have experienced one, while a quarter have had three or more. What’s more, distressing experiences in childhood are fairly common in even comfortable and affluent families. In short, this is an issue that can affect all children from all backgrounds.


2. There are three main types of ACE

According to the official scoring system, Adverse Childhood Experiences can be split into three main categories: abuse (physical, mental, emotional and sexual); neglect (physical and emotional), and household dysfunction (such as mental illness, death, divorce, addiction, a parent in prison, or one parent physically abusing the other).


3. The effects of ACES can last for a lifetime 


Research by the Centre for Disease Control has found that there is a direct and powerful connection between ACEs and physical, mental and emotional health issues in adulthood. This means that ACES can have a bigger and more lasting impact beyond the initial distress caused by the situation in childhood. 


In other words, even when a person has grown up and left the circumstances of their younger years behind, they can still be carrying the effects of ACEs in their body and mind.


4. And these effects are actually caused by toxic stress


Not all stress is bad — sometimes we need it to respond to a temporary challenge in life such as attending a job interview. And in a healthy stress response, your body will return back to normal when the challenging event is over. 


However, if a child is stuck in a distressing situation with little or no support, then this can cause the body’s stress systems to stay switched on long term. And the negative effects of this on both the body and brain can last well into adulthood.


5. Toxic stress can cause many different conditions


In fact, people who experience one or more ACEs in childhood are at a dramatically increased risk of all sorts of issues. These include physical problems such as heart disease, diabetes, strokes, obesity and even a greater likelihood of broken bones.


There are also mental, emotional and social effects as well. These can include depression, anxiety, addiction, poor academic achievement, time away from work, suicide attempts and trauma related conditons like C-PTSD. Essentially, the higher your ACE score, the higher your risk is of having these issues.


In the words of Dr. Nadine Burke Harris, author of The Deepest Well: Healing the Long-Term Effects of Childhood: ‘Twenty years of medical research has shown that childhood adversity literally gets under our skin, changing people in ways that can endure in their bodies for decades. It can tip a child’s developmental trajectory and affect physiology. It can trigger chronic inflammation and hormonal changes that can last a lifetime. It can alter the way DNA is read and how cells replicate, and it can dramatically increase the risk for heart disease, stroke, cancer, diabetes — even Alzheimer’s.’ 


6. You can learn how to spot the signs of ACEs in children


For instance, children who are suffering from toxic stress can sometimes be misdiagnosed as having ADHD, due to issues with impulsivity, anger and difficulty regulating emotions. Other signs can be recurring nightmares, seeming distracted or withdrawn, or reenacting trauma through play.


Thankfully, these effects can be reversed in children if their situation changes and they begin to feel more secure. For instance, if their home becomes safer, or a parent gets mental health support, then this can ‘rewire’ the child’s brain in a healthier way, switching off the toxic stress response.


7. ACE scores don’t take into account other childhood stressors 


For instance, growing up in poverty can also be an adverse experience, even although it isn’t included in the official ACE scoring system. Families in poverty can find themselves living in homes that are damp, cramped or inadequately heated, having to move a lot, or going without food. This can have an effect on a child’s stress levels. Also, different types discrimination such as racism can have a huge impact on a young person’s life, as can school bullying or living in chaotic or violent surroundings. 


In fact, if you experienced any of the above as a child, then you may also be vulnerable to some of the mental, physical and emotional health challenges linked to ACEs.


8. ACE scores also don't tally positive experiences 

Finding out your ACE score can be useful — but it leaves something very crucial out of the picture and that is the impact of positive experiences on a child’s life. In fact, positive, loving and nurturing experiences can help children to become resilient to other challenges they might be facing. And this gift of resilience could often end up making a big difference to their adult life. In the words of Gabor Maté, ‘Children don’t get traumatized because they get hurt. Children get traumatized because they’re alone with the hurt.’

Resilience can be built through many types of positive experiences and relationships. For instance, loving grandparents, encouraging teachers or trusted friends. Community services can also make a difference, such as programmes, activities and support schemes for children. All of these things can help to lessen the impact of trauma on a child, or at least help them to cope better with it.

9. Therapy can make a difference to the effects of ACEs

It is important to remember that the physical, mental and emotional effects of adverse childhood experiences aren’t a life sentence — help is out there. Building a trusted relationship with a therapist can help you to work through any pain and stress you might have experienced but never had a chance to fully process. And if you are wondering which kind of therapy might be best for you, it is believed that the trauma-informed approach is the most effective for processing ACEs.

In fact, there are various kinds of trauma-informed therapies that you can try. One of these is EMDR, a combination of both talk and body-based therapy that can help you to work through any unprocessed experiences from your childhood (find out more by reading about Jonathan’s EMDR experience). 

Another is Dialectical Behaviour Therapy (DBT), which can help you to learn skills to cope with difficult feelings and also empower you to choose how to respond to triggers. Trauma-Informed Cognitive Behavioural Therapy (CBT) can also help you to become more mindful of any negative or self-critical thoughts that could have their roots in childhood.

Finally, body-focused (somatic) approaches such as Somatic Experiencing, Sensorimotor Psychotherapy and CRM use a range of techniques to safely release any childhood trauma that is trapped in the body.

10. People with high ACE scores can lead happy and successful lives

Your ACE score doesn’t have to define your future — it just indicates that you have a greater risk of certain issues, not that those issues are pre-determined.

We are all unique and we each respond to adversity in different ways. For instance, having challenging experiences in childhood can sometimes cause a person to develop greater empathy for others, or lead them onto a path of self-growth and personal development, or make them determined to excel in life. Painful childhoods can also inspire people to help others or to advocate for social changes. Oprah Winfrey is one example of a person with a traumatic childhood who went on to become hugely successful and driven to help other people. In her book written with trauma expert Dr. Bruce Perry, What Happened to You? Conversations on Trauma, Resilience and Healing, they explore the effects that adverse early experiences can have on physical and emotional health. Yet they take a hopeful view of the topic, looking at how we can move away from blame and shame towards healing, understanding and resilience.


That said, overcoming childhood adversity isn’t about becoming a millionaire or a celebrity — it can be as simple as finding a loving long term relationship, raising your own children well or finding a sense of purpose in life. It can be as simple as feeling happy and safe.

However, if you are struggling to cope with your childhood experiences then it’s important not to condemn yourself for that either, or somehow feel that you have to be a ‘high-achiever’ or ‘overcomer’. Everyone’s childhood is unique, stress affects people in different ways and it is impossible to measure pain. All you can do is be kind to yourself and move forward at your own pace.

It is true that no one’s childhood has to define them. Yet it’s also true that the better we understand the impact that distressing childhood events had on us, the better we can understand ourselves. And by doing so, we can hopefully stop condemning ourselves for any struggles we might have with mental health and instead, see that the roots of these issues lie in our youth. Then we can finally move toward overcoming the impact of these experiences and no longer let the painful memories of our younger years cast a shadow on the present.


Struggling with the effects of childhood trauma, loss or stress? Therapy can help. Find a world-class MTA therapist today for an in-person, video or live chat appointment.

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