Shrink Rap

This is one test patients don’t want to ace

By: Merrill Powers, LCSW
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To obtain An ACEs questionnaire, email


When you visit your doctor, why would he or she ask about your childhood? What’s that got to do with your health? Quite a lot, it turns out. From 1995 to 1997 over 17,000 Kaiser HMO members in Southern California receiving physical exams completed confidential surveys about their childhood experiences. Researchers Vincent Felitti, M.D., and Robert F. Anda, M.D., discovered that childhood trauma leads to the adult onset of chronic diseases, depression and other mental illness, putting people at risk of early death. Called ACEs, for Adverse Childhood Experiences Study, the study was cosponsored by the Center for Disease Control and Kaiser Permanente.
The higher your ACEs score, the greater the chance you will develop a chronic, potentially life-threatening illness due to the neurological damage of long-term toxic stress and the development of poor coping skills that make you feel better in the short-term, but threaten your health long-term, such as smoking, or numbing out with alcohol, drugs or food.
ACEs are common. Nearly two-thirds of adults have at least one. The more you have, the greater your risk. For example, people with a score of 4 are twice as likely to be smokers and seven times more likely to be alcoholic. A score of 4 increases the risk of emphysema or chronic bronchitis by nearly 400 percent and suicide by 1200 percent. People with an ACE score of 6 or more are at risk of a shortened life span of 20 years.
It’s no coincidence that many of the clients I see in my psychotherapy practice are suffering not only from relationship challenges, anxiety and depression, but also from sleep difficulties, autoimmune diseases, addictions, poor health, and compulsive eating. When I give them the ACEs questionnaire, many of them score 4 or above.
Stress is the body’s normal response to challenging events. Stressful events can be positive, such as starting a new job or performing in a play. Parents can help children prepare and teach them how to handle it. The body responds with increased heart rate but it is temporary.
Stress can also be due to threats of harm in our environment. If the saber tooth tiger is about to ravage our camp, we instantly go into fight, flight, or freeze mode until we are out of danger. But if the raging tiger comes home drunk every night, and sometimes beats up Mom or Brother, or myself, toxic stress is the result, producing an overload of stress hormones cortisol and adrenaline that harm the development and function of the child’s brain. Chronic stress can also damage the body, weakening the heart from high blood pressure, reducing the immune system, and increasing inflammation.
Traumatic experiences haunt the psyche. A painful childhood can leave psychic scabs that come off with present-day stressors. But what if the infection under the scab could be cleaned out so the wound could finally heal? What if disturbing memories could be processed, so they are powerless to cause distress?  Newer therapies reprocess the memories until they feel neutral, reducing the emotional symptoms that are the result of the trauma memory being triggered by events in the present. What many of my clients find amazing is that their physical symptoms are also reduced, and sometimes eliminated!
Here’s an example: (The name and some details changed for confidentiality.)
Jim, in his early 60s, came to my office bent over in pain, for which he took several addictive medications. His problem? He was afraid of his grandchildren! He scored 8 on the ACEs. His abusive mother routinely left him in charge of his two younger brothers, an infant and a disabled toddler. Jim was 7 years old when the infant died in his sleep. His mother blamed and severely punished him. Using EMDR (eye movement desensitization and reprocessing) therapy, we reprocessed the memory so that his irrational beliefs about himself, and the feelings of guilt, were replaced by the realistic belief that it wasn’t his fault, but his mother was irresponsible leaving a baby and a disabled toddler in the care of a 7 year old.
As Jim progressed, he came to my office walking a little easier, standing more upright, with more color in his face. By the end of treatment he was able to stop his pain medication and he was enjoying his grandson. His body had held onto the pain the same as his brain held onto the memory.
The good news is that healing your emotional wounds may help lessen poor health effects of childhood trauma. Even better news is you can break the cycle with your own children. I’ll write more about it in future articles.
For more information, blogs, and an inspiring TED talk, visit the following links: for Pediatrician Nadine Burke Harris’ TED talk on How Childhood Trauma Affects Health Across A Lifetime.
Merrill Powers is a licensed clinical social worker in private practice in Downtown Auburn. She can be reached at