ACEs: what we all deserve to know about them

In 1994, two physicians called Vincent Felitti and Robert Anda, set out to study the relationship between abuse, neglect, and household dysfunction on the one hand and adult chronic diseases and leading causes of death on the other. They used a questionnaire from which they later distilled the ten most prominent adverse experiences. Years later, it was acknowledged that, for example, poverty and racism can also be considered ACEs. The image below mentions the original ten items.

What was astonishing then – and still is today – is the prevalence of ACEs. ACEs appear to be very common in the countries where dedicated research has been conducted, both in rich and in underprivileged communities.

We now have hundreds of studies on ACEs and their impact on adult life, as well as many countries and communities around the world taking action to widely publicise information about ACEs. Studies steadily show that the more ACEs a person experiences, the higher their risk for common adult chronic diseases like heart disease, diabetes, obesity, anxiety, depression, as well as negative outcomes regarding substance abuse, smoking, academic achievement, time out of work, and early death. Therefore, some countries see the prevention of ACEs as a crucial public health issue, as it can help avoid the loss of overall health and wellbeing while also preventing healthcare costs.

How are ACEs correlated to chronic disease?

The evolution of our brains and nervous systems has made us the intelligent beings we are. Some parts of our brain, however, still serve the very basic functions we share with all other animals: detecting threats to our safety, in order to take action that safeguards survival. To demonstrate this, we use the triune (three-part) brain model in neuroscience. The brain is divided in three parts:

  1. The reptilian brain: comprises the instinctive parts of the brain. This part of the brain is developed at birth and highly attuned to activating survival responses: fight, flight, freeze, or fawn. Continuous activation, especially in the early years, leads to toxic stress. This makes proper social, cognitive, and immune functioning difficult.
  2. The mammalian brain (or limbic system): regulates emotions, memory and social interactions. This part of the brain is developed in the first years of a child’s life (roughly from 0 to 5 years old).
  3. The primate “thinking” brain (neocortex): is involved in executive functions, language, consciousness, and rational, analytic competence. This part of the brain develops well into the adult years (mid-20s).

As mentioned above, in the face of a threat, the reptilian brain will be in charge of releasing hormones that will help the body go into the fight-flight-freeze-fawn responses, a clever way to escape real danger. How else to survive an encounter with a grizzly bear, for example?

We usually don’t have to worry anymore about grizzly bears or sabre tooth tigers in our daily lives, but the reptilian brain can be activated every time we experience stressors that make us feel like our existence is under threat. This starts when early in life (‘first 1000 days’), we have social experiences that our brains perceive as life-threatening. If these are too frequent or lasting too long, we get an overactive reptilian brain. Stress that is adaptive and useful under short-term serious physical threat, can in the long term become maladaptive and toxic under constant social threat.

Moreover, toxic stress can alter normal brain development and lead to lifelong problems in behaviour, social interaction, learning, and mental health and well-being. It’s as if you are always on the lookout for threats from your environment. The toxic stress from ACEs suppresses the immune system and can lead to chronic inflammation in the body, which can manifest in depression, anxiety, substance use or chronic diseases such as obesity, cancer, cardiovascular diseases, etcetera.

How can I prevent ACEs in my child’s life?

If we know how moldable the young brain is, it makes sense to strive for positive or beneficial experiences. Cultivating safe, stable, and nurturing relationships and thus fostering resilience, can help not only to raise healthy children, but also possibly mitigate negative effects of ACEs.

Many parents’ initial reaction after learning about ACEs and toxic stress is to ask: “Why didn’t anyone tell me about this stuff?” The mere realisation that we were parented and are parenting in ways that might not promote secure attachment, or, even worse, in ways that expose us or our children to toxic stress, can be frightening and can trigger both deeply buried pain and confusing denial or defense mechanisms. That is why we feel everyone deserves to know about these insights.

It is important that you are kind to yourself when you want to dive into this. Do not harshly judge yourself for harmful behaviours: you tried to cope with your difficult situation and that coping brought you here. You survived!

As you are reading this and you start this journey of (self-)discovery, you could ask yourself questions such as:

  • What does this new knowledge reveal to me about my own health and wellbeing and about the way I parent?
  • What difference does this knowledge make in my life right now?
  • Can I think of ways to gain a better insight into my own childhood and where my own pain and needs stem from?

In the following months, we are going to discuss common parenting aspects through an ACE-aware lens, which may help you understand how this important piece of information might affect your parenting journey. Make sure to follow our social media accounts to share your thoughts and ideas and be notified when a new blog post is published. We look forward to your feedback!

Posted in Theory.