Why Adverse Childhood Experiences Cause Physical Disease

In recent years, there have been giant leaps forward in the public face of science. Gone is the idea of a gene for this or that determining our fate. Instead is the pragmatic and sensible thesis that our environment from conception to age three determines the adults we become. In a nutshell, adverse childhood experiences create our lifelong biology, beliefs and behaviours. Too late and too bad if you had a hapless or miserable early childhood, right? Or is it?

The Adverse Childhood Experiences (ACE) study

The ACE study (1) tells us that childhood experience has a greater impact than genetics on our health as adults.

In this study, children exposed to a range of stressors had an increased risk of both mental and physical disease as adults. Childhood stressors were abuse of any kind, witnessing domestic violence, parental separation, or having a parent with mental health or addiction issues, or sent to prison.

Compared to children without these stressors, children with such experiences had an increased risk of later drug abuse, mental illness, suicide, obesity, diabetes, lung disease, hepatitis, heart disease and early death. Time, it seems, is no healer.

An inescapable reality

The findings of the ACE study suggest we should move our focus from intervention and rehabilitation to primary prevention. Meanwhile, in the interval between educating parents and creating better childhood outcomes, we continue to tinker with the broken and maligned. Governments worldwide are throwing fresh resources at overburdened healthcare systems. They continue to ‘rehabilitate’ prisoners in environments not too different from their early home lives. Although we repeat these measures, the outcomes never change.

Why are we doing the same things over and over, and expecting different outcomes? This nonsensical approach suggests humans are in a hopeless spiral of victimhood. One that begins in childhood, with better outcomes unable to be bought no matter the price we pay.

We can trace this view of an inescapable, helpless reality back to René Descartes. Dubbed the father of modern philosophy, Descartes is famous for his annunciation, “cogito ergo sum”. I think, therefore I am. Descartes’ ideas introduced us to a separation between mind and body. We view the body as a machine with material properties. We perceive the mind as a nonmaterial substance. Because the two are different kinds of substance, they are forever separate in nature.

The mechanics of healthcare

Descartes created his mechanistic natural philosophy almost 400 years ago. In the same century, Isaac Newton set out the agenda for a scientific understanding of a matter-only universe. Together, Descartes’ dualism and Newton’s materialism laid the groundwork for the current biomedical model used to diagnose and treat illness.

One way to think about the biomedical model is to think of the doctor like a jeweller. A jeweller is essentially a mechanic for the watch or timepiece. The jeweller doesn’t require any knowledge of the owner to determine what repairs need to be made to an ailing watch. The jeweller uses his experience to diagnose and fix the problems found in the gears and springs. Restoring the structure and function of the watch doesn’t require further insights.

The biology of victimhood

This understanding is now part of the collective psyche that informs our worldview of the body as machine. Accordingly, we believe the substance of the body is mechanical, incapable of feeling or thought. The mind, in contrast, emerges as a consequence of having a body. It is a byproduct of the material brain from which our experience of consciousness arises. With consciousness located in the brain, our emotions are expressed and felt only in the space between our ears.

The outcome? After our biology has been programmed in early childhood, the prevailing view is that we’re powerless. Powerless as a child and powerless as an adult. Powerless to change our biology, beliefs and behaviours because the mind does not exert any significant control over the body. The body and mind may as well be worlds apart.

The mind versus body problem

The central problem with the biomedical, mind-emerges-from-body model is that it fails to explain how mind and body interact. For interact they must if we are to have conscious experience, qualia or sentience. Nor does the biomedical model adequately explain important everyday phenomena. For example, it does not explain the placebo effect or the nocebo effect. Nor does it explain inherited memory in organ transplant recipients, hysterical strengthsynchronicityspontaneous healingphantom limb painsomatic metaphordissociative identity disorder, the ability of acupuncture to alleviate pain, the health benefits of volunteering

How the biomedical model explains disease

The findings of the ACE study leave us with one critical question. How do our adverse childhood experiences contribute to physical disease in later life? And just to be clear, ‘physical’ disease in this context includes diseases such as diabetes and heart disease. In other words, diseases of the body.

Unsurprisingly, common explanations are based on materialistic assumptions. So if a disease is physical (i.e., of the body), biomedicine explains the disease in physical terms. Thus, an individual with high childhood adversity adopts risk behaviours, such as poor diet, sedentary lifestyle, smoking, drug abuse or excessive alcohol consumption. These factors are used to explain the subsequent development of a range of ‘physical’ diseases and early death.

But, there’s another problem…

In the ACE study, the data were adjusted to account for possible confounding factors. In other words, the investigators allowed for differences between study participants to enable a meaningful ‘look’ at the data. The investigators found that the health-risk behaviours of people with several adverse childhood experiences compared to people without such experiences only partly explained the differences in later disease (1).

Thus, we’re unable to conclude that physical factors alone explain causation. We need other factors to explain the increased risk of disease and early death in these people. Two further examples from the ACE study amplify the problem.

Emotional factors explain stroke and ischemic heart disease

In the first of these examples, the ACE study found a 3-fold higher risk of stroke in people with a high level of childhood neglect than those who reported a moderate or low level (2). Again, the investigators considered possible confounding factors. These included other predictors of stroke, such as socioeconomic status, diabetes, physical activity, smoking, and heart problems. The results were unchanged, indicating we need another explanation to explain the increased risk.

In the second example, the ACE study found a 4-fold higher risk of ischemic heart disease in people with several adverse childhood experiences compared to those without such experiences (3). The investigators found that emotional factors such as depression and anger were more important than traditional risk factors in explaining the cause of heart disease.

Thoughts do not create things?

We can conclude that traditional risk factors do not explain the excess death, stroke or heart disease in people with adverse childhood experiences. Conversely, we can say that negative feeling states originating in childhood and persisting into adulthood are important determinants of adverse health outcomes independently of physical factors.

But as long as we adhere to a philosophy in which mind emerges from body, we must reject the idea that negative feeling states attributed to our subjective childhood experiences cause disease. When we are only a biochemical machine…when our personhood exists only as the behaviour of a vast assembly of nerve cells…and when we are the product of a molecular text that is altered only by material interactions with the environment…then it is impossible for our subjective stories of early childhood to physically change our bodies. Mind emerges from body, but does not bend or shape it. Thoughts do not create things.

This view of self suggests it’s futile to turn our lives around as adults. The damage done to the developing brain in our early childhood is irreversible, right? Once set on the wrong path, only drugs and surgery can correct our damaged biology. No wonder our hospitals and prisons are overburdened! Meanwhile our subjective early childhood stories are ignored in any assessment of well-being.

Reversing the irreversible

Critical questioning of the science reveals we shouldn’t abandon any faith in our human potential. Even if you didn’t receive an enriched environment when you were young, there is hope!

Take as a starting point a mature plant failing to thrive. A simple solution is to uproot and replant it in a different environment – no drugs needed! The pragmatists among us will say that our complex nervous system surely sets us apart from a bean. But human experience follows a similar pattern to the plant. Changing something in the environment, moving to a new environment, and even altering our perception of an environmental stressor can have a profound impact on our biology.

How can this be?

When scientists elucidated the structure of DNA in 1953, they believed that genes controlled their own expression. And because genes controlled themselves, scientists also believed that genes controlled almost every process in the body. This was a great story, but it was incorrect.

Today, the science of epigenetics recognises that genes do not control their own expression. Rather, ‘signals’ outside the cells in which genes reside induce heritable changes in gene expression. These changes occur without altering the genetic blueprint of our DNA. These signals come from the environment both inside and outside the body. For example, a signal can have chemical properties, such as a nutrient, hormone, drug or toxin. A signal can also have mechanical properties, such as sound or touch. And genes also respond to electromagnetic signals, such as light, thermal radiation or x-rays. But what about thoughts and emotions? Could these also act as epigenetic signals?

Assumptions of epigenetics

The knowledge that epigenetic signalling can profoundly affect our biology is useful in resolving the mind-body problem. If we view thoughts, feelings and emotions only as constructs of an immaterial mind, they are not epigenetic signals. They are therefore incapable of inducing heritable changes in our biology.

But the assumption of materialistic science is that mind emerges from body. An assumption, no less, not a fact.

An alternative assumption is that mind and body co-emerge from a third, neutral substance. We’ll call this neutral substance ‘the field’, but more on that soon. Suffice to say, our thoughts, feelings and emotions will have properties amenable to epigenetic signalling in the same way that light is an epigenetic signal.

Evidence for thoughts as epigenetic signals

We can test the assumption that mind and body are co-emergent properties and that thoughts are epigenetic signals. For example, we could look for evidence of an improved health outcome when a patient ingests a sugar pill they falsely believe to be medicine. That’s been done, and it’s called the placebo effect (4).

Or what about surgery? There’s no such thing as a placebo effect in surgery is there? Um, yes, there is (5).

We can also look for a deleterious health outcome, for example, when someone is informed they have a fatal cancer when in fact they don’t. That’s been done too, and it’s called the nocebo effect (6).

We could look for signs of normal intelligence in a person whose brain is missing a cerebral cortex. If mind emerges from the brain as scientific materialism suggests, you’d need to have one of them to operate normally. But apparently you don’t (7).

Bringing mind back to body: The bodymind

The concept of the bodymind now exists to understand body and mind as an integrated whole. This concept resists not only Descartes’ dualism, but also the scientific materialism that seeks to explain mind only in terms of body. The term bodymind is therefore useful in advancing the assumption that mind and body are inseparable.

But to establish the bodymind as a valid scientific framework, we need ‘solid’ evidence that mind and body co-emerge together. It turns out this evidence has been available for the better part of the last century. Unfortunately, biomedicine ignores this in favour of a belief we are nothing more than corporeal bodies in a mechanical universe.

Matter isn’t really matter at all

Nowadays, if you ask a physicist what constitutes matter, she’ll tell you two things: Light and energy. That’s it. Pure and simple.

Think of Albert Einstein’s E = mc². E is energy, m is mass, and c is the speed of light. Without getting into the detail, we can say that energy and matter are entangled, incapable of separation. Even the atoms we’ve traditionally associated with ‘tangible’ matter are just vortices of energy. These atoms are constantly spinning and vibrating, with each radiating a unique energy signature. Yet, on close examination they have no physical structure. What we perceive as matter, quite literally, appears out of thin air!

Consequently, modern science has abandoned its belief in a Newtonian, material universe. Physicists have come to accept that the universe is one indivisible, dynamic whole. Matter is ‘physical’ in the ordinary sense only in that it has a tendency to exist as a ‘solid particle’. The rest of the time, matter exists as an immaterial energy field or wave.

This energy field is central to the story. As Einstein said, “The field is the sole governing agency of the particle.” In other words, when it comes to describing matter, the immaterial stuff is the only reality. Critically, some physicists now believe whole systems and not just atomic particles become entangled, having found “shocking evidence that [entanglement between matter and energy] affects the wider, ‘macroscopic’ world that we inhabit” (8).

The evidence for a unitary bodymind

In a quantum or holistic universe, one way to think of mind is energy. Like energy, we can only observe mind indirectly. Mind is unable to be measured in its own discrete units, only in terms of its effects on observable systems. And like energy, we have no objective knowledge of what mind actually is. Our experience of mind occurs through its entanglement with matter.

Moreover, there is scientific evidence to advance a non-local experience of mind (energy) with body (matter). In other words, mind is not ‘located’ in the space between our ears. Indeed, it’s not located at all. And body doesn’t end at the skin.

Yet, the biomedical model persists today in all of its original austerity. One of the reasons for this is self-evident. If I’m eviscerated in a car crash, I want the best that emergency medicine can offer.

Explaining ‘physical’ disease from adverse childhood experiences

As discussed, the biomedical model explains disease in terms of random molecular aberrations and also traditional risk factors. All things that have ‘physical’ effects on the body. And all things that are given weight in explaining disease causation.

With a bodymind assumption, we need to give the same ‘weight’ to thoughts, feelings and emotions, which have traditionally been viewed in terms of mind. These are the embodied feelings, emotions and thoughts that emerge from our adverse childhood experiences.

Since the bodymind reflects a holistic understanding of the whole-person, our experiences at the time of disease onset bear a direct relationship to the disease itself. We can explain these experiences in terms of the embodied feelings we have, and any related thoughts. We can also look for patterns or echoes dating back to our early childhood that reinforce our current situation.

Out of this, our ‘story’ emerges…

Developing narrative to understand disease

The holistic view of the bodymind doesn’t require disease to be an abstraction, which occurs when we describe disease as a random molecular aberration. On the contrary, disease from a holistic perspective is not random at all, but meaningful. We’re required to embrace the subjective narrative of our adverse childhood experiences to heal from disease. We’re encouraged to find meaning.

In this regard, our memories are our guide. These are strongest when the associated emotional intensity is strongest. Traditionally, we’ve thought of memories as being ‘stored’ in our brains. But from a bodymind perspective, memories and emotions are not stored but rather ‘held’ within the field. Remember that the field is the sole governing agency of the particle, our memories and emotions which are in the field continue to inform our bodyminds.

Early responses to adverse childhood experiences may once have served as an adaptive mechanism to meet our needs as children. But when this adaptive mechanism no longer serves our needs or becomes maladaptive, we may begin to experience disease.

Advancing the bodymind for a healthier you

With the assumption of bodymind, it’s possible to think of disease as a form of communication. This communication or ‘red flag’ may emanate from an unconscious aspect of the individual (9). It might be an unconscious tactic for expressing dissent or resistance (10). It could be a journey whose need fulfilment brings us to wholeness (11).

In the overall context of well-being, we should never settle for next best. Our understanding of a quantum universe and a unitary bodymind presents an opportunity to transcend the antiquated biomedical model and develop new insights into health and disease. One in which our subjective experience and any associated thoughts, feelings and emotions are centre-stage.

In the interval between training a new generation of health workers and biomedical scientists in the nature of these insights, many individuals suffering as a result of their early childhood experiences will want to experience meaningful shifts in wellbeing right now. And they can.

But that’s a whole new story.

ACEs too high? Find out when you take the ACE test here.
References
  1. Brown DW, Anda RF, Tiemeier H, et al. Adverse childhood experiences and the risk of premature mortality. Am J Prev Med 2009;37:389-96.
  2. Wilson RS, Boyle PA, Levine SR, et al. Emotional neglect in childhood and cerebral infarction in older age. Neurology 2012;79:1534-9.
  3. Dong M, Giles WH, Felitti VJ, et al. Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation 2004;110;1761-6.
  4. Kirsch I, Deacon BJ, Huedo-Medina TB, et al. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med 2008;5:e45.
  5. Moseley JB, O’Malley K, Petersen NJ, et al. A controlled trial of athroscopic surgery for osteoarthritis of the knee. N Engl J Med 2002;347:81-8.
  6. Meador CK. Hex death: voodoo magic or persuasion? South Med J 1992;85:244-7.
  7. Lewin R. Is your brain really necessary? Science 1980;210:1232-4.
  8. Brooks M. The weirdest link. New Scientist 2004;Mar 27(2440).
  9. Broom, B. (2007). Meaning-full disease: How personal experience and meanings cause and maintain physical illness. London, UK: Karnac Books.
  10. Scheper-Hughes, N. (1994). Embodied knowledge: Thinking with the body in critical medical anthropology. In R. Borofsky (Ed.), Assessing cultural anthropology (pp. 229–242). New York, NY: McGraw-Hill.
  11. Sanford, J. A. (1977). Healing and wholeness. New York, NY: Paulist Press.

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