In 1985, Dr Vince Felitti was running a weight-loss clinic in San Diego operated by Kaiser Permanente. He was having incredible success with his patients and feeling really good about himself.
Until one day “Patty” came back for a regular weigh-in and she had gained 37 pounds in one month.
Dr Felitti was stunned. He’s never seen such weight gain that quickly in such a short amount of time. Patty herself blamed it on sleepwalking. But that wasn’t enough. Dr Felitti wondered why now. Patty wasn’t sure. But he kept asking questions. Patty told Felitti that an older man at work complimented and propositioned her. Helpful, thought Felitti. But why such an extreme response? he wondered. Patty broke down and told Felitti that her grandfather began raping her when she was 10.
Felitti began asking more and more of his patients about their childhood, including whether or not they were molested or raped as children. He learned that about 1/2 of them were victims of child sexual abuse. Felitti knew the healthcare world would never believe him that early childhood trauma could affect adults so many years later. So he decided he needed to prove it in a larger way. It was Patty’s story and so many survivor stories that led Felitti to partner with another physician Dr. Bob Onda to start the ACE Study in 1995.
Felitti did prove it. It was through the ACE study that we learned that adverse childhood experiences like sexual abuse can have a long-term impact on health and wellness. Childhood trauma including sexual abuse but also neglect, a parent with mental health issues, an incarcerated parent and more have a lower life expectancy. They are more likely to suffer from depression and suicidal ideation. They are more likely to smoke and drink and develop lung cancer. The list is exhaustive. There is what is called a dose response relationship between childhood trauma and health and wellness challenges. The more trauma, the greater impact on health.
Vince Felitti has gone on to talk about the impact of ACEs all over the world. He talks about the science, the facts, the people behind the science. He believes, as do I, that providers must ask their patients - in a trauma-informed way- about their whole history in order. And yet 40 years later, providers don’t ask or when they ask they ask terribly, too early or in a re-triggering way. We’re not much further along than we were in 1995. Adding to the challenge is that many of us still believe, whether healthcare provider or not, that was in the past is in the past. That “kids are resilient” or don’t remember. But the science tells us something different. It almost doesn’t matter if we don’t remember; our body does.
And we wonder why people can’t lose the weight, struggle to follow a care plan or are continually sick or unwell. And why we can’t breastfeed or suddenly feel nauseous when our chosen partner’s body is next to us in a moment of intimacy.
Being heard is healing. Someone asking us, in an empathetic thoughtful way, about ourselves, even about our childhood, can be freeing. It can help survivors unlock a piece of themselves. And sometimes that piece is exactly the part that has been secreted away, turned from in shame and neglected. We are not supposed to suffer in silence. We are supposed to feel understood by others. We are supposed to be cared for by our providers. It’s not always about fixing someone. It’s about caring enough to ask…and to listen.
Well into his 70’s, Felitti is still talking about the ACE Study. The least I can do is exactly the same.