There are some final thoughts I would like to share from the article entitled: The Relationship of Adverse Childhood Experiences to Adult Health: Turning Gold into Lead.


The authors of the ACE Study have come to completely embrace the concept that negative early childhood experiences have a profound impact upon one’s adult life—both physically and emotionally. Furthermore, the authors point out how rarely the medical/professional community recognizes or acknowledges this correlation. The authors compare this dilemma to the relationship between smoke and fire. They point out that firefighters long ago learned the relationship between cause and effect; thus they carry water hoses to fight the fire within the building, rather than fans to blow away the smoke emanating from the burning structure. Similarly, physicians should address the root causes of illness rather than merely treating symptoms. But how often does this occur in real life? How many of us have had our children’s trauma history ignored, or had our children diagnosed with disorders that describe symptoms such as ADHD or—one of my personal favorites—Intermittent Explosive Disorder (clearly a label of symptoms!) rather than have the underlying fire addressed?


The authors of the ACE study have this to say about ignoring the fire…

Clearly, we have shown that adverse childhood experiences are common, destructive, and have an effect that often lasts for a lifetime. They are the most important determinant of the health and well-being of our nation. Unfortunately, these problems are painful to recognize and difficult to deal with. Most physicians would far rather deal with traditional organic disease. Certainly, it is easier to do so, but that approach also leads to troubling treatment failures and the frustration of expensive diagnostic quandaries where everything is ruled out but nothing is ruled in.

I love the “rule out, rule in” reference. We used that often in vet school. Charts were full of “R/I or R/O ________” as we listed our initial “differential diagnoses.” When I do workshops, I often make mention of the “Aunt Minnie” approach to diagnostics. It goes like this… My Aunt Minnie had these symptoms, and she had this disease. You have these symptoms so you must have this disease. The idea is not to be an Aunt Minnie practitioner, but I have met physicians and veterinarians who did take this approach. They had x number of slots of diseases they recognized, and by golly, you or your pet had to fit in one of those slots. They seemed incapable of expanding their R/I/R/O list.


If we could just get the docs to see our kids as traumatized kids with multiple issues…imagine the possibilities!


The authors conclude their “Gold into Lead” article by stating they have found 22% of their Keiser Permanente patients were sexually abused as children. Nearly one quarter! And their final thoughts about this fact are as follows:

It reveals that the primary issues are well protected by social convention and taboo. It points out that we physicians have limited ourselves to the smallest part of the problem, that part where we are comfortable as mere prescribers of medication.

I found this study quite fascinating, and I was encouraged by the example set by these pioneering physicians. We need many more like them.


Check out this article about trauma and attachment or this one by Dr. Bruce Perry.


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