Volume XVIII | Issue 2 | Spring 2018

Childhood adversities

Negative experiences in childhood create life-time risks

Readers are immediately drawn into Dr. Nadine Burke Harris’s new book, The Deepest Well, with a compelling account of a 43-year-old man who is suffering a stroke. He’s young and healthy, and doctors are perplexed why someone with no risk factors is suddenly at risk of dying.

Dr. Nadine Burke Harris

But unbeknownst to the principals in this true story, the man does have a risk factor — a big one that meant he was twice as likely to have a stroke as someone without that factor. The culprit? Childhood adversity.

The research resulting from the landmark Adverse Childhood Experiences Study (ACES) demonstrates with startling clarity that negative experiences in childhood become, for adults, a significant risk factor for many of the country’s most deadly diseases. In the case of Burke Harris’s opening saga, the patient had had a difficult childhood with a schizophrenic mother. Other adverse experiences include physical and sexual abuse, neglect, violence in the home, and parental separation or divorce.

“The body remembers,” she writes. “Twenty years of medical research has shown that childhood adversity literally gets under our skin, changing people in ways that can endure in their bodies for decades.”

Burke Harris uses storytelling to take readers on her journey of discovery, weaving hard scientific data with vivid stories from her pediatric practice in a low-income area of San Francisco. And while the scope of the problem is huge, Burke Harris says there are solutions.

Early detection, she says, is critical. Identifying those at risk for toxic stress with early screening for Adverse Childhood Experiences (ACEs) can both catch related illnesses early on, and, by treating the underlying problem, prevent future illnesses. Of course, not all adult illnesses are due to adverse conditions in childhood, but screening can help those at risk.

“If we put the right protocols into place in pediatric offices across the city, country, and world,” she says, “we could intervene in time to walk back ... damage and change long-term health outcomes for the roughly 67% of the population with ACEs and their children.”

Not all bleak

Burke Harris takes pains to point out that things are not all bleak. “I know that the long-term impacts of childhood adversity are not all suffering,” she says. “In some people, adversity can foster perseverance, deepen empathy, strengthen the resolve to protect, and spark mini-superpowers, but in all people, it gets under our skin and into our DNA, and it becomes an important part of who we are.”

Burke Harris winds up her book by returning to the stroke saga and a real-world plot twist (we’ll let readers discover that on their own) that brings the book home. 

“I believe that when we each find the courage to look this problem in the face, we will have the power to transform not only our health, but our world,” Burke Harris concludes.  

This book is available free to residents of Oregon and Siskiyou County, Calif., through The Ford Family Foundation Select Books Program (www.tfff.org/select-books). 

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