Journal Article

ACEs, Jacks, Kings, and Queens

Ellen White has given great counsel to parents and parents-to-be about raising children. One prominent theme is parental tenderness, encouragement and words of kindness and affection rather than sternness, frowns and harsh treatment. Another is the solemn responsibility of parents to protect their children from harmful influences, potentially risky relationships, and compromising situations.

… Be careful how you treat the precious little ones, the lambs of the flock. There need be no harsh tones, no hard, painful strokes upon the little form. If, in the fear and love of God, you will do your duty, you will not deserve the pain you cause your child to suffer because of your masterly spirit that is so easily provoked. We would be much happier if we would manifest the gentleness of Christ in dealing with the little ones, who have everything to learn from the lips and character of the parents. It is a pleasant thing for God and the angels above to behold this work carried on in the families of earth in a Christ-like manner, the parents fully appreciating the value of the souls of the little ones committed to their care. -Review and Herald, May 17, 1898

“Tender affection should ever be cherished between husband and wife, parents and children, brothers and sisters. Every hasty word should be checked, and there should not be even the appearance of the lack of love one for another… Cultivate tenderness, affection, and love that have expression in little courtesies, in speech, in thoughtful attentions… give them [the children] the opportunity of seeing the father offering kindly attentions to the mother and the mother rendering respect and reverence to the father”. -Adventist Home p. 198

Are the preceding words sound advice, or merely 19th century sentimentalism? How fascinating that one of the most amazing scientific discoveries over the last century—relating to the diseases and health conditions of society—confirms exactly what she wrote above.

Every year, at Kaiser Permanente’s Department of Preventive Medicine in San Diego, more than 50,000 people are screened for diseases while still asymptomatic; it is one of the largest medical evaluation sites in the world. In 1980, using a data-driven approach to scientifically assist patients to return to a healthier size, department chief Dr. Vincent Felitti launched an obesity clinic designed for people who were 100 to 600 pounds overweight.

Yet, in 1985, Dr. Felitti was perplexed. Why were half of their patients dropping out of the program in the midst of their personal weight loss success? Through their analysis of patient data, he thought he and his team had learned a lot about people, but the high dropout rate of successful weight losers was a mystery that he attempted to solve by gathering new data through questionnaires.

One day, instead of asking the correct version of a question, he misstated it and asked “How much did you weigh when you were first sexually active?” The female patient replied, “Forty pounds.” He was baffled by the answer but repeated the same question, expecting her to correct her response. To his surprise, she repeated “Forty pounds,” and then burst into tears as she added that she was four-years-old at the time, and that her father was the offender!

In a short while, Felitti and his medical colleagues collected histories on 286 patients in the clinic, and most were discovered to have been sexually abused as children. Furthermore, they learned that food was a “pain reliever” because it made the victims feel better and ease their psychological pain. Eating quieted their anger, depression, anxiety, and fear; food, to them, was a trusted friend. For many as well, being obese solved the problem of being a target since obesity provided them with “sexual invisibility.” So when a female patient’s weight loss prompted a sexual comment about her, it increased her unconscious fear and anxiety, and so losing weight became unbearable. Thus, she dropped out of the program; it was a means of coping.

His findings were, initially, met with ridicule. Later, however, Dr. Felitti and a research group from the Centers for Disease Control and Prevention, led by Dr. Robert Anda, studied over 17,000 patients in regard to childhood trauma, using the clues they had gleaned from the earlier interviews and the published literature. These traumas included abuse (sexual, verbal, physical); family dysfunction; a parent who was mentally ill or an alcoholic; a mother who was a domestic violence victim; a family member who had been incarcerated; the loss of a parent through divorce or abandonment; and, finally, emotional and physical neglect.

Each item was scored and were collectively known as ACEs (Adverse Childhood Experiences.) Between 1995 and 1997 the initial data were collected, and these 17,421 people were followed for the next fifteen years before the first major analysis. The participants had an average age of 57, 40% had bachelor degrees or beyond, and they identified themselves ethnically as white (75%), black (5%), Asian & Pacific Islander (8%), and Hispanic (11%). Two in nine had ACE scores of three or more; one in every eight had a score of four or more.

In this study, there was a direct link between childhood trauma and adult mental illness, incarceration, and even inability to hold a job. More than three of every five persons surveyed had one or more types of ACEs, and of those almost ninety percent experienced two or more types. The ACEs did not happen in isolation – an alcoholic father or a mentally ill mother may inflict multiple types of abuse on their children. Additionally, and perhaps most surprisingly, the greater the number of ACEs the greater the association was with not just mental and social problems as an adult, but with physical problems as well!1 Eating disorders, obesity, depression, anxiety spectrum disorders, substance abuse, non-chemical addictions, STDs, cancer, heart disease, chronic lung disease, diabetes, hypertension, risky sexual behavior, domestic violence, learning disabilities, and even unemployment and incarceration—all have been linked with high ACE scores in a “dose-response” manner.

We live in a society of broken, emotionally damaged people. The stress of severe and chronic childhood trauma, such as being regularly hit, constantly belittled and berated, having your need for affection or security denied or withheld, watching your father repeatedly hit your mother-releases hormones that physically damage a child’s developing brain. People with four or more ACE categories have a thirty-two times greater chance of developing learning or behavior problems in school in contrast to those who had no adverse childhood experiences.

But it does not stop there. Children without the nurturing home environment that Ellen White wrote about, and who instead are subject to toxic trauma, live a life of brain stress overload and anatomical, physiological and biochemical derangements that negatively impact frontal lobe development. Such children cannot easily focus on learning; many fall behind in school; many cannot develop healthy relationships with others; and they often create tense situations with teachers and other authority figures because they are unable to trust adults. While some young people are affected more than others, the intense psychological pain clamors for relief and drives them to the anesthetics of modern life: food, alcohol, tobacco, drugs, pornography, sexual deviation, and high risk behaviors. Others might become shopaholics, or even workaholics, clamoring for worldly “success.” Yes, some may become workaholics and over achievers.

In short, it does not matter if a person is a pauper, a knave, a jack, a king, or a queen. What he or she has experienced early in life, be it good or bad, affects the individual in adulthood.

Thus, as Ellen White wrote, a loving family as portrayed as ideal in the Bible—with parents who are married and who love God, each other, and their children—has been shown to be a powerful resilience factor for children. Children raised in intact traditional families have, on average, higher academic achievement, better emotional health, and fewer behavioral problems.2 Meanwhile, married mothers are less likely to experience abuse and violence. In one study, among mothers who were currently married or had ever been married, the rate of abuse was 38.5 per 1,000 mothers; among mothers who have never been married, the rate was 81 per 1,000.3

Children and adolescents who customarily (5x/week) have dinner with their families are at a 200% lower risk for substance abuse when compared with those who had dinner infrequently (2 or less times/week). In one study they were found to be 2.5 times less likely to smoke cigarettes, more than 1.5 times less likely to drink alcohol, and almost three times less likely to try marijuana.4

This impact carries over into the spiritual realm. Children raised in intact families by happily married parents, one male and one female, tend to be more religiously in tune in adulthood. Children in families with two happily married biological parents showed even greater “religious inheritance,” but this was seen even in well-adjusted adopted children. Six measures of religiosity were used in this study: daily influence of religious beliefs; frequency of Bible reading; frequency of viewing/listening to religious media; prayer frequency; frequency of participation in church-related activities other than worship services; and frequency of church attendance.5

And what about Seventh-day Adventists? In her study population of over 10,000 Adventists, Dr. Katia Reinert found that high ACE scorers are prevalent despite the high level of education and high religious involvement in the group as a whole. The results show that childhood traumas have a significant negative effect on overall physical and mental health of affected Adventists, as seen in the general population. However, religious involvement factors such as spirituality or intrinsic religiosity, religious coping, forgiveness, and gratitude had a salutary effect for high ACE scorers, regardless of gender or race. She concluded with the observation that counseling interventions that support religious coping, intrinsic religiosity, forgiveness, and gratitude may be effective in helping individuals overcome the negative effects of ACEs in certain groups.6

So how can people, broken as we ourselves are, create homes that are monuments of God’s grace and help others who also live in brokenness?

By pointing them to the ONLY ONE who can! His promise to us is this: “Come unto me all ye that are weak and heavy laden…” and “Seek ye first the kingdom of God…” Parents and parents-to-be would do well to heed the counsels of God through Ellen White written to us more than 100 years before the ACE study:

The home that is beautified by love, sympathy, and tenderness is a place that angels love to visit, and where God is glorified. The influence of a carefully guarded Christian home in the years of childhood and youth is the surest safeguard against the corruptions of the world. In the atmosphere of such a home the children will learn to love both their earthly parents and their heavenly Father. -Adventist Home p. 198

Modern science, however painful the results, affirms this wonderful truth.

References:
1. Felitti VJ. Childhood sexual abuse, depression and family dysfunction in adult obese patients: a case control study. South Med J 1993;86:732- 6 and Felitti VJ et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults – The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, May 1998, Vol. 14, Issue 4, pp 245-258
2. Youngmin Sun, “The Well-Being of Adolescents in Households with No Biological Parents,” Journal of Marriage and Family 65, No. 4 (November 2003): 894-909.
3. Robert E. Rector , Patrick F. Fagan, and Kirk A. Johnson, “Marriage: Still the Safest Place for Women and Children,” Heritage Foundation Backgrounder No. 1732, (March 9, 2004): 1-4, http://s3.amazonaws.com/thf_media/2004/pdf/bg1732.pdf.
4. The National Center on Addiction and Substance Abuse at Columbia University, “The Importance of Family Dinners II,” (September 2005), http://www.casacolumbia.org/download.aspx?path=/UploadedFiles/cvq5rn5t.pdf
5. Scott M. Myers, “An Interactive Model of Religiosity Inheritance: The Importance of Family Context,” American Sociological Review 61, No. 5 (October 1996): 858-866.
6. Reinert KG et al. The Role of Religious Involvement in the Relationship Between Early Trauma and Health Outcomes Among Adult Survivors. Journal of Child & Adolescent Trauma September 2016, Volume 9, Issue 3, pp 231-241

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