The studies were begun nearly two decades ago, but they are still relevant and pertinent.
Performed by Vincent Felitti and Robert Anda they demonstrate two salient points. First, children who have been traumatized are far more likely to have medical or behavioral problems. Second, the incidence of these problems is, the authors explain, “unexpectedly common.”
David Brooks summarized the results in a recent column:
In the 1990s, Vincent Felitti and Robert Anda conducted a study on adverse childhood experiences. They asked 17,000 mostly white, mostly upscale patients enrolled in a Kaiser H.M.O. to describe whether they had experienced any of 10 categories of childhood trauma. They asked them if they had been abused, if their parents had divorced, if family members had been incarcerated or declared mentally ill. Then they gave them what came to be known as ACE scores, depending on how many of the 10 experiences they had endured.
The link between childhood trauma and adult outcomes was striking. People with an ACE score of 4 were seven times more likely to be alcoholics as adults than people with an ACE score of 0. They were six times more likely to have had sex before age 15, twice as likely to be diagnosed with cancer, four times as likely to suffer emphysema. People with an ACE score above 6 were 30 times more likely to have attempted suicide.
Later research suggested that only 3 percent of students with an ACE score of 0 had learning or behavioral problems in school. Among students with an ACE score of 4 or higher, 51 percent had those problems.
It’s nice enough to say that we need to counter the effects of poverty and to provide a better education, but, at root, Brooks suggests, Americans are psychologically damaged. Unless we deal with that problem, public policy solutions are unlikely to be beneficial.
In the past several decades, policy makers have focused on the material and bureaucratic things that correlate to school failure, like poor neighborhoods, bad nutrition, schools that are too big or too small. But, more recently, attention has shifted to the psychological reactions that impede learning — the ones that flow from insecure relationships, constant movement and economic anxiety.
… across vast stretches of America, economic, social and family breakdowns are producing enormous amounts of stress and unregulated behavior, which dulls motivation, undermines self-control and distorts lives.
Ferlitti himself explained that pathological behaviors are attempts to self-medicate:
"We saw that things like intractable smoking, things like promiscuity, use of street drugs, heavy alcohol consumption, etc., these were fairly common in the backgrounds of many of the patients...These were merely techniques they were using, these were merely coping mechanisms that had gone into place."–
But, how did we get to the point where “social and family breakdowns” are traumatizing children and undermining their character?
Brooks does not say it, but we, as a nation, have, for the past few decades been engaged in a grand social experiment. We have decided that personal self-fulfillment is more important than social stability or family stability. We act as though our mental health depends on our ability to let it all hang out, to be free from all social strictures, to be open and honest and out of control.
Add to that the stress that comes from constant movement and economic insecurity and you have a culture that is unfriendly, even hostile, to children.
These children might not have been physically abused, but they live with parents who place their needs before their responsibilities. These parents have been told by pseudo-scientists that they should be more permissive and indulgent. Thus, they try to make a virtue of their own detachment and neglect by failing to discipline their children. The experts cheer them on, telling parents that this helps children to develop their creativity.
So, kudos to Ferlitti and Anda for quantifying the problem, and kudos to David Brooks for drawing out attention to it. For my part I would add that the state of the national psyche is the natural outcome of our own Great American Cultural Revolution.
As one might expect, the eminently sensible Brooks proposes something resembling a national confab to bring together teachers, psychologists and social workers to find a solution.
The idea is mental balm for uneasy minds, but still, it does not address the most important issue here, the issue of responsibility.
For many years now the American educational system has given itself over to the task of providing therapy for children, mostly in the form of mindlessly puffing up children’s self-esteem.
How’s that been working out?
I would be happy to see all of American’s parents turn into Tiger Moms and all schoolteachers turn into disciplinarians who reward excellence and call out failure and sloth, but that would require such an extreme culture shift that one doubts that it will happen in the foreseeable future.
Too many people are too invested in self-esteemism for it to disappear any time soon.
One understands why Brooks would call for more mental health services, but, seriously, do you believe that America is lacking in mental health services. Children are regularly exposed to counselors, social workers, psychologists and psychiatrists.
It would be more accurate to say that Americans, both children and adults are drowning in mental health services. Americans have been therapied and drugged to the limits of their endurance.
If the Felitti and Anda studies are correct, we must conclude that all the varied modes of therapeutic intervention are simply not very effective.
All the counseling and pills seem to have very little real impact on the outcomes of childhood stress and abuse.
And it is not as though therapists have not been aware of the negative consequences of childhood trauma. Freud founded psychotherapy over a century ago as a theory about infantile trauma.
And yes, I am aware of the fact that the American Psychological Association has recently reported that all forms of therapy are effective.
But then, ask yourself this: what did you think that a professional association of psychologists and therapists would say?
Would you trust the American Bar Association to offer an objective appraisal of the cost of excessive litigation?
If, as the studies show, nothing that we, as a society, are offering to children who have suffered childhood stress and abuse has a helped change the course of their lives, then clearly, the therapy industry is failing to do the job.