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"As the twig is bent, so grows the tree." ~ Traditional
"The Study makes it clear that time does not heal some of the adverse experiences we found so common in the childhoods of a large population of middle-aged, middle class Americans. One does not ‘just get over’ some things, not even fifty years later." ~ Vincent J. Felitti, M.D., The Relationship of Adverse Childhood Experiences to Adult Health: Turning Gold into Lead [PDF]
"Is it still possible in today's Germany to escape the realization that without the mistreatment of children, without a form of child-rearing based on violence to inculcate blind obedience, there would not have been a Hitler and his followers? And thus not millions of murdered victims either?" ~ Alice Miller, Adolf Hitler: How Could a Monster Succeed in Blinding a Nation?
It is almost impossible to overstate the emotional ill-health of this world. Regular readers of STR probably have a more-realistic-than-average view of the political tyranny mankind suffers, but may not be so clear about how pervasive emotional damage is. This damage is painful to see, and although it is often well-hidden, it is all around us.
The interconnected nature of love and freedom suggests that if emotional health (the cornerstone of love) is damaged, freedom is harmed as well. History supports that; repeatedly, we see that damaged and repressed humans create damaging and repressive societies. In contrast, people who are healthy and free inside create healthy and free societies. There is no reason to think it will ever be otherwise. If we want more freedom in the world, we must, among other things, reduce those factors which cause emotional damage, especially to the very young.
The duality of love and freedom is not mere symbolism; it is a concrete reality. How could widespread government torture exist without serious emotional damage in those who order and those who carry out such horrors? How could tyranny be the norm in this world without a widespread lack of empathy for one’s fellow human beings? How could war and death camps even be conceived, much less implemented, in a world where most people had been treated with love and respect in childhood?
Those are important questions, and the answers all come down to this: tyranny (be it from parents, organized religion, schoolyard bullies, the mafia, or so-called “legitimate” governments) has its roots in emotional damage. The root evil of widespread systematic coercion (tyranny) is the major tool by which this emotional damage is perpetuated. Tyranny’s companion—widespread emotional damage—is the power source that fuels the tyranny. These Two Great Evils, as I have also called them, feed upon each other. Neither can long exist alone.
It is worth remembering that genocide and other crime are only part of what we are talking about. The problem is really the human condition, including the inner states that cause crime in the first place, and which cause misery even where no crime is being committed. Neurosis itself is a form of un-freedom more powerful than any government dictatorship.
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How common is neurosis and what are its effects on individuals? The rough answers are “near-universal” and “near-infinite in number.” Of course, the level of damage and the specifics vary from person to person. To answer the question in more detail I will quote extensively from the article by Dr. Vincent Felitti linked at the start of this column, about the Adverse Childhood Experience Study. With over 17,000 participants, the ACE Study provides a good sense of the types and levels of damage involved and of the numbers of adults who might be affected in middle-class America. The Study looked at:
“. . . eight categories of childhood abuse and household dysfunction. The abuse categories were: recurrent physical abuse, recurrent severe emotional abuse, and contact sexual abuse. The five categories of household dysfunction were: growing up in a household where someone was in prison; where the mother was treated violently; with an alcoholic or a drug user; where someone was chronically depressed, mentally ill, or suicidal; and where at least one biological parent was lost to the patient during childhood – regardless of cause. An individual exposed to none of the categories had an ACE Score of 0; an individual exposed to any four had an ACE Score of 4, etc.”
Other events can cause neurosis and problems later in life; for example, a traumatic birth or infancy, drug use by a pregnant mother, a rigid upbringing, or childhood events so repressed that the adult has no memory of them. Nonetheless, reported events in these eight Study categories were enough to produce massive negative results. First, how common were these forms of abuse and distress?
“Slightly more than half of our middle-class population of Kaiser members experienced one or more of the categories of adverse childhood experience that we studied. One in four were exposed to two categories of adverse experience; one in 16 were exposed to four categories.”
The effect of such childhood experience on later life is stunning. Participants with higher ACE scores were dramatically more likely to smoke, to drink, or to use intravenous drugs; more likely to suffer from cancer; more likely to be depressed or to attempt suicide. In fact, a participant with an
“. . . ACE Score of 4 or more was 460% more likely to be suffering from depression than an individual with an ACE Score of 0. Should one doubt the reliability of this, we found that there was a 1,220% increase in attempted suicide between these two groups. At higher ACE Scores, the prevalence of attempted suicide increases 30-51fold (3,000-5,100%)! Our article describing this staggering effect was published in a recent issue of the Journal of the American Medical Association.”
Nor is that all:
“In addition to these examples, we found many other measures of adult health have a strong, graded relationship to what happened in childhood: heart disease, fractures, diabetes, obesity, unintended pregnancy, sexually transmitted diseases, and alcoholism were more frequent. Occupational health and job performance worsened progressively as the ACE Score increased.”
Felitti’s use of simple bar charts makes this “strong, graded relationship” between childhood distress and adult problems gut-wrenchingly clear. As powerful as the numbers are, reflecting on the individual human experiences they represent has even more impact. For example, Felitti briefly describes a patient’s history in relationship to her present symptoms:
“Review of her chart shows her to be chronically depressed, never married, and, because we routinely ask the question of 58,000 adults a year, to have been raped by her older brother six decades ago when she was ten. That brother molested her sister who is said also to be leading a troubled life.
“We found that 22% of our Kaiser members were sexually abused as children. How does that affect a person later in life?”
Clearly, one answer to that last question is “strongly.”
Traumatic levels of abuse and other distress in large numbers of people affect a town, a nation, or the world as a whole in powerful and destructive ways. We see this in every history book and in every newspaper. We see it in the statistics on alcohol and tobacco use. We see it in racism and bullying and grim or violent religious fanaticism. We see it at work in wars and genocides and in the coercion used by every government—and in the stunted empathy that allows most of us to ignore the plight of those being coerced.
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How do we begin solving this problem?
To create more emotional health and to protect that health, we must also create more freedom. Only a society free of tyranny—from any source—will reliably foster and protect emotional health in all its members. Creating freedom requires renouncing the use of initiated coercion to run society, or for any other purpose.
To create more freedom and to protect that freedom, we must also create more emotional health. Only an emotionally healthy world can be safe for freedom. Creating more emotional health requires, especially, bringing more compassion and freedom into the lives of pregnant mothers, infants, and children.
When large numbers of people show deep understanding of those truths, you will know we are on the road to a free and compassionate world.
Next week: Womb, Birth, Infancy, Childhood.
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My thanks to Dr. Vincent J. Felitti, M.D., for making available his Gold Into Lead article as quoted here. A shorter version of that article in HTML is available. I highly recommend reading Felitti’s full PDF article, which includes more data and useful insight not covered in this short column. The PDF is an English translation of: Felitti VJ. Belastungen in der Kindheit und Gesundheit im Erwachsenenalter: die Verwandlung von Gold in Blei. Z psychsom Med Psychother 2002; 48(4): 359-369