What Happened to You? (Part 1)

We all kind of understand that what happens to us as a child affects us as an adult, but there is recent evidence that the way our childhoods affect us is so much deeper and more surprising than we thought. So where do we start when we’re talking about how childhood adversity affects us? We start by looking at a childhood. One childhood, from a few different angles. And this child’s name is Britt.

This episode was produced in partnership with: Call to Mind, American Public Media’s initiative to foster new conversations about mental health; and St. David’s Center for Child and Family Development, which is building relationships that nurture the development of every child and family; with support from the Sauer Family Foundation, which is committed to improving the lives of disadvantaged children and their families in Minnesota.

Transcripts may not appear in their final version and are subject to change.

I’m Nora McInerny, and this is Terrible, Thanks for Asking.
At my worst, I am the worst. Truly, when I’m on a plane and someone is rude to a flight attendant, or puts their jacket in the overhead bin when they JUST ANNOUNCED that overhead space is limited and so we should reserve it ONLY for suitcases? I seethe. When I have to work with someone who is a jerk, I can’t handle it. I’m like, OH MY GOD DUDE WHAT IS WRONG WITH YOU?!
A good way to think about it, that healthier people than me have suggested is not thinking “what’s WRONG with you” but “what happened to you?”
Because we are shaped by what happened to us. In varying degrees and in varying ways, we are. We know, anecdotally, that our childhoods affect us as adults. For some of us, we were bitten by dogs when we were kids, and now we go around biting dogs. For others, we were abused as kids and now we’re in abusive relationships. Or we were raised by people struggling with addiction, and now have our own addiction issues.
Instagram therapists — a genre of account, and one that I love — will tell you that we all have work to do healing our inner children. They say things like, “You can exercise and change your diet all you want, but if you don’t heal what’s going on in your heart, you’ll never be free.”
Messages like that are a nice sentiment on instagram when you just want something simplified and easily digestible. But like all the rest of Instagram, that sentiment has been cherry picked from a much larger, much more complicated thing.
It’s not to say it’s not accurate. There is a lot of truth to a saying like that — that what happens to us as kids shapes who we are as adults. It’s just not the whole story. And it’s not just anecdotal.
It turns out that science has been studying all this. And what many people consider just a part of growing up — that life is hard, and it sucks to be a kid — has big implications. Dr. Nadine Burke Harris: I’m talking about threats so severe or pervasive that they literally get under our skin and change our physiology.
Dr. Allison Jackson: The Center for Disease Control names it as the prime determinant of health, and yet unlike texting while driving or smoking cigarettes, for most of us it is still an unknown epidemic.
Dr. Nadine Burke Harris: In the words of Dr. Robert Block, the former president of the American Academy of Pediatrics… “adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today.”
Dr. Vincent Felliti: The magnitude of this problem is so huge and the complexity of dealing with it after the fact is so huge… that realistically the only serious approach is going to have to involve primary prevention.
Dr. Nadine Burke Harris: When we recognize this to be a public health crisis then we can begin to use the right toolkit to come up with solutions.
In a world where all adults are former children and most children are future adults — a health crisis that starts in childhood is big. It means that this isn’t just happening to “other people” but that this is something that affects all of us in some way.
As a team, we think this is all so important that we are going to spend the next three episodes exploring in depth the effects of childhood trauma and what it means for all of us.
We’re going to go down some surprising paths, share a lot of interesting and hopefully useful information, and ask a lot of questions.
How do we understand our own health? Our own childhoods? And how are those related?
How do we understand and talk about the big cultural, political and economic systems that keep hurting kids?
How do we do better for the kids in our lives, especially the ones who are going through something hard?
We hope that by the end of this series we’ll all have a common language to help us move towards a common understanding of how our childhoods aren’t behind us… and everyone who is now a kid is hopefully going to grow up… and take their childhood with them.
We get to understand how to look at each other and ask “what happened to you” when we think “what’s wrong with you”.
And we’ll get started with all that, after this quick break.
[MIDROLL 1]
And we’re back.
So where do we start when we’re talking about how childhood adversity affects us?
Well, let’s look at A childhood. One childhood. From a few different angles.
[MUSIC]
So, this is Britt. She is now 32. But when she was a kid, she was…
Britt: [00:00:21] A tomboy. First of all. I had brothers– mostly brothers and I loved playing with them at the park outside. I loved art all my life. I was the smallest and youngest child so I spent a lot of time wanting to have my siblings play with me and probably the annoying one if I can recall correctly I was the tattletale. I would tell if my siblings didn’t play with me. Maybe some of what happened in YOUR childhood is positive–I grew up seeing my parents read in bed every night, and that’s how I have to end my days, too. Maybe your family prayed before meals, and now you do that with your kids. Maybe your family loved a specific sports team, and you still do, even though that sports team represents a place you never lived, and maybe never even visited. We’re definitely going to get to some of those wonderful things for Britt, but this show is not called My Childhood Was Great, Thanks for Asking…, so we’re going to start by focusing on the more difficult parts of Britt’s childhood.
Britt: I felt misunderstood. I felt small. At times I felt neglected. I think in hindsight just being the– you know the youngest.
[MUSIC OUT]
Britt’s parents were divorced before she was old enough to even realize what that means. When they divorced, her mom remarried, and Britt’s siblings include her biological big sister, and a blended family with a bunch of brothers.
Britt: [00:03:08] I do remember living with my mom and my stepdad and my two stepbrothers and my real sister full time. And I would visit my real dad on the weekends. I loved the schools that I went to. I loved my friends. I loved… that part of… the town I lived in. My mom’s house there was always Enya. She played Enya nonstop. We would get up and make hash browns for breakfast… sometimes pancakes. We lived across the street from a park so we spent a lot of time as siblings over there playing.
Doesn’t that sound lovely? Enya and pancakes and siblings and playing at the park?!
It was, and then, when Britt was 5, her mom changed…
Britt: [00:01:27] and that was scary for me… ‘cause there was… little talk about it and I would just… see my mom start to… change in appearance and… I remember one time she came out of the bathroom crying. And I went in the bathroom to see what was making my mom sad… and I saw this grocery bag– this little paper bag full of my mom’s hair and it was… just kind of seeing… little signs of things that were not normal but not a lot of talk that I can recall about what was happening. [[MUSIC CHANGE?!?!]]
Britt’s mom had bone cancer. She was diagnosed at age 29.
Britt: So when I think back of that period of my life… I remember with my mom mostly being just afraid for her health. And I knew she loved us very much and that’s what everyone tells us.
Nearly three years later, on New Years Day of 1996, when Britt is 8, Britt is waking up in her room at her dad’s house… Britt: [00:07:58] on the bottom bunk and my sister was on the top bunk and my dad came in and it was around… 7 a.m. I think and he was crying and he let us know that our mom passed away. And… the really kind of embarrassing… response that I had was I laughed. And I was clearly in shock but I laughed and then I felt like an asshole… while my sister cried and I laughed… out of shock. But my dad still comforted both of us and… later that day took us to see some movies to kind of distract us. The movie that they picked that day after going to see their mom one last time and playing for a bit with their stepbrothers… was the Leslie Nielsen comedy “Dead and Loving It.”
After her mom died, she and her sister went to go live with their dad full time. It was a whole new life.
Britt’s dad starts dating a few different women that Britt likes, but it’s nothing too serious. Until a year later, when he meets a woman who will become Britt’s stepmother. Britt is 9 at the time, and she thinks of this lady as … Britt: [00:18:18] a nice woman who would buy us ice cream. And I really loved ice cream.
But another part of her was wary.
Britt: it wasn’t that she did anything in the very beginning of dating that seemed… off putting or alarming or unsafe but it was just that she didn’t have this warmth about her that… I was used to with my mom or with… the women that my dad dated. I don’t know we just weren’t really close from the beginning.
But Britt kept those misgivings to herself because what else was she going to do? Tap her dad on the shoulder and say “hey, I know you’re getting serious with this person but I’m getting a bad vibe from this lady?” She’s a tween, and didn’t feel like she in the position to tell her dad how to live his life! So she doesn’t say anything, and after two years of dating they all move into a new house with the girlfriend and her son who is the same age as Britt. Britt: [00:19:51] at that point that’s when… life shifted drastically because I went from… the middle school that I loved… on that part of town that I grew up in to… moving in a different part of that town and… whole new school. All new friends. Just starting from scratch. Really vulnerable. And just… life never felt the same after that.
It’s a new life and a new family. Which is made official a few months later with a courthouse wedding. Britt does her best to be happy for her dad. She tries to be happy for all of them.
Britt: [00:20:45] It was a forced happiness I didn’t feel very genuine but… I felt like I was just a witness to this new life– kind of… a passenger.
[MUSIC]
NEGLECT
Britt: [00:22:49] The only thing that felt blended was… that we were together and our furniture was blended. But I didn’t have a sense that this dynamic was coming together it always felt from the very beginning that we were butting heads… Britt could see this incompatibility in the way that her dad and her new stepmom parented.
Britt: [00:23:23] you know there’s my dad’s version and then there was the step mom’s version and she raised her child very differently than how my dad raised his child.
In middle school, early in their new blended family, Britt started to feel like she and her sister were always being targeted for discipline by their step mom, even though they made a lot of effort to be obedient. That they were starting to be constantly in trouble.
At this point Britt’s dad was working 40-50 hours a week. Coming home. And working. He would go out of town on work trips 4-5 times a year.
Britt: [00:34:14] So I think he was just… he was just taking on… taking on… a new role and… maybe was just too stretched thin to… be super present in his kids lives because he was just trying to survive.
Britt’s dad says that always tried to be there for the girls and be interested in what they were doing in life. But that he also was trying to navigate all sorts of new dynamics in the family.
And Britt’s stepmom is the one at home most of the time. So Britt’s home life is mostly spent with her stepmother. And her feelings of isolation are increasing…
Britt describes this time as…
Britt: [00:29:16] really feeling unheard… small… neglected.
[PAUSE]
Britt: To feel neglected felt… like I wasn’t seen… and considered. And… that was just a… constant feeling throughout my childhood. Like that I wasn’t valued enough to… have a voice and have feelings about what was going on.
YELLING
And then one day… things shift again in the household. Suddenly the isolation and anxiety were amplified. Britt: [00:35:04] my dad was out of town… and she was watching us and… we were woken up to her yelling that one of– my sister I had opened up a letter that she wrote my dad… and I can tell when my sister’s lying and we both looked at each other and… to see who was at you that opened up this letter and… neither of us did… to this day we still… promise to each other that neither of us opened it… and she was irate that one of us was sneaking through her personal stuff and… from that day forward she didn’t trust us… From then on, Britt feels she and her sister being isolated from their father. And there was more yelling.
Britt: [00:37:22] Like say… some chores weren’t done. I feel like a rational way to talk about that to middle schoolers would be to ask them to do their chores instead of… screaming at them and… going into a spiral about all the things that are wrong with them so it became… you know every little tiny… instance could spiral out of control to be this big thing and she would bring up things in the past and… become nonsensical and it would just– it would– it would be… a pattern of… we did something wrong… and then we would get grounded and if we ever tried to defend ourselves or explain ourselves… we would get in even more trouble.
Britt remembers the yelling became a part of their daily routine. Everyone focused on the immediate fight instead of yesterday’s fight, which meant there was never any resolution, no closure. And Britt felt like some of the yelling was based on hyperbole or situations that the girls didn’t have any control over.
A lot of the yelling happened when Britt’s dad was at work.
Britt: [00:39:47] So when my dad was not home… my… step mom would either just be in her bed… watching TV… or yelling at us. And… when my dad was home… it was that she was running around… maybe cleaning… and or… consulting him on how terrible we were. And oftentimes she would call him at work and… you could hear her in the other room screaming and telling him how terrible things are and… to get home as soon as possible. That was a frequent thing.
PROTECTION
As a middle schooler, Britt didn’t want to tell her friends about this. It was embarrassing. It would set her apart from them and their lives. Could she talk to her dad about it? Could he do something? She tried. But it didn’t have the kind of result she was hoping for. He acknowledges that his wife yelled, and that, “anyone who heard [her] yelling could say it was intense”. And he says he feels like it was abusive. But in the moment, Britt didn’t get the sense that he understood how it affected her. Because when she would try to talk with him about it in private…
Britt: [00:48:38] …And I would say to him that I’m afraid… he would… you know like a loving father try to… navigate that and talk with her about it and then I would get in trouble and you know she would say I was lying. And then I would actually get grounded for quote making these things up.
Britt loved her dad. But she started to find that in most cases he was siding with Britt’s stepmom whenever a conflict would come up. His response to Britt expressing hurt would be to defend his wife.
This made Britt feel like she had no one to protect her. She learned to hide herself and her feelings and reactions to try to avoid it escalating. But no one reached out to her in the way that she needed in that lonely place.
This is hard for Britt — all of her feelings about what’s happening. And feeling like her feelings about what is happening are not important. This is stressful to her.
PAIN PILLS
Britt: [00:40:51] on occasion the whole family would get together and try and explain to her that what she was describing didn’t actually happen and so that’s when I started to realize… through overhearing my dad and her talking that… she was on pain meds and… you know hearing my stepbrother mentioned that these pain meds… are making her act differently and that the same thing happened with her last relationship with his dad. So there was a pattern that was being repeated and I just… it was kind of… validating to– to hear that because then it gave… a reason for why she was acting… so irrational. because prior to that I just thought this was just an angry woman who… we could never please. And let’s be clear – chronic pain can be a devastating thing that can change someone’s personality and cause all sorts of problems. And as we know, some of the drugs – opiates – that are used to combat chronic pain come with their own huge huge problems.
We asked Britt’s dad about his wife’s chronic pain, her use of medications, and her behavior.
He said that “most of her irrational behavior would be due to the multiple medicines that her varied doctors put her on for one thing or another.” He said that “the pills changed her personality” He also said that “most other people just shrug it off because they understand she has good reason to be in a bad mood. People with good health don’t understand the torture of poor health”
He ALSO said that “not everything can be blamed on opioids”.
I want to tell you that we called Britt’s stepmom and stepbrother to ask them about everything in this story. They…did not want to participate or did not respond.
[MUSIC AND PAUSE]
Britt’s family saw a lot of movies. And one day the movie was a gem called… Harriet the Spy.
HARRIET THE SPY/TAPE RECORDER
It’s based on a book, and in it, the young heroine, who wants to be a writer, decides to spy on the people in her neighborhood and write about them in her journal. It ends with a lot of hurt feelings, but the overarching storyline isn’t what sticks with Britt. It’s Harriet who sticks with her. Harriet, who feels small and ignored by her parents. Harriet, who is the hero of her own story. Harriet, who has a strong voice and a strong point of view. Britt: [00:43:07] And this was a girl about my age maybe a little older and she witnessed a lot of you know fighting in her household and that really resonated with me. She would put her ear up to the door and take notes on what they were saying and I really… loved how powerful this little girl seemed to me in the movies and… I then had the seed planted that I wanted to become a spy and I wanted to… save up to buy a tape recorder and so I did that.
Some of this tape is hard to listen to — so if you want to skip ahead a few minutes, that’s okay. [TAPE MACHINE PLAY BUTTON]
Step Mom [archive recording]: We went overboard for you guys at Christmas and you don’t appreciate it you sit there– nothing was good enough for you every goddamn thing you have is [incomprehensible]. And you know what? I’m sick of this crap. It wasn’t that we picked out things that weren’t good for you… we went through a lot of work and spent a lot of time going down there after work when we were tired and didn’t have the money… to get you guys Christmas presents and… you sent everything back and you know what? You spoiled brat.
[TAPE MACHINE STOP BUTTON]
Britt: [00:45:20] it gave me like this sense of control when I didn’t have any control in my environment and that was really important for me and… and I think also something that I realized after– you know listening to the tapes after 20 years of not hearing it I thought that I was completely voiceless and that I wouldn’t stand up for myself but something that… I heard that kind of shocked me was on occasion I would you know be taping it and I think that that gave me like a little sense of… courage because I knew that I was documenting it so you know remain calm Britt and– and you know prove how crazy life is and I would– you know address my stepmom and whereas before the tape recorder I wouldn’t have done that and it kind of just gave me this like cushion of security that I could show someone this and prove that I wasn’t making this up.
[TAPE MACHINE PLAY BUTTON]
Teen Britt [archive recording]: I was trying to talk to you I was– I came up and you were like screaming and I’m not… you [incomprehensible] just waking up a screaming and… made us feel uncomfortable and… yes.
[Dad and Step Mom talking incomprehensibly over each other]
Teen Britt: We weren’t against you.
Step Mom: Go to your room next time and shut up is bottom line is– if I have to pull that [incomprehensible] on you because… nobody is going to treat me like… you are my equal– I’m not your fucking roomate and I will say “fucking” because I’m really pissed off right now as you stood there like “what did I do?”
[TAPE MACHINE STOP BUTTON]
Some people have different ideas about what yelling is. And about what is acceptable to say to kids. Some people might not think twice about examples like that. While others might be deeply offended at a parent talking that way to a child.
The important thing is, though, isn’t how any of those folks feel about it. The only thing that matters is how Britt felt about it. To her, this was constant, and it was aggressive, and it was dismissive. For her, this made a huge impact on her emotions and sense of self.
POLICE
And sometimes it got bad. There were a few times that the fights got so loud that neighbors would call the police. But one night when Britt was about 15, the fight between Britt’s dad and Britt’s stepmom was getting really heated. Britt and her dad agreed that this night was the worst that they experienced.
That night, Britt was looking out from her room down the hall towards her dad in the hallway. She could see him at the door to the kitchen on the other side of the room from her step mom.
Britt’s stepmom was standing near the sink yelling at Britt’s dad.
And Britt turned on her recorder. [TAPE MACHINE PLAY BUTTON]
[TAPE AMBI]
Again, if you don’t want to hear it, just skip ahead 5 minutes.
Step Mom: Who the hell do you think you are? I have bent over backwards for you the last three years
After Britt starts recording… there are several minutes of arguing. And then suddenly, Britt’s stepmom claims that Britt’s dad has pushed her.
Step Mom: OW! You pushed me!
Dad: I didn’t push you.
Step Mom: Yes you did.
Britt: And then I hear my step mom scream…
Step Mom: Goddamit… stay away from me.
Britt: And then she says that he shoved her into the sink or something like that or shoved her down…
Dad: I can’t believe it that is going too far–
Step Mom: You just shoved me into the sink.
Dad: I saw what you did and it–
Step Mom: Bullshit you shoved me.
Britt and her dad both claim that he wasn’t near her and didn’t touch her.
Dad: I just walked in and she acted like she fell over.
Step Mom: Bullshit. I am calling 911.
Britt: … and that she was calling the police. Step Mom: You shoved me up against it. [Dials 911]
Britt: I was so scared and I was glad that I was recording it but I didn’t have you know a video recording of it so I didn’t think it would hold up. Brother: Mom… mom… please stop it.
Britt: And then you know my brother comes upstairs he’s trying to rationalize with her and just calm her down. So he’s saying to her that she needs to calm down because she was really upset that he wasn’t taking her side and didn’t believe her. Brother: Mom… you’re not acting sane–
Step Mom: You’re not my son anymore. Get out. You and the girls I don’t care if you don’t love me anymore because I don’t like you either.
This is a difficult part of the tape to listen to and goes on for several minutes. Britt’s step mom threatened restraining orders and eviction for family members, accused everyone in the house of lying and conspiring against her, and threatened to leave.
Brother: You wouldn’t trust yourself if you saw you like this either.
Step Mom: [screaming] I’m in a lot of pain right now!
Brother: Mom, calm down, please.
Dad: Ok… just
Brother: No everyone is on your side you just need to… calm–
Step Mom: Oh you and the three girls? Get them out of my face and you too. I am not your mother anymore. You understand?
Brother: Mom!
Britt: So then the cops show up…
Dog: Bark bark bark bark bark.
Britt: …and I’m in my bedroom and I’m still recording this thing from the very beginning…
Cop: [knocks]
Britt: and he comes into my bedroom and I think he says Brittney…
Cop: Brittney?
Teen Britt: Yeah?
Cop: Can I come in?
Teen Britt: Yeah.
Britt: He either asked like how are you doing or he said something like what do you think is going on something like that. Cop: Everything ok?
Britt: And I remember being pretty mute and scared to describe what was going on because I I knew what was going on… but I again still felt very voiceless so when I had my opportunity to say something I didn’t. But he is talking in the recording and he’s talking with I think another officer and they’re kind of describing what’s going on and that there’s pain meds and she locked herself in the bathroom and it was just one of the scariest fights I’d ever witnessed and heard. Britt: And the thing that really stands out to me with listening to the tape recorder is it was the first time that someone came into my bedroom during a fight and asked how I was doing and checked in with me and regardless of the fact that I choked up and couldn’t say anything it just I felt heard. Teen Britt: I thought they wouldn’t even believe me.
Cop: No, we’re all believing you.
Britt: And so I broke down listening to the tapes because that’s really what I wanted my dad to do. And to have a stranger come in and be so present and to see right through it and to see that something was not right. It was very validating and it was really healing to to hear that tape and he just said… you’re going to go downstairs and be with your brother and sister they’re waiting for you everything’s gonna be OK OK? And I think I like muffled OK.
Cop: [muffled]
Teen Britt: Ok.
[TAPE ENDS]
We’re gonna take a break.
[MIDROLL 2]
And we’re back.
OK, so what can this ONE childhood show us about how you and me and we are affected by what happens to us early in life? Well, there’s this scientific framework that Britt’s story can help us understand.
It starts with stress.
At the core of Britt’s story is stress. In Britt’s brain, all this stuff created STRESS.
So we brought in someone to help us understand stress.
Brian Lynch: [00:00:00] My name’s Brian Lynch. I’m a general pediatrician I work at Mayo Clinic in Rochester, Minnesota. Dr. Lynch works with kids and studies childhood trauma and resilience. Brian Lynch: [00:24:12] stress isn’t inherently bad. The stress response is actually very helpful for us if we have to do well on a test… or if a bear is chasing us and we have to get away… the stress response is very helpful to us.
So mild, infrequent stress can be called positive stress. Great. Love it. Give me more.
Brian Lynch: [00:11:29] And then there’s toxic stress. And toxic stress is when you’re overwhelmed, it’s stress that’s either frequent or severe or sustained and you don’t have the appropriate buffering mechanisms in place to handle it and coping mechanisms.
So… like if that bear is always running after you. Like constantly? Brian Lynch: [00:24:35] that’s when we see problems.
[MUSIC]
You might say yeah, so what? – the world is stressful. I’m stressed all the time. My job is stressing me out. My family is stressing me out. The state of the world is stressing me out. Sure sure sure. But it’s JUST stress. Yes, I eat a little more. Yes, I have some trouble sleeping. Yes, my stomach hurts literally all the time.
But I live with it. So how bad can these quote unquote problems be from quote unquote toxic stress?
Brian Lynch: [00:11:46] it can actually change your brain and change your biological systems.
Especially when you’re a kid and your brain is still developing. When that stress is activated all the time from trauma or something difficult… and it turns toxic… that can literally change the way your brain develops.
Brian Lynch: [01:07:50] We do know at this point that it actually can change the size of your brain and how it functions. For example, areas that help you with decision making or emotional control can be smaller in your brain. If you’d experience adverse childhood experiences.
Toxic stress can mean that as you as you grow up, your physical systems that help you cope with stress don’t work correctly.
And that is serious, but it goes even deeper. Literally. Toxic stress can change the way your genetics are expressed..
Brian Lynch: [00:13:51] So… we all have sort of chemical marks on our DNA. And those marks can be rearranged based upon the experiences we have in life. And every day we have lots of experiences. And positive experiences can rearrange them in a way that then can predict good health outcomes. But experiences like adverse childhood experiences can rearrange them in a way they’re going to be at higher risk for negative health outcomes.
This is why what we’re talking about isn’t just a bad childhood, but a public health crisis. A way of contextualizing these childhood experiences and their effects is called ACEs, which is short for Adverse Childhood Experiences.
[MUSIC]
ACES is based off of a study done in the 1980’s when an internist named Dr. Vincent Felitti… and his research partner Dr. Robert Anda of the CDC… asked 26,000 people if they’d participate in a decades-long study. Each participant had to go through all sorts of tests – medical, physical, biological, etc. And then they were asked a series of 10 questions about their childhood. Brian Lynch: [00:00:54] And in that study, they categorized the ACES as either abuse, neglect or household dysfunction.
Abuse– questions like – were you ever sworn at/yelled at, struck, made to feel unsafe? Were people in your family? Neglect — questions like – did you live with an addict? Did you not have enough to eat, or clean clothes? Dysfunction– questions like – did you witness violence in your family? Some of the questions are framed entirely with the words “did you ever feel?” Those traumas are about the child’s perception. Not feeling loved or looked out for. Not feeling safe. Not feeling like there was anyone who could take care of them in an emergency.
Brian Lynch: [00:35:09] And how the child perceives that is almost just as important in these experience… itself.
Felitti and the researchers matched up what people went through in their childhood… and how they were doing health-wise as adults… and suddenly they had a big public health data set that helped them see patterns. And those patterns started to reveal that yes… there IS a documentable correlation between what happens in childhood… and adult health decades later….
[MUSIC OUT]
So that second part of the study… the questionnaire where people were asked to detail if bad things happened in their childhoods… it has taken on a life of its own.
It’s called the Adverse Childhood Experiences questionnaire… It’s just 10 questions — you get a point for every question that you answer “yes” to. And even though most experts say you should take this survey in context — with a group of people, or a therapist — the minute I heard of it, I took it right in the studio. And so did pretty much everyone on the team. Which again… is not what you should do because some of it can be triggering.
The average ACEs score is 2. My personal score is 1.
Britt has taken the test. She has an ACEs score of 7. Things like the divorce of her parents, the yelling from her stepmom. The neglect she felt from her father not taking her side. All of the adverse things in her childhood added up to an ACEs score of 7.
So what does that mean? My 1… Britt’s 7? Is that good? Bad?
Well… that’s complicated.
[MUSIC]
Because the researchers have all this data to compare scores with health outcomes, they can start to make correlations between the two. Brian Lynch: [00:01:47] and then subsequently we learn from this study… that these adverse experiences are associated with chronic health conditions in both children and adults.
They could start to say that STATISTICALLY… people who score higher on the ACEs questionnare more frequently experience things like drug use, alcoholism, suicide, going to prison, and risky sexual behavior.
And the higher your ACEs score, the more the risk.
For example, remember I have a score of 1. That means I’m twice as likely to suffer from alcoholism than a person with a score of 0.
But Britt has a 7, which means she’s at least 7 times more likely to suffer from alcoholism.
Remember… increasing the odds is just that, higher odds – not a determination for your life.
And that increase is not linear. The risks for some things escalate much faster than for others.
So for example… I’m twice as likely to attempt suicide than someone with no ACEs, whereas Britt would be 12 times more likely.
And the same trends apply to diseases like cancer?
[Record Scratch Sound]
Yeah. Cancer. Because toxic stress weakens our immune system, and can increase our risk for cancer and plenty of other terrible things…
Hepatitis, liver disease, heart disease, chronic obstructive pulmonary disease, frequent headaches, multiple bone fractures and 16 different autoimmune diseases. And more and more.
If you’re like, OH GOD THESE ILLNESSES! There are so many! Yeah. That’s true. An ACEs score correlates with higher risk for most of the illnesses that constitute the leading causes of death in the United States.
Brian Lynch: [01:05:52] we’ve traditionally attributed these conditions to either the genetics you’re born with, the behaviors you have including, smoking, physical inactivity, eating habits and your age.
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Brian Lynch: [01:06:47] Well, of course those health behaviors of smoking or physical inactivity or poor diet are gonna increase your risk. But now what’s understood is even separate from those risks, just having that adverse experience as a child also increases your risk. So it probably makes it extra important if you’ve experienced adverse childhood experiences to not participate in those high risk behaviors that increase, than your risk for those chronic diseases like heart disease or chronic obstructive pulmonary disease.
And beyond those behavioral, mental, and physical risks, there’s the correlation with life expectancy.
Let’s say your ACEs are a 1 or a 2 like me… well, good for you! Our average life expectancy is 80 years.
Let’s say your ACES are a 6 or higher like Britt… your average life expectancy is 60 years.
That is 20 years less.
[MUSIC]
This is why experts are calling childhood trauma a public health crisis. Brian Lynch: [00:03:12] So this finding… that adverse childhood experiences are associated with these chronic diseases… makes it imperative that we address… this… currently very under-addressed… public health threat.
So when we take this big picture, data view of the issue… when we put all of our terribles together, we don’t just measure what can go wrong with people… we can start to study how people can short-circuit the worst possible outcomes… and create a better path. We can start to see HOW to care for ourselves and for one another. How to show up beyond instagram memes.
We can start to see why the question we developed early on in the episode isn’t “what’s wrong with you?”
But “what happened to you?”
And “what can we do to help?”
Even Britt’s dad says — about his wife — that “the more and longer I know {her}, the more I understand how she was brought up and her struggles.” We don’t know what happened to Britt’s stepmom. We just know what happened to Britt. [MUSIC]
So… what is Britt supposed to do with her score? What does that mean for her?
Is she totally doomed?
No! Probably not! No. None of us are doomed.
In what we told about Britt’s childhood we basically reduced her down to her sad childhood story. Just her ACEs. But no one is just a sad story or just ACEs.
Brian Lynch: [00:21:48] it doesn’t look at it in a three dimensional lens. It doesn’t look at the fact that… what is going on around you while you’re experiencing the ACE really impacts those health outcomes.
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Brian Lynch: [00:36:51] Probably with everybody we live with in our lives, we have positive and negative experiences. And… just like the negative experiences can increase risk for health concerns, the positive experiences… can… mitigate those risks or decrease those risks.
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Brian Lynch: [01:19:07] So it’s gonna be very important… to… if you identify that you’ve got ACES in your life… to make sure and see that within the full context… of what else was going on at that time.
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Brian Lynch: [00:21:58] Do you have protective factors in place? Do you have supportive adults around you? Do you have self-confidence, self-worth?
How does all this research help us be kinder to ourselves and each other? To not live out our worst possibilities?
And how do we talk about resilience?
And we’ll get into all of that… in our next episode.
We’ll go back and take another look at Britt’s childhood from the perspective of protective factors.. We’ll hear about how Britt and the family is doing now.