Adverse Childhood Experiences (ACEs)and Neuroplastic Symptoms

By David D. Clarke MD (Association for the Treatment of Neuroplastic Symptoms)

How can you tell if you are still affected by ACEs?

ACEs are life events you would not want for a child of your own. They range in visibility from the traumatic (such as physical or sexual abuse) to subtle pressures to perform, to solve family problems, or to suppress emotions. Any of them can have significant long-term impacts on mental and physical health far into adulthood. 

In thousands of my patients who had neuroplastic symptoms for longer than a year or whose symptoms were numerous or severe, ACEs were present in nearly all I can recall. The challenge is that many people with ACEs do not recognize them. Unless you understand the impact of your ACEs, recovery from neuroplastic symptoms is likely to be slower or incomplete. 

ACEs are very common. Even when screening is limited to just ten types of ACEs, more than half the population experienced at least one and nearly a quarter experienced at least three. They are strongly associated with every neuroplastic condition in which they have been studied and with many conditions of the body such as obesity, autoimmune illnesses, cancer, diabetes, and heart disease. 

Many more than ten ACEs exist, however, so the ATNS relies on a single broad screening question:

If you learned that a child you care about was growing up exactly as you did, how would that make you feel?

1. Happy

2. Neutral

3. Sad or Angry

4. Very Sad or Very Angry

Notice the shift from asking a person about their ACEs to focusing on an innocent child. This helps people to more accurately recognize the magnitude of the adversity they endured. 

In a representative U.S. national survey that compared this question to the 10-item research questionnaire, people who answered “Happy” had an average of 1 ACE and people who answered “Very Sad or Very Angry” had an average of 5 ACEs. An astonishing 58% of the sample responded “Sad or Angry” or “Very Sad or Very Angry.”

What are the impacts of ACEs on adults?

The next step in assessing yourself for ACEs is to look at four categories of their impact on adults. These are personality habits, triggers, problematic coping measures, and repressed emotions.

The personality habits are learned by children who are coping with an adverse environment by trying to improve the situation in every way they can. They are watchful, detail-oriented, trying to be the best children they can be, feeling responsibility for events that go wrong, depriving themselves of opportunities for carefree play, and trying to solve all the problems they encounter. As adults, these characteristics can turn into stressful personality habits commonly seen in people with neuroplastic symptoms, including:

Internal Stressors

• Low Self-Esteem

• Excessive Self-Criticism

• Limited Self-Care Skills

• Perfectionism

• Living on High Alert

• Anxiety and/or Depression

External Stressors

• Focus on pleasing others

• Choosing problematic or narcissistic partners

• Co-Dependency

• Self-sacrifice

• Difficulty setting boundaries

• Poor assertiveness

• Fear of abandonment

• Need for external validation

Positive Traits (still a source of stress)

• Highly Reliable

• Detail-Oriented

• Compassionate

• Hard-Workinga

Learning how these habits developed during your childhood facilitates change. For example, I often suggest to patients that their ACEs are analogous to parachuting into a dangerous jungle or mountain range as a toddler. This was not their fault. In addition, the heroic perseverance needed to endure the ACEs can be a source of self-esteem and pride. As that new self-image is internalized, the need to be perfect declines, willingness to take time for enjoyable activity increases, reduced tolerance for toxic people supports boundaries, and the concept that “I deserve better” takes hold.

Triggers are people, situations, or events that are highly stressful because of links to ACEs or trauma. A common example is an adult (such as a parent) who caused adversity for you as a child and who is still active in your life today.

Ironically, positive life events also can be triggering. Examples include a first mutually supportive relationship or a life affirming career milestone. These can be triggering for people who have not experienced love or affirmation in the past. A person might feel unworthy of the positive event (impostor syndrome) or fear it will not endure. Positive events also can highlight the injustice of maltreatment in the past. This can stir up anger or resentment (though often unconsciously).

Problematic coping measures provide relief from the stress linked to ACEs. These include:

• Addictions to substances (nicotine, alcohol or drugs) or behaviors such as sex, food, gambling, pornography, work, exercise, shopping, hoarding and others

• Eating disorders provide a measure of control for people in emotional chaos

• Cutting or self-mutilating behavior provides the relief of feeling something to people who have lost contact with their emotions (alexithymia). 

Repressed emotions are often the most challenging source of stress to diagnose. Children learn this either because it helps them cope with ACEs or because their families encourage it or both. Because they have lost the ability to feel or express emotions, they resemble dormant volcanoes with solid rock on the outside and boiling magma on the inside. Their anger, fear, shame, grief, or guilt finds its outlet via the body as neuroplastic pain or illness. 

In some of my patients a repressed emotion (usually anger) is felt or expressed in another form such as grief or depression. For these patients it is important to learn the details about experiences that cause their sadness or depression. Then consider whether those experiences would make most other people angry or afraid. If so, the techniques described next will probably be helpful.

The single screening question above is a good way to begin the process of uncovering repressed emotions. Another exercise is to imagine watching the child in that question as they try to cope with your ACEs for a week or so. Journaling about how that would make you feel and what you would say to the child to give support often provides insight. 

Free writing is another option for connecting with repressed emotions. Choose an important ACE-related person, event, or situation and take 10 minutes to rapidly write every thought, word, or phrase that comes to mind. Avoid analyzing or worrying about spelling or grammar. This will help your subconscious communicate more directly, bypassing the repression process. After you finish, study what you wrote and create a journal entry about what it means to you.

The good news from all this is that by understanding the long-term impact of ACEs on adults, many ACEs-related stresses will improve. This can lead directly to relief of neuroplastic symptoms.