A new and profoundly important paradigm for understanding overwhelming emotional pain has emerged over the last few years, with the potential to change the way we conceptualize human suffering across the whole spectrum of mental health difficulties. It is an evidence-based synthesis of findings from trauma studies, attachment theory and neuroscience, which offers new hope for recovery. It also presents a powerful challenge to the biomedical model of psychiatry in that it is based on scientific evidence that substantiates and attests to what many individuals with first-hand experience of mental health problems have always known — that the bad things that happen to you can drive you mad.
The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study revolutionizes the way we think about the body and mind.
The ACE Study settles the question of whether we are shaped by genetics or the environment: we are shaped by both. Nature Versus Nurture: Where We Are in 2017
The ACE study proves that child abuse causes enduring neurological damage that can affect a person’s health and quality of life throughout the lifespan.
The body of a frightened child floods with hormones and prepares to fight, run, or die.
In less than an instant, the amygdala sends an alarm to the hippocampus, which tells the adrenal glands to release adrenaline.
Adrenaline increases heart rate and breathing, oxygen goes to the muscles and brain, which increases hearing and sharpens eyesight.
Adrenaline wears off and cortisol takes over; cortisol is a longer acting stress hormone designed keep the body alert.

If a child fears for his life, he may freeze and go numb.
For a prey animal in the wild, numbing is a blessing.
For abuse survivors, it means gaps in memory
During the fight, flight or freeze response the brain inhibits the prefrontal cortex.
The prefrontal cortex is responsible for retrieving memories.
The memory is there but the brain can’t retrieve it.
A chronically abused child lives in fear which damages the structure and
functioning of a the brain. Harvard University
The toll of chronic fear on physical health includes:
- Immune system dysfunction
- Endocrine system dysfunction
- Autonomic nervous system alterations
- Sleep/wake cycle disruption
- Eating disorders
The toll of chronic fear on emotional health includes
- Difficulty forming attachments
- Learned helplessness
- Phobic anxiety
- Mood swings
- Obsessive-compulsive thoughts
- Dissociation from self

It takes nine months for the fetus to become a baby that can survive beyond
the womb.
Between birth and the age of two, we have no words; for the first ten years of our lives, we are helplessly dependent on our parents and communities for our physical and psychological well being.
Child abuse is a betrayal of unconditional trust.
You don’t just ‘get over it’.
People with dissociative disorders report the highest occurrence of abuse and childhood neglect among all psychiatric disorders. This suggests dissociation is the ultimate reaction to significant trauma. Links between Trauma, PTSD, and Dissociative Disorders
A 2018 review found changes in the structure of the brain in people with DID. These changes are complex and include decreased limbic activity, increased frontal lobe activity, and changes in communication between these two regions.

DID is something done to you, like the rapes and daily beatings.
One must accept what happened and make peace with it.
Acceptance means seeing what might have been and grieving the loss.
Acceptance means letting go of the idea that I brought it on myself, that I am shameful and not good enough, and it means not letting the dismissive arrogance I sometimes encounter gnaw at my soul.
Acceptance means holding abusers accountable for the messes they make.
Acceptance means believing the abuse will end.
I am not completely there.
How do I accept the evil of child abuse when the abuse never ends?
For now, broken but better is the best I can do.
DID: When Everything is a Trigger
Get Your ACE Score
(C)Rob Goldstein 2019
‘Child Abuse Lasts Forever” (C) Rob Goldstein 2019
All other graphics were found online and are used here for educational purposes.
Your post presents some very interesting findings in a fair and straightforward presentation. Thank you. Although I was never physically abused as a child, there was emotional, hurtful damage done from careless words and attitudes. Your post makes me think SOME of the mental/physical issues I deal with today started way-back-then, perhaps. My surge of adrenalin in potentially psychically threatening situations is definitely a real thing, and wherever it developed or started from, although unknown is a very REAL thing.
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It’s logical that our developing brain would be affected by environmental factors before and after birth. The thalidomide tragedy is dramatic example of how combinations of chemicals can interfere with the normal development of a fetus. And you’re right, verbal and psychological abuse is insidious and just as harmful as physical abuse. Thanks for reading the post and leaving a comment.
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You always give me something to think about, and often to apply to my own life or situation. TY!
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Thank you, Rae. I’m glad you got something good from the post. I think it’s great that psychiatry is returning to principles of healing the mind after years of focusing on managing behaviors.
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A beautiful image to go with this post, Rob. The doll looks different to me.
This study information is not just important, it is validating. Thanks for adding your mindful elaboration. Hugs on the wing.
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That’s Bobby as a 12 year old. When the whole second life thing started, Bobby was about 12. He’s aged up since then. 🙂
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Wow. This is enlightening. Thanks for sharing.
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Thanks you for reading it and leaving a comment. It’s a fascinating study and it may revolutionize the treatment of mental illness. Wouldn’t it be nice if we could prevent it by giving our children the resources they need to thrive?
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It would be nice, but sadly, the parents would need the resources first. I shudder to think what I put my kids through, inadvertently.
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I sense that Americans want to restore elements of the New Deal. It;s not like the United States doesn’t have a history of investing in its citizens. I frankly don’t understand the confusion over the differences between outright socialism and regulated capitalism. The generation that gained the most from the fully funded public education and safety net programs is still alive and should still have functioning memories.
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Here, here! I don’t get that either.
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It’s all so strange. It’s as if I woke up in an alternate universe in which the Confederacy won the American Civil War.
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Thanks for sharing this important study, Rob. Hopefully, it will lead to better understanding and more effective treatments.
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I was surprised to log into twitter this morning to see Senator Elijah Cummings use the ACE study to argue against Trump’s Family separation policy. For me it’s a relief and a blessing. It’s difficult not to internalize stigma so on some level I blame myself for this beast of an illness. Knowing that medical science can prove why and how it happens is comforting. Perhaps we will discover new ways to treat trauma. Thanks for stopping by, Mary. 🙂
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I get full of self-blame too Rob… but in my heart I know that the bullies and abusers are there, no matter how many people want to “turn on the gas light.”
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It’s horrible. I’ll repeat what I wrote before: The difference between the trump administration and life in a violent community of racist psychotic drunks is zero
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Will you reblog, I’m getting an error. I haven’t been able to reblog in several days. It’s rampant. 🙂
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My ACE score is 6. Didn’t read what it meant. Maybe good?
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The higher the score the greater the chance that some of aspect of your childhood was abusive. A good rule of thumb is, if you keep letting abusers into your life, you were probably abused.
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I think I sent you a wrong comment.
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Robert, you are a work in progress and you have got so much insight, also about what to do to be able to go on and also feel alive without the abuse.
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I’ll be honest Irene; the Trump administration is taking a huge toll on me. My therapist tells me that therapists in general are seeing more symptoms in patients as trump escalates his gas lighting and abuse. Trump behavior triggers my symptoms and makes me feel crazy. The last straw was the photo of trump using an infant whose parents died in a massacre as a prop. That infant is an orphan because of trump’s abuse of the power of the president. All I could think of is how violated that child will feel when he’s old enough to realize why his parents were murdered. I can’t stand to see how easy it is for a rich psychopath to get away with the psychological abuse of an entire nation.
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I hear you, Robert.
I can only agree with you, he is an abuser. I view him as a narcissist at high level. He will never do anything, if he doesn’t get anything. Unfortunately there are several of his kind in the top of many countries at the moment. I hope, that people in those countries will wake up, before it is too late.
They destroy everything around them.
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They seem to thrive on hurting innocent people.
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They hunt all they are able to, Robert. This is also why, it is so important for people to wake up and see the reality, as it is.
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I agree, Irene. Today was another terrible day. Now he’s launching anti-Semitic attacks and has thinks he’s the savior. The difference between trump’s presidency and life in an alcoholic family ruled by an abusive narcissist is zero. Thank you for giving me a chance to vent a bit. 🙂
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Let us hope for a new and much better president next time, Robert. This one destroy all, he touches. Take good care of yourself.
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Thanks Irene. I hope you continue to get better. 🙂
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Thank you Robert.
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🙂
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P.S. Thank you for your kind and encouraging words.
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You deserve them, Robert.
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Thank you, Irene. I hope this passes. Life is already painful for so many people. Kindness makes a difference.
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I found this full of good information. Thank you for sharing this. I went to the Ace link. I strongly believe in the later life issues on the whe body, mind and soul. Hopefully its a trend that will diminish .
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Thanks Denise. It makes seems logical to conclude that we are is product of genetics and environment. I shudder to think of where I’d be if I didn’t have such a strong will to survive and learn.
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Reblogged this on Survivors Blog Here.
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Thank you for sharing, Rob. I studied the ACE a while back and most of my clients suffered from it with different degrees. Yes, understanding, accepting, and recognizing what triggers the current behaviors help. Nobody is completely there, it’s a daily coping. Thank you again!
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Thank you, Miriam. So much has changed in the decade since my diagnosis. The ACE study is a compelling argument for treatments that use a combination of approaches, including structured settings and psychotherapy.
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Yes, I’m glad the treatments are very promising, Rob!
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Neuro-biology confirms many of Freud’s ideas. Our childhoods and cultural experiences have a profound effect on our minds. It’s good to see the ‘mind’ return as a factor in our discussions of policies related to health care.
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Powerful information, Rob. Thanks for sharing.
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Thanks John. Now that we know the medical and social cost of poverty and violence on our children, I hope we can put an end to political theater and get down to crafting policies designed to protect the health and well being of our children. All of them. I hope. Thank you for stopping by and leaving a comment. 🙂
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You are asking a lot of a gaggle of politicians.
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I believe we can find good political leaders, John. That faith in the possibility of principled leadership keeps me going. I also know it’s a long shot. 🙂
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I’m reflecting on the past thirty years. Been a problem with our Congress.
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Yes. There’s been a problem with the country in general. This either an opportunity to fix it, or to decide we don’t care any more and give our freedoms to a tyrant.
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I agree.
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I should add that my personal experience as a gay activist is the system works when citizens unite to make it work. It took a lifetime to end sodomy laws and make gay marriage real, but we did it.
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Very true. Our leadership in government is a disgrace. I’m talking both the executive and legislative branch. It’s like watching a group of kindergarten kids on a playground. Meanwhile nothing of substance is getting done.
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Right John. It doesn’t have to be like this and I sense the millennial generation is willing to sacrifice for something better. I don’t know how it got this bad but I do know we as a species have the power to change it. The problem is one of will. The prognosis is not good. We have the catastrophic climate scientists predicted in the 1960’s, and our climate policies are actually moving backward. If Homo Sapiens doesn’t survive, I hope whatever intelligence rises after ours does. Our self-destruction is a tragedy, but this planet, and the universe, and life will go on.
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Maybe the new species will have learned something.
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It’s possible the multiverse is full of intelligent life, but not the kind that makes tools. We have dozens of examples of this on Earth. My favorite fantasy is we’ll perfect self replicating AI based robots and send them to explore other planets and solar systems before we go extinct.
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Good one.
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I’d love to be able stick my brain in an Android’s body and fly into deep space. In space, no one can see you switch. 🙂
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Ha haha
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