DID: The ACE Study

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.

A New Paradigm for Understanding Severe Mental Distress

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.

Illustration from Harvard Medical School
Understanding The Stress Response, Harvard Medical School

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

The Pyramid of effects of abuse on the lifecycle
Abuse Affects the Life-cycle

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.

An illustration depicting a little boy glaring at his drunken mother, passed out on the floor
Child Abuse Lasts a Lifetime

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.

Happy Birthday Daddy 1940-1992

from the Looking for the Light Blog

Looking For The Light

The morning after you killed yourself we went to secure the house. I knew immediately you suffered slowly. Among the papers, trash and clothes I found your lock box. The divorce paperwork to my mother, every card I gave you as a child. I found the pad you were writing on. Your Bible on coffee table, dried tears as you read Job.

The note had 11:30 a.m. written in corner. I could see you called your best friend and the phone number to a suicide line. There were words and a drawing that made no sense. Granny paralyzed, crying, asking why. The house ransacked, not sure anything made sense to her.

Dirty dishes piled high, nothing in refrigerator, how did you live like this, how long? You phoned me several times in the months before your death. Delusional and highly paranoid each time. Someone was tapping your phone, they were trying…

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The Chat

CAUTION: May be triggering.

Kaitlyn: Me too. I dream about houses that I’ve seen but don’t
recognize.  And yes. There was a woman. The woman was his
accomplice.  She led the police to Mom’s body after the killer
ditched her.

Benjamin: Wow! It’s strange I dreamed that woman!
In my dream, she’s in her late forties.

Kaitlyn:  I’ve never seen her. I saw the man though.
It took police a year to find him. The woman never
did time. But he got life.

Benjamin:  Was it a robbery?

Kaitlyn: No. I don’t think so. Mom was found at the woman’s house.

Benjamin: I thought it was a hotel.

Kaitlyn: No, it was her house.

Benjamin: She had a house?–was it big?

Kaitlyn: The woman lived in a housing project. Like the one we grew  up in.
I once drove by out of curiosity.

Benjamin: The house in my dream; it had two floors.

Kaitlyn: Her house was like the one we had in Ben
Tillman Homes.

Benjamin: Right!

Kaitlyn: This place had two floors.

Benjamin: There were stairs?

Kaitlyn: Of course!

Benjamin: In my dream, I went upstairs…

Kaitlyn: I know so much about Mom’s death.

Benjamin: Was anything…? Did Mom have her ring?

Kaitlyn: She was badly beaten.

Benjamin: I mean, do you know if her ring was gone?

Kaitlyn: I don’t know

Benjamin: Wow! I wonder…

Kaitlyn: The Coroner said there was no rape and she
didn’t have nothin’ to steal.

Benjamin: Was she found upstairs?

Kaitlyn: She was found downstairs…In the living room.

Benjamin: She always wore her ring! It was her
engagement  ring; was that listed?

Kaitlyn: I dunno.

Benjamin: Why was she there?

Kaitlyn: …It was her birthday an she was homeless
an she met this guy an he got her got her drunk an
got her into that house and I dunno! Nothing ever
makes sense!

Benjamin: I’m sorry, Kate.

Kaitlyn:  She died a horrible death.

Benjamin: I see her death over and over in my mind.

Kaitlyn: I dream about finding her body.

Benjamin: Hey! I had a dream last night but it wasn’t
about Mom! It was about a woman making porn.
(laughs) What a funny dream!

Kaitlyn: Maybe you dreamed up Mom’s shitty best
friend, Skip.

Benjamin: Skip? I don’t think I remember her.
Did Skip make porn?

Kaitlyn: You don’t remember her?

Benjamin: No!

Kaitlyn: You don’t remember we got taken away
from Mom and placed in foster care with the

Benjamin: No!

Kaitlyn: We stayed with Skip for over a year!

Benjamin: I don’t remember that!

Kaitlyn: You don’t remember any of it?

Benjamin: I must have been little!

Kaitlyn: Ben, you were nine.

Benjamin: I remember a lady that made phone calls to Jesus.

Kaitlyn: “Jesus” was a guy named Dan. Dan was Skip’s boyfriend.
Skip called “Jesus” so Dan could tell her what kid he wanted that night.

Benjamin: I remember it scared me when the lady called Jesus.

Kaitlyn: There were five other kids besides us. You were Dan’s favorite.
He always said you were too pretty for a boy.

Benjamin: Oh my God! Did Skip make porn!

Kaitlyn: Ben, do you really want to know?

Benjamin: NO!…OK!…no…ok…

Kaitlyn: Ben, Skip had sex with you for Dan. Dan got off on it. He took pictures.

Benjamin: In my dream, the lady squeezes a pillow between her thighs.

Kaitlyn: In the morning, your face was always rubbed raw, I didn’t really
understand why until now.

Benjamin: …Maybe it’s better to leave the past alone.

Kaitlyn: That’s not so easy! Not for people like us!

Benjamin: I don’t remember!

Kaitlyn: I wish I could fucking forget!

Benjamin: I’m sorry Kate. I didn’t mean to piss you off.

Kaitlyn: Mom told me once that she wanted to go to
Hell for what she did to you.

Benjamin: Did she say what she thought she did?

Kaitlyn: Dreams have meanings. I have beliefs too!

Benjamin: Umm…OK…Tell me about your beliefs.

Kaitlyn: OK. I believe Mom comes to us for a reason. And I think she is trying to help us resolve something or solve something and she won’t rest until we get it done.

Benjamin: So, death is Mom’s chance to be a good Mother?

Kaitlyn: You’re still a little snot, Bennn-jamin!

Benjamin: I’m sticking my tongue out. I hope she comes back as a Ford.

Kaitlyn: Stop making me laugh! You’re lifting my mood!

Benjamin: How much you wanna bet that guy took Mom’s ring!

Kaitlyn: He prolly did. Hell, he took her life!

Benjamin: Hey…Maybe we could get together and go to Charleston and do some research…

Kaitlyn: It’s up to you

Benjamin: Or maybe not.

Kaitlyn: I think Mom knew she had met her death that night.

Benjamin: You know Kate, every dream I have about Mom takes place in
a house I’ve never seen, but think I know. Do you have that dream, Kate?

Kaitlyn: Me too. I dream about houses that I’ve seen
but don’t know.

Benjamin: I’ve had two dreams about Mom this month.  She always comes at Thanksgiving and leaves after  Christmas.

Kaitlyn: That was her favorite time of year

Benjamin: I didn’t know that.

Kaitlyn: Yea it was. She loved the holidays. Ben? Don’t
you remember the fuss she made over Christmas?

Benjamin: No. I remember almost nothing. When I left, I left completely. I  wanted to be to be free of Mom and the pain and the stupidity of that disgusting little town with it’s hypocrisy and ante bellum pretensions. I hate everything about it! If I could go back in time I’d give Abie baby a Nuke and tell him to use it.

Kaitlyn: (laughs) Are you saying you don’t like the City of Charleston?

Benjamin: (laughs) A little. Let’s talk more about Mom.

Kaitlyn: I had a long talk with Mom after Dad died.
Are  you sure you want to talk about Mom?

Benjamin: Yes…

Kaitlyn: Mom said that when she was 16 her Father died and she  had a nervous breakdown. She said she felt trapped  when he died because he loved her and treated her like she mattered. But her Mother–

Benjamin: Grandma…

Kaitlyn: Yes, Grandma, Her favorite was her oldest Son, Alex. Mom said she
disappointed Grandma because she wasn’t beautiful.

Benjamin: Mom was beautiful!

Kaitlyn: Yeah, but not the way Grandma wanted.

Benjamin: Grandma thought Mom was beautiful, too!

Kaitlyn: Ben! You said that you wanted to hear this. I won’t tell it to you if it’s going to make you angry.

Benjamin: I’m sorry.

Kaitlyn: Mom said that when she got sick Grandma thought she was acting crazy for attention. Mom said she lost control and wound up at “Bellevue”. The shrink there wanted to keep her but Grandma pulled her out and sent her on a “vacation”. Mom said Uncle Alex had married a “rich piss-elegant bitch” from Charleston.

Benjamin: (Laughs) I bet she delivered that line with a z snap!

Kaitlyn: Yeah…So Grandma sent Mom to to “the low-country” to meet Aunt “Lauren”.

Benjamin: (Laughs) How low can it go!

Kaitlyn: Pretty fuckin’ low! Mom said Grandma bought her a whole new wardrobe based on Aunt Lauren’s.

Benjamin: I remember that scene from “Now Voyager“.  See!  I do remember something!

Kaitlyn: Imagine my eyes. Now imagine them rolling.

Benjamin:   (laughs) That must hurt.

Kaitlyn: Mom said that when she arrived she met Lauren’s “beefy” cousin and married him a week later.

Benjamin: Guess that was Dad.

Kaitlyn: It’s hard to think of Dad as “Beefy”

Benjamin: Sounds like she wanted to get the hell out of New York.

Kaitlyn: That’s what she said. You were born ten months later.

Benjamin: I always wondered about that. The neighbors used to call her that  “Yankee whore”. They hissed at her when we went out.

Kaitlyn: Hypocrites live everywhere, Ben.

Benjamin: So I was born. What did she say about it?

Kaitlyn: After you were born she felt all wrong. She said she loved you but was angry and felt trapped. She said she hurt you when you were three weeks old and got scared and called Grandma. Grandma came down from New York to help.

Benjamin: Did she say how she hurt me?

Kaitlyn: It frightens me to say it.

Benjamin: It scares me a little too. How did she hurt me?

Kaitlyn: Oh Ben! She pressed a hot iron onto your back.

Benjamin: …Oh!

Kaitlyn: Mom was diagnosed with schizophrenia!

Benjamin: Jesus Christ!

Kaitlyn: She was sick!

Benjamin: No wonder I’m a mess!!

Kaitlyn: Grandma asked Uncle Alex to take you so Mom could have a break but he thought Mom was exaggerating and said that the burns weren’t  that bad–also, he didn’t like dad.

Benjamin: The burns weren’t that bad? He blamed Dad?

Kaitlyn: He called Dad a ‘poor Jew boy’ and shamed Mom for getting married to him. He said that neither of them was good enough for you cuz as you got older he could see that you were smart. He didn’t like that either.

Benjamin: Uncle Alex said that Mom and Dad was no good for me?  And he didn’t like me for being smart?

Kaitlyn: Yes. Grandma said she thought you were gifted. Uncle Alex was jealous.

Benjamin: Wow!!

Kaitlyn: Uncle Alex thought Mom was pretending. He said if Mom didn’t act normal he would take permanent custody of you.

Benjamin: Grandma and Uncle Alex left me with a woman who tried to kill me?

Kaitlyn: That was Mom’s biggest fear. That she would kill you.

Benjamin: I’m so confused!

Kaitlyn: Mom did her best to make everything right, but she had another fit. She said that she called Uncle Alex one last time and begged him to help.

Benjamin: What had she done.

Kaitlyn: She said that she had burned your arms and legs.

Benjamin: …no…

Kaitlyn: She said Uncle Alex said it was normal to lose patience with kids. Mom said that after that she went numb.

Benjamin: When did Mom get that diagnosis?

Kaitlyn: She got it when I had her committed.

Benjamin: You had her committed?

Kaitlyn: She had stopped taking care of herself. And I wanted to get her off the street.

Benjamin: That must have been hard, Kate.

Kaitlyn: I did what I had to do. She was in the hospital for thirty days. She never really tried to get better.

Benjamin: None of this feels real…

Kaitlyn: She tried to commit suicide about a year after dad died.  I went to her. She was scared to love anyone, especially us. She was afraid she would hurt us. She was especially afraid of you.

Benjamin: I hate this story! I don’t want this story!

Kaitlyn: We didn’t choose this!

Benjamin: Kaitlyn–I want to ask you a tough question…

Kaitlyn: Ask.

Benjamin: Did you purposely set it up to have your Daughter taken away.

Kaitlyn: Prolly did. I couldn’t let her go but I was afraid to keep her.

Benjamin: I thought so.

Kaitlyn: Ben, did you decide to go Gay so you wouldn’t have kids?

Benjamin: I don’t think you can decide things like that but if it was a choice then yes.

Kaitlyn: When I think of the lives we could have had I get sad.

Benjamin: Why was Momma afraid of me.

Kaitlyn: You really don’t know, do you?

Benjamin: No.

Kaitlyn: She told me she really loved you and respected what you did with your life.

Benjamin:  Like spending most of it in and out of psych units!

Kaitlyn: She said the last time she saw you, you were angry.

Benjamin: I said, “I’m so mad at you I can’t sit next to you”.

Kaitlyn: That was when she knew she was gone for you.

Benjamin: Gone?

Kaitlyn: She said you had wished her away.

Benjamin: …What did she mean?

Kaitlyn: You forget people.

Benjamin: I never forgot Mom!

Kaitlyn: Yes you did!

Benjamin: That hurts, Kate.

Kaitlyn: That’s just your share of the pain.

Benjamin: (Silence)

Kaitlyn: There were crumpled notes in her purse.
Most of them were notes about us.

Benjamin: Ohh…man…

Kaitlyn: Do you want to hear what she wrote?

Benjamin: I have to, right?

Kaitlyn: No. You can hang up and forget her again.

Benjamin: (Silence)

Kaitlyn: She wrote that God had gifted her with two beautiful children and that she had tortured them.  She wrote that she tried to get help but all she found were harsh judgments and that the result was that she became angry and bitter.  she was in trouble and that we were in danger and that She wrote that everyone knew they shamed her instead of doing what they knew was right by us. She wrote that she wanted to take back our wounds and that she was ready to go to hell–especially for what she had done to you.

Benjamin: It sounds like a suicide note.

Kaitlyn: She didn’t think she had a right to live.

Benjamin: (Silence)

Kaitlyn: She wrote it a week before she was killed.

Benjamin: (silence)

Kaitlyn: (silence)

Benjamin: You know Kate, every dream I’ve ever had about Mom happens in a house I’ve never seen, but think I know. Do you have that dream, Kate?

The Chat – 2 –




Image and text (c) Rob Goldstein 2014-2017 All Rights Reserved