©Arlene R. Taylor, PhD

“The Body Keeps the Score.”
—Bessel Van Der Kolk, MD

“The holidays are coming. The ‘goose’ is already obese. I simply don’t think I can make it through another season visiting my family. Supposedly, everyone is celebrating. In fact, the ‘goose’ would rather die than go through the ordeal. I look around the house and feel like throwing up. I don’t know why, but that is what happens. Unfortunately, if I go, I know I will overeat again. It’s the only comfort during the entire season. I do not want to do that. Unfortunately, the ‘goose’ is also out of acceptable excuses. They keep insisting I visit, but when I do, either I am ignored or am the butt of ‘fat’ jokes.” Melannia squirmed her rather massive self in the wooden armchair. It creaked ominously. “I feel like I am walking into hell and don’t know why....”

“How many years have you and I been through this?” asked the Doctor. “Whatever happened to you in childhood is coming out in your body. Your body keeps the score, you know. Until you are willing to deal with your past, I believe you will continue to gain weight along with an increased risk for 50-plus diseases associated with obesity.”

“Please tell me that you are not going to talk about family-of-origin work again!” muttered Melannia. The chair creaked once more.

The Doctor shook her head. “I am going to talk about ACEs,” she said. “Adverse Childhood Events.”

“I know I am morbidly obese,” said Melannia. The chair continued to protest. “But I’m sure if I get my stomach stapled everything will be all right.”

“I am just as certain that unless you and I can get to the bottom of the reason you are obese and hanging onto each pound with a tenacious grip, nothing will change for the better—even if you do get your stomach stapled. That would be a wasted surgical procedure—and dangerous at this time—in my brain’s opinion.” The Doctor was firm.

“All right,” sighed, Melannia. “Tell me about, what was it? Oh, yes, ACEs.”

“A landmark study of Adverse Childhood Events, led by Dr. Vincent Felitti, has linked ACEs with lifelong consequences: Chronic Depression, Obesity, Suicidal thoughts, Smoking, Alcoholism and similar addictive behaviors that accelerate aging, risky sexual activities, and other dysfunctional behaviors including violence.”

Melannia’s eyes widened. “You know that I simply cannot think of any Adverse Childhood Events that could have triggered them. My obesity is the issue.”

The Doctor nodded. “I know you cannot recall any ACEs. I also know that obesity is not the real issue. I believe it is only a symptom of underlying, often unidentified, ACEs. Until you dig to discover Adverse Childhood Events, look at them with adult eyes, and do the work to recover from them, the symptoms will not go away for any length of time. They can eventually shorten your life. It would be such a pity for your life to be shortened simply due to ACEs that you experienced due to no fault of your own.”

“So, you want me to spill my guts. Even if I could recall something, would that lose some of this weight?” Melannia chuckled scornfully. The chair squeaked again.

“Actually, no, on both accounts,” said the Doctor kindly. “What I would like you to do is simply look at this list and circle any that apply to you from childhood. They come from the Adverse Childhood Events or ACE research. Ten categories (not events) were identified of equal impact when determining a person’s ACE score.”

“I doubt I have any, but what if I do?” asked Melannia. “What then?”

“Then I would refer you to an ACE specialist who can help you recover,” the Doctor replied. Handing Melannia a sheet of paper and a pen, the Doctor said, “Please read through the 10 categories and highlight any that apply to you.” The Doctor settled back calmly to wait.

Melannia accepted the paper and pen and began to read.

The minutes ticked by.

The chair squeaked.

Melannia highlighted and sniffled.

Finally, her eyes filled with tears, Melannia handed back the paper. “I have ACEs in all three of these groups. Moreover, I have remembered the reason I hate going back to my parents’ house. During the holidays they liked to party, and they used to lock me in the closet while guests were there to keep me out of the way. Sometimes they would be so drunk they would forget to unlock the closet and put me to bed. When they remembered the next morning, if I had wet myself from not being able to go to the bathroom, they’d leave me there the rest of the day.”

Melannia’s eyes were very large.

“I would get so hungry and thirsty! No wonder I overeat, period, but especially whenever I return to that house.” She paused. “May I please have that referral?”

The Doctor smiled, nodded, and wrote something on a referral pad. Handing it to Melannia, the Doctor said, “You know you can do this.”

It was Melannia’s turn to nod and smile.

*****

Ten Categories Identified by the ACE Research Study

5 Categories of Household Dysfunction (85 percent of study participants identified one or more). These categories involve growing up in a home in which one or more of the following occurred:

• Substance abuse (27 percent)
• Loss of biological parent <18 (death, suicide, murder, divorce, separation, abandonment, foster, adoption), 23 percent
• Depression, suicide, anxiety, other DSM 5 diagnosis, 17 percent
• Domestic violence of mother, 13 percent
• Incarceration, 5 percent

3 Categories of Abuse (61 percent in the study)

• Physical abuse by parent/parent figure (not spanking), 28 percent
• Sexual contact by anyone, 22 percent (16 percent male, 28 percent female—self acknowledged)
• Psychological/emotional by parent (recurrent humiliation) 11 percent

2 Categories of Neglect (25 percent in the study):

• Emotional, 15 percent
• Physical, 10 percent

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Adverse Childhood Events, Dr. Vincent Felitti
https://juvenilecouncil.ojp.gov/sites/g/files/xyckuh301/files/media/document/ace_studygold_intolead_dr_felitti.pdf