UPDATED FOR 2023. I was standing in line, horrified at how a man in front of me was treating his two little girls.
The girls looked to be about two and four years old. One of them was in a stroller. He yelled at the older girl — I don’t know why. When she started crying, he yelled at her again, threatening to hit her if she didn’t stop crying.
No matter what the kids did — dropped a blanket on the floor, touched the stanchion rope — the guy yelled.
If this father was treating his kids this way in public — what in the world was he doing at home?
Make no mistake — the guy was engaging in child abuse, and the kids will likely suffer from it for the rest of their lives.
I’m not exaggerating. Research shows that children who endure “adverse childhood experiences,” such as abuse and neglect, were hugely more at risk for alcoholism, cancer, heart disease, suicide, drug use, promiscuity — just about all the bad things that can happen in life.
Adverse Childhood Experiences study
The Adverse Childhood Experiences study gathered data from 17,337 patients of Kaiser Permanente, the largest managed care organization in the United States, from 1995 through 1997. The research was conducted by Dr. Vincent Felitti, chief of Kaiser Permanente’s Department of Preventive Medicine, and Dr. Robert F. Anda, of the U.S. Centers for Disease Control and Prevention.
I first learned of this study while reading The Body Keeps the Score, which I reviewed previously. Here’s what the author, Bessel van der Kolk, wrote:
The first time I heard Robert Anda present the results of the ACE study, he could not hold back his tears. In his career at the CDC, he had previously worked in several major risk areas, including tobacco research and cardiovascular health. But when the ACE study data started to appear on his computer screen, he realized that they had stumbled upon the gravest and most costly public health issue in the United States: child abuse. He had calculated that its overall cost exceeded those of cancer or heart disease and that eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, IV drug use, and domestic violence by three-quarters. It would also have a dramatic effect on workplace performance and vastly decrease the need for incarceration.
I was shocked. This research was conducted 25 years ago! How could a problem be this big, yet there be so little discussion of it? Where was the outrage? Where was the demand for public education and solutions?
The ACE questionnaire
The research asked survey participants if they had any of 10 adverse experiences before they reached 18. The first question, for example, was:
Did a parent or other adult in the household often or very often: Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
If a respondent answered “yes” to the question, it counted as 1 point towards their ACE score. There were 10 total questions, which identified the following:
- Emotional abuse
- Physical abuse
- Sexual abuse
- Mother treated violently
- Household substance abuse
- Household mental illness
- Parental separation or divorce
- Incarcerated household member
- Emotional neglect
- Physical neglect
Scores could range from zero — meaning no adverse childhood experiences — to 10. Here is the actual ACE questionnaire:
Only 36% of survey respondents had a score of zero. Conversely, 64% of participants suffered some type of negative experience when they were young.
The researchers found that children often endured more than one type of adverse childhood experience, which meant their ACE score went up. For example, someone who experienced emotional abuse, sexual abuse, saw their mother being beaten, and someone in the house abusing drugs, had an ACE score of 4.
Here’s more info on the study data:
About the CDC-Kaiser ACE study, on CDC.gov.
Health effects
The researchers correlated the ACE scores with study participants’ health records. What they discovered was that the higher the ACE score, the more health problems the children experienced as adults.
Jane Ellen Stevens wrote a terrific series of articles for the Huffington Post called The Adverse Childhood Experiences Study — the largest most important public health study you never heard of began in an obesity clinic. Stevens wrote:
Things start getting serious around an ACE score of 4. Compared with people with zero ACEs, those with four categories of ACEs had a 240 percent greater risk of hepatitis, were 390 percent more likely to have chronic obstructive pulmonary disease (emphysema or chronic bronchitis), and a 240 percent higher risk of a sexually-transmitted disease.
They were twice as likely to be smokers, 12 times more likely to have attempted suicide, seven times more likely to be alcoholic, and 10 times more likely to have injected street drugs.
People with high ACE scores are more likely to be violent, to have more marriages, more broken bones, more drug prescriptions, more depression, more auto-immune diseases, and more work absences.
In her article, Stevens explains exactly how this happens. Essentially, an environment of abuse interferes with a child’s neurological development, which leads to more problems later in life. The ultimate consequence of child abuse? Early death.
What causes child abuse?
To solve the problem of child abuse, its cause first needs to be correctly identified.
Child abuse does not occur in a vacuum. It’s not the flu, where you catch it by touching germs on a door handle, or the zika virus, where you get bitten by a mosquito.
Child abuse is inflicted by another person. And this seems to be the point that no one wants to address.
I did a Google search on “what causes child abuse?” One of the top search results came from the Human Services Department of the government in Victoria, Australia. Here’s what it said:
What are the causes of child abuse?
There is not any single fact which causes child abuse; abuse usually occurs in families where there is a combination of risk factors. Abuse and neglect occur most often in families who are under pressure and lack support. Most abuse other than sexual abuse occurs in families to which some, or all, of the following apply:
- Poverty
- Lack of education
- Serious marital problems
- Frequent changes of addresses
- Violence between family members
- Lack of support from the extended family
- Loneliness and social isolation
- Unemployment
- Inadequate housing
So according to the Victorian government, the top causes of child abuse are poverty and lack of education. Except that’s not what the ACE study found.
The people who participated in the ACE study were mostly employed at companies that offered good health benefits — that’s why they were being screened at Kaiser Permanente to begin with. Of the total, 74.8% were white, and 75.2% had at least some college education or were college graduates.
They were white, middle-class people with good jobs. They came from home environments that enabled them to pursue an education and obtain a good job. Yet 64% of them suffered some kind of adverse childhood experience; 12.5% had an ACE score of 4 or higher.
Conversely, plenty of poor families raise their children with love and care. Low-income parents frequently work hard and sacrifice so their children can have better lives.
So I don’t believe the contention that abuse and neglect occur most often in poor families who are under pressure and lack support.
The true cause of child abuse
I think that the people who are inflicting child abuse are personality disordered.
Experts estimate that 1% to 4% of the population could be diagnosed as psychopathic or antisocial, 6% as narcissists, and 2% as borderline personality disordered. That adds up to 12% of the population.
Gee — 12% of the ACE study participants had a score of 4 or higher. I don’t think that’s a coincidence.
Child abuse is probably caused by people who have personality disorders.
Maybe if our society admitted that bad people live among us, and they do bad things to children, we could start to solve the problem of child abuse.
Learn more: How abusive parents affect you and how you can recover
Lovefraud originally posted this article on April 11, 2016.
LETTERS TO LOVEFRAUD: Pulled in by the child in the sociopath
Thanks for sharing this very important information. I consider myself reasonably well read and informed, but did not know the eyeopening statistics regarding the relationship between adverse childhood experience and health lifelong problems.
The personality disordered will abuse children along with everyone else, unless it suits their motive to be a ‘good parent’ to a certain child at a certain time. Since they don’t care about a child’s welfare, if it suits their purpose to be abusive they will do so. Spaths will not change; no intervention, except removing the child from the situation, will end the abuse, because the spath is doing what he wants to do.
Many studies have shown that potentially good and normal people behave in abusive/harmful ways towards children (and others) under conditions of stress and lack of support, and out of ignorance. These situations can be remedied by education and easing difficult circumstances. There are many examples. Some victims of the personality disordered may have experienced acting in ways we regret, including ways that are neglectful and harmful to ourselves and others, when we were under the stress of a psychopath. In cultures with little stress, stable and secure families, and strong social support systems, there is less child abuse; but these factors have no effect on a spath. When a spath is in a situation, there’s a lot of stress, no stability nor security, and support systems will likely be cut off.
Narcissistic parents set time bombs. While I didn’t have that background myself, all of us here have experienced some version or other of the control and all-about-themness, the emotional neglect and sociopath math, that comes from the disordered. The fundamental dissonance and pain that comes from feeling that someone should care for us and yet doesn’t act that way, how we can internalize this as a problem with ourselves. For a child that would be devastating; they would have no other experience to base a sense of self-worth on, and disordered parents provide at best a highly shifting foundation for development.
Some experts on addiction, like Dr. Gabor Mate (see http://www.huffingtonpost.com/entry/gabor-mate-addiction_us_569fd18ae4b0fca5ba76415c?s284obt9 ) consider that unfulfilled needs, and especially a need to belong, are significant factors in addiction, and that emotional pain often manifests physically if untended. A deep sense of not belonging is also a major contributor to depression and suicide. This makes a sick kind of sense to me — we are social creatures, descended from people who lived in close tribes that needed others to work together for us to survive. The way we bond and instinctively need agreement is part of that, part that sociopaths exploit and use to control us even as they deny us the feeling of belonging and so set us adrift.
Fascinating study. Mind-opening.
From my own personal experience (adopted child) s*x abuse is handed down through the generations. It can infect an extended family. Having met some abusers and abused there’s tons of secrecy and covering up. But they otherwise came across as completely normal. I don’t believe all the people I met had personality disorders.
But abuse – including neglect – does cause attachment disorder.
There are four key (often overlapping) stages in brain development. In the first year of life the brainstem (regulating stress arousal, sleep and fear) is developing. In the first and second years the midbrain (integrating sensory experiences and controlling muscles) develops. From the first to fourth years the limbic system (emotions, language, socialising, empathy, attachment) forms. From years two to six the cortex (abstract thinking, stream of consciousness, humour, creativity, language or maths skills etc.) forms.
Each stage builds on the next, and if one stage is damaged then the next stages can’t function properly. As a minor example our social worker told us it was very important for our adopted child to experience ‘messy play’ (a completely new experience for her). Later on (as with most normal children) there was endless playing of ‘school’ games as she verbalised and processed her emotional experiences. Children who are abused before they can process their experiences through the use of language bury their traumas since they can’t make sense of them (don’t remember where I read that). These buried and incomprehensible feelings can be overwhelming if they suddenly surface.
The connections in a baby’s brain are ‘use-dependent’ i.e. determined by interactions between the baby and the environment (caregivers, noise, shelter, food etc.) At eight months old there are many more brain connections than will eventually be needed. Normal babies’ brains therefore undergo pruning of certain unused connections whilst other connections that aren’t needed are never built. So a child in a farming environment (animals, outside play) will have different physical brain connections compared to a child in an inner city musical environment (musical instruments, indoors).
There are three types of attachment behaviours in babies – aversive (e.g. crying) which their caregivers want to stop, attractive (e.g. smiling) which the caregivers want to interact with, and active (e.g. crawling) where the baby goes and gets the attention of the caregiver.
A baby gets stressed (e.g. hungry), cries and hopefully gets fed by a loving caregiver in a ‘dance’ where stress arises in the baby (and the carer) and is then relieved. An abused baby (neglected, physically abused) will have a brain that is physically different from a securely attached baby, and ready for hyper-arousal (distress, irritability) or dissociation (stressed, but not showing it).
Dissociation (splitting of awareness, distancing) is a despairing defence that protects the baby or child from being overwhelmed and eventually it becomes ingrained as a stress response in adulthood.
Hyperarousal is a less despairing response to being overwhelmed and is an attempt to maintain the energy to defend oneself. In older children it leads to flight or fight. Apparently in younger children hyperarousal leads to ‘freezing’ and regressing as it’s the only available option and demonstrates to any adults nearby that the child is too threatened to cry out and urgently needs help.
Dissociation is more common in girls, younger children, situations of pain, helplessness and inescapability.
Hyperarousal is more common in boys, older children, trauma in which the child is a witness or active participant.
Most abused children use a combination of these behaviours to survive.
Abused babies may show a range of responses related to unregulated stress – crying constantly, not crying at all, being rigid, being limp, jumping when startled, blank-eyed, staring intently etc. As the midbrain develops (years one and two) they may develop muscular (‘clumsy child syndrome’) or sensory problems, for example literally not being aware of their own body. As they get older and the next stage of the brain is being built they may have difficulties with memory, sentences, making sense of pictures and empathy.
Babies try and meet the needs of the caregiver in order to ensure that the caregiver will look after them. Adults have four different attachment styles, and the baby will match the attachment style of the caregiver.
55-70% of adults have a ‘secure and autonomous’ attachment style – they’ve processed all their childhood issues and are emotionally available and responsive without being interfering or overwhelming. Their children develop ‘secure attachments’.
20% of adults have a ‘dismissing’ attachment style. They dismiss the importance of feelings and of their own childhoods in shaping them. Their children have an ‘insecure and avoidant’ attachment pattern, suffering distress but avoiding showing it in order not to make demands on their carers.
10% of adults have a ‘preoccupied’ attachment style. They haven’t moved on from their own childhood issues and are often dependent on the good opinion of their parents. They’re not reliably responsive to the child, though when they are responsive they’re warm. The child can’t trust the parent to respond and so trust is mixed in with stress and rage, leading to an ‘insecure and ambivalent’ attachment pattern from the baby.
Finally there are adults who have an ‘unresolved’ attachment style, typically suffering from PTSD (perhaps from their own childhood) which is described as a permanent state of inner terror which becomes their norm. Babies are very sensitive to the emotional states of their caregivers (on whom their lives depend) and experience overwhelming fear in the presence of such carers. They need their carers but fear with them. The responses of such babies and children are bizarre – they may freeze completely, head-bang or bite, and cannot develop trust, curiosity, empathy or social interaction.
All infants and toddlers have to learn to regulate impulses as well as stress. Their normal unregulated impulses lead to shame but abused children don’t experience ‘I have done a shameful thing, now my carer is making it better’ but (because their carers don’t respond appropriately) experience ‘I am a shameful person’.
Abused children, because of their unregulated stress, may also have damage to the parts of the brain that control impulses.
The feeling of shame occurs before they are capable of processing, let alone understanding, emotions and therefore can become part of their core identity. Such children are likely to be very angry (a common response to shame) and very controlling (they’re so easily hurt and never comforted that they have to be in control at any cost). They try and hide from, and build defences against, the pain of shame leading to ‘crazy lying’, rigid perfectionism, domination and blaming others. Their damaged impulse controls also lead to stealing, destroying property and hurting themselves and others.
If abused children express self-assertive emotions such as sadness or fear etc. they might be shamed by their caregivers and instead of feeling sadness or fear they learn to feel shame instead. They literally no longer feel sadness or fear. All they feel is shame in response to normal emotions, leading to whatever their shame response is – self-harm, alcohol etc.
As they mature then normal drives such as nurturing others, needing praise, relating to others, creating boundaries, s*xual desires or even hunger can also be replaced by an overwhelming feeling of shame (these are known as ‘shame binds’). Children or adults who have shame binds can react in bizarre ways – a young person who has been praised at school might experience overwhelming shame and then trash her room, for example.
Older abused children find themselves with a very different brain from their peers, who can find them alien and bizarre. They can be unable to express themselves emotionally, feel excessively shameful or anxious, be unable to interpret non-verbal signals, exist purely in survival mode and see others purely as resources to use. They find trusting others impossible and because of this are unable to distinguish between those who are genuinely trustworthy and those who are threatening. They can’t form close trusting relationships and can’t distinguish between different degrees of relationship.
Those last few lines have made me think – abused children can become ‘sociopaths’ in the sense of individuals who are NOT psychopaths but have the behaviours of psychopaths (e.g. seeing others as resources to use), and abused children can also become the TARGETS of psychopaths.
Taken from ‘Attachment, trauma and resilence’ by Kate Cairns.
Additional information can be found at
https://en.wikipedia.org/wiki/Attachment_theory
NoLongerShocked – Thank you so much for the additional information. Early life is so critical. It’s important that we understand that.