The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture

by Gabor Maté

San Diego internal medicine specialist Dr. Vincent Felitti was one of the lead investigators of the now famous (though not famous enough) Adverse Childhood Experiences (ACE) Study. The study emerged after Felitti decided to listen to the life histories of patients at an obesity clinic who all reported childhood traumas. Carried out in the 1990s in California’s Kaiser Permanente health care network, the research showed that among a cohort of over seventeen thousand mostly Caucasian, middle-class persons, the more adversity a child had been exposed to, the greater the risk of addictions, mental health issues, and other medical problems they faced in adulthood.[1] Adversity was categorized under three general headings: abuse (psychological, physical, sexual); neglect (physical, emotional); household dysfunction (alcoholism or drug use in the home, divorce or loss of a biological parent, depression or mental illness in the home, mother treated violently, imprisoned household member). The impacts of such experiences did not merely add up; they multiplied each other. An adult reporting an ACE score of 6 had a risk of intravenous drug use forty-six-fold greater than a child with none of the adversities named.