Up Close With Dr. E

Explore the link between early life trauma and adult illness


If knowledge is power, then today’s column is an atomic blast. What’s it about?

Neuroscience (the study of how the brain works) has discovered the link between extreme stress events — traumas — occurring in the first two decades of life, and adult medical illness. In the same way that smoking cigarettes is now linked to lung cancer, so too are early life traumas — occurring from birth to age 18 — linked to adult diseases, such as high blood pressure, obesity, diabetes II, COPD and premature death. Using a question and answer format, let’s look at this groundbreaking science.

Q: How was the link between early life traumas and adult illness discovered?

A: In 1985, Vincent Felitti, MD, became curious about why specific patients in his obesity clinic stopped treatment, even though they were losing weight. After reviewing their histories, he found that most had experienced ELT’s. When Felitti presented his findings at a conference in 1990, Robert Anda, MD, a scientist at the CDC joined forces and together, the ACE (Adverse Childhood Experiences) project was launched.

Q: Did they develop the ACE Test?

A: Yes. The ACE Test is a 10-question test which measures 10 types of trauma. Five questions are child-based traumas — Abuse (verbal, physical, sexual) and neglect. The other are family-based: domestic violence, addiction, family member in jail, loss of a parent by death, divorce or abandonment.

Q: How was the ACE Test used?

A: 17,000 adults took the ACE Test, as well as a physical examination.

Q:  What did they find?

A: 40% of the subjects had experienced two or more types of traumas; 12.5% reported four or more traumas. The higher the ACE Score — which goes from 0 to 10 — the greater the risk for adult illness.

Q: Given that 2/3 of the adult subjects had ELT’s, and that these ELT’s are linked to adult illness, are you saying that ELT’s alter brain functioning?

A: Yes, but not just brain functioning. ELT’s alter the entire human organism, as well as their developmental path. Think of a rocket that has its guidance system destroyed, and the rocket veers off into unknown territory.

Q: How do ELT’s cause adult illness?

A:  An ELT is like a bolt of lightning that strikes a child. After being struck, their entire nervous system has been altered. This means that the “Before-the-strike-child,” is different from the “After-the-strike-child.” But guess what? The altered child looks, walks and talks just like the former child.

Confusing, isn’t it? Perhaps this story will help. As a child, I loved science fiction movies. That is until I saw “Invasion of the Body Snatchers,” starring Donald Sutherland. In this movie, aliens, which look like giant pod-plants, invade the earth. The pods captured and transformed humans into aliens, who looked like identical copies. Throughout the movie, I rooted and cheered for Donald, as he fought the pods, saved others and clearly was going to win the battle. But then, at the end, I saw him stare directly at the camera and emit a “Screech,” which sounded like fingernails on a chalkboard.

Donald, my hero, had his body snatched away and was turned into an alien. The German noun, “Doppelganger,” is defined as, “a ghostly double of a living person that haunts its human counterpart.”

Trauma turns children (and adults) into Doppelgangers. How? By altering their entire nervous system. What does this alteration mean for a traumatized child?

The post-trauma child views the world through a different brain, one which has the following characteristics:

1. The world becomes a dangerous place. To adapt, the child’s brain constructs emotional radars which scan and sweep the classroom, the living room, all rooms. This energy drain causes a state of exhaustion. The first victim is the child’s ability to learn in school.

2. Intimate relationships are no longer safe. The child creates distance from everyone.

3. Sleep, food, fun, play — are discarded. With their childhood lost, they become combat soldiers whose sole mission is survival.

4. The child loses the ability to describe with words the sensation in their bodies as well as their emotions. Their body has been snatched away, and their emotional landscape now feels alien.

Q: ELT’s cause adult illness by chronic physical/mental exhaustion, loss of social support, and the wear and tear of a fight-or-flight system. Are there other variables which impact adult health?

A: Yes. The arrival of adulthood forces new strategies to numb loneliness and pain: pills, alcohol, drugs, and high-adrenalin activities such as dangerous driving, unprotected sex.

Conclusion: You have learned that trauma alters the nervous system, which, in turn, leads to adult illness. Can one heal from trauma? Can Donald Sutherland be transformed back into his pre-pod persona? Stay tuned to upcoming articles. If you wish to take the ACE Test, go to: acestudy.org. The content of this article is for educational purposes only, and should not be used as a substitute for treatment by a professional.


1. Adverse Childhood Experiences (ACE) Questionnaire, Good Therapy.org.

2. “The Body Keeps the Score,” Van der Kolk, Penguin Books, 2014.


Dr. Richard Elghammer contributes his column to the Journal Review each week.


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