The relationship between adverse childhood experiences (ACEs) and illness later in life has received a great deal of attention since the original ACE study in 1998[1]. In essence, this study found that emotional, physical, and environmental trauma in childhood—including a broad range of adverse experiences such as abuse, neglect, family alcoholism/addiction, exposure to domestic violence, and others—are in many cases linked with chronic medical conditions, chronic pain, substance misuse, and other physical and behavioral health concerns in adulthood.
These research findings and the perspective they offer are notable. Also notable, however, is that within the centuries-old tradition of Chinese medicine[2], understanding the relationship between trauma and illness has always been seen as essential for healing. Simply put, according to Chinese medicine, our histories—including both personal experience and intergenerational (epigenetic) factors—impact us in the deepest layers of our bodies, and can emerge later as symptoms in a variety of forms.
Root and Branch
Central to Chinese medicine is the concept of ‘root and branch’—that is, the idea that illness has an origin (root) and manifestation, or symptoms (branch). In some instances the relationship between root and branch is simple and straightforward—for example, eating contaminated food (root) can result in nausea, vomiting, and other symptoms associated with food poisoning (branch). But in many cases, the relationship between root and branch is complex and subtle, and the idea that emotional, interpersonal, and psychological adversity—in a word, trauma—can lead to numerous forms of illness is a primary principle of acupuncture, herbal medicine, qigong, and other methods within the framework of Chinese medicine.
Fight / Flight / Freeze
From a biomedical perspective, one explanation for the findings of the ACE study is our fight / flight / freeze response to traumatic experiences. Essentially, our bodies respond to perceived danger by secreting hormones and engaging in other responses that are geared to help us flee from, hide from, or combat stress or danger. Even relatively mild forms of stress can create this arousal reaction, but especially if stressors are chronic or severe, our bodies tend to remain in this state, and eventually, we wind up with a variety of health conditions, from asthma to hypertension to obesity to addiction to chronic pain. In conjunction with standard medical treatments for the presenting illness, various forms of psychotherapy, mindfulness-based interventions, and somatic therapies may be helpful in addressing the ‘root’—de-escalating the aroused states that linger from childhood trauma, or, to put it another way, interrupting the ‘circuit’ of a longstanding fight / flight / freeze response.
Chinese Medicine
Although its language and frame of reference differ from a biomedical understanding of the ACE study findings, Chinese medicine also conceptualizes the human body as a system that can be thrown out of balance by acute or prolonged trauma. A symbolic, environmental analogy may be helpful: the human body is a kind of geography, with waterways, weather patterns, and terrains of all kinds, all of which nourish and sustain each other, as is the case in the outer natural world. This system is able to adjust to moderate fluctuations in ‘climate,’ but prolonged or acute stresses—severe changes in ‘weather’ and other environmental patterns—if they are beyond what we are able to accommodate, can throw our entire internal climate into significant imbalance. Often, symptoms resulting from this climactic imbalance (root) are evident only after the passage of time, when the branch emerges in the form of illness.
Acupuncture
Probably the best known treatment method within the broader system of Chinese medicine, acupuncture involves the insertion of very fine needles (historically, silver or gold, but in modern practice sterile stainless steel) into specific points on the body in order to re-establish the ecology of the body. Although a full discussion of the many traditions within acupuncture is beyond the scope of this article (for further exploration, The Acupuncture Handbook by Angela Hicks as well as Between Heaven and Earth by Beinfield & Korngold may be of interest), both classical and five element acupuncture emphasize the impact of psychological trauma on overall health.
Here’s an example of how working with root and branch (or, ACE and subsequent illness) might work in acupuncture practice: in the hypothetical case of a person experiencing wheezing, shortness of breath, and other symptoms associated with asthma, and who experienced significant loss and abandonment in childhood, along with other points we might consider the acupuncture point Lieque, meaning ‘broken sequence.’ This is a point on the lung meridian (Lung 7), which as an aspect of the metal element can relate to feelings of grief, shame, and disembodiment—as well as to overtly lung-related symptoms such as asthma. Lieque also gives access to the Ren meridian (conception vessel), which has a strong relationship with early development, and so may be particularly helpful for certain aspects of loss or disruption in infancy and early childhood; in addition, this point accesses the associated luo meridian (connecting vessel), in which emotional residue often lingers. Further, the point name ‘broken sequence’ can refer to the ruptures experienced as the result of intergenerational trauma, such as disrupted lineages and loss of cultural or family relationships and traditions.
Alaska
Awareness of ACEs and their effects are of particular relevance for Alaskans: of ten states plus the District of Columbia tracking ACE study categories, Alaska shows the highest per capita incidence[3]. This is of importance for primary care medicine as well as for a nuanced, trauma-informed perspective on substance misuse (alcohol, opiates, and others) and other physical and mental health concerns.
The good news is that with increasing awareness of ACEs, more attention is being paid both to the impact of trauma on children, and to its effect on adult health. This new understanding of the impact of trauma on health has now become common language in primary care and other medical settings, and has generated a great deal of work on new approaches to healthcare as a whole. But in the midst of what seems to be an innovative perspective based on new information, it behooves us to remember that traditional wisdom—and centuries of healing tradition—can also offer a rich and valuable perspective.
[1] Felitti, et al (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study.American Journal of Preventive Medicine, 14, 4, p.245-258. [2], For the sake of convenience, I’m using the term ‘Chinese medicine’ as shorthand for acupuncture, herbal medicine, medical qigong, and other methods of East Asian medicine—especially the traditional medicines of Japan, Korea, and Vietnam—which are historically derived from Chinese medicine.[3] CDC Behavioral Risk Factor Surveillance System, 2015 data, in http://dhss.alaska.gov/abada/ace-ak/Documents/ACEs-ThreeYearsBRFSS.pdf
