Back in the mid-1980s, a physician working with obese patients in San Diego discovered something unexpected: The people making progress with his weight loss program were the ones most likely to reject it and walk away. Puzzled, Dr. Vincent Felitti studied 286 of these patients in greater depth and learned that many had been beaten or sexually abused as children — obesity, it turned out, was their shield against unwanted physical attention. They did not want to let it go.
Meanwhile, across the country in Atlanta, Dr. Robert Anda at the Centers for Disease Control was studying lifestyle-related diseases like cirrhosis of the liver and certain cancers. By the early 1990s, the two doctors had teamed up to design the largest U.S. study ever on the link between adult health disorders and traumatic childhood experience.
With 11 simple questions, many of them surprisingly pedestrian, they surveyed more than 17,000 patients who were visiting a California clinic for standard check-ups. The results were stunning.
Nearly two-thirds of participants — the majority of them white and college-educated — reported some form of childhood trauma, abuse or neglect. This ranged from fairly typical stuff, like watching parents divorce, to witnessing substance abuse and domestic violence. All of it significantly elevated the likelihood of adult depression, suicide and a host of costly medical conditions from heart disease to breathing disorders.
Take the Adverse Childhood Experiences test and see for yourself. Huge numbers of everyday people — regular, working folks who hardly appear to fit the label “at-risk” — may recognize themselves in questions like, “Did you often or very often feel that your family didn’t look out for each other, feel close to each other, or support each other?” Sixty-three percent of participants reported one category of childhood trauma and 20 percent logged three or more. By this definition, many of us could be described as “at-risk.”
What, then, does this term actually mean? At-risk for screwing up at work or drinking too much or making bad choices? At risk for becoming a ward of the state, a drain on the system? The renowned psychologist John Briere, Ph.D, has observed that if child abuse and neglect were to disappear, the Diagnostic and Statistical Manual — an 886-page tome cataloging some 300 mental disorders — would shrink to the size of a pamphlet, and the prisons would empty in two generations.
Considering this, it becomes easier to understand why foster youth, all of whom experienced home dysfunction severe enough to warrant removal, display astronomical rates of homelessness, poverty and incarceration as young adults. They are, says child psychiatrist Mick Storck, exhibiting a magnified version of traumas similar to those that many of us lug around.
“The same questions that we’re all grappling with — Do I have a place in this world? Will anyone love me? Do I really belong anywhere? — they’re sort of precociously in touch with,” he said. “Foster kids have this acceleration of the existential grid.”
We were discussing all this while sitting outside the gracious home in Ravenna where Storck has lived for 23 years, as idealized a setting as you could imagine. But I was thinking of the 23-year-old I’d met not long before, a young woman named Carrie who lives in an apartment so barren that looking at her bare walls and empty kitchen, I assumed she’d moved in just weeks ago. She’d been living there for three years. Carrie was a college student, working toward a degree in social work. But she could not settle in. She could not believe in her life.
During high school, Carrie often walked out of class to sit by herself in detention — that is, when she wasn’t on the run.
“I had a lot of things on my mind," she said. "I had to figure out, is the place where I think I’m going later today, really the place I’m going? Because anything can happen. You never know how the foster parent is going to feel about you. It’s like, I know you care, but I also know you don’t love me. I guess that’s the reason I always ran, because you don’t feel loved. You don’t.”
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