“ACE” made me do it.

There is a relatively new addiction model called Trauma Therapy. One of it’s chief proponents, Dr. Gabor Mate, explains that people are born perfect and adverse childhood experiences (ACEs) create trauma which leads to addiction. In an interview in The Fix Mate claims, “if children receive conditions of love and respect in their childhood, they’ll never be addicted, they’ll never get depressed and they’ll never be anxious.”

What qualifies as an ACE? Physical, sexual or verbal abuse, physical or emotional neglect, living with a parent who is abused or addicted, having an incarcerated or mentally ill caregiver, or suffering the loss of a parent through divorce, death or abandonment. The Centers for Disease Control developed these markers to identify people at high risk for obesity, depression and addiction.

According to Mate all IV drug users score positively on the ACE scale. Furthermore he insists if you do not recall childhood trauma then you are repressing it and in need of extensive “trauma therapy.” (If this is not a siren call for false memories then I don’t know what is.)

I shared my doubts with a follower of Dr. Mate. I explained that my child did not meet a single marker on the ACE scale. Stymied, they asked if her childbirth had been traumatic (which felt a bit like “mother blaming”). When I explained that she was the easiest of my childbirths I was told my daughter must be a victim of epigenetics. This was explained as “inheriting on a cellular level the trauma of previous generations.” I was then asked if something ugly could have happened to me as a child, something that I may not even recall. A subconscious molestation could be the reason I birthed an addicted child.

This does not sound like responsible science to me.

Epigenetics is the science of gene expression. It explains how the environment may turn on/off the expression of certain DNA coding. For example there is scientific evidence that extensive stress can cause permanent damage to the body’s production of cortisol. This makes sense since we are biological beings and our bodies interact with, and are affected by, our environment.

The proponents of an epigenetic basis for addiction cite work done by Rachel Yehuda Ph.D., at the Icahn School of Medicine. Dr. Yehuda hypothesized that genetic damage suffered by an individual could be passed down to future generations. She deduced this after finding an increased rate of anxiety, depression and obesity in the children of Holocaust survivors. She attributed their health problems to inherited faulty cortisol production and enzyme regulation; rather than asking if growing up with PTSD-affected parents could have produced an environment that fostered stress in the children.

It is important to note that Dr. Yehuda’s work has been debunked. The Chicago Tribune (citing various sources) reported “Yehuda’s study began with too small of a study size. Only 32 survivors and 22 of their offspring were studied. That’s a very small group on which to base this theory and a major study flaw.” The article further revealed a major flaw within Yehuda’s research: “While the team studied the children of women who lived through the Holocaust, they would have to study the great-grandchildren of survivors to prove actual epigenetic inheritance from mother to offspring. Why must four generations be studied? The eggs that made you were present inside your mother when she was a fetus inside your grandmother. Because a pregnant woman already possesses the DNA of her grandchildren and these genes can be affected by things during her pregnancy, the DNA of the great-grandchildren has to be studied to show that epigenetic changes were passed on across generations.”*

I also can’t help but think that if generational trauma was a prescription for drug abuse the species would be extinct by now. The circle of damage would have increasingly widened as generations multiplied exponentially through time.

Strict reliance on ACE is problematic on another level: it rigidly shuts the door on other causes of addiction. Purdue Pharma flooded the market with highly addictive pills that have been proven to change neuro-pathways in the brain. Are we really going to insist that those who got addicted did so because of early trauma (divorced parents possibly?) and not because they were the victims of corporate greed?

Interestingly Mate acknowledges that “not all of those who have ACEs become addicts, but all addicts have ACEs.” Why isn’t Mate questioning this discrepancy? Could the difference be attributed to the fact that some people are genetically predisposed? Or that they have less emotional resiliency because of a psychological disorder that is eased by substance use such as anxiety, bipolar, or depression?

Dr. Mate insistence that psychological disorders are created by early trauma is nonsensical. Babies are not born perfect! Every day children are born deaf, blind and lame. They have congenital heart defects, they have sickle cell anemia. To think that the newborn brain is inure to imperfection is ridiculous.

Imperfection is part of nature. I often ask my art students to go outside and find the perfect tear shaped petal, the perfect circular rock. They always come back empty handed and we marvel at the impossibility of it. It is only the foolish or megalomaniacal who dream of perfection.

My daughter is flawed – but not any more than me. She is stubborn, I am prideful. She is anxious, I have self doubt. She did not have a traumatic childhood; she had a fairytale one lived out in a house near the sea with a sister, a brother and a big fluffy dog. She tells me nothing untoward occurred during her formative years and I believe her. Can she benefit from trauma therapy? Of course. But it would be for trauma experienced while using.

Mate’s proposition is maddening because it is reductionist. And because it asks people who are already suffering to seek another layer of pain where none may exist. It also demands that science take a back seat to a condition that people are finally beginning to accept as a disease.

I feel traumatized by the possibility of it.

One thought on ““ACE” made me do it.

  1. You hold me from the very first sentence and I am still captured by your very last sentence. Your questioning and analysis of ACE is done in a thorough scientific, clinical approach, made very readable by your facility with language. This article deserves wider exposure.

    Like

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