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The Adverse Childhood Experiences Study (ACE Study) is a research study conducted by Dr. Vincent Felitti, Chief of Kaiser Permanente’s Department of Preventative Medicine in San Diego California, and the Centers for Disease Control and Prevention (CDC).

Dr. Felitti realized individuals he worked with who struggled with obesity were hundreds of pounds overweight, but they did not see their weight as a problem. For them, eating was the solution to the problem. Eating soothed the anxiety, fear, anger, or depression – similar to the effects drugs, alcohol or tobacco have.


This discovery was the beginning of the mind-shift that would provide greater understanding about the lives of millions of people around the world who use coping methods including alcohol, drugs, marijuana, food, tobacco, violence, and work, to escape intense fear, anxiety, depression, and anger.

The Real Problem

Public health experts, social service workers, educators, therapists, and policy makers commonly regard addiction as a problem. Some, however, are beginning to understand that turning to drugs is an expected response to serious childhood trauma, and that telling people who smoke or overeat or overwork that they should stop because these things are bad for them does not work when those behaviors provide a temporary, but gratifying, solution to a bigger problem.


ACE Score and Health Risk

As the ACE score increases, rick for other health problems increase. 

Behavior Risks
Alcohol Abuse
Drug Use

Physical Risks
Heart Disease


Mental Health Risks
Suicidal Ideation

ACES Pyramid.png

Impact of ACES

Neurological Development

Cognitive Development

Physiological Development

Emotional Development

Behavioral/Relational Development

A girl feeling sad
Image by Tobias Tullius

Survival Mechanisms

When we experience a traumatic event, our coping abilities become overwhelmed, and our survival mechanisms are activated. To give us the best chance of survival, relevant areas of our brain are prioritized. This enables our body to gear up for fight or flight with hormones and adrenaline. Our senses are heightened, and our responses are enhanced.


At the same time, fewer resources are directed to brain areas that are not directly involved in the survival response, thus, there is less capacity for critical thinking or analytical decision-making. The communication between our emotional and cognitive processing areas also largely goes offline.

Fight: This can look like physical fights, yelling, aggression, and property destruction.

Flight: This can look like avoiding interactions with others or fleeing the situation altogether.

Freeze: This can cause us to feel mentally checked out as a means of finding emotional safety.

Fawn: People who fawn may feel unseen and eclipsed by those around them.

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