Adverse Childhood Experiences (ACEs) and the Impact on Marriage

The Adverse Childhood Experiences study was a huge research study conducted in the USA that has traced the impact of very difficult childhood experiences into adulthood. For those who have faced these challenges, we want to explore what the potential impacts are in marriage and how to best respond so that you can create or keep a happy, content marriage. Adverse Childhood Experiences The ACE study wanted to explore the effects of childhood abuse and neglect on later life. It included over 17000 participants and further follow up studies continue to add to the original findings[i]. The study looked at ten different forms of adverse childhood experience (ACE), split into three categories: Abuse Neglect Household challenges Under abuse they looked at emotions, physical and/or sexual abuse. Under neglect they looked for emotional and/or physical neglect. And there were five household challenges: Mother treated violently Substance abuse in the household Mental illness in the household Parental separation or divorce Household member incarcerated Initial Findings Almost two thirds of the surveyed adults reported at least one ACE, and more than one in five reported three or more ACEs. ACEs are also often experienced together- if you experience one of the ten factors you are much more likely to have experienced at least one more[ii]. So how do these early experiences impact the rest of your life? ACEs are found to lead to a huge range of negative outcomes in adult life including damage to physical and mental health, dangerous or unhealthy lifestyle choices, and reduced life potential. Now we need to unpack the impact of ACEs a little more but I want to pause to make a point first. Our goal here is not to point out damaged goods or to make anyone feel like they are somehow permanently emotionally crippled or, in the context of our marriage podcast, that they will make a terrible spouse. Not at all. There are as many wonderful people with ACEs as there are without. However, by acknowledging the potential impact of ACEs, at least now a couple knows how and why some of the current challenges may have developed and they can create some specific and targeted goals for healing. Allow me to illustrate from the physical realm. Imagine I had a set of challenging and unexplainable physical health problems. After a lot of struggle and problems and doctoring it came out that I had been drinking from a polluted water source. Now I know that I need to stop drinking that water and also find out what was in the water. Once I know that I need to understand what the pollutants were and how they have impacted my health. And then I can take steps towards dealing with those symptoms in order to restore my health. Same with ACEs. Once I understand that my present struggles are tied to my childhood experiences, I can begin to face those things in order to pursue healing. The ACE Pyramid One of the things the researchers discovered is that there were a potential set of negative changes that built one upon another. They charted this out as a pyramid because you have many people at the bottom and few at the top. In other words, the further up the pyramid you go the less likely you are to be affected unless you’ve had very severe ACEs. The base level of the pyramid is the adverse childhood experiences themselves. The next level up is disrupted development. So children with ACEs experience poor physical and mental development due to abuse, trauma or neglect. The next level from there is social, emotional and cognitive impairment. Some of those children as adults will manifest poor coping skills, attachment disorders, mental illness, and cognitive impairment. Next, some of them will go on to adopt health-risk behaviors. Risky behaviors such as smoking, alcohol use or promiscuity. Often adopted as coping mechanisms to help them survive the difficult circumstances they find themselves in. Again the next level up involves some of that group experiencing disease, disability, and social problems. These are typically caused by both poor development and risky behavior choices. This is exacerbated by low economic income caused by low cognitive ability leading to low achievement and employment prospects. You’ve got this whole cocktail of poor lifestyle choices and bad surroundings making it all the more likely your physical and mental health will suffer. Finally, the peak of the pyramid is one sad little triangle with the words “early death” in it. Yes, people with higher ACEs are at greater risk of premature death. Some specific effects caused by ACEs include: Increased risk of chronic illnesses including cancer, heart disease and liver disease[iii] Poor work performance, low academic achievement, leading to financial strain Risk of mental health issues such as depression and increased risk of suicide Risk of drug abuse and alcoholism Higher rates of teen pregnancy and STDs The effects are cumulative- the more forms of abuse are present in a child's life, the higher the risk of each of these outcomes becomes[iv]. Let’s pivot now and bring it to our area of interest which is marriage. ACE’s and Marriage Many of the negative effects of ACEs can potentially further impact marital quality. Again, let’s not make assumptions: it is not necessarily a given that if you had ACEs you will have marriage troubles. It is more likely, however, so it’s best to consider what those impacts might be. Some of the potential impacts on marital quality include: Health: poor mental or physical health in one or both spouses can negatively impact marital satisfaction Poor social and coping skills: this can lead to increased stress and likelihood of bad conflict management Attachment: bad attachment styles formed in childhood can make it harder to form good marital bonds and trust Financial strain can negatively impact marital satiation and increase conflict Sex Can Be Impacted Adults who have experienced ACEs often display a range of risky and adverse sexual practices, such as higher number of partners, higher chance of teen or unwanted pregnancy, higher rate of catching STDs and more risky sexual behavior[v]. All of this sexual baggage can have a negative impact on marital quality and stability. Domestic Abuse Witnessing or suffering abuse as a child drastically increases risk of both perpetrating and suffering abuse from your spouse[vi]. Experiencing one of these issues doubles the risk of being involved in an abusive marriage and having experienced all three increases the risk by almost four times. Again, this is not to say that every guy who has had ACEs will be an abusive husband. However, having this insight may help point you to areas of healing that need to be addressed if you do find yourself acting in an abusive manner. So while this study has brought to light many difficult adult issues that stem from difficult experiences in childhood, one of the hopeful and promising facts that we want to point out is that marriage can be a healing agent in recovering from those experiences. Despite the many negative effects of ACE on marriage (and life in general), research has shown many adults who suffer ACEs find that marriage can be a place of healing and recovery from the trauma[vii]. A loving, stable, supportive marriage can help ACE survivors to process the trauma and counteract many of the adverse effects. Spouses married to ACE survivors can help them work through the trauma by providing a listening ear and emotional support, and by accepting them non-judgmentally[viii]. A loving marriage bond can also improve an ACE survivor's attachment style by modeling to them what a healthy relationship looks like, helping them form more loving and trusting bonds. Marriage can therefore teach an ACE survivor better emotional regulation and coping skills, as well as providing them with more motivation not to engage in unhealthy behavior. This then stops the "pyramid" of ACE at those early levels, reducing the likelihood of progressing further up the pyramid to illness and early death. This is where spouses can really team up to counteract negative effects and join together to shift the trajectory away from cascading problems and towards healing. That’s a beautiful thing that marriage can do when both spouses are open and honest about the challenge of ACEs and are united in their vision to heal and grow rather than to remain as victims of the choices of others. References [i] Vincent J. Felitti et al., “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, no. 4 (1998): 245–58. [ii] Felitti et al. [iii] David W. Brown et al., “Adverse Childhood Experiences Are Associated with the Risk of Lung Cancer: A Prospective Cohort Study,” BMC Public Health 10 (January 19, 2010): 20, https://doi.org/10.1186/1471-2458-10-20. [iv] Leah K. Gilbert et al., “Childhood Adversity and Adult Chronic Disease: An Update from Ten States and the District of Columbia, 2010,” American Journal of Preventive Medicine 48, no. 3 (March 2015): 345–49, https://doi.org/10.1016/j.amepre.2014.09.006. [v] Felitti et al., “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study.” [vi] Charles L. Whitfield et al., “Violent Childhood Experiences and the Risk of Intimate Partner Violence in Adults: Assessment in a Large Health Maintenance Organization,” Journal of Interpersonal Violence 18, no. 2 (February 1, 2003): 166–85, https://doi.org/10.1177/0886260502238733. [vii] Linda Skogrand et al., “Traumatic Childhood and Marriage,” Marriage & Family Review 37, no. 3 (2005): 5–26. [viii] Skogrand et al.