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CHAPTER THREE
Why Do Some Suffer More than Others?
Not everyone’s health is sabotaged by unremitting, unpredictable stress in
childhood.
Some adults who endured a difficult childhood thrive and are emotionally
resilient. For some reason, the past doesn’t cast such a long shadow over their
lives.
In a Harvard study of elderly people who have enjoyed remarkable longevity,
neuropsychologist Margery Silver found that “a particular characteristic that is
typical of centenarians” is that they manage life stress very well. Even those
centenarians who have “had really very difficult, and even traumatic lives” of
extreme adversity—including holocaust survivors—seem to be able to “roll with
the punches . . . accept their losses, grieve them and then move on. They bounce
back.”
Resilient people have what psychologists call “wobble”: the ability to waver
under the weight of life’s suffering and trauma but not fall down. Others fare
less well in the face of what life throws their way. The question is: why are some
more fragile than others?
Psychiatrists refer to the amount of trauma we experience over the course of our
lives, and the cumulative effect of that trauma—how much wear and tear it takes
on our body, brain, and mind—as our “allostatic load.” The term, coined by
Bruce S. McEwen, PhD, professor of neuroendocrinology at Rockefeller
University, is derived from “allostasis,” the ability to adapt over time to the
stressful emotional and physical trials that we encounter, return to a state of
equilibrium, and regain our sense of well-being. We wobble, we recover, and we
get on with living our lives.
But most kids who experience chronic stress and trauma don’t have the tools
or maturity to regain their equilibrium. They’re just kids caught up in
circumstances over which they have little control, trying to make sense of their
own confusion and the emotional chaos of the adults around them.
Generally speaking, the higher a child’s Adverse Childhood Experiences
Score, the higher her allostatic load, and the more likely she will have a high
degree of physical and neural inflammation, and that her body and brain may
eventually pay a steep physical cost for that early emotional suffering.
When my children were young, we played a game called Elephant, which
involves piling planks on top of the elephant’s back to build a tower. If you don’t
place your pieces carefully, the tower starts to sway precariously and topple.
Being a child who endured early, unpredictable stress is a little bit like being
that elephant carrying wobbly cargo. Having a lot of early wear and tear can
make it harder to bear up under later challenges, and harder to find an interior
sense of well-being and solidity—an inner resilience.
Yet some people who’ve faced a lot of adversity fare better than others. Not
every single person with an Adverse Childhood Experience ends up with heart
disease, an autoimmune condition, or an anxiety disorder. The correlation is
high, but it is not a given.
In his recent book
David and Goliath
, social theorist and researcher Malcolm
Gladwell argues that losing a parent in childhood can lead to a mix of both
negative and positive outcomes in adulthood, for reasons we don’t quite
understand. A boy who lost his mom to cancer when he was ten might go on to
be a MacArthur genius recipient in cancer research. Such individuals’ lives are
governed by what Gladwell calls the “Theory of Desirable Difficulty.” Struggle
strengthens their resolve. It even leads some to do extraordinary and profound
things with their lives.
Gladwell researched the personal histories of noteworthy leaders in business,
science, and politics and found that in rare cases, there exists an odd benefit of
early trauma: “If you take away a mother or father, you cause suffering and
despair. But one time in ten, out of that despair arises an indomitable force.”
One out of ten is low odds—but that 10 percent is notable. A third of US
presidents lost or were distant from a parent. That loss became an impetus for
grit and self-reliance, for making something remarkable of themselves. The same
applies to a large percentage of British prime ministers and other prominent
figures, including Supreme Court justice Sonia Sotomayor, whose alcoholic
father died when she was nine.
Of course many leaders who lost or had distant parents in youth also suffered
deeply from illness in adulthood, in addition to their great achievements.
Abraham Lincoln, who lost his mother in childhood, suffered debilitating bouts
of depression. John F. Kennedy, whom biographers cite as having had a cold,
preoccupied mother who “never said I love you” or “rumpled his hair,” and an
overbearing father, suffered from Addison’s disease, an autoimmune disease in
which the adrenal glands are so overtaxed that they fail to produce the proper
steroid hormones. These men were luminous and extraordinary, and we admire
them all the more for having led a nation in spite of their private illnesses.
Some might argue that if the pain of having lost a parent or having had a
distant, unloving mother or father gives one the extra mental muscles and grit
needed to successfully lead a nation, it is a price well paid. But early adversity is
far more likely to hold us back. As Gladwell found, nine out of ten people who
lose a parent early in life “are crushed by what they have been through.” Most
kids who have suffered from toxic stress and adverse experiences do not recover
without help. And as adults they are all too often still swimming unaware against
the hard and invisible current of those emotional forces from long ago, as they
try to make their way toward a happy and fulfilling life.
It doesn’t matter what type of Adverse Childhood Experience a child faces: all
ten categories of ACEs can cause very similar biophysical changes and
inflammation. Yet the effect of childhood stress on body, brain, and mind differs
for each of us—but not always for the reasons we think it will.
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