Childhood Trauma: The One Test You Don't Want to ACE
Welcome back to PsyberSpace. I'm your host, Leslie Poston. Today, we're talking about a test that's been quietly shaping lives for decades. It's not a test you study for, and it's not one you take in school, but its score can influence your health, your relationships, your work life, and even how long you live. I'm talking about the ACE test.
Leslie Poston:ACE stands for adverse childhood experiences. It's a short questionnaire, only 10 questions. Each question asking about a kind of hardship you might have faced as a kid. That could be abuse, neglect, addiction in the home, a parent going to jail, that sort of thing. The more yes answers you check off, the higher your score.
Leslie Poston:The higher your score, the more likely you are to struggle in adulthood, not just emotionally or mentally, but physically too. This isn't just psychology, it's biology. And what's wild is that this test has been around since the nineties, but many people still haven't heard it. Or if they have, they don't realize just how much it explains. So in this episode, we're going to talk about what the ACE score really is.
Leslie Poston:We'll look at how trauma rewires the brain and the body. We'll talk about how it shows up in your job, love life, and friendships. We'll explore why trauma doesn't just live in your memories, but also in your muscles, breath, and gut. And we'll end with something important, what healing looks like, what you can do if this episode hits close to home. Let's start at the beginning.
Leslie Poston:In the nineties, a researcher at Kaiser Permanente noticed something odd. Patients who were struggling the most with things like obesity, diabetes, heart disease, or depression also tended to have really difficult childhoods. So he partnered with the CDC. They surveyed over 17,000 people, and they asked about 10 categories of adversity in childhood. These categories included physical, emotional, and sexual abuse emotional and physical neglect, and five kinds of household dysfunction.
Leslie Poston:Those are things like having a parent who abused substances, a parent who was incarcerated or divorced, mental illness in the home with any relative, or violence between any adult in the household. Each yes answer became one point, and they called this your ACE score. Zero means you had little to no exposure to these 10 things. Four or more are where the risks begin to climb sharply. People with an ACE score of four or more are significantly more likely to experience anxiety, depression, addiction, autoimmune disease, cancer, and even early death.
Leslie Poston:People with a score of six or higher, the research shows their life expectancy drops by as much as twenty years. But here's the thing. Trauma isn't always about the big obvious things. Sometimes it's about what was missing. So a child who was never hit, but was constantly ignored or a child who never saw violence, but also never felt safe.
Leslie Poston:Trauma can be loud, sure, but it can also be quiet. What matters is what it did to your nervous system. It's also important to say trauma is not just personal. It's not always about what happened inside your house. It could also be about the systems around you.
Leslie Poston:If you grew up in a neighborhood where violence was common or where your school didn't feel safe or where poverty meant basic needs weren't met, that shapes your development too. And if you were part of a marginalized group, whether race, gender, sexuality, disability, or immigration status, you may have carried stress that was chronic and unavoidable. That kind of structural trauma doesn't show up in the original 10 ACE questions, but it should. Researchers now call these expanded experiences community level ACEs. They add layers of risk and complexity that are often overlooked.
Leslie Poston:Healing from trauma means humming the individual, but also challenging the systems that produce harm. The brain develops rapidly in childhood. Those early years are when we build the wiring for safety, connection, and emotional regulation. When a child grows up in a chaotic, threatening, or neglectful environment, that wiring gets altered. Sure, the brain learns to survive but not to thrive.
Leslie Poston:It learns that the world is unpredictable and that people aren't safe. Love might hurt or people in love might disappear. The amygdala becomes hyperactive. That's the part of the brain that detects danger. The hippocampus, which helps with memory and learning, often shrinks.
Leslie Poston:The prefrontal cortex, the part responsible for decision making and impulse control, can be underdeveloped. These changes don't just fade with time. They shape how we respond to stress, how we relate to others, and how we see ourselves. There's also something called the window of tolerance. It's the range where your nervous system can handle stress without tipping into panic or shutting down.
Leslie Poston:People with lower ACE scores tend to have a wider window of tolerance. Stressful things happen and they can respond without losing their sense of safety. But people with higher ACE scores often have a very narrow window of tolerance. A small trigger can lead to hyperarousal, which is anxiety, anger, and panic, or it can cause hypoarousal where you go numb, freeze, or dissociate. It's not a personality flaw.
Leslie Poston:It's how your nervous system was trained. The good news is that window can expand. With support, with regulation practices, with healing relationships, your body can learn that safety is possible again. So let's talk more about the body because trauma doesn't just live in your thoughts. It lives in your tissues.
Leslie Poston:When your body spends years in a high alert state, flooded with stress hormones like cortisol or adrenaline, it starts to wear down. Inflammation increases, the immune system weakens, your blood pressure rises, and your gut becomes sensitive while your muscles stay tight and restricted. And that's why people with higher ACE scores are much more likely to develop chronic illnesses, not because they're imagining things, but because their systems have been overloaded from a young age. Researchers have even found changes at the genetic level. Childhood stress can affect how genes related to inflammation and immunity express themselves.
Leslie Poston:The field study in this is called epigenetics, and it's still growing, but what it's already showing is clear: trauma changes your body. So what does this look like in everyday adult life? Let's take work. For a lot of people with higher ACE scores, work feels threatening, not because their job is bad, but because the workplace mirrors the unpredictability they experience growing up. A critical manager can feel like the parent who yelled.
Leslie Poston:A missed deadline can feel like a failure that might lead to a punishment. Office politics might bring up memories of walking on eggshells through their home. These reactions aren't just emotional. They're so physical. The heart is racing.
Leslie Poston:The muscles are tense. Your breathing becomes shallow, and your focus at work becomes difficult. Decision making can feel paralyzing because the traumatized brain is constantly scanning for threats instead of processing information. You might find yourself overthinking simple choices or avoiding decisions altogether. Some people describe feeling like they're watching themselves work from outside their body, going through the motions, but not fully present.
Leslie Poston:Some people cope by becoming hyperproductive. They never rest. They always try to prove their worth. Others withdraw and might miss deadlines, struggle with teamwork, not because they're lazy or unmotivated, but because their nervous system is overwhelmed. Trauma often makes people feel like they're either too much or not enough, and work becomes the arena where that internal battle plays out.
Leslie Poston:There's also the pattern of perfectionism paired with impostor syndrome. People with high ACE scores often become high achievers, but they can't internalize their success. Every accomplishment just feels like luck or fraud. They work twice as hard to feel half as worthy. And when they do receive praise, they might dismiss it or wait for the other shoe to drop.
Leslie Poston:And then there's the social dynamics at work. People with trauma histories might struggle to read workplace cues correctly. A neutral email feels hostile. A closed door meeting triggers abandonment fears. They might overshare personal information too quickly, trying to build connection, or stay completely isolated to avoid potential rejection.
Leslie Poston:Networking events, team building, and even casual conversations by the coffee machine can feel like navigating a minefield. Career trajectories often reflect this internal struggle too. Some people become serial job hoppers, leaving whenever things get uncomfortable or before they can be rejected or before they can be rejected. Others stay in toxic environments far too long because chaos feels normal. Many underachieve professionally, not because they lack talent, but because success feels dangerous or undeserved.
Leslie Poston:Now think about relationships. People with high ACE scores often struggle with attachment or the way we form emotional bonds. If caregivers were unreliable, abusive, or emotionally distant, their brain has learned that love isn't safe, and that people can't be trusted, and potentially that it's better to protect yourself than to be vulnerable. So in adulthood, their relationships can feel confusing. Someone gets too close and panicked that's it, or they fall into relationships that are chaotic or controlling because that feels familiar.
Leslie Poston:Maybe they cling too tightly or push people away. Not because they don't want a connection, but because connection feels dangerous. Even friendships can be hard. A friend who cancels plans might trigger feelings of abandonment, and a disagreement might feel catastrophic. People could say you're overreacting, but the body remembers, and it's reacting as if the danger is still present.
Leslie Poston:Then there's parenting. People with higher A scores often struggle with parenting, not because they're bad parents, but because they're trying to give what they never got. They may be determined to break the cycle, but they find themselves triggered by their child's emotions or falling into patterns they swore they'd avoid. This doesn't mean they're failing. It means still healing.
Leslie Poston:And trauma doesn't just stop with one generation. Studies show that parents with higher ACE scores are more likely to raise children who also experience adversity. And this isn't about blame it's about biology and behavior. A parent struggling with emotional regulation may unintentionally pass on that same dysregulation, but the reverse is also true. Healing your trauma can interrupt the cycle.
Leslie Poston:It's called intergenerational repair. Even small changes like learning to pause before reacting can ripple forward into the next generation, making things better. Let's look at the medical side. Many people with trauma histories go through years of chronic illness without getting any clear answers. They're often told it's all in their head or that their pain doesn't match the lab, their labs are normal, that they're too young to feel this bad, or maybe they have, quote, anxiety.
Leslie Poston:But studies show a clear link between early trauma and conditions like fibromyalgia, irritable bowel syndrome, chronic fatigue, migraines, autoimmune disease, and much more. Trauma doesn't just cause emotional pain, it causes physical suffering. People with higher ACE scores often report something else too, being dismissed by doctors. They're told their symptoms are just stress, that they're too young to be sick. This is sometimes called medical gaslighting, and it's not always intentional, but it is always harmful.
Leslie Poston:Women, especially women of color, are the most likely to be dismissed this way, and so are people with chronic pain, fatigue, and other hard to quantify conditions. What gets missed is that these symptoms often are stress related, but not in the just relaxed sense. There are biological consequences of years of trauma. So when medical professionals aren't trauma informed, patients fall through the cracks and get labeled difficult. These patients stop seeking care, and their health worsens.
Leslie Poston:Trauma informed health care doesn't mean blaming trauma for everything. It means asking better questions. As in, not what's wrong with you, but what happened to you? One of the most frustrating things about trauma is that it often hides. People don't always remember what happened, especially if the trauma occurred before their brain was mature enough to process it.
Leslie Poston:But their body remembers. It remembers in their tight shoulders, their clenched jaw, in restless sleep or insomnia, in stomach problems, in chronic asthma or difficulty breathing, a chronic exhaustion no amount of rest seems to fix. Some people also experience dissociation. That's when you feel disconnected from your body, your surroundings, or even your own thoughts sometimes. For some, it can feel like zoning out or losing time or watching your life like a movie.
Leslie Poston:Dissociation is the body's way of protecting you when it thinks something's too much for you to handle. One reason ACE scores are so predictive of later health outcomes is their connection to coping behaviors. People with higher ACE scores are more likely to smoke, overeat, drink heavily, or engage in risky sexual behavior. These aren't moral failings, survival strategies. They're ways to numb pain, to regulate emotion, or to find and experience a feeling of fleeting control.
Leslie Poston:The problem isn't the behavior, it's what the behavior is trying to solve. Until that is addressed, the coping may continue even if it causes more harm long term. One of the most overlooked effects of childhood trauma is sleep disruption. People with high ACE scores are more likely to have insomnia. Nightmares are a light, restless sleep pattern.
Leslie Poston:Not because they're doing something wrong, but because their nervous system never fully settles at night. When the brain has been trained to stay alert for danger, it doesn't just shut off because it's bedtime. Good sleep hygiene helps, but trauma work is often what makes depressed possible again. That's why some people find talk therapy helpful, but others feel stuck. Because trauma isn't just about your story, it's about your body, your nervous system.
Leslie Poston:It's about those sensations that never got completed and emotions that never got processed. That's where something like somatic therapy comes in. Somatic therapies focus on what the body is doing, not just what the mind is thinking. They help people learn to notice their sensations, to reconnect with their bodies, and to complete stress responses that got stuck. Therapies like somatic experiencing, sensorimotor psychotherapy, and others work with these systems directly.
Leslie Poston:And there's also EMDR, eye movement desensitization and reprocessing. It helps the brain reprocess traumatic memories so they don't feel as intense. It doesn't erase the memory, but it helps separate the past from the present. EMDR uses a rhythmic movement like guided eye motion to help your brain make new associations, kind of crossing the streams inside the brain to remap the memories and the feelings associated with them. Many people who felt struck for years have found relief through this method.
Leslie Poston:And then there's polyvagal theory, which explains how your vagus nerve helps regulate our sense of safety. And when we feel safe, we can connect, think clearly, and rest. And when we feel threatened, our body shuts down or goes into overdrive. And that's why things like breath work, singing, humming, cold water, or safe touch can all help. They all tell your body you're safe now.
Leslie Poston:Your brain's ability to change is called neuroplasticity, and it doesn't just happen in childhood. Even in adulthood, your brain can grow new connections. Isn't that cool? The nervous system can learn new patterns. What that means is healing from trauma is absolutely possible.
Leslie Poston:And there's another concept to post traumatic growth. Some people, after going through therapy or doing body based healing work, report becoming more emotionally connected, more compassionate, and more grounded. Not because trauma is a gift, if not, but because they had to rebuild from the inside out, they got to decide what kind of life they wanted on the other side. Research shows that with the right support, people can and do change and not just survive, but thrive. If anything in this episode sounds and feels familiar, there are a few things you can do.
Leslie Poston:First, get curious about your ACE score. It's not a diagnosis. It's not a label. It's just information. There are free ACE quizzes online.
Leslie Poston:I'll put a couple links in the show notes. They take about two minutes, and they can help you see patterns you might have missed. Second, start noticing how your body reacts to stress. Not what you think, but what you feel. Do your shoulders tighten?
Leslie Poston:Does your breath stop? Does your jaw clench? That's your body communicating with you, and it's worth listening. Journaling through this process can help you connect physical feeling to emotional feeling as well. And third, experiment with grounding techniques, things that bring you back into the present.
Leslie Poston:That might be as simple as putting your feet flat on the floor or taking a slow breath in through the nose and letting it out through the mouth, doing timed breathing like in for four, hold for four, and let out for seven count, or looking around the room and naming five things you see. These things sound simple, but for a nervous system that's stuck in survival mode, they can be a quick, powerful way to reset. Fourth, if you're ready, find a trauma informed therapist. Not all therapy is created equal. Some approaches focus only on thoughts, but trauma is stored deeper, so look for someone trained in EMDR, somatic work, or trauma focused cognitive behavioral therapy.
Leslie Poston:There are websites online that can help you find this, or if you are lucky enough to have insurance, your insurance company probably has a list of therapists that list their specialties. Be sure to call their office and find out more information so you're comfortable before you. There's also some hopeful research on what are called positive childhood experiences or PCEs. These include things like having a trusted adult who believes in you, feeling safe at school, or having a sense of belonging in your community. Studies show that even when people had high ACE scores, those that also had high PCEs were more resilient, less likely to develop depression or PTSD.
Leslie Poston:So if you're parenting now or mentoring someone younger, know this: your present, your consistency, and your belief in someone might be the buffer that changes whatever they're experiencing at home. And lastly, be patient. Healing is not linear. Some days will feel like progress, and others will feel like relapse. That's not failure.
Leslie Poston:Your body's just learning how to feel safe again, and that takes time. And if your a score is high, I want you to know something. You're not broken. You are not weak or defective. You adapted to overwhelming circumstances, and those adaptations helped you survive.
Leslie Poston:They were smart, but now you get to decide if they're still serving you. There's a quote that I love that says, you are not what happened to you. You are what you choose to become. And that doesn't mean ignoring the past. It means understanding it, working with it, and choosing to move forward.
Leslie Poston:Thanks for listening to this episode of PsyberSpace. I'm your host, Leslie Poston, signing off. I'll include links to the ACE quizzes to somatic resources, therapist directories, and sub studies in the show notes for anyone who wants to dig deeper. And if this episode resonated or helped you understand yourself or someone you care about, do share it. You never know who might be walking around with a high ACE score wondering why everything feels so hard.
Leslie Poston:Don't forget to subscribe and get this in your inbox every Monday. And as always, stay curious.
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