The Myth of Normal 186

shopping: yes or no?” The right answer, embedded in the question, is “yes or no,” depending on the degree of pain one needs to soothe. San Diego internal medicine specialist Dr. Vincent Felitti was one of the lead investigators of the now famous (though not famous enough) Adverse Childhood Experiences (ACE) Study. The study emerged after Felitti decided to listen to the life histories of patients at an obesity clinic who all reported childhood traumas. Carried out in the 1990s in California’s Kaiser Permanente health care network, the research showed that among a cohort of over seventeen thousand mostly Caucasian, middle-class persons, the more adversity a child had been exposed to, the greater the risk of addictions, mental health issues, and other medical problems they faced in adulthood.[1] Adversity was categorized under three general headings: abuse (psychological, physical, sexual); neglect (physical, emotional); household dysfunction (alcoholism or drug use in the home, divorce or loss of a biological parent, depression or mental illness in the home, mother treated violently, imprisoned household member). The impacts of such experiences did not merely add up; they multiplied each other. An adult reporting an ACE score of 6 had a risk of intravenous drug use forty-six-fold greater than a child with none of the adversities named. “It is commonly believed,” Felitti said, discussing his research, “that repeated use of many street drugs will in itself produce addiction. Our findings challenge those views . . . Addiction has relatively little to do with the supposed addictive properties of certain substances, other than their all providing a desirable psychoactive relief . . . In other words, this is an understandable attempt at self-treatment with something that almost works, thus creating a drive for further doses.”[2] Felitti’s childhood adversity findings lay further waste to the myth of genetic determinism that I began debunking in the chapter on epigenetics. No single addiction gene has ever been found—nor ever will be. There may exist some collection of genes that predisposes people to susceptibility, but a predisposition is not the same as a predetermination. What’s true of physical illness is just as true of addiction: genes are turned on and off by the environment, and we now know that early adversity affects genetic activity in