When he was a child, maybe 7 or 8 years old, Fred Nelson remembers what would happen when his mother and her boyfriend drank. After a few beers, they would start arguing, then the boyfriend would hit her.
“I knew then that there was a problem,” said Nelson, now 54. “I knew that something wasn’t right about all of that.”
Children are adaptable and often don’t know anything but their own “normal.” But Nelson’s youthful intuition was remarkably accurate.
Alcohol or other substance abuse by a parent is considered an adverse childhood experience, or ACE. In 1998, a group of psychologists coined the term in one of the largest investigations of the effects of childhood abuse and neglect on later-life health and well-being. That study – and others that followed – revealed a relationship between ACEs and negative well-being throughout life.
Nelson’s mother was an alcoholic. Now, so is he.
John Bachman is a psychologist who specializes in addictive behaviors and disorders, and the generational tale that Nelson shares wouldn’t surprise him. According to Bachman, the majority of his patients suffering from addiction have extraordinarily traumatic pasts. In many cases, that includes coming from a household where a primary caregiver struggled with substance abuse, as well.
“With kids growing up in families where one or more members are struggling with addiction, the issue is the inattention to the child’s needs that the drug-addicted parent demonstrates,” Bachman explained. “One of the hallmark diagnostic features of opioid drug dependence is that there’s a constant craving for the high. There’s compulsive behavior around getting the next dose and there’s a sense of, ‘To hell with the consequences. Getting high is much more important than changing a diaper.’ ”
Katie Haupt was a few years older than Nelson when she first understood her father had a problem. Growing up in Lake County, she said her dad always drank and had drugs around the house, but she thought that’s just what adults did. But around 11 or 12, when she started inviting friends to sleep over, Haupt realized her father’s behavior was out of the ordinary.
“My dad would be barbecuing or whatever, and then he’d start drinking. Then some kind of argument would happen, and it would turn really violent and loud,” said Haupt, who now lives in Texas. “And my friends would get scared that they were in danger, and to me, I was like, ‘Oh, no, he’s not going to mess with us. They’re just arguing.’ I was just so used to this. ‘Don’t be scared. This is normal.’ But, for them, it was not normal and they wanted to go home.”
The National Institute on Drug Abuse estimates that a quarter of children in the U.S. grow up in households where there is substance abuse, and studies suggest that children of addicts are eight times more likely to develop an addiction of their own.
A pyramid depicts the conceptual framework for the ACE study. Adverse childhood experiences make up the base and each level escalates from there: disrupted neurodevelopment to social, emotional and cognitive impairment to adoption of health-risk behaviors to disease, disability and social problems. The tip of the pyramid is early death.
Nelson’s childhood was plagued by ACEs. Beyond witnessing his mother’s alcoholism and abuse, he struggled in school and got involved with street gangs. He said a female relative sexually abused him when he was as young as 5 years old, a secret he kept from his family for decades in fear of creating problems.
Built on that base, his adult life followed the troubling and dangerous progression of the ACE pyramid. Nelson struggles with alcohol and cocaine addiction. He said he has been diagnosed bipolar and he contracted HIV under the influence of drugs. He has been in and out of prison and rehab. Right now, he is homeless.
Nelson receives help from Heartland Alliance Health, a Chicago organization that works in communities across the U.S. to serve those who are homeless or living in poverty. He has been attending its therapy sessions for years. Joan Liautaud, Heartland’s senior director of clinical operations, said destructive behavior is a common reaction for children of substance abuse, but pointed out that the unhealthy pathologies aren’t limited to substance problems.
“It’s very common for these children to develop addictions of their own. And when I talk about addiction, I mean broad-based,” she said. “So it could be some sort of compulsive behavior. … That’s on top of things that most people struggle with, more typical things like identity development or self-worth.”
Haupt, now 31, never battled drug or alcohol abuse, but she realized she ate and shopped compulsively when she was emotional or unhappy.
“It was partially because when things got really crazy, my mom would say, ‘Oh let’s go shopping.’ To escape. To get away from this, let’s cover it up and pretend it’s OK by doing that,” Haupt said. “It wasn’t until later that I realized that it’s not healthy to cover up pain. You have to kind of figure it out, deal with it, face that pain, instead of burying it down. That’s why people get addicted, because they get addicted to not feeling pain.”
Liautaud elaborated that the compulsive behavior often manifests as codependent caregiving or a desire to over-commit. Bachman also noted that even if people break the cycle of substance abuse, they may continue to seek out the sort of treatment they received as children.
“In adulthood, oftentimes a child raised in that neglectful environment will seek out other adults who will behave in similar ways,” Bachman said. “Or the child who has now become the adult, that person’s default behavior is to treat others with neglect and abuse. That’s what his or her role model taught him or her.”
Many of those unhealthy behaviors continue to manifest themselves in Nelson’s life today.
“I come from what they call a dysfunctional family. I have a lot of resentment,” Nelson said. “So when I think about those things, that’s enough to make me feel like, I don’t know – it’s not like I can’t be happy and have a good life, but sometimes that plays a part in why I act out the way I act out.”