10 ms·

Book Review: The Body Keeps the Score

130 points by rayalez 7y ago

afpx 7y ago
The reviewer shows lack of critical thinking and lack of understanding of how genes work when he goes on a political rant at the end of the first section. Armchair scientists have got to go.
- uxp100 7y ago
  practicing psychiatrist, but armchair scientist, I suppose.
- skybrian 7y ago
  It seemed reasonable to me, but I'm no expert. What do you think he got wrong and do you have any recommendations for further reading?
  - afpx 7y ago
    My issue is that he implies that there’s something nefarious going on because of a lack of discussion of genes. I claim he lacks critical thinking because he ignores that the book’s primary audience is a person with past trauma, not someone with sufficient biological understanding to get the nuances of “genes”. So, instead of implying some political agenda, it’s safer to infer that the author left out the discussions to prevent an overly-generalized explanation that may cause more harm. For example, see what happened with BRCA. Look also what happened with “The Bell Curve”. It’s easy for a lay reader to view genetics as the cause rather than one (extremely nuanced) factor of many. And, when we see that many victims of trauma are, by circumstance, at the lower end of the social class spectrum, this leads down a slippery slope. Second, medical doctors aren’t usually also research scientists. They’re specialists in clinical treatment of physiology. He’s probably smart and well educated. But, not a scientist. As an analogy, it’s similar to when I cringe when I see a programmer try to write a new cryptography protocol or algorithm. Some things are complex and risky enough to leave to the experts.
    - skybrian 7y ago
      I haven't read the book so I don't know who's right. But this sounds a little too much like "how dare he question authority?" The reviewer is a doctor and doctors are supposed to be able to understand genetics and read the scientific literature. Maybe not at the same level as a specialist, being able to follow along and tell good science from bad is useful. As a programmer, I wouldn't be so foolish as to write my own cryptography code, but I understand the basic principles, I do try to keep up, and I expect a researcher writing a book to discuss security issues without dumbing it down too much. If I were reviewing a book saying something about cryptography that seems wrong I would definitely point it out. (Though, not being an expert, it might be in the form of asking questions.) We can't get anywhere without trusting experts, but that doesn't mean we can't read critically.
- commandlinefan 7y ago
  He's a medical doctor... I'm sure he has a better understanding of genetics than 99% of the population.
keeptrying 7y ago
This might be one of the only books that I would classify as a “must read”. The perspective of being able to debug your own brain is invaluable and understanding other methods to do the same are worth the price of the book. Buy an electronic and paperback. Great book.
- bananatron 7y ago
  I totally agree. It's been the most insightful book I've read this year.
- azeirah 7y ago
  I do agree. I stand with SSC's criticisms about the details, but I do believe that despite its flaws, it does communicate a very important message effectively. Namely, that your mental health is part of your body, not part of your mind. It really changed my perspective, where before I had contempt about my body, saw it as a nuisance, I now understand I -am- my body. It's as much a part of me as my mind. It helped me look into the right direction for treatment and additional resources.
  - jimmux 7y ago
    The other side of the coin that this book helped me to see is that I am not my symptoms. There were parts of my behaviour that held me back, but I thought were crucial to my identity so I was reluctant to let them go. After I realised that they were symptomatic of psychological injury and not part of my fundamental identity, I allowed the change to happen. It felt more like going through a process of healing in the same way that I might treat a muscle strain, and not spend the rest of my life limping because of a bad fall. I realise that sounds a bit contradictory - I guess the idea is that my mind is part of body and can be treated as such, which makes it necessary to liberate the ego from the rest of the mind. It made the concept of mindfulness finally click for me.
jacek 7y ago
Another summary of the book that was discussed on HN three weeks ago: https://praxis.fortelabs.co/the-body-keeps-the-score-summary/ https://praxis.fortelabs.co/the-body-keeps-the-score-summary... Discussion: https://news.ycombinator.com/item?id=21340636 https://news.ycombinator.com/item?id=21340636
imgabe 7y ago
> First, I think van der Kolk downplays the importance of the APA’s philosophical commitment to categorizing by symptoms rather than cause. Consider four patients, Alice, Bob, Carol, and Dan. Alice has poor concentration caused by child abuse. Bob has poor concentration caused by bad genes. Carol throws tantrums because child abuse. Dan throws tantrums because bad genes. The current DSM would categorize Alice and Bob as ADHD, and Carol and Dan as intermittent explosive disorder. Van der Kolk would like to classify Alice and Carol as having Developmental Trauma Disorder, and Bob and Dan as…I don’t know. Bad Gene Disorder? Seems sketchy. When the APA decides not to do that, they’re not necessarily rejecting the seriousness of child abuse, only saying it’s not the kind of thing they build their categories around. This seems like a problem with the APA. Why would they categorize around symptoms? The same symptoms can have different root causes and would then require different treatments. So doesn't it make sense to categorize around root causes? The rest of medicine seems to be more concerned with causes. A sore throat might be a cold, or it might be cancer. Obviously they require different treatments, so they don't lump them all into "sore throat" and do the same thing every time there's a sore throat. Likewise if someone exhibits the symptom of ADHD and the cause is "Bad Genes" but you're trying to treat them for non-existent trauma, it doesn't seem like it's going to be effective.
- barry-cotter 7y ago
  > This seems like a problem with the APA. Why would they categorize around symptoms? Because the APA is well aware that for many if not most psychiatric illnesses they are at the “fever” level of specificity in diagnosis, not “malaria” or “influenza”. But they have treatments that work for fever and very limited insight into the etiology of the diseases they work with. > The same symptoms can have different root causes and would then require different treatments. So doesn't it make sense to categorize around root causes? If they could they would. I’m sure there are examples of where a single psychiatric illnesses’ etiology has been uncovered and then they’ve broken it out into its own thing, and recommended the specific treatment for it that reliably works.
- nabnob 7y ago
  I thought all medicine used differential diagnosis, where you start with symptoms and gradually eliminate potential causes, until you're left with the most likely cause.
patrec 7y ago
> Like so many things, PTSD feels self-evident once you know about it. Only from the myopic perspective of people only used to a life of luxury and ease. Throughout most of history several of the people most close to you would have made an early and often quite unpleasant exit before you reached adulthood -- most of your siblings and children would probably not make it into adulthood and women had a double digit chance of dying from child birth[1]. And that held true even if you were an affluent member of a relatively stable and successful society. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1139114/pdf/medhist00088-0087.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1139114/pdf/med... So a priori it seems extremely unlikely to me that severely unpleasant experiences have psychologically crippling effects on a majority of people. Because that would seem to be extremely maladaptive for almost all of the last few millenia.
- throwanem 7y ago
  The same reasoning, from the same prior, suggests that lead poisoning probably also doesn't exist. After all, the Romans made water pipes out of the stuff, and look how well they did.
  - Filligree 7y ago
    Roman water pipes ended up covered in (substance I don't recall the name of), and so not much lead leeched into the water. Water jugs made of lead were probably more of a problem. The same holds true for modern lead pipes. They work fine, until they don't.
- nyolfen 7y ago
  anthropologist greg cochran has made the same point: https://westhunt.wordpress.com/2018/08/18/ptsd/ https://westhunt.wordpress.com/2018/08/18/ptsd/ then again, from what we can tell about the premodern world it seems much more violent than what we are accustomed to.
  - pjc50 7y ago
    Per his wikipedia he appears to believe that homosexuality is caused by a virus? https://en.wikipedia.org/wiki/Gregory_Cochran https://en.wikipedia.org/wiki/Gregory_Cochran
docdeek 7y ago
>> The standard textbook of psychiatry at the time stated that incest was extremely rare in the United States, cocurring about once in every million women. This would seem incredibly low, even for a non-expert. At the time, as the article notes, there were 100 million women in the US - for incest to only impact 100 women in the country and yet be something that there is a word (noun) for, laws against, and historical records of stretching back millenia stretches credibility, surely.
- pjc50 7y ago
  This sounds like more confirmation that the old standard textbooks about psychiatry contained far more traditional belief and sexual pseudoscience than the profession was willing to admit. Remember how long it took to get homosexuality removed from the DSM? It's a bit like global warming denialism. Admitting that child abuse within families is not extremely rare has absolutely horrifying implications for people's moral universes. Much easier to deny it happens. > [Update, written a few weeks after the rest of this post: maybe it is all wizardry. I recommended this book to a severely traumatized patient of mine, who had not benefited from years of conventional treatment, and who wanted to know more about their condition. The next week the patient came in, claiming to be completely cured, and displaying behaviors consistent with this. They did not use any of the techniques in this book, but said that reading the book helped them figure out an indescribable mental motion they could take to resolve their trauma, and that after taking this mental motion their problems were gone. I’m not sure what to think of this or how much I should revise the negative opinion of this book which I formed before this event.] "We have some treatments; they seem to work sometimes, although we don't really understand why and they're not entirely reliable" is still a far better place than "we have no treatments", which in turn is far better than "your condition does not exist and you are lying". I feel slightly better about SSC for admitting this and being willing to carry on working in an uncertain environment.
  - slfnflctd 7y ago
    The practice of psychiatry is filled with disasters, and has been more of a reflection of our culture than a science for much of its history. It is good of you to point out how there's been steady improvement-- we should remember that the field's utility can be improved. I still would hesitate to recommend a psychiatrist's services to anyone without an extensive disclaimer, though. [In a way that I wouldn't with a general practitioner, or even a talk therapist.] It would be great if that changed one day.
foobar_ 7y ago
On a minor pedantic note, its more like the amygdala keeps the score. There is no difference between physical abuse and emotional abuse when it comes to the final end result on the brain.
- pjc50 7y ago
  That's .. the unsolved research question under discussion? As to whether there is a score at all, where it is kept, and how it might be affected? And while is seems there is some evidence, we're still in the middle of the replication crisis?
  - Mahn 7y ago
    According to Dr. Sapolsky (Why Zebras Don't Get Ulcers, Behave), there's ample evidence of enlarged, hyperactive amygdalas in chronically stressed individuals, both on artificially stressed lab rats and when looking at differences in individual human beings.
michael_j_ward 7y ago
Interesting bit burried in section IV that I'm posting here in the likely event that most people don't read that far. TL/DR- he's mostly critical of the book, but provides this update: >[Update, written a few weeks after the rest of this post: maybe it is all wizardry. I recommended this book to a severely traumatized patient of mine, who had not benefited from years of conventional treatment, and who wanted to know more about their condition. The next week the patient came in, claiming to be completely cured, and displaying behaviors consistent with this. They did not use any of the techniques in this book, but said that reading the book helped them figure out an indescribable mental motion they could take to resolve their trauma, and that after taking this mental motion their problems were gone. I’m not sure what to think of this or how much I should revise the negative opinion of this book which I formed before this event.]
- alex504 7y ago
  Yes I found this very amusing. For several reasons: - Within a week he seems to have found that the content of the book was more effective than years of his treatment of atleast one patient - He buries this as deeply within the article as possible - This experience casts light on the crux of my issue with the article, which is that it is very much a "prereplication" book review. The reality is that neither the author of the book or the review have solid empirical evidence one way or the other, in terms of modern style studies. The book review seems to be drawing an overly negative conclusion about the research because of this fact. To me this is a demonstration of an overreliance on empiricism that seems to dog alot of western medicine practitioners in general. I found this line very revealing: >later studies – done in an atmosphere of boredom, by large multi-center consortia – are almost always disappointing. I'm not sure what the phrase "atmosphere of boredom" signifies but it doesn't sound like a faithful attempt to get something to work. If you are doing any of these treatments in an atmosphere of boredom will it actually be effective? Is doing it in an atmosphere of boredom really a valid way of testing it? I haven't read the book but will read it. It does seem to me that the thesis of the book, that trauma causes the mind to disconnect from the body and shapes the body, is something that Chinese medicine / Qi Gong practitioners have known about for thousands of years. I don't have any empirical evidence to back these specific practices but I have mountains of anecdotal evidence that would seemingly be rejected by the author of the review.
fellow_human 7y ago
> Even the studies that have passed the test of time look a little weird. The Adverse Childhood Experiences study found that obesity and other seemingly nonpsychiatric diseases were linked to child abuse, and recent studies confirm this – but the controls for socioeconomic status are always insufficient, and there’s surprisingly little shared environmental component. I'm not sure of the author is purposefully ignorant about this, but the original ACE study was done on middle class households, 75% white. https://www.npr.org/sections/health-shots/2018/09/17/648710859/childhood-trauma-and-its-lifelong-health-effects-more-prevalent-among-minorities https://www.npr.org/sections/health-shots/2018/09/17/6487108...
- SpicyLemonZest 7y ago
  I'm not sure I follow. The US is 75% white, and by many definitions (I can't tell from this article how they defined it) is mostly middle class.
  - fellow_human 7y ago
    Perhaps whiteness is irrelevant, perhaps not. Socioeconomic background was controlled for the fact that the participants were from the middle class. Whether that's inherent to the US population due to the fact that it's a big part of it, or not is irrelevant. Unless I've missed your point?

130 points by rayalez 7y ago

afpx 7y ago

The reviewer shows lack of critical thinking and lack of understanding of how genes work when he goes on a political rant at the end of the first section. Armchair scientists have got to go.

uxp100 7y ago
practicing psychiatrist, but armchair scientist, I suppose.
skybrian 7y ago
It seemed reasonable to me, but I'm no expert. What do you think he got wrong and do you have any recommendations for further reading?
- afpx 7y ago
  My issue is that he implies that there’s something nefarious going on because of a lack of discussion of genes. I claim he lacks critical thinking because he ignores that the book’s primary audience is a person with past trauma, not someone with sufficient biological understanding to get the nuances of “genes”. So, instead of implying some political agenda, it’s safer to infer that the author left out the discussions to prevent an overly-generalized explanation that may cause more harm. For example, see what happened with BRCA. Look also what happened with “The Bell Curve”. It’s easy for a lay reader to view genetics as the cause rather than one (extremely nuanced) factor of many. And, when we see that many victims of trauma are, by circumstance, at the lower end of the social class spectrum, this leads down a slippery slope. Second, medical doctors aren’t usually also research scientists. They’re specialists in clinical treatment of physiology. He’s probably smart and well educated. But, not a scientist. As an analogy, it’s similar to when I cringe when I see a programmer try to write a new cryptography protocol or algorithm. Some things are complex and risky enough to leave to the experts.
  - skybrian 7y ago
    I haven't read the book so I don't know who's right. But this sounds a little too much like "how dare he question authority?" The reviewer is a doctor and doctors are supposed to be able to understand genetics and read the scientific literature. Maybe not at the same level as a specialist, being able to follow along and tell good science from bad is useful. As a programmer, I wouldn't be so foolish as to write my own cryptography code, but I understand the basic principles, I do try to keep up, and I expect a researcher writing a book to discuss security issues without dumbing it down too much. If I were reviewing a book saying something about cryptography that seems wrong I would definitely point it out. (Though, not being an expert, it might be in the form of asking questions.) We can't get anywhere without trusting experts, but that doesn't mean we can't read critically.
commandlinefan 7y ago
He's a medical doctor... I'm sure he has a better understanding of genetics than 99% of the population.

keeptrying 7y ago

This might be one of the only books that I would classify as a “must read”. The perspective of being able to debug your own brain is invaluable and understanding other methods to do the same are worth the price of the book. Buy an electronic and paperback. Great book.

bananatron 7y ago
I totally agree. It's been the most insightful book I've read this year.
azeirah 7y ago
I do agree. I stand with SSC's criticisms about the details, but I do believe that despite its flaws, it does communicate a very important message effectively. Namely, that your mental health is part of your body, not part of your mind. It really changed my perspective, where before I had contempt about my body, saw it as a nuisance, I now understand I -am- my body. It's as much a part of me as my mind. It helped me look into the right direction for treatment and additional resources.
- jimmux 7y ago
  The other side of the coin that this book helped me to see is that I am not my symptoms. There were parts of my behaviour that held me back, but I thought were crucial to my identity so I was reluctant to let them go. After I realised that they were symptomatic of psychological injury and not part of my fundamental identity, I allowed the change to happen. It felt more like going through a process of healing in the same way that I might treat a muscle strain, and not spend the rest of my life limping because of a bad fall. I realise that sounds a bit contradictory - I guess the idea is that my mind is part of body and can be treated as such, which makes it necessary to liberate the ego from the rest of the mind. It made the concept of mindfulness finally click for me.

jacek 7y ago

Another summary of the book that was discussed on HN three weeks ago: https://praxis.fortelabs.co/the-body-keeps-the-score-summary/ https://praxis.fortelabs.co/the-body-keeps-the-score-summary... Discussion: https://news.ycombinator.com/item?id=21340636 https://news.ycombinator.com/item?id=21340636

imgabe 7y ago

> First, I think van der Kolk downplays the importance of the APA’s philosophical commitment to categorizing by symptoms rather than cause. Consider four patients, Alice, Bob, Carol, and Dan. Alice has poor concentration caused by child abuse. Bob has poor concentration caused by bad genes. Carol throws tantrums because child abuse. Dan throws tantrums because bad genes. The current DSM would categorize Alice and Bob as ADHD, and Carol and Dan as intermittent explosive disorder. Van der Kolk would like to classify Alice and Carol as having Developmental Trauma Disorder, and Bob and Dan as…I don’t know. Bad Gene Disorder? Seems sketchy. When the APA decides not to do that, they’re not necessarily rejecting the seriousness of child abuse, only saying it’s not the kind of thing they build their categories around. This seems like a problem with the APA. Why would they categorize around symptoms? The same symptoms can have different root causes and would then require different treatments. So doesn't it make sense to categorize around root causes? The rest of medicine seems to be more concerned with causes. A sore throat might be a cold, or it might be cancer. Obviously they require different treatments, so they don't lump them all into "sore throat" and do the same thing every time there's a sore throat. Likewise if someone exhibits the symptom of ADHD and the cause is "Bad Genes" but you're trying to treat them for non-existent trauma, it doesn't seem like it's going to be effective.

barry-cotter 7y ago
> This seems like a problem with the APA. Why would they categorize around symptoms? Because the APA is well aware that for many if not most psychiatric illnesses they are at the “fever” level of specificity in diagnosis, not “malaria” or “influenza”. But they have treatments that work for fever and very limited insight into the etiology of the diseases they work with. > The same symptoms can have different root causes and would then require different treatments. So doesn't it make sense to categorize around root causes? If they could they would. I’m sure there are examples of where a single psychiatric illnesses’ etiology has been uncovered and then they’ve broken it out into its own thing, and recommended the specific treatment for it that reliably works.
nabnob 7y ago
I thought all medicine used differential diagnosis, where you start with symptoms and gradually eliminate potential causes, until you're left with the most likely cause.

patrec 7y ago

> Like so many things, PTSD feels self-evident once you know about it. Only from the myopic perspective of people only used to a life of luxury and ease. Throughout most of history several of the people most close to you would have made an early and often quite unpleasant exit before you reached adulthood -- most of your siblings and children would probably not make it into adulthood and women had a double digit chance of dying from child birth[1]. And that held true even if you were an affluent member of a relatively stable and successful society. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1139114/pdf/medhist00088-0087.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1139114/pdf/med... So a priori it seems extremely unlikely to me that severely unpleasant experiences have psychologically crippling effects on a majority of people. Because that would seem to be extremely maladaptive for almost all of the last few millenia.

throwanem 7y ago
The same reasoning, from the same prior, suggests that lead poisoning probably also doesn't exist. After all, the Romans made water pipes out of the stuff, and look how well they did.
- Filligree 7y ago
  Roman water pipes ended up covered in (substance I don't recall the name of), and so not much lead leeched into the water. Water jugs made of lead were probably more of a problem. The same holds true for modern lead pipes. They work fine, until they don't.
nyolfen 7y ago
anthropologist greg cochran has made the same point: https://westhunt.wordpress.com/2018/08/18/ptsd/ https://westhunt.wordpress.com/2018/08/18/ptsd/ then again, from what we can tell about the premodern world it seems much more violent than what we are accustomed to.
- pjc50 7y ago
  Per his wikipedia he appears to believe that homosexuality is caused by a virus? https://en.wikipedia.org/wiki/Gregory_Cochran https://en.wikipedia.org/wiki/Gregory_Cochran

docdeek 7y ago

>> The standard textbook of psychiatry at the time stated that incest was extremely rare in the United States, cocurring about once in every million women. This would seem incredibly low, even for a non-expert. At the time, as the article notes, there were 100 million women in the US - for incest to only impact 100 women in the country and yet be something that there is a word (noun) for, laws against, and historical records of stretching back millenia stretches credibility, surely.

pjc50 7y ago
This sounds like more confirmation that the old standard textbooks about psychiatry contained far more traditional belief and sexual pseudoscience than the profession was willing to admit. Remember how long it took to get homosexuality removed from the DSM? It's a bit like global warming denialism. Admitting that child abuse within families is not extremely rare has absolutely horrifying implications for people's moral universes. Much easier to deny it happens. > [Update, written a few weeks after the rest of this post: maybe it is all wizardry. I recommended this book to a severely traumatized patient of mine, who had not benefited from years of conventional treatment, and who wanted to know more about their condition. The next week the patient came in, claiming to be completely cured, and displaying behaviors consistent with this. They did not use any of the techniques in this book, but said that reading the book helped them figure out an indescribable mental motion they could take to resolve their trauma, and that after taking this mental motion their problems were gone. I’m not sure what to think of this or how much I should revise the negative opinion of this book which I formed before this event.] "We have some treatments; they seem to work sometimes, although we don't really understand why and they're not entirely reliable" is still a far better place than "we have no treatments", which in turn is far better than "your condition does not exist and you are lying". I feel slightly better about SSC for admitting this and being willing to carry on working in an uncertain environment.
- slfnflctd 7y ago
  The practice of psychiatry is filled with disasters, and has been more of a reflection of our culture than a science for much of its history. It is good of you to point out how there's been steady improvement-- we should remember that the field's utility can be improved. I still would hesitate to recommend a psychiatrist's services to anyone without an extensive disclaimer, though. [In a way that I wouldn't with a general practitioner, or even a talk therapist.] It would be great if that changed one day.

foobar_ 7y ago

On a minor pedantic note, its more like the amygdala keeps the score. There is no difference between physical abuse and emotional abuse when it comes to the final end result on the brain.

pjc50 7y ago
That's .. the unsolved research question under discussion? As to whether there is a score at all, where it is kept, and how it might be affected? And while is seems there is some evidence, we're still in the middle of the replication crisis?
- Mahn 7y ago
  According to Dr. Sapolsky (Why Zebras Don't Get Ulcers, Behave), there's ample evidence of enlarged, hyperactive amygdalas in chronically stressed individuals, both on artificially stressed lab rats and when looking at differences in individual human beings.

michael_j_ward 7y ago

Interesting bit burried in section IV that I'm posting here in the likely event that most people don't read that far. TL/DR- he's mostly critical of the book, but provides this update: >[Update, written a few weeks after the rest of this post: maybe it is all wizardry. I recommended this book to a severely traumatized patient of mine, who had not benefited from years of conventional treatment, and who wanted to know more about their condition. The next week the patient came in, claiming to be completely cured, and displaying behaviors consistent with this. They did not use any of the techniques in this book, but said that reading the book helped them figure out an indescribable mental motion they could take to resolve their trauma, and that after taking this mental motion their problems were gone. I’m not sure what to think of this or how much I should revise the negative opinion of this book which I formed before this event.]

alex504 7y ago
Yes I found this very amusing. For several reasons: - Within a week he seems to have found that the content of the book was more effective than years of his treatment of atleast one patient - He buries this as deeply within the article as possible - This experience casts light on the crux of my issue with the article, which is that it is very much a "prereplication" book review. The reality is that neither the author of the book or the review have solid empirical evidence one way or the other, in terms of modern style studies. The book review seems to be drawing an overly negative conclusion about the research because of this fact. To me this is a demonstration of an overreliance on empiricism that seems to dog alot of western medicine practitioners in general. I found this line very revealing: >later studies – done in an atmosphere of boredom, by large multi-center consortia – are almost always disappointing. I'm not sure what the phrase "atmosphere of boredom" signifies but it doesn't sound like a faithful attempt to get something to work. If you are doing any of these treatments in an atmosphere of boredom will it actually be effective? Is doing it in an atmosphere of boredom really a valid way of testing it? I haven't read the book but will read it. It does seem to me that the thesis of the book, that trauma causes the mind to disconnect from the body and shapes the body, is something that Chinese medicine / Qi Gong practitioners have known about for thousands of years. I don't have any empirical evidence to back these specific practices but I have mountains of anecdotal evidence that would seemingly be rejected by the author of the review.

fellow_human 7y ago

> Even the studies that have passed the test of time look a little weird. The Adverse Childhood Experiences study found that obesity and other seemingly nonpsychiatric diseases were linked to child abuse, and recent studies confirm this – but the controls for socioeconomic status are always insufficient, and there’s surprisingly little shared environmental component. I'm not sure of the author is purposefully ignorant about this, but the original ACE study was done on middle class households, 75% white. https://www.npr.org/sections/health-shots/2018/09/17/648710859/childhood-trauma-and-its-lifelong-health-effects-more-prevalent-among-minorities https://www.npr.org/sections/health-shots/2018/09/17/6487108...

SpicyLemonZest 7y ago
I'm not sure I follow. The US is 75% white, and by many definitions (I can't tell from this article how they defined it) is mostly middle class.
- fellow_human 7y ago
  Perhaps whiteness is irrelevant, perhaps not. Socioeconomic background was controlled for the fact that the participants were from the middle class. Whether that's inherent to the US population due to the fact that it's a big part of it, or not is irrelevant. Unless I've missed your point?