Adverse Childhood Experiences: The ACEs You Don’t Want to be Dealt

Last week I reviewed academic research regarding homelessness and foster care from this century’s first decade. Scholars debated the circumstances within which people develop executive function: planning ahead and giving up immediate rewards for long-term benefits. How do people on long losing streaks avoid “learning helplessness,” the fatalistic sense that, regardless of what we do right, everything goes wrong?

The consensus developed during the second decade is that ACEs (“adverse childhood experiences”) go wild: ACEs such as suffering abuse or neglect, witnessing violence in the home or community, or having a family member attempt or die by suicide, undermine senses of safety and stability. Substance use and mental health problems also deal ACEs. Many U.S. adults experience at least one type of ACE, but here’s what we can’t ignore if we hope to understand our most visible national plague: Most homeless adults hold in their hands at least four ACEs.

Continuing my academic journal-skipping service for readers, I won’t run through all the studies here, but will concentrate on a November 2021 Lancet Public Health article. Lead author Michael Liu and his colleagues examined “Adverse childhood experiences and related outcomes among adults experiencing homelessness.” They found that homeless adults have usually suffered physical, sexual, and emotional abuse and neglect, along with exposure to domestic violence. Nearly nine in ten homeless adults have been exposed to at least one early traumatic experience, and more than half have been exposed to four or more. (The incidence among the general population is 3-5%.)

There’s more: Five out of six young homeless adults had been physically abused. Most were sexually abused. Those exposed to four or more of those childhood traumas are 17 times more likely to have attempted suicide than those not traumatized in childhood. And yet, many discussions of homelessness ignore the ACEs those asleep on the streets (or trying to sleep) are clutching.

Of the dissertations I’ve read, one of my favorites is Gwendolyn Dordick’s Something Left to Lose: Personal Relations and Survival Among New York’s Homeless (1997), which she turned into a Temple University Press book. It’s lively and evocative, starting in her first chapter where she profiles Ron, Raheem, Sayjay, and Joey, whose ages run from 24 to mid-thirties — but we don’t learn much about their childhoods, since “they discourage talk of life prior to being on the street. ‘Everybody has a sob story,’ the men explain.” Yes, and it’s because everybody has one that we need to tell them.

Community First! Village founder Alan Graham says the single greatest cause of homelessness is “a profound, catastrophic loss of family.” Dordick’s next chapter introduces us to Susan, who lived in a shanty by the East River and became hooked on heroin while working at E.F. Hutton. She had older brothers and sisters who at first helped by hospitalizing her. She then lived with her brother, but when she “got hooked on dope again” her brothers and sisters “refused further help.”

The situations of other Dordick interviewees — Sammy, Tito, Ace, Red, Ginger, Lisa, Nina, Elaine, Richie, Louie, John, Juan, and Jimmy — illustrate Graham’s contention. One, Ollie, “wanted to ask his family for help . . . but felt ashamed to.” Others were not “in contact with housed relatives, and among those who were, visits ‘home’ were rare.” Reasons included banishment, shame, and pride. Ace said, “Livin’ up under my family, I couldn’t do it.” It’s poignant that Ginger “carries her mother’s phone number in her pocket but never calls.”

One classic book, My Life on the Street: Memoirs of a Faceless Man by “Joe Homeless” (1992), tells us on page three, “My story begins after I had turned thirty.” No, to see Joe’s face we should begin when he’s a newborn (or even earlier, as victims of fetal alcohol come to know). Another classic, Steven Vanderstaay’s Street Lives (1992), profiles one woman nicknamed “Hell” whose “mom had emotional problems, some type of mental disability, and drug addiction and alcoholism on top of it. . . . I was put into different foster homes. But they had their own children and their children were great and I wasn’t shit. So I had to — I kept running away from home and everything. And nothing went right.”

To understand why nothing goes right for hundreds of thousands who remain homeless year after year, we should follow once again the closing line of The Great Gatsby: “So we beat on, boats against the current, borne back ceaselessly into the past.” One man in Street Lives with the pseudonym “Batman” begins his story only when he’s an accomplice to robbery at age 17. That’s late. Another, Raymond, says merely, “I started getting into incidents. . . . the next thing I know my whole previous life had just vanished.” Maybe so, but it’s also hard to varnish abuse: memories of ACEs weigh down many who are homeless.