Authored by Kelly Matthews-Pluta, MSW

Gregory Miller, PhD, gave one of the many interesting presentations from the 54th Symposium on Bowen Theory and Psychotherapy in Washington, DC, on November 4-5, 2017.  Dr. Miller, a professor at Northwestern University in Evanston, IL, discussed his research on Adverse Childhood Events/Experiences (ACES) and physical health in adulthood.  He described experiences in childhood being “sticky” in a biological sense and often showing up later in poor physical health outcomes.  The ACES he outlined were the usual suspects: abuse and/or neglect and low socio economic status (SES).  These hardships in childhood appear to have transferred to the cell make-up.  In adulthood this can translate to impaired immune function, heart disease, stroke, cancer and obesity.  The common thread with these diseases is chronic low level inflammation.  He used the phrase “reactive cells” to illustrate stress response system reacting more and calming down less.  The wear and tear of chronic stress, sometimes low levels, but near constant, appears to deplete the system.  So the rate of shut down, the down regulation after a threat is removed or neutralized, may be more important than how often it is activated.

In addition, his studies show that improvements in SES in adult hood, say from a childhood of low SES, does not always correlate with improvement on physical health.  The cells appear embedded with ACES.  While some groups with low childhood SES and high ACES show some health stabilization in adult hood, people of color do not.  In fact, his findings indicate a person of color, who had a high ACES score and raised their SES in adult hood, would have a higher likelihood of poor health than a similar scoring peer who did not raise their SES.  This outcome is puzzling as it would seem a person with high ACES, who then graduates from college and lives in a higher SES would fare better than a peer who’s SES stays low.  However, if you consider the toll it might take to improve one’s SES and contend with racism, the outcomes become clearer.  To complicate the picture further, Dr. Miller’s work shows better mental health outcomes for the group of college graduates at the same time the physical health outcomes are worse.  The cost of success for people of color, who came from low SES, is high.  The light in this tunnel appears to be relationships.  The one factor that showed better outcomes was if the person of color reported a responsive, available and nurturing caregiver in childhood.

The implications of Dr. Miller’s work fit well with the relationship focus of Bowen Theory.  The difficult and challenging experiences of high ACES and low SES can be managed within a responsive caregiver relationship.  The importance of human relationships and connections is a key piece in Bowen Theory.  The research of Dr. Miller appears to show similar results.