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Joanne Pizzino, MD, MPH, is board-certified in Preventive Medicine, and Integrative Medicine through the American Board of Physician Specialties. Whole Health Solutions practices the art of “trauma-informed care.” Check out our information on the Services tab to learn more about Advanced Integrated Therapies.

Is It Really Self-Inflicted, or Actually Self-Preservation? The Case for Compassion

By Joanne Pizzino, MD, MPH
Medical Editor of Health&Healing

Dr. Pizzino

Is quick, If you are like most humans, you have a strong instinct to first look at the external environment when something feels wrong or threatening. In a world of tigers and hurricanes, it is logical to look outside ourselves first to initiate self-preservation. This has led to our conventional beliefs that apparently harmful behaviors such as overeating and addiction to various substances or activities (gambling, sex, etc.) must lie in the chemical properties of the substances or neurotransmitters that the addictive behavior produces. Unfortunately, this view confuses mechanism with cause. Could it be that self-inflicted “dis-eases” actually come from something much deeper inside, and perhaps so long ago that it is all but forgotten? Could this place needless guilt or blame, and more compassion?

Why do only a small percentage of persons exposed to addictive substances become compulsive users? Vietnam veterans provide an interesting example of this: Many enlisted men in Vietnam regularly used heroin. However, 10 months after their return to the US, only 5 percent of those considered addicted were still using. Studies showed that treatment did not account for this high recovery rate. The current crisis relating to opiate addiction parallels this with many exposed to addictive prescription narcotics, but only a minority developing compulsive behaviors relating to the substance. Almost all of us are exposed to sugar, one of the most addictive of known substances, yet not everyone suffers heart disease, diabetes, dementia, or myriad other illnesses related to its over-consumption. Why not?

The Power of ACEs

The dozens of studies of Adverse Childhood Experiences (ACEs) reveal the most significant factors that tend to select those who will suffer health-related effects due to irrational behaviors, often called “self-inflicted harm.” In the mid-1980s, physicians in HMO Kaiser Permanente’s highly successful Weight Loss Program discovered that the biggest losers were most likely to drop out. This puzzling finding led them to discover that overeating and obesity were often being used unconsciously as protective solutions to unrecognized problems dating back to childhood. Along with researchers at the CDC, they found that ten aspects of severe adverse experiences during childhood could account, not only for obesity, but also for other “self-inflicted” behaviors. Ranging from physical abuse and neglect to poverty and death of a parent, these ACEs powerfully predict who will have heart, lung, liver, autoimmune diseases, cancer and mental illnesses 50 years later.

And, just like bigger doses of a poison, the more ACEs one has, the more cumulative damage. (See link “When 4 ACEs Do Not Add Up to a Win” to learn more about ACEs’s effects on physical health For instance, having 4-6 ACEs (that is, lots of difficult experiences as a child) increases one’s likelihood of smoking 250 percent, becoming an alcoholic 500 percent, or using injected drugs 4600 percent. What this is saying is that bad luck growing up leads to 2.5 to 46 times more likelihood to need to use psychoactive substances (including food) than someone who did not have these experiences.

The Case for Compassion

Could it be that the short-term benefits of these “self-destructive” behaviors are an attempt to calm long-buried triggers to the fight-flight-freeze mechanisms of the body (the sympathetic nervous system)? Could the need to escape from these perceived life-threatening demons outweigh potential long-term harm? Perhaps “self-inflicted” behaviors are really subconscious attempts to gain relief from long-buried prior life traumas concealed by shame, secrecy and social taboo.

If you or someone you know suffers with the very visible effects of self-preservation instincts such as obesity, alcohol or drug dependence, the first response should be compassion. Compassion for yourself or family members so afflicted leads to acceptance of root causes and finding solutions rather than blame.

At Whole Health Solutions, we use Advanced Integrated Therapies (see to gently modify the triggers that lead to compulsive “self-destructive” behaviors. Stop and give yourself a hug first; know you are doing the best you can to cope with adverse experiences you never asked for. And, then ask for that compassion and understanding from those who can help you to enjoy life free from substances that control you.