Unvalidated childhood emotions do not cause back pain

Once upon a time on social media, Jennifer Mann (@iamjenmann) expressed this opinion about how back pain works:

“The child whose emotions were never validated, is the adult with chronic back pain.”

I do not concur. Blaming back pain on relatively minor childhood emotional issues is extremely childish. It’s a reach even if we’re talking about more serious abuse and neglect.

Sharing this on social media provoked strongly … let’s say “polarized” responses. 😜

Some people clearly think this is an obnoxious way to gaslight people with a bogus idea of how back pain works (these are mostly from Dr. Jonathan Stea’s commenters, not mine):

• “I mean, if your ‘adverse childhood experience’ was being beat up and causing spine injury, sure, it could be why you have chronic back pain.”
• “Pretty sure that my chronic back pain comes from a horse shattering my L1 but please go on and tell me about my lack of validation as a child that caused it.”
• “Mmmm, mine is due to collapsed vertebrae.”
• “I guess the two negligent drivers who hit me and broke my neck, back and shoulder are off the hook.”
• “This kind of crap is absolutely infuriating. Perhaps she should try walking a mile — hell, even a block — in the shoes of any one of the thousands of people who suffer from herniated discs, scoliosis, sciatica etc.”
• “My recurring back problems were definitely caused by a child and trauma! Damaged it right after giving birth to my firstborn due to the natural state of my back muscles then!”

On the other side, many others think it’s a fine way to express an important principle of how pain works! Almost every comment in that vein referenced “adverse childhood experiences” as a significant factor in adult chronic pain.

But the “unvalidated childhood emotions” claim (and many others like it) is much too simplistic, and more like a parody of the significance of ACEs, taking it too literally and going way beyond what the science can support. It’s so silly that it is corrosive to the credibility of that more serious discussion.

Correlation versus causality strikes again (and worse)

Childhood trauma probably is relevant to adult health in complex and unpredictable ways … but I am not going to draw even a meandering line of causality between them. The research is actually quite limited and definitely incapable of showing causation, even if it’s good research.

But it may not be.

This isn’t just about the traditional, perpetually problematic conflation of correlation with causation: it’s also debatable whether the research even shows an actual correlation! Maybe it does. But definitely not necessarily. I know this will come as a big shock to everyone, but the studies aren’t actually all that great. Dr. Jim Coyne:

Most claims about trauma causing mental and physical health problems are, at best, based on very weak evidence, if they depend solely on the ACE checklist.

Dr. Coyne was an acquaintance of mine, and a fancy guy. I recruited him to write for ScienceBasedMedicine.org many years ago, and he was super generous with his correspondence and mentorship after that. I’m sad to report that he passed away late last year. Citing him on this important topic seems like a nice tribute, and an excellent example of what he contributed to our knowledge. Here are three of his articles about this:

• Stop Using the Adverse Childhood Experiences Checklist For Claims About Trauma Causing Physical and Mental Health Problems
• Independent Peer Review of the Adverse Childhood Experiences Checklist (ACEs)
• Wisdom of the Ego: Childhood Adverse Experiences Are Not Destiny

I link to these with an exasperated caveat: they are all technologically annoying! Not “paywalled” exactly, but behind a maze of hoops to jump through. Here’s a more accessible overview of the topic from Bronnie Lennox Thompson, just an ordinary webpage, hallelujah: Trauma: where do we go with it?