Vincent Felitti conducted the ACE study in the 1990s as a way to study adverse childhood experiences, after noticing a potential connection between patients struggling with obesity and histories of incest. The study asked a variety of questions and gave participants a score; higher scores correlated to a host of behavioral and social issues. Despite providing ample empirical evidence of how childhood trauma causes other problems in people’s lives, the ACE study was largely ignored by the medical community—a telling example of contemporary medicine’s refusal to accept childhood trauma as its own diagnosis. 

Van der Kolk defines agency as “the technical term for the feeling of being in charge of your life” (97). Agency means “knowing where you stand, knowing that you have a say in what happens to you, knowing that you have some ability to shape your circumstances” (97). Loss of agency is a key factor in trauma. Both adults and children who have been traumatized experience a lack of agency, which leads to feeling like they don’t know themselves and have no control over their lives.