How Early Experiences Shape Who We Become

Pick up a stone from any beach and turn it in your hand. Notice its shape, its smoothness, the way light catches the striations of mineral deposits laid down perhaps millions of years ago. This stone remembers everything that shaped it—the volcanic heat that transformed its original composition, the glacial movements that carried it across continents, the endless rhythm of water that smoothed its rough edges over millennia. The stone cannot forget these forces. They are not memories to be recalled or dismissed; they are the stone itself, written into its very structure.

We are not so different.

When I work with professionals in healthcare, education, and social services—people who encounter individuals struggling with addiction, mental illness, and trauma—I often meet resistance to the developmental perspective: the notion that what shaped us so long ago may still exert a persistent force. In some ways, the resistance makes sense: accepting that early experiences shape vulnerability to addiction and mental health challenges later in life can feel like accepting blame, fatalism, or an excuse for poor choices. It can feel like we’re saying childhood determines everything and nothing can be changed.

But that’s not what the developmental perspective says. It says something both more nuanced and more hopeful: early experiences create vulnerabilities and dispositions that shape how we respond to life’s challenges, not destinies that cannot be altered. Like glaciers shaping stones, like water smoothing rough edges, like volcanic heat transforming mineral composition—early experience literally shapes who we become, not through cause and effect, but through the fundamental plasticity of the developing nervous system during critical windows of development.

This isn’t speculation or bias; it's what decades of research have consistently demonstrated. Understanding this changes how we support people struggling with addiction and mental health challenges.

The child is father of the man.

The Evidence

In the 1990s, two researchers—Vincent Felitti and Robert Anda—asked what seemed like a simple question: Do adverse experiences in childhood create vulnerabilities that persist across the entire lifespan? They surveyed over 17,000 adults about ten categories of childhood adversity occurring before age 18: physical, emotional, and sexual abuse; physical and emotional neglect; witnessing domestic violence; household substance abuse; household mental illness; parental separation or divorce; and having an incarcerated household member (Felitti et al., 1998).

They affirmed what most clinicians already know: childhood experiences (ACEs) don’t just affect people during childhood—they create biological and psychological vulnerabilities that persist across the lifespan, dramatically increasing the risk of addiction, mental illness, chronic disease, and early death. The relationship between ACEs and health outcomes followed what researchers call a “dose-response” pattern, like stones accumulating on a beach, each one weighing down the developing child’s capacity to thrive:

• One adverse childhood experience doubled the risk of alcoholism
• Two ACEs quadrupled the risk
• Four or more ACEs meant a person was seven times more likely to struggle with alcoholism and ten times more likely to inject drugs (Felitti et al., 1998)

This pattern extended to nearly every major health outcome. Adults with four or more ACEs showed twelve times higher prevalence of suicide attempts, seven times higher likelihood of alcoholism, and dramatically increased risk of heart disease, cancer, chronic lung disease, and liver disease compared to those with no ACEs (Felitti et al., 1998).

The pattern was unambiguous: the more adverse experiences in childhood, the higher the risk of physical and mental health problems in adolescence and adulthood. Not because these experiences caused illness directly through simple cause and effect, but because they shaped the developing nervous system in ways that made the individual more vulnerable.

The Evidence Keeps Accumulating

In the more than 25 years since the original ACE study, the findings have been confirmed across hundreds of studies in diverse populations and multiple countries. Recent research continues to demonstrate the profound and lasting impact of early adversity:

A 2024 study tracking health outcomes over 20 years found that children exposed to ACEs showed significantly higher rates of traumatic injuries, mental health disorders, and physical health problems throughout childhood and adolescence (Martins et al., 2025). A 2024 meta-analysis examining data from 33 U.S. states between 2019-2023 found clear dose-response relationships between ACE exposure and 17 different chronic health conditions in adulthood, with effects particularly pronounced for individuals from historically marginalized communities (Jemiyo et al., 2025).

Perhaps most compelling is research from 2024 using twin study designs to control for shared genetic and environmental factors. Even after accounting for familial confounding, associations between ACEs and adult psychiatric disorders remained strong, particularly after sexual abuse or multiple ACEs (Daníelsdóttir et al., 2024). This suggests the impact of early adversity isn’t simply about genetic predisposition or family environment—there’s something specific about the experience itself that shapes vulnerability.

A 2024 systematic review and meta-analysis found robust associations between ACEs and multimorbidity (having multiple chronic health conditions simultaneously) in adulthood, with clear dose-response patterns across diverse populations globally (Senaratne et al., 2024). The relationship between childhood adversity and adult health outcomes is among the most consistent findings in medical and psychological research.

The most recent data from the 2023 Youth Risk Behavior Survey—the first national survey to ask adolescents directly about their ACE exposure—found that 54% of U.S. high school students reported at least one ACE (that number is 62% in Canada), with clear associations between ACE exposure and poor mental health, substance use, suicidal ideation, and risk behaviors (Swedo et al., 2024). The effects don’t wait until adulthood to manifest; they shape young people’s lives during adolescence.

This is established science. The childhood developmental environment shapes vulnerability to mental illness and addiction. Like glaciers shaping stones, like water smoothing rough edges, like volcanic heat transforming mineral composition—early experience literally shapes who we become.

How Early Experience Gets “Under the Skin”: The Neurobiology

Understanding the neurobiology helps move the conversation beyond blame to mechanism. Early experiences literally shape the developing brain—not through choice or willpower, but through the fundamental plasticity of the nervous system during critical developmental windows as the structure and function of the brain changes in response to early experiences.

The Stress Response System Forms Early

During the first years of life, the hypothalamic-pituitary-adrenal (HPA) axis—the body’s primary stress response system—is being calibrated. When a child experiences chronic stress without adequate co-regulation from caregivers, the HPA axis develops altered sensitivity. The system becomes dysregulated, either hyper-reactive (responding to minor stressors as major threats) or hypo-reactive (becoming blunted after chronic activation), creating lasting vulnerability to stress-related disorders (Kuhlman et al., 2020; Reid et al., 2022).

The evidence for HPA axis alterations following early adversity is extensive. Meta-analyses find altered cortisol patterns in children exposed to maltreatment, with effects varying depending on timing, type, and chronicity of adversity (Bernard et al., 2023). These alterations don’t simply disappear when the adverse circumstances end—they represent a recalibration of the stress response system that can persist across the lifespan, creating vulnerability to depression, anxiety, PTSD, and addiction (Kuhlman et al., 2020).

Emotional Regulation Depends on Co-Regulation

Infants don’t regulate their own emotions—they depend entirely on caregivers to help them move from distress to calm. Through thousands of repetitions of the cycle (distress → caregiver response → soothing → return to calm), the infant’s nervous system learns how to regulate. This process, called co-regulation, literally shapes neural pathways involved in emotional regulation (Thompson, 2008).

Research on attachment and early brain development shows that caregiver responsiveness during infancy shapes gray matter volume in brain regions involved in social cognition, emotional processing, and executive function (Rifkin-Graboi et al., 2017). Children with more secure attachments to caregivers in infancy show larger volumes in the superior temporal sulcus, temporo-parietal junction, and prefrontal regions in late childhood—areas critical for social understanding and emotional regulation (Moutsiana et al., 2015).

When co-regulation is inconsistent or unavailable, the capacity for self-regulation doesn’t develop properly. The neural circuits that should be strengthened through repeated experiences of distress being soothed remain underdeveloped. This isn’t about willpower or motivation—it’s about neural architecture that was built (or not built) during critical periods of development.

Brain Structure and Function Change

Extensive research demonstrates that early adversity literally alters brain structure and function. Childhood maltreatment is associated with reduced volume in the hippocampus (involved in memory and emotional regulation), altered amygdala activity (involved in threat detection and emotional processing), and changes in prefrontal cortex development (involved in executive function and impulse control) (McCrory et al., 2024; Teicher & Samson, 2016).

These aren’t subtle changes—they’re measurable structural and functional alterations visible on brain imaging. Meta-analyses of task-based fMRI studies consistently find increased amygdala activation in individuals with ACE histories, particularly during processing of negative emotional stimuli, suggesting the brain develops a bias toward threat detection (Mothersill & Donohoe, 2016; McLaughlin et al., 2019).

The timing of adversity matters. Research suggests sensitive periods during development when particular brain regions are most vulnerable to the effects of adversity—periods when neural circuits are being established and consolidated (Teicher et al., 2022). Adversity during these sensitive periods has particularly profound and lasting effects on the neural systems involved in emotional regulation, threat detection, and reward processing—exactly the systems implicated in vulnerability to addiction and mental illness.

Attachment Patterns Become Neural Templates

The patterns of relationship with primary caregivers become encoded in neural pathways that serve as templates for all future relationships. Secure attachment creates neural patterns organized around the expectation that reaching out brings response and that others can be relied upon for comfort and support. Insecure attachment creates different patterns—either hyperactivation (anxious preoccupation with relationships) or deactivation (dismissal of relationship needs)—that shape how individuals approach relationships across the lifespan (Coan, 2008).

Neuroimaging research demonstrates that attachment security is associated with distinct patterns of neural activation during social and emotional processing. Securely attached individuals show more effective regulation of emotional responses and more balanced activation of neural circuits involved in threat detection and social reward (Vrticka & Vuilleumier, 2012). These patterns, established in early relationships, become the neural infrastructure for how we navigate relationships, manage emotions, and respond to stress throughout life.

Recent research emphasizes that these early relationship patterns don’t just influence behavior—they shape the developing brain’s architecture through experience-dependent processes. The infant brain develops within an interpersonal context, with structural and functional networks shaped by the quality of early caregiver-infant interactions (Callaghan & Tottenham, 2016).

Why This Matters: Vulnerability, Not Destiny

Here’s what’s crucial to understand: the developmental perspective describes vulnerabilities and dispositions, not deterministic causes or fixed destinies. Early experiences create patterns of nervous system organization that make certain outcomes more likely when faced with particular stressors or challenges. But many people who experience significant childhood adversity do not develop addiction or mental illness. Many find healing through subsequent relationships, through therapy, through circumstances that support nervous system reorganization. (Crucially, one has to do something to heal; just hoping things will improve on their own does not work. More on that below and in the guide for therapists.)

The metaphor of the stone helps here. The stone on the beach has been shaped by forces largely beyond its control—geological processes that determined its mineral composition, movements of ice and water that transported it across continents, endless waves that smoothed its surface. These forces created the stone’s current form. But the stone isn’t finished. It continues to be shaped by new forces—by today’s waves, by this season’s freeze-thaw cycles, by the footfalls of beachcombers who might pick it up and carry it somewhere new.

We are shaped by what happened to us in childhood, but we are not determined by it. The developmental perspective explains why certain vulnerabilities exist, why some people struggle more than others with addiction or mental illness despite apparently similar life circumstances, why approaches that work for one person might fail for another. Understanding this allows us to design interventions that address the underlying patterns rather than just managing surface symptoms.

The Importance of Critical Windows

One of the most important insights from developmental neuroscience is the concept of sensitive or critical periods—windows of time when particular brain systems are especially plastic and responsive to environmental input. During these periods, the brain is organizing itself based on the environment it encounters. Experiences during sensitive periods have disproportionate impact on neural development compared to similar experiences occurring outside these windows (Knudsen, 2004).

For example, the first three years of life represent a critical period for the development of stress response systems, emotional regulation capacities, and attachment patterns. Adversity during this period has particularly profound effects on these systems. Similarly, adolescence represents a sensitive period for the development of executive functions, social cognition, and the consolidation of identity. Adversity during adolescence can disrupt these developmental processes in ways that create lasting vulnerability.

This doesn’t mean experiences outside these windows don’t matter—they do. But it helps explain why early adversity has such lasting impact and why interventions targeting these early patterns can be so powerful. We’re not just addressing current symptoms; we’re working with foundational patterns laid down during periods of maximal neural plasticity.

The Intergenerational Nature of Developmental Vulnerability

Another crucial piece: many of the patterns that create vulnerability in children are themselves transmitted across generations. Parents who experienced adversity in their own childhoods often carry unresolved trauma, attachment difficulties, and nervous system dysregulation that affect their capacity to provide attuned, responsive caregiving—not because they’re bad parents, but because they’re parenting from their own unhealed wounds (Narayan et al., 2021).

This intergenerational transmission happens through multiple pathways: epigenetic changes that can be passed from parent to child, modeling of emotion regulation strategies, quality of attachment relationships, and the cumulative impact of poverty, discrimination, and social marginalization that concentrate across generations. Understanding this doesn’t excuse harm done, but it provides context—it helps us see that the person struggling with addiction carries not just their own developmental history but potentially the unresolved trauma of previous generations.

This perspective should evoke compassion rather than blame. The parent who was unable to provide consistent co-regulation because of their own depression, the caregiver who modeled avoidance because that’s how they learned to cope, the family system organized around managing one member’s addiction—these patterns make sense when we understand them developmentally. And recognizing them allows us to interrupt intergenerational transmission by addressing the underlying patterns rather than just responding to surface behaviors.

What This Means for Supporting Recovery

Understanding the developmental foundations of addiction and mental illness changes how we support people struggling with these challenges:

1. We recognize that healing takes time. We’re not just addressing current symptoms—we’re working with patterns established during critical periods of development. The nervous system reorganization required for sustainable recovery from addiction typically takes 3-5 years, not weeks or months. This isn’t failure; it’s realistic expectation based on developmental neuroscience.
2. We prioritize relationship-based interventions. Since the wounds were relational (failures of co-regulation, attachment disruptions, absence of attunement), the healing must be relational. This means therapy that emphasizes the therapeutic relationship, peer support that provides genuine connection, family work that repairs attachment patterns, community that offers belonging.
3. We address nervous system regulation as foundational. Before someone can engage meaningfully in cognitive-behavioral work, narrative reconstruction, or insight-oriented therapy, their nervous system needs enough regulation to tolerate the work. This means starting with somatic approaches, mindfulness practices, body-based therapies that help establish basic capacity for self-regulation.
4. We avoid approaches that replicate developmental trauma. Confrontational interventions, coercive treatment, punitive responses, or approaches that shame people for their struggles can replicate the early experiences that created vulnerability in the first place. Effective treatment requires safety, attunement, and respect for autonomy.
5. We recognize complexity and avoid oversimplification. The developmental perspective resists reducing addiction to a simple “disease” or “choice” model. It acknowledges the intricate interplay of genetic predisposition, developmental experience, current circumstances, social context, and individual agency. This complexity is not a problem—it’s reality, and our approaches must honor that reality.

The Alchemy of Hope

Here’s the paradox: the developmental perspective feels more painful than simpler explanations, but it offers more hope. Consider the alternative—if addiction were simply about willpower or choice, then wanting to stop should be enough. But we know it’s not. People desperately want to stop, try with everything they have, and still struggle. The “just try harder” narrative sets people up for repeated experiences of failure that deepen shame and hopelessness.

The developmental perspective explains why trying harder isn’t enough, why the pattern is so difficult to interrupt, why the person feels compelled toward behaviors they consciously don’t want. And in explaining the “why,” it points toward what might actually help: not more willpower, but nervous system reorganization; not more guilt, but repair of underlying attachment patterns; not more punishment, but experiences of safety and attunement that allow different neural patterns to develop.

Research on neuroplasticity—the brain’s capacity to change throughout life—demonstrates that the patterns formed in childhood can be modified through new experiences, through therapy, through relationships that provide what was missing early on (Kolb & Gibb, 2011). The brain remains plastic across the lifespan. Recovery is possible precisely because we’re not trapped by our developmental history—we’re influenced by it, shaped by it, sometimes constrained by it, but not imprisoned by it.

The stone on the beach continues to be shaped by today’s waves. The patterns laid down by ancient geological forces remain, written into its mineral structure, but new patterns are always forming on the surface, gradually transforming what the stone will become. This is the hope the developmental perspective offers: understanding the patterns of the past while remaining open to the possibilities of transformation in the present.

Beyond Blame: Holding Complexity with Compassion

The developmental perspective asks us to hold multiple truths simultaneously:

• Early childhood experiences shape vulnerability to addiction and mental illness
• Most parents do the best they can with the resources and awareness available to them
• Your best might not have been enough for what your child’s particular nervous system needed
• Not being enough doesn’t mean you failed as a parent or person
• Understanding what created vulnerability helps guide effective intervention now
• The person struggling with addiction is not weak, undisciplined, or making poor choices—they’re responding from a nervous system organized by early experiences

Can you hold all of these truths at once? It requires a kind of mature complexity—moving beyond simple narratives of blame or excuses into a territory of compassionate understanding that makes room for everyone’s humanity. It requires accepting that we are all stones shaped by forces larger than ourselves, that we are all doing our best with what we received, that we are all both influenced by the past and capable of change in the present.

The developmental perspective is an invitation to this complexity. It’s an invitation to see addiction and mental illness not as moral failures or simple brain diseases, but as understandable responses to developmental experiences that created genuine vulnerabilities. It’s an invitation to respond with compassion while maintaining accountability, to understand the “why” while still addressing the “what now,” to hold the reality of constraint alongside the possibility of transformation.

This is not an easy conversation. It requires looking at territory many of us would rather avoid—our own childhoods, our own unresolved wounds, the ways we may have unintentionally contributed to our children’s struggles. But it’s a conversation that leads somewhere. Unlike narratives that circle endlessly through blame and shame, the developmental perspective illuminates specific pathways toward healing. It explains why certain approaches work and others don’t. It offers both understanding and direction.

The Mystery That Remains

The developmental perspective explains much, but not everything. It describes patterns and vulnerabilities but cannot predict individual outcomes with certainty. It offers frameworks and models that are useful for organization and illustration but cannot reduce the irreducible complexity of any single human life. This is as it should be. We are not machines whose behavior can be perfectly predicted from initial conditions. We are living systems, always in process, always capable of surprising ourselves and others.

The developmental perspective, properly understood, should deepen our humility rather than our certainty. It should help us recognize that we’re working with profound patterns laid down during the most vulnerable periods of development, patterns that have biological, psychological, relational, and cultural dimensions we cannot fully disentangle. This recognition should inform our work with tremendous respect—respect for the complexity of what we’re engaging with, respect for the courage required to reorganize patterns established before conscious memory, respect for the mystery that remains even after all our explaining.

The Stones and the Shore

No two stones are identical. No two developmental paths are the same. And yet patterns emerge—patterns of how glacial movement distributes certain minerals, patterns of how water erodes particular rock formations, patterns of how volcanic processes create specific mineral compositions.

Understanding these patterns doesn’t diminish the uniqueness of any single stone. It enhances our appreciation of how this particular stone came to be exactly this shape, this weight, this color. It allows us to hold the stone with greater understanding, to see its current form as the visible outcome of invisible forces operating across vast stretches of time.

The developmental perspective simply acknowledges this shaping, respects its power, and refuses to pretend that we emerge into adulthood as blank slates uninfluenced by everything that came before. We are shaped, and continue to be shaped. Understanding the shaping that has already occurred helps us participate more consciously in the shaping that continues.

This is what the evidence shows. This is what decades of research consistently demonstrates. This is why the developmental perspective remains the most important framework for understanding why people are the way they are—not as deterministic cause and effect, not as fixed destiny, but as patterns of vulnerability and resilience laid down during critical windows when the nervous system was organizing itself around the environment it encountered.

The stone remembers. And so do we. And understanding what we remember—how those memories are written not just in conscious recall but in the very architecture of our nervous systems—should inform how we support healing, recovery, and transformation.

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