"TOO MUCH TRAUMA"

How trauma-based therapy modalities undermine our emotional and physical health

I remember the celebratory feelings in the air when "holistic" and "Western Medicine" parked next to each other in the hospital parking lot. There was hope—a lot of hope—that finally, medical professionals would see us as the complex human beings we were and are, instead of body parts.

But that's not entirely what happened, is it?

TRAUMA CO-SURVIVORS

"Eighty-eight percent."

My doctor, an MD, asked me and my husband if we knew how many marriages don't survive when one partner becomes chronically ill. We hadn't known. He had.

88%

The percentage was staggering, and as the chronically-ill person in the room, it jarred me. Then, terms like "caregiver burnout," "empathy fatigue," and "caregiver support," were bandied about as my husband squeezed my hand reassuringly.

I felt chilled to the bone.

I already felt immense guilt for allowing the supposed 'safe' medications to scramble my brain, but my guilt suddenly had a new component.

The suffering that comes with acute, tardive, and chronic AKATHISIA—among other drug-induced neurological damage, including movement disorders—was already overwhelming. But after that appointment, I suddenly realized how precarious my situation was. It hadn't occurred to me that it was possible—more than possible—that my husband, K, might leave me to battle the progressive health-horrors—caused by long-term use and treatment of psychiatric medications—alone.

It turns out, I'm not alone—not in my fears, nor in real life. Lucky for me—unfortunately, though, I'm the exception, not the rule. Even though K and I are "very married," that nagging fear of abandonment persists, and it plays no small part in some of the conflicts we have as my conditions continue to progress.

I think what was most troubling (or maybe not, since it seems par for the course), was that my doctor had no problem validating the new and unwelcome role that had been thrust upon my husband when I developed the DIMDs, but he has yet to acknowledge that the medications his colleagues prescribed me were responsible for my worsening health conditions.

If you weren't aware, women and men are treated very differently in healthcare settings. That said, I often wonder why my doctor felt it necessary to glibly spout such an odd and nefarious piece of information.

Was it for my husband's benefit ("Cut your losses and run, man, you're still young-ish") or mine ("You don't know how lucky you are—stop complaining and maybe try a little makeup.")

In either case, when you've been a victim of iatrogenic harm, it feels extremely isolating and hopeless at times. We need our families, our partners, friends, more than ever.

Ironically, those are the first to disappear.

MR. MEDICAL MONSTERS

I've heard from (and know) too many people who have been left after medical mistreatment.

Abandoned and forced to battle their condition(s) alone and only a little less bad than 'alone' is being treated as if you're not sitting there, writhing, trembling, moving, contorting, while the people surrounding you roll their eyes, stay away, and display zero curiosity or care.

Right, we get it. We just need attention.

I wonder if someone got cancer from medications… would that change anything? Highly doubtful. It turns out, doesn't matter if you were harmed by treatments or you're just plain sick. Being ill is a lonely business.

One might ask, what kind of monster leaves someone who develops chronic health struggles? The answer? All kinds—but usually it's the human ones that hurt most.

In an article from Oprah.com, it seems even people who develop cancer are abandoned. But the article (likely playing to the target audience?) cited statistical evidence, along with some terrifically stupid reasons, as to why women with serious or life-threatening illnesses are 6 times more likely to be abandoned than men with similar conditions.

In fact, the stats show 21% of women v. a paltry 3% of men are left at the beginning or during the health crisis.

One of the more stupid (stupider?) reasons for this, according to the article, cited an antiquated gender bias: Men are not natural caregivers.

Aren't they? Hm. Someone should alert the predominantly male healthcare profession.

Other explanations for why men bail included this: "…the demands of a spouse's illness can interfere with one's ability to earn a living which may be harder to swallow—or afford."

Yes, because having children certainly doesn't interfere with our careers, and being sick is costly. So it's a logical conclusion to want a divorce. Cheaper, since the partner who still works would likely be ordered to pay child support, alimony, and continuing insurance benefits, in-home care, all while supporting two separate households instead of one. Yes, much more affordable.

One excuse had some validity in my book, but only because of my experiences. It stated in effect, that men really aren't suited, nor prepared to do the 'icky' work of changing wound dressings and dealing with things traditionally done by healthcare workers (read: female healthcare workers).

The only reason I 'get' that is that when my mother had breast cancer, my dad couldn't do any of her care after her mastectomy. I did that, and her sister, my aunt did it: the drain tubes, wound care, the trips to and from chemo. But my dad, he was hopeless at boiling water, too. He was born in the 1920s.

Finally, since we're going all 'circa-1950s stereotype,' the article mentioned that women tend to have more of a support system.

So, you know, they can ring their friends up and natter on while ironing shirts or blather away about what a baby their sick husbands are as they hang laundry on the clothesline out back. As opposed to men, who stifle their emotions and take them out on the battlefield or in the boardroom.

Seriously, WTF, Oprah?

All of these info-nuggets were provided by MDs. Oncologists, 2 male, one female, deep-diving into the human psyche to help us understand abandonment—why these people leave in the face of illness. But now, there's a term for it—a term for partners or spouses who stay with someone who faces (or faced) a serious illness and fought, continues to fight for their lives, every day.

A term for those who don't abandon their partners during times of "sickness," ill-health, fear, and uncertainty: COSURVIVOR.

Because it's all about branding.

I hope you'll excuse me if I don't pat their backs for keeping their marriage vows.

"…FEELINGS… NOTHING MORE THAN FEELINGS…"

While the Oprah article seems to be slanted in favor of women, don't be fooled. The whole article speaks to the more sinister underpinnings of societal expectations regarding intimate relationships and illness—especially when psychiatry gets involved. Especially-especially when things go very wrong with medications.

There's no question: when someone you love is ill, you suffer, too. There are feelings of helplessness, loss, grief, and your life gets effectively smacked down on its backside. I know how harrowing it is to watch someone you love suffer with pain, illness, disease.

The thing about "chronic" illness is there's no planning for "when this is all over." Instead, the days are labeled "good," "hard," "bad," "better."

But it's never over. And on top of that, the article conveys what our society continues to give to men in particular, which is the tacit and implicit green light, to leave your sick spouse.

Look at those pathetic reasons, above. Really? I remember a time when it was okay to leave your pregnant girlfriend. Who wants the responsibility of being a father, amIright?

But the real problem we're seeing in our specific area of the awareness sphere is when medical doctors decide to play Psychologist and give families the green light to leave, ignore, and emotionally abandon someone who isn't 'medication compliant,' aka someone who is being tortured by medications and taper off, only to be left with permanent neurological damage.

So, they suggest to their patient's partner or spouse (or family) that whatever's at play is not physiological. Sometimes they (MDs) don't have the diagnostics to test for what's ailing someone—or, even worse, the "tests" come back within normal range—and therefore whatever's going on is based on the patient's psychological makeup and background.

In other words, their trauma.

Don't get me wrong. Trauma matters because we're complex beings, but not everything is a convenient "anxiety disorder" when tests and diagnostics fail to identify the problem.

This is especially true for iatrogenic harm that gets redressed as psychogenic.

IT ABSOLUTELY IS ALL IN YOUR HEAD

Drug-induced AKATHISIA can cause a range of horrendous physical states that can also (or sometimes only) present behaviorally and emotionally.

From everything we've studied and based on consultations with a brain-injury specialist, AKATHISIA likely occurs, in part, due to chemical damage sustained in the limbic system and brainstem, along with having a significant impact on vagal nerve function.

In other words, a damaged, malfunctioning limbic system. So what does that look like? How would that "present"?

Well, here's a (very) brief summary of the limbic system's function. I've bolded some of it for the purposes of my article.

"The limbic system is the part of the brain involved in our behavioural and emotional responses, especially when it comes to behaviours we need for survival: feeding, reproduction and caring for our young, and fight or flight responses.

"You can find the structures of the limbic system buried deep within the brain, underneath the cerebral cortex and above the brainstem. The thalamus, hypothalamus (production of important hormones and regulation of thirst, hunger, mood etc) and basal ganglia (reward processing, habit formation, movement and learning) are also involved in the actions of the limbic system, but two of the major structures are the hippocampus and the amygdala." —from "The limbic system," Queensland Brain Institute

If you've ever seen something beyond horrific that your mind can't process, your brain changes on a physiological level.

It's why we have restrictions—or should—on how much violence our children are exposed to, whether real or in HD, because before age 8, they really can't tell the difference. And even if they tell you they know it's make believe, even if you explain it thoroughly, doesn’t matter. This is their neurological development we're talking about here, not your wishful thinking because a much-anticipated slasher movie is coming out this weekend and you can't find a sitter.

So, if we look at this excellent diagram of some basic neuroanatomical brain regions, you'll see that everything is physiological to varying degrees, which means there's really nothing that can be explained away as 100% behavioral, 100% emotion-driven, 100 % environmental, and as you may or may not know, much of our behavior is not 100% conscious.

Image courtesy: https://www.dana.org/article/neuroanatomy-the-basics/

Look at #13. Are you kidding me? That encompasses the entirety of the DSM criteria.

That said, we can't possibly claim the term 'psychogenic' applies in any circumstance when there are also physiological complaints present. This is especially true when it comes to distressing emotional states and/or psychological and behavioral responses that are counter to the best interests of the individual. In other words, they don't want to be ill, they don't want to behave as they do.

So working backwards, here's an example of how "trauma-informed" therapy doesn't belong in medical exam rooms.

After a head injury, if a patient complains of having no appetite, insatiable thirst, severe ringing in one ear, along with severe panic and insomnia, there might be no way to ascertain that via diagnostic imaging. But any doctor worth their salt would suspect damage to corresponding regions of/in the brain.

Now, if the TBI complaint is absent the typical physical earmarks and it runs along the lines of mood dysregulation and behavioral changes, it would be absurd for a medical professional to suggest the patient has an anxiety disorder and Major Depressive Disorder because their father was a drunk.

And yet.

That's exactly what happens. As a matter of fact, head-trauma patients are given SSRIs or benzodiazepines—arguably the most evil, useless medications on the market today—to treat unknown injuries inside the brain as a matter of standard practice, despite the lack of ANY benefits. Physicians claim that SSRIs still give the patient a 'robust placebo effect.' Please feel free to use your critical thinking skills while reading the above paper.

I want to ask these medical folks if they think these drugs work or are they elaborate sugar pills? If they don't work, why not give them sugar pills? If they do something, why in the hell would you muck around with a TBI patient and their recovery?

THE AH-HAH!! MOMENT

There's no doubt that serious emotional traumas change the brain on a physiological level. My brain-injury specialist calls PTSD an "emotional concussion."

Trauma changes us. It might even cause physical conditions, but the 'chicken-and-egg' dilemma remains.

Which came first? We don't know, but why does that matter, exactly?

Back in 2018, my doctor had done some light reading over the weekend… and instead of meeting with me and my husband, he wanted to see me alone. His question startled me a little.

"Had any trauma in your life?"

I had, and frankly, I was moved that he cared about that. And so I told him. All of it. He asked things like "Any physical assaults? As an adult or child..?" and so on.

I was an open book.

In the end, though, I told him that the crowning 'trauma' of my life was being misdiagnosed, medicated, brain damaged, then dismissed by the medical community. That. That was the worst trauma I'd ever experienced. He didn't seem to hear that one.

He was terribly interested in my childhood, though, my past relationships and marriages, as well as the then-wobbly state of my current marriage, due to—you guessed it—the chronic pain and all the progressive conditions that, at the time, had both my husband and me in a kind of existential couplehood-crisis.

As he took notes, he shook his head and repeated over and over, "Too much trauma…. too much trauma. "

His 'light reading'? A book I'd read a few years prior called The Body Keeps the Score by Bessel van der Kolk. My then-therapist had suggested it.

My doctor was enthralled by it.

I think the above book is a must-read if you've experienced any trauma, personally, and if you're a therapist, it's also a must-read.

If you're a medical doctor or prescriber and you think it would be a good move for your clinical practice? Then no. No.

The DSMs have provided physicians with enough God Complex-porn to last a lifetime-squared, thanks.

So, NO. You do not get another theoretical diagnostic "tool" to help you wave away our physical ailments and symptoms, specifically when they point right back to medical treatment, gone awry.

I met with my Doc last week. I've been seeing this particular doctor since 2018, when he'd asked about trauma, told me about abandonment, and here we are. Three years later, he's still barking up the trauma tree, which seemed odd since he knows everything. Maybe he doesn't keep impeccable notes, who knows.

As we sat over our Zoom call/appointment, I told him about the publication of three books this year, one in particular that was harrowing and emotional to write since it was about my childhood, family, and so on.

He asked me why it had been tough to write. I explained and his eyes lit up.

"Ah! So… the rough childhood might be, you know, related to some of your psychological issues—" and I stopped him right there.

I explained that I've dealt with/talked about my childhood with more than a couple therapists, and then I told him that just because someone has a tough or even horrible childhood, that does not make them fundamentally broken and therefore, riddled with 'psychological issues.'

People heal, people come to grips with ____, people move on, move forward, especially if we've been in therapy before or are in therapy, working toward those ends.

But if we're held up to our past traumas by medical professionals each time we need medical care, then the implications are that no one heals from emotional trauma, ever. The more cynical interpretation is that also gives medical providers an all-too-easy out when it comes to difficult patients and complicated cases.

We must understand that those who have been harmed by medicine are, by our very existence, a threat to medical providers' worldviews. We're anomalies to good people in healthcare and they don't want to think about the possibility that others in their profession might not be as above reproach as they are (or would like to believe they are.)

If people who have suffered trauma become ill, a physician's cursory glance over their charts doesn't give them all the information they need to pat that individual on the head and tell them to 'go home—take a mental health day.'

When does it end?

And while I'm pleased my doctor has branched out a little in his own weird way, I'm displeased with how easy it is to smack patient experience away using 'trauma' as the bat.

I'm not broken, baby. I'm cracked. And "...there's a crack in everything... that's how the light gets in." According to the late, great Leonard Cohen, anyway.

Look. There's enough pressure in the world on families, marriages, communities, and indeed, in the healthcare system, as we're still in the thick of a pandemic. We don't need to add any more 'psychogenic' to the shit-show.

Yes, I've had traumatic things happen to me in my life, thanks for the nod. But what I really need from you, Doc is for you to do less light reading when it comes to your clinical practices, and more significant reading like this, this, and this.

It might keep someone like me from ever having to walk through your door again.