Over the years here at WholeHealth Chicago, we’ve treated thousands of patients, mainly women, for chronic physical and emotional symptoms that produce no positive test results. Our patients have been told by multiple doctors that nothing can be found wrong with them, but as we explore their biographies we find that many problems have roots in childhood abuse, sexual harassment, rape, or other sexual assault.
Like most viewers, I was mesmerized by Christine Blasey Ford’s testimony and found myself simultaneously wiping away tears and reflecting on how deeply sad it was that I’d heard variations on her testimony many multiple times from so many patients.
A challenging topic
This may be an emotionally difficult Health Tip for some of you because it triggers memories you want to forget or because you simply don’t want to know it exists in the real world.
Child abuse is one unfathomable example. Imagine you’re a small child and for as long as you can remember no face has ever lit up with a smile when you walked into a room. In fact, to avoid being struck by a family member you’ve learned a variety of avoidance strategies, maybe even unconsciously tensing your muscles to ward off the recurring blow or sexual assault. Imagine there’s a relative who does terrible things to you when you’re home alone. Your muscles tense when you hear a knock on the door. That’s home life.
Or imagine 15-year-old Christine Blasey Ford, not as the MA/PhD we watched last week and followed breathlessly, but as a young girl–prone to giggling, worrying about whether she’ll be popular–just entering womanhood. She’s not old enough for a driver’s license and may or may not have even had her first kiss. But it’s summertime. What better place to meet boys than at a country club party.
Little does she suspect that one of her first contacts with boys will be the experience of one hand slammed over her mouth while the other probes under her clothing.
Just so we get our terms right. Christine at 15 was an underage juvenile and the victim of a criminal sexual assault. The word rape is being used less and less today to avoid arguments about penetration. There are about 100,000 reported incidences of sexual assault annually, with five times that number going unreported.
Please pause for a moment and let those numbers sink in.
In the early 1980s when Christine was assaulted, most sexually assaulted young girls did not tell anyone because of shame and embarrassment. Brace yourself for more statistics:
–15% of all women in Christine’s age group (12 to 17) are victims of assault each year.
–30% experience symptoms of PTSD (post-traumatic stress disorder) a year or more after the assault.
— 80% of victims who know their assailant experience long-term emotional issues, including problems with relationships, at work, and in school.
What we see at WholeHealth Chicago are the long-term effects–both physical and emotional–of sexual assault victims.
A book entitled The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma is being hailed as a masterpiece. From the book’s description:
Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps The Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring specifically in areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies.
To my utter astonishment, this research is precisely the field that Blasey Ford would enter a decade after her assault. In her testimony she described how norepinephrine “locked” the memory of her attacker’s laughter into her hippocampus, a deep part of the brain involved in long-term memory. Maybe I shouldn’t be surprised by her choice of career. Freud used the word sublimation to describe a psychological defense mechanism in which a socially unacceptable thought (“I’d like to kill Brett Kavanaugh for what he did to me”) is transformed into an acceptable one (“I will do research on what has happened to my brain”).
You and the consequences of your biography
We’re only just beginning to grasp the emotional and physical consequences of being the victim of traumas as diverse as bullying or date rape. The Adverse Childhood Experiences (ACE) study from Kaiser Permanente in California gave the brief questionnaire on page 1 of this link to 17,000 people with chronic illnesses and found an astonishing correlation between self-reported childhood trauma and a smorgasbord of apparently unrelated medical and psychological disorders.
I first began to appreciate the consequences of childhood trauma more than 25 years ago when I attended a conference held by Caroline Myss, PhD, whose book Why People Don’t Heal and How They Can had become required reading for members of the American Holistic Medical Association. Her phrase “Your biography becomes your biology” became a mantra for physicians attending her talks.
It was Dr. Myss who led me to shift dramatically from the history-taking techniques I’d learned in med school (which focused on the patient’s current illness) to the biography-oriented interview all our physicians use at WholeHealth Chicago today.
Patients virtually never volunteer information about physically or emotionally traumatic childhoods, but in a quiet, private, and utterly nonthreatening setting this information is begging to come to the surface. The Kaiser Permanente study allowed for total anonymity in its questionnaire, permitting participants to reveal deeply held secrets of the past without fear.
Health consequences of childhood trauma and sexual assault
Years after Dr. Myss’ pioneering work, conventional medical journals started publishing articles on the connection between childhood trauma and adult health issues. Remember, at 15 Christine is still a child (as any parent of a 15-year-old will tell you). When one study showed that 25% of fibromyalgia patients had endured some form of trauma when younger, doctors were shocked. The survey and results went on to be replicated in different parts of the world and, yes, the number remained 25%.
I devoted an entire chapter to this connection in my book Healing Fibromyalgia and to this day I’m surprised to find that most, if not all, of the dozens of fibro books available don’t mention it.
The Kaiser Permanente Adverse Childhood Experiences (ACE) study showed that many psychological disorders (including depression, anxiety, OCD, bipolar disorder, alcoholism, and drug abuse) as well as seemingly unrelated physical illnesses (e.g., coronary artery disease, some cancers, and a variety of autoimmune diseases) were linked to respondents who had high ACE scores. It was estimated that especially high-scoring ACE victims would lose 20 years off their anticipated life expectancies.
Other confirmatory studies link childhood trauma to chronic migraines, diabetes, stomach ulcers, chronic lung disease, and a variety of arthritic disorders.
Profound effects, including fibro
What’s happening in the body of a traumatized child or young adult that renders him or her so susceptible to a possible lifetime of long-term physical or emotional ill health and potentially reduced longevity?
I need not tell Dr. Ford, since this is her field of research, but would tell you as my patient, “You’re far more complicated that you’ll ever know. Even with your keen self-awareness, you’re just scratching the surface of yourself. Your personal mind-body recording unit remembers everything and the results can be profound.”
It’s not at all impossible that most of the health issues you’ve experienced–from chronic depression and alcoholism to fibro or chronic fatigue, with susceptibilities to cancer, diabetes, autoimmune disease, and early heart disease–are related to deeply buried issues from stressful events in your early life and your brain’s massive memory capacity.
It wouldn’t surprise me to learn that Dr. Ford struggled with fibromyalgia. She clearly describes two phases of severe stress.
With sudden acute stress–the sexual assault–adrenaline poured through her body and into her muscles to make her a temporary superwoman. As the second person in the room jumped on the bed while Kavanaugh was on top of Dr. Ford they toppled over and she was able to get up and flee.
Norepinephrine etched the event itself into her hippocampus like a loop of slo-mo film. This is why Dr. Ford can remember specific details (hand over her mouth, pelvis grinding into her, background laughter) with great clarity.
Dr. Ford’s adrenalin rush rescued her, but this was followed by an outpouring of a second adrenal hormone, cortisol, which actually blocks memory formation, likely explaining why she has trouble remembering how she got home.
And then chronic stress that follows. Weeks, months, and years after an assault, the tense muscles, useful to fight/flee, now won’t let go. They remain contracted, unconsciously trying to protect the victim from another sexual assault by creating a virtual suit of armor. Except it’s a suit of armor that hurts and can’t be taken off. That’s fibromyalgia.
Healing childhood traumas
The connection between trauma and immune issues is more complex. Dr. Myss explains that our immune systems are hard-wired to protect us from infections, such as from viruses or bacteria, and cancer cells. However, when a child is faced with repeated trauma, her immune system gets overly excited and starts to turn against her physical body.
This situation is profoundly worsened by the child’s loss of self-esteem in the wake of victimhood (“Who could possibly love me?”). Combine low self-esteem with an overly stimulated immune system and you’ve set the stage for an autoimmune disorder.
Cancer works in a similar setting, but this time low self-esteem is combined with an utterly exhausted immune system that’s burned itself out trying to protect its owner. Such thinking, Dr. Myss was first to point out, has the potential to be very badly misinterpreted if blame for an illness is placed on the victim.
“Am I responsible for my cancer?” “Did I deserve my autoimmune disease?” The answer is a loud and clear no. These machinations in your mind-body are so deep within you as to be inaccessible to your conscious mind. Everyone in the field of mind-body medicine is quick to point out that a majority of people with cancer or virtually any chronic illness had perfectly happy childhoods and aren’t carrying larger knapsacks full of psychic baggage than the rest of us.
For this majority, the causes are usually lifestyle choices such as poor nutrition, tobacco use, or lack of exercise. But for a small and important subset of people with chronic illnesses, if any underlying cause is to be discovered, it may be the final phase of a childhood from hell.
“An ocean of pain”
I’d like to close with an on-the-record statement, made by Senator Chris Coons (D) of Delaware, which to me sums up how many people are still carrying the deep hurt of sexual assault and trauma:
One of the most striking things about this hearing for me has been the so far five, five personal friends, acquaintances, people I’ve known for years or decades who have conveyed to me their experiences of sexual assault on this phone while this testimony was going on. That suggests that there is an ocean of pain in this nation not yet fully heard, not yet fully addressed, not yet appropriately resolved. And I, for one, will not countenance the refrain said by too many in response to these allegations by Dr. Ford, that it happened too long ago and that in our nation, boys will be boys. We must do better than that and we must set a better standard than that for our own families and for our future.
By this time next week, we’ll know how everything in the confirmation process plays out. But, right now, if you’re not outraged you’ve simply not been paying attention.
David Edelberg, MD