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.
Be well,
David Edelberg, MD
Kelley H: Now that more facts are in perhaps you are taking another look at this situation. No-one disagrees that sexual assault is a serious problem, only that we are also have a guilty until proven….. This highly publicized case was presented as the guilty by the court of some public opinion. …. and yes, Dr Ford did portray the picture of a victim, not understanding questions and exhibited someone whose life was turned upside down by this alleged assault. It is difficult for me to assess how she received an advanced degree and then taught in front of college students. It also appears there were several inconsistencies in her story.
Paula
Sure.
There’s a term in psychology “denial” where when you’re confronted with information you simply don’t want to hear, you push it out of your mind. It’s called a ‘defense mechanism’ and it’s part of being human. Think of a woman whose husband cheats on her constantly but she stays married and doesn’t want to even think about his philandering. That’s using denial. I think the Kavanaugh family as they enjoy the Washington good life will all be using ‘denial’ a great deal. I’m not condemning Kavanaugh. Dr Ford took care of that.
Dr E
I wonder, Dr., would you care to make any prognostications on the damage Ms. Ford’s unsubstantiated accusations have done/will do to the health of Judge Kavanaugh and his wife and children. Or are you condemning them as you did their husband/father. You did a lot of diagnosing without not having seen the patient. Very unprofessional.
Mary Jacks
yes I have had some sleepless nights too recently reliving my own pain experienced in the 80s..through listening to this supreme court thing.
1. people… bottom line…… it is SAD that this young women suffered this sexual assault(from whomever). ACTION required from us all NOW: let us teach our young women and empower our young women their right to say “hell no” and flee. we are currently taught to be good girls and do whatever we are told.
2. people… bottom line: it is SAD that this young man(whomever it was) did NOT perhaps realize his forcing himself like this was an offense? or perhaps he was too drunk to recall the event. men are taught mixed messages from our society on what is and isn’t sexual assault…ACTION: let us teach our young men consensual intimacy and NOT consensual intimacy and also the effects on alcohol on judgement.
THESE are THE TEACHABLE MOMENTS HERE!
thank you Dr E. you are a kind and generous hero to women. we value you. thanks!….
Dr Tish
What happened to innocent until proven guilty? She has the burden of proving her accusation. Not saying that it didn’t happen but she’s been an adult for a very long time why now does this come out? Politicians don’t care about Dr. Ford and it’s unfortunate that they and their families have to endure this on national tv.
Sue
Hi Doc,
I value very much your medical expertise, but mixing it publicly with politics….? You are not a shrink. And even if you do have some knowledge of brain chemistry and physiology, please dig deeper before you judge that someone is a rapist. To help you out understanding stress look at my story….. at 26 I was forced to jump (parachute) from damaged airplane, according to witness i was 3-5 seconds from demise, and I was aware of it. Surely you can compare it to rape stress wise. Today I’m 71 but i steel remember speed, altitude, coordinations, type and registration # of ship, date, time of the day, how I came to airport and how I drag my bruised ass home. I hope it will help you understand, that bending medicine to fortify your political view can be dangerous. I presume that your political hero is Obama and Hilary. Nobody else but Obama famously sad “election have consequence”. You had your disastrous eight years, now i have my two-four- eight… maybe more. By trade I’m a rocket scientist, but i have very good nose to BS hidden in medical dissertations.
ziggy
Hi Dr. Edelberg
Thank you for the blog post today. I appreciate your attention to childhood trauma and it’s lasting effects. As you may remember, I work at Youth Guidance with our BAM (Becoming A Man) program. We have data on our sister program WOW (Working On Womanhood) showing that up to 70% of the adolescent girls we’ve worked with over the past four years in Chicago Public Schools have endured trauma, and many of them suffer from PTSD, anxiety, and depression as a result. While sexual assault is but one type of trauma, many have experienced this. Any attention at all to the devastating affects of sexual assault, along with it’s prevalence, is critical.
Once again, thank you.
—Wendy
Wendy Fine
I suffered from child sexual abuse at the hands of my grandfather for many years beginning as a toddler. I’ve also been the victim of false accusations from an unknowingly sick sister-in-law. Years afterward her illness was diagnosed, paranoid schizophrenic. I know the desperation of someone being accused of something they didn’t do. I blew up, screaming and crying my eyes out like a maniac at a family party in my home because my husband and his family believed his sister over me. They now believe me. Anyone can say anything, doesn’t make it true. Please Doctor, do not judge unless you know what is certain. In this case, we do not know, do not know whose memory is foggy, do not know if either or neither is being truthful. Just because the judge is a white male, doesn’t mean he’s a liar and just because the accuser is a woman, doesn’t mean she’s being honest.
anonymous
I would normally let this pass, but sorry Paula, I have to point out that your are the pot calling the kettle black. I didn’t see a “rush to judgement” in Dr. Edelberg’s blog post.** But, I hear loads of judgement in your comments. You make judgements about Dr. Ford and Judge Kavanaugh and give no facts to support them.
Right now we have conflicting testimony. So, one of them may not be truthful. Yet you have already made your own judgements:
You describe Ford as trying to manipulate others by purposefully having messy hair for her testimony so she appears the victim. Your proof? There are photos of her with quaffed hair! Why do you assume/judge that Dr. Ford is lying? (She took and passed a polygraph.)Where is your concern for her feelings and that of her family?
Why do you judge Kavanaugh to be a moral, truthful person, incapable of what he is accused? Every day we are hearing of ministers and priests,very godly people, doing ungodly things that their own family did not think possible. Why is it outside the realm of possibility that what Dr. Ford described may have happened?
Were you at the party in question where the alleged assault occurred? How do you know for a fact that he is innocent? How do you know that Kavanaugh is the moral person you judge him to be? (Is he willing to take a polygraph?)
**I can’t speak to Dr. Edelberg’s intent, but when I read his blog post, I didn’t assume he was speaking ill of the Judge. I thought he was just relaying some of the testimony and saying that if it happened as Ford described,this is how it would have affected her brain chemistry and physiology.
If he was expressing who he feels is more credible,that is his right.
Kelley H.
I appreciate learning about the science connecting sexual assault or trauma at an early age to long term medical conditions. I would also like you to address the possibility of Ms. Ford’s memory not being accurate; perhaps there is a chance that she is mistaken in who might have assaulted her. I remember when a young man accused Cardinal Bernardin of sexual assault. The young man recanted shortly before Cardinal Bernardin passed away of cancer. He said that he came to realize that he could not rely on his memories. I thought Mr. Kavanaugh’s testimony and denial was also compelling and am greatly disturbed that there can be accusations against someone without any corroboration that can ruin a person’s and their family’s life. This is very, very scary to me and is causing me sleepless nights. To paraphrase Benjamin Franklin, Voltaire, Sir William Blackstone – it is better to let 100 (2, 10) guilty persons escape than let one innocent person suffer.
Patricia
Well, Doc, looks like you went and got yourself slammed by a couple folks that had a knee-jerk reaction to your post. I did not see it from a political point of view, nor do I think your intention was political. Also, I am far too old and have seen far too much to have my intelligence insulted. I don’t take myself that seriously.
I remember Dr Myss quite well from years ago, and I thank you for reiterating her profound study of the biochemistry of trauma. Your post should be an eye opener for many that have suffered years of abuse, as well as for those who whole heartedly are attempting to understand the mechanics and chemistry of physical and emotional trauma.
David W Bailey, DC
I am a lawyer as well, and one who deals with sexual assault and sexual harassment in my practice. As a lawyer and trier of fact evaluating evidence in these cases, it has been very helpful to me to have expert medical and psychological evidence about how memories are made and retrieved, especially in a trauma situation, as well as testimony about why victims, and especially young victims, often do not report sexual abuse for years. I also am called upon to evaluate the long-term psychological effects on alleged victims. It is only part of the evidence in a case, but important, and this is not really a “political” issue. I appreciate health care providers who are aware of these issues, and their effect on and prevalence in women’s health.
Jeanne
Seriously? Political commentary from my doctors office? Completely and wholly inappropriate. As a lawyer, I find evidence to be extremely relevant in forming the basis of my opinion, as I know you do in forming a diagnosis. Most of this “health tip” was insulting to my intelligence as an adult capable of evaluating evidence and forming an opinion.
Sheri
Wow what a dense health tip, a convergence of politics and medicine in a soup of psycho-social cause and effect. The phrase in Coons quote, “Boys will be boys,” resonated differently for me in the context of the writing. What I took away was acceptance of BWBBs normalizes the impacts of sexual assault. Since BWBBs, the health effects of sexual trauma are codified as a “normal” state of being a woman in this country and in the eyes of the medical and political establishment.
Rob
I cannot fully express how essential this is that men are advocating for this message too. It can no longer afford to a ‘woman’s issue’. It is humankind’s issue.
Jill
Her testimony was convincing so she has been successful in forever tarnishing the reputation of an individual who has long served throughout his adult life who has up to this date served with distinction and displayed good morals. She has no-one to back up her allegations. I am aware of buried and blocked memories. I also when seeing other photos of her see a well-coifed individual rather than that of a hair over the face which screams I am the victim here. Only God knows. I thought the accused should have the opportunity to hear the accusations directly from the accuser. She was not raped, but thought she was going to be. Her recall was sketchy at least. What about him, the male victim here. What about his young daughters and his wife. What about the lasting impact this will have on the children’s lives. There are many many questions here that are unanswered and as far as the public goes, are unasked. This sick rush to judgement is indicative of an immoral attitude and the sad state of our country today. Depending on who, what and where you are governs even the right to be heard.
Paula Brentnall
Thank you. I’m only beginning to understand why my body aches, most days, for no reason. The tension I carry when I am out in the world always felt “normal” because I’ve lived with it for so long.
It’s not normal and I hope one day my mind can unravel the tangled mess.
Regina
Thank you for shedding light on a subject that hits too close to home, unfortunately for too many. The mind-body connection information is helpful. Yes we are outraged. Maybe bringing assault to the forefront will help bring about much needed change. Dr. Ford is a hero and a warrior, as are the countless people who have shared their stories.
Cathy
Thank you for this Health Tip!
I have been so outraged by people condemning Dr Ford for not remembering aspects of the assault like it must have not happened or it was so long ago why don’t you just let it go..
Thank you for putting perspective and a reality to her trauma and how it has affected her life.
I am so in awe of Dr Ford’ s courage and strength to come forward.
Linda Silbert
Truth-
Pat