when storytelling is an obstacle to healing

The goal of training in narrative medicine is to provide the health care provider with tools to help him uncover otherwise unspoken details that might impact diagnostic accuracy and successful treatment. 

"You'd be surprised what lengths

people will go to not to face

what is real and painful inside them."

~Various Attributions~

This is especially important given what we now know about childhood trauma and its remote influence on adult health and well-being. Most patients don't make the connection between their experiences as a child and the headaches, hypertension, IBS, anxiety, depression, and addictions that plague them as adults. 

The enduring effects of childhood trauma in its many guises--verbal/physical/sexual abuse or neglect, injury or illness, a significant loss, the stress conferred by poverty, racism, and even bullying--can be hard for patients to put into words. This is especially true if the trauma they experienced occurred pre-verbally, if it was a secret they kept, something they couldn't tell anyone about...and still can't, or if it was so severe they dissociated from it. They may have suppressed the memory of it, or lack the language to express it. 

"You can spend a lifetime

trying to forget a few minutes 

of your childhood."

~From HealthyPlace.com~

But make no mistake...they still feel it in their bodies. 

Working with these patients can be a challenge because just the process of narrating the experience can be traumatizing to them. When they are encouraged to re-tell the story, they can re-experience the trauma, and regress or shut down. In this case, exploring the patient's narrative can pose an obstacle to healing. 

You may sense this when the patient's body language shifts. His posture may change. His facial expression and the tone of his voice may change. He may start fidgeting, stiffen, or slump. Instead of asking him what he is thinking about, it may help to ask him where in his body he is feeling it. Does his neck ache? Is he aware of his heart beat? Is he shaking? Does he feel nauseated? Lightheaded? Once he understands that he is safe despite these somatic manifestations, he may be able to connect them with his traumatizing experience, and eventually with his ability to heal.

"Trauma comes back as a reaction,

not a memory."

~Bessel Van Der Kolk~

Somatic psychotherapy helps patients integrate the physical manifestations of illness with the fear, anger, grief, shame, confusion, and denial they cannot express. Suppressed memories may emerge.

When the patient understands that he is safe despite the fact that his chest aches, or his energy is drained, or his mind goes blank, the mind-body connection is strengthened, and a pathway to healing is revealed. 

Six Steps to Strengthen

Mind-Body Connection:

1. Close your eyes and

    take a deep breath

2. Scan the body

3. Be aware of any sensations,

     pleasant or unpleasant

4. Notice where the sensations

are coming from

5. Let your awareness travel

around your body

6. Follow these sensations

     until they disappear

~From Quotemaster~

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jan