posted by Amy on Dec 5
Last summer I read two books that explicitly connect trauma and illness. One, by the late Swiss psychiatrist Alice Miller, is called The Body Never Lies; The Lingering Effects of Hurtful Parenting. The other, by Bessel van der Kolk, is called The Body Keeps the Score; Brain, Mind and Body in the Healing of Trauma. Miller wrote many books about what she called “poisonous pedagogy,” the utterly normal but toxic methods of raising children in certain European/American cultures. Van der Kolk is an expert in trauma and healing. I first learned about him in a seminary class called “Theology and Trauma.”
In his book, van der Kolk describes in detail a landmark study conducted by the Centers for Disease control and Kaiser Permanente. In its initial phase from 1995 to 1997, thousands of Kaiser patients were asked about ten specific “adverse childhood events” and then their answers were linked with their medical records. The ten questions related to physical, emotional, and sexual abuse and other sorts of adverse experiences. Each yes answer is scored as one point; therefore, a person’s ACE score can be any whole number between zero and ten. Van der Kolk says, “The ACE study revealed that traumatic life experiences during childhood and adolescence are far more common than expected.” In a mostly white, middle class, middle aged, relatively prosperous sample, only one-third of the respondents had a score of zero.
Van der Kolk describes many correlations between adverse childhood events and adult outcomes. For example, 66% of women and 35% of men with an ACE score of four or higher are chronically depressed, whereas the overall rate of chronic depression for people with an ACE score of zero is 12%. But I was diagnosed with melanoma in 1999 and metastatic breast cancer in 2011, so the finding that most engaged me was this: Those respondents with an ACE score of six or higher were four times as likely to have cancer. Van der Kolk says, “the ongoing stress on the body keeps taking its toll.” (As sometimes happens to me when I blog, WordPress won’t let me insert a link, but if you go to http://www.cdc.gov/violenceprevention/acestudy/ you can get current information about this research.)
The book tells of many new and innovative approaches to helping people heal from trauma. It is a hopeful, encouraging book, and I recommend it enthusiastically. But right now I want to focus on what van der Kolk says about the ACE study. The study authors concluded that they had “stumbled upon the gravest and most costly public health issue in the United States: child abuse.” They calculated that “eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, IV drug use and domestic violence by three-quarters.” Besides all the suffering, harm, and early death that would be alleviated, the economic effect in reduced medical costs and increased productivity would be worth many billions of dollars. Yet the study has not led to changed child rearing practices or changed priorities in public health.
Alice Miller’s thesis, that “normal” child rearing practices are abusive, toxic, and harmful, and that they cause severe, lifelong damage to the emotional, psychological, and physical health of millions of people, is controversial. She spent her entire career railing against conventional psychoanalysis and trying to get people to take poisonous pedagogy seriously. She wasn’t able to make much of a dent in conventional “wisdom” about child psychology or child rearing. It seems obvious to me that the ACE study goes a long way towards vindicating her. But this is an extremely touchy area. As Miller describes in detail in her books, most people who were abused as children deny it vehemently. And they get extremely defensive whenever they come close to the truth.
I have cancer and I want to heal from it. If possible, I want the cancer to go away. Even if that doesn’t happen, I want to have as healthy, vital, strong, serene, and rich a life as possible in the time I have left. Participation in groups and other work I have done since my diagnosis have led me to a deeper understanding of healing. The body, mind, and spirit are not separate, and healing is not simply a matter of correcting an identified physical malady. One reason I blog and participate in support groups is to share what I learn in hopes of benefiting others.
One day last summer when I tried to talk about Miller, van der Kolk, poisonous pedagogy, childhood trauma, and the ACE study in a group session, the leader forcefully silenced me. She interrupted me twice to make me quit talking. I was not saying that “trauma causes cancer,” though maybe that’s how she heard it. I was trying to say that there is hope for people who have experienced trauma. Brains and nervous systems can be rewired, and brain chemistry can be corrected. She said this line of inquiry was “interesting” but “irrelevant.” She was very agitated. There were only two other patients there that day, and one of them was trying to participate in the discussion as well, so she was silenced too.
I was very hurt. I felt demeaned and rejected. I wanted to walk out, but I stayed until the end of the session and haven’t raised the issue again in that setting. But I’m writing about it because it’s important.
When you get cancer treatment they don’t ask you about past trauma. If you ask for it you can get prescriptions for anxiety or depression, and you can see people who specialize in the psychological care of cancer patients, but as van der Kolk, a psychiatrist, says in his book, psychoactive drugs have their uses, but they only treat symptoms. That can be a significant first step to healing, but it’s not sufficient.
Treatment for people with Stage IV cancer is palliative; there is no “curative intent.” The goal is to control the cancer as well as possible for as long as possible, with acceptable side effects. I understand that. I know it’s based on science. It’s been working quite well for me, and I have no complaints. It appears that, in the same vein, psychiatric treatment for cancer patients is palliative and not curative in intent.
But, as I said, my personal objective is to heal completely (whether or not the cancer goes away, though that is my preferred outcome). Trauma gets lodged in the body, and probably requires some bodily, kinetic solutions such as yoga, walking meditation, and other activities in order to be dislodged. It distorts the “fight, flight, freeze” circuitry of the nervous system. I was in my late 30s before I realized it’s not “normal” to be in a state of heightened alertness all the time. I had to learn to like being in a “resting” state. I had to learn to like serenity. When, in my mid-40s, I figured out I had PTSD, I learned techniques for interrupting the “flooding” that occurs when my PTSD is triggered. Through prayer and meditation I have been cultivating a new baseline state.
I am also much more aware of how certain people and relationships affect me, and I am more willing to protect myself from toxic people and interactions. Growing up, I didn’t expect anyone to take care of me or protect me from harm. As a matter of fact, the people closest to me caused me tremendous harm. Now, as I work on growing up again, I am learning to be a good parent to myself.
When I was first diagnosed in 2011 I worked with guided imagery to heal from cancer. I also obtained imagery and affirmations for trauma, but I only did it a couple of times. It was very, very intense. It seemed too daunting. I didn’t know if I’d live long enough to get that stuff resolved. Recently I’ve revisited the trauma tape, and, as promised in the introduction, the “story” has changed and softened over time. It (along with in-person therapy and journaling) has helped me figure out how I really feel, and what I really want and need. I am becoming more comfortable in my own skin, more authentic, and more real.