Joanne woke up one morning not feeling well. It could be a regular winter virus, but it could also be something more serious, and with her notoriously weak immune system, she always errs on the side of caution. Joanne calls in sick and makes a doctor’s appointment. As she sits in the waiting room, she suddenly starts feeling anxious. The ticking of the clock pounds her head like a hammer, and her heart threatens to jump out of her chest. She tries to get the attention of the secretary behind the desk, but her throat is stuck closed with crazy glue, and her body is as heavy as a tonne of bricks.
Joanne is experiencing a full-blown panic attack, triggered by a normal, everyday situation. As someone who has lived with chronic pain and illness for her entire life, Joanne has undergone more diagnostic tests and medical procedures than she can count. She has suffered through years of invasive treatments, horrible side effects, endless bureaucracy, doubtful doctors, and of course, debilitating physical pain. Despite the fact that she was waiting for a routine doctor’s appointment, anything even slightly associated with the medical system has the power to completely derail her.
Trauma triggers and chronic pain
Many people who live with chronic pain also experience trauma. Trauma triggers are psychological stimuli that recall a previous traumatic experience, whether it be a life-threatening accident, violating medical treatments, or the challenges of living with something that no one else can understand. They can be indirect or amorphous – like a smell, noise, or feeling – or more obvious and predictable – like the site of an accident or an invasive medical procedure. In some cases, those that are triggered have no idea what triggered them and why, nevermind what deep trauma is being recalled.
When triggered, the Fight, Flight, or Freeze alarm bells in our brain go off, communicating that we are in immediate and life-threatening danger and must focus solely on survival. In many situations, pain itself is interpreted as a threat from which the brain needs to protect itself, meaning that those who live with chronic pain may find themselves in a constant state of emergency. Living in fear and panic not only makes it extremely difficult to treat the original pain, but it can also cause heightened stress, pain, and illness.
Joanne is not weak, crazy, or overreacting: she is triggered. Her brain has heroically switched into survival mode in order to protect her, shutting off all body systems that are not connected to this life-saving mission. In this emergency state, it is impossible to fulfill seemingly normal tasks – like waiting for your turn to see the doctor for what is probably a common cold.
Treating chronic pain without understanding trauma
Managing chronic pain sometimes feels like staggering through a maze: every step forward is followed by two steps back. Despite years of effort, sometimes it feels like we haven’t made any progress at all. At Live the Pain, we know that one of the core reasons that many treatment plans fall short of their goals is that they are missing a critical piece of the puzzle: trauma.
It may seem dramatic to suddenly wonder if we have been traumatized – isn’t chronic pain enough? Isn’t trauma something that only happens to victims of serious abuse and soldiers in war? But recognizing that trauma often comes hand in hand with chronic pain is an essential step in determining the path toward healing. If we do not understand what is happening inside our body and brain, how can we move forward? Trying to treat chronic pain without addressing the traumatizing aspects is like shoveling your driveway with a rake. It doesn’t work, because you’re using the wrong tool.
Breakthroughs in trauma research
There has been major progress in the field of trauma treatment in recent years. Once we recognize that there are traumatizing aspects in the chronic pain experience, we have access to a toolbox of evidenced-based methods that can be used to address them. Psychodynamic approaches are now being complimented by those that take into account the inextricable link between our minds, bodies, and emotions, allowing for more integrative and effective treatment.
Among these trauma-informed therapeutic models are EMDR, which combines exposure therapy with guided eye movements, and Somatic Experiencing, a body-oriented approach that provides clinical tools to release the survival energy stored in the body.
These therapeutic models address the root cause of trauma symptoms, helping people release the trauma that has been stored in their minds and bodies, exacerbating their original pain. After years of “talking things through” with a therapist, sometimes a shift in perspective that provides new and more relevant tools can finally help people release all of this damaging, pent up energy. LTP integrates these cutting-edge approaches into all of our programs, because we know that once trauma is released, we can regain a sense of agency over our lives and put our pain back into perspective.
Finding hope in trauma
Obviously, not every person who suffers from chronic pain also experiences trauma, and even for those who do, recognizing and addressing trauma will not magically cure chronic pain. However, by acknowledging the prevalence of trauma in the chronic pain experience, we open up the possibility of new ways of looking at our pain. By incorporating trauma-informed approaches to our treatment plans, we create open roads of hope where we previously saw only brick walls in a maze.