blog · Change · eating disorders · Mental Health · shame · trauma

Why Trauma Survivors Don’t Go To The Doctor

I have not been feeling well for months. -low energy, aches and pains everywhere, chills, and chronic fatigue. I’m so exhausted that I can barely make it from my bed to the couch downstairs without feeling drained. At first I thought maybe it was depression, but as the months went on, I started to get this feeling that there is something deeper going on with me aside from depression. I have a history of thyroid issues in my family, and I’ve been told by a few doctors that I should keep an eye on my thyroid levels, as they have historically been on the lower end of the spectrum.

Thus, after months of feeling like total crap, I picked up the phone and made an appointment with an endocrinologist, hopeful that this doctor will give me the answers I am looking for. I scheduled my appointment for the end of December – and what did I do immediately after I hang up the phone?

I agonized over the appointment. Every day that it got closer to me having to go to the doctor, I felt my anxiety increasing. I loathe going to the doctor. In fact, I’m petrified. And here is a little glimpse as to why doctors appointments, for myself and many others, are often traumatic:

My recent appointment with the endocrinologist went as follows:

I arrived, checked myself in for my appointment, got my temperature taken, and was called back by one of the techs.

“Step on the scale please,” she says. I respond “Oh, no, I am in recovery from an eating disorder and I cant – ” She cuts of me off. “Ma’am, we really do need your weight if you’re going to be a patient here.” I feel myself starting to shut down. “Ok dont be a big baby, just get on the scale” I think to myself. As I step on the scale, I say to her “Okay but it’s triggering to weigh myself so can you please not tell me what my weight -” She cuts me off again to say my weight out loud in front of multiple other people in the office so that someone else can write it down.

And then the shame starts. I start sweating. “Oh my god oh my god that bitch yelled my weight out to the whole office everyone is going to know my weight oh god I cant breathe.” I walk into the room to wait for the doctor. Soon enough the doctor barges in the door and says hello without making eye contact. She sits down at her computer and asks me deeply personal questions without looking back at me one single time.

“You wrote down that you have PTSD?”

“Yes.”

“From….?????”

My heart sinks right into my gut. I stammer on my words as I try to give a 15 second elevator speech about my trauma to a woman who isn’t even looking at me. As I finish speaking I start to cry into my mask. “Why couldn’t I just tell her I wasn’t comfortable discussing it?” I think to myself. But I cant help it. I’m with an “authority figure”. I’m playing out my trauma – giving my all to a person who promises to help me but doesn’t actually care about me.

She types on the computer in complete silence for what feels like 15 minutes. She gets up, touches my hands, my ankles, my neck, my chest, and says “There doesn’t seem to be anything wrong.”

I finally start to get angry. “That can’t be right. I’m telling you, I don’t feel well. I know when something is wrong with my body. I am in recovery from my eating disorder and eat better now than I ever have in my life and somehow have put on an excessive amount of weight in the last few months that has me extremely concerned about my health.”

She says “Well, I’ll send you for more bloodwork but in the meantime, you should exercise, 20 minutes a day. Sound good?”

NO THIS DOES NOT SOUND GOOD, DOC. If exercise was the f&%$*@! answer, I wouldn’t be here talking to you, now would I? The problem is that I do exercise, perhaps not as much as I would like because I’m so exhausted I can barely function but I do my damn best. I’m not here because I needed you to tell me to exercise. I’m not here to talk about how to lose weight – I’m here because everything in my body is screaming “SOMETHING IS WRONG.”

But I dont say any of that to her. Instead, I nod through my tears “Yes, I’ll exercise.” and I am sent to the front desk to check out. The woman hands me a piece of paper with the summary of my appointment, in which it says that the doctor discussed BMI with me and I agreed that I was going to exercise every day for 20 minutes.

And I sobbed. The discharge summary said nothing other than that I am overweight and need to exercise. I threw it in the garbage because IT IS garbage. Why why why can we be so obsessed with someone’s weight but be completely oblivious about the trauma that is often behind the number on the scale? Why are we still even talking about BMI? There is a plethora of research negating its validity as a tool for determining health.

How differently could that appointment have gone if she had asked me what is going on in my life aside from exercising? If she had looked me in the eye when she walked in the door and made me feel seen and heard? Would I have been so horribly triggered if they had respected my right not to step on the scale? I guess I’ll never know, but I do know one thing:

This sort of stuff happens in doctors appointments over and over and over again. Folks who are struggling with eating disorders are often masking trauma. When you get to the root of the trauma, you mitigate the eating disordered symptoms. The person then learns how to listen to their bodies and eat intuitively, and their weight becomes whatever it is meant to be.

WEIGHT WILL TAKE CARE OF ITSELF. It is not necessary for doctors to be discussing BMI when 90% of the time, we don’t show up to the doctors to discuss BMI. Weight isn’t, despite what so many people think in this fat-phobic society, the root of all evil. Unprocessed emotions, underlying autoimmune diseases, irregular metabolic functioning, and suppressed trauma, are just a few of the many, many things that are more important than BMI.

I wasn’t given the time of day by this doctor, as has been the case with dozens of other doctors. Instead of leaving with answers for what is going on with me when I know something is wrong, I left full of shame and rage that no one will listen to me when I am doing everything short of screaming at the top of my lungs “SOMETHING FEELS OFF WITH MY BODY PLEASE HELP.”

I’ve been in recovery from my eating disorder for awhile now. I’m more in tune with my body than ever before, but because my BMI labels me as being overweight, everyone jumps to the conclusion that it must be my diet and exercise that are off.

We need to do better. We need to get rid of the BMI are start assessing people’s ACE scores (see https://alyssascolari.com/understanding-adverse-childhood-experiences/ for more info on ACE scores) because this is ultimately what’s going to kill people, not their BMI. You can put someone on the biggest, best diet in the whole world and they will still continue to have health issues until you get to the core of their wounds.

“Trauma-informed” is not just some training that we need to get in order to check off another box on our “to-do” list. It’s a crucial part of the work that all healthcare professionals do. When we start to shift our focus towards a truly trauma-informed practice, I can guarantee that we’ll start saving more lives than the BMI chart ever has.

blog · Change · trauma

The Loss of the Living

I never thought I would have to write a post like this. Lord knows I don’t want to sit with the feelings that come up as I write, but I know I need to.

There is a special kind of grief many of us experience that is unlike any other type of grief in this world. It is the loss of those who are still living – those who, at one point in your life brought you comfort and joy and peace, but no longer do. 

When you love somebody with all of your heart, when you trust them and allow yourself to be fragile and vulnerable in front of them, when you feel enveloped in safety by them, it is an indescribable type of pain to lose them. I do believe that there is a type of trust that, once broken, can never be rebuilt. When the trust is first broken, we get the urge to try to figure out how we can fix it, justify it, or rationalize it. Sometimes we even try to blame ourselves for the broken trust. This is because at the end of the day, when we are betrayed by somebody that we love, our hearts ache just a little bit less if we can find some way to take the blame for it.

But the fact of the matter is that not all relationships are able to last; and just because two people love one another dearly does not mean that they are meant to be in each other’s lives forever. 

There’s not nearly enough attention given to the loss of loved ones who are still alive – the ones who continue to move on with their lives. One of the most painful parts of parting ways with a loved one is knowing that life continues beyond this relationship. You will both laugh again, you will both continue to build relationships with others, and the memories of what happened will eventually fade. You will no longer be at the forefront of each other’s minds, and one day, other thoughts, feelings and memories will take precedence. I am not talking about a specific type of relationship here. This could be a romantic relationship, a friendship, or any individual who you trusted and loved deeply.

I have to admit, for the first time in a long time, I don’t have the answers for how I’m going to move through the ending of a relationship that I held so dear to my heart. I’m not being specific about who I am referring to because despite all that has happened, I still maintain a respect for this person that I don’t think will ever go away. It has been difficult to move forward while still trying to process what happened. My world as I knew it for the last 3 years has changed in ways that I still don’t understand. It hurts more than I can describe. And that’s okay. My pain only further confirms how special this person was to me, and it’s okay to be deep in grief. It’s uncomfortable, it’s awful, it’s excruciating, but over time it will pass. Just because feelings are uncomfortable does not mean we are incapable of sitting with them. 

There have been moments of full-on transparency with some of my patients this week who pointed out that I did not seem like myself. I even had a session with a client where I needed to pause, remove myself, let myself burst into tears for 30 seconds, and regroup. This is what grief looks like – allowing it to pass through you when it comes up, but not letting it ruin your life or your day. All I can do right now is show up for both myself and my patients, whatever that may look like, even if it means needing to take a moment for myself throughout the day. After all, when I’m not busy being a therapist, I am simply another human being – my heart breaks just the same as anyone else’s. 

If you’ve ever experienced this type of loss, I hope you can relate. I hope my words can provide some comfort and some insight. It’s okay to be devastated over the loss of someone who is still living. Yes, it’s easier to be mad at that person, it’s easier to try to make that person out to be a monster in your head, it’s easier to blame ourselves, because it helps us to avoid the grief. But the grief is still there. It’s to be expected. Let it come in whatever way it will. 

As for me, I will hold this person close to my heart and soul as I continue to process what happened. It’s an ache for which there are no words, only tears. 

My favorite poet, Rupi Kaur, has said it best: 

“They did not tell me it would hurt like this
No one warned me
About the heartbreak we experience with friends
‘Where are the albums?’ I thought
There were no songs sung for it
I could not find the ballads
Or read the books dedicated to writing the grief
We fall into when friends leave
It is the type of heartache that
Does not hit you like a tsunami
It is a slow cancer
The kind that does not show up for months
Has no visible signs
Is an ache here
A headache there
But manageable 
Cancer or tsunami 
It all ends the same
A friend or a lover
A loss is a loss is a loss”

the underrated heartache by Rupi Kaur

blog · Change · Mental Health · self care

It’s A New Dawn

Change – the thing many of us crave but run far, far away from when faced with it.
“I want a new job.” 
“I always wanted to try yoga.”
“I wish I could afford to travel.” 

And then one day it happens:
-You get a new job offer.
-Your friend invites you to a yoga class that she goes to every week.
-You finally have enough money saved in your bank account to fly to the country of your dreams!

Opportunity knocks, and you would think it would make you happy, but instead you are terrified.  
“Well what if I hate this new job?” 
“What if I look like a fool in yoga?” 
“I can’t go on vacation, God forbid I need this money for an emergency down the road. It’s too scary to travel right now anyway.” 

We long for change! We pray for it! We beg for it! We curse the skies and ask God why things aren’t changing. Then one day, we see an opportunity on the horizon, and instead of embracing it, most of us are like “Nope, no thanks. Not today.” Personally, I have struggled with change my whole life, especially lately.

Last week, I resigned from my position with the police department. If you didn’t already know this, I have spent the last two and a half years as a counselor for a local police department. The fact that I will no longer be an employee there after this Friday is something I still cannot wrap my brain around.  

When I first started this job in 2018, I was ecstatic. I thought I had the rest of my life figured out. I told myself I’d have a secure job, a pension, vacation and sick time, holidays off, etc. Prior to this position falling into my lap, I had always wanted to go into private practice. But when I started this job, I put those dreams on the back burner for the promise of a guaranteed salary, benefits, a pension, and the opportunity to help others in a very unique way – most police departments do not have a full-time counselor on board. 

But one day last summer, I left work realizing something was missing in my career. I wanted the opportunity to work long-term with kids and adults who have endured trauma, something I was unable to do given the short-term counseling I was limited to providing through the police department. The majority of my job included helping others only with surface-level problems, teaching them healthy coping skills, and then referring them to someone else to dive deeper into their trauma.

I longed to walk with people on their journey to recovery instead of referring them to someone else. I knew that I could help people so much more outside of the confines of short-term stabilization counseling. So last summer, I opened my own private practice as a trauma therapist. The intention was for me to do this part-time while maintaining my job at the police department. My practice opened in August of 2019. I started out renting a small office from a very kind woman until my practice became big enough to be able to afford my own office, which took about two months.

In October, I moved into my own office. From there, it took about 6 more months for my practice to grow into a full-time job. I was so torn because I loved both of my jobs. Working with the police allowed me to form relationships with law enforcement officers, school district employees, multiple victim service organizations, among many others who dedicate their lives to helping and serving others. I’ve had the opportunity to deliver food to the homeless, to console people in their grief after a traumatic loss, to offer a safe space for kids who are living in neglectful and abusive environments, and so much more.

I could write a book alone on what it is like to be the only therapist working with law enforcement officers on a regular basis. I met some amazing men and women who work tirelessly, putting their lives on the line for others, sacrificing time with their own families so that others may be protected. My friends in law enforcement have challenged me and opened my eyes to what their lives are really like and why they think the way that they do. I’d like to think that I helped do the same for some of them when it comes to mental health. After all, being the only therapist in a room full of police officers helped me to find my voice and develop confidence in who I am and what I do.

But as time went on and I continued to work in the police department, major changes started happening – a combination of changes in myself and changes in the department. Out of the respect that I have (and will always have) for most of those that I worked with, I won’t go into those changes. I’ll simply say that in my gut, I knew it was time for me to move on.

Yet, I struggled. “What if I quit and they hate me? What if I quit and my private practice doesn’t continue to flourish? What if I can’t make it as a trauma therapist? How can I give up guaranteed income for a job where, if I don’t work, I don’t get paid? And most importantly, what will happen to the people who might need my help through the police department in the future?”

But you can’t pour from an empty cup, right? What good would any of those things be if I wasn’t truly happy with my job? And the truth is, the more that time went on the more I felt I belonged in private practice. So as scared as I was, I honored my instincts, and I resigned. I cried after I sent in my letter of resignation; and after my last day this Friday, I will surely cry some more. Change is horrifying, but as scared as I may be, I know I did the right thing. I mourn the loss of what could have been if I stayed, because I know I had so much potential to thrive in that position. I truly valued the work I did at the police department and the wonderful people I met. But I know those relationships will live on whether I work at the police department or not.

Change is happening at a pace so rapidly and so unexpectedly that I can barely keep up. My husband starts his dream job on Monday; and on Friday, I will say goodbye to a job I thought I would stay at forever – and that’s just scratching the surface of the changes that have been occurring in 2020!

I’m terrified, but I’m moving forward. I’m shocked at myself, but I’m proud. I’m nervous, but I am SO EXCITED for what’s to come.

In the words of the famous singer/songwriter Nina Simone:

“It’s a new dawn,
It’s a new day,
It’s a new life for me,
And I’m feeling good.