Season 2 Introduction - Why do we need to talk about trauma?

Episode 40 - Season 2 Introduction -Why do we need to talk about trauma?

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Transcript

Welcome back to Mind your Fibro podcast, Season 2. I continue the podcast with episode 40. 

If you are just starting to follow this podcast and want to learn about fibromyalgia, I recommend starting with episode 1 of season 1. Also, please download the season 1 episode guide that will guide you through the content of season 1 – where I talk about what fibro is and how it is diagnosed and treated. Other episodes cover pain science, the pain-stress connection, self-care, diet, exercise, and sleep. This season also includes important topics on grief, relationship, and pushing & crashing. Use season 1 to keep track of your progress; the link to download is in the show notes-  https://www.rheumcoach.com/season1

 So many of you kept asking me about Season 2. I gave myself permission to take a short pause around the Christmas holidays so I can recharge, do some self-care, and spend more time with my family. Well, I have fallen off the podcasting wagon. Apparently, just like any habit, it is hard to restart podcasting once you stop. So, I stopped, and every week, I kept thinking about restarting but kept procrastinating and moving the recording to the following week. So week after week, and oops, several months have passed. I bet anyone who ever wanted to implement a health habit like exercising or a new diet can relate! 

Well, I got a new jolt of energy that finally ended procrastination when Melissa Talwar with The Support Fibromyalgia Network reached out to me about my podcast and May being the Fibromyalgia Awareness Month! So please go to Facebook or any other social media, find The Support Fibromyalgia Network, and thank Melissa for pushing me to do what I have planned to do week after week since last episode of my podcast was released! So please support the network, get involved, listen to her Facebook lives, attend the conferences or listened to replays on YouTube and spread the word about Fibro. Also, this week, I saw that the podcast downloads surpassed 55,000 downloads, it is now top 2% podcast worldwide. It was such an energy boost, a new milestone, the additional push I needed to relaunch my podcast. Anyway, I think, I got over myself and my fears and procrastination, got a new breath of enthusiasm after seeing so many new people finding my podcast, except I still need to get used to waking up again at 4 am to record it as my house is never ever quiet. But, I also promised myself better self-care, and getting help with editing – so, hopefully, I can focus on creative part more, and will have more regular episodes. So, thank you all for your support! 

Back to the delay of the season 2 release. Of course, there are usually more reasons of procrastination. I will actually make a whole episode on procrastination later this season. Stalling is protective. Indecision is a decision to not make a decision. Since the last episode of my podcast, I have identified many reasons or triggers, why I could not restart. 

So, last year I decided to dedicate this season to psychological trauma. I have been learning so much about psychological trauma over the last few years and its effect on pain and health I wanted to explore this topic in depth on the podcast. The trauma topics can be oh so triggering. As a woman, mother, daughter of divorced parents, wife, physician, immigrant, someone who lived in the Soviet Union, the topics of trauma are personal. Trauma like stress is universal. 

Our mind is protective. Talking about sensitive topics is hard. Making it relatable and less triggering to my audience or me is an effort. My mind wanted to stall and avoid it. So, the imposter started to whisper in my ear that I was not qualified and needed to invite guests to speak or do some other topics that felt safer. But, I finally decided not to let the imposter win and kept the decision to dedicate 2023 to the subject of trauma. I also started the trauma coaching certification to complement my studies and it gave me some confidence.  I implemented additional self-care practices to feel less triggered and have the support I can use when I do. 

Season 2 of the podcast will be dedicated to trauma and trauma-informed Fibromyalgia care.  You will be learning about trauma, how we cope with it, it affects your health, your mind, your life, and relationships, and how they manifest in the symptoms of fibromyalgia, chronic pain, and many other health issues. This work is deeply personal to me, and I hope to translate my passion and knowledge into each episode. 

Now I am not an expert on trauma, and let me be clear, I am not a psychologist or psychiatrist, but as a rheumatologist, I see patients daily who are affected by trauma, either as children or adults or both.  Most of us experience the impacts of trauma, individually and collectively in our families and society. As I studied trauma over the past few years, I now recognize that majority of the patients I see in my clinic and coaching practice, my co-workers, friends, my family and myself, have experienced psychological trauma. Trauma, just like stress, is universal. And yet, there’s still little awareness about what trauma is, how it impacts our health, our lives, and relationships and how we can build or rebuild our lives not only to heal trauma but resolve the effects of on our health. 

My podcast episodes intent to provide information, but if any of this is triggering or activating your nervous system, please pause, do some self-care, talk to someone. This is not intended to add more pain, but rather provide education, another reason for self-compassion, show the common humanity of our experiences and that you are not alone in your struggle. This is also not medical or psychological advice, remember, I provide education only. 

So, what is psychological trauma? 

Most of you may think that trauma is something catastrophic that happed to a person – explosion, car accident, assault, or some type of act of violence. And these are examples of psychological trauma and do not need to be minimized, but this is not the only type of trauma people can experience. But this notion that only something catastrophic is trauma is widespread and no wonder. The front page of the website of the American Psychological Association lists trauma as “an emotional response to a terrible event like an accident, rape, or natural disaster. Immediately after the event, shock and denial are typical.” This definition is so incomplete, but again, reflects how many, including healthcare providers and patients thinks of trauma. 

Now these events can be traumatic and can have an affect on the person who experienced it. 

But, this definition describes only one type of trauma, what we call acute trauma or big T trauma - a reaction to a deeply disturbing, life-threatening event or situation. That's why we usually think of extreme events when we think of trauma—the war, plane crash, natural disasters, violent crimes, a school shooting, or a serious car accident or the death of a parent or loved one. 

But so many of us may not have lived through a single event such this. Or if we lived, it may not have affected us in a negative way. For example, I lived in Florida and survived a hurricane, a natural disaster, even though it was stressful and potentially traumatic for some, I felt safe and I do not see it affecting me years later. 

During this podcast season will talk about trauma in a different way. I want you to see trauma from the perspective of your nervous system, your emotional and physical health. When we experience something traumatic it changes the way we see ourselves and the world, we feel overwhelmed and powerless, we don’t feel safe, and the body that feels locked in a traumatic state doesn’t feel safe, feeling stuck in the survivor mode. Trauma affects the whole body, physical health, not just emotional health.  It is not only the immediate response, but also very often a long lasting, often profound and life altering response of your nervous system and your body overall.  Dr Gabor Mate said "Trauma is not what happens to you. Trauma is what happens inside you as a result of what happens to you." 

Trauma is the lasting response that often results from living through a single distressing event or several events, some episodic and some could be continuous. I like this definition of trauma, per Psychology Today that defines trauma as “anything that is too much, too soon, or too fast for our nervous system to handle, especially if we can't reach a successful resolution..“

Dan Siegel said: “The simplest way of defining trauma is that it’s an experience we have that overwhelms our capacity to cope.”

Too much, too soon, or too fast for your nervous system to handle, especially if you couldn’t reach a successful resolution, when you did not have the capacity to cope with it, especially if you did not have someone to help you through it, what happens inside as a result of what happened to you. 

Many of you could not find a way to cope with trauma, did not have the successful resolution or someone who supported you, provided love, care and guidance when trauma happened. You may not even know that what you experienced was psychological trauma or perhaps, you swiped it under the rug, pretending it did not happen. 

So why does this matter to you as a patient and to any medical doctors or other providers who may be listening to this podcast? 

I believe that unaddressed trauma history can negatively impact our quality of life, mental and health conditions, and response to treatment. And it’s not only my beliefs or experiences, but years of research. 

Since the results of the groundbreaking CDC-Kaiser study on trauma were released in 1998, the detrimental effects of adverse childhood experiences or ACEs have become better documented. ACEs are defined as potentially traumatic events that occur before adulthood experienced by children, including abuse and neglect. The research team observed a direct correlation between the number of adverse childhood experiences experienced and the likelihood of developing a mental and physical illness, including fibromyalgia and autoimmune conditions. 

 According to research published by the American Psychological Association, children who suffer trauma from abuse or violence early in life show biological signs of aging faster than children who have never experienced adversity. The study examined three different signs of biological aging—early puberty, cellular aging, and changes in brain structure—and found that trauma exposure was associated with all three.

This study concluded that exposure to adversity in childhood is a powerful predictor of health outcomes later in life—not only mental health outcomes like depression and anxiety but also physical health outcomes like heart disease, diabetes, cancer and chronic pain. 

Other studies also examined the relationship between adverse childhood experiences and rheumatoid arthritis (RA) and other chronic inflammatory diseases. That research suggests that adults who experienced 2 or more traumatic events during childhood are at a 100% increased risk of developing rheumatic disease.

So, not only we need to understand and acknowledge that people who had history of trauma will likely have more health issues, but also it will affect their personalities, behaviors, habits, lifestyle choices, and physical symptoms, including chronic pain, depression, and anxiety. This may be particularly relevant for people who are resistant to treatment or may not be able to be compliant with treatment. For example, research shows that an unaddressed childhood trauma history can negatively impact a patient’s response to Rheumatoid arthritis treatment. We must acknowledge the relationship between trauma, perceived social support, social undermining, and illness perceptions.

Our body, mind, and spirit do not exist in isolation; they are connected. 

Modern healthcare so often is focused on providing physical care, medications, and treatments for a physical complaint, often not addressing psychological pain and suffering. And it’s a global, not just a physician issue. And we will talk about physician burn out and stress and suicide risk in the future episodes, as I think it’s a super important to acknowledge the pressures put on doctors by the modern healthcare systems. 

Patients also often focus on quick fixes, focusing more on medications, than lifestyle. It is also true that many patients hope that once their physical pain is gone, their life will be better and that one magic pill or weight loss, a special diet, will fix everything. Which are all, normal human desires. No one wants to live in pain. 

So the goal of this podcast season is to start a conversation, bring awareness, and connect the dots between physical and emotional pain and suffering; talk about the traumas that often may preceded the onset of your physical illness, the recovery, and coping with symptoms and challenges of treatment.  

I know that not everyone has or will have access to therapy. Although I recommend that everyone with a history of adverse childhood experiences, adult trauma, chronic ongoing stress, and burnout – seek professional care, but starting to be aware that maybe there is a relationship between your experiences, trauma, and health can be a start. We will talk about many manifestations of trauma that may go unrecognized - people pleasing, perfectionism, shame, inner critic, grieving and coping by overeating, overdrinking and substance abuse, and many other topics. Again, as you listen, please take care of yourself. If you feel overwhelmed, pause the podcast. Find someone close to you who can share your feelings and process your emotions or pain. Dysregulated nervous system plays a significant role in fibromyalgia and its treatment. Our nervous system needs a tribe to regulate and feel connected. 

If you are interested in joining my tribe, the Rheum Mate membership is not open for enrollment, but you can add yourself to the wait list. You can find the link in the show notes. This membership was designed with trauma-informed care in mind; we work on regulating our nervous system, reducing the effects of chronic stress, and combining the mind, body, spirit, and lifestyle approaches to healing. 

I hope this season of the Mind Your fibro podcast will help many people, not only those with fibromyalgia but their support circle, including family, friends, co-workers, and clinicians. 

If you are a listener, thank you for your support. If you know someone who can benefit from listening, please share. Let's create a global awareness of trauma.