Yup, It's All In My Head
“Where do we go for help?” was the question posed by two readers who also suffer from post-traumatic stress disorder induced in part by abortion. I say in part, because I recently read in commentary at After Abortion a very good argument against even having a subset disorder known as post-abortion stress disorder (PAS, or PASS). I concurred, so I will no longer use these acronyms. There was no single event in my life that caused PTSD; there were many. Several occurred in childhood and adolescence, when I was most vulnerable to trauma, including my abortion. My symptoms began then, and continued. As in every life, the years brought more strikes, and with each successive strike, my symptoms would worsen with weaker shocks required each time. I believe I have some understanding of kindling theory because I live it.
I admitted I had no answer for the questioners, but promised to discuss the problems. I originally wanted to do so by scolding the medical community for its inadequacies, because I was on the Doctor-Go-Round for many years. I was one of their hard-to-diagnose cases. According to the various general practitioners and specialists I have seen over the years, I could have any number of things: fibromyalgia with an unrelated peripheral neuropathy of unknown origin; multiple sclerosis; lupus; a congenital connective tissue disorder; and, most often, “I don’t know, but something’s not right.” I really wanted to verbally rip to shreds every physician and therapist I have ever seen over the last two decades who missed the PTSD link, dismissed my complaints, misdirected my therapy, over-medicated me, misdiagnosed and underdiagnosed me, and ultimately left me to find my own way in the dark. It would be more graceful, though, and perhaps much more helpful to others, if I explain why I was such a lousy patient. Since I did nothing to help any of these professionals come to the correct conclusions in the first place, it doesn’t seem fair to lay the blame squarely on the medical community – but they are not innocent.
I was always afraid my problems were being dismissed as just in my head. I was right on both counts. My problems were being dismissed and/or misdiagnosed, and they are all in my head. But that didn’t mean they weren’t real. Step one is not to make the mistake in thinking that those who suffer from mental disorders are imagining their physical symptoms, and that the mind and body are separate entities to be treated in different ways. Anti-depressants might be a good example to use in this regard.
In clinically depressed patients, researchers discovered the link between the amount of free-floating serotonin, a neurotransmitter, and the psychological symptoms of depression. With the administration of SSRI’s, serotonin-reuptake-inhibitors that we know by such brand names as Paxil and Prozac, the symptoms of clinical depression may abate. But it is not logical, nor is it proper scientific method, to conclude that it is this chemical imbalance that causes depression. Depression may cause the chemical imbalance in the first place, and what we are doing is observing and treating a physiological sign of a mental disorder. There isn’t a thought that passes through our brains that isn’t accompanied by an electrical signal between neurons. It is very likely that future researchers will find, not a physical cause for mental illness (and bad behavior - ! – coming soon, “The Wages of Sin”), but that mental illness is displayed by measurable physiological dysfunction of the human nervous system, which produces real, not imagined, systemic physical sensations and problems as part of the stress response, and also in response to kindled signals: chronic pain, fever/flushing, digestive disturbances, difficulty swallowing, dry mouth, sensitivity to temperature, vertigo, sensitivity to sound (this is also a dysfunction of the vestibular system, like vertigo), urinary difficulties, inhibition of reflexes, cardiac arrhythmia and postural hypotension, tremor, muscle spasms, paraesthesias (numbness), and more.
I didn’t understand the complexities of the problem for a very long time, and blamed the medical community in general for failing. But I was part of the problem. I have not had a good relationship with any of the physicians I have ever seen, male or female. I have doctor-hopped dreadfully, not seeking medication, which I was either too freely given or flatly (and with prejudice/suspicion) denied, when I had no intent to ever ask; instead, I was seeking an explanation for systemic neurological dysfunction that was measurable, and therefore, real – not merely psychological, as I considered it then. I have been an enigma to at least four neurologists; a rheumatologist (who thinks he knows what it is, but he didn’t have the whole picture); two pulmonologists; an ear-nose-throat-don’t-make-me-spell-it-ologist; a urologist; several cardiologists who didn’t help by looking at me and my test results with alarming alarm; and too many family practitioners to count. Doctor-hopping is not a good idea. But I dreaded every appointment, and disliked almost every one of the physicians I saw even as I plodded on in search of an answer. I argued with them (which was often necessary in order to get permission to stop medications that were making me feel worse). I would not hesitate to butt heads and rudely debate their opinions about things which they knew better than I. Is this due to my own arrogance? Yes, in a strange way. I don’t trust the opinions of others, but not because I love my own so very much. There was one time when the advice I received was quite wrong, and I lost the argument about the choice made on my behalf, for my own good. The decision to abort my child when I was sixteen had been aided by our family physician, someone I trusted. I have no confidence in the ability of others, particularly medical professionals, to make right decisions for me because that trust was once so deeply violated. No, I was not able to handle having an abortion, and I am angry that no one in the position to do so was able to see it. These were adults and professionals. If they didn’t know what was best, who could?
But the problem runs deeper than that, to areas beyond my control. It is also hyper-vigilance, anxiety, and all of the symptoms of PTSD that became an obstacle to proper treatment. I could not find help from medical doctors because every occasion to visit one was triggering a post-traumatic stress response, and no one could see that, either, especially me. Now, here’s a problem to overcome. When I go into a doctor’s office, hospital, emergency room, clinic – it doesn’t matter what kind of medical facility it is – there are always environmental cues that are triggering the emotions of fear, anxiety, horror, guilt, and shame that are associated with my abortion experience. I’m going to close my eyes and try to recall some details from my abortion, and while I do, I will record what my senses remember, those I am able to verbalize, and I won’t over-edit my recollections:
White – everything was white. The blankets, white cotton, woven in a pattern of small squares. The nurse’s white uniform (I prefer people who wear brightly colored and patterned scrubs). The walls were white. The abortionist was all in white, and his hair was white. He was old to me, but I was young then.
Red – the only color I see is red, because everything else is black or gray. I sat up before she took the cart away, and I see how black. No, it can’t be a dissecting tray, I don’t care what it looks like. Long, coiled tubes that should be transparent, clotted with red. Glass jars that should have been used for sun tea, and were not. The nurse’s face was white in contrast, just then, when I sat up too soon. My feet were still in the stirrups. [Ladies, for a moment, assume the stirrup position – what are your legs doing? Our toes are pointed at the ceiling, and the calf muscles from the back of the knee to the back of the ankle are stretched taut. This is a posture that I fight with even when I am “at rest.” And isn’t it an odd coincidence, that I have nerve conduction studies showing dysfunction in the nerves that feed these specific muscles? It brings to mind Dr. Scaer’s description of posturing, when an animal recovering from the freeze response assumes the last physical position and/or activity it was performing just prior to the loss of conscious control. The gazelle, waking up on its side in the grass after the not-so-hungry-after-all lion has left it alone, flails its legs as if running. My toes pull to the ceiling, as if I am in gynecological stirrups, frozen in that moment in time when I reached the utmost state of helplessness and horror, too.]
Examining tables – they are so hard, my rear-end gets cold. The vinyl is also cold. Needle pricks and the niggling discomfort of the IV.
Sounds – the humming of machines and voices, office noises. Phones ringing. The creak of the vinyl of the examining table. Vacuuming with a gurgling sound, like the appliance dentists stick in our mouths to suck out debris and fluid when they are working. No, I don’t like dentist appointments, either. All of the sounds seem to be filtered through ear muffs.
Smells. They are the hardest. [They are known to evoke the strongest emotions, because the sense of smell is processed differently than the input from our other senses. It is a more direct route to the emotional connection made by the amygdala.] Disinfectant. Blood. Cotton.
When I am sitting in an examination room today, for whatever reason, I am fighting the post-traumatic stress response to these and other triggers, because the last straw needed to feed the kindled flames of my post-traumatic stress disorder was delivered by medical professionals in a clinical setting. So much for finding help from physicians. Could I be a better patient now? Possibly, since I understand why I am so emotionally wrought in a doctor’s office. Also, I now know why I never felt as much pain under examination as I do at home – the stress response releases endorphins, natural pain killers that result in the physician’s inability to elicit to its fullest extent the worst of the myofascial and neuropathic pain that I feel.
But what about getting help from a mental health professional? I mentioned my abortion and my anger about it in a group therapy session once many years ago, and the information landed in the room with an audible thud before the group leader changed the subject and moved on. This was an anger-management group to treat my cutting behavior, which did me absolutely no good since it disregarded the source of my anger. The APA refuses to acknowledge the traumatic effects of abortion. What chance do I have of finding a sympathetic ear? I am also not likely to be comfortable with a male therapist because of the gender of my abortionist and the physician who advised abortion. But a female therapist may be an abortion victim herself. If she feels fine, can she validate my own, not-so-fine, feelings? I have great doubts.
So this limits my options. I had thought to seek psychological help from the pro-life community, where many different groups are offering post-abortion counseling. Many of these are based on the group-therapy model that has had good results in PTSD treatment, and which has the victims offering help to each other. Unfortunately, I have trust issues, and the two programs I looked into each let me down in one way or another – in one case, it was the counselor who bailed, as unreliable in her post-abortive state as am I; in the other, it was me – I didn’t feel I could place trust there for some reason I haven’t been able to identify. I have used this as a convenient reason not to pursue professional counseling at this time, and yes, it is clear to me that my efforts in writing about the disorder are certainly an attempt to treat myself for the condition. I don’t recommend it, but it’s all I have at the moment.
Fifty-percent of women who have had one or more abortions will never admit it. It’s not going to be easy for any of us to receive help from the medical community in this regard if we don’t start complaining, loudly. Why should they “believe in” what they have not seen? I don’t go to doctors any more, though, so they aren’t likely to hear from me unless they read this blogspot. I decided nearly three years ago that I was getting off the Doctor-Go-Round, and I did. I have no desire to see any more white blankets, or to experience the smell of disinfectant, or continue filling my system with medications that more often than not make the problem worse. This is not a reasonable and long-term solution, I know. As I said, I have no answers, just problems. There are treatments that are specific for post-traumatic stress disorder, and I will go into those in a future segment. For the moment, I need to recover from the stress of remembering, and the best answer I have found to that is prayer.