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Experiences as a child taught me not to advocate for myself, and taught me to doubt my experience of reality.

I'm conditioned to be "ok" no matter what and to make sure that no one is upset by me under any circumstances, even if that means keeping them from extending genuine care and support.

So... going to the doctor is really hard for me.

My therapist is encouraging me to see a GP for the first time in years and really discuss everything that I've kept bottled up to the detriment of my health.

I compiled the following letter from others found online, I thought it would be helpful to share with this community.

My therapist said these are reasonable accommodations... but I know I'll feel terrified asking for them! Without her help I never would have known that I could even hope to advocate for myself.

Does anyone else have suggestions for communicating with doctors/ navigating the stressful world of healthcare?






Dr. _____,

I'm writing because I am a soon-to-be patient of yours, and there are a few things that I think it would be beneficial for you to know prior to our first appointment on (date).

I am a survivor of childhood physical and emotional abuse, physical and emotional neglect, and sexual abuse. My medical records will not reflect these things specifically as this is the first time I have communicated them to a medical professional. I've recently entered a new season of safety in my life, with limited or eliminated contact with my abusers, and I am seeking to find a physician who will partner with me in my future health care and help me to address the lingering effects of abuse on my health which have been partially or fully unaddressed.

Because of my history, meeting new doctors and undergoing physical exams can be extremely anxiety provoking for me. My counselor has helped me to assess what I may need in order to feel safe in medical environments and during medical procedures/exams. I thought it would be best to share some of that prior to seeing you.

One thing that is extremely helpful to me is if the first appointment with a new provider can be a consult in which there will be only discussion and no exam. I believe that this is what we have scheduled on (date), and I just wanted to confirm that need.

During the appointment, I will likely be anxious, and will have trouble processing the information we discuss. It is a struggle for me to express what I am thinking and feeling, and whether or not I am feeling safe. It's likely that I will become dissociative during/following a physical exam or during/following discussion of health topics related to the abuse. This dissociative state may or may not be apparent to an observer. For these reasons, if possible, I would like to request to be scheduled for slightly longer appointments than usual, so that I can have time to get grounded, process information, and ask questions.

For a variety of reasons (including history of head trauma, neglect, iron-deficiency, and Complex-PTSD) I will be unable to remember in detail what we've discussed following our appointment. I will take notes during the appointment and may record our conversations; but, if possible, I would like to request to be supplied with a copy of your records from each appointment.

I have trouble initiating dialogue, which is why I thought it was important to send this letter prior to our first appointment. I am very willing to talk about the content of this letter, but I will do much better if I am asked questions, rather than having to start the conversation. Especially in our first appointment, it will be helpful if you will initiate conversation.

Additional accommodations I would like to request include:

• Being in a position during exams where I can have eye contact with someone at all times.

• Being reassured that I can ask questions about any part of my care.

• Having an explanation of procedures. Including knowing that I will be touched, how and where I will be touched, and if I should expect discomfort.

• Assurance that staff want to know what they can do to make me more comfortable, and that they will not be angry or upset if I request something to be done differently.

• Patient reassurance of safety should I exhibit signs of a panic attack, startle when touched, or experience pain during an exam.

• If it is necessary for a male medical professional to be involved in my care, I request that a female medical professional also be present.

I am hopeful about working with you for my ongoing care, and I truly appreciate the time you are taking to read this letter. Please include this letter in my medical records for future reference.

If you have any concerns or would like to touch base about anything prior to our first appointment, please leave a message on my cell and I will return your call promptly: _________.

Sincere thanks,

Hey folks.

I had a day last week where I was extremely confused. I drove, but now I know I shouldn't have because I had trouble figuring out which lane I was supposed to be in, delayed reaction time, etc.  I had trouble with much easier tasks too, such as fixing breakfast and sorting vitamins for the day.

My stress level with work and dealing with FOO has been exceptionally high, in addition to dealing with chronic pain, so I'm not surprised that this happens/happened... I would just like to shed a little light on it.

I have a few questions:

1- Is this "normal"? I understand now that it's a symptom of PTSD. I had always thought it was something that everyone experienced on a regular basis because that was part of my experience of life. Do non-PTSD sufferers experience anything like this as a regular part of life?

2- My second question is more academic, can anyone tell me what's going on in the brain that causes confusion?

3- I could have hurt myself or someone else by driving last week, but I didn't realize what a state I was in until after I was on the road and having trouble with a route I take everyday. I need to find a system for recognizing when I get in that state. What are some tools you use to check in with yourself to make sure you're functioning well enough to participate in life?

Thanks!

Anyone using a service dog to help mitigate their symptoms?

If so, would you mind sharing what work/tasks your dog helps you with, or other ways you benefit from their presence?

Hoping I'm putting this in the right section...

This YouTube channel is 100% geared towards providing useful information to adult survivors of childhood abuse. Specifically sexual abuse, but most of the topics apply to the broad spectrum of cptsd.

They broadcast every Monday night accompanied by an interactive Twitter conversation.

https://www.youtube.com/channel/UC_pxd6gjX2Dd5amM_uboiRA

[it was incredibly helpful.]

 

I recently read "The Body Keeps the Score"... listened actually since the audio book is up on Youtube (yay!).

Dr. van der Kolk strongly recommends the use of yoga to help us get in touch with our bodies. They've done some really interesting studies on yoga's positive effect on folks who have experienced trauma. If you haven't read it yet... don't delay! (But, be warned that he does describe a few experiences of patient's trauma which could be upsetting to listen to if you're not prepared.)

Anyway... I went to a beginner's yoga class today.

I won't get into it much, but between shutting down from family drama and dealing with chronic pain, I have a long history of blocking out my body's sensations and needs. Like many women, I also have a somewhat distorted view of myself, thinking that I weigh too much and feeling like I have to apologize for the space I take up.

The yoga practice was gentle and simple. I wouldn't consider it a workout, just light stretching and core stabilizing. So it's the kind of thing most anyone can walk into and feel able to do.

We focused on our breath and on an awareness of the body in order to hold the poses correctly.

I wasn't expecting it... but it was incredibly helpful. Now, I'm not saying I'm cured and yoga is the answer to everything ever... but I felt my body in a different way than I'm used to. Holding the Warrior 2 pose, looking out over my hand, I looked and really saw myself. I felt a connection between what I was seeing, and feeling, and doing. I saw my bony hand and wrist. I saw a skinny arm. I saw myself for what I really am instead of how my mind plays tricks on me.

Maybe that sounds ridiculous, but it's a real struggle. I'm sure this awareness is just the tip of the iceberg, but it was a positive experience that I look forward to exploring more. (Way more than I look forward to discussing my body in counseling! )

Would love to hear about anyone else's positive yoga experiences!

[They know a woman who goes out of her way to serve others.]

I've hesitated to start one of these journals. Putting sensitive information online seems like an inherently bad idea with potential negative repercussions down the road. However, I'm struggling to make sense of my world and can't think of where else to turn. I've been lurking for many months, occasionally commenting, and I've been consistently encouraged by the supportive community I've found. Sometimes I wish we could gather together; I think we would find safety in one another's company.

Safety is lacking in my face-to-face relationships. Or, rather, my fear interferes with my perceived safety.

I feel I cannot disclose sensitive information to even my closest friends. As a result, no one really knows me. They know the front I put on. They know a lie.

They know a woman who goes out of her way to serve others. They don't know that I'm often unable to even identify what my own needs are. They don't know that even the concept of wanting causes me to freeze in extreme stress and brings overpowering emotional flashbacks of shame, hatred, selfishness.

They know a woman who laughs at the world. They don't know the profound sadness which drives me to laugh as a coping mechanism.

The know a woman who struggled to get traction in the professional world after college, but now enjoys an interesting career. They don't know the intense anxiety and crippling depression that has inhibited my professional life. They haven't seen me hide in a closet at my place of employment to endure a panic attack or overwhelming, irrational emotion. They don't know of my fear of speaking on the telephone which keeps me from engaging with the world. They don't know that searching for work brings back crippling memories and emotions of being told that I'm a stupid, worthless, piece of ****, who will never amount to anything, and deserves to be raped and hurt by the people in my life because of my selfishness.

They know a woman who is always well dressed. They don't know that I was once a smelly, under-nourished kid with one pair of jeans and one pair of shoes to her name. They don't know that my unstable parents abdicated their responsibility to properly feed, clothe, and teach me how to care for myself. They don't know that I struggle to groom myself properly.  They don't know that I can't stand the sight of my naked body. They don't know that I change my underwear as infrequently as possible because doing so reminds me of unpleasant things. They don't know that the feeling of the shower water on my skin makes my entire body tense up. They don't know that I go through periods of not brushing my teeth before bed because my unconscious mind tells me I'm not worthy of dental hygiene (that's so ridiculous when I say it out loud that it really makes me laugh).

They know a woman who is not athletic. They don't know how disconnected my mind is from my body.  That I've endured decades of chronic pain and have become desensitized to my body's needs. Do I need to eat? Or use the bathroom? Am I holding tension in my shoulders? Is my hip on fire? They don't know how I panic and dissociate when my counselor, fitness instructor, or chiropractor tries to get me to tap into an awareness of my physical self.

Thanks for giving me a space to share. It helps. Enough for now.

[Can anyone point me to more information about this topic, namely, the effects of abuse and neglect on the development of a person's ability to process life & store memories?]

Hi all,

In speaking with my therapist about emotional neglect, she briefly mentioned that she thinks the pattern of neglect is the reason my memory developed poorly. Something about how when we're young children we experience things primarily as feelings/emotions without really putting words to experiences. It seems like she was saying that without proper emotional support the brain doesn't properly get away from processing experiences into full-fledged memories... leaving us with emotional memories rather than clear memories that we can describe.

Does that make sense? Can anyone point me to more information about this topic, namely, the effects of abuse and neglect on the development of a person's ability to process life & store memories?

A good bit of my personal history is one big, hazy blur with bits of events scattered throughout. What I do remember, I remember primarily with how it felt/what my emotion was at the time. My memory tends to be out of context with time and I struggle to put things in chronological order. Even as an adult, I've forgotten entire vacations and needed photographic evidence to remind me of the event. Details go the way of the wind... what I wore a week ago or a conversation I had a month ago. If I don't write things down I know I'll lose track of them as if it was never there. (Kinda scary sometimes!)

Is this "normal" or is it, as I assume, another side-effect of ptsd? Do you think your ability to store and recall memories has been affected by your experiences?

Thanks, I appreciate any kind of response! Let's hope I remember to check back 

Maybe there's already a thread around this topic, I wasn't sure what to search for. If you know of a resource I should look at, please let me know

Recovery is complicated. I've been recovering for years, but I've been doing it without support and while lying to myself that the abuse could have lasting effects on my life. I thought that I could deny it power in my life by failing to acknowledge that it occurred, or "putting it behind me". I could also say that my recovery has only just begun within the last few months because I finally broke down and accepted that the abuse had far-reaching consequences in my life and that I need outside help to really move forward.

My question is this:

Has anyone else gone through a period of intense identity confusion when beginning the healing process? I mean to say that I can now see how pervasive the aftermath of abuse has been in my life, seeping into every corner of my personality, and it has challenged my understanding of who I am at my core self.

As an example:

Do I really love my chosen profession or was I groomed to love it because that's the only area of my life I was ever given approval for by my abusers? Is that an authentic part of who I am or is it wrapped up in the abuse? Will healing from the abuse take away my joy in what I do?

I hope what I'm saying makes sense, let me know if I need to clarify!

http://www.radiolab.org/story/addiction/

Listen to this podcast! It's very interesting.

They discuss the use of opioid antagonists in treating alcoholism and drug addiction. Essentially, it takes away the positive response to the substance. The idea being that if you don't feel drunk or high you're less likely to want to use again. It's an attempt to eradicate the pavlovian response.

It just got me thinking... We know that addictions are not about the substance, eating disorders are not about the food, hurting yourself is not about the pain, etc. all these things are coping skills. They give us something to do with the emotions we don't know how to deal with. They create a little relief from the pressures of a life that is altogether too confusing. Whether or not we're using substances or acting on other coping skills, we're still addicts. We're seeking the 'high' of our own opiates that our brains release. We're biological-opiate addicts! What started out as a means of helping us cope morphs into having a life of it's own.

A google search for "dissociation opiates" gives a result for a forum (link below) where self mutliation is treated with the drug mentioned in the podcast.

http://www.dr-bob.org/tips/split/Naltrex-op-self-injurious.html

And another (link below) which states "Treatment with low-dose naltrexone may be a helpful element in the treatment of patients with complex posttraumatic stress disorder. However, it has to be realized that the decrease of dissociation may lead patients to a not yet resolvable challenge, in as much as dissociation had previously been a necessary mechanism of self-protection."

http://www.ncbi.nlm.nih.gov/pubmed/25421416

I'm curious, has anyone ever heard of this or been offered this drug in connection with their mental health? What was your experience with it?

I had a latte today to help perk me up after getting half the sleep I'm used to getting. As I'm learning about cPTSD and paying closer attention to myself I think I'm seeing a pattern of being easily triggered when sleep deprived. I guess my defenses are down when I'm worn out?

The coffee made my heart race, but not just caffeine-jitters, I went into panic mode. Over a couple of hours I swung from angry, to overstimulated, to light sensitivity and wanting to hide in the dark far away from all other humans, to wanting to cry, to spacing out, to feeling normal, to nauseous, to hyperventilating, and back to irritable (as in "please, don't talk to me or I'll chew you out"). I kept working and apart from taking some deep breaths (ok, and turning the office lights off) I didn't do anything to act on the anxiety and eventually calmed down.

This happened pretty often in college (little sleep, lots of caffeine... lots of panic), but I just chalked it up to me being weird. I'm wondering if anyone else feels that they're triggered by substances? The last time I had alcohol I had a particularly intense panic attack and I'm afraid to drink again for fear of triggering a similar sequence of events. Should I consider caffeine "off the table" for the time being as well?

Is it "normal" to experience such a range of responses? Anything to help me understand what's going on in my head, or at least to know that I'm not alone would be really helpful! It's so frustrating to feel so out of control!

My therapist says I'm "driving on ice" right now. Any sudden motions and my car's going to end up in the ditch. Things like this show me that she's absolutely right!

Hello!

I've been reading a lot of the posts on this forum and myptsd (dot) com, and finally decided to add my voice. I admit, it feels very strange to speak about this, even in an anonymous setting. It has been very helpful to read what others have experienced and know that I'm not alone; so I figure that if my voice can potentially help someone else then I shouldn't stay in the background.

At 26 I just had my first boyfriend. I met someone this summer who pursued me even when I barely gave him the time of day, eventually I relented and we dated for 3.5 months. I broke things off when I realized that we would not be long-term compatible, but I'm extremely thankful for those months we spent together. All of a sudden, I found myself in a 'safe' relationship with a gentle, kind, thoughtful, loving man... and it triggered extreme anxiety for me (as well as panic attacks, dissociative behaviors, flashbacks, insomnia, etc.).

I realized that I was having fear responses that had nothing to do with him; most notably, I jumped out of my skin when he first put his arm around me. That was enough for me to recognize that I wasn't having rational responses to the situation, so I contacted a Therapist and have been seeking help.

The T helped me identify cPTSD and has been an immense help to me as I've begun to face the past for the first time. She says that the BF gave me a gift in triggering my anxiety. He gave me a glimpse of what it means to be respected, loved and accepted unconditionally. She says that he treated me the way I should have been treated all along. Now I have an idea of how I should be treating myself, and how I should expect to be treated by others.

I desperately want to live a more vibrant life. I've so long been controlled by fear, crippled by anxiety, and manipulated by the lies of a negative self image. It's difficult for me to accept that this is something that I can't fix overnight, but with the help of my T, my friends, and this community I am hopeful for my future.

Nice to meet you all!