Trauma

Have you ever met someone who experiences things that are unexplainable, or are you one of those people?

From my days of working in one of the largest NYC hospitals, I saw a lot of it. There were 2 sides of the hospital, one on the main street which had a large house-less population and a lot of activity. If you went to the other side of the hospital, that was where there were a lot of private doctor’s offices, that although it wasn’t advertised as such, was for the middle to upper class patients. Those doctors did not take state funded insurance, and therefore saw people who were mostly “well enough” to keep jobs or married to someone that was. It was like visiting 2 different worlds in the span of one block. It was also in the middle of Washington Heights, a population of mostly Dominican Republic (DR) born immigrants. Because I am fluent in Spanish, that was most of my clientele. Because most people immigrating here from DR, which is a developing country, didn’t come with large sums of money or from a lot of resources, they typically came without a lot when it came to money, insurance, housing, and all of the other basic necessities that the people who were one block away were familiar with having access to.

Both sides were very different.

On the side I worked, there was a lot of trauma and traumatized people. Familial abuse, which was typically physical and sexual, and had been passed down from generation to generation. The Emergency Room was typically overflowing on a daily basis. There were people who had life threatening emergencies like heart attacks, strokes, etc. There were people who had emergencies of mental health issues; suicidal, schizophrenia, psychosis, etc.

NYC does not have a lot of resources. It is odd because if you ask any New Yorker, they will tell you that we pay high taxes and that NY is typically one of the more “generous” states but you wouldn’t know it when you enter the emergency room. There are houseless people who are going to the ED for a warm place to stay, a bed, a hot meal. There are beds in the hallway, people spending days in the emergency room because there is no bed to move to in the units in the hospital. It’s a mess.

I worked as a therapist in an outpatient cliinic that mostly worked with state or government based insurance (i.e Medicaid, Medicare, etc). I honeymooned as an inpatient social worker on the weekends in the hospital. During the week, I would work with people with anxiety, depression, PTSD, bipolar disorder, just to name a few. We were working together to track symptoms of their depression or anxiety and see if the new meds they had prescribed were working. I worked in collaboration with some brilliant psychiatrists and learned meds really well in the time I was there. On the weekends I would help plan discharges for people to either go home with or without services or make a transition to a rehabilitational facility or nursing home. The issues were different in the two different places that I worked.

The issues in my weekday job working with people with state based insurance and typically living in poverty and with a significant amount of trauma centered around constantly being retriggered and not having a lot of ways to cope with the stressful lives they had to leave. Frequently people were going to the Emergency Room on a regular basis for non-emergency issues. I got to hear about these cases when we would meet as a team with doctors, psychiatrists, social workers, and clinic staff. I remember we discussed the case of a woman who went to the emergency room nearly every day. She stated she was having abdominal pain and needed an IV. She got attended to because you can’t be turned away from the ER, but her case got flagged because she was going too much. The team was stumped. They even tried giving this woman her primary doctor’s number so that she could call before she went to the ER, but that only worked in keeping her away a couple of times.

I remember asking the team if anyone had looked into what happened to her abdominal area in the past. Had there been a rape? Unwanted pregnancy? Abortion? Miscarriage? The team responded that this woman had a history of giving birth to a stillborn baby. “A-HA” I said. “She is going back to try to find her baby.” The team looked dumbfounded. I explained somatic experiencing and the fact that the body remembers everything and will respond accordingly. I explained that the woman didn’t know that is what she was doing, but I would venture to guess that it was exactly that. So what happened next? The team in the ER responded to her completely differently. They let her know what they thought might be happening, which opened the door to the woman to talk about the loss of her baby. They were able to admit her into an inpatient mental health program and she didn’t continue going back to the hospital. Had we not made that connection, that woman would have continued to returned to the emergency room to get no explanation and feel that no one was helping her.

In the hospital, when working inpatient, I would typically deal with angry people who weren’t getting the discharge they wanted; they were being let out without a plan that was satisfactory to them, or they were angry with the treatment they were getting. Totally different problems. They weren’t being triggered, per se, they were not getting what they expected. A big difference.

However, one day there was one young woman who was having seizures. She had been kept under observation but they couldn’t explain why the seizures were happening. It was time to discharge her. When I did my assessment I found that this woman had been significantly traumatized as a child. She was physically and sexually abused. She did not have seizures before and they onset pretty quickly. The fact that her brain waves were normal and medication was not helping, I suspected something else was going on. Psuedoseizures are not epilepsy, they are psychiatric in nature. Essentially, until this woman processed the trauma in her past, they would likely never stop. It was difficult in the small period of time that she was in the hospital to understand what was really going on. I had a hypothesis that there was a problem at home, because every time we were getting ready to discharge her, a seizure would happen. Her body was preventing her from having to go back to whatever she was experiencing at home.

I always wondered what would have happened if these folx had received Ketamine treatment and been able to process things without being emotionally overwhelmed by them.

If you have unexplainable things happening to you, I suggest you dig deeper. Sometimes if you aren’t able to find the answer in regular therapy, you might want to open yourself to other possibilities. It may be possible that you have buried something so deep, which is our body’s way of coping with traumatic experiences, in order to not be overwhelmed. But they will come out in some way later on. It’s a gift that there are many other ways being developed, like Ketamine, to be able to find a way to work with trauma in a way that is not overwhelming.

I am hopeful that I have been witness to the healing of people’s deeply buried trauma and facilitated a new experience.