Doctor Addresses Prevalence of Medical Trauma

by: FHE Admin

As medical director of Boulder, Colorado’s Mapleton Rehab Center for 20 years, I saw hundreds of auto accident victims with PTSD and whiplash. These patients exhibited all of the pain, dizziness, and cognitive impairment associated with those conditions. Many patients suffered for years, only minimally helped by therapy. This left me searching for answers.

In 1996 one of my therapists, Marcus Kurek, gave me an article by local psychologist, Peter Levine. Dr. Levine’s article addressed trauma and PTSD— and also described many of the physical symptoms of my whiplash patients. Upon reading his work on Somatic Experiencing®, I sent several auto accident patients to Dr. Levine. After years of ineffective therapy, many of their emotional symptoms of PTSD and also their physical symptoms related to whiplash disappeared with SE®. I realized that whiplash was a traumatic experience, not merely a physical injury. I also realized that their contact with the medical system had contributed greatly to my patients’ trauma by creating an environment of helplessness.

I myself had experienced many surgeries with ether anesthesia as a child, including loss of an eye at age four. I never realized that those experiences were traumatic and had shaped much of my life. I asked Dr. Levine to show me what he did, in SE, with my patients. My response to his treatment session showed me that I had unwittingly carried a huge trauma burden my whole life. For years I’d had a “nervous tic” in my left eye which disappeared after that session. I came to understand that much of my trauma was produced by the terror of my hospital experiences. In my medical training, my teachers had no concept of medical procedures being potentially traumatizing.

The medical care system is dedicated to healing— so what should we do to prevent it from actually being traumatic? How can we adapt these concepts to children, who are even more susceptible to trauma than adults?

Hospitals are scary places, even for adults. Being loaded into an ambulance with your head strapped to the stretcher can be terrifying. Getting X-rays, scans, and blood tests are isolating, strange, noisy, and sometimes painful experiences. You’re often left alone in rooms filled with strange machinery. The operating room is cold, sterile, and everyone is wearing a mask. Having a mask placed over your face for anesthesia feels like you’re being suffocated— but at least they’ve stopped using ether! Can you imagine how a child responds to these experiences? Everything seems designed to make you helpless. And children, in particular, are uniquely susceptible to helplessness and being traumatized by the medical care system.

Empowerment is the antithesis of helplessness. There are many ways to empower the child. We should ensure the presence of the parent when at all possible, especially in the run-up to surgery. We should explain, step by step, what is happening to the child and why. If the child already is familiar with the events leading up to a procedure, the threat associated with strangeness can be mitigated. Ana do Valle addresses these concepts and more in the video below:

Please view the first video of the new Somatic Experiencing Trauma Institute’s medical trauma series here  (9:55) –

These simple techniques are easy to learn and can be practiced by both parent and child. With the skills mentioned in the video, Emma was able to assert her control of the strange operating room. Through simple acts like asking for everyone’s name, she was able to banish her helplessness. This is a powerful step toward preventing medical trauma.

Best,
Bob

Traumatology expert Robert Scaer, MDAuthor Robert Scaer, M.D. directed the brain injury and chronic pain programs for many of his 20 years as medical director at the Mapleton Rehabilitation Center in Boulder, Colorado. Board certified in neurology, he practiced for 36 years. Now retired from clinical practice, Dr. Scaer continues to write and lecture in the field of traumatology.  His book, The Trauma Spectrum: Hidden Wounds and Human Resiliency, is available here, at the Somatic Experiencing bookstore.

Preventing Medical Trauma workshop
with medical trauma specialist Ana do Valle, OTR, SEP
Saturday, August 18, 2012 in Boulder, CO
This event has concluded. To find out information about upcoming events, please contact Laura Piché at the SE Trauma Institute.

Comments (19)
  1. Dr. Scaer,
    This was a beautifully done & touching video. And I was moved by your personal statements about your own trauma. My own younger brother also lost an eye at age 3, and I’ll never forget the trauma in our family re the surgeries, the implants & maintenance of them, & his adjustment issues as he grew up.
    Thank you for your contributions, & thanks again for your help several years ago when I phoned you about a patient with RSD.
    Sincerely, Stu Cohen

  2. Dori

    Hello, I have a question about PNES and trauma. We have a 21yr old son that has had PNES for about 7 months now with some progress with therapy. Do you think this somatic training could help his situation improve? I will gladly give you more info later if needed.
    You can contact me at my email address above.
    Thank you

    1. I assume that PNES refers to psychogenic/pseudo seizures. They are considered to be a form of conversion hysteria and therefore psychological. However, hysteria (a terrible name for a perfectly explainable manifestation of the body in trauma) is indeed considered to be psychological, when it is a prototype manifestation of procedural memory for what the body tried to do to protect one in a traumatic event. Somatic experiencing would be by far the most helpful of therapies, assuming the PNES diagnosis is correct.

    2. PNES refers to non-epileptic grand mal seizures, and are considered to be conversion hysteria. I consider conversion hysteria to be a neurophysiologic expression of the procedural memory for a traumatic ever, replicating the failed physical act of self defense. When my body went into an intense contraction of my eye, face, neck and shoulder at the time of my first session with Peter Levine, I recognized it as a replication of what my body did when I was four years old, and lost my left eye in an accident. That procedural (body) memory had persisted for 60 years in the form a an eye tic when I was stressed. The “discharge” in SE is basically the same phenomenon – conversion hysteria actually completing the failed act of self defense. My tic disappeared as the body memory was completed. The same concept applies to PNES.

  3. Geoff

    Fascinating article Bob. I had a serious ADR from a misprescribed antibiotic at an ER and can vouch for the helplessness experienced and potential trauma, out of dozens of medical professionals I met at the time, only one had any empathy or interest. The majority were too pressured/busy, ill informed or arrogant. Some I was aware even found the suffering of patients entertaining and this needs to be included in an understanding of the potential traumatising experience of patients too. As well as considering the effects of drug/medication adverse reactions which medical staff have little knowledge of how to deal with. My ADR which is not unusual for the class of antibiotic I was given has caused long term harm to thousands including chronic neuro/spinal pain in my case.

    1. Michele

      PRIVATE

      Geoff,

      I had a slightly similar situation and fully identify with ADR, robotic & impersonal medical “professionals”–ill-informed & arrogant, lack of expertise in ADR and, now, similar result condition resulting in chronic pain and pressure. This, in addition to my newfound fear and avoidance of the medical establishment, has me left in need of repair. Yet, I can’t and won’t re-enter their sphere. It made no difference that I’ve worked full-time in the local health field from 1989 to present. It made no difference that I’ve a Master’s degree or that my undergrad is in Health Science. It made no difference that I had a lot to add, potentially, because I was silenced, more or less, and not allowed to weigh in on my own care. How could I be silenced and held as having no credibility? Because they mistakenly assumed I was “presenting as a paranoid psychotic”. I had no friends or family in ER with me to collaborate my information as factual. With their assumption of me being a mental patient with psychosis, they reacted accordingly, ignored my repeated requests for an attorney, denied me my patient rights, one after another. I came in the ER with my heart in arrhythmia. Additionally, with the ADR, my body was both distressed and impaired in other ways. My body was suffering a trauma and then they further traumatized my situation with this response: putting me on a 72-hour hold in a locked wing of psychiatry. Being I called 911, and have had a previous history of maintaining wellness and routinely seeking all preventative care and corresponding follow-up, I was utterly dismayed that I was being treated like a flight risk and it was they who had fears of me being injurious, only because they hadn’t a clue of what I was going through or who I was/am. There is no medical professional in the world more vested in my spiritual/mental/social/physical/financial/professional/preventative health care and wellness than me! And, I have the pro-practice history to back it up. Clearly they current believing me, even though I asked them to collaborate my info with my medical history. This was a nightmare of a lifetime. Now, everything revolves around my avoiding the medical system. I’m both horrified and disappointed in humanity. Prior, my view of the world was that the glass or cup is half full. I live my life pararalyzed by this trauma. You may never see this, as your post is from 2012. Today is August 3, 2014. Likely, you’ve another email address by now. In the event that you receive this, I want you to know that I’m replying to the post of a total stranger (you) because yours is the closest story to mine that I’ve found online. I’m desperate to be looking for support and healing online. In reality, I recognize I need the healing that can only be found in human relationships with compassionate others, in person. However, I’ll appreciate any insightful reply you can write.

  4. Kat

    Great article. I was a little disappointed that the profession of child life was never mentioned. Child life specialists’ main job is to prevent traumatic experiences for children in the medical setting by preparing, supporting, educating, coaching, and working with medical professionals to prevent and minimize the trauma kids experience during medical events.

    1. I plead total ignorance – I’ve never heard of child life. Perhaps that’s because it’s been 30 years since I had a medical practice and worked in hospitals with surgical patients. Tell me more about it.

  5. Deborah Mullins

    Thank you for this …thank you for the awareness..having experienced much childhood medical trauma undiagnosed and unacknowledged for most of my 56 yrs I am heartened and encouraged by these advances. It is just so wonderfully touching

  6. Ann Rose

    Thanks so much for this article. While I have always understood myself as a frequently hospitalized child, from the age of around 1 day (or less), I did not necessarily think to link all of the random proddings, IV insertions (many of them failed), extensive operations and days or months in NICU and briefer adolescent visits I endured with my hypervigilance, occasional very odd but vivid dreams of an operating room, and current depression. My parents did the best they knew how all those years ago, and I can now be my own advocate during medical procedures, but I know that a very large part of my psyche remains fragile and damaged.

    1. I acknowledge your experience, and the painful residues you’re experiencing. I believe that SE is uniquely effective in extinguishing the recurrent physical and emotional distress of medical procedures. When these have occurred in childhood, they are especially devastating because they rob you of resilience, and make you more vulnerable to similar medical traumas.

  7. Barbara

    Robert, I can see it would be healing for the people making comments here to read your response and feel their trauma acknowledged. I’m in process right now looking for a SE practitioner after living with trauma for 30 plus years after experiencing two Caesarian sections under a general anaesthetic – where the drugs didnt work – and I was left awake, paralysed, unable to speak or move – but could feel everything. I feel sad that a big part of my life has been robbed from me, but anticipate the possibility of freedom from the hypevigelence, anxiety & dissasociation that has ‘helped’ me survive so far.

  8. PRIVATE – I have had my tonsils out under ether (in the early 1960’s) and lazy eye surgery at age eight in the mid-sixty’s. I was told that I came out of the anaesthetic climbing the walls, so obviously some kind of adverse reaction to the ether. As a 10-11 year old girl, there was some non-touching sexual abuse and my father abandoned my mother and four young children when I was age 11. I became promiscuous in my teens, including getting pregnant; miscarrying, getting pregnant again and this time having an abortion. I married at age 20 to a man that I was his only sexual partner. He has quizzed (grilled) me over the years as to what happened before we married and I told him some things but not the worst (sex with a cousin 10 years older than me when I was 16 or 17 and another encounter with a older man that I approached for help being pregnant). After being married 25 years which had many good parts and some tough spots, I committed adultery over a period of approx three years with someone I worked with. I withdrew from this situation somewhat slowly (sort of backed away) and have not discussed with my husband until Sept 1 of 2013. He wrote out a document of what he knew and confronted me. This adultery occurred from late 2002 until into 2005. Most of the details that he is looking for, I can’t remember. As I travelled with this person for work, there are locations that I know we travelled to but cannot remember being there or having sexual relations with this person. Needless to say, my husband does not believe I can’t remember most of it, but I truly can’t remember and says I am not trying. Could all of this lack of memory, or even having an affair relate to the early trauma of surgery, father abandonment, etc? Prior to the start of the adultery, my husband I delivered our two youngest daughters to university and had an empty nest. Did this trigger the abandonment issue to reoccur? Too much going on in my head! Any direction you can provide would be greatly appreciated. Thank you.

  9. phil engen

    PRIVATE

    Do you still see patients?

  10. Qukis

    Why isn’t the internet full of articles like this???

    I have a severe PTSD which I received during childhood years in a hospital due to medical procedures.
    I’ve been carrying out with trauma and various disorders for 30 years already…
    No one can understand this horror unless one experiences it in a helpless state. I always cry when I see an animal in a lab, because I know exactly what this creature feels.
    We have to draw public attention to the horrifying intrusive medical machine. It’s not a joke. It doesn’t matter, whether it’s people or other animals.

  11. Broken Heart

    PRIVATE Qukis, wow. I was already thinking of animals when I started to read this article. How I used to be filled with empathic pain going to a veterinary’s office as I felt the terror in animals. And you are right… it was like being an animal. I was left in a gurney freezing in the hallway, tricked to blow up the balloon but was an ether mask and had a horrible smell, I was left alone when my mother left and I knew I was going to die so I just used pure defiance to survive. The smells and the terror… unimaginable. I am almost 50 and spent a life in PTSD since 3 when, I , too, lost an eye in an accident. Then years and years of doctors and prodded and …

  12. Kathryn Lamoureaux

    PRIVATE
    I was so hopeful, happy to see this video. Just plain common sense but who knew yrs ago. I myself had many hospital procedures as a child. In addition, I was sexually abused by my GF and a Catholic priest from 5-11 yrs old. Will SE be helpful for me? I have suffered from depression and other issues my whole life. As an adult I have also survived 4 cancers, and all the related helplessness. Thanks, Kathryn Lamoureaux

  13. Sheila

    PRIVATE
    Dear Doctor, thank you for a very interesting article. I’m going to watch your video later on. Right now, I’m most curious to find out whether there are any books or articles you might have written, or be be aware of which address the experiences of adults undergoing multiple traumas induced by medical treatments such as weekly debridement of open wounds in chronic wound patients, performing minor surgical procedures such as removal of an ingrown toenail, or suture removal from an abscessed incision – all without anesthesic or with inadequate anesthetic. I have personally experienced these painful treatments multiple times (and many other types of such treatments) and believe that I am having symptoms now that are similar to some type of post traumatic stress disorder that are the result of having been medically traumatized. I’m just a concerned patient who could use some help in understanding: 1) Why medical professionals feel it is acceptable to inflict pain on a patient when it is unnecessary; 2) What I, as a patient, can do to protect myself from such treatment; and 3) How I can reverse the damage done to my psyche with all of the medical trauma I have endured.

    I appreciate any help you could provide. Thank you.

  14. cathy

    i soo wish more drs had your sensitivity! this is such a great article! I’ve been hugely traumatized by the medical system . . them using anethesia even though i emphasized i didn’t want it . . .etc. When Drs. violate patient consent in order to do fast food procedures it is extraordinarily damaging to patients. More Drs. are using Versed for their patients who have EGDs to make them “forget” the procedure & to make them very compliant & less bothersome. GIs use it as standard procedure now for a lot of patients & it is very traumatizing for a lot of folks out there . .i have read about lots of others who consent is violated adults as well as children. This needs to stop. THANK YOU! you sound like a wonderful Dr. & a wonderful human! <3

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