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.
Author 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.