Treat yourself with kindness

Would you believe that changing the way you see yourself and the world can change the way you feel physically?

Research shows strong connections between physical and mental health. Especially difficult experiences from childhood can be the underlying driver of lots of health problems for people of all ages, according to Anthony Gargano, MD, a PeaceHealth internal medicine provider in Bellingham, Washington.

He has studied and been practicing an approach called “trauma-informed care” for the past few years. “It’s the most powerful thing they didn’t teach me in medical school and it potentially could be more important than anything I learned in medical school,” he noted.

Trauma-informed care helps adults and young people recognize and overcome deeply painful experiences from earlier in their lives. This approach grew in response to a study in the 1990s that revealed long-term health consequences of abuse and neglect. And according to the Centers for Disease Control, one in eight children experiences trauma severe enough to cause damage that lasts well into adulthood. Learn more about adverse childhood experiences (ACEs) by watching this video.

Oprah's story on trauma

National celebrity, Oprah Winfrey and 60 Minutes aired a story on the subject in the spring of 2018. The approach doesn’t ask “what’s wrong with you?” but rather “what’s happened to you?”. It’s not only used by healthcare providers, but also by social workers, teachers, police officers and other professionals who work with individuals in distress. Trauma-informed care continues to evolve and grow as a way to help adults and young people build up resiliency and gain a sense of control over their own lives.

Since starting to use it in his practice, Dr. Gargano has seen some remarkable changes in patients who came in with chronic pain, addiction and other challenging conditions such as insomnia, digestive issues and fatigue.

He recalls one patient in his 30s, homeless, addicted to heroin and very emotionally unstable. They talked at length. “I told him his drug use wasn’t his problem. He was using it as a solution to his problem; it just wasn’t a good solution,” said Dr. Gargano. “A lot of problems or diagnoses are just symptoms of the underlying problem [childhood trauma].”

“As I put things in perspective for him, he had an ‘aha’ moment. He didn’t do a full review of all that happened to him. He didn’t need to. But in that moment he realized he wasn’t at fault for what happened to him. He felt a lot less shame. He’s now off drugs, has a job and a place to live and he has his child back in his life.”

This young man was just one of many who have had similar epiphanies and found healing from health problems that had been plaguing them. “When I explain to patients how their childhood experiences might relate to current symptoms or diagnoses, their sense of shame decreases and their trust increases. And trust improves medical outcomes.”

Not every diagnosis stems from trauma

Dr. Gargano is quick to point out that this is a complicated subject. Not every diagnosis relates to trauma. And many of those who have experienced trauma might not feel the need to revisit their past. Still, it’s helpful to be open and aware on the subject.

“Stress is a driver of chronic pain,” he said. Rather than simply prescribe medication for pain, he might talk with the patient about ways to reduce or manage stress—both internal and external.

Dr. Gargano helps patients learn to reframe their thinking, talk positively to and about themselves and name their feelings. After a few visits, he said many patients with post-traumatic-stress disorder can more easily recognize a “flare-up” of emotion and know how to cope until the feeling passes.

You are loved and worthy of love

One of the essential points Dr. Gargano shares in the trauma-informed training he offers to medical colleagues is the importance of helping patients understand that “unconditional self-love” is important to their health. It’s the basis for everything.

Do you feel your present health issues might be related to a painful past? Here are Dr. Gargano’s recommendations:

1. Read or learn more about the subject of adverse childhood experiences and trauma-informed care. You can find several resources online, but one of the definitive books is The Body Keeps The Score by Bessel Van Der Kolk, MD.
2. If you’re hurting mentally or emotionally, find a talk therapist, particularly one who’s trained to help people overcome trauma.
3. Talk with your primary care provider. While not all physicians have training in traumatology, they can provide objective perspective and may be able to help you explore solutions.
4. Practice mindfulness—notice how you feel and what you sense in the present moment without judgment. Avoid dwelling on the past or replaying negative experiences.
5. Try yoga or tai chi. Studies have shown these to be particularly effective for those overcoming post-traumatic stress.
6. Build trusting relationships. “If you grew up not being able to trust those closest to you, it’s no wonder you have trouble with trust,” Dr. Gargano noted. “Having trusting relationships, even with just one person, is part of what will help you survive and thrive.”
7. Give yourself grace and realize you are loved and worthy of love.