THE MIND-BODY CONNECTION
By Kathy Lewis
Making sense of women's pain and sexual abuse In the dream, through the maze of corridors I pursued children - all ages and zes - some barely conscious, some wild-eyed and desparate. Where were they going? I had to know. One stopped to tell me before she sped on, lemming-like, to the inevitable.
When I woke up my heart was pounding; I gasped for breath; my body shook in terror - and then, the pain. Permeating my limbs like foul gas, not stopping until it lodged in my feet, my ankles, my knees, elbows, shoulders, neck, temples, eyes, fingernails.
The crazyily wielded ice-picks of migraine, the fiery needles of fibromayalgia. I had not felt the pain when I was awake; medication had taken care of that. The relief should have lasted until morning. But now, with the dream, the memory, it poured through me as if someone had dumped a can of paint over my head. The children, myself at various ages, were running blindly to the sadists that inflicted the pain for many years.
When I was a child I suffered severe physical, sexual and emotional abuse at the hands of my parents and their "friends", to whom I was basically "sold". The emotional abuse continued well into my forties until my father was rendered speechless by Alzheimer's; my mothered finally silenced by her death, her last words to me, "You wanted HIM. It was YOU who wanted him.". Now, at 46 years of age, having long ago attained an Honours BA, a Master's Degree in English and a Bachelor of Education, after having successfully taught high school for 15 years and acting as Assitant Department head for 3 of those, the voices still haunt me. Shadowy memories of dark places they took me to flare up as unpredictably as the fibromyalgia pain. When the memories became real in 1992, I left a $70,000 a year job and all my dreams of a stable future in education. Unlike many to whom this has happened, I was fortunate to have reasonable disability insurance and a supportive partner, psychologist and doctors who treat my past with respect and ensure that I will never have to live in poverty and isolation like so many of my sister and brother survivors of childhood sexual abuse.
I do not remember a time in my life when my head did not ache. Over the years, from childhood on, the constant ache has taken many forms: classical migraines, common migraines, tension headaches spreading from my shoulder up my neck and all the way over my head finally boing into my teeth. Before receiving 24-hour a day pain medication, the headaches were a constant reminder of the grief, the betrayal and the rage I'd spent a good part of my energy pushing into a far away place of forgetfulness. In 1992,leaving my job, I devoted my life to understanding my past, learning to live in the present, and easing the pain of life-long abuse. This is the first time I have told my story in any public way. I've chosen to do this now because my understanding of chronic pain and its relation to hisotrical abuse may give someone else the key to unlocking both unbearable mysteries and long-awaited healing.
When I entered psychotherapy in 1990, I was empty and frozen; terrified, exhausted, and unable to connect the thoughts in my head with the pain in my body. All my life I'd experienced mysterious ailments that I was sure would kill me: the headaches, bouts of painful month-long menstrual bleeding, inexplicable but breath-taking pain that moved all over my body. Slowly, as I began to "thaw" and tentatively speak of the memories of childhood, the pain became less and less of a mystery. Now, certain memories, no longer frozen in silence, bring immediate, staggering pain: I am hit in the head - pain sears through my temples; thrown against a wall - my shoulders and arms scream out as if dislocated; my body is invaded by other body parts and objects so out of proportion to its smallness - I am split open; my jaws ache; I cannot breathe. For one year I spat up blood every 20 minutes, even through the night. With the nightmares, recurrent ones that i've had ever since I was a child, comes inescapable, electric pain through my kidneys and up my spine. When I sit, my once-broken coxycc pinches me to remind me of how they broke me.
So many times, I hae been convinced I was dying. I couldn't believe that my "symptoms" were evidence, memories, of the years of abuse. I'd say to myself going for this or that medical test, "If they can't find anything wrong this time, I will believe in my memories, believe that my mind and body are reliving abuse. No pathology has ever been discovered to explain any of the symptoms, including the blood, the headaches, the joint pain. Just labels: migraines, fibromyalgia. But there are memories, memories which co-incide with the pain. The pain and the memories are inseparable: the dancer and the dance.
So maybe it's all in my head. Perhaps I have an imagination so powerful and such a perverse desire to be haunted by disgusting, blood-curdling images, to give up a job I loved so that I can sit around and feel worthless and revel in the chronic pain, that I just invented it all. There's so many secondary gains in living on half my salary. Well, the political lobby group formed to re-repress the fact that abuse of children forms the underbelly of this society, called the False Memory Syndrome Foundation, would have you believe just such nonsense. They say they have "scientific" proof that these memories are not real, despite the fact that they have never done a single study in traumatic memory. But there is "science" that corroborates what my body knows. First, the social scientists, in the most conservative studies, tell us that 1 out of 3 girls and 1 out of 8 boys were abused before the age of 18 by trusted family members. More rigorous studies (ie. those done by the police) show the numbers are closer to 1 out of 2 girls and 4 out of eight boys . These statistics do not take into consideration the almost "normal" events of a girl/woman's life, all of which I've experienced: sexual harrassment, stranger rape, date rape, sexual discrimination. All those everyday occurances that injure the body, mind and the spirit.
For years, those working in the healing professions, primarily women, have "known" the connection between mind and body. They have taught that the body holds memories of traumatic events at a cellular level. Our minds may resist and intellectualize that the memories it stores are accurate depictions of reality, but the body never lets us forget. When I asked one therapist, who works almost exclusively with survivors of childhood sexual abuse, why she chose to give up the profession of nursing and devoted herself to this gruelling work, she answered, "Because I saw so many women dying of breast cancer and ovarian cancer, which I myself had, and I knew that the reason they were dying of these things is because they had histories of childhood sexual abuse." This is not to say that all women who have been abused will develop these illnesses, or that all women with those illnesses are survivors. However, recent studies done on the relationship between chronic pain and disease and a history of abuse, support what healers have know for centuries. Dr. Bessel van der Kolk an M.D. and Harvard Medical School professor and researcher of the effects of trauma, entitles one of his papers on "memory and the evoling psychobiology of post traumatic stress", THE BODY KEEPS THE SCORE acknowledging that what the mind may forget, the body will remember. In this paper he catalogues the many biological/chemical changes that occur within a traumatically stressed body. I refer anyone interested in the exact science of these changes to his paper. One of his conlusions, however, based on the evidence is: "Chronic exposure to stress affects both acute and chronic adaptiation: it permanently alters how an organism deals with its environment on a day-to-day basis, and it interferes with how it copes with subsequent acute stress." More specifically, Wendy Hovdestad and Dr Connie Kristiansen of Carlton University in Ottawa concludes: "Trauma causes alterations in the production and release of stress-responsive neurochemica : ls such as norepinephrine and the endogenous opiods, and extreme levels of these neurochemicals disrupt everyday, explicit information processing." I leave the medical interpretation of these facts to the experts; however, lay people will understand the profound changes that occur in the traumatized body and the many possibilities that these changes open up.
Nellie Radomsky, MD, PhD, in her ground-breaking book, LOST VOICES: Women, Chronic Pain and Abuse, tells us in her Preface, that she has written the book "for all women who experience chronic pain and for all women who feel silenced; " for women who sit patiently in doctor's offices hoping to be fixed" ; " for women who feel confused when more blood tests, more x-rays, more procedures, and more knives put into their bodies fail to remove pain". The book explores how current medical practioner's view chronic pain and how , in the doctors office, women are silenced about the effects of chronic abuse.
Dr. Radomsky cites the many studies done that show a significant co-relation between illness and physical and/or sexual abuse. For instance, one study revealed that of 30 women studied with headaches, 66% reported prior physical or sexual abuse; abused patients were more likely than non-abused patients to report pelvic pain, multiple somatic symptoms, and more lifetime surgeries; of 135 chronic pain patients, researchers found that 39% of the women and 7% of the men reported childhood sexual abuse. In her own study, she "found that women identifying sexual and/or physical abuse were diagnosed with more chronic illness than women denying abuse (67%, compared with 25%)".
So, for those of us who suffer chronic pain and have a history of abuse, what implications does this have for how we go about taking care of ourselves? It is critical to put these facts into context. We live in a society where women and girls experience abuse so often, that it is almost "normal" to us. Some would say that women live in a state of chonic trauma. This is not a "personal" or individual problem and most of the solutions aren't either. It is a political problem, and the solutions are political. To be a part of changing the conditions that allow abuse to occur: male dominance, child "rearing" methods, the sexualization of children, the relative powerlessness of women, is a "healing" activity. Working with others for change gives us strength and courage to face our own memories and pain.
Changing the way the medical system treats us is also critical. Doctors carry into to the examination room and education which includes a whole canon of medical literature that devalues and discredits women, as well as societal and personal misogyny. Rarely do they see the context of violence in which women live their lives. Although doctors take an oath to "first do no harm", whenever a woman walks into a doctor's office she is at risk for harm. She experiences harm in being silenced, in being disbelieved, in being drugged into complacency, in being told it's all in her head, into being denied drugs that would really ease the physical pain, in sometimes being sexually assaulted. Women have to fight to be heard and believed and understood. We need each other to do this - to demand respectful, contextual medical care in which our symptoms are investigated and if found to be a result of abuse, they are not dismissed. Long-acting narcotics ease chronic pain, yet we are rarely given the choice of using them. Instead we are offered brain-chemical altering "anti-depressants" the effects of which are more far-reaching and life- altering than narcotics. We need to educate ourselves in pain management and learn how to find doctors who will act in partnerships with us, doctors who will respect our herstories,our needs and our choices. We cannot do this alone, any more than we can change the conditions in which women live, by ourselves. For these changes to occur we must be part of the movement to change the way male authority and interpretation of our lives affect us.( I include women doctors as part of the male-dominated medical profession although, in my experience, women are more likely to act in less traditional, woman-positive ways).
In my own life, psychotherapy has been essential. This is not to say it is for everyone. There are many harmful practioner's of many harmful varieties of therapy. Finding the right therapist can be a walk through a mine-field. Despite the many compelling intellectual arguments against even the best feminist therapy, I would not be alive today or able to put these thoughts on paper without 7 years of gruelling work with a therapist who knew how to ask the right questions and taught me how to reach out to others like myself for support and companionship.
For me, long-acting narcotics have allowed me a quality of life I had given up hope of ever re-experiencing. Chronic pain deters us from being in society, enjoying what we love, doing things with friends, working at what fulfills us. So I advocate strongly for giving chronic pain sufferers the choice to use these drugs. Educating oneself and taking responsibility for one's own pain are necessary if we are to negotiate the medical mazes without being re-victimized.
There's so much more to say about what helps, but what I've shared here has given me the strength, courage, comfort, knowledge and will that I have needed to help myself live with past abuse and its devestating effects on my body, mind and spirit. We need to work publically with others who view the world as we do, in comunity, to force the broad sweeping changes that have to occur to end the abuse of future generations. We need to work within ourselves to understand how abuse has conditioned us and how to undo that conditioning. We need to accept that the harm that was done to us may be permanent and learn what it is we need to alleviate some of the phsyical suffering. We need to overcome our isolation and find that like-minded community, risk intimate relationships, give and take support of others. We cannot do it alone.
Lewis, MA, B.Ed
May 8, 1998
Bibliography Hovdestad, Wendy and Kristiansen, Connie, (forthcoming) Mind Meets Body: On the Nature of Recovered Memories of Trauma. Women and Therapy .
van der Kolk, B.A. (1994) The Body Keeps the Score: Memory and the evolving psychobiology of post traumatic stress. ,Harvard Review of Psychiatry, 1 , 253-264.
Radomsky, Nellie A. (1995) Lost voices: Women, Chronic Pain, and Abuse, Binghamptom, New York: Harrington Park Press.