Thursday, 29 December 2011

Somatic illness

I said I would put something up here about 'somatizing', so here it is.

I've gone into this new therapy because I'm convinced the pain is rooted in psychological trauma. More specifically, I believe it's all about feeling abandoned - now sacrificed (see this post) - by my mother.

I told the therapist this, and we talked a bit about 'somatic illness'. Somatic illness is where a physical illness is actually caused by emotional trauma. The mind can't cope with the trauma, it can't express it, so it turns on itself and attacks the body. It reduces blood flow (hence the new sling worked by increasing bloodflow to my shoulder), it constricts nerves and it makes other changes, like disrupting nerves so they send pain signals when they shouldn't.

It's very common, and the illness - all the symptoms etc - is completely real. Although it's created by the mind, there is nothing 'made up' about it. It is not 'all in the head', it's not hypochondria, the patient isn't doing it all on purpose. It's real symptoms of a real illness - it's just that rather than a pathogen or a virus causing the physiological changes, it's the brain doing it, essentially because there is something that the brain feels it can't cope with in any other way.

All of these things are happening subconsciously, and so the patient has no idea it's going on, and is equally powerless to stop it. Even when you do know it's happening, it's still not possible simply to turn it off; you have to work out and understand what it is the brain can't cope with, and resolve that underlying conflict. Only then will the illness go away - because the brain no longer needs it: it can now cope with the trauma itself.

Any stress-related illness is essentially somatic e.g. headaches, irritable bowel syndrome (IBS). Somatic illness commonly hits the digestive and genitourinary tracts, so you get ulcers, IBS, cystitis, thrush etc. Also eating disorders - when someone who's never really shown an interest in dieting, develops an eating disorder (like me 12 years ago), you'll often hear doctors say it's because they are trying to exert control over their life, and the only thing they feel able to control is their food . The point, though, is that there is something else in the patient's life or their past that they couldn't control, and the eating disorder is the brain's way of compensating for that. You may also hear of paralysis that has no physical cause and which later resolves itself (this, unhelpfully, used to be called 'hysterical paralysis', once again making it sound like something you intentionally do to yourself).

Tangentially, it's also not uncommon to hear of sexual abusers later developing testicular cancer; all the guilt from what they've done with that part of their body gets returned there, by the mind. I'm still waiting and hoping to hear that about my father, though I do know he's had quite a lot of medical problems down there, including, I think, surgery. (Yes, it's wrong to wish that on someone else, but think about what he did to me - really think about it - then tell me I'm wrong.)

In talking to the therapist, and reading the book, I realised that I have suffered somatic illnesses since I was about 14, ranging from joint pain, IBS and anorexia, to cystitis, excema and skin allergies. Although I recovered from the knee injury caused by the motorbike accident accident (it was a slow recovery, as soft tissue injuries generally are, but there was no hint of long-term fallout), by the time the car accident happened 15 months later, something had changed,

Something in my psyche had reached crisis point, and the trauma(s) that had caused 25 years of often overlapping somatic illnesses, came together in one life-altering, disability-inducing condition - chronic pain.

It all started with my shoulder. When that didn't help (i.e. it didn't achieve what my brain needed it to, in order to resolve the conflict), things got worse, with the addition of the neck pressure. My brain was not only inducing my nerves to send faulty signals, now it was constricting nerves, so that I developed neurological problems, like numbness, twitching, explosive headaches, migraines and back pain. Each deterioration since then can be seen as another attempt by my brain to resolve an unresolveable conflict.

That 'conflict' lies in my feelings about my mother abandoning me both to and for my father (again, back to that earlier post). I'm not going to go into it in any more detail, because some things really are just too personal. The difficuly, though, is that none of this is going to get any better until I have resolved those issues. And there are all sorts of other issues tied in to that, like issues of control, feeling unsafe, anger; until all of these are dealt with, I don't have a chance of the pain getting any better. My brain is doing all this in a misguided attempt to help me; it's not going to stop until it perceives that help is no longer needed. And that means that physically, things could get a lot worse, before they get better.

Which perhaps explains why today has been such a shitty day, and why popping to Tesco to get nibbles for a New Year's Eve party I'm starting to doubt I'll ever make it to, triggered hideous pain and left me stuck in bed all day. It also explains why increasingly the meds are having zero impact on the pain, even when I'm swimming in side effects; my brain is desperately hanging on to it's coping mechanism, despite my best efforts to unpick it, because it fears the world will fall apart without it.

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