I have been on a bit of hiatus, well, kinda since everything went downhill a while back. I have spent the last few weeks working on taking my practice to a real office, ya know, with a waiting room and actual exam rooms, the whole thing. I know a scary concept to say that I am nervous about everything is something.
We are in a holding pattern on the office I have a bid in on. Nothing weird, the landlord accepted my offer; I have to wait on the owner who is examining an offer to buy the building. It sounded like a low probability of sale, but it was nerve-wracking. Given my lovely attitude of late, I am thinking the worst.

The person managing my office asked why I was so negative. I think it is the trauma. I am pretty sure it is. Because of past trauma, I often view myself as inferior or unworthy to those around me.

I have a constant imposter complex. As a healthcare professional, I must overcome quickly because, many times, I’m it.

You may or may not know the feeling where you stop in the middle of doing something and think, why the fuck are they trusting me with this kind of responsibility. Yeah, kids, that’s me.

Part of my trauma is the fear of speaking up for myself and working towards boundary enforcement. Yeah, I suck (unless I am at work, where the rules are in my favor).

I know I write a shit load about trauma, but It is very underpublished. It is also grossly brushed aside by those idiots who would say something like; pick up and move on. I have a friend that says this in a reasonably impolite way that honestly makes me feel less worthy.

Any kind of treatment in this matter is nothing more than victim-blaming. These are comments that survivors of abuse or assault often hear:

You didn’t fight back
You didn’t say no
You don’t remember
Your story doesn’t make sense.

However, research shows that over 70% of domestic and sexual violence survivors enter a “freeze” state during their experience. The freeze state is precisely what happened in my traumas. I froze, I actually couldn’t move, and my brain just shut down. My nervous system took over, and I was essentially “playing dead.” Honestly, it was like I completely disconnected from what was going on around me.
In my assault as a boy scout, My rescue came only because my assailant made enough noise that the other guy in my tent stopped it.

Additionally, the part of the brain that is responsible for storing memories, the hippocampus (yeah, I always think about some university full of hippopotami), goes offline and the survival brain or the limbic system takes over. Survival mode or the limbic system is how the brain tries to protect us from the memories of the trauma. This switch to the limbic system is why trauma survivors remember things years later.

The fact that someone didn’t fight back didn’t say no, don’t remember, or that the story doesn’t make sense is further evidence that trauma occurred.

We see a lot of past trauma every time we walk out on the streets.  Most of it is not obvious and you will never notice it on those around you.  This is the real trouble in my profession.

We see hundreds of patients a year. When new patient walks in, you have no idea what their past is like, unless the previous provider was meticulous at charting (trust me most aren’t).  So you are left to hope that some mannerism you have does not trigger old memories. It is a delicate balance and something that all providers suck at.

As a provider, a little empathy and careful review of history will go a long way.  As a patient, make sure that you are upfront with your provider.  You need to tell them your past, it helps them with your future diagnosis.

Be the kind of person your dog and your mom hope you are.