It’s a pain: the physical impact of trauma
Is this normal? I wonder. Again. Will it ever change?
Physical symptoms are a big part of life for me with DID. Yes, I have ‘multiple personalities’, the “two or more distinct identities that recurrently take control of the body” and I’m not for one moment denying the significance of that or the impact it has on my day-
I have worked hard at bringing my dissociative symptoms ‘under control’ – to work together as a team, to be co-
There’s a scene in the film The Bourne Identity, towards the end, that has always resonated with me. The film is about a CIA agent, Jason Bourne, who is trained using coercive mind-
Then, towards the end of the film, there is a shoot-
I too had often wondered: does anyone else get the headaches?
Now I know, through meeting and corresponding with people with DID all over the country, that the headaches are a fairly common symptom. They are not migraines. They are not normal headaches. They don’t respond to paracetamol. They don’t respond to rest. They are not hangovers, and they don’t occur as a result of being hit over the head with a lump of wood. They are thick, and muzzy, like your head is being gripped in a vice, like someone has stuffed loft insulation into it so tightly that your head is crammed to bursting with too much mashed-
Some people have suggested that they are caused by conflict between alters, and the pressure of alters wanting to switch or ‘come out’. I don’t know if that’s true for me, although it may be true for others. For me it feels more like a car crash in my head: the contents of my mental boot have been strewn about all over the place and everything is aching and bruised from some kind of collision.
Then there is the nausea. For about 3 years I had nausea every single day. At first we blamed it on gastritis. But it wasn’t that. Gastritis doesn’t tend to get worse in the run-
As everyone will know, nausea is horrible. It demands stillness; it commands every last scrap of attention and focus. At times it made living daily life almost impossible. Sometimes food would relieve it, and sometimes it would make it worse. Sometimes food – the taste of something different – would relieve the sense I constantly had of yuk in my mouth. This was a taste, but more than a taste – an actual physical sensation that there was something in there. I could feel it. Memories such as this are powerful phenomena – this isn’t some vague recollection of yesteryear; this is here-
But by far the most distressing physical symptom has been pain. It is so difficult to describe pain, to express it in words, to explain it to another person. Everyone has their own experience of pain, their own thresholds. What if you have never felt pain like I have? How do I describe that? For a while I attended an outpatient Pain Clinic to try to help alleviate my symptoms, and the conclusion the Consultant came to was that my ‘pain sensing system’ had malfunctioned. He said that early life physical trauma, of which torture played a big part in my first few years, had – using his metaphor – burnt out the circuits. It had left me with an unusually high pain sensitivity, which is why some days even wearing clothes is painful. But the circuitry has not simply been scorched so that it was permanently ‘on’; it has become entangled and disrupted so that some days I don’t feel pain at all – even the pain I should feel. I recently gashed my thumb and felt nothing at all. I couldn’t understand where all the blood was coming from – I literally felt nothing. The same has happened when I have burnt myself, and so I have been unable to administer basic first aid: cold water could have reduced the damage to my skin, but I couldn’t sense the damage, so I didn’t know to do something about it. When the pain hit a few hours later, it got its revenge: from analgesia to hyperalgesia, zero or ten … like much of the rest of my life, my pain levels seem to know only extremes.
But apart from injury pain and general sensitivity levels, I have also struggled with chronic medically unexplained pelvic pain. I called it ‘left side pain’ as it tended to aggregate on that side, but at other times it would spread over my entire abdominal region. This was like period pain, at times a dull ache, at other times a searing, burning ball of fire. It made no sense. It wasn’t cyclical through the month – it could strike at any time. But the pattern we noticed was simply that the less able I was to communicate my feelings in words, the more likely it was that I would be in pain. Fanciful though it at first seemed to us, this physical pain seemed to be somatised emotions. Contact with my abusers, situations in day-
Other forms of pain also manifested in my life. Other people, when tired, seemed to yawn and go a bit drowsy. When I was tired – or rather when I was tootired – I felt pain in my legs. This was a shooting kind of jolt, a second or two of unbearable ‘electric’ pain. It took me years to realise that this was my body saying it was tired. Once I made the connection, I began to realise that I needed to get to sleep before it happened. Or it became a vicious cycle in the night of being tired, having pain in my legs as a result, and then not being able to sleep because of the ever-
I also experienced many ‘somatic flashbacks’ or ‘body memories’. Like every abuse survivor, I was told not to tell, and threatened with dire consequences if I did. When I did ‘tell’ in adult life – in therapy or to my husband, for example – I was ‘punished’ again with severe pain. This was a kind of memory, a somatic flashback, and often my alters would appear either with a narrative to accompany it or as if reliving the event: the physical torture as a child was being re-
Other ‘body memories’ included being desperately cold: I would become chilled and frozen, with even my skin cold to the touch, no matter how warm the room was, or how thickly I wrapped myself in blankets and duvets and hot water bottles. “I’m cold,” would bleat one of my parts helplessly. “I’m so cold.” It was very very real. At other times, I could feel things that were not actually there: sensations like ropes around my wrists, a hand on my shoulder, pain in my genitals. Body memories are easy to dismiss as melodrama or psychosis if you’ve never experienced them, but they are terrifyingly real and disturbing to endure.
Medication rarely helped. At one point I was on a brutal cocktail of drugs, and I cycled through various potent mixes over time: amitriptyline or fluoxetine or citalopram or pregabalin, buspiron or diazepam or propranolol, codeine or tramadol or diclofenac or feldene. Eventually I became so dampened down by this pharmaceutical kosh that emotionally it felt like I was starring in an underwater-
So the physical impacts of trauma for me have been numerous, and debilitating. But the good news is that things have improved. Pain is still my number one symptom and the most difficult part of my life to come to terms with. But as therapy has progressed, my body is recovering just as my mind is. I have been learning to manage my pain better: through diet, through exercise, through mood, through self-
I have learned so much lately about the impact on the body of trauma, how ‘body memories’ operate, what processes are at work in somatisation, and how to open and close the ‘pain gate’. Why not enrol on my online course Trauma and the Body: Dissociation and Somatisation and hear what else I have to say? The day is suitable for both survivors and therapists and anyone else involved in recovery from trauma.