Causes of psychophysiologic disorder (PPD) symptoms are so diverse that even after assessing thousands of patients I still encounter new variations. Earlier this year a 65 year old retired nurse practitioner from Oregon whom I have worked with in the past contacted me because of months of abdominal pain. She suspected PPD because medical evaluation was unrevealing and her symptoms fluctuated for no obvious reason.
Posts Tagged ‘childhood stress’
Recent on-line and in-person discussions with my colleagues who care for patients with Psychophysiologic Disorders (PPD) make it clear that there are many successful approaches to diagnosis and treatment. What these techniques have in common is clarifying for patients that psychosocial stress can cause real pain and/or other physical symptoms and that uncovering and treating these issues can relieve the illness (partially or completely). Our discussion led me to summarize my approach: (more…)
A colleague asked how I would screen for Adverse Childhood Experiences (ACEs) in primary care patients with unexplained illness, chronic pain or functional syndromes such as irritable bowel or fibromyalgia. (A blog of mine describing ACEs is here with an important web site here). Here is my answer:
There is a new compilation of the latest research on the long-term impact of childhood adversity. I have written about this key subject in earlier blogs (here and again here). Now there is a new DVD where the latest research and its implications for policy are presented by those who conducted the studies.
A therapist recently posed a key question about adverse childhood experiences (ACEs): what is the benefit to a patient of their family doctor knowing this information?
David Seidler was pre-school age and living in London when the Nazis bombed his apartment and later killed his grandparents in the Holocaust. Understandably, the family decided to relocate to New York. David developed a stammer during the move that he believed was connected to the war-time traumas. He struggled with his voice for over a decade.
The article about the Chinese “Tiger Mother” (described in the last three posts) reminded me of another issue of key importance for the 55% of my stress illness patients who have survived dysfunctional childhood environments. Often they struggle to perceive accurately the long-term impact of this experience. There are a couple of reasons for this, most simply that they have no parallel life to contrast with their own experience. More subtly, part of surviving a difficult environment involves suppressing your emotional reaction to what is happening. When this is done repeatedly, in later years it becomes difficult to look back and accurately perceive what took place.
Continuing the comment from the last post about the article Why Chinese Mothers are Superior. Another concern I have about the author’s parenting choices is the absence of any perspective on the limitations it places on her own life. The approach to her daughters is tremendously demanding of time and emotional energy. Of course she has every right to allocate these resources as she thinks best, but giving a little more time to her career, husband or other interests is not considered.
Continuing the comment from the last post about Amy Chua’s article in the Wall Street Journal titled Why Chinese Mothers are Superior. To achieve goals the author has for her daughters, she imposes high levels of pressure and coercion. There is a significant risk that this will result in long term damage to their self-esteem. This damage is the common denominator in my patients whose symptoms are linked to their childhood experience.