Mary’s Million Dollar Workup
When I think of the fundamental role of mindbody medicine, I think of Mary.
By the time I met Mary, she had long suffered from a gnawing pain in her gut, intermittent nausea, and a resulting loss of appetite that had caused her to lose 25 lbs.
When those symptoms first began, Mary did what most anyone would (and should) do in the face of serious physical discomfort — she went to her doctor. Thus her healthcare provider did what any healthcare provider would (and should) do to care for a patient in serious physical discomfort — they attempted to determine the cause.
They ran tests. Then when those didn’t reveal anything consequential, they ran more.
The law of the instrument suggests that when all you have is a hammer, everything looks like a nail. And to medical professionals, trained in a dualistic paradigm, every physical symptom looks like the manifestation of physical illness.
So the search continued: pancreas function tests, endoscopes, colonoscopies. Then, eventually, an emergency cholecystectomy and the removal of her gallbladder. Hundreds of thousands of dollars worth of medical intervention.
And yet, the symptoms persisted.
Mary was eventually referred to me by her gastroenterologist. She was seeking help for her insomnia and the recurring panic attacks that frightened her so much she could no longer drive on the freeway out of concern an attack would cause her to lose control of her vehicle.
It wasn’t long until we uncovered Mary’s trauma, and the throughline between her traumatic history and her panic and insomnia was easy to see. Moreover, a throughline between her trauma and her stomach pain and discomfort was illuminated. Sure enough, through integrative treatment of her trauma, Mary was able to find relief from her symptoms and her distress.
While Mary and her “million dollar workup” may have been an extreme case, the basic tenets of her story — unaddressed trauma manifesting physically and psychologically — is far from uncommon.
You’ve likely seen the recent headline-grabbing stat that 30% of COVID survivors may have PTSD. I wasn’t shocked by the stat itself — few who’ve worked in a hospital setting would be — but I was staggered by the volume of trauma it implied. Given the pervasiveness of the pandemic, 30% translates into millions of individuals. This, in addition to the trauma experienced by the burnt out healthcare professionals, the trauma and grief of the families whose loved ones did not survive the illness, and on and on.
Quite simply, we are primed for a massive wave of trauma. This trauma is likely to present in myriad ways: in the family practice clinic as unexplained migraines, in an outpatient therapy session as depressive thoughts, at an obstetrics appointment as irregular cycles, or in a school counselor’s office as the inability to focus.
The good news is, the mindbody approach we utilize at True Life encourages us to get curious about identifying the root cause of symptoms, and to consider that the cause may fall outside of our purview. If one of True Life’s mental health patients was suspected to have an unaddressed medical condition contributing to their symptoms, for example, we would not hesitate to call on our network of MDs and specialists for further exploration. Traditionally, the reverse (physicians calling in/on mental health professionals) has been less likely, but I’m hopeful that is changing, because collaboration across disciplines, modalities, and practitioners is one key component of mindbody treatment. And mindbody treatment offers a path forward in the healing of our individual and collective trauma.
We can see the evidence of mindbody treatment’s efficacy via studies like a 2020 study published in Psychological Trauma, where veteran’s diagnosed with PTSD were enrolled in a 10-week Mind Body Skills Group (MBSG) program. Those who participated in the MSBG (which included skills like meditation, breathwork, self-expression and biofeedback) experienced improvement in their PTSD score, decreased hyperarousal, anger and sleep issues compared to a control group receiving standard treatment.
Many studies have borne similar results, as demonstrated by the number of systematic reviews done to compile the conclusions. One such review, published in The Journal of Evidence Based Integrative Medicine, took into account 33 studies and concluded that “scientific evidence of benefit for PTSD was strong for TMS and good for acupuncture, hypnotherapy, meditation, and visualization.”
Of course for those of us practicing integrative medicine, we see its impact everyday through the transformations of patients like Mary; whose return to physical and psychological health not only provide symptom relief, but also unlock mindbody awareness that serves as the groundwork for a lifetime of wellness.
