WARNING: Graphic Images
Suppose I took a knife and gutted you with it, like a fish. Suppose I left you to bleed out on the floor, but you somehow survived that catastrophic assault. Would you expect to be unchanged by it? Would you expect to recover just by thinking happy thoughts?
Physical v. Mental Complaints
Yet this is the cold comfort some physicians offer abuse victims suffering from long-term depression/anxiety and PTSD or other chronic conditions, for instance migraines, stemming from our abuse. We are not trying hard enough for them. Better still, we must be malingering. Who could possibly grieve for decades over a “mere” childhood violation?
Forget it. Put it behind you, we are told. Easier said than done, however.
The ignorance of such physicians is palpable. They simply do not consider psychological problems as significant as physical ailments .
Many of us suffering from mental health issues seek help first from our primary care physicians. Out of embarrassment, we may never consult a psychiatrist or psychologist. If that is the case, we are likely to find ourselves accused of lacking “objective findings” to support our complaints, especially if they are chronic.
Which begs the question, do the scars of cutting and attempted suicide count? How precisely are scars on the soul measured, anyway?
While these questions are meant to be facetious, it can be enormously painful for victims to confront the critical attitude of some physicians. Our credibility is challenged exactly when we feel most vulnerable. We are forced to justify our right to receive care to the very individuals who should be providing that care.
Remind you of anything? The situation is, of course, reminiscent of the very abuse we endured. Not that the physicians being consulted are likely to recognize that.
The doctor-patient relationship was never intended to be adversarial. When it is, we can wind up feeling discouraged and rejected. Some of us will give up seeking medical care at all.
One reason for this may be patient profiling:
“Patient profiling is the practice of regarding particular patients as more likely to have certain behaviors or illnesses based on their appearance, race, gender, financial status, or other observable characteristics. Profiling disproportionately impacts patients with chronic pain, mental illness, the uninsured, and patients of color .”
Studies have shown that patients suffering from more than one chronic condition experience greater functional deficits than those coping with a single chronic illness . It can, in other words, be debilitating to fight long-term on multiple fronts.
But primary care physicians often fail to treat depression as a chronic condition altogether . That would require time that may not be available to instruct the patient in managing his/her condition, and would involve follow-up.
Instead, platitudes and short-term remedies are suggested. Often, these temporary fixes are insufficient to our needs.
The Long Haul
Another factor that can play a role in the quality of our care has to do with physicians, themselves. It is not easy for a physician to deal with patients in chronic pain – mental or physical. Sticking it out with us for the long haul can be painful for a caring physician .
But, as patients, our goal is precisely that. Sticking it out for the long haul. Like salmon, we know what it is to swim upstream. We have done it all our lives.
“Is there no balm in Gilead, Is there no physician there? Why then is there no recovery For the health of the daughter of my people?” (Jeremiah 8: 22).
 Huffington Post, “Study: Doctors Don’t Take Mental Health as Seriously as Physical Health” by Lindsay Holmes, 3/9/16, http://www.huffingtonpost.com/entry/mental-illness-physical-illness_us_56def9a7e4b0ffe6f8eac4aa.
 Ideal Medical Care, “Patient Profiling: Are You a Victim?” by Pamela Wible, 1/21/14, http://www.idealmedicalcare.org/blog/patient-profiling-are-you-a-victim/.
 Journal of the American Medical Association (JAMA), “Functional Status and Well-Being of Patients with Chronic Conditions” by A. Stewart, et al, 1989 (262: 907-913), http://s3.amazonaws.com/academia.edu.documents/41576290/Functional_Status_and_Well-being_of_Pati20160125-3547-1dv24pu.pdf?AWSAccessKeyId=AKIAJ56TQJRTWSMTNPEA&Expires=1474548223&Signature=Xlw6GyupqgJUf5qYBOe79c24y0E%3D&response-content-disposition=inline%3B%20filename%3DFunctional_status_and_well-being_of_pati.pdf.
 NPR, Shots, “Doctors Often Fail to Treat Depression like a Chronic Condition” by Shefali Luthra, 3/7/16, http://www.npr.org/sections/health-shots/2016/03/07/469504900/doctors-often-fail-to-treat-depression-like-a-chronic-illness.
 Alternet, “The Wrenching Dilemmas of a Caring Doctor Helping Those in Pain” by Lex Pelger, 5/10/16, http://www.alternet.org/trenches-battle-against-pain-doctors-tale.
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