Sockeye Salmon jumping a waterfall, Author Marvina for Fish & Wildlife Service, Source (PD-Federal govt.)

Salmon jumping a waterfall on the way to spawn, Author Marvina Munch for Fish & Wildlife Service, Source (PD-Federal govt.)

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?

Obviously not.

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 [1].

Objective Findings

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.

Patient Profiling

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 [2].”

Temporary Fixes

Studies have shown that patients suffering from more than one chronic condition experience greater functional deficits than those coping with a single chronic illness [3].  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 [4].  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 [5].

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).

[1]  Huffington Post, “Study:  Doctors Don’t Take Mental Health as Seriously as Physical Health” by Lindsay Holmes, 3/9/16,

[2]  Ideal Medical Care, “Patient Profiling:  Are You a Victim?” by Pamela Wible, 1/21/14,

[3]  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),

[4]  NPR, Shots, “Doctors Often Fail to Treat Depression like a Chronic Condition” by Shefali Luthra, 3/7/16,

[5]  Alternet, “The Wrenching Dilemmas of a Caring Doctor Helping Those in Pain” by Lex Pelger,  5/10/16,



Filed under Child Abuse, Christianity, Emotional Abuse, Neglect, Physical Abuse, Religion, Sexual Abuse

18 responses to “Salmon

  1. Reblogged this on ComeFlywithme and commented:
    My dear friend Anna Waldherr writes with such clarity, compassion and wisdom about a subject which many find difficult – mental health. For many mental health is considered “taboo”. Many would rather empathise with you on a physical ailment: a broken leg over a mental health issue such as depression. But aren’t those two worthy of the same depth of understanding and compassion. One you can obviously see and understand how debilitating and unpleasant this can be: restricting movement and preventing you from carrying out necessary everyday tasks. The other equally debilitating and that too preventing you from living life as you would wish until it “lifts” if indeed it ever does. Let us remove the taboo heading over mental health and begin to talk about it in just the same way we would never shun someone with a physical health issue such as a broken leg. This is perhaps easier said than done, but someone has to start the conversation, don’t they? Thank you Anna for doing this so brilliantly!

  2. Thank you Anna for such a brilliantly written post, which I have reblogged on ComeFlywithme.

  3. Monochrome nightmares

    An excellent and very interesting post Anna.
    And I thank God that I never had to walk the dark
    roads that you speak of.

  4. Reblogged this on STOP ROMANCE SCAMS! and commented:
    This very on-target article discloses the lack of validation emotional abuse sufferers have to endure. It’s time society recognized that your brain is a physical organ that controls the workings of your mind. When you’re abused or misused, the effects on your brain are detrimental and haunting.

  5. Sorry to sound melodramatic, but my tears seem to never cease over these issues you speak about with pointed elegance. I’ve stopped seeing my GP of many years, and have no other options due to my low-income status and that lovely term,”patient profiling”. So, assuming I choose to soldier on, I will be doing it with no medications by December (by law, he has to see me once a year to refill Rx’s, and he is stone deaf to why I don’t want to see him, thus no refills or actual “health care”)–But Please Don’t Fret, as I am energized by the challenge to trust God as Healer, and watch Him fulfill His Word. This is where Faith’s rubber hits the road, and I have nothing to lose 🙂 God bless you always with His abundant favor–for who you are, and all that you do for others ❤

    • You don’t sound melodramatic at all to me, Delyn. My heart goes out to you. Is there any possibility of your seeing another GP? Or trying a walk-in clinic perhaps? If not, a hospital emergency room should be able to give you a referral to its own clinic and short term prescriptions. Not every physician is so deaf and blind. I am concerned for you. Withdrawal from anti-depressants can be painful, can last for weeks, and should be medically supervised, if at all feasible. Try and remember that you are precious in God’s sight, just as you are. May God watch over you. You’re in my prayers. ❤

  6. This was so insightful. Thank you, Anna.

  7. I’ve been absent because of trauma issues from my long term abuse. I didn’t know that just leaving was the beginning of a whole new set of issues on the path to becoming whole again. I feel mentally broken, but just in the sense of how I function mentally. The abuse changed me.
    Great post, I missed them.❤

    • How wonderful to hear from you, Joyce! I’m sorry you’ve had to endure so much pain and grief. I wish I knew how to speed past all that. But the cliche is true: You are smarter than you think, and stronger than you know. Please, keep in touch. You’ve been missed, too. ❤

  8. A most interesting post, Anna… I think Patient Profiling is just outrageous… Mainly if we consider that psychiatry and psychiatrists are behind this… we are making reference to disciplines based on scientific principles (or at least much more scientific than psychology or psychoanalysis. Stereotypes and prejudices should be left out, with no exceptions.
    Thanks for sharing… Have a great day.

    • I am glad you liked the post, Aquileana, and glad our paths have crossed. It struck me, while I was visiting your own blog, that the emotional reality often reflected in myths may give us insights into abuse. The psychologist, Bruno Bettelheim (also, a concentration camp survivor) wrote about this topic in “The Uses of Enchantment: The Meaning and Importance of Fairy Tales”. Thanks again for stopping by! ❤

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