Welcome everyone to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. This week I had the opportunity to talk with Dr. Mike Adler (clinical psychologist, specializing in sexual abuse and trauma) about the long term health effects of ABUSE.
Integrative medicine focuses on a patient’s overall health and well-being. Mental issues unaddressed can lead to unnecessary disability, unemployment, substance abuse, poor quality of life, and even suicide. ABUSE is not something to be silent about!
In my practice, I look at the physical, mental, and the spiritual. The mental side of things can be very complex. When I am with a patient who has a chronic disease, I’ll ask them questions about their lives. I want to figure out WHY. We often skip over this as doctors. As you know, most doctors are in a hurry and need to get out of the room. I really like to get to know a person, and the root cause of the problem. Note: A lot of times when you start digging, you realize there’s something deeper than what meets the eye (i.e., on a lab test). It takes time.
Before moving deeper into our podcast subject, I will share a couple of fun facts about Mike. I’ve known Mike for years. Second to counseling, he loves competitive dancing. Mike and his wife Kim are two time world champions in the Couples Division of the United Country Western Dance Council (UCWDC) and creators of “Dancing With The Tri-Cities Stars” (a Benefit for Jeremiah School, serving children with Autism). They are such great people who do good for others. We are blessed to have Mike in our community of wellness.
Let’s get started….
The Long Term Health Effects Of Childhood Abuse and Neglect
We always talk about stress in our practice, but most of the time it is related to the present, not so much the past. Things that happened early on in life could have a huge impact on the way patients view life today, even the way they view themselves.
Early abuse and early trauma, without the ability to process it, has to go somewhere. Oftentimes that becomes internalized and wreaks havoc on many of our systems, hormones being just one. We know that this level of stress has ramifications for heart disease. Early trauma that’s left avoided or ignored can lead to many different health conditions and experiences. Note: Trauma and adversity in childhood raises the risk of numerous health problems such as diabetes, heart disease, cancer, and mental illness in adulthood. ¹
According to the U.S. Department of Health and Human Services, neglect is the most common form of child abuse in the U.S. This can happen when children are left alone or simply not loved and cared for. Note: Eating can sometimes be a very unhealthy coping mechanism for feeling bad or unhappy. There is a strong correlation here.
Sexual Abuse Statistics
In his practice, Dr. Adler deals with the victims of sexual abuse as well as the abusers. He mentioned in our conversation that the abusers usually were abused themselves. It’s not a causal effect, but a strong correlation.
Over the course of his 40 year career in the field, he estimates that 75-80% of the abusers, as patients, were at one point abused. That, of course, varies. It’s also important to note that only 1 out of 4 individuals who are sexually abused would actually turn into sexual abusers. So, it certainly doesn’t mean all those abused will become abusers.
Note: In Tennessee, the most common age of a child being abused is 8 years old. At this age, there’s lots of hormonal changes going on and growth.
Hyperthymesia is a rare condition where people can remember everything they experience. I found this interesting. We think that because we can’t remember things that they no longer impact us. That’s not the case. The ability to recognize those experiences, the impact they have had on our lives, and how we have perceived those experiences, is what’s important.
Dr. Adler explained mental health as three people:
- The person I am.
- The person I want to be.
- The person I should be.
The further away I am from those three people, the more difficulty I will have emotionally and mentally. When my experiences impact my perception of who I should be, and who I am (so that they don’t match), that’s where we get into a lot of mental illness, a lot of bad, negative, destructive behavior that wreaks havoc on our system.
What should we do with bad thoughts? I asked Dr. Adler that question on the podcast. Of course, he said that dealing with them is the healthier thing to do. So much of what we believe about ourselves happens by the age of 6. Those experiences happen when we’re egocentric thinkers, which means we can’t really formulate possibilities of why we are being treated the way we’re being treated. We can only process that it has something to do with us. That’s going to lead to childlike beliefs about ourselves that are not accurate. Being able to go back to those experiences and understand how we’ve distorted certain experiences is extremely helpful.
We can go back and we can look at how we made sense of those things and change that through cognitive restructuring. This would help a person have a better, more accurate picture of themselves. It’s not about blaming parents or other people. The issue is how we perceive what was happening to us from a child’s mind, which in cognitive development is very egocentric.
Note: Although egocentric thinking is normal in children who are in the pre-operational stage of thought (ages 2-7), it can affect individuals at any age.
Q. Somebody who comes to you and realizes that 30 years ago they were sexually abused. What’s your gameplan of helping that person get better?
A. We’ve got to deal with the shame and guilt that’s distorted. As a child, they didn’t do anything wrong. Yet, almost all victims that I work with feel ashamed or guilty for what happened. Sometimes that becomes extreme and also a way of them attacking themselves. We have to help them to recognize that what happened to them wasn’t their fault. That’s the first thing. Then we can start to unpack how they distorted what happened to them (took responsibility that was not theirs to take) and empower them to survive that.
Q. When talking with the abusers, what stands out?
A. Their inability to feel loved, to believe someone would care about them. The only way they could believe that someone would care for them or love them would be to trick them or coerce them or manipulate them.
In general, the medical community tends to ignore or brush it aside and come up with a pill that will help you feel better. With an antidepressant for example, you’re just masking the problem. You haven’t dealt with the issue. Note: We do need medications to help for severe cases of depression and anxiety. There’s some people that have to have anxiety medicine. Some people need antidepressants.
The older I get and the more I practice medicine, the more I try to get to know my patients. I am less afraid now to ask my patients tough questions.
- What is the cause of your problem?
- Why are you really here?
- What are you worried about?
- Why are you hurting all the time?
- Why are you depressed?
Let’s try to get to the bottom of this. A lot of times people will open up, and a lot of times they won’t, but if they do (and it’s appropriate) I will refer them to a mental health specialist, such as Dr. Adler. When they start to heal mentally, the physical healing usually follows.
The parting advice (in the podcast below) from Dr. Adler to anyone struggling from past or present abuse:
- Be brave. Open yourself up to face whatever experience that has caused you emotional pain. In the process, you will realize that what you are believing about yourself is not true.
- Don’t compare yourself to other people. You’re never going to win that comparison.
- Get professional help.
Abuse is real. Around one in four girls and one in six boys are sexually abused before they turn 18. (April 18, 2023 Google stats) This is one aspect of medicine that really needs to be brought to the forefront.
Stay Educated. Stay Healthy.
Till next week.
¹Scommegna, Paola. “Childhood Trauma Has Lifelong Health Consequences For Women.” PRB. Accessed 21 November 2019.