Self, absorbed.

Amber was a therapist who specialized in working with survivors of war-related trauma and torture. During a workshop on secondary trauma--a job hazard for anyone who works with refugees--she talked about her own experiences that left her in need of specialized care.

Amber had run from a car when a rifle-toting military thug in Africa pushed his gun into her face. Although she had missed getting shot, the terror stayed with her for years. It was eventually compounded when she was involved in a near-fatal car accident that left her unable to function in everyday life. These two stories gave Amber's presentation a credibility it otherwise would have lacked for me, especially because I knew Amber to be a credible, genuine person.

Amber and her copresenter, Sissy, talked about somatic memory. I hadn't heard of it before. They showed pictures of brain scans illustrating electrical activity in the brains of people who had endured tremendous trauma and stress. They explained why the psychological component of torture is often more dangerous than the physical abuse. Then they talked about what happens when thoughts, memories, and feelings are buried. Maybe ignored. Possibly rerouted. Thoughts are taken out of the processing loop and pushed into a far corner of the brain where they no longer cause anxiety, sadness, and fear, otherwise lived over and over again.

I still have the handout somewhere. It includes a diagram of the brain, showing which sections control thoughts, memories, emotions, instincts and reflexes. Amber told us that each part of the brain needs to process information in its own way. There was no avoiding it, although delay and reinterpretation were possible.

The presentation fascinated me because it was the first academic explanation I had heard outlining why stressed out people get sick so often. While the brain is busy putting constant--but not conscious--effort into suppressing bad thoughts, it is no longer spending as much effort keeping the body's systems in top working order. It was the first time I heard the term somatoform illness. It was the first time I had an in-depth lesson on PTSD.

Survivors of torture and deep trauma who never effectively process their experience often exhibit somatoform symptoms in addition to the more straightforward evidence of PTSD. Given enough time, the brain will actually rewire itself so the somatoform illness becomes ingrained. The only way to stop the physical symptoms is by reconciling the emotional.

Amber stated that those deeply emotional experiences, when not neutralized, literally take up residence in the tissues of the body. We carry our troubles like a heavy suit that wears us down with each day it is not removed. It can become too physically painful to overcome.

Chronic pain can be both a cause and a form of somatoform illness. Not wanting to miss anything, my doctor is addressing my rapidly worsening problem with medication, physical therapy, nerve manipulation, meditation/visualization, EMDR, and lifestyle. No matter what the source of the pain turns out to be, the goal is to not let it get so far along that my brain starts to register it as a normal condition.

My pain is real. I just hope it isn't rooted in memory--some new and unprovable humiliation spun out of an already deeply defective brain. I can't think of any hidden trauma--physical or emotional that I've forgotten about. I believe that with all of the therapy I've been through, there can't be anything left to tease out of the folds of my brain tissue.


I told my husband that I want to feel better because I cannot survive this level of unrelenting, excruciating pain if there is to be no end in sight. Aside from the pain itself, I'm not sure I can survive the humiliation if this knife in my gut turns out to be nothing but uncollected thoughts seeping into the viscera.

I am not a hypochondriac. How do I prove it given this maddening absence of physical evidence?