Changing the Conversation

Trigger Warning: Trauma re-enactment

I am 65 years old and a trauma survivor. When I entered therapy, I was labeled as having an adolescent adjustment reaction. Years later, the mental health label was changed repeatedly—from schizoaffective disorder to post-traumatic stress disorder (PTSD) and major depression and then later to dissociative identity disorder, paranoia, and bipolar disorder. It was clear to me that my trauma symptoms determined the diagnosis. I wanted a cure and a reduction of my symptoms, instead of a variety of methods to merely manage them.

My commitment to making therapy work was matched by the efforts of my therapist. She is a learner spirit and as tenacious as I am. Even so, it has taken a lifetime to arrive at an enduring sense of safety and freedom from the daily derailing of my consciousness by the intrusion of trauma memory content. Therapy changed as new knowledge of the impact of trauma emerged. I wondered if there was a way to combine therapies to improve the quality of my life and speed recovery.

Trigger Warning: Violence, Trauma

Being on the streets poses many challenges. Finding food, water, and shelter from the elements is always the top priority. But, the one thing that we (even street folks) forget about is mental health.

While I was on the streets, thinking about my mental health always felt like a tsunami. About seven years ago, I was living on Haight Street in San Francisco. I hung around Golden Gate Park, often sleeping somewhere in the thick of the park. I had been in San Francisco for about three months, had made some great friends, and was in the midst of living the California dream. I spent most of the day hanging out with friends, panhandling, and making music, arts, and crafts - just trying to have a good time. I had gotten in the habit of sleeping with my friends, but one night I didn’t have the energy to make it up yet another hill; if you don’t like hills don’t go to San Francisco without a car. I decided to sleep in Panhandle Park instead of walking all the way back to Golden Gate where my friends gathered. I woke up at 6:30 am, packed up my stuff, and took a quick inventory of my things. I had $20, so I raced to the local coffee place, grabbed breakfast for everyone, and went to Golden Gate.

Too often, trauma research focuses solely on impact on patients in health services—especially people who experience mental illness, trauma, substance use disorders, and homelessness. We need to expand the research questions to include the following: How does trauma impact physicians and what are the implications for their relationships with patients?

After learning about the Adverse Childhood Experiences (ACE) Study while in graduate school, I experienced an epiphany. As a public health student, not only was it a revelation to learn about such a revolutionary study in the field of trauma, but also a personal moment of clarity. Finally, for the first time in my life, I felt as if all the previous adverse experiences I had endured were universal, normalized, categorized, understood—and I wasn’t alone.