“CONSULT WITH A PSYCHIATRIST”

Medical trauma is a psychological or emotional injury that might occur as a result of medical events, treatments, or interactions with healthcare systems. It happens when a medical experience is perceived by the person as threatening, overwhelming, painful, or out of their control.

It can possibly be closely related to trauma responses seen in conditions like Post‑Traumatic Stress Disorder.

Key Idea

Medical trauma may not only be about the illness or injury itself, it can also come from:

• Fear of death or severe disability
• Painful procedures
• Loss of control or bodily autonomy
• Feeling ignored, invalidated, or mistreated by medical staff
• Prolonged hospitalization or intensive care

Some of the Common Possible Causes of Medical Trauma

1. Severe medical emergencies
   • heart attack
   • stroke
   • major accidents
2. Invasive procedures
   • surgeries
   • intubation
   • emergency interventions
3. Medical experiences
   • repeated hospitalizations
   • painful treatments
4. Birth complications
   • traumatic labor
   • emergency C-section
5. Chronic illness treatment
   • long-term painful treatments like chemotherapy
6. Possible medical system experiences
   • misdiagnosis
   • medical neglect
   • feeling powerless during treatment

Possible Psychological Symptoms

Some people with medical trauma may develop symptoms similar to PTSD:

• Intrusive memories of hospital events
• Nightmares about medical procedures
• Avoidance of doctors and/or hospitals
• Panic during medical appointments
• Hypervigilance about bodily sensations
• Dissociation during examinations

Possible Behavioral Signs

Examples include:

• Avoiding necessary medical care
• Anxiety before checkups
• Refusing procedures
• Extreme fear of needles or hospitals

Medical Trauma in Some

Some are especially vulnerable because they often:

• don’t understand what is happening
• cannot control procedures
• may feel physically restrained during treatment

This possibly, can later lead to lifelong medical anxiety.

Related Psychological Fields

Medical trauma could be studied in areas like:

• Health Psychology
• Medical Psychology
• Trauma Psychology
• Behavioral Medicine

Treatment Approaches

Possible, Common treatments include:

• Trauma-informed therapy
• Cognitive Behavioral Therapy (CBT)
• Somatic therapies
• Gradual exposure to medical settings
• Psychoeducation

Clinical Perspective

Some psychologists might, now emphasize “trauma-informed care”, meaning healthcare providers are trained to understand that medical procedures themselves can become traumatic experiences for patients.

Possibly, some patients report near-death experiences, altered states, or anomalous perceptions during severe medical events. These experiences can interact with trauma processing in complex ways.

“CONSULT WITH A PSYCHIATRIST”

Shervan K Shahhian

Clinical dissociative symptoms are disruptions in the normal integration of consciousness, memory, identity, emotion, perception, body awareness, or behavior. They go beyond ordinary “spacing out” and are typically distressing, impairing, or trauma-related.

I will outline both descriptively and diagnostically.

Core Clinical Dissociative Symptoms

1. Depersonalization

A sense of detachment from oneself.

• Feeling like an outside observer of your own thoughts or body
• “I feel unreal” or robotic
• Emotional numbing
• Altered body perception

Seen prominently in Depersonalization/Derealization Disorder.

2. Derealization

Detachment from the external world.

• Surroundings feel dreamlike or artificial
• Visual distortions (foggy, flat, overly vivid)
• Time distortion

Often co-occurs with depersonalization.

3. Dissociative Amnesia

Inability to recall important autobiographical information (usually trauma-related).

• Memory gaps for specific events
• “Lost time”
• Sudden unexplained travel (fugue state)

Associated with Dissociative Amnesia and, in extreme form, dissociative fugue.

4. Identity Disturbance / Identity Fragmentation

Disruption in sense of self.

• Feeling like different parts of self take control
• Internal voices (not psychotic in origin)
• Shifts in behavior, affect, skills

Most pronounced in Dissociative Identity Disorder.

5. Dissociative Numbing

Emotional shutdown or anesthesia.

• Reduced emotional reactivity
• Detachment during trauma reminders
• Often part of trauma-spectrum disorders

Common in Post-Traumatic Stress Disorder (especially the dissociative subtype).

6. Absorption / Trance States

Extreme attentional narrowing.

• Losing awareness of surroundings
• “Autopilot” functioning
• Hypnotic-like states

Mild forms are normative; clinical when frequent and impairing.

Clinical Clusters

Dissociation typically falls into three functional domains:

Differential Considerations

Dissociative symptoms must be differentiated from:

• Psychotic disorders (loss of reality testing)
• Neurological conditions (e.g., temporal lobe epilepsy)
• Substance-induced states
• Severe anxiety or panic states
• Personality disorders (e.g., borderline-level identity disturbance)

Unlike psychosis, dissociation typically preserves reality testing.

Trauma Link

Clinically significant dissociation is strongly associated with:

• Early attachment disruption
• Chronic childhood trauma
• Overwhelming affect states
• Developmental relational trauma

Neurobiologically, it reflects altered integration between:

“Consult a Neurologist, an MD”

• Limbic system (emotional activation)
• Prefrontal cortex (executive regulation)
• Default mode network (self-processing)

When It Becomes a Disorder

Dissociation becomes clinically diagnosable when it:

• Causes distress or impairment
• Is recurrent and involuntary
• Is not culturally normative
• Cannot be explained by substances or medical causes, get a Medical Doctor’s Opinion”
• Shervan K Shahhian