Understanding Medical Trauma: Causes, Consequences, and the Need for Trauma-Informed Care

'Medical trauma' refers to a patient's psychological and physiological response to a negative or traumatic experience in a medical setting. It's the emotional and physical responses to pain, injury, serious illness, medical procedures, frightening treatment experiences, and medical gaslighting. Trauma experienced within the medical setting can have lasting effects with reactions like Post-traumatic Stress Disorder (PTSD), anxiety, depression, anger, avoidant behaviours, traumatic grief, helplessness, suicidal thoughts, and various somatic complaints. Despite its prevalence, medical trauma is frequently overlooked in healthcare systems that prioritize physical recovery over emotional well-being. Recognizing, addressing, and preventing medical trauma is essential for improving patient outcomes and rebuilding trust in medical institutions.

Causes of medical trauma

Medical trauma can result from a variety of situations. These include invasive medical procedures, life-threatening diagnoses, emergency room visits, intensive care unit (ICU) admissions, prolonged hospital stays, painful treatments and medications, traumatic surgeries, a frightening diagnosis, or from chronic illness management. It includes medical events such as heart attacks, stroke, emergency surgeries, and intubation due to a sudden medical event. For children, trauma can originate from early experiences in neonatal intensive care units (NICUs) or from frequent procedures like surgeries or injections, and this trauma may persist well into adulthood. If not treated correctly, these can create lasting emotional scars.

Trauma may not just come from the illness itself, but also from interactions perceived as dismissive or dehumanizing by healthcare professionals; whether or not the patient feels listened to, respected, and properly informed. In my own practice, many of the clients I see with medical trauma have experienced medical gaslighting; when doctors dismiss, downplay, or ignore their health concerns. This can feel deeply traumatic and often changes how people relate to the healthcare system. They may start to doubt themselves and their symptoms, feel worse emotionally, or become angry and powerless. As a result, some avoid going to the doctor altogether (I've written more about that here and here).

The consequences of medical trauma

The mental effects of medical trauma can be deep and long-lasting. PTSD for example, is present in around 20 percent of patients with medical trauma, and may present as flashbacks, nightmares, feeling constantly on edge, or avoiding doctors and hospitals. People might also struggle with anxiety, depression, or panic attacks. These feelings can create a harmful cycle where being afraid of medical settings can lead to avoiding care, which may make health problems worse. This can also affect daily life, relationships, and the ability to work. On top of that, the stress from trauma can weaken the immune system and make existing health issues worse, making recovery even harder. The stress associated with medical trauma can also present physically, leading to conditions such as high blood pressure, digestive disorders, and chronic pain.

Paths to recovery from medical trauma

As we have seen, medical trauma can profoundly affect a person’s well-being, and recovery is often a complex, nonlinear journey, shaped by the individual’s experiences, support systems, and available resources. It can also exist on a continuum. While medical trauma can leave lasting scars, there are multiple pathways that can help individuals heal and reclaim their lives. Finding a therapist specialized in trauma-informed care is a good start. They can tailor treatments to the unique challenges for each individual person, and may use therapy modalities such as Cognitive Behavioural Therapy (CBT - helping individuals reshape negative thought patterns and emotions associated with their trauma), Acceptance and Commitment Therapy (ACT - helping individuals to regulate their emotions and to accept difficult thoughts and feelings, rather than struggling to control or avoid them), and Eye Movement Desensitization and Reprocessing (EMDR - helping individuals process traumatic memories by using 'bilateral stimulation' - most commonly eye movements - while focusing on the traumatic event). They should also use various somatic therapies that I will describe in more detail below.

Medical trauma often affects not just the mind but also the body. Traumatic experiences related to illness, surgery, or invasive medical procedures can create lasting physical tension, dysregulation, and a sense of disconnection from the body. Somatic therapies focus on the body-mind connection to help survivors process trauma and restore a sense of safety and embodiment. 'Somatic Experiencing' and 'Sensorimotor Psychotherapy' are examples of body-centered therapeutic approaches that recognize trauma as stored in the body’s physical sensations, muscle tension, and nervous system patterns. Unlike talk therapy alone (a top-down process), the primary goal of somatic therapies is to modify the trauma-related stress response through bottom-up processing. It focuses on healing the body's responses to trauma by directly addressing physical sensations, emotions, and implicit memories, rather than relying solely on cognitive or verbal processing. This approach recognizes that trauma is stored in the body and can be accessed and processed through bodily awareness and sensations. For example, Somatic Experiencing helps individuals become aware of bodily sensations related to trauma and gently guides them to release tension and interrupt the 'fight, flight, or freeze' responses. It is highly effective for medical trauma as it emphasizes safety and pacing.

Sensorimotor Psychotherapy combines talk therapy with body awareness and movement. It helps patients process trauma by noticing physical responses and learning new ways to regulate emotions and posture. Tailored yoga practices may also be helpful that focus on mindfulness, breath, and gentle movement to restore bodily connection and calm the nervous system. Somatic therapies work best as part of a holistic recovery plan, often alongside psychoeducation, traditional talk therapy, medical care, and social support.

Seeking Information and Education: Education about medical procedures and their potential outcomes can help alleviate fears. This empowerment allows individuals to feel more in control during medical encounters. Many trusted online resources offer reliable information regarding various health topics. Educational resources can clarify what to expect during recovery and reduce fears about the future. Empowerment comes from gaining knowledge and regaining a sense of control over one’s body and health decisions.

Social Support: Recovery is often bolstered by compassionate family and friends who offer emotional support and practical help. Also, connecting with others who have had similar experiences can foster a sense of belonging and hope, especially if support at home is inadequate. Support groups - whether in-person or online - provide spaces to share stories, exchange advice, and feel less alone. These communities can empower patients to advocate for themselves and navigate recovery with encouragement. Indeed, research shows that those who participate in support groups report increased feelings of connection and reduced anxiety.

Trauma-informed care in the health-care setting

Medical trauma is a crucial yet often overlooked aspect of healthcare. The psychological effects can be as debilitating as the physical conditions needing treatment, with repercussions that may persist long after the medical event. By recognizing its causes, acknowledging its symptoms, and implementing trauma-informed therapeutic strategies, healthcare systems can better support patients in their physical and mental recovery. This method fosters a more compassionate, inclusive, and efficient healthcare system that honors the dignity and resilience of every individual.

Trauma-informed health care involves establishing an environment where individuals feel safe, respected, and empowered. It requires medical professionals to recognize that many patients have faced challenging experiences and to avoid inadvertently exacerbating their distress. This approach includes being compassionate and transparent when explaining procedures, involving patients in decision-making about their care, ensuring they fully comprehend and consent to treatments, and providing emotional support. Increasingly, hospitals and clinics are incorporating mental health specialists into their teams, engaging with patients after difficult procedures, and training staff to identify signs of trauma.

If the trauma is severe, gradual exposure to medical settings by gently re-introducing oneself to medical environments can help reduce fear. This may involve visiting healthcare facilities for non-threatening appointments, easing into the environment without the pressure of needing treatment. Touring the facility or meeting staff without undergoing any procedures can help provide a sense of safety and familiarity.

Medical trauma and grief

Trauma and grief often go hand in hand, especially after a sudden loss or overwhelming experience. As we have seen, trauma can shake a person’s sense of safety and control, while grief is the deep emotional response to loss. These losses can include physical abilities, roles, relationships, and a sense of self, and can significantly impact mental health and overall well-being. When combined, they can make it harder to process emotions, feel connected to others, or find a sense of meaning. This kind of grief may feel confusing, prolonged, or intense, and healing often requires both time and compassionate support. I will write more about traumatic grief in my next article.

Conclusion

Medical trauma is a complex and often overlooked issue that affects many people during their healthcare journeys. It can feel overwhelming and isolating, but there are ways to recover. By combining education, validation, professional care, engaging in therapeutic practices, peer support, and self-care, people can find hope and rebuild their lives. Healing from medical trauma is not an overnight process; it demands time, patience, and self-compassion. Progress can involve setbacks, and it's crucial for individuals to understand that recovery is a personal journey that progresses at their own pace. This journey is never straightforward but with the right resources, individuals can move toward healing beyond their trauma and live a really meaningful life.

If this is something you’ve been affected by, please leave a comment below. If there’s something important you’d like to add, please do so. I'd love to hear from you.

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Dr. Ingela Thuné-Boyle is a licensed Practitioner Health Psychologist and a Doctor in Behavioural Medicine who specializes in stress and loss, especially in improving the quality of life of people struggling with long-term health problems, chronic pain and trauma. She runs a private online (telehealth) practice at www.ingelathuneboyle.com.

Please note: Advice given in this blog is not meant to take the place of therapy or any other professional advice. The opinions and views offered by the author is not intended to treat or diagnose, nor is it intended to replace the treatment and care that you may be receiving from a licensed physician or mental health provider. The author is not responsible for the outcome or results following their information and advice on this blog.