So I pulled up my Amazon music app one day and there was a suggested song for me. The song started with "I thought I could take this to my grave. But instead I let it bury me." Wow if this isn't ACES in your faces....
The last example of ACEs awareness I provided was for a minor involved in a motor vehicle accident. As I was accessing my patient's present health for a sign off, I informed them that they may have an arrhythmia and they should follow up with their doctor. This freaked them out with the notion they might not get into the military because of a heart defect.
A little background; They did not have a valid driver's license. They snuck out of the house with a family car without permission and hit another car in the early morning hours. My patient just signed enlistment papers to join the military at the early age of 17 in the very near future. This is screaming of high risk behavior.
First I addressed the possible reason why one joins the military — the sense of belonging. Many join because belonging to a family or community never formed completely. A feeling of loneliness persists. I asked if their parents where married. The reply, yes, but the relationship was greatly strained for a long time. They acknowledged the feelings of not being part of the family. I could see the desperation on their face brought on by the trigger of my narrative about loneliness.
Then I start my narrative on the ACE survey, dividing up the five household dysfunctions and five abuse/neglect questions. I kept sexual assault last. They trigger on this. Tears of pain. I normalize the assault and move on to the next moment. I ask if they smoked. Answer is yes. Three years ago they started. I ask if they knew that cigarette smoking is a antidepressant and anti-anxiety medication. They did not know this. I ask what happened for the need to sedate. The sexual assault becomes the reason with the sign of tears emerging again.
When I normalize patient childhood trauma, I stress that they are not alone and it's never their fault. I encourage counseling, with attention on the total picture of their childhood trauma. I attempt to bring events of the past to connect the dots that bought them to the present point of events. My patient had a real palpable fear of not being able to get away from the family. There was a terror of retribution from the father. I informed them that they are of the age that they should not tolerate physical punishment and the police should be called if they are struck.
We discussed the signs of PTSD that they were already experiencing and that the military might not be the best avenue at this time. Regardless of how sharp the dress uniform would look on them. We chuckled together over this.
As we parted ways, my patient couldn't thank me enough. Their sincerity was palpable.
With our discovery of the shame caused by the reasons of estrangement from the family, I hope my patient would not allow it to remain part of the secrets that could make them sick. To find safety elsewhere. To impart with this new knowledge that their secrets don't have to bury them.
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