Lady Gaga’s Pain a message of hope

Lady Gaga’s recent disclosure that she suffers from PTSD and chronic pain highlights a set of problems that affects more than 1 in 10 women, many of whom never get treatment.  Pain associated with PTSD often goes unreported and untreated because of a combination of factors including shame associated with sexual trauma, ignorance about the health effects of sexual trauma and lack of awareness of recent advances in the treatment of these problems.

 

Shame is the most common emotional response to sexual trauma. Sexual assault is such an assault on our physical and psychological personhood victims often feel dirty and marked for life. The shame associated with sexual trauma makes it the only crime where the victim is the one who feels guilty! Added to this, ignorance about the health effects of sexual trauma and judgemental attitudes make it even harder for victims to get help. When Lady Gaga tried to communicate her needs on her Born this Way tour, she was ignored, leading to injury, pain and added trauma. Noone it seems, is immune from the damaging effects of trauma. When Lady Gaga published a letter about her ordeal with PTSD and pain news commentator Piers Morgan quickly dismissed it as “absolute rubbish” on the grounds that she was not a war veteran. Although PTSD was originally created to describe the problems that Vietnam veterans reported, it is now recognized as that it can be caused by a wide range of traumatic events. Piers Morgan’s response, although extreme, reflects the fact that the progress that society has made in accepting the problem of sexual abuse has not been matched when it comes to dealing with the long  term health effects of sexual trauma.

 

Recent advances in brain science mean there is no longer any excuse for not understanding people whose pain does not fit traditional ways of thinking. We’ve known for years that psychological trauma such as sexual assault causes changes in brain functioning which predispose the person to a host of health problems including chronic pain – PTSD sufferers are four times more likely to develop chronic pain. We know quite a bit about how this happens. Lady Gaga describes how the thinking part of her brain (prefrontal cortex) gets overridden by the emotional part of her brain (the amygdala) leading to problems expressing herself and problems regulating emotions, both of which can exacerbate pain. Then there is dissociation, a splitting off between thoughts and feelings leading to a numb unfeeling state Trauma expert David Calouf describes dissociation as “natures tincture of numbing and forgetting.” This numbness enables trauma sufferers to maintain a semblance of normal functioning even though they might be in great physical or emotional pain. This illusion may be enhanced by dressing and behaving in ways which draw attention away from how they are really feeling. One of Lady Gaga’s hits is a song called “Perfect Illusion.”

 

Increased understanding of how the brain is affected by trauma has also led to new treatments which aim to reverse the brain changes that maintain pain. These include traditional practices like meditation (which Lady Gaga mentions), and newer therapies such as EMDR. (Eye Movement Desensitization and Reprocessing). The design of these therapies is consistent with the hierichical nature of information processing in the brain. For example,  EMDR uses a dual-focus of attention/bilateral stimulation process to de-activate the amygdala and stimulate improved communication with the PFC, leading to more normal functioning. The direction of activation is bottom-up, which is how the brain processes new sensory information, one of the key pathways for new learning. Because of how it fits with information processing, EMDR stimulates more rapid resolution of pain memories. An integrated approach is usually adopted, incorporating education, emotional regulation, trauma processing and re-integration “lessons learned”). Victims learn that they are not the problem, but that they have been damaged by what they have endured, and that this can be reversed. The result is that victims of sexual trauma feel less shameful and more empowered and hopeful. As Lady Gaga points out “After five years of searching for answers to my chronic pain, and the change I have felt in my brain I am well enough to tell you that there is hope and a chance for recovery.” Hopefully sufferers of PTSD and pain will hear this message and feel emboldened to seek the help they need.