The following was excerpted with permission from Healing Honestly: The Messy and Magnificent Path to Overcoming Self-Blame and Self-Shame 2023 Berrett-Koehler Publishers www.bkconnection.com

Now I get to introduce you to a friend of mine, Anna Holtzman, LMHC, who has helped me so much on my chronic pain journey. Anna is a licensed therapist and chronic pain expert whose expertise is at the intersection of chronic pain and trauma. She is also a childhood sexual trauma survivor, and you know we love survivor-to-survivor wisdom!

A year ago, I was dealing with chronic migraines. At my request, Anna sent me information about how chronic pain works in the body, along with resources like guided imagery and journaling prompts. One of the coolest things I learned was that research shows that simply learning about how chronic pain works can in and of itself be an effective treatment for pain. So many fellow CSA survivors struggle with physical pain, like shoulder/neck/ back pain, migraines, and pelvic pain the way I have. It isn’t a coincidence, and it certainly isn’t our fault.

WITHOUT GETTING TOO PHILOSOPHICAL ON YOUR ASS, WE ARE GOING TO ASK OURSELVES, “WHAT IS PAIN?”

Anna explained to me, “Pain is nothing but a danger signal and triggered by fear. Sometimes the danger is physical, like a broken leg; sometimes the danger is emotional, like emotional abuse.” She continued, “Pain is a danger alarm created in our brains when our nervous systems feel unsafe. This is a process that doesn’t happen consciously, nor is it based on decisions we make.”

There are loads of examples of how this mind-body connection works. If we are nervous about a job interview, having a difficult conversation, or awaiting results of an important test, we may get stomach pains, nausea, loss of appetite, tightness in our neck and back. Or, if you’re me, you get the nervous bubble gut and you’re just grateful to make it through without pooping your pants. We don’t decide to get an upset stomach or back pains during these high-stress experiences; they are things that happen subconsciously.

There are these one-off stressful experiences, “but when you are dealing with chronic stress or chronic trauma, it can cause chronic pain. We can see examples around us, like having a super stressful job, which is an everyday experience, which may lead us to have headaches or back pain most days,” said Anna.

It all sounds too simple, right? Well, that’s kind of the point, she said. “This is all actually very simple. We all intuitively understand the connection between pain and trauma and our mind and body. But we’ve been conditioned to distrust our own knowledge of our own emotional and physical experience. We have been gaslit into believing our emotional feelings are not valid.”

While the world outside of us tells us that physical and emotional pain are completely different things, one being considered “real” and provable and the other constantly invalidated and dismissed, they are interwoven inside of us.

Anna explained, “Physical pain and emotional pain are created in very similar parts of the brain, so the two are inextricably connected. They are coordinated aspects of stress response, so we cannot divorce one from the other, not ever. Even if you have pain from a bone, there’s an emotional response to that from the physical sensation of the broken bone.” I can personally attest to that as someone who, as a kid, all on separate occasions, broke her leg, three toes, one finger, and an arm (from literally, I shit you not, napping on the couch while watching Baywatch reruns and slowly rolling over onto the floor, landing on my arm. Yes, it was just a regular couch.)

Anna continued, “Chronic pain is a result of the chronic tension between the part of us that wants to fight back and the part of us that has learned to be afraid to fight back, probably for good reasons, at least in childhood or before you had allies to support you.”

To illustrate the point, she offered us this prompt:

• First, let’s imagine lots of angry energy inside of you, the kind of fury of fighting back against all that is wrong. Tap into the anger and fury that is a part of each of us.
• Now that you’ve tapped into that feeling of righteous anger, try suppressing all that fighting energy with all of your might.
• What does your body feel like when you try to suppress your anger and fighting energy? It may feel pretty tense and tight in your body. If each of us sustained that for a while, we might start to feel some pain.
• Now that this little experiment is over, give your limbs a light shake or do some deep exhalations to release all that tension and discomfort, because that isn’t a pleasant feeling!

Presumably, if we continued to suppress and silence the natural fight response in us for long periods of time, say our whole childhood, we can see how some pain would start to develop. So this prompt is helping us understand a little better how chronic pain comes from this tension of suppressing our healthy natural emotional selves. Whether the prompt was illuminating to you or not, that’s okay; we have more to learn together!

COMMON SURVIVAL BEHAVIORS THAT CAN PERPETUATE CHRONIC PAIN (NONE OF WHICH ARE ANYTHING FOR US TO FEEL ASHAMED OF!)

In further exploring the chronic pain and CSA survivor relationship, Anna explained to me that there are some common survival behaviors that we survivors engage in that can perpetuate chronic pain.

1. Vigilance and preparing for the threat of danger.
   Many survivors experience hypervigilance as a part of their trauma. I feel I am often on high alert, playing worst-case scenarios in my head as a way to anticipate danger and prepare for ways to deal with the fallout. Do you observe yourself being constantly on high alert? No shame if you do! This was developed for good reasons!
   
   “The habit of vigilance perpetuates chronic pain because it keeps our danger alarm on high alert all the time. Pain is a danger signal, so when we fear we are in danger, our body sends us pain as a message, Anna explained. If we spend a lot of time with our danger alarms going off, this can continue our cycles of pain.
2. People pleasing and suppressing anger.
   Many of us can relate to being conditioned to suppress anger, because if we tried expressing it when we were younger, we may have received explicit or implicit signals that it wasn’t safe for us to be angry. Have you observed any people-pleasing/appeasing tendencies within yourself? Again, no shame if you have! This was developed for good reasons! (Yes, I will repeat this again because it is worthy of repetition!)
   
   “The people-pleasing/appeasing/suppressing anger survival behaviors perpetuate chronic pain in a few ways, including that when we have the urge to fight back but have to suppress it, it is as though our internal gas pedal and brake pedal are being slammed on simultaneously, which causes physical tension,” Anna explained.
3. Perfectionism and self-criticism (I am the best at this one!)
   My therapist says I am the best at criticizing myself for things that aren’t my fault — which also fulfills my perfectionist tendencies, so take that. We can be so hard on ourselves in hopes that it prevents us from “inviting” (we never actually invite abuse from someone, hence the quotation marks) abuse from someone else. Do you join me in having a lot of perfectionism and self-criticism tendencies too?
   
   When I asked Anna how this survival behavior contributes to chronic pain, she explained, “When we are perfectionists and intense self-critics, we are terrorizing ourselves all day long, and that turns on our danger alarms and sends signals of pain within us.” I did a true, honest-to-God spit-take when she said this last one, because it was so real to me that my only option was to hysterically laugh.

It’s no wonder so many of us deal with chronic pain! Look at all the coping strategies we had to develop just to try to stay safe and function in the world as survivors. Those same things can cause us pain. Thinking about all this together fills me up with a deep feeling of compassion for all of us.

HOW PAIN CAN SHOW UP DELAYED FOR US, LIKE A FUN SURPRISE FROM HELL!

A really important aspect of pain for us CSA survivors is that sometimes danger is a present-time threat, like touching a hot stove, but other times danger can be a conditioned response that reminds us of past danger or abuse. We can be going about our days and then get a headache or back pain and not know why, but it could be because we smelled or heard or saw something that subconsciously reminded us of our abuse. Anna explained that this can be a confusing part of pain, especially if we are trying to explain it to people who don’t know what it’s like to have trauma and experience triggers.

“An example I like to use is that when we get near a flame, our body automatically recoils from it because we know It’s dangerous. How do we know it’s dangerous? We aren’t consciously thinking about how fire is dangerous, so we must move our hand. We aren’t thinking about the first time we learned fire is dangerous. We may not consciously remember how and when we learned fire was dangerous, but our nervous system remembers fire is dangerous to touch, so our nervous system is recoiling our hand from the flame,” Anna said.

For some of us, we experienced chronic pain throughout our childhood. For others, we didn’t experience it until adulthood. Sometimes people ask, “Why now?!” to their pain who didn’t experience pain in their childhood.

“Often with chronic pain, we experience the pain when our bodies are safe enough to relax our survival mechanisms a bit and we determine, in a subconscious place, that it’s safe enough for us to fully feel the pain connected to the stress,” Anna explained.

WE CALL BULLSHIT ON THE NOTION THAT OUR EMOTIONS ARE “TOO BIG” TO FEEL

I’ve heard some people imply that we have chronic pain because our emotions are too big, or too hard, for our minds to process, so our bodies store them. When I asked Anna about this, she told me that every one of her trauma teachers has said that people suppress their feelings because they are too overwhelming, and that’s what leads to chronic pain.

“In my opinion, that is bullshit,” I was surprised to hear her say. “I don’t think we are unable to handle big feelings. Or that there are feelings too big for our nervous systems to handle. But rather, it’s that we can’t handle big feelings in isolation. We need companionship in order to safely process our feelings.”

We weren’t born suppressing our emotions. We learned to suppress our emotions because we learned from the people around us that we were not going to receive empathy and companionship with our feelings. Expressions of our feelings were met with silence, criticism, denial, and even punishment. Bad f — -ing things. At the same time, we learned that our physical pain would be taken seriously and met with some sympathy and support. So our bodies brilliantly channeled all our pain and emotions into the parts of us that would receive care and support when hurt. Fancy, smart moves from our bodies.

“We feel physical pain because it has a greater chance of being socially validated than emotional pain, and we stuff emotional pain down because we know we aren’t going to get empathy for it and the world around us has shown us it isn’t safe to process it,” Anna shared. Are there ways you’ve seen your physical pain garner more support and empathy than your emotional pain throughout your life?

The good news is that, as adults, we can seek out empathetic witnesses to our pain, like a trusted friend or a good therapist, who can offer us companionship that allows us to safely express our big feelings.

“Feeling our feelings without the presence of compassion makes our nervous system freak the f — – out because it feels exposed and vulnerable to potential threats. But feeling our feelings in the presence of compassion makes our nervous system feel safe,” Anna told me.

What is most important is for each of us to know we aren’t alone in our pain. “You are not crazy, and none of this is your fault. It is possible for you to find relief, and while you can never prevent all pain, it absolutely can get better,” Anna offered.

I know that was a lot of information about chronic pain and trauma! What kinds of emotions, including potentially unpleasant ones, does all of this bring up for you? However you feel, it is totally normal.

Want to read more? Grab a copy of the book, Healing Honestly: The Messy and Magnificent Path to Overcoming Self-Blame and Self-Shame!

The post Overcoming Self-Blame and Self-Shame appeared first on Medika Life.

Twitch is a platform that provides content creators the opportunity to livestream video games, cooking, political commentary, travel, or anything else that the creator chooses, so long as it falls within the platform’s terms and conditions.

Twitch enters into an agreement with each of its partnered content creators, allowing them to monetize their channels and splitting the revenue received from subscribers who pay up to $24.99 per month to support their favorite streamers. This arrangement has been lucrative for Twitch, and content creators with large followings can make well into the high six figures annually, with the very top echelon pushing into seven figures in earnings. Many leverage their fame and reach into other lucrative opportunities for sponsorships or content creation on other platforms.

Cracking the Façade to Find an Ugly Reality

One of those enormously successful streamers is a 28-year-old named Kaitlyn Siragusa, better known by her Twitch handle, Amouranth. She’s one of several young women who have attracted vitriol and blowback from some corners of the internet and media for leveraging their appearance, sexuality, and charm as part of their online personality to make a living. Whether you agree with her persona and presentation or not, you can’t argue with her success. Siragusa pulls in a reported seven figures per month, Twitch being her primary platform.

But the reality is much darker.

Beyond the standard harassment that any woman in the public eye, particularly in the historically male-dominated world of gaming and streaming – sadly experiences, Ms. Siragusa revealed on a live stream on October 16^th that she’s not actually single, as she’s represented in the past. In fact, she’s married to her trafficker.

She’s alleged she’s a victim of labor trafficking, her husband forcing her to stream and create content – some of it risqué – against her will. Live on stream she showed text messages from her husband in which he threatens her with financial abuse and her pets with physical harm if she doesn’t comply and keep up the facade. She claimed he’s taken control of her finances and bank accounts and has physically broken the door to the room in which she streams so she can’t lock him out.

“I’m basically living in a fancy prison,” she said.

The recording of the stream has since been deleted.

Toxicity, Misogyny, and Liability

Fellow prominent Twitch streamers broadcast their support for Ms. Siragusa across their own social channels, but a vocal contingent of her community and other streamers, some with enormous reach, had a different perspective.

The issue, they said, wasn’t that she had been forced to entertain them against her will. The issue was that she pretended to be single when she wasn’t and because they’d been duped, they deserved refunds for all the money they’d spent supporting her.

Twitch is no stranger to controversy, but this time feels different. The company has banked millions of dollars from its partnership with Amouranth, but it seems clear that those profits were the direct result of exploitation and forced labor. Does Twitch, or any organization for that matter, have an obligation to the people from whose efforts the company profits?

I’m not an attorney, but it seems unlikely that there’s any legal exposure for Twitch or Amazon in this case. Siragusa is an independent contractor and thus has none of the myriad worker protections that those with employee status enjoy. Further, there’s been no indication that she told anyone at the company about her situation before she came forward publicly on her stream. The moral argument is more crucial in this case.

Twitch boasts up to 8 million unique streams every month. More than 31 million people visit the site or use the app every day. They employ more than 1800 people globally. It a dominant player in the streaming space.

What do you do as an industry leader when such an ugly situation comes to light on your platform and the response from certain corners of your customer base and creator community isn’t sympathy or support, but anger, misogyny, and victim-blaming? This is a question that cuts to the core of the kind of company Twitch wants to be, who they want to serve, and who they want to partner with as a business.

What Comes Next?

The easiest thing that Twitch, and by extension Amazon, could do would be to ignore the situation entirely, to put the onus on Ms. Siragusa to manage the crisis on her own. That’s not how a responsible organization behaves, but it wouldn’t be entirely unexpected.

Though there may not be a legal obligation for Twitch to investigate whether this is an isolated incident, could a conscientious organization really fail to do so? Can a company live with itself, and what price will it pay in the court of public opinion, if it does nothing or stays silent when entangled in something as ugly as this that its directly profited from?

If you’re a woman who works at Twitch, or who streams on the platform, how would you feel about an organization that’s historically done relatively little to stem harassment and toxicity and is now silent after this revelation by one of their partners? I might find myself questioning how many other prominent young women on the platform are being forced to work against their will.

I would argue that the time is now for some introspection, and an evaluation of how the platform incentivizes content creators and protects potentially vulnerable individuals. Children as young as 13 can stream on the platform, after all. Is there more that Twitch could be doing? Almost certainly.

These are uncomfortable questions that should concern an organization if they’re being asked by employees or business partners, and even if the microscope of public scrutiny hasn’t found Twitch or Amazon yet, it’s only a matter of time should other content creators on the platform come forward, inspired by Ms. Siragusa’s bravery.

You can’t be dedicated to responsible business practices only when it’s convenient. It requires getting your hands dirty when things get complex and messy, taking ownership, and showing leadership. You don’t need to have all the answers, but people know the difference between right and wrong. Make sure they know that your company does too.

Neither Twitch nor its parent company, Amazon, have to this point issued a statement on the matter.

Ms. Siragusa published a recent video announcing that her husband is “getting help” and that she has regained access to all her finances and accounts and is “seeking legal and emotional counsel.”

The post Amouranth, Twitch, Amazon, and the Unraveling of Compassion and Common Sense appeared first on Medika Life.

Of course, it says that beauty is the be-all and end-all of our lives, and we should be rocketing toward that goal our entire life. Forget about education or career plans because beauty takes care of everything. How wrong can a tale be? Some research indicates that taller, more attractive people have advantages in career achievement.

What of those who aren’t beautiful as their culture demands of them? They are sentenced to life as vengeful witches or evil women with nothing but mean intentions and wickedness in their lives. Old crones are anathema to us, and that’s where the old, the “ugly,” and the wrinkled belong. What should we do since that wrecks our self-esteem and career goals?

When the women’s movement began in the 60s with the publication of books like Betty Friedan’s “Feminine Mystique,” the question of moralizing children’s stories, books, and the all-important bedtime fairy tale came under a new microscope. Most parents never suspected that the tales were derived from ancient rape, kidnapping, and child sacrifice stories. These were supposed to be tales of good-over-evil and a pleasant means to instill moral standards in children.

Bruno Bettelheim explained it in his allegedly plagiarized book, The Uses of Enchantment. He outlined that Sleeping Beauty had been a prostitute in the original Italian tale, and Little Red Riding Hood was murdered for her naivete.

But the “mirror” sentence stands out because none of the other tales have such a memorable line. I wonder what standard the new children’s books and bedtime stories convey. Marlo Thomas sang “You’ve Got to Be Carefully Taught,” and the question of beauty remains as kids learn to accept each other.

Should the old, the wrinkled, and the misshapen be banished? TV ads keep hammering away at the battle for “beauty” against wrinkles, so the unconscious message is that being old and wrinkled is unacceptable. We need to fight to plump up our skin, laser off those age spots, and build that core. The only good advice is related to keeping our core muscles in shape for better health and maintaining our ability to pursue our lives actively.

And, in the beauty biz, men are now one of the last areas of marketing pursuit with skin lotions, body washes, laser hair removal (chest, of course), and even subtle makeup to achieve that glow of the great outdoors. They are being pursued to use facial fillers and wrinkle-removing products to retain a youthful appearance and advance their careers. Think about the Neil Young lyrics for “Old Man.”

One of the best things I saw coming out of Tinseltown lately was that women and producers seek meaningful roles for women over 45. Yeah, that’s a female actor’s sell-by date for getting roles. After that, she can head for the food pantries and forget her health benefits. I believe Angela Lansbury helped with the latter by employing older actors on her TV show, Murder, She Wrote.

Is beauty always skin without wrinkles, or is it so much more?

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Earlier this year she was named one of the 50 top healthcare influencers by respected journal Medika Life  – in part a recognition of her work addressing inequalities, racism and sexism in maternal health.

The post HT World Correspondent and Medika Editor Gil Bashe Talks with the Medika50 Influencer Who Put Everything On the Line for Patients appeared first on Medika Life.