A serious or frightening medical experience can affect us long after the immediate physical danger has passed.
For some people, this follows an obvious medical emergency: a sudden heart attack, emergency surgery, an intensive-care admission or an experience in which they genuinely feared they might die.
For others, the experience may be less straightforward. Perhaps you developed sudden or unexplained physical symptoms, went through repeated investigations, experienced frightening episodes without knowing what was happening, or felt powerless and unsafe during medical treatment.
Even when the physical problem has been treated or stabilised, your nervous system may not immediately receive the message that the danger is over.
What is medical trauma?
Medical trauma refers to the psychological impact of frightening, painful, invasive or life-threatening health experiences.
It is not determined simply by how medically serious an event was. What matters is also how the experience felt to you.
A medical experience can be particularly difficult when there was:
- a fear of dying or becoming seriously disabled;
- sudden loss of control;
- severe pain or breathlessness;
- uncertainty about what was happening;
- emergency treatment or surgery;
- frightening procedures or hospital experiences;
- difficulty communicating or feeling heard during treatment;
- repeated investigations without clear answers;
- or a sense that your body could no longer be trusted.
For some people, the medical event becomes a clear dividing line between life before and life after.
What can happen afterwards?
Following a frightening health experience, people sometimes notice that they have become much more alert to changes in their body.
A racing heart, dizziness, shortness of breath, chest discomfort, pain or another unfamiliar sensation may trigger an immediate sense of danger.
Thoughts can quickly move towards:
What if it's happening again?
What if this is something serious?
What if nobody finds out what's wrong?
What if I die?
This can be particularly confusing when the original event involved real physical danger. Your fear did not come from nowhere. At one point, your body really did give you reason to be afraid.
The difficulty is that the nervous system can sometimes remain on high alert long after the immediate threat has passed.
People may experience:
- panic when they notice physical sensations;
- repeatedly checking their pulse, blood pressure or other symptoms;
- difficulty trusting reassurance from medical professionals;
- fear of hospitals, procedures or medical appointments;
- intrusive memories of the original event;
- nightmares or disturbed sleep;
- avoiding exercise or activities that increase heart rate or breathing;
- becoming frightened when alone;
- repeatedly seeking reassurance;
- or feeling constantly watchful for signs that something is wrong.
Some people describe losing their previous sense that their body is fundamentally safe.
"But what if there really is something wrong?"
This is an important question.
Psychological therapy should not involve dismissing new or concerning physical symptoms as anxiety. Appropriate medical assessment remains important, particularly when symptoms are new, changing or medically concerning.
The challenge for some people arises after appropriate medical investigation or treatment, when the nervous system continues to respond to bodily sensations as though another catastrophe is imminent.
It is possible for two things to be true at the same time: you can take your physical health seriously and work therapeutically with the fear and trauma that developed around it.
The goal is not to teach you to ignore your body. It is to help your system become better able to distinguish between a present medical emergency and a reminder of a previous frightening experience.
How might EMDR help with medical trauma?
EMDR — Eye Movement Desensitisation and Reprocessing — is a psychological therapy used to help people process distressing or traumatic experiences.
A frightening medical event can sometimes remain stored in a way that feels very immediate. Something in the present — a physical sensation, hospital smell, medical appointment, pain, a television programme or even hearing about somebody else's illness — can activate the fear associated with the original experience.
You may intellectually know that you are safe now while another part of you reacts as if the emergency is happening again.
EMDR aims to help the brain process these experiences so that memories of what happened become memories of something that happened in the past, rather than experiences that continue to trigger the same level of danger in the present.
Therapy may involve working with memories such as:
- the moment you realised something was seriously wrong;
- being taken to hospital or into surgery;
- hearing frightening medical information;
- waking after an operation;
- experiencing severe pain or difficulty breathing;
- feeling trapped, helpless or unable to communicate;
- waiting for test results;
- or a particular moment when you believed you might die.
The work may also address current triggers and fears about the future.
EMDR is not about convincing you that nothing bad will ever happen
After a serious medical experience, it is understandable to want certainty that it will never happen again.
Unfortunately, neither therapy nor medicine can provide absolute certainty about future health.
The aim of therapy is different.
It may help you move from:
"Something could happen, therefore I am never safe"
towards something more like:
"I went through something frightening. I can take appropriate care of my health without living as though another emergency is happening every day."
That can make a significant difference to quality of life.
Is EMDR suitable for everyone after a medical trauma?
Not necessarily, and therapy does not always begin by immediately processing the most frightening memory.
The first stage is usually understanding what has happened, what is currently triggering distress, how you respond when you feel unsafe, and what support or stabilisation may be helpful before trauma processing begins.
For people with ongoing medical conditions, therapy also needs to remain grounded in the reality of their current health situation.
A thoughtful assessment can help determine whether EMDR is appropriate and how the work should be paced.
Rebuilding a sense of safety after a health crisis
One of the hardest consequences of medical trauma can be the loss of a basic assumption that many of us previously took for granted: my body will probably be okay.
After a heart attack, frightening diagnosis, traumatic surgery, unexplained physical symptoms or another serious health experience, that sense of security can be profoundly disrupted.
Recovery does not mean pretending the experience did not happen or convincing yourself that you will never become unwell again.
It can mean being able to remember what happened without repeatedly reliving it, respond to your body without immediately expecting catastrophe, and gradually return to a fuller life.
BlueSky Psychology currently has availability for online EMDR therapy for adults across Ireland. Our psychologists providing EMDR work with a range of trauma-related experiences, including difficult or frightening medical experiences.
