Living With Disability Can Be a Small ‘t’ Trauma

Content warning: The following contains discussions of trauma and death.

Sometimes I forget that I have, like, an actual degree in counseling. People come to me for advice, and it takes me a hot second to remember that I have, in fact, put the work in. I’m no longer an undergrad psych student with a passion for mental health advocacy.

I have chops. Professional chops. With thousands of dollars in student debt to show for it.

But I still get imposter syndrome, especially when friends come to me for advice. Who am I to walk people through the process of finding a therapist? I know the pros and cons of dozens of therapeutic modalities and can write essays about my theoretical framework of choice, but it’s surprisingly difficult to apply that knowledge in everyday life.

I’m so caught up in revising my novel that whenever I’m faced with the opportunity to whip out my master’s degree, I get a shot of adrenaline. You mean I didn’t spend thousands of dollars and years of my life on an education I’ll never use? It’s a miracle! A downright blessing! Suddenly, all the exams and essays and anxiety attacks over undergraduate research seminars become worth it.

Recently, a friend asked if it’s possible to exhibit trauma symptoms without a diagnosis of post-traumatic stress disorder (PTSD). I wouldn’t go so far as to say that trauma is my specialty, but I am drawn to the intersection of trauma and disability. As a society, we’ve come to associate trauma — and thus PTSD — with newsworthy headlines.

Freak car accidents. Assault. The aftermath of physical and psychological warfare. Veterans. Trauma is a big word of which many of us feel unworthy.

I can say from experience that denying ourselves a trauma diagnosis can be harmful. This isn’t to minimize the experiences of folks with PTSD, or to claim “all trauma as inherently equal.” But it’s important to acknowledge our deepest hurts, and to identify the ways in which we carry trauma throughout our lives.

Many psychologists differentiate between large “T” and small “t” traumas. The former is what we’d normally associate with PTSD: natural disasters, abuse, any instance of generally fearing for one’s life. The impact of the latter, while smaller, is easily dismissed, especially when we fall prey to comparison.

In my opinion, disabled folks are far too quick to dismiss their traumas. Our dance with death. Our reliance on able-bodied caregivers for everything from personal hygiene to household chores. Our experience with healthcare, from ignorant practitioners to painful — and sometimes life-threatening — procedures. It’s all trauma. And it all adds up.

I’ve written previously about my spinal fusion, but the truth is that I spent over a decade berating myself for my fear of anesthesia. Bursting into tears with a needle in your arm is one thing; hyperventilating in the waiting room because your doctor offhandedly mentioned the possibility of surgery is another. I thought I was weak. Childish. I hated the fact that I couldn’t seem to control my reaction to something as innocuous as a conversation.

The therapist in me realizes that I was — and still am — triggered by medical procedures. Even now, writing this column, I can feel my muscles tensing, my heartbeat quickening. My body is on high alert, slipping into fight-or-flight mode, and all because of a memory, something in the past that can’t hurt me now, as I’m safe and secure in the present. But that’s trauma for you.

I don’t have PTSD. I’m fine 99% of the time. But all it takes is a phone call. A recommendation made by a well-meaning medical professional. An event on my calendar, an appointment with a urologist about potentially getting a suprapubic catheter.

Nothing is set in stone. I can back out at the drop of a hat. But I’m already running the scenarios — that moment of weightlessness before the anesthesia kicks in, the journey down the hall in the hospital gurney, lights flashing above me, bright white and searing, telling my parents I love them one last time, just in case I don’t wake up.

That’s trauma for you.

We all have our trauma. Part of being human is wrestling with the small “t” and big “T” traumas that make up our lives. It’s easy for us as disabled folks to dismiss our pain as “not that bad,” because we’re used to it. But pain is still pain, even when we’re scared to look it in the eye.

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If this column has resonated with you, I want you to know that I see you. Grief work is hard, especially in the middle of a pandemic, and I am so proud of you for showing up. If you’re interested in learning more about the impact of small “t” traumas, I highly suggest “Ambiguous Loss: Learning to Live with Unresolved Grief” by Pauline Boss and “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” by Bessel van der Kolk. Feel free to drop a comment below, or reach out via email at [email protected]. My inbox is always open.

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Note: SMA News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of SMA News Today, or its parent company, Bionews, and are intended to spark discussion about issues pertaining to spinal muscular atrophy.