Dr. Blanton allowed me to continue on the NuvaRing for a couple more months, but after my next checkup, when I came back depressed and in pain, she didn’t hesitate a moment. She didn’t deny my pain. She didn’t make me feel as if I should be responding to treatment better or as if any of this was my fault. “Well, you’re not going to continue on this treatment plan anymore,” she declared brightly. “You’re not going to take something that makes you feel bad. Emotional pain is just as bad as physical pain, and we’re here to make you feel better.”
She took me off the NuvaRing and started me on pelvic floor physical therapy—fifteen minutes of stretches a day.
Within a month, I was feeling better. Shortly thereafter, she took out my copper IUD. That reduced my symptoms to the point where my pain was totally manageable. And—for the first time in the ten years I’d had my IUD—my premenstrual dysphoric disorder symptoms alleviated significantly. If I hadn’t had the courage to leave my crappy gynecologist, I’d probably be going through menopause right now.
And if I hadn’t had the courage to leave awkward Mr. Sweater-Vest, I might never have found the therapist who gave me the healing I so desperately needed.
CHAPTER 37
“The essence of what trauma does to a person is it makes them feel like they don’t deserve love,” the voice in my headphones said. I was on the train, on my way to yet another doctor’s appointment, but this statement rang so true that I dug furiously through my bag and pulled out a notebook to write it down. I was about to put away my pen when I heard another especially good line, so I kept it out, writing furiously on my lap.
My friend Jen, who often sends me little poems and links throughout the day, sent me this podcast—Road to Resilience, a show put out by the Mount Sinai Health System. This episode, “The Long Arm of Childhood Trauma,” features comedian Darrell Hammond, who is a C-PTSD survivor, speaking with Jacob Ham, a psychologist at Mount Sinai. It’s nice that a celebrity like Hammond is out here normalizing the condition. But it was Ham who excited me. He kept spouting off some of the best nuggets of trauma-based truth I’d ever heard. Especially when he talked about the Incredible Hulk.
He explained that Bruce Banner was abused as a child, and as a consequence, he developed a trauma-informed rage. Then he was blasted by gamma rays that made his rage an actual superpower. Ham said the Hulk operates exactly like someone who has been triggered. As his rage grows, his IQ decreases. He can’t speak, he can’t form complete thoughts, he loses self-awareness. All he cares about is what’s in front of him and how he can protect himself. And he can’t turn the Hulk off immediately—it takes time for him to calm down, sleep it off.
“The…thing I love about the Hulk is that he’s not a villain. He’s actually one of the most badass superheroes in the whole universe, right?” Ham said in my headphones. When your own triggered Hulk starts to come out, the reflex is to think, Oh no. I’m getting rageful. I’m turning into a monster again. No, stop, Hulk! Go away! But Ham takes an opposite approach. He talks to his own Hulk tenderly. “What I’m trying to do is to say, like, ‘Hulk, you’re back? You think that I’m in trouble? Oh, thank you so much for loving me so much that you’re trying to protect me.’
“Make friends with the Hulk,” Ham asserted.
I still felt so much shame when my Hulk emerged with all its terrifying rage. But to frame it this way was comforting. That rage is not always evil. It can even be productive if deployed correctly.
Then Ham said that we as a society should be tolerant of Hulks sometimes. He advocated explaining your Hulk to others. To tell those close to you, “Sometimes he comes roaring out. And then as soon as the Hulk is gone, I’m going to be back. But please don’t mistake me for my Hulk.”[1]
It would feel so safe to have everyone in my life understand where I’m coming from just a little bit better. I was immediately inclined to text this podcast to everyone I knew, but I stopped myself. I was full of questions. How could I ask people to tolerate my Hulk? Wouldn’t it be considered selfish? Why shouldn’t everyone just get rid of their Hulk friends? So as soon as I got home, I found Ham online. He is the director of the Center for Child Trauma and Resilience at Mount Sinai. I shot him an email, explaining that I’m a journalist researching trauma and I wanted to know more about effective treatments for C-PTSD…and I had questions about his Hulk comparison. He replied eight minutes later, asking me to come to his office next week.
* * *
—
Jacob Ham has a small office down a sterile tan corridor at Mount Sinai. His office decor is straight out of a CB2 catalog: modern gray furniture, soothing-yet-hip blue-gray walls, decorative wooden…doohickeys. The kind I’d pick up and examine at a store, then shruggingly put back because they were too expensive. A cubed bookshelf filled with trauma books, snacks, and games for his kid patients. A standing desk.
He greeted me with a mixture of warmth and hesitation. He was smiley and slim, with glasses and good Korean skin. Was he thirty-five or fifty? No way to know. He moved gracefully around his office, as if everything were made of glass.
In contrast, I sat down with a loud flop on his gray couch, yanked my recorder out of my backpack, and immediately got down to business: I loved your podcast, such a fan, so interesting, the Hulk part! Wow! Yes, sit here. Yes, your mouth should be this far from the microphone. What did you eat for breakfast? You sound great!
And then I launched into my questions. “So I’ve read a bunch of trauma books, and it seems like there are a lot of tactics for intervening in traumatized children’s lives but not so many solid answers for what to do with adults, particularly for complex PTSD. It seems like techniques like biofeedback or EMDR or CBT or IFS or MBSR or a bunch of other crazy acronyms can help for singular trauma, but for people with complex PTSD, these therapies are less reliable. So for someone who has C-PTSD, where do you start as a clinician? How do you treat them?”
“I trained in five different evidence-based treatments for trauma: TFCBT, attachment, self-regulation and competency, something called STRONG Families, and child-parent psychotherapy. But I currently use modern relational psychoanalytic approaches. And I really do think that it’s through the relationship that I get to exercise different experiential states, self-states that are free from trauma,” he said.
I nodded, trying to act smart. “Oh…”
I tried to pull more out of him, but each explanation led to another confusing explanation. He spoke abstractly about different kinds of attunement and the relationship between prefrontal cortex deterioration and attachment issues. He kept saying he practiced “pulling for poignancy,” which I felt like I should get but didn’t. All of these terms and phrases were familiar, so why didn’t I understand him? Would admitting my confusion make me seem like a bad journalist?