What is Sanctuary Trauma? Could it be the Cause White Coat Syndrome | Ep. 28 (Audio Only)

Welcome to my podcast. I'm Dr. Nicole Cain, a naturopathic doctor with a master's in clinical psychology and a former anxiety sufferer turned anxiety freedom rebel. Hey there, loves. It's good to see you. Today we're talking about a topic that's pretty near and dear to me, and it's something that I get a lot of questions about, and it's about Dr. Anxiety, aka White Coat Anxiety. And so the questions to start today is, do you get anxious when you go to the doctor? Are you terrified that they're going to find something wrong with you or that you're going to get bad news, that your blood pressure is going to be too high, or that they're going to give you a diagnosis of some sort? Are you avoiding going to the doctor at all costs? And have you been putting it off? Or maybe you've had a negative experience with the doctor or you have had sanctuary trauma? Today, I'm going to teach you the secrets to solving White Coat Syndrome and to clear that anxiety and to talk about why that anxiety is happening. And I'm going to share with you something that nobody else is talking about. We're going to actually uncover the actual reason you're afraid of going to the doctor. And over the next minutes together, you're going to learn three strategies to deal with Dr. Anxiety once and for all. And I want you to imagine a life where you aren't afraid of going to the doctor, where you're not worried about getting bad news, where you are able to show up at your doctor's visits from a place of power instead of a place of feeling afraid and like a victim or unsure or insecure, imagine how that would change your life. Imagine how that would impact your family members and those who love you. If you had the confidence to be able to go to the doctor from your best and highest self. Sounds really great, right? And that's possible. And I'm a testimony of that. I'm a testimony of being able to take center stage in my life instead of letting my fear of the health care system, my fear of the doctor, my trauma, the things that happened to me as a result of a faulty health care system, in no longer letting those run my life. And so I am a testimony of that. And having one foot in clinical psychology and the other in integrative medicine and naturopathic medicine, I am going to bring to you three powerful strategies that will help you deal with this doctor Anxiety once and for all. We have to start by defining two things, and that's white Coat syndrome and sanctuary trauma. White coat syndrome is basically where a patient experiences an anxiety response in the presence of a doctor or a health care provider or a clinician, if you. It could be even the lab tech. And initially this was observed in people. They would go to the doctor, they get their blood pressure taken, and then whenever a doctor was taking their blood pressure, someone in a white coat, it would go way up. They're nervous, they're having this fight, flight, freeze, flaw and response, this anxiety, nervous response, and their blood pressure would go up. And so they called this white coat syndrome. And we're seeing, as we grow in our awareness of this pain patterning is that it could be more broad. It could be anything from my blood sugars are going up in the moment, or I'm crashing in the moment and I feel sweaty and nauseated and scared, or I feel restless or tingly, or my heart is throbbing, or some people, they get anxiety or they get diarrhea, or they get pains in their stomach and their gut or their muscles, their necks and their shoulders when they go to the doctor. And it's all a mechanism of the same thing. And there's many reasons that you may fear going to the doctor. It may be because you had a bad experience. It may be health anxiety. It could be really because of trauma, something that happened to you in the past. And that's what I want to focus on today. Have you heard of sanctuary trauma? Sanctuary trauma is when something that's a form of trauma happens in a place that should be safe, a place where you should be able to be vulnerable, a place where you should be able to be really real and not have your guard up. And when trauma happens there, that sanctuary trauma. And I'm going to tell you a story about my sanctuary trauma. I was 12 years old, and around that age I started having some asthma, running outside in the cold air in the grass. And so I expressed it to my parents, and they took me to prime my primary care doctor, who then referred me to a specialist. And I remember this like it was yesterday. And so I'm sitting in the specialist office, and he opts to choose to do a certain type of diagnostic test where you inhale a chemical and if it induces asthma, you have asthma. And so he gives me this chemical. I'm inhaling it with a nebulizer, and I start to suffocate, and I'm terrified. And I remember looking over at this doctor in his white coat and he's like, yes, it appears that she does have asthma. And he's writing notes and my caretaker, my parent is like interesting. And I'm powerless, I'm panicking, I'm scared, I can't breathe. And it felt like a million years. And the doctor came over and he changed the chemical. He gave me an albuterol. My bronchials open and I can breathe. And that is called sanctuary trauma. That doctor should have been protecting me, he should have been taking care of me or at least explaining to me what was going to happen. And then when that occurs, our body responds in an amazingly brilliant way to protect us. It creates an ego state, it creates a part. And as an adult I look back at this experience and I see that little 12 year old me who formed this part to protect myself with such compassion. And I have so much mercy for her. And I think about how I have had such a distrust of the medical system for so many years. And that part was harmed by the medical system in a way. She was frightened, she was powerless. And her mission was to give me power. And the way that I had power after that was to be very fearful and skeptical of doctors, which has served me well until it started to run my life. Make sense how our parts can emerge to protect us, to make our lives more hypervigilant, to look out for that. And it's okay when it's a warning signal and it's rightfully in its role as a warning signal, but when it starts to take center stage and starts to control you and controlling your decisions and running the show, that's when that part has taken its role a little bit too seriously. And that's what we're going to work on today. And I want you to remember that it doesn't have to be dramatic in order to be traumatic. That trauma is defined as anything that overwhelms your nervous system. And so that means you can have five people go through the same thing. And their nervous systems are all equipped with different ways of managing that, different levels of distress tolerance. And that comes from our genetics, our resources, our environment, our home, our families, our self confidence, our biology. All of these different variables come together to create something called affect tolerance. Affect tolerance we describe in the ACT method as our ability to tolerate affect. And sometimes trauma overrides that and other times it doesn't. But in those moments when it does, when we can't deal with it, our body does the best that it can and it can create a part or an ego state. And we'll talk more about this in just a couple of minutes. But the goal, the goal of the work that I'm going to teach you is to be able to shift from feeling afraid, shift from that fight, fight, freeze, fop response, into confidence, self control, and calm. And there are three solutions that you're going to learn today, three solutions that you need in order to finally send White coat syndrome and Dr. Fear backstage where it belongs. And that's doing parts work, role reset and empowered communication. So we're going to explore these more together today. I also want to let you know that at the end of this, at the end of what we talk about today, I actually have an exclusive offer that I want to share with you. And it's free. And so stick around, because this is just a toe. It's a toe in the water of stuff that works. So stick around. I promise you're going to love it. Okay, so parts work. Let's dive into that. When we show up to the doctor, we are bringing our presenting self, our now self, and all of our past selves. What does that mean? And this is the foundation of the study called Parts Work. And parts Work recognizes that all of our current experiences are impacted by our past experiences. Whether it's positive or negative. Our life events creates a lens through which we see the world and interact with the world. You may have heard of this, referred to as ego state, which was developed by psychotherapists John and Helen Watkins of 97. This was 10 years after Francine Shapiro came out with EMDR, which is Eye movement desensitization and reprocessing. And Shapiro was blowing the tops off of the research in how amazingly effective EMDR was at helping with trauma and helping with anxiety, at helping with depression and ego state and EMDR marry together in an incredible way, which you're going to learn today. Let me share with you an example. Have you ever felt anxious or sad or even physical symptoms, but you didn't have the words to express why you felt that way? It's just the way you felt, right? We know that there's a strong link between the mind and body, but sometimes we just can't access the words to take us from the body into the mind where we can process it and understand it and deal with it. As you can imagine, this is where cognitive behavioral therapy and talk therapy really falls short. The counselor, the person you're speaking with, asks how you feel. Is it logical, how you want to change how you feel? And you. You don't know. You just shrug. Talk therapy leans on logic. And sometimes our emotions are outside of logic, sometimes they're outside of words. And they're just pure sensations. Have you ever had that happen where you don't know why you feel the way you feel, but your body is just on all cylinders? Right. This is where ego state, this is where parts work can save the day. Ego state therapy and parts work therapy creates a linguistic bridge to help bridge the gap between the way you feel in your body and in your emotions to the logical centers of your brain so that you can heal. In other words, parts work gives words to your experience when you don't have them. So let's say I go to the doctor and I'm sitting in the exam room on a cold, sterile examination bed which is covered with that crisp white cold paper and I'm looking at posters on the wall of all of the health things that could go wrong. And a part of me, that little girl, that 12 year old part of me remembers, white coat equals being forced to inhale. Chemical equals suffocation. That part associates doctors with danger. And even though I know logically now that I'm no longer 12 years old and I'm no longer back in that office and that is not that doctor that I'm going to see and that I'm all grown up and I have autonomy, she doesn't know that. And so in an attempt to protect me and get me out of that dangerous situation, that 12 year old, that part, that part of the brain that doesn't have access to now, that doesn't have access to language, starts to provoke a fear response, right? Right. So cortisol rises, adrenaline rises, my heart is beating faster, my body temperature rises, I start sweating, I'm poised to run, my muscles are trembling. My doctor, she may come in and check my blood pressure. And now it's increased. And so, of course, now I'm afraid there's something wrong with me, causing my blood pressure to go up and on, end, on, end, on. Does any of that sound familiar? Does anyone here relate to that? As you're seeing underlying parts that have endured negative situations with, doctors will continue to inform you of their experiences even years down the road. Their goals are to protect you. Just like hearing the growl of a hungry tiger in the woods protected our ancestors from becoming lunch. The growl of fear and anxiety is trying to remind you. Hey, this is reminding me of something scary. And I'm going to need you to listen. Up, up. And that's why the more we suppress anxiety, the more we ignore anxiety, the louder it gets. Are you with me? It may start as a little rumble, a little blip in our stomach. And it can build and build and build over time, whether suddenly or even over years into some full blown panic attacks, or maybe even rage attacks, or maybe even just despair and learned helplessness where you just feel like giving up. Have you ever felt that way? While your parts are well intended, they are also uninformed of the here and the now. And that is because of how your brain stores trauma. Think about it this way. If your brain learns that hearing the growl of a tiger equals danger, it's more advantageous for your brain to interpret it as a current danger. So you continue to be afraid of growling tigers, or at least anything that resembles that, as opposed to to your brain hearing that growling like sound and thinking, oh, that's the past. Right. So what that means is that your brain doesn't timestamp trauma. You have to timestamp trauma. And I have two free webinars that will teach you exactly how to timestamp trauma. I have one is called the three Minute Hack and then there's the more advanced one called the Anxiety Freedom Masterclass. And in both of these you're going to learn how to identify your partner heart or parts that are holding onto the trauma, that are holding onto those past events that are coming up and trying to protect you in well meaning ways, but are running your life. And with these free resources you will get the skills to actually heal, heal that inner powerless child and take back your life. Being anxious doesn't change the past, it doesn't change the present and it doesn't change the future. But it definitely changes you your experience, right? Would you rather avoid dread going to the doctor, maybe missing visits, or maybe you want to go to the dentist and you want to get dental work done, but you're so terrified of going to the dentist because of what ifs, or maybe the white coat, or maybe it's not logical and it's just in your body and every time you try to make yourself go, you fall into despair or panic or grief, Right? Which would you rather? To have control over that and to send anxiety backstage and to not let it be center stage anymore, to not let it control you, but rather send it to the side where it can whisper, hey, pay attention. And you can say, I got your message, I hear you, I honor you and I'm in control. Which would you rather? You don't have to be afraid. There are resources that work. I am a walking testimony of that. And I've worked with thousands of people to help them turn the page in their anxiety. And I want to give you Free resources on how to do this work. And I have two webinars for you. And there's no risk to taking these webinars. You just simply download it onto your computer and watch it at your leisure, totally free. When you do sign up, I will send you free and helpful emails. But if you don't love the emails, you just unsubscribe. We're not going to spam you. Remember, you have resources now that you didn't have when you were little. It's time to send anxiety back into its rightful place as a warning signal and not the star of your show. It's time for you to take center stage and own your strength. It's in there. It's just been backstage, it's just been waiting. And now it's time for you to let it show up for you in a real way. And remember, sometimes scary or negative events do not have a linguistic bridge. Which means you may not be able to logically remember or identify or think of past events that are extremely impacting your current experience. And that is the nature of trauma. Remember, it doesn't have to be dramatic to be traumatic. Maybe for your little self it was a big deal and for your now self it doesn't resonate. And this is the magic of parts work. And so even, and especially if you can't put your finger on any events that might be making you feel anxious about going to the doctor today, this step is profoundly important. So I want to go to number two. I know this is just the beginning of three. So this is rule reset. And when it comes to the second secret of overcoming Dr. Anxiety and white coat syndrome and taking back your power, it's absolutely necessary to remember who's the boss. Hint that's you. Remember, the doctor is your customer. You or your insurance are paying them to take care of you. You are paying them to take care of you. You have to shift the power dynamic. There's this hierarchy that drives me crazy in medicine where the doctor is seen as the holier than thou, most amazing, high wise, all knowing clinician. And I come from that culture and I want to help you break that down. Because while yes, your doctor likely knows more than you about how to take blood pressure and run tests and differentially diagnosed and all of those things, that's why you see them, right? But you know your body, you know your history, you know yourself. And so it's time to take back your power and approach your medical encounters with your doctor with equal authority. By changing that dynamic from hierarchical to collaborative, you are going to be taking leaps towards freeing yourself from the delusion that your doctor's assessment is end all, be all. And that starts speaking to the fear of getting a diagnosis, the fear of being told that something's wrong with you. I could talk for days, nonstop about story after story of people being misdiagnosed or being told something that never happened. And that's why it's so important to take data, but don't take it as the end. There's always a period followed by the opportunity to turn that into a little bit of a comma at the end of your sentence, right? In my story, it was clear I had asthma. I struggled to breathe when I was playing outside in the grass. And my doctor had the choice to chemically induce an asthma attack for his own confirmation and sit there and take notes while I felt like I was suffocating or that doctor could have approached the situation differently. The treatment would not have changed, but my experience would have. While I can't change what happened to me as a child, I can make different choices as an adult. And you have that power now, too. You're no longer little, you're no longer back where you were, and your parts just don't know that yet. As an adult, I have the personal power to pick who I want to see. Someone has good bad side manner, a philosophy that resonates with my own, who's willing to work collaboratively with me and to respect me. I get to decide the tests that I feel are best for me and to decline others. Yes. I get to say no. As a child, I didn't have the power. And maybe you didn't either, and you didn't get to say no. And so today, take back your power. If you have a doctor who's unkind, who's treated you with disrespect, who doesn't honor your autonomy over your body, then fire them. You have permission to do that. I hope you hear me as I say this. Are you listening? You have permission to fire them. You're worth finding the right fit. Especially in a society where telehealth has opened the doors to accessibility to doctors that are outside of our community borders. Your options are now better than they have ever been. Don't settle. It's time for a role reset. It's time for you to take center stage and to make sure that your doctor is your co star. So the third one, this is empowered communication skills. And this last step is described in the House of Boundaries in the act method. And I want to teach you about the cable criteria. Cable is mnemonic that's considered necessary for you in engaging in relationship in a healthy way with somebody both personally and professionally. Cable stands for communication, boundaries, listening and empathy. So let's start with communication. Your doctor needs to take time to communicate to and with you. Notice I said to and with. It's not just one sided, it needs to be collaborative. Right. So communication also involves nonverbal communication. Is your doctor multitasking while talking with you? Are they typing on their computer and staring at the screen? Are they even facing you? During your visit, I've heard stories from my patients about going to their doctors and their doctor is just facing the wall so they can type on their computer and they're not talking to them at all. It's not effective communication and it's definitely not honoring the patient doctor dynamic. Right. You deserve someone who can communicate with you and who uses good bedside manner and good nonverbal communication to show you that they care. So that should be a criteria. The second is boundaries. Boundaries are necessary. In my childhood story, the doctor wanted to run a test and my. If my adult self had been there, I would have questioned the doctor and said, absolutely not, not happening. And a doctor who respected boundaries would have respected that sometimes you put up a boundary because we need more information. And so if you're feeling resistant, if you get what I call yellow lights inclinations that you need to slow down and not move forward so quickly. The good boundary is to be able to express that doubt and to ask for more information. And a good doctor will give you what you need in order to feel comfortable. Whatever direction you go, your doctor should have time or make time to hear you, respect you and talk about your feelings and to not push you beyond where you are comfortable. As I say that, I do imagine that there could be a pause, that sometimes we don't know if we should do a test, sometimes we don't know if we should do a certain type of treatment. And what. I'm not talking about not listening to your doctor. I'm talking about us having a boundary and the doctor respecting that. And so I want to make sure that we're clarifying the difference between those 2. Because boundaries versus uncertainty and guidance, those are different conversations, right? So I just want to make sure we talk about that. The L is for listening. You deserve to be heard. You deserve to be respected. And no matter what age you are, you deserve your doctor to talk with you. You. When I was teaching medical students at the medical school, we would sometimes have a patient Come in an older patient who would bring in their child who is an advocate for them. And oftentimes the students would be inclined to talk to the. To talk to the child and not to talk to the adult. And so what would happen is that the adult would feel more demoralized, not feel like they're being advocated for. And that is not listening. That's not having a good doctor patient relationship. And so when you go to your doctor, you want them to listen to you. If you bring a family member, and that's great. But make sure that your doctor is listening to you and your needs. If they are going to assess you and order the right testing for you and make the right treatment recommendations for you, they need to be able to listen to you. Right? And then e is for empathy. Empathy is the action of understanding, being aware of, relating to, or even vicariously experiencing the thoughts, the feelings, the experiences of others. Empathy lives hand in hand with compassion and respect. If you have Dr. Anxiety, the ACT method teaches us to look at our social cast of characters. These are the people that are around you, your community, your family, your and your health care practitioners. Right? And while doing the parts work is important and profoundly healing, it's also important to take an audit of your health care providers. Using the cable criteria will help you decide if this provider is a good fit for where you are and where you want to be and to help you pursue the healing that you deserve. In today's lesson, we learned about the secrets of why you may struggle with Dr. Anxiety and White Coat Syndrome. We introduced two concepts from the ACT method for anxiety freedom. We talked about the psychological cast of characters, your parts. And we also talked about the social cast of characters. And we talked about creating boundaries for yourself so that you can protect yourself from things like sanctuary trauma or just doctors who aren't respectful of you. And then of course, you're going to be anxious. Right? We talked about changing the experience from a hierarchical model to more of a collaborative model. Your doctor gets to be the medical expert and you get to be the expert of you. This stuff is powerful. And for a limited time, I'm offering two teaching sessions totally for free. This is the first, the three minute hack. While it teaches you to quickly dive into your parts and saves you a lifetime on a clinician's couch, you can do this from the comfort of your own home. And we also have the Anxiety Freedom Masterclass, which is an advanced way of diving in and doing this work. And so I highly encourage you, if you have health anxiety, if going to the doctor gives you dread. If you're tired of anxiety controlling your life, take advantage of these free resources. There's literally no risk if your anxiety is impacting your loved ones. If fear is causing you to avoid facing a health issue head on, give yourself the opportunity to try something different. Take these free webinars. They're completely risk free. Bring my gift to you because my 12 year old self needed this and I expect that maybe some of your little selves and your now selves do too. I've been there. I get you. I honor you, I empathize with you and with my experience in clinical psychology, my other and integrative medicine. Know that I've got your back. I've changed my own life and I've helped thousands of others change theirs. Will you take the risk free opportunity to change your own? Check out the free resources today. Babe, you're worth it. Thank you so much for being here. We'll make sure to put the tab the information in the below and I will definitely talk with you next time. Thank you so much. Bye.

The recording you just listened to consists of the personal opinions of Dr. Nicole Caine, a naturopathic doctor with a Master's in Clinical Psychology. While these opinions are based upon literature, her counseling education, medical training, and clinical experience, this content should not be viewed as the definitive opinion on these subjects. Listening to this podcast is not a substitute for any sort of medical, psychological or other form of treatment. If you are in a Crisis, please call 911-OR call the National Suicide Prevention Line at 1-800-273-8255. If you're in need of counseling, don't hesitate to make an appointment with a counselor in your area. Dr. Nicole Cain is so passionate about people getting their life back. If this resonates with you think this podcast would help someone you love? Please share it with them. Stay in the conversation with Dr. Nicole Caine about writing the next chapter of your life so that it plays out just the way you want it. Explore your options for working with her at www. Dr. Nicolecane.com that's Dr. D R Nicole N I C O L E Caine C A I N.com when you're there, be sure to take advantage of the free Anxiety Freedom One week challenge. We look forward to seeing you on the next episode of the get your life Back podcast. Here's to your next chapter.

Sam.