What Even IS A Stomach?
Beyond the Book: Thoughts on trauma and the mind-body connection
cw for discussion on food, disordered eating, and trauma
It starts with the world’s most boring mystery.
Last week, in the middle of the night, I found myself doubled over in unbearable pain. Again. It was radiating up my back and wrapping around my ribcage. I had fallen asleep feeling fine and then woke up in agony. The pain didn’t subside for hours. After the pain meds didn’t work, pacing the floor didn’t work, sedatives didn’t work - I started to panic. Then I felt like I couldn’t breathe.
This was the second time in about a week or so that I’d experienced this sort of attack. And it was a pain I had remembered cropping up every few weeks for many years. I try to avoid googling body ailments because I always come out of such internet sessions hyperventilating, convinced I’m dying of cancer (find me a google search for a body ailment that doesn’t end in cancer and I’ll name my next pet after you). But I was desperate, and I knew that if this was happening to me with such frequency then it must be happening to other people as well and surely at least one of these people has found a solution.
I remembered that I had eaten the same meal from the same restaurant that I had eaten at the last time this attack of back pain happened. So I wondered if maybe it was some sort of allergic reaction that somehow caused back pain. Starting with that premise was a smart move because a search for “can certain foods cause back pain” quickly turned up an option for back pain associated with stomach upset. My searches said that sometimes stomach pain is felt through the back, and often is associated with IBS.
I knew almost nothing about IBS but further searches had my symptoms line up quite neatly with IBS (type C). I’ve had at least 20 years of digestive issues that I’ve regularly either written off as just having a “weird body” or decided that people who poop more than once a week are the weird ones. That’s sort of beside the point though, because I still need to see a doctor for a more firm diagnosis.
So why am I writing this?
I’m writing this because as I finished eating breakfast this morning, my back started hurting again. My immediate thoughts were, “Oh did I sleep weird?” “Was my posture that bad last night when I was watching tv in bed?” But the ache in my back wasn’t a sharp pain, it was the radiating, throbbing pain I’d had just last week. I looked down at the remains of my breakfast: Coffee with oat milk creamer, a bagel with butter, cantaloupe with yogurt - the really good full fat with added cream kind.
I’m lactose intolerant. My mom, sister, and brother are as well. My two sons are. With the addition of a partner who is also lactose intolerant I have often marveled at how in this household I’m the only one who can seem to indulge in dairy (within reason) without paying much of a price outside of some gas. I’ve had to pick my kids up from school early because the milkshake they begged for the night before had kept them in the bathroom the first two periods of school the next day. When I was their age I too used to have horrible stomachaches after eating dairy that left me pretty incapacitated for hours. But over the years that had faded to an extent that really surprised me.
As I stared at my breakfast and felt the pain radiating up my back I realized that I was likely experiencing stomach pain. I closed my eyes and tried hard to concentrate on my body. The feeling of unease that was filling me. Was that anxiety, my old friend? Yes. But behind that it was….nausea? Yes, that might be what nausea is to me today.
It might seem weird to have to sit and concentrate to figure out if you feel nauseous or not but as I realized that I was probably experiencing nausea it all clicked into a long, familiar pattern in my relationship with my body, especially with my digestive system. It doesn’t exist.
The relationship, that is. Pretty sure my digestive system hasn’t gotten up and walked away (although if it did, I likely wouldn’t have noticed).
The first time I passed out due to low blood sugar was in the first grade. It was certainly not the last. Years of iron supplements, vitamins, doctor recommendations, nothing helped. By the time I hit high school I was swooning like I was a white maiden in a Jane Austen novel who had just been told that we could only afford 5 household servants due to our now “reduced circumstances”.
There was about a 10 year period of time between my mid-twenties and mid-thirties where things were a bit better. I was only swooning about once a month and full-on passing out and hitting the floor about once a year, if that. But then it started to get worse again.
My partner is the sweetest, gentlest human I’ve ever had the pleasure to know. Which makes his hanger even more adorable. He’s never mean when he’s hungry (he’s never mean ever). I’d hesitate to even call him difficult. He just becomes ridiculous. His ability to… can… just absolutely disappears. Any inconvenience might just end him. Whenever I see this beautiful patient being look like he’s going to melt into a puddle of goo because there’s a sound that he just suddenly can’t stand or there are too many people just existing around him I know that we need to get food in him.
I like to tease him a bit (a bunch) once his blood sugar is back up and his sense of humor has returned.
The last year or so, though, my partner has started looking at me at seemingly random times of the day and saying, “we need to get some food in you.” I’m always surprised and used to always want to argue. I’m not hungry, I’d say. I’m just tired. I’m just a little sick. Maybe I’m coming down with something. I am just anxious. Maybe it’s the heat. Even though I hadn’t eaten yet that day and it was, say, 3pm, I surely wasn’t hungry. But Gabriel would convince me to eat and then I’d find myself feeling better. Hmm…
A few months ago I walked into our room and said to Gabriel, “I don’t think I can tell when I’m hungry.” He nodded solemnly and, to his credit, didn’t say, “DUH.”
We’ve tried to work together to figure out what hungry feels like in my body. When I’m exhibiting outward signs that my partner has associated with my needing to eat, he will sometimes ask, “what are you feeling in your body right now?” and I’d concentrate on my body and try to describe what I was feeling in the moment. At times it felt like we were making progress. A few times after working on it more steadily I even said, unprompted: “I think I’m hungry,” and Gabriel would enthusiastically cheer my body recognition. But the moment I’d become stressed by work or family or a combination of the two, all progress would fly out the window.
I’m also somebody who is always racing to the bathroom to pee (I bet this is not the newsletter you thought you were going to read today, is it). I don’t go often - legit only once or twice a day. I chalk the low frequency up to my aversion to water. But even when I’m trying to be better and at least down a decent amount of La Croix in a day, I don’t go much more. When I do need to go I’m suddenly running a race against a pelvic floor that has birthed two very big-headed babies. Every time. I run, I dance. I try to figure out how to get my underwear down while not uncrossing my legs. It’s annoying and embarrassing.
As I started to try to work on figuring out when I am hungry, I realized that I probably have to pee a lot sooner than I think. I guessed that I just probably have the same general disconnect with my bladder that I have with my stomach. That was easier to confirm. I was able to catch myself feeling twinges of something in my bladder that is likely what most people recognize as, “needing to pee” and shaking it off as an inconvenience, only to find myself racing to the bathroom about an hour later.
Anyways, all this to say, I’ve come to realize these last few months, at the young age of 41, that I have no connection to my digestive system and likely haven’t for at least a few decades.
Why am I sharing this with you all? I’m sharing it because it’s part of a larger pattern of disassociation that I have related to trauma. Childhood trauma to be exact. And I figure at least a few of you might be struggling with similar issues and this discussion may help.
I grew up incredibly food insecure. We were not just “food bank and food stamp” poor. We were “mustard sandwiches for school lunches” poor, “free church meals” poor, “you better eat this because it’s all we have today,” poor. The first of the month, when food stamps and government checks would come in, we’d have one really indulgent meal. Then, as days passed and we got towards the middle to the end of the month, things would become dire and meals would become more scarce and sad. My mom had been gifted a Costco membership and I remember occasional days when she would have the gas money to take us to Costco and would say, “Get as many samples as you can kids, because it’s your dinner.” Those were good days. A friend spent the night at our apartment one weekend in 6th grade and by Monday I was known as the kid with “no food in their house.”
When you can’t change a situation you are in, it’s a pretty common defensive response to disassociate in some way. The more powerless you are in a situation, the more likely. As a kid, to avoid the pain, discomfort, shame, and unsafety of hunger, I disassociated from feelings of hunger and all the other physical symptoms that went along with it. I remember trying to do anything to distract myself from how my body was feeling. I remember trying to fall asleep at 4pm so that I could bypass the nausea and stomach pains that awaited me until I could eat again. This pattern continued when I left home and worked swing shift as a hostess at a local diner for minimum wage. I would try to sleep as late as possible, eat a giant spoonful of peanut butter and smoke a cigarette or two and then try to go back to sleep. Then I’d go to work in the evening, eat the free side salad that every employee was entitled to (we could instead get half-off an actual meal, but I rarely had the money for that as I didn’t get server tips), drink gallons of the free soda drinks, smoke ferociously at every break, and then go home and go to sleep. Rinse and repeat. I continued this cycle until I was passing out so often that I ended up in the ER.
When I had my children and they got into big kid food, the dizziness and fainting reduced pretty drastically. I realize now that it was because, even if I couldn’t be counted upon to eat regularly on my own, my deep unnamed fear that my kids would experience any of the food insecurity that I had experienced as a kid had me serving three meals a day, every day, at rigidly predictable meal times.
Now, my kids are 14 and 20. The oldest lives on his own and the youngest is in the teenage constantly-eating-his-way-through-all-the-kitchen-cabinets-and-then-saying-he’s-not-hungry-for-dinner-until-11pm-when-suddenly-he’s-starving-to-death phase of eating. My partner wakes up for work at 3am and so has eaten breakfast far before I’ve woken up and has to eat dinner by 3 or 4 pm in order to sleep comfortably at 7pm. In this “everyone for themselves” style of eating that the household has turned to in recent years (aided by the pandemic and a house fire that left us without a working kitchen for months), where we at best eat one meal a day or every other day at the table as a family, I’ve fallen back into old patterns of feast and famine, made worse by a hazy, forever-wandering, work from home writing schedule.
This isn’t to say that I don’t eat. I love food. Food is delicious. When I have food, I eat it all. But I don’t eat because I’m hungry. I eat when I want to watch something on television, or when I don’t feel like working. I’ll eat when something reminds me of a food I really like. My menu is often chaotic and almost always indulgent. I’ve convinced myself that a dedication to multivitamins will make up for whatever deficiencies my diet contains.
I started seeing a therapist recently (yes, I actually followed through) and we’re working on some of the many ways that trauma lives in my body and keeps me trapped in defense cycles that no longer serve me. At times it can seem overwhelming, as someone who spent so much of their life convinced that my own feelings and my own care were at worst an exercise in selfishness and at best an extreme inconvenience and distraction. Is someone who can find the words for just about anything happening in my brain at just about any moment - hence this career - it’s weird to come to the realization that I can almost never do the same for what’s happening in my body.
But for many years now, the way in which my body has been trying to tell me that it can no longer be the sole receptacle for my pain and trauma has become increasingly impossible to ignore. So I, someone who has always considered herself to be very introspective, am trying to make friends with - or at least the acquaintance of - this body that has been working so hard to shield and protect me from what I have long been convinced that my brain cannot handle, and is so very tired. I’m trying very hard to honor what a great job my body did to help me weather various storms when I had no other resources available to me, while also recognizing the resources I have today. At least I think that’s what my therapist says I’m trying to do.
This is just a small part of the work of living and healing, and it feels pretty scary at times. But the fact that I’m here, that my body was able to get me through so much often without my conscious knowledge, makes me hopeful for what I can do now, with this beautiful brain I have, the relative autonomy of my adulthood, and the privilege of my improved social and financial circumstances.
I mean, I’m hopeful right now, because I’m thinking of it. I don’t often operate on such a conscious level - but I’m working on that too.
I really do think my stomach hurts right now, y’all. It’s interrupted me multiple times in writing this newsletter. I'm pretty sure that’s what it is that I’m feeling. So I’m going to go now and see what I can do about it.
That’s pretty cool to be able to say.
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