One thing we know is that children who have been abused often have a hard time telling their stories in a coherent way that would stand up in court. We don’t always remember things in the correct order, and our timeline of events can often get very jumbled up in ways that make our stories seem a little off. This can lead to far too many survivors not being believed and have many legal cases dismissed, but this article ponders where it might create some other issues as well, with healthcare.
According to this article, one of the reasons adults with childhood trauma in their background struggle to get quality healthcare is an inability to tell their story coherently. So, for example, they can’t answer basic medical questions very effectively. The authors suggest there are two types of what they call narrative incoherent, preoccupied, and dismissive.
If you’ve dealt with more than a handful of trauma survivors, you might recognize these. People who are preoccupied are often so stressed and anxious about communicating that they just sort of throw everything out at once. Florence, for the article I linked to previously, for example:
Florence’s pattern is called preoccupied. Her anxiety is obvious. She is too overwhelmed by fear to organize her thoughts. She presents events out of sequence; her thoughts are unfinished; there are too many details; it is hard to tell the signal from the noise.
I’ve seen this in many a survivor story, and even in written memiors. Events are not in any specific order, details are dumped out without much thought to which ones are important, and which are not, etc. Maybe, in the end, this is why so many survivors want to write books, in an attempt to force their story into a better narrative?
The dismissive type is one we see with survivors frequently too. The “It wasn’t that bad”, “I’m fine”, I’m not sure it was really “abuse” types of stories are not hard to find either. There are so many survivors of childhood trauma running around struggling with mental health, relationships, decision-making skills, etc. who don’t see the connection.
I will admit, in healthcare, these two types of narrative incoherence could cause a problem. How would a medical professional move forward with a diagnosis when our response to the first question is to dump an overwhelming amount of possibly relevant, possibly not, information, or to dismiss any symptoms? It really would be difficult to know. We know that the folks who get to the quickest, and best, healthcare are the ones who come in with details like what is wrong, how long it’s been going on, what happened previously to an illness or injury, etc. Trauma survivors typically struggle with exactly that.
This is only one way where not being able to tell a story in a coherent, effective, way hurts survivors. It blocks us from legal proceedings, as I said before, and it blocks us from being understood by those closest to us quite often. So, if you really want to connect with others, and maybe get better healthcare, learn to tell stories. That’s how the world communicates. But, if you’re confronted with someone who is struggling to tell a coherent story, consider what kind of trauma they may be dealing with, and have a little patience.