How remarkable are your insights into the root causes of a person's behavior. When I apply your approach to my Father and his Mother, or to my wife and her Mother, or to my wife and our full of conflict raising of our 2 Daughters, I see such a jumbled complexity of influences that our Daughters have absorbed in one way or another. Yes, forgiving myself is just the starting point of a conscious reconciliation for all of us. A thousand thanks to you, Dr. McBride !
Dr. McBride, that's my story! Thank you so much for this reminder. I'm almost 58, former high-altitude runner for decades coming back from Covid for the second time. Fighting the ten pounds around my belly. My doctor, a man my age, and you would be buddies. He won't give me Ozempic and asks me what's really going on. How fortunate am I to have him and your great advice. Thank you so much.
I am so glad this made sense to you - and wow, if that is your story I have so much empathy for what you have been through. I am glad you have a doctor who is treating YOU - not just the number on the scale. 🙏
It's strange but so true that the hardest person to find compassion for is yourself. Our culture makes us see it as an act of weakness. It takes courage to make a beginning in this regard. Thanks for the lovely anecdote.
What a wonderful trauma-informed response to your patient. Having done several years of therapy and other modalities, I now look at the world through a trauma lens and it has increased my empathy and compassion in countless ways. I finally understand the messages I internalized as a child and how they affect my adult behaviors. Such a gift and your compassionate and loving approach to your patients is changing lives.
Thank you, AKSag. Really appreciate that you *get* it. Of course not everyone with body image issues or obsessive thinking has past trauma - and not everyone with trauma ends up with self-flagellation... however childhood trauma IS SO DARN COMMON and so commonly affects later-in-life thoughts, feelings, behaviors, and relationships that it is ofter the elephant in the room for patients with refractory issues like my patient's. Yet no one would know - sometimes even the patient themselves. Which is why it is so important to name and normalize the painful parts of our stories and how they relate to *now* - in order to give people more agency over their health. Appreciate you!!
Totally agree. The naming and normalizing is so important and something I rejected for a long time - in part because it triggered shame I was trying to avoid at all costs. Plus, perhaps like the patient in your example, I received a lot of positive reinforcement for being "so responsible at such a young age" so it was a narrative that I aspired to fulfill all the time. People who are "addicted to exercise" (as a possible characterization) receive lots of affirmation for their drive and "healthy" behaviors. And perhaps "trauma" is too strong a word as I internalized many harmful messages, some of which were the result of my parents' divorce - but maybe it's exactly the right word. Sometimes language illuminates and sometimes it detracts from understanding - often such a personal preference. Thank you for responding and for your way of being in the world - you are making a wonderful difference for so many people.
Wow! Wonderful story and "case study". And a great reminder for me as a therapist. I think unfortunately she wasn't able to touch her emotions in her therapy and with your compassion and psychological insight you were able to help her do that.
The article on aging is excellent. The part about staying “socially connected” was v. helpful. I’m not one that does that easily. Your encouragement was the best. Thank you for sharing about your elderly patient….what a great lady!
Dear Dr. M! Great article. Thank you for making this connection!!
We spoke at your last zoom gathering about informing your doctor that you've experienced trauma, and you said you weren't sure they would want to take that on... I'm going to push back once more and say that I do think it's important, too often our society stays silent about these things, and it is a critical part of our health (as you have shown in this article.)
Thank you, Eileen, for this!! I definitely think past trauma is a huge factor is many people’s health - physical and emotional. I hope some day every physician is able and willing to understand its relevance and importance. Thanks, too, for this infographic. I definitely will write something about this! Lucy
We need to keep talking about the importance of letting your doctor know about your exposure to trauma as a child.. see my other comments above.
“However, most previous studies on the impact of ACEs on mortality risk among adults have not taken medical illnesses into account. A better understanding of the link between ACEs and mortality across diverse medical conditions may inform us of how to optimize trauma-informed care.”
Absolutely! For me, letting my doctors know about my trauma allows them to consider the effects that this long-term stress has had on my body and to work with me to make a plan to mitigate some of those effects. I told my primary care doctor and my cardiologist so they will consider stress/anxiety when they consider physical issues I may have, and as part of my goal to prevent heart disease. My GYN needs to know that some of the dysfunction in my sex life may be due to the effects of the trauma.
I know I can’t control the reactions of my providers or expect them to take on dealing with my trauma in a 10 or 15 minute visit. But maybe they'll be a little extra sensitive during an exam, or, if I'm lucky, help me connect the dots between by physical and emotional health. We need to be able to talk about our whole selves. Thanks so much for e-listening! Eileen
Guess we can all substitute our hurts in place of hers and come up with similar diagnosis. Would love to see you expand a bit on “self compassion” or perhaps a reference.
I always love your feedback, Carl... tell me what you'd like to learn more about re: self compassion... like a "how to" guide? I think others might want something like that, too!
What a story! I particularly appreciate you showing how our bodies - plain old health - is a fantastic window into our emotional health, and the job of the true doctor is to treat both.
I'd share more how I resonate, but I've gotta run teach. Been a lot going on in life recently (we had a baby 2 weeks ago, and lots more!), so I'm literally hundreds of Substack emails behind, but so glad I read this now and was able to respond briefly.
Thanks! I've been working hard on The Healthy Jew recently, and I must say really enjoying finding a voice there - while I'm also struggling with other forms of media, as I'll be posting about tomorrow morning.
Was it you, Dr. McBride, who shared this profound wisdom....."optimal is optional"? Yes, we are o.k.;, just the way we are; yes "good enough" is just fine for us as human beings. My colleague and cofacilitator,Anne, always reminds us that we need to immerse ourselves in acting and honoring ourselves as human BEINGS and not merely constantly evaluate ourselves as HUMAN doings.
Self acceptance and self love are the essential ingredients for being whole.
How remarkable are your insights into the root causes of a person's behavior. When I apply your approach to my Father and his Mother, or to my wife and her Mother, or to my wife and our full of conflict raising of our 2 Daughters, I see such a jumbled complexity of influences that our Daughters have absorbed in one way or another. Yes, forgiving myself is just the starting point of a conscious reconciliation for all of us. A thousand thanks to you, Dr. McBride !
Glad this piece resonated with you, John!
Dr. McBride, that's my story! Thank you so much for this reminder. I'm almost 58, former high-altitude runner for decades coming back from Covid for the second time. Fighting the ten pounds around my belly. My doctor, a man my age, and you would be buddies. He won't give me Ozempic and asks me what's really going on. How fortunate am I to have him and your great advice. Thank you so much.
I am so glad this made sense to you - and wow, if that is your story I have so much empathy for what you have been through. I am glad you have a doctor who is treating YOU - not just the number on the scale. 🙏
It's strange but so true that the hardest person to find compassion for is yourself. Our culture makes us see it as an act of weakness. It takes courage to make a beginning in this regard. Thanks for the lovely anecdote.
What a wonderful trauma-informed response to your patient. Having done several years of therapy and other modalities, I now look at the world through a trauma lens and it has increased my empathy and compassion in countless ways. I finally understand the messages I internalized as a child and how they affect my adult behaviors. Such a gift and your compassionate and loving approach to your patients is changing lives.
Thank you, AKSag. Really appreciate that you *get* it. Of course not everyone with body image issues or obsessive thinking has past trauma - and not everyone with trauma ends up with self-flagellation... however childhood trauma IS SO DARN COMMON and so commonly affects later-in-life thoughts, feelings, behaviors, and relationships that it is ofter the elephant in the room for patients with refractory issues like my patient's. Yet no one would know - sometimes even the patient themselves. Which is why it is so important to name and normalize the painful parts of our stories and how they relate to *now* - in order to give people more agency over their health. Appreciate you!!
Totally agree. The naming and normalizing is so important and something I rejected for a long time - in part because it triggered shame I was trying to avoid at all costs. Plus, perhaps like the patient in your example, I received a lot of positive reinforcement for being "so responsible at such a young age" so it was a narrative that I aspired to fulfill all the time. People who are "addicted to exercise" (as a possible characterization) receive lots of affirmation for their drive and "healthy" behaviors. And perhaps "trauma" is too strong a word as I internalized many harmful messages, some of which were the result of my parents' divorce - but maybe it's exactly the right word. Sometimes language illuminates and sometimes it detracts from understanding - often such a personal preference. Thank you for responding and for your way of being in the world - you are making a wonderful difference for so many people.
Wow! Wonderful story and "case study". And a great reminder for me as a therapist. I think unfortunately she wasn't able to touch her emotions in her therapy and with your compassion and psychological insight you were able to help her do that.
The article on aging is excellent. The part about staying “socially connected” was v. helpful. I’m not one that does that easily. Your encouragement was the best. Thank you for sharing about your elderly patient….what a great lady!
thank you for reading!!
Dear Dr. M! Great article. Thank you for making this connection!!
We spoke at your last zoom gathering about informing your doctor that you've experienced trauma, and you said you weren't sure they would want to take that on... I'm going to push back once more and say that I do think it's important, too often our society stays silent about these things, and it is a critical part of our health (as you have shown in this article.)
May is Trauma Awareness Month. A perfect time to bring up the topic! Here's a great infographic on trauma from the National Council for Behavioral Health...note "how to talk to your doctor" at the bottom... https://www.thenationalcouncil.org/wp-content/uploads/2022/08/Trauma-infographic.pdf.
I'd be willing to draft something or discuss if you are up for this... no expectations...
All the Best, Eileen
eileen.zerhusen@gmail.com
Thank you, Eileen, for this!! I definitely think past trauma is a huge factor is many people’s health - physical and emotional. I hope some day every physician is able and willing to understand its relevance and importance. Thanks, too, for this infographic. I definitely will write something about this! Lucy
I just saw this JAMA pediatrics article from Nov 2025:
https://jamanetwork.com/journals/jamapediatrics/article-abstract/2840519#
We need to keep talking about the importance of letting your doctor know about your exposure to trauma as a child.. see my other comments above.
“However, most previous studies on the impact of ACEs on mortality risk among adults have not taken medical illnesses into account. A better understanding of the link between ACEs and mortality across diverse medical conditions may inform us of how to optimize trauma-informed care.”
Absolutely! For me, letting my doctors know about my trauma allows them to consider the effects that this long-term stress has had on my body and to work with me to make a plan to mitigate some of those effects. I told my primary care doctor and my cardiologist so they will consider stress/anxiety when they consider physical issues I may have, and as part of my goal to prevent heart disease. My GYN needs to know that some of the dysfunction in my sex life may be due to the effects of the trauma.
I know I can’t control the reactions of my providers or expect them to take on dealing with my trauma in a 10 or 15 minute visit. But maybe they'll be a little extra sensitive during an exam, or, if I'm lucky, help me connect the dots between by physical and emotional health. We need to be able to talk about our whole selves. Thanks so much for e-listening! Eileen
Such a thoughtful post, Lucy. Compassionate & wise. I hope many women read and I will share. 🙏
please do
it never ceases to amaze me how difficult - yet therapeutic - self compassion can be
xx
Guess we can all substitute our hurts in place of hers and come up with similar diagnosis. Would love to see you expand a bit on “self compassion” or perhaps a reference.
I always love your feedback, Carl... tell me what you'd like to learn more about re: self compassion... like a "how to" guide? I think others might want something like that, too!
This is beautifully written. Everyone should have a physician like you.
🙏
What a story! I particularly appreciate you showing how our bodies - plain old health - is a fantastic window into our emotional health, and the job of the true doctor is to treat both.
I'd share more how I resonate, but I've gotta run teach. Been a lot going on in life recently (we had a baby 2 weeks ago, and lots more!), so I'm literally hundreds of Substack emails behind, but so glad I read this now and was able to respond briefly.
Thank you, Shmuel, for making the effort to reach out in your hectic day.. I know those well ☺️
I have been meaning to write you about YOUR wonderfully thoughtful pieces lately.. some day we will connect in real life! :)
Thanks! I've been working hard on The Healthy Jew recently, and I must say really enjoying finding a voice there - while I'm also struggling with other forms of media, as I'll be posting about tomorrow morning.
Self-awareness is the blueprint for all of what we need, want and strive for. Love this!
Was it you, Dr. McBride, who shared this profound wisdom....."optimal is optional"? Yes, we are o.k.;, just the way we are; yes "good enough" is just fine for us as human beings. My colleague and cofacilitator,Anne, always reminds us that we need to immerse ourselves in acting and honoring ourselves as human BEINGS and not merely constantly evaluate ourselves as HUMAN doings.
Self acceptance and self love are the essential ingredients for being whole.
I couldn’t agree more - and no it wasn’t me who came up with “optimal is optional” - I thought that was YOU! 😆
It is indeed spot on.
Thank you for sharing your patient’s story. A beautiful post to start the week.
Thanks, Aris!
Love this so much. Thanks for your amazing guidance.
Awww.. appreciate it, Susan. ❤️
I loved this, such an important message for each of us. Thank you!