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PLUM SPRING CLINIC

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PLUM SPRING CLINIC
MICHAEL SHARP, MD

184 Lystra Estates Drive
Chapel Hill, NC 27517
Telephone: 919-945-0300
www.michaelsharpmd.com

Childhood Trauma Shapes Lifelong
Physical and Mental Health

“I would argue,” says Dr. Michael Sharp of Plum Spring Clinic, “that the studies on the health impact of adverse childhood experiences (ACEs) are the most important epidemiological studies ever done.”

From left: Lorre Fleming, Michael Sharp, MD, and Kathleen Williams

The research he refers to—known as the ACEs studies —began with large-scale studies at Kaiser Permanente in the mid-1990s. These studies— corroborated repeatedly in the 25 years since—found a power-ful link between childhood trauma and long-term physical health problems.

“Anyone in the healing arts has suspected that there is a connection between physical wellness and what we experience emotionally,” observes Dr. Sharp. “But these studies provide inescapable evidence of that connection. In fact, the data make clear that ACEs have a profound, negative impact on every aspect of life, from physical and mental health to education and career opportunities.”

ACEs (adverse childhood experiences), Dr. Sharp explains, include physical, sexual, and verbal abuse, physical and emotional neglect, as well as mental illness or substance abuse in a household member. Divorce and death of family members also have an impact.

“Over 60 percent of adults report that they have experienced at least one type of ACE,” he notes, “and nearly one in six has experienced four or more. And it’s that accumulation of trauma that takes a toll—contributing to development of serious chronic health problems in adulthood. These include not only mental health problems and substance abuse, but a wide range of physical problems. For example, experiencing four or more ACEs is associated with a significantly increased risk for leading adult causes of death, including heart disease, stroke, cancer, COPD, diabetes, Alzheimer’s, and suicide.”

Healing in the Wake of ACEs

“At Plum Spring Clinic, we see the impact of ACEs every day,” observes Dr. Sharp. “Many of our patients come to us with challenging, complex health issues—often after having spent years looking for help, but not being able to find it. They may have been diagnosed as having fibromyalgia or chronic fatigue or irritable bowel syndrome—but a clear healing path has eluded them. In many cases, we find that they also have a history of trauma—an underlying factor that not only contributed to their physical complaints, but continues to interfere with healing.”

In a conversation with Health&Healing, Dr. Sharp and his Plum Spring colleagues describe their approach to finding a healing path for patients whose unresolved childhood traumas form an integral part of their health problems. Stress Resilience Coach Kathleen Williams, and Trauma Recovery Coach Lorre Fleming are key members of a team-based model that integrates medical and mental/emotional therapies.

Health&Healing: Which physical problems are highly associated with childhood trauma?

DR. SHARP: I don’t know of any that aren’t. Cardiovascular disease, cancer, autoimmune illness, diabetes—just to name a few. Being raised in an environment that provokes a lot of insecurity can be at the root of anxiety and depression and self-esteem issues as an adult. And all of those things have a powerful effect on our wellness.

MS. WILLIAMS: ACEs can impact brain development, which guides functions such as resilience to stressors. In people who experience the world as an insecure place, everything becomes a threat. This ‘set’ of the nervous system channels physiological resources to the systems in our body that are required for mobilization and threat response—our heart, our muscles, our brain. But the digestive tract, the detoxification system, the immune system—are shut down as ‘non-essential’.

MS. FLEMING: And there’s a vicious cycle at work here, as well. A stress response, while normally triggered by fear, itself triggers more fear in the system. That fear produces physical symptoms—stomach ache, muscle pain, insomnia, fatigue. And when, as often happens, a doctor will say, “I can’t find anything wrong,” the fear intensifies. Now they are thinking: “I not only don’t know what’s the matter with me; I can’t find anybody to help me.”
H&H: How do ACEs inform your clinical work with patients?

DR. SHARP: Plum Spring clinic is a functional medicine practice or, essentially, a “root cause” practice. We work to determine fundamental causes of illness. For those with a history of trauma, the roots of their physical illness can be fear and pain ‘frozen’ or buried, in the system, so it can be a slow, delicate process to find that cause.

The entrée might be, where is the source of this chronic diarrhea? We can start with testing. If the patient isn’t ready to confront the stress, we can begin with medicine—to see what nutrients are missing and what trouble their digestive system is having. We’ll start there.

MS. WILLIAMS: New patients start with a two-hour intake with Dr. Sharp. While he’s taking their health history, he’s really inviting them to feel seen and heard. That’s a critical factor—because we know that safe connection to others is a powerful intervention.

Because the health we’re seeking is both physical and mental/emotional, we offer many different modalities for building the self-caring to nurture wellbeing—including coaching, mindfulness exercise, somatic experiencing, and the therapeutic use of ketamine (see below)—guided always by the specific needs of individual patients.

MS. FLEMING: That’s what happened for me. I started my relationship with Dr. Sharp as a patient, with chronic pain and autoimmune conditions. He gave me attention and care that I wasn’t getting anywhere else. We did somatic experiencing work that allowed me to experience rage that I had been swallowing for decades. That was the moment my healing started. It took many months of work, but the chronic pain dissipated significantly.

Ketamine-Assisted Therapy

“Ketamine is a medication that has earned its place among our tools and techniques for healing the trauma and chronic stress that are often residual to adverse childhood events,” says Kathleen Williams.

“Until recently,” she explains, “ketamine was valued as a safe and effective battlefield anesthetic, and is still used for pain. However, in our setting, ketamine is utilized for another of its properties, that of inducing ‘non-ordinary states of consciousness.’ These states, combined with skillful medical supervision, attending, and integration, can allow access to the roots of unresolved trauma that can be otherwise very difficult to get to, or take much longer.” 

Ketamine must be prescribed by a physician. And, following a medical evaluation by Dr. Sharp to determine appropriateness of this treatment for the patient, both treatment and medication are ordered.

“At Plum Spring Clinic,” explains Ms. Williams, “ketamine-assisted therapy begins with one or more preparatory coaching sessions to establish trust and rapport with the team member who will be the patient’s companion in the process. The ketamine session itself is scheduled for three hours in a comfortable living room setting, with music as an important element. The medication is most often administered orally, and the patient then is encouraged to lie back for the journey, with the attendant as ‘travel companion’ to share with, to be encouraged by, or just to hold the safe space for the client’s travels.

“We come to this process,” says Ms. Williams, “with reverence for the opportunity we regard as sacred. Depending on the client’s cultural or spiritual frame, we offer a ceremonial element to encourage this reverence. Treatment is followed within a few days by an integration session to help the client ‘digest,’ learn from, and incorporate into conscious life the insights gained.

“We know that the body—every body—knows how to heal,” she observes. “But the burden of stress that is wired deeply into the body system by painful or frightening adverse experiences is a profound hindrance to that capacity. We have found that the supported and attended journey into non-ordinary consciousness, and the skilled support for integrating that experience, can help relieve that stress burden and allow the return to health.”