I hear people say, "Why is this person so reactive?" "They are suspicious." "They just aren't nice. Why can't they be nice?"
When I get a new patient in clinic who is not friendly and looks suspicious at my questions and is not warm, I do not react. I assume that this person has been hurt and has a past that has a lot of dark in it.
Recently I was talking to a person about chronic pain. We were nearly out of time and I was describing Adverse Childhood Experience scores.
"I have the highest possible score," he said.
I made some sort of neutral noise and waited. He had my attention.
He did not want to tell me about it and he knew we were out of time. "I ran away when I was six." he said flatly.
I said, "Yes, if things were that bad, I think you would have the highest possible score."
That was the end of that visit. I gave him the link to the CDC website about ACE scores and studies and set up a follow up.
But think about that. He ran away at age six and lived on the streets. Not with a sibling or a parent or an adult. He was by himself.
He told me a little more on the second visit. I knew he could read. I pictured street classes under bridges. "How did you learn to read?" I asked.
"The authorities kept picking me up. I would run away from foster care as soon as they placed me. Usually the same day. When I was fifteen, a judge said "If you get your GED, I will emancipate you." It took me a year and three months, but I got my GED."
So is this your image of a street person? All losers? All crazy? This is a man who left because the street was safer than home and got a GED living on the streets.
He said, "My life has all been like that."
I said, "Chronic pain is not exactly surprising then, is it?"
There is a song by The Devil Makes Three with this line: "I grew up fast and I grew up mean, there's a thousand things inside my head I wish I ain't seen. Now I just wander through a real bad dream, feeling like I'm coming apart at the seams." That song speaks to me and speaks about the people who view the world with suspicion and fear and whose porcupine defensive spines are quickly raised if they feel threatened. I do well with them because I am the same way and I mostly don't react. I don't tell them to calm down. I don't get scared or angry. I stay present and wait. And sometimes they will tell me what happened to them.
How can any of us blame an adult for their fearful terrible childhood? Instead we need to give them space and not reject them out of hand. All that does is reinforce the damage. I think that people can heal, but we must make room for them and behave ourselves and not react.
Also published on wordpress blog.