Continuing the story of Carla’s uncontrolled vomiting, at that time I had much to learn about stress illness. Weeks were needed to see how the pieces fit together because, as is usually the case, Carla herself did not comprehend and could not explain what was happening. The first clue was that her illness began when she was a teenage unwed mother who gave up her son for adoption. Second, when Carla was a child, her mother lived just 20 miles away but completely ignored her, causing Carla to feel unworthy and to assume guilt for many life events. Third, she had a strong belief in a God that played a direct, active role in her daily life.
These clues, and empathy for Carla acquired through daily hospital rounds, helped me feel the intensity of her guilt about the adoption. This led to questions that confirmed she still felt the weight of her “sin” even though it was now seven years later. That made me wonder, now that she was pregnant again, if she feared divine retribution in the form of harm to her unborn child. This was a large leap in logic, but I could not imagine anything else connected to her first child that would be powerful enough to produce severe symptoms so many years later.
When I asked, she admitted fear the fetus would be malformed as punishment for her past unwed motherhood. She had barely been conscious of this and never verbalized it until I asked. Using empathy and the fact that her vomiting increased exponentially as her abdomen began to “show”, I concluded that her fear was sufficiently intense to cause her illness.
The next problem was to find a way to relieve her symptoms short of the delivery of a (we all hoped) healthy child which was not due for another few months. More about that in the next post.
Tags: Carla, empathy, mental health education, Mind-Body Problem
