Lady Gaga's psychiatrist shares why trauma could be behind your illness

Some people will experience fundamental changes to their brains from trauma, and long term health and behavioural issues as a result. Photo / Getty Images

In 2017 a young woman was admitted as an emergency patient suffering from chronic pain to the private hospital where psychiatrist Dr Paul Conti worked in New York. After reassuring her that he was an Italian from New Jersey, just like her own father, they embarked on a two-year journey to break her out of her paralysis.

That young woman was Stefani Germanotta, better known as Lady Gaga. The actress and singer has since been open about how being raped as a 19-year-old and becoming pregnant caused a trauma so profound that she was left living with fibromyalgia – a long-term condition that causes pain all over the body, sometimes sparked by trauma or severe stress. At the point where she was hospitalised – having suffered from hallucinations during a world tour – she had no idea that her health problems were linked to her previous trauma. It was the subsequent conversations she had with Conti that allowed her to start to heal.

Our understanding of trauma has come a long way since shell-shocked soldiers returned from the trenches of World War I.

A variety of studies have pinpointed the impact of trauma on key structures of the developing brain. These include the hippocampus, which helps us with memory and spatial navigation; the amygdala, which enables us to process emotions; and the cortex, which plays a role in complex cognitive behaviours, personality expression and moderating correct social behaviour.

In his new book Trauma: The Invisible Epidemic, for which Germanotta wrote the foreword, Conti, a Stanford- and Harvard-trained medic, argues that many of us are suffering health conditions linked to trauma without being able to recognise the signs.

Of course, a certain level of trauma is the stuff of life – some people can go through terrible events and demonstrate remarkable resilience. Many concentration camp survivors live full lives despite suffering the worst possible ordeals. While Conti says scientists don't understand the genetic aspects of resiliency well, we do understand the importance of meaning and of a supportive societal structure.

Yet other people will experience fundamental changes to their brains from trauma, and long-term health and behavioural issues as a result.

"It's not always a case of 'what doesn't kill us makes us stronger'," says Conti.

My friend Dr. Paul Conti wrote a great book about trauma, and I was proud to write the foreword for him. This book can be so helpful for anyone going through a hard time, especially now during the holidays. Learn more and order it now at https://t.co/MKvm4WWdck

— Lady Gaga (@ladygaga) December 23, 2021

Unaddressed trauma can result in unhealthy coping mechanisms to alleviate the pain, anything from bingeing on unhealthy food or overeating, drug abuse, or engaging in risky sexual activities.

In the short term, trauma causes an intense, biological "alarm state" including a rush of adrenaline, cortisol and other hormones as well as intense fear. We stop thinking so that we can fight against or flee the dangerous situation.

Raised stress levels mean conditions linked to trauma exposure can include chronic lung and heart diseases, auto-immune diseases and even cancer, the latter more normally as a result of stress-induced behaviours, such as smoking, rather than the stress itself.

In the 2014 bestseller The Body Keeps the Score by Boston-based Dutch psychiatrist and pioneering PTSD researcher Bessel van der Kolk, he argues that the energy of trauma is stored in our bodies' tissues (primarily muscles and fascia) until it can be released.

A 2020 study in the Journal of the American Heart Association found children who experienced severe adversity – such as verbal, physical or emotional abuse or living with drug or alcohol abusers – were 50 per cent more likely to develop cardiovascular disease later in life than those with low exposure to childhood trauma.

Meanwhile, a recent study by researchers at Haukeland University Hospital in Bergen, Norway, suggests childhood trauma can raise the risk of multiple sclerosis, finding that women who had been sexually abused had a 65 per cent greater risk of developing the disease.

Conti defines trauma as an experience that can be acute, chronic or vicarious that overwhelms our coping skills and we think differently going forward.

Many of his patients are trapped in a cycle of denial and dysfunction. The young woman who was abused as a child now suppresses her trauma with drugs and was a "frequent flyer" at the hospital, only to then return to her cycle of homelessness and drug abuse. Or another woman who, as a young teenager, had been sexually assaulted and declined a college scholarship to stay with her abusive boyfriend.

"Whatever it was that I was trying to help with, be it alcohol dependency, depression, domestic violence, insomnia, no matter what the level of severity, the roots of the problem would often lie in trauma. This would also occur around physical health issues; limb function, heart attacks, lupus."

Trauma doesn't have to be caused by a one-off acute experience such as a sexual assault or the death of a close relative. Conti also sees cases of chronic trauma, caused by extended traumatic events such as a long-term serious illness, or bullying.

Acute trauma such as that occurring in Ukraine may also have consequences that will be felt for generations – a 2018 study found that the male offspring of Civil War soldiers who spent time as prisoners of war were more likely to die early than people whose fathers had not. The researchers concluded that paternal stress could affect future generations and that the impact may occur through epigenetic channels.

Yet surely trauma is the result of ordinary existence, a necessary part of the life cycle that we will all face? Conti doesn't deny it: "A certain amount of trauma is natural and universal."

Stefani Germanotta, better known as Lady Gaga, has worked with Dr Conti to process her trauma. Photo / Getty Images

Around the same time that Conti's book was published in the US in October last year, George Bonanno at Columbia University in New York published The End of Trauma: How the New Science of Resilience Is Changing How We Think About PTSD, in which the psychologist argued that our propensity to view things as traumatic, means we may also be overplaying the impact.

His research has shown that, given time, most of us will recover even from the most horrifying experiences. In light of this, says Bonanno, the word "trauma" has lost all meaning. Surprisingly, Conti agrees.

"Trauma loses meaning when we look at everything through the lens of trauma; so everything is traumatic. That's a misuse of the word which undermines the entire concept," he says. "The trauma that I'm talking about is not esoteric. It's not about what you find triggering."

When maintaining the distinction between a traumatic experience and a negative one, it's important to remember that the latter can be instructive. "If I didn't get picked for the team or get a good enough grade, I should work harder. That's not trauma."

Can trauma be anything from witnessing a mugging to being shouted at? How do we define what trauma isn't?

"Trauma isn't anything that, to put it in a simple way, washes through us as opposed to staying with us and changing us," says Conti.

Still, words like "resilience", "snowflake" and "stoicism" muddy the waters of trauma and can make us see it through a jaundiced eye. It's why Conti thinks it's important that we see trauma as a concept rooted in science.

"What we are talking about is defined by brain science. We have seen MRI scans that show trauma has the power to change how our brain looks."

In some situations, antidepressants can help with the symptoms of trauma, but Conti says they rarely fix problems. So what can we do if we think our health problems are a result of trauma?

First, we can find time for introspection to unpick negative thought patterns and also talk to friends and family to identify what's going on.

Conti says: "People who create meaning in their lives, often through helping others and trying to make the world a better place, are much more resilient and being interconnected with loving people, and with spirituality, also seem to be quite important."

Then there's communication with a professional such as Conti. Traditional talk therapy isn't the only treatment option, though. Emerging experimental treatments such as controlled doses of MDMA have shown positive results and is a technique Dr Conti is positive about.

His hope is that by starting a conversation about trauma, sufferers might be better able to recognise their own situation. From there they can start a process of self-reflection that might lead them out of their own trauma mindset; by simply acknowledging that pain with self-compassion they can start to heal.

Where to get help:

• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youthline: 0800 376 633 or text 234 (available 24/7)
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (12pm to 11pm)
• Depression helpline: 0800 111 757 or text 4202 (available 24/7)
• Anxiety helpline: 0800 269 4389 (0800 ANXIETY) (available 24/7)
• Rainbow Youth: (09) 376 4155If it is an emergency and you feel like you or someone else is at risk, call 111.