Validation, Accessibility, and Medical Trauma

Episode Overview 

In this episode of Trauma Informed Conversations, host Jessica Parker is joined by integrative therapist Louise Brooks. As a physically disabled therapist, Louise brings both professional expertise and lived experience to a vital but often overlooked topic: Medical Trauma.

Moving beyond clinical definitions, Jess and Louise explore the cumulative impact of "medical gaslighting" - the exhausting experience of not being believed or having symptoms dismissed by professionals. They discuss how these interactions can create a cycle of shame and anxiety, transforming necessary healthcare into a source of psychological distress. The conversation shifts the focus toward disability-affirmative practice, emphasising how validation and small systemic shifts can restore a sense of safety for patients.

Key Takeaways

• The Weight of Medical Gaslighting: Medical trauma often stems from being told symptoms are "all in your head". This lack of belief can lead to physical trauma responses like nausea, breathlessness, and heart palpitations before future appointments.
• The Burden of Explanation: Many disabled people spend entire therapy or medical sessions explaining their condition. Louise highlights the importance of professionals doing independent research to reduce this "retraumatising" labour for the client.
• Practical Systemic Shifts: Small changes, such as offering double appointments as standard, can provide the extra time needed for cognitive processing or physical transfers, making care truly accessible.
• Disability-Affirmative Therapy: Finding a therapist who is "disability affirmative" means working with someone who understands the social and systemic barriers disabled people face, rather than viewing the disability as something to be "fixed".
• "Not Disabled Yet": A poignant reminder that accessibility is a community responsibility. Whether through physical access or inclusive language, creating safe environments benefits everyone - because many people are simply "not disabled yet".

Resources Mentioned

• Trauma Informed Consultancy Services (TICS): Visit www.ticservicesltd.com to access live training events, further information on trauma-informed practice, and to contact the team for support.
• Disability-Affirmative Resources: 
  • Louise's Challenging Ableism CPD Session (11th April 2026)
  • Emotional Respite (Charity)
  • Spokz People - Modules to support people wanting to learn more and an online community for disabled people to join.

Guest

Louise Brooks is an integrative therapist in private practice, specialising in working with physically disabled and neurodivergent clients. Working exclusively online for inclusivity and access, Louise incorporates person-centered therapy, attachment theory, and compassion-focused approaches into her trauma-informed work. As a disabled practitioner, she is a passionate advocate for disability-affirmative care and challenging the ableist structures within the medical and therapeutic fields.

Subscribe to Trauma Informed Conversations for more honest discussions about trauma, recovery, and building systems rooted in care and humanity.

Transcript

SPEAKER_01 0:09

Hello and welcome to Trauma Informed Conversations, the podcast about trauma, healing, and hope. Well, hello everyone. Welcome back to another episode of Trauma Informed Conversations. Today I'm delighted to have the wonderful Louise Brooks with me. Hi Louise. Hi Jess. Just wonder whether, yeah, you want to tell our listeners a little bit about yourself and yeah, kind of what brings you on to the podcast today.

SPEAKER_00 0:42

Yes, so I'm Louise. I'm an integrative therapist. Um, have been in private practice for five years now. Um, and all of my private practice I work online for inclusivity and access reasons. Um I work predominantly with disabled clients, whether that's clients who are physically disabled or have a range of neurodivergence, and for whatever reason, they often find online um sessions more useful, more practical, more accessible. Um, and that is the reason that I that I started my private practice. Um, predominantly person-centred, uh, but bringing in in areas of attachment theory, sometimes a little bit of CBT, um, and big on compassion focused, and obviously I've done a lot of training on trauma informed too, hence how we got in contact.

SPEAKER_01 1:44

That's right, yeah. And so we were thinking about the topic for today, Louise, weren't we? We were kind of torn between so many things, but it really felt right to centre today's episode on I don't know about for yourself, Louise, but something that I don't think we talk about a lot in the world of trauma, and that's medical trauma.

SPEAKER_00 2:01

Absolutely, absolutely. Um, yes, so I probably should have said as well, I didn't, I don't think, in that introduction, but um, I myself am a physically disabled therapist, um, and so I sort out working with physically disabled clients um intentionally. I'd um come to the realization that sometimes clients seek out a therapist with some kind of similar um experience. I know certainly clients that I've worked with where I have um kind of partially self-disclosed, so often they know that I have a disability. Not all of my clients know exactly what type, depending on, you know, obviously the self-disclosure is whether it feels appropriate for the client. Um, but yes, a lot of them have spoken about, oh, you know, I I don't have to necessarily explain to you what PIT means or what benefit system mean, or you know, when I'm having this appointment or that appointment, what maybe what different medical definitions mean. Um, but I guess in my work as a therapist, I would always say, yes, okay, I might know what that word means, but I'd like to know what it means for you.

SPEAKER_01 3:19

Yeah, that really resonates, Louise. And I think, you know, whether we're in the therapy room or not, just as human beings, sometimes it does help to speak with somebody who may well have those similar experiences. And then also, you know, your really clear boundary setting there as well about, you know, kind of how you work out as a therapist, you know, is this, you know, maybe a client that's gonna benefit from, you know, maybe me disclosing a little bit or or not. Um, so I guess just for our listeners, because we don't know who's out there right now listening to us, what is medical trauma then? You know, if I was to look it up in the dictionary, like what would I see? Um pressure, no pressure.

SPEAKER_00 3:59

Yeah, I was gonna say, not sure about the the official dictionary definition, but certainly my definition from both myself and when I've spoken to clients is when so often, um, certainly in the physically disabled community, I'm talking from a point of view and about people that have had a lot of medical appointments, multiple, multiple over the course of a year and multiple years. Um, and it is often, I think the term medical gaslighting can often go alongside medical trauma of, you know, whether it's the multiple appointments, whether it's kind of some sort of invasive treatment, so physically invasive, maybe even emotionally invasive. I know a lot of the time the clients feel like they're the expert in themselves in medical appointments. And whilst they don't always want that, it's kind of nice for a medical professional to say, oh yes, I've heard of that condition and I know a little bit about that condition, without the client having to explain everything of the background before even getting into what their specific problem at that time might be. Um, so I think certainly medical trauma can be exhausting, it can be being gas lit, it can be being not believed, certainly in other people could speak of this more freely than me, but in terms of invisible disability, um, I myself have a visible physical disability. So I think that's a little bit different, but I have worked with a lot of people with invisible conditions, and I think medical trauma can occur a lot in those situations where people say, Oh, you know, the the medical professional just didn't believe me when I said this was happening and that was happening, or oh, you know, it must be all in your head. Well, no, it's unlikely people would go to the uh seek help multiple times if something wasn't there on their mind, like of a concern. You know, we we all know how hard it is to get a medical appointment sometimes. So yes, trying to seek that out for a reason of something being all in their head in inverted commas, like I don't know why people would do that. So, or you know, saying things like, I don't know, have you tried exercise or have you tried losing weight or have you tried a different diet? And often the answer is, well, yeah, of course I have. I've done all of that before I've come to you. Yeah, and I guess then you could go on to things like it feeling difficult to then go to medical appointments because people have had a bad experience previous ones. And you know, schematherapy and all of that would suggest that, you know, we think, okay, that's happened before, therefore it's going to happen again. Hopefully, it won't always happen again. Um, but it's understandable that people would think it did if if they've had it happen once before, they might associate it and feel more anxious about going again in case it does happen again.

SPEAKER_01 7:23

Yeah, absolutely. And I I think then so it's it's not just one isolated situation, then it could be cumulative, right?

SPEAKER_00 7:32

Absolutely. And I think that does add to it when you know you've had multiple appointments, it's happened once it happens again. So over the years, you know, I've worked with people who could give multiple different accounts of, oh, this happened and then this person said this, and that person said that and didn't believe me about this or when I said the other. And so then, yes, that all adds up to add to the whole sphere of medical trauma as a whole.

SPEAKER_01 8:05

Yeah, so how might those kind of trauma responses present them? You know, so for example, you know, how might people know that they've almost experienced, you know, medical trauma? You know, what what might we be, you know, looking out for, or you know, from your point of view as a therapist even?

SPEAKER_00 8:24

Yeah, absolutely. I mean, I'd certainly say anxiety can be a big one. Yeah. Um, physical symptoms of, you know, the heart palpitations, um the kind of really anxious, even maybe even breathlessness, just really not wanting to go to any appointments, or even telling yourself, you know, oh, of course they won't believe me. They didn't believe me before, they're not going to believe me this time. Um just sort of really kind of on edge. Um, maybe I know I've had certainly in in therapy sessions, and maybe even myself, asking others for reassurance of like this happened, is is this really happening to me? Tell me that, tell me that I'm not making this up, whether that be to friends or family members. So people have that reassurance before going into that medical appointment. Um, but it might be not even feeling able to go to the appointment in the next instance. It might be I've known of people feeling really nauseous and maybe even actually vomiting before appointments as such a physical response to feeling scared, nervous, anxious about not being believed essentially.

SPEAKER_01 9:41

Yeah, it's a difficult one. And you know, so for listeners who so, you know, if you don't know Louise, so we have social workers and teachers and therapists and all sorts of professionals that listen into our podcast. Like, what advice or guidance could we give them? You know, perhaps if they found themselves supporting someone who had had an experience maybe where they, you know, they kind of felt medically gaslit to use your phrase there, or you know, kind of if they felt as though they were kind of experiencing, you know, that kind of aspect of trauma, like what can they do to support?

SPEAKER_00 10:17

I think maybe certainly if you've been working with somebody for a while and have built that therapeutic relationship, if I notice something like that where somebody is feeling particularly anxious about an appointment, or they might say, Oh Louisa, I don't think this GP or whoever is going to believe me when I say I'm having these symptoms. But I I might even say that there sounds like some uh that sounds like there could be some trauma there, or certainly some feelings around uh medical appointments feeling really difficult or challenging for you. So because they may not have had it named before, or even asking the client themselves if if they would name it. If if you could name this feeling, what would what would you call it? Um, but then supporting them, I guess the big thing like we would do with any client or anyone we're all working with, like hear their story, hear their experiences, listen to them, believe them, because certainly you're often the people that they're closest to or share some of their deepest things and thoughts with. And so I I highly doubt they're gonna lie to you about this kind of stuff. There might even you might even pick up on some ideas of shame when clients are talking about it. Is is this right? And and doubting themselves, hence the like the whole idea of being gaslit, like the the doubt and the shame. And and so kind of really hear that and work with it, and and things like you know, I might have said previously, but I it's really hard to hear that professionals haven't believed you before, but I believe you now. Um, and I like to think that has been a helpful intervention.

SPEAKER_01 12:11

I mean, yeah, definitely. And I guess, you know, also kind of you know, the behaviour reframe of you know, the fact that our bodies, our nervous systems are communicating something to us, especially what you know, what was being communicated at that point, and as you say, you know, kind of really holding that relationship, you know, sort of front and center, um, is something that's just massively anchoring and grounding, isn't it? The other thing I was thinking about as well is is you know, the sort of pressure also from again, you know, we mentioned GPs there, but the pressure like systemically for GPs, healthcare professionals, you know, working in really, really, you know, pressured environments, appointments to keep for sure. It's it's really difficult. But I wonder maybe whether you had kind of any thoughts as as to sort of how you know we might maybe be able to sort of hear those in front of us that bit more, or you know, maybe even again to kind of recognise that perhaps you know, this could maybe be a patient or a client that has had you know difficult or distressing experiences previously who may not articulate that to us. Um, I don't know whether that's a question or more of a thought, but yeah, what do you think there?

SPEAKER_00 13:26

No, I think that's right. And one of the things I have done or fortunately have had done for me personally when I've had appointments. I know I had a really good GP probably about 10-15 years ago, and I was very fortunate that you know I would be offered double appointments as standard. So they did have that little bit of extra time, even you know, for some disabled people, they their cognitive processing might be slightly slower, so they might need that little bit of extra time to even explain what's happening for them in that moment. Um, and then to be able to hear the responses takes that little bit of extra time. If someone is being examined, maybe you know, that other half of the appointment can be used for transferring, or you know, that process of being able to be examined in a way that feels safe and as comfortable as possible for a client or a patient that can't do those things as as easily as maybe a non-disabled person.

SPEAKER_01 14:35

Yeah, that sounds incredibly powerful. So I guess we're not talking about adding work to people's plates, but sometimes those quite small shifts can make the world of difference. You know, as you say, maybe having perhaps that double appointment, for example, should enable somebody to slow that pace, be able to articulate themselves that bit more clearly. Um, and you know, actually that's useful for us as professionals as well, isn't it?

SPEAKER_00 14:59

Yeah, and even things like so if I'd have a client that an initial assessment and maybe it's a it's a condition, a disability that I've heard of but don't really know much about, and I've had that information before the initial session, I'll do my own research just quickly before to get a general idea of the types of difficulties or challenges they might be facing, and obviously ask them how it affects them personally. But I think it's helpful for disabled people, certainly speaking from my own experience of you know, I I go to a therapist and not really want to have to explain exactly what my condition is. So obviously, we'd get into the ins and outs during therapy, I'm guessing, of kind of what it means to me and how it affects me. And of course, that is the client would need to tell you about that. But to know, oh yeah, I've I've heard of this condition, and I've heard sometimes it can affect you cognitively, it can affect motor skills, it can affect, you know, fatigue levels. Is does that resonate for you? And I think if you can bring some of that in so it it shows and can and can tell that you know you've done your research, then I think that's really helpful. I I know as well, um, and I'm sure she won't mind me sharing. Maybe, maybe she'll listen to this. Um but uh a friend and colleague of mine um did actually talk of her own experience of medical trauma on video for some training that I did. And she had a really disability affirmative therapist eventually. She said, you know, I've been through a few that didn't generally feel very helpful. But when she found a disability affirmative therapist, one of the things for her personally that helped was knowing her therapist telling her when she'd been on, I don't know, specific training events or thinking, oh, I did this training and they talked about XYZ and actually I related it to what we'd been talking about, or to your condition and had, you know, so that's real evidence that the client is being kept in mind. And I think certainly for people that have had multiple therapists or been involved with multiple professionals and felt dismissed previously, to have someone that really hears them and and yeah, keep them in mind and and think, oh yeah, I almost I saw this and thought of you in a therapy sense.

SPEAKER_01 17:42

Yeah.

SPEAKER_00 17:42

Um, can be really helpful.

SPEAKER_01 17:45

Yeah, I can appreciate that. So I guess that light bulb moment then for your friend was the validation of you know, actually, I get it. You know, yes, I may not have, you know, perhaps, you know, had the exact same experience as you, or but actually, you know, I am a disability affirmative therapist, and you don't have to kind of explain, you know, your your whole being to me, you know, because uh that can be exhausting, can't it? You know, really having to sometimes explain who we are, what we've been through.

SPEAKER_00 18:20

And I think as well, spending, you know, clients can spend, I don't know, half a session, a full session, explaining just what their disability or condition is. And they might feel like that's I don't know, a waste of money, or oh, actually, I I had a list of things I wanted to talk about, but I didn't even get to the list because I was talking about my condition. Um, and you know, and I think often as therapists, certainly like sort of later on, we we might be the tenth professional that somebody has spoken to. Yeah, and the tenth time somebody's had to explain this. And I've I know I've had people talk to me before about sometimes I just wish I made a recording to just play at the start of sessions of this is me, this is what I go through, so I don't have to talk about it again. Because sometimes I think even that in itself, even retelling this is my condition, this is the disability I face, these are the challenges I face, yeah, can re-traumatize in some situations.

SPEAKER_01 19:25

Of course, and maybe almost that feeling of, are we making any progress here? Or am I almost feeling stuck, you know, in the kind of situation that I'm in? I mean, if anybody is listening out there, Louise, who maybe is struggling to perhaps find a therapist, even if it isn't related to you know today's topic of medical trauma, like what advice or guidance could you could you give them? Because I can imagine being in that situation. Sometimes we think, do you know what? I've tried 10, 12 therapists now, I'm never going to find someone that I maybe can relate to, or yeah, what would you suggest?

SPEAKER_00 20:02

So obviously, on any of the directories or anything where people might search for therapists, you can search disability, and often if people have worked with disability or are disability affirmative, they will tell you that will be in their profile. Um, certainly it is for me, you know. I personally work for a charity where we're all disabled therapists, um, working specifically with disabled clients all online. Um, you know, so that's searchable, things like that, I think. And and also maybe have those initial calls with diff with a couple, a few different therapists, if hopefully if they I know I certainly offer that sort of quick 10-15 minute intro call for a for a client to decide whether they want to book that initial session. And I'm very aware that maybe they'll be talking to other therapists as well. And I I will say that, I'll be like, okay, so yeah, I'd be happy to work with you, but go away and have a think about it because you might be talking to others, and and sometimes they say yes, sometimes they say no, and yeah, as and just so just kind of I know it sounds quite cliche, but shop around, I think.

SPEAKER_01 21:18

Yeah, absolutely. It's like the the therapy version of window shopping.

SPEAKER_00 21:22

Yes.

SPEAKER_01 21:23

That's amazing, and you know, Louise, if you're if you're happy to disclose, I'd be more than happy to put the name of the charity that you work for, maybe um, in the podcast show notes so that people can also see, you know, perhaps what you know who is out there, essentially. Um, because it's difficult, isn't it? Sometimes to kind of know where to start, know where to look. Um, so that would be massively helpful.

SPEAKER_00 21:47

But and there are there are blogs on there as well about people's personal experiences, not always, sometimes about therapy, sometimes about general disability. So yeah, and yeah, you're more than welcome. I'll give you. Details.

SPEAKER_01 22:00

Thank you, Louise. Thank you so much. And I guess you know, if there was a golden takeaway, maybe for any professionals that were listening to the call who may or may not be therapists, you know, what would we want people to kind of take away really from our conversation today?

SPEAKER_00 22:15

I think I'd say do your do your research and and hear the client and go back to those sort of go back to basics, those core conditions, those really hear your client. Um as best they can. Your client is the expert in them, but sometimes they want a break, certainly where disability is concerned. And just kind of uh yeah, hear them, but uh like be alongside them, but say that it's okay to talk about some of these things. You know, a lot of disabled people haven't really spoken about their disability in therapy before I found. And uh as I said before, they might feel shame and they might feel discomfort. But if you've built that therapeutic relationship, yeah, then you could be their safe space to explore some of that. But yeah, if you hear about disability, about a condition, research it. There's CPD available on disability, not not enough, in my opinion. I would like there to be some more. Yeah, but there is disability CPD out there, so research and and even if you think I think this is it actually, the tag way, even if you think you don't work with disabled people, you probably do. Or you work with somebody who knows a disabled person or somebody, and this is quite a hard hitting phrase, but a lot of people are not disabled yet, you know. Even if we think about the elderly, people are gonna have difficulty with mobility as they get older. So keep it in mind. So you know, if you think, yeah, I that sounds great, but it it's not my area of work. A think about invisible disabilities and that people might not have disclosed, and B, it might not just be your area of work yet. Somebody might disclose part way through sessions, so yeah, just always keep it in your awareness, I'd say.

SPEAKER_01 24:29

Like that, I like that. And what about maybe for so we again we'll have listeners in in schools and colleges and community settings who won't be working therapeutically? Like, what about just as citizens? Like, is there anything that we can be doing to support others in this way?

SPEAKER_00 24:47

Yeah, I think um think about somebody's access requirements, you know, if you've if you're um in charge of helping people get into a building, think about I know I'm talking from physical access, certainly, but is there a step to get in? I one of my favorite phrases has been, oh, we uh we are accessible, we've only got one step. And I'm like, well, then you're not accessible then because I can't get my wheelchair up one step. It doesn't matter if it's one or ten.

SPEAKER_01 25:18

Right, it's the same thing. A barrier is a barrier, right?

SPEAKER_00 25:21

Yes, absolutely. So that maybe have a look at some use of language. There are lots of trainings on ableism and use of language, and just yeah, I guess just keep learning and and ask people. Often disabled people will ask, will tell you if you ask how you can help them. So I guess just keep it in mind.

SPEAKER_01 25:48

Yeah, absolutely. Well, Louise, thank you. I mean, I think for me, what stands out from our lovely conversation that we've had today, and thank you so much for being so open about you know your own personal experiences and again your your work as well as a therapist. But first of all, I'd say then, and correct me if I'm wrong, Louise, that medical trauma isn't always about what's happened, it's about actually how it almost continues to the cumulative effects. Absolutely, but then also you know, just how much there is that we can do. Um, and I think the other one, and you did say it was a hard-hitting phrase, but it definitely resonates, and I know it will with our listeners, as well as, you know, perhaps somebody isn't disabled yet. So that could even maybe be somebody in our, you know, in our community more broadly, or you know, irrespective of the work that we do, where there are people, you know, there is always something that we can do. So I guess whether people feel heard, whether they feel believed, you know, whether they had any sense of control perhaps in previous moments, you know, although we can't change the history, you know, we can really shape a better present moment, can't we, for those around us?

SPEAKER_00 26:59

Absolutely. Absolutely. I think that's key.

SPEAKER_01 27:03

Well, Louise, thank you so much. Hopefully, you'll be back for another episode at some point. Um, I personally have learned a lot, and thank you so much for kind of gifting your knowledge and wisdom um to all of our listeners. And uh, we will make sure to pop a couple of resources um in the podcast notes for everyone. But thank you so much, Louise. Enjoy the rest of your day.

SPEAKER_00 27:22

Brilliant, Jess. Thanks for having me.

SPEAKER_01 27:32

Thank you so much for joining us. To learn more, visit the Trauma Informed Consultancy Services website. We'll see you next time.