Therapy for Medical Trauma & Chronic Illness

A serious illness, injury, chronic health condition, or change in physical functioning can affect far more than the body. It can alter your sense of safety, independence, identity, relationships, and the future you imagined for yourself.

Sometimes the psychological impact is immediate. At other times, it emerges gradually, after the medical crisis has passed, when others expect life to return to normal but you find that you don't quite feel like the person you were before.

For 30 years, I served as Director of Psychological Services in Rehabilitation Medicine at Jacobi Medical Center and North Central Bronx Hospital. Throughout my career, I have worked closely with people and families confronting serious illness, injury, chronic pain, disability, and profound changes in functioning and independence.

When Medical Experiences Become Traumatic

Medical care can itself be frightening or traumatic. An unexpected diagnosis, accident, emergency hospitalization, surgery, invasive procedure, prolonged treatment, or time spent in an intensive care unit can leave a lasting psychological impact.

You may find yourself replaying what happened, avoiding medical settings, feeling unusually anxious about your health, or becoming intensely distressed by physical sensations that remind you of the original experience.

For others, the trauma is less about one particular event and more about what has accumulated over time: repeated procedures, uncertainty, pain, loss of control, or the experience of living in a body that no longer feels predictable or safe.

These responses can be difficult to understand, particularly when the medical treatment was successful or others believe you “should” simply be relieved that the worst is over.

For a fuller discussion of these reactions, read When the Medical Crisis Is Over but You Still Don’t Feel Safe: Understanding Medical Trauma.

Living With Chronic Illness

Chronic illness asks something different of us. Rather than recovering from an event and leaving it behind, you may have to adapt continually to symptoms, limitations, uncertainty, medical appointments, or treatments.

There can be grief for the person you were before becoming ill, or for things you expected to be able to do. Relationships may change. Dependence on others can feel uncomfortable. Work, sexuality, parenting, friendships, and plans for the future may all be affected.

At the same time, people living with chronic illness are often expected to be resilient—to remain hopeful, grateful, or positive. Therapy offers a place where the more complicated reality can be acknowledged, including anger, fear, grief, resentment, uncertainty, and exhaustion.

Chronic Pain

Persistent pain can gradually narrow a person's world. It may interfere with sleep, work, relationships, physical activity, concentration, sexuality, and the ability to participate in things that once brought pleasure or meaning.

Chronic pain also has a complicated relationship with emotional life. Stress, fear, depression, trauma, and pain can influence one another without making the pain any less real.

Psychotherapy does not begin from the assumption that pain is “psychological.” Instead, it can help with the emotional burden of living with pain, the losses and changes that accompany it, and the cycle of fear, vigilance, avoidance, and distress that sometimes develops around physical symptoms.

Disability, Loss of Functioning & Changes in Identity

Losing an ability that once felt ordinary—walking easily, working, driving, caring for yourself independently, participating in a favorite activity—can be profoundly destabilizing.

These changes often involve grief. They can also raise difficult questions about identity: Who am I if I can no longer do what I used to do? How do I accept help without feeling diminished by it? How do I maintain relationships when my needs have changed? How do I build a meaningful life when the life I expected is no longer possible in quite the same way?

Therapy can provide room for both realities: mourning what has been lost while also discovering what remains possible.

The Impact on Relationships

Illness rarely affects only the person who is ill.

Partners and family members may become caregivers. Roles can shift. One person may feel guilty about needing help while another feels overwhelmed by providing it. Fear and uncertainty may make communication more difficult at precisely the time when closeness is most needed.

Medical conditions can also affect intimacy, sexuality, body image, and one's sense of desirability or connection to a partner.

These experiences deserve attention in their own right rather than being treated simply as secondary consequences of a medical problem.

My Approach

My approach is psychodynamic and relational. Together, we can explore not only how you are coping with what has happened medically, but what the experience means within the larger context of your life: your identity, relationships, history, losses, fears, and hopes for the future.

My three decades of work in rehabilitation medicine have also taught me that adaptation does not mean pretending that a difficult situation is acceptable or finding a positive interpretation of everything that has happened. Sometimes the work begins with having a place where the full reality of the experience can be acknowledged.

When a medical experience has resulted in PTSD or trauma-related symptoms, I can also incorporate evidence-based trauma treatments, including Cognitive Processing Therapy (CPT) and EMDR, when appropriate.

Treatment is individualized. For some people, the work is relatively focused; for others, illness or injury becomes part of a broader psychotherapy involving relationships, identity, grief, aging, or longstanding emotional concerns.

Medical Trauma & Chronic Illness Therapy in NYC and Westchester

I see adults in person at my offices on the Upper West Side of Manhattan and in Westchester County, and I offer secure virtual psychotherapy throughout New York State.

I offer a free 15-minute phone consultation—a chance to tell me a little about what you're going through, ask questions, and get a sense of whether working together might be helpful.