• The Letter PTSD Survivors Should Write: Informing Medical Providers about Your Triggers

    PatientOn.gurney.bwMany of our readers know the story of how my colleague, co-author and friend Wanda and I met. Long story short, we were strangers who lived on opposite sides of the country. Wanda was a radio producer, and I was an author. She booked me by email to be on her show, but following our limited professional correspondence, I couldn’t get her name out of my head.

    One day I called her, not knowing she’d struggled with PTSD for decades and had planned her suicide for just a few days after our call. She poured out her story to me, a stranger. Weeks later, she was admitted to the hospital for a medical crisis and trusted me enough to allow me to fly to her side and serve as her medical advocate.


    Because most individuals who suffer with PTSD fear hospitals and often must dissociate simply to walk through the doors.

    Those who have suffered severe trauma are often triggered by medical environments.

    We often dissociate in order to cope with sights, sounds, smells, and memories of painful events in our past. Medical personnel may or may not be trained to provide trauma-informed care, so it’s important for trauma survivors to communicate their triggers and request reasonable accommodations in writing. 

    We recommend that you write a letter of no longer than one page that includes the following things:

    1. A brief (3-4 sentence) description of your trauma story. You don’t have to be graphic, but include enough information for the provider to gain an understanding of your background. For instance: “I experienced severe trauma as a child and may be triggered in medical environments. I was held in captivity, tortured, abused, and confined in small spaces.”

    2. A list of your primary triggers:  “The following are my primary triggers: tape, the sound of ripping tape, the sight of blood, being approached from behind, restraints of any kind (for instance, ‘swaddling’ in blankets).”

    3. An explanation of how you respond to your triggers: “When triggered, I often dissociate, which can make it difficult for me to speak or communicate. My speech may become delayed, or I may appear ‘out of it.’ I may also become angry or enraged if I feel threatened.”

    4. A request for reasonable accommodations: “I request the following accommodations: 1. Use of paper tape or no tape when possible. 2. For personnel to ask or give a brief statement of preparation before touching me. 3. That NO SEDATION be administered that would cause me to lose consciousness or lose memory. 4. That should I shown signs of anxiety or dissociation, that my medical advocate be called (provide name and phone number). 5. That this letter be copied, placed in my medical records, and the original be returned to me.”

    Of course, your letter should be adapted to your needs. Carry it with you and use it when you feel necessary. And be sure that your medical advocate is someone who can speak on your behalf and represent your needs as you would yourself.

    Do you feel that a letter like this would benefit you or a loved one? We’d love to hear from you.

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