In the assessment of a chronic pain or stress sufferer, we often seek information on “the things you hear, see, smell, touch, and taste”. Some of these can be DIMs (dangers in me) or SIMs (safety in me).
I was talking to counsellors and staff at STTARS (Survivors of Trauma and Torture Assistance and Rehab Service) last week about DIMs and SIMs and we were discussing “the things you hear” that could be DIMs, thus contributing to danger activity in the brain. The conversation was about noise not language. I gave examples from my world – how the sound of an ambulance could evoke memories for some and make them stop in their tracks and sweat. Other examples of mine were how the sound of a dentist drill can lift sensitivity to all inputs and also how music can sound dangerous.
Then from almost another world, the STTARS staff reminded me that for some the sound of the police siren as the secret police visit, or the sounds of drills as used in torture, or loud, painful repeated music have a massive impact.
I realised I didn’t know much about noise and pain. There wasn’t much in the pain literature either, though I was delighted to see that there was a Noise Health journal. On reflection, when contemplating noise, I did have a focus towards decibels and kind of noise. The STTARS discussion reminded me that attention to attitudes, beliefs and memories related to the source of the noise (or perception of the source of the noise) would better the collection of DIMs and SIMs.
I would love to hear all noisy thoughts.
– David Butler
Yes agree I also work in trauma and use the DIM SIM list; noise is often a trigger for pain especially Tinnitus and can be very personal for the person and the trauma it could be the light rain falling, it could be a hairdryer, it could be the screeching of the brakes on a car, it could also be silence, that triggers tinnitus.
Hi David
Thanks for this great blog!
I have a patient who lived through a war as a small child. He described how his father had to travel for work across the country in the dark of the wintertime. This was an era of bombings and sectarian murders. Apparently an attempt had been made on his father’s life by running him off the road. As a small child he was unable to sleep being consumed with fear around his Dad’s safety. He described lying terrified and awake straining to hear the car return each night and only when he heard the crunch of the car tyres drive over the gravel was he able to relax and finally sleep. To this day this sound has deep significance for him. He said it is comforting even now because while the memory includes fear, the sound eventually led to safety.
Kind regards
Blanaid
What a powerful story Blá, thanks for sharing this one. Also a reminder of complexity and changeability of human experience.
My very best
Tim