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When the Body Remembers

Asthma may trigger anxiety in survivors of child abuse.

Asthma

In yet another indication that the mind and body are inseparable, two Chicago doctors report that anxiety can trigger asthma-like symptoms in adult survivors of child abuse.

Among adults with multiple personality disorder (MPD)—a condition almost always linked with a history of abuse—about 15 percent have been diagnosed as asthmatics, compared to five percent of the general population.

But only one-third are truly asthmatic, say psychiatrist Bennett Braun, M.D., and internist Saeed Khan, M.D., of Rush-Presbyterian-St. Luke's Medical Center. The others experience a tightening of the larynx rather than a constriction of the lungs.

"Many are using asthma as a way to get out of a stressful situation and into a safe place like a hospital," says Khan. The abused are not faking breathing difficulties—doctors are simply misdiagnosing their problem.

The duo examined 40 patients with MPD and found six who had been previously diagnosed with asthma. Two had symptoms such as wheezing in all personalities and tested positive for asthma; the other four suffered breathing problems in only some personas. Therapy sessions revealed all six recalled having been choked as a child into unconsciousness by their abusers.

"It's possible that strong emotions, like anxiety, trigger somatic memories of this experience and the person starts to constrict his or her larynx, unconsciously reliving the abuse," says Braun. Stress at work or in relationships may set up the response.

Psychologically induced breathing problems are best eased with anti-anxiety medications such as propranolol, a beta-adrenergic blocker—but these drugs may also worsen true asthma.

Khan's take-home advice: Don't assume that people who have trouble breathing but test negative for asthma are faking it—there's a lot more going on.