Self-Harm: A Survival Adaptation, Not a Character Flaw

Posted on August 14, 2026 by Shay Seaborne, CPTSD

A few years ago, when I was struggling the hardest, I occasionally engaged in self-harm. My body knew the practice offered relief, but I still felt some shame, because I’d been indoctrinated to believe self-harm is a kind of pathological weakness. But from a Relational Neuroscience lens, self-harm is not a mystery or a failure of willpower. It is a sign that a person’s system has been pushed past what it can hold and is trying to regulate in the only way it has access to at that moment. It is a survival adaptation, not a character flaw.

A human system under chronic overload loses access to connection, curiosity, and other stabilizing states. When someone is drowning in activation, pain, or aloneness, the body searches for even a brief sense of clarity, control, grounding, or release. Many people describe self-harm as the only thing that makes the unbearable feel containable. That tells us the real problem is the degree of threat and isolation the system is carrying, not the behavior itself.

IPNB reveals to a few key dynamics:

Loss of relational holding
When someone cannot feel seen or supported, the body often slides toward collapse, self attack, or frantic attempts to override the internal storm. Self-harm becomes a substitute for co-regulation when co-regulation is missing.

Overwhelming activation without relief
When the system cannot discharge distress or settle, pain turns inward. The behavior is an attempt to shift state fast.

A body trying to interrupt dissociation
For some people, self-harm pulls them out of numbness so they can feel present again. That shows how much they need grounding and connection.

A way to communicate what words cannot carry
The body speaks when language fails, especially when the world has shown it will not listen.

IPNB never reduces this to “bad coping.” It asks what conditions made this the only available option. The focus is on what the person needed and did not get: safety, resonance, steadiness, and the felt sense of being accompanied.

Responding to self-harm from this perspective means widening support rather than shaming or pushing. The questions become:

What load is this system carrying?

What threat cues keep firing?

Where has connection been disrupted?

What would help this body feel even a little more supported and less alone with its pain?

And the steps toward change are about restoring capacity, not forcing behavior:

  • small moments of co-regulation with people who can stay steady
  •  predictable routines that give the system anchors
  •  practices that build interoceptive clarity without overwhelm
  •  environments that reduce threat and remove the pressure to perform
  •  ways of expressing distress that do not require hurting the body to be heard

IPNB treats self-harm as a signal that the system needs more connection and protection, and less load. The remedy is never about telling someone to “just stop,” but in creating enough safety in the mind, body, and relationships that the survival adaptation is no longer necessary.

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The Falsehood of “Post-Traumatic Growth”

Posted on August 12, 2026 by Shay Seaborne, CPTSD

People sometimes tell me I am experiencing “post-traumatic growth.” They say it like it’s a compliment, and I should feel encouraged. As if this is the gold at the end of  years of fighting for my life. That’s a falsehood.

The reality is that I can finally function a little better after years of severe trauma followed by even more severe trauma at the hands of people and systems that claimed to help. And now that I’m not actively drowning every second, people want to rebrand that as growth.

I am trying to recover what I once was. I am working doggedly to reclaim capacities I had before I asked for help and paid for it with my body, relationships, sense of safety, and my future. I am still a fraction of who I was. I have recovered only a fraction of the range, stamina, and level of well-being I once lived.

From an Interpersonal Neurobiology (IPNB) perspective, trauma does not create growth, but narrows life. It forces survival and strips choice. It demands constant threat detection at the expense of connection, creativity, learning, and rest. Nothing about that produces expansion.

What people call post-traumatic growth usually shows up only after the threat finally decreases and some safety is restored. After connection becomes possible again. When the relentless demands on the system ease just enough that life can start to re-enter the picture. That’s not trauma making someone better. That’s recovery: capacity slowly coming back online once it is no longer being crushed.

When I hear “look how much you’ve grown,” I’m reminded that my massive losses are still invisible: years I didn’t get to live, work I couldn’t do, relationships I couldn’t sustain, and capacities that vanished when survival took over. The person I was before asking for help, before being harmed again and again for being honest about the egregious harms done to me throughout my life by people in positions of power.

Calling this growth skips over the brutal truth. It smooths the story into something palatable. It lets people avoid grappling with how much damage was done, how preventable it was, and how long recovery takes when harm is chronic and institutional.

It also quietly puts the burden back on the person who was harmed. If trauma leads to growth, then suffering is reframed as meaningful. Necessary, even. The abusive systems don’t have to change if the injury becomes the teacher. It’s like being met with what pain specialists call “the C7 salute.” Middle finger up.

But what I’ve learned did not come from trauma. It came from surviving it without adequate support. It was hard won from having to see clearly because denial was no longer an option. It came from experiencing what happens to human beings when hierarchy, cruelty, and neglect are built into the structures that claim authority over our lives.

From an IPNB lens, humans grow in environments that support safety, dignity, and mutual care. Trauma disrupts that process. Prolonged threat reshapes what is possible in the moment because survival demands it. When the pressure finally eases, the nervous system does what it has always tried to do: return toward life. Toward homeostasis. 

That return can look dramatic from the outside:  insight, boundaries, refusal to tolerate harm, and clearer values. But none of that requires trauma as a prerequisite. Those capacities flourish in supportive environments, too. The difference is that trauma makes naming the cost visible.

I don’t celebrate “post-traumatic growth.” I present recovery as what it is: slow, uneven, incomplete, and hard-won. I share the truth that I am still rebuilding after years of being pushed past human limits. I present the loss alongside the persistence. I am not harvesting wisdom from trauma, but doing the exhausting, unfair work of rebuilding after being repeatedly harmed for seeking care. 

The only thing that deserves recognition is the relentless drive toward life that keeps showing up even after everything that tries to shut it down. That, and the rage and determination that kept me fighting a “healthcare” system and domination culture that drove me excruciatingly close to death. 

Calling this “post-traumatic growth” is an egregious falsehood, and I won’t stand for it. It erases loss, launders harm, and turns recovery into a feel-good story so no one has to look too closely at what was done or why it keeps happening. Trauma did not give me anything. It stole from me, repeatedly, and what you see now is me fighting to reclaim ground I already had, under conditions that should never have existed. I will not let language be used to soften cruelty, excuse systems that overload human beings, or rewrite survival as transformation. Recovery deserves honesty. Anything less is just another way of treating harm as acceptable.

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The Hidden Load of Heat When You Live With CPTSD and CRPS

Posted on August 11, 2026 by Shay Seaborne, CPTSD

Lately, everything feels more challenging. I have been sleeping more. Some days I take two or three naps. I feel lethargic and become cognitively stressed more easily. My productivity, which is already limited by chronic illness, is even more impeded2. Simple tasks require more effort, decision-making takes longer, and concentration is harder to sustain. I wondered what was wrong. Then I started looking more closely at the role heat may be playing.

Many of us have been taught to think about hot weather as a minor inconvenience. We complain about it, drink a little more water, and carry on. But for people living with conditions like Complex PTSD, CRPS, dysautonomia, chronic pain, chronic illness, and other conditions that affect the body’s regulatory systems, prolonged heat can become a significant physiological stressor. Understanding that has helped me give my body more grace this summer.

Relational Neuroscience teaches us that our experience emerges from the ongoing flow of information in the body, within the brain, and between us and our environment. We do not exist separately from our surroundings. The body constantly takes in information about temperature, hydration, circulation, energy availability, social connection, physical safety, and hundreds of other variables..Heat changes the equation.

When temperatures rise, the body has to work harder to maintain a stable internal environment. Blood vessels dilate, sweating increases, heart rate often rises, more fluids are needed, sleep can be disrupted, and energy is diverted toward cooling and maintaining basic physiological balance.

For someone with a healthy, flexible nervous system and no chronic health conditions, these adjustments may not be particularly noticeable. For someone like me, they can become impossible to ignore.

I live with severe Complex PTSD and quadrilateral CRPS. One of the features of my CRPS is hyperhidrosis. When the weather gets hot, I am not simply sweating a little more than usual. I can have sweat literally dripping down my legs from old scarred areas. At the same time, I am trying to stay hydrated, which is difficult enough under normal circumstances.

The result is that I often feel depleted before I have even started my day.  But I know fatigue is not laziness, naps are not a character flaw, and te cognitive difficulties are not a lack of motivation. My body is dealing with an increased physiological workload.

I expect many people with chronic conditions are experiencing something similar without realizing it. It can be particularly challenging because the effects of heat do not always show up in obvious ways. Sometimes they appear as increased pain, irritability, brain fog, poorer concentration, greater sensory overwhelm, reduced stamina, disrupted sleep, or an increased need for rest. People often blame themselves for these changes.They assume they are failing, that they should be able to push through, or that they are imagining it. Yet from a neurobiological perspective, there may be very real reasons their capacity is reduced.

Complex PTSD already involves a nervous system that has spent years adapting to chronic threat, unpredictability, or relational disruption. CRPS involves altered pain processing, sensory processing, circulation, temperature regulation, and autonomic function. Add prolonged heat to that mix and it is not surprising that many people find themselves struggling.

The body is being asked to do more. At the same time, many of us are trying to maintain the same expectations we had when the weather was cooler. That can create a great deal of unnecessary self-criticism.

One of the most useful shifts for me has been moving away from asking, “Why can’t I keep up?” and toward asking, “What is my body dealing with right now?” That changes everything. Instead of treating my fatigue as a problem to overcome, I can treat it as information. Instead of seeing naps as evidence that I am failing, I can recognize them as part of how my body adapts to increased physiological demand. Rather than trying to force myself through the hottest parts of the day, I can build my schedule around what my body needs.

For me, that means spending more time in air-conditioned environments. I have an air conditioner in my bedroom, which helps me sleep reasonably well. But I cannot spend my entire day in my bedroom. That would quickly become isolating and miserable. But outside my bedroom the house is often 88-95°F.

So I have been thinking differently. Rather than staying home and struggling through the hottest hours, I am strategizing to spend more of that time in air-conditioned public spaces: libraries, coffee shops, community spaces, and other places where I can cool down, conserve energy, and perhaps most importantly, have some contact with other human beings.

That social connection matters too. From an IPNB perspective, relationships are not separate from health. Human beings regulate one another in countless ways. Supportive social environments can reduce physiological strain. Isolation often increases it. My strategy for staying cool also supports.overall well-being.

I am also paying attention to when movement feels most accessible. For me, that often means walking first thing in the morning or about an hour before bed. I especially like walking before bed. It seems to help me settle into sleep more easily.

If you find yourself more fatigued, less productive, more cognitively stressed, more symptomatic, or simply less able to do what you normally do during periods of prolonged heat, consider the possibility that your body is responding to real physiological demands.

You are not imagining it or failing. You may simply be living in a body that is working very hard to maintain balance under challenging conditions. When the heat turns up, it is vital to listen more carefully to what our bodies are telling us.

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Extreme Wealth Gaps Create Widespread Chronic Stress

Posted on August 10, 2026 by Shay Seaborne, CPTSD

Extreme wealth gaps, like we have today, create widespread chronic stress. But there are other ways to structure society, ones that support mutual thriving, shared safety, and dignity for all. Reducing inequality is about making sure our collective nervous systems aren’t stuck in survival mode.

We need policies and structures that prioritize collective well-being and shared responsibility. For example, universal healthcare relieves individuals of the constant stress of affording basic care. Strong public education systems reduce long-term inequality and increase everyone’s chances of contributing meaningfully. Housing-first policies give people a stable base from which to regulate and rebuild. Cooperative business models spread resources and decision-making. Paid family leave, childcare support, and living wages reduce chronic stress for families.\

These are choices some societies already make, and they tend to result in better mental and physical health, stronger communities, and lower crime. It’s not about making everyone the same, but creating conditions where more people can feel safe, valued, and connected.

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Letter to a Now Former Friend 

Posted on August 7, 2026 by Shay Seaborne, CPTSD

One of the hardest things about trauma recovery is the process of recognizing which relationships are mutual and supportive and letting go of those that are not.

I’ve done this over the course of years, particularly with family members, most of whom are clearly toxic to me. But also with people who I had considered friends and supporters for many years. I had to let them go after multiple attempts to help them understand that my condition is the result of a lifetime of abuse, especially sexualized violence,  compounded by psychiatric and medical abuse in the last 8 years. Instead of believing what I say about my lived experience, and the neuroscience behind it, they let me know in subtle and not so subtle ways that they think I’m the problem. I’m not taking the right perspective, thinking the right thoughts, or making the right choices. If I would just do what they think I should do, my life would be better.

Recently, I decided to tell a long-time connection why I had backed away. I had enough respect for what had come before and for the person who had been my friend to let her know why I had stopped responding to her messages of encouragement. I wrote her a note that told her how her behavior had affected me and that it was not okay for me to keep being exposed to that.

She responded with a lengthy letter of her own. It said that she hadn’t meant any harm, just that she believed in my potential and she hoped I would see things her way. And she went on and on about her way. There was no acknowledgment of what I’m actually dealing with. Her words made clear that what I had sensed was true. She thinks she has the answers for my life, even though she doesn’t understand it.

I thought about not responding, but I decided to give her an object lesson in case it could help her treat the next traumatized person better. Here’s what I sent:

“Thank you for taking the time to write back. My letter wasn’t questioning your intentions, but describing the effect those interactions had on me. Intent and impact are different.

I know you’ve accomplished a great deal in your life, and I’ve always admired your dedication to your family and community. That’s why I hope you’ll consider something I’ve learned.

From what I can see, you still have unresolved developmental trauma that is limiting your ability to fully understand yourself and others. My hope is that you’ll find a truly trauma-informed therapist and commit to several years of deep work. Once you’ve done that, you’ll be able to see relationships, conflict, and healing in a completely different way.

If my suggestions come across as dismissing your perspective and experience, I’m truly sorry. My intention is simply to encourage you because I believe so strongly in your potential. I can see a future where you’re no longer held back by the patterns you can’t yet recognize. This is offered with love and respect.

If that landed badly, it is because it does exactly what your letter did. It assumes authority over your life, identifies a problem you didn’t ask me to diagnose, tells you what kind of healing you need, predicts what you will think afterward, and wraps it in love and respect. In reality, I would never presume to know more about your life and needs than you do, or prescribe a formula for you to follow.

I don’t need someone to decide what a meaningful life should look like for me. I need people willing to understand the conditions I have lived through and how those conditions have shaped my options, losses, and values.

Trauma has nothing to do with “holding on to pain.” It’s a neurophysiological condition caused by too much demand for too long combined with insufficient social support. Particularly, lack of attunement, compassionate witnessing, empathy, and validation of lived experience from those we turn to for help.

Your view assumes that if I’m not content, I am simply using the wrong strategy. That overlooks how much of my life has involved navigating institutional betrayal, chronic health challenges and disabilities created by medical and psychiatric abuse, how hard I’ve had to fight for appropriate care, the deep financial impact of uncovered care, and the long-term effects of developmental trauma. None of those disappear because someone offers a different philosophy.

My focus has been on building a sustainable life, and surrounding myself with people who don’t keep adding to the harm. Our bodies respond to the conditions in which we live and the relationships in which we engage. When those are grounded in respect, safety, and recognition of reality, we function better. I don’t seek the “control,” you described, but an environment that supports my well-being instead of repeatedly undermining it.

My letter wasn’t asking you to imagine a better future for me. It was explaining why I need relationships where my present and past can be acknowledged without being redirected. Your reply explains why you responded the way you did, and offers more of the same response. Rather than recognition of what has been stolen from me, the focus returned to prescribing a path forward. I understand why you offered that, but it also confirmed what I sensed. Pushing positivity while ignoring the conditions under which I live is like telling a drowning person that everything will be OK if they would just smile hard enough.

I truly appreciate the kindness you’ve shown me over the years, and I will always be grateful for that. At the same time, I recognize that the kind of relational support my body needs is different from what you can offer. There is no blame, simply an acknowledgment of what is essential for my well-being.”

I expect I won’t hear from her again. I’m a little sad that the connection turned out to be the fair weather type, but that’s okay. Letting go of that frees up energy and focus for relationships that are mutual and supportive.

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The Doctors in My Recovery Plan

Posted on August 5, 2026 by Shay Seaborne, CPTSD

Many people have trouble believing that caring doctors became an essential part of my Interpersonal Neurobiology-based trauma recovery plan. Some dismiss it entirely because they assume healing relationships have to happen with family, friends, a romantic partner, or a therapist. That was not my reality. By early 2020, two years of repeated psychiatric and medical abuse had narrowed my world so dramatically that doctors became my primary points of human contact. At times over the following three years, I had two or three appointments in a day, sometimes as many as twelve in a week. Those visits were with physicians, specialists, physical therapists, occupational therapists, psychotherapists, and body workers. Most days, arriving on time and within the bounds of good hygiene took almost everything I had. Afterward, I usually needed to go home and sleep. I didn’t have a social life or the capacity to build one. The harm done by the systems that were supposed to help me had stripped those away. Recovery had to begin with the few relationships that were available.

The clinicians who became part of my recovery did not simply provide pills and perform procedures. They became steady, repeated experiences of safe connection. They listened and respected my boundaries. Some stood beside me when others dismissed or harmed me. That counted even more because many were physicians, most were men, and they belonged to a group that had repeatedly held power over me and caused harm. Each appointment became another experience that gently taught my body it could expect better.  Human beings don’t heal in isolation. The quality of our relationships can determine whether we access care, whether our bodies can tolerate that care, and sometimes whether we even survive.

Thanks in large part to how these doctors have cared for me, I have rebuilt some of my capacity to feel safe in connection with others, and have started to build new relationships and deepen older ones, as well as to cast off those that impede my well-being instead of supporting it.

Many people with severe developmental, psychiatric, or medical trauma do not have the capacity to build friendships or community yet. Their reliable human contact may be limited to a few clinicians, home health aides, or other helpers. From an IPNB perspective, those relationships can become part of a person’s relational environment if they are characterized by consistency, respect, attunement, and safety. They are not a substitute for a broader community forever, but they can become the bridge that makes broader connection possible, as they did for me.

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Where Psychiatric Labels Fall Apart

Posted on August 3, 2026 by Shay Seaborne, CPTSD

Psychiatry puts forth the idea that a person is one thing, then something happens inside them, a kind of switch, and they become something else. As if so-called “mental illness” appears without context, history, or conditions that accumulate over time. That has never matched my experience.

There was a long stretch of my life where I functioned in a sustained, practical, outward-facing way. I lived in one house for 17 years. I could plan years ahead instead of weeks. I could build things that required follow-through across time.

That material stability was part of a marriage that was not mutual. My partner engaged in passive aggression, emotional absence, and conflict avoidance. Repair was rare to non-existent. The stability provided structure. The marriage reduced relational contact. The structure still shaped what was possible.

In that same period, I was able to become deeply embedded in community life as someone people relied on and invited into ongoing work: political campaigns, homeschooling networks, state associations, boards, and committees. I ran seminars across the state. I helped double membership in a statewide organization in a year and helped create conferences. I supported a variety of organizations in multiple ways.

My community showed up for me, too. When I separated and moved, people came with trucks, furniture, and pizza. When I had surgery, there were people to drive me, to sit with me after, and bring food and good company days later. That was a functioning network of mutual responsibility. I was part of it in both directions. That kind of life runs on continuity, trust, and repeated contact over time.

Looking at it through an Interpersonal Neurobiology lens, I don’t see a “stable personality” versus a “disordered personality,” but a nervous system shaped by conditions.

When housing is stable, the nervous system does not have to spend constant energy on uncertainty. When routines are stable, planning becomes possible. When relationships are reliable enough, even if imperfect, the system can stretch into contribution instead of contraction. When community response is consistent, the system stays more open to engagement because it expects return. Capacity expands because the conditions allow more of the system to be available at once.

Then those conditions changed. When I separated, the material base shifted. Housing and resources changed. The relational network that had been distributed across many people became less accessible. Over time, the pattern changed from accumulation to interruption. Instead of building over years, energy went into re-establishing basic stability.

In that phase, labels like depression or PTSD were applied from the outside as if they explained what was happening. But they do not describe what was lost, or how much functioning is tied to housing, continuity, and reciprocal community systems.

The psychiatric model suggests that a person crosses a threshold and becomes fundamentally different. That there is a before and after that lives inside the person alone. My experience does not show that. It shows variation tied to conditions.

When conditions supported continuity, my life supported long-term building, leadership, and sustained community involvement. When conditions reduced continuity, my functioning narrowed, not because a core identity changed or my brain chemicals suddenly went wonky, but because fewer systems were available to support output, connection, and recovery.

Even in the difficult periods, the shifts were not total. There were still moments of clarity, participation, and contribution. That shows range, not collapse into a fixed state.

Psychiatry takes the lowest functioning point and turns it into a category. Then it treats that category as the explanation for itself. Medications and cognitive reframing are then positioned as primary interventions, as if the main issue is correcting thinking or regulating mood directly.

But thinking and mood reflect the conditions the system is operating under. They change when those conditions change. I learned that as I saw my functioning expand when stability was present and narrow when stability was reduced. I watched community participation grow when I was embedded in place and shrink when I was displaced from it. The pattern was consistent.

Clinical language overlooks that human functioning is not fixed inside a person. It is distributed across housing, relationships, routines, resources, and the reliability of return from the people around us. When those layers add up to sufficient support, the system has room to move. When they don’t, the system contracts. Calling that a mental illness hides the structure that produced it.

I came to greatly distrust psychiatry through repeated exposure, study, and other’s stories of how the industry abused them. And it usually started with the assertion that something in their brain had changed, making them mentally ill like a switch was turned on. But they’re never told what caused the switch. Because psychiatry has no clue.

Years of experience have taught me I can trust Relational Neuroscience, which shows us that the same person naturally has different capacities under different conditions. Capacity is a reflection of how much support the system is receiving at any given point.

When people recognize that pattern in their own lives, the question changes. It stops being “What is wrong with me?” and becomes “What conditions affect what is possible right now?” That question allows choices that support well-being. No diagnosis necessary.

 

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There is No Shortcut to Meaning

Posted on July 31, 2026 by Shay Seaborne, CPTSD

A LinkedIn member posted that “Changing ‘why is this happening to me?’ into ‘what is this trying to teach me?’ is a game-changer.” From an Interpersonal Neurobiology (IPNB) perspective, that reframe can actually be harmful because it skips over the most basic needs of the nervous system. When something painful or overwhelming happens, the first priority isn’t to assign meaning, but to restore a sense of safety and regulation. Jumping straight to “what is this teaching me” risks bypassing the body’s natural responses of fear, grief, or anger, which are signals that need acknowledgment and support.

If someone feels pressured to turn every hardship into a lesson, it can create shame when they’re unable to do that. Instead of integration, the nervous system gets stuck in survival mode, carrying the burden alone. Real growth comes not from forcing meaning, but from having the connection, validation, and regulation that allow the body and brain to settle. From there, sometimes meaning emerges naturally, but it can’t be imposed as a shortcut.

 

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When “Patient and Family Relations” Becomes Part of the Harm

Posted on July 29, 2026 by Shay Seaborne, CPTSD

The original harm was devastating. What happened afterward taught me just as much about the system.

After the psychiatric abuse, I contacted the hospital so-called Patient and Family Relations Department. I expected a process that was interested in understanding what had happened, looking at where things went wrong, and preventing it from happening again.

Instead, I found a protracted, painful, do-everything-you-can-to-make-the-person-shut-up-and-go-away experience. I have a stack of letters from that department, mostly stonewalling and word salad.

They wondered why I kept coming back. Most people gave up after a few tries. I hung in there probably longer than anybody ever had. Part of the reason was because I wanted to see what the system would actually do. Not just for me, but for anybody who reported serious harm. I took notes on every interaction and saw the patterns.

It took eighteen months just to get a meeting. And the meeting wasn’t even with the psychologist whose actions had caused the harm. Instead, it was with two physicians from the same satellite facility. It seemed like they hadn’t been briefed in advance. Their faces wore matching “thrown under the bus” expressions, with eyes like silver dollars.

Oddly enough, their surprise turned out to be the best part of the whole process. Unlike the Patient and Family Relations personnel, their responses weren’t scripted for legal security. They were genuinely shocked and upset by what I described had happened to me in that facility.

I felt bad for them because it appeared they had walked into a booby trap. Knowing that made me even more determined to treat them with respect. I didn’t go off on them. They weren’t responsible for any of my problems.

I brought with me a list of intervention points that had been missed. Any one of them could have prevented the manufactured mental health crisis I experienced after being given a pharmaceutical “remedy” for the distress that came from a lifetime of abuse. As we went through the list, they became increasingly engaged. They were impressed with what I had put together and asked if they could keep it.

From an Interpersonal Neurobiology perspective, people make sense of their experiences through relationships. Institutions do the same. When a system responds to reports of harm with delay, deflection, bureaucratic language, and endless process instead of curiosity and accountability, it teaches everyone inside it how not to respond. The complaint process stops being a path toward repair and becomes another layer of the injury.

I wonder where those two doctors are today. My guess is they’re long gone from that hospital. It is hard to imagine they could go through that process and go back to business as usual. Who would want to stay in a place that treated patients that way? And who would want to practice medicine in a system that treats its own doctors that way, too?

Unfortunately, the psychiatric abuse was just the beginning for me. The non-consensual gynecological surgery–medicalized genital mutilation–was even worse. I didn’t turn to Patient and Family Relations for help. I knew from prior experience that it’s the soft end of the hospital’s legal department. Its goal is not helping distressed patients and families, but containing their distress, extinguishing their expression of it, and protecting the institution’s fiduciary, reputational, and administrative interests.

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The Problem With Functional Medicine

Posted on July 27, 2026 by Shay Seaborne, CPTSD

Functional medicine presents itself as a more complete approach to health, but, like mainstream medical treatments, it focuses on individual physiology and treats the body as the primary site of explanation and intervention. Distress is framed as the result of internal imbalance, measurable through lab values and addressed through protocols, supplements, and lifestyle prescriptions. This determines what is seen and what is ignored.

Functional medicine consistently underaddresses the role of relationships and social conditions in shaping health over time. Human regulation is affected by ongoing interaction with caregivers, partners, institutions, and communities. Early relational harm, chronic insecurity, social exclusion, housing instability, and institutional abandonment leave lasting physiological effects. Functional medicine tends to compress all of this into the category of stress, which reduces complex lived conditions into a background variable rather than a primary driver.

The neurobiological dimension is also treated narrowly. Functional medicine often measures downstream correlates such as hormones, inflammatory markers, or neurotransmitter byproducts. These can describe a state but they do not explain how that state developed or how it is maintained through daily interaction with the environment. Regulation is treated as chemistry rather than as an ongoing process created by safety, predictability, and connection. As a result, cause is often misattributed. Effects of chronic relational strain or systemic precarity are reframed as internal dysfunction requiring individual correction.

This approach aligns well with a market-driven healthcare environment. Expansive lab panels, repeated testing, and long-term supplement regimens are costly and usually paid out of pocket. Promises of personalized answers and root causes appeal to people who have been dismissed or underserved elsewhere. The structure rewards certainty and intervention even when the evidence is thin. When improvement does not occur, responsibility quietly shifts back to the individual for not following the protocol closely enough or for having a body that is too complex.

Another problem is that functional medicine relies on continuity and resources that many people do not have. Trauma, poverty, and housing insecurity disrupt continuity. When care models require consistent attendance, sustained purchasing power, and stable life conditions, they systematically exclude the people most affected by chronic stress and relational harm. The model then interprets dropout or nonresponse as individual noncompliance rather than as a predictable outcome of structural strain.

Functional medicine is not entirely without value. Some practitioners are careful and restrained, and some physiological issues do benefit from closer attention to diet, inflammation, or metabolic health. The problem is that biology is treated as separable from relationship and context. Health is produced through interaction over time, not solely through internal adjustment.

When relational conditions are ignored, care is incomplete. When neurobiology is reduced to lab values, regulation is misunderstood. When social systems are left out of the analysis, individuals are left holding responsibility for conditions they did not create. That is the core limitation of functional medicine. It promises a whole-person approach while leaving out the conditions that make whole-person health possible.

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