A few months ago, I agreed to a podcast interview with a prominent pain specialist, someone widely known for using Stellate Ganglion Blocks (SGBs) to treat people diagnosed with PTSD. He states that the shot works fast, with people often “feeling like themselves again” within 30 minutes. At the time of the interview, I had undergone 27 SGBs for severe Complex PTSD (CPTSD) and quadrilateral Complex Regional Pain Syndrome (CRPS). That means I was not talking about a single reaction or an outlier experience. I was speaking from repeated exposure over time, with ample opportunity to notice patterns, shifts, and delays in how my body responds.
I went in willing to speak plainly about my experience, not as a testimonial or a success story, but as a person living in a body shaped by prolonged threat, repeated violations, and layered loss.
At one point, I told him something simple and ordinary. For me, it usually takes about two weeks to notice the full effect of a stellate ganglion block. Not hours. Not days. Weeks.
His response was a single word. “Interesting.” He showed no interest in how change unfolds over time in a human nervous system that has been carrying load for decades. Just a pause and a quiet closing of the door.
What makes this especially telling is that my experience is not unusual. In PTSD forums, other people share how they have similar experiences. The shift is gradual. Sleep may change first. Vigilance softens later. Pain, digestion, and social tolerance often follow more slowly. This is common, particularly for people with complex trauma histories. Two weeks is not strange. Pretending there is one clean timeline is.
Later in the interview, I showed the doctor a painting I made about the neurobiological effects of hierarchy. It came directly from lived experience and from years of studying Interpersonal Neurobiology (IPNB). His response was to sarcastically accuse me of having a negative view. Then he changed the subject. Soon after, he cut the interview short. That told me a great deal about him.
Sarcasm is often a way to assert dominance without engaging. Painting my view as negative, he avoided the actual subject, which was how hierarchy shapes stress, safety, and human capacity. It also made clear that this was not a shared inquiry. He controlled the frame, the tone, and the ending.
From an IPNB perspective, this is an example of how hierarchy behaves when it is exposed. When lived experience disrupts a tidy intervention narrative, or when someone points to power itself as a source of suffering, control tightens. The conversation narrows. The person with institutional authority decides what is acceptable to discuss and when the discussion is over.
This specialist is well-versed in SGB for PTSD as a diagnosis. But he did not want to engage with CPTSD, where threat has been chronic, relational, and embedded in systems. In those bodies, change is rarely immediate. It unfolds over time, in interaction with daily life, with safety, and depending on whether the person is still living under domination and contempt. Bodies adapt to conditions. They do not obey scripts.
The physician’s behavior told me he is comfortable with his place in the hierarchy. Comfortable enough to deflect, dismiss, and shut down the podcast recording once the hierarchy itself was made visible. Such comfort depends on hierarchy remaining unexamined.
When people talk about healing without talking about power, something essential is missing. When clinicians center interventions but refuse to look at the structures that keep bodies in prolonged threat, they protect their position, which does not support recovery. And when lived experience is treated as an inconvenience rather than a source of knowledge, hierarchy is doing exactly what it is designed to do.
I considered sending the specialist a follow-up email, but quickly recognized that I am not interested in conversations that require silence about this, or narratives that flatten complex human recovery into neat timelines. And I am not willing to participate in spaces where control matters more than truth.
Hierarchy shows up in bodies and conversations. And when you make it visible, the conversation often ends. But I will keep sharing my lived experience, including with the podcasting doctor, to ensure the conversation about the harms of hierarchy continues.
