Will Smith’s slap is a trauma response [PODCAST]

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“As physicians, we are masterful at suppressing so many of our emotions, and the thoughts and memories associated with them. However, trauma has a way of impacting us in great big obvious ways (as we saw with Will Smith), and not such obvious ways (perfectionism, workaholism, lack of boundaries).

I’m not suggesting any of us go unearthing swaths of past trauma. Simply be aware that it may be impacting you in ways you recognize and have yet to address, or in ways you never quite thought of as being associated with trauma. And, if needed, allow yourself to get the support you need by working with a trauma-informed therapist, trauma-informed coach, or other trauma-informed specialist.”

Melissa Hankins is a psychiatrist and physician coach.

She shares her story and discusses her KevinMD article, “Will Smith’s slap is a trauma response.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. Today on the show, we have Melissa Hankins. She is a psychiatrist and a physician coach. She wrote the KevinMD article “Will Smith’s slap is a trauma response.” Melissa, welcome to the show.

Melissa Hankins: Oh, thank you so much for having me. I’m really looking forward to this discussion.

Kevin Pho: So we’ll get into your article in a little bit, but first off, share your story and journey to where we are today.

Melissa Hankins: My journey to medicine came about because my mom, who died when I was 16, struggled a lot with her own illness. She had lupus, systemic lupus, and we were in a space of really having a lot of financial struggle during that time. She was a single mom. I was the youngest of three, and she had gone on disability for several years before she died. And she was a nurse, and it was something that my 16-year-old self saw: that she was really not heard by the medical establishment. I don’t know if that was because of her gender. I don’t know if that was because of the socioeconomic status we were in. I would say maybe racially, but she was white, a white, you know, woman. I’m biracial, and so that didn’t really enter my mind at the time. But after she died, that really galvanized my desire to go into medicine and to help people, who, regardless of their socioeconomic status, really deserve quality care.

And so when I went to medical school, I was convinced, absolutely 100 percent convinced, I was going to go into internal medicine. If you had told me psychiatry, there was no way. And then I did my psychiatry rotations, and I fell in love. I fell in love with psychiatry, and what I loved about it was the fact that people were sharing their most intimate parts of themselves: their minds, their thoughts, their feelings. That’s not something that I experienced in other rotations during medical school, and I thought it was a great gift that they were giving me. It was also a place where I felt every single emotion personally. I experienced the whole gamut, so I felt alive in psychiatry, and for me, that was it. I was like, “OK, that was my choice.”

And I loved psychiatry. I now actually work full time as a coach and EFT practitioner. EFT is emotional freedom techniques, or tapping, acupuncture without the needles kind of thing. My coaching and EFT work, and the transition to that, came about after my own burnout, my own kind of crash and burn, I feel, in a very real way, and that occurred back in 2012. Prior to that, I kind of knew I wanted to get out of medicine, actually. I became certified as an executive coach, and this was at a time when coaching was really for the corporate sector. It was unheard of within medicine. I got certified as an executive coach, and I just kind of sat on it. It didn’t propel me in the ways that I wanted at that time, so I continued on with psychiatry.

When my son, who’s now 14, was four, I had my major burnout, where I was not staying on top of my charting. I was falling way behind. I had really ill patients and an unending panel of patients, like most of us, and I was trying to balance that and trying to balance my home life, and trying to be perfect. I think that’s something that, as physicians, you know, we strive toward, unfortunately, and perfectionism is a fallacy. But I was trying my darndest to be perfect and be everything to everyone, and I was being nothing to myself.

It got to the point where one day, I felt, it was the day after my son’s fourth birthday, and I thought he would be better off without me. And so I said, “That’s not so good,” especially for a psychiatrist treating people around their own, you know, suicidal ideation. And so that day, I went and asked. I said, “I need to take an immediate medical leave.” And my supervisor at the time said, “Oh, OK, but can you come in and see your patients for the next couple of days?” And being the, you know, good physician that I am, I said, “Yes, of course.” And the next day, I had the biggest, and first, major panic attack I’ve ever had. I couldn’t get dressed. I couldn’t leave my house. It was horrible. It was really horrible. And then I called the administrator, and I was sobbing, and I said I couldn’t come in, I couldn’t come in. And she was like, “OK, all right.”

After I pulled myself together, after 20 minutes, I had to get my son to school, and I realized it was his last day of ice skating lessons at Montessori. We went, and no anxiety, no panic. I was fully present. It was the first time that I was actually there for one of his events, because I missed everything because of work. And so that, to me, really started my journey of taking time for myself. I thought I was going to be out for two weeks. It turned out I was out for 10 months, and I eventually resigned from that position.

But I just really started doing therapy more intensely. I’d already started prior to that. I did coaching, I was doing EFT work, and meditation, and all of those things came together to help heal me and help me to deal with my own traumas, if you will. You know, my trauma of being a physician, because there’s so much trauma inherent in our work as physicians, our training or work. So that really kind of started that journey. I eventually went back to another position, and I started doing some EFT work with some of my patients, and the staff were amazed by how well the patients were doing with this, and they said, “Can you do that with us?” So I started doing some lunch-and-learns and really helping them with the stress of charting and overwork and lack of resources, and just really helping them to regulate their emotions and their physical bodies and their thoughts, and bringing in this mindfulness piece, which EFT really does. It was really a beautiful thing. They started asking me, “Well, can I work with you one-on-one?” And so that really kind of started the coaching and EFT business, and it just kind of grew from there.

Kevin Pho: What a wonderful story. We probably have to do another episode talking specifically about your coaching and EFT.

Melissa Hankins: Absolutely.

Kevin Pho: I would love to hear more about that. But there were some issues about trauma you observed from the recent flap from Will Smith during the Oscars, and you wrote about that in your KevinMD article, very well received, over 13,000 shares as of today. It’s titled “Will Smith’s slap is a trauma response.” Now, for those of you who get a chance to read your article, just walk my audience through it and share the story of why you decided to write it.

Melissa Hankins: Yes, absolutely. It actually started as a Facebook post. Actually, one of my EFT colleagues had written a little post on his Facebook wall about this, the slap, and I thought, “Wow, OK, yes.” Something just clicked with me. He mentioned trauma in it, you know, trauma response, but didn’t really explain much about it. And I saw it, and I said, “Oh my gosh, yes, physicians need to hear more about this.” Because my whole point in writing my post was actually to educate physicians more about trauma and how it can show up for us as physicians in the subtle ways that we don’t often think about, you know, the perfectionism, the workaholism, things like that that I mentioned in the article. But this was just such a slap heard around the world that everybody was aware of it. And so to use that as a really common example that everybody knew about, to talk about trauma, it was just perfect timing, and to then kind of go into a discussion of how trauma can be experienced and how it can manifest in our adult lives.

Kevin Pho: So go into more detail in terms of that intersection. In Will Smith’s case, I guess, how did past trauma potentially lead to his reaction during the Oscars?

Melissa Hankins: Yes. So, you know, with Will Smith, of course, in his autobiography, “Will,” he had written about an experience when he was nine years old of watching his father beat his mother, you know, in front of him, to the point where she was bloodied, and it was just really horrific for him. He wanted to really be able to protect her and stand up to his father, but he was this nine-year-old child, of course. But that, of course, stayed with him, and he was bringing that drive, if you will, similar to my trauma around my mother’s death and that propelling me in my work. This was something that propelled him in his work and his achievements and everything that he did. He talked about how he was really doing it for his mother, to make his mother proud, to be this person that he couldn’t be then.

And so when things happened with the slap with Chris Rock, who absolutely has his own trauma history that we know about, and yes, I didn’t discuss it in the article, however, it absolutely is relevant, because he had his own response that was not aggressive, but more of an avoidant kind of, either, you know, flight or freeze response. But for Will, you know, he’s hearing this disparaging of his wife by Chris Rock, and it’s very likely, did I examine him? No. Can I say for certain? No. However, given the background information, it’s very plausible that his reaction was a traumatic response, where he saw the woman he loved being bullied, and it triggered something in his mind, in his amygdala and hippocampus, where we hold memories and emotions, and brought him back to that nine-year-old self. And now he was an adult. Now he could actually do something. He didn’t have that fear of that nine-year-old self holding him back, and he reacted. He protected the woman that he couldn’t protect then as a nine-year-old.

Kevin Pho: Now, through your lens as a psychiatrist, was there anything that Will Smith could have done to address this or treat this before it came to a head during the Oscars?

Melissa Hankins: Oh, absolutely. And, you know, for anybody who’s experienced trauma, it’s very important to work with a trauma-informed psychiatrist, therapist, or practitioner of some sort who can help you work through the trauma. And with trauma, it’s very important to understand that what you’re experiencing is not simply held in our prefrontal cortex, the part of our brain at the front of our heads there that is responsible for cognition and our cognitive thinking. Our trauma responses are really based in survival, and that is a different part of our brains, and so traditional psychotherapy does not really access that.

Things like EMDR, eye motion desensitization reprogramming, which is a subspecialty of some therapists, are a good modality for being able to work with trauma. Different somatic therapies can be helpful, or somatic modalities can be helpful, that incorporate the brain, because we hold our emotions in our bodies as well. When we are traumatized, we have almost a muscle memory of however we were trying to respond in that moment, and with trauma, we’re not able to execute that physical response. And so the kind of modalities that are really helpful, and that, you know, I’m hoping at this point that Will Smith is engaging in, are things that would involve a mind-body-emotion kind of combination.

Kevin Pho: So you mentioned that there are some lessons here that you want clinicians to learn from. So what are some specific things that my clinician audience who may be listening to you here, what are some lessons they can draw from this whole event with Will Smith?

Melissa Hankins: Yeah, you know, that we are human beings, that we are emotional beings, that as physicians, especially, we are taught and trained to suppress our emotions, and therefore we’re taught and trained to suppress part of our humanity. And that is going to come out one way or another. It’s going to come out either in a kind of more physical, aggressive way, maybe yelling at other staff or yelling at your family members, or it may come out in ways of trying to hide and be invisible, be perfect, be people-pleasing, or overworking, these things to try not to draw attention to yourself. So, to be aware of those things: When you are noticing patterns of behavior for yourself that have become problematic, that you’re wanting to change but that you’re having a difficult time changing, there’s likely some trauma that’s holding it in place.

Kevin Pho: We’re talking to Melissa Hankins. She’s a psychiatrist and a physician coach. She wrote the KevinMD article “Will Smith’s slap is a trauma response.” Melissa, what are some of your take-home messages that you want to leave with the KevinMD audience?

Melissa Hankins: Yes, absolutely. It’s very important to engage in your own self-care and become self-aware that you are a human being who is deserving of care, deserving of treatment. If you need that, seek that out. I know, as physicians, we’re told, and often punished, for seeking out treatment. But that is something that, regardless of the idea or fear around punishment, around your licensure or anything like that, if you’re not alive or around to be able. Because oftentimes, when we suppress things, it can get to the point of feeling suicidal. We know that with physicians. If you’re not around, then it doesn’t matter what happens with your license. So take care of yourselves and seek out the support that you need.

Kevin Pho: Melissa, thank you so much for sharing your time and insight. Thanks again for being on the show.

Melissa Hankins: Yes, absolutely. Thank you for having me.

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