When Did We Stop Listening to the Person?

A young woman in her thirties walked into my shop frightened, profoundly unwell and taking so many different medications that she couldn't initially remember them all. As we talked, it became clear that her story was about far more than the symptoms written on her medical records. She had also survived domestic violence and had been through experiences that had placed an enormous burden on her physically and emotionally.

Yet somewhere along the way, the woman herself seemed to have disappeared beneath the diagnoses and prescriptions.

This was a difficult article for me to write because cases like this genuinely affect me. They also bring together everything I have been talking about throughout this month's newsletter.

We have looked at the body as an ecosystem, at the importance of the terrain, at what happens when somebody feels desperately unwell despite being told their results are “normal”, and at the consequences of repeatedly suppressing symptoms without continuing to ask why those symptoms appeared.

Then somebody walks through my door and suddenly none of this is theoretical anymore. There is a human being sitting in front of me whose life has become dominated by ill health, and I find myself wondering: at what point did we stop listening to her story?

A Human Being Is More Than a Collection of Symptoms

When somebody presents with anxiety, digestive problems, pain, exhaustion, poor sleep, headaches, hormonal symptoms or any number of other complaints, it is very easy for each problem to become its own separate conversation. One symptom may lead to one treatment, another symptom to another, and over several years that person's health history can become divided into increasingly smaller pieces.

But the person hasn't divided into pieces. Her nervous system doesn't exist separately from her digestive system. Her digestive system isn't separate from her microbiome or immune system. Her hormones don't operate independently of her brain, metabolism, nutrition, sleep or stress response. And none of those systems exist separately from what she has experienced in her life.

This is why I believe the person's story matters so much. When did she first stop feeling well? What was happening in her life at the time? Which symptom appeared first and what came next? When was each medication introduced and what changed afterwards? Was she eating properly? Was she sleeping? What had happened to her digestion and menstrual cycle? Had anybody looked at her nutrient status or considered the enormous physiological burden of living through prolonged fear and trauma?

These aren't irrelevant details surrounding the “real” medical problem. They are part of the person experiencing it.

What Does Living in Survival Mode Do to the Body?

Someone who has lived through domestic violence hasn't simply experienced a series of unpleasant events that can be separated from their physical health. Prolonged threat can keep the body's stress-response systems activated, affecting sleep, digestion, appetite, concentration, muscle tension and the way somebody experiences their own body.

This is particularly important to me because we sometimes use words such as “anxiety” as though naming the symptom explains it. But anxiety can be part of a much bigger story. If somebody has spent years frightened, hyper-alert and trying to survive, surely we should be interested in what their body has been through rather than seeing their distress only as another isolated symptom to suppress.

That doesn't mean every physical symptom experienced after trauma is caused by trauma. It means we should be capable of holding the whole story at once. The question shouldn't only be, “What is wrong with you now?” Sometimes we need to ask, “What happened to you, and what has happened to your body since?”

When One Treatment Becomes Many

This young woman's medication list also brought me straight back to the subject of my previous article. When somebody is taking numerous medications, I don't think it is enough simply to write down the names. I want to understand the sequence.

Perhaps one medication was introduced for anxiety and another for sleep. Something was prescribed for pain, something else for digestive symptoms and another for a physiological marker that had changed. Over time, it can become extremely difficult for the person themselves to distinguish between their original symptoms, changes associated with their underlying health and unwanted effects that appeared after treatments were introduced.

There is a recognised phenomenon called a prescribing cascade, where an adverse effect from one medication is interpreted as a new condition and another medication is prescribed to treat it.

Instead of seeing a long medication list as the end of the conversation, perhaps it should prompt more questions. Why was each medication started? Is it still required? What changed after it was introduced? Could any current symptoms be related to the combined medication burden? Has nutrient status been considered? When was the entire list last reviewed as a whole?

And underneath all of those questions is the most important one: how is the person actually feeling?

We Need to Hear the Story in the Right Order

When somebody has been unwell for years, their story can become incredibly complicated. This is why one of the most useful things we can do is slow it down and reconstruct it chronologically.

I want to know who that person was before they became ill. I want to know when their health began changing, what was happening around that time and which symptoms came first. Then we can begin following the thread through changes in digestion, energy, sleep, hormones, mood, pain and metabolism, alongside significant life events and the introduction of medications.

Sometimes the person themselves begins making connections simply by seeing their story laid out in front of them. That doesn't mean we have suddenly discovered one neat explanation for everything. Human health isn't that simple. What we have done is something much more fundamental: we have stopped looking at a snapshot and started looking at a life.

Knowledge Changes the Conversation

One of the most powerful things I have seen in my work is what happens when people begin understanding their own bodies.

There is something very different about being told that your body is malfunctioning and being helped to understand how your digestive system, microbiome, nervous system, hormones, blood sugar, nutrients, sleep and environment interact. Suddenly symptoms aren't simply random things happening to you. They become information that can be explored.

That knowledge changes the questions somebody asks. Instead of only asking, “What can I take for this?”, they may begin asking, “Why did this start?” Instead of assuming that every new symptom represents another unrelated problem, they may ask, “What changed before this appeared?” Instead of handing complete responsibility for their health to somebody else, they can become an informed participant in their own care.

For me, that is incredibly important. Knowledge doesn't mean somebody should diagnose themselves. It means they understand enough about their own body to ask questions, notice changes, have informed conversations and participate in decisions about their health.

The Terrain Includes Our Life Experiences

Throughout this newsletter I have used the word “terrain” repeatedly. We have talked about the terrain of the soil and the environment in which plants grow, and then about the internal terrain of the human body. But I think we need to take that idea one step further.

Our terrain isn't only what we eat or which microorganisms live in our gut. Human beings also exist within relationships, families, communities and environments. We experience love, safety, fear, loneliness, grief, connection and trauma, and our biology responds to the world in which we live.

This is why the story of a woman who has survived domestic violence cannot simply begin with her latest blood test. Her experiences, environment, nutrition, sleep, digestive health, nervous system and medication history all matter. Most importantly, she matters.

None of those things should automatically be assumed to explain every symptom she has, but neither should they be ignored because they don't fit neatly into a laboratory box.

Sometimes We Need to Ask a Different Question

There is a huge difference between asking, “Which medication treats this symptom?” and asking, “What has happened within this person's life and biology that might help us understand why they are struggling?”

The first question may sometimes be necessary, but it shouldn't automatically replace the second. If somebody is exhausted, frightened, unable to sleep, struggling with their digestion and experiencing pain, simply dividing those problems into separate categories can cause us to miss the pattern connecting them.

This brings me back to the garden analogy from my previous article. If a garden is struggling, we can continue treating everything that appears above the surface individually, or we can kneel down, put our hands into the soil and start asking what happened to the environment underneath.

With people, we have to do something even more important. We have to listen.

The Woman Underneath the Medication

This woman was intelligent, articulate and very aware that she did not want to continue living as she was. She was taking so many medications that she initially struggled to remember them all, and she desperately wanted help to reduce them. What she felt was missing was somebody willing to listen to that request and help her understand how she could move forward safely.

When she explained to her psychiatrist that she wanted to come off some of her medication, she told me that the response was to offer her another medication.

I think this is an important part of her story because there is something else that many people may not realise. Suicidal thoughts and suicidal behaviour are recognised potential risks associated with psychiatric treatments, and UK medicine information contains warnings about this. In December 2025, following concerns raised by patients and families, an expert review advising the MHRA concluded that information for these medications needed to communicate the risk of suicidal behaviour more clearly. Its recommendations included stronger wording in patient information leaflets, a patient card specifically highlighting suicidal behaviour and additional information to support conversations between patients and healthcare professionals.

This subject is particularly difficult for me because I have unfortunately known people who have reached a point of profound desperation and ended their lives. I would never pretend to know that one single thing caused somebody to reach that point; suicide is far more complex than that. What has stayed with me is the desperation of people who felt they had nowhere left to turn, particularly when the people or services they believed were there to care for them did not seem to hear what they were trying to say.

Nobody who is frightened by what is happening to their mind or body should feel abandoned in that situation.

That is why I believe listening matters so much. If somebody taking psychiatric medication says that they feel dramatically different, increasingly distressed, suicidal or frightened by changes in their thoughts or behaviour, those words matter. They should never simply disappear underneath another diagnosis or another prescription. They are information about what that human being is experiencing, and they deserve to be heard.

She Isn't an Isolated Case

What upset me most about meeting this young woman was knowing that her story wasn't unusual. I have spoken to many people who feel as though their health has gradually disappeared underneath years of appointments, diagnoses, prescriptions and new symptoms. They often arrive believing that their body has somehow failed them.

But when you start going through their story properly, there is often so much more to understand. Sometimes that understanding begins with something remarkably simple: somebody finally has enough time to listen, not simply to the symptom they walked through the door with, but to the entire journey that brought them there. That is exactly the message running through your original ending.   

I have helped many people who have found themselves overwhelmed by their health and the number of medications they are taking, and I hope to help this woman too. That doesn't mean telling somebody to simply throw their medication away. Some psychiatric medicines can produce significant withdrawal effects and may need to be reduced gradually with appropriate professional support.

What I can do is listen to her, help her understand her body, support the foundations of her health and help her become more informed and confident when discussing the changes she wants with the professionals responsible for her medication.

One Body. One Terrain. One Human Being.

This month's newsletter began with our relationship with nature and the idea that health depends upon the environment in which life is trying to flourish. We moved from the soil beneath our feet to the microbiome within us, from blood tests and reference ranges to symptoms and medications.

For me, this woman's story brings all of those threads together.

We cannot talk about the human terrain and then forget the human being. We cannot continually separate the gut from the brain, the hormones from the nervous system, physical health from someone's lived experiences, or today's symptoms from everything that happened before them. Nor should we assume that suppressing what is visible tells us why it appeared.

We need to ask what happened first, what happened next, what changed along the way and what the person's body may have been responding to throughout that journey.

Because behind every blood result, diagnosis, symptom and prescription is a human being. We need to understand what happened to their terrain, but we also need to understand what happened to them.

And perhaps one of the most powerful things we can give that person isn't another label.

It's the opportunity to be heard.

Sometimes the most important place to begin is simply to listen.

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