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Erin Hayford, ND
A case study demonstrating how treating complex trauma—rather than suppressing symptoms—led to profound healing and personal transformation in a patient with long-standing rheumatoid arthritis.
This case study explores a unique therapeutic approach to early-onset rheumatoid arthritis (RA) that centers on addressing complex trauma rather than directly treating the disease itself. The patient, a 30-year-old female diagnosed with RA in early adolescence, presented with a wide array of symptoms including chronic joint and muscle pain, fatigue, immune dysregulation, and dysautonomia. Having cycled through numerous conventional treatments—including disease-modifying antirheumatic drugs (DMARDs) and biologics—she sought care to explore the trauma-illness connection that had long been unaddressed. Interventions included nervous system education, Somatic Experiencing®, and guided self-inquiry through my own proprietary mind-body methodology. Over the course of several months, the patient experienced significant insight and functional improvements, reporting the deepest personal transformation of her life. This case challenges the dominant paradigm of treating chronic illness solely through symptom suppression and highlights the importance of trauma-informed care in naturopathic practice.
Note: Details of this case have been altered to protect patient confidentiality. The clinical trajectory and therapeutic outcomes remain true to the original case.
Rheumatoid arthritis (RA) is a progressive autoimmune condition that commonly affects the synovial joints and is frequently associated with chronic inflammation, pain, and disability. While pharmacologic interventions are often effective at symptom management, they rarely address the underlying psychosocial and emotional terrain that may contribute to the onset and perpetuation of disease. Emerging research has linked cumulative childhood trauma to an increased risk of autoimmune diseases in adulthood.1 Additional studies have highlighted the significant impact of early life stress on lifelong health outcomes, including autoimmunity.2
This case study offers a window into what is possible when chronic illness is viewed through a trauma-informed, mind-body lens. Rather than centering the treatment around reducing joint inflammation or modifying the immune response, this approach focused on the body’s innate intelligence, treating illness as an attempt to interrupt unsustainable nervous system activation and the resulting adaptive behaviors and beliefs. Here, RA served as a protective mechanism—a physiological expression of the patient’s internalized “no” when her external boundaries were not safe or allowed. This case offers valuable insight into how deep inner work, when guided with care and clinical skill, can catalyze transformation far beyond physical relief.
The patient, “Jane,” is a 30-year-old female who was diagnosed with RA at a young age. At the time she pursued care with me, she had been living with the diagnosis for over two decades. Her symptoms included fatigue, joint and muscle pain, cognitive fog, poor immune resilience, low libido, abnormal menstrual cycles, and chronic back and neck pain. She also reported feelings of disconnection, dissociation, difficulty concentrating, and a longstanding fear of being seen.
Though Jane had tried nearly every conventional approach—including methotrexate, prednisone, hydroxychloroquine, sulfasalazine, and low-dose naltrexone—she had been on biologics for the past decade, which controlled her joint inflammation but did not bring the full-body healing she sought. Her motivation to begin care was rooted in a desire to finally bridge the gap between an intellectual understanding of the role her nervous system was playing in her illness and embodied healing. She was familiar with nervous system-based tools but struggled to implement them consistently. She described herself as caught in a loop: highly capable of analyzing her symptoms and beliefs, but unable to change or embody new ways of being.
Jane’s symptom history and emotional narrative pointed clearly toward complex PTSD (cPTSD). Her childhood had been marked by emotional neglect, verbal abuse, and unpredictable explosions of anger and inconsistent support from her primary caregivers. Her nervous system had adapted by cycling between fawn and freeze responses. From a young age, her strategy for safety was to stay small, agreeable, and perform excellence—from elite gymnastics to Advanced Placement courses—in order to maintain any semblance of approval and connection.
Given the patient’s history and symptoms, differential diagnosis included fibromyalgia, chronic fatigue syndrome, generalized anxiety disorder, and dysautonomia. While the patient did indeed experience overlapping symptoms of dysautonomia and anxiety, the primary lens of this case was not to rule out one diagnosis in favor of another, but rather to reframe the diagnosis itself as a communication tool from the body. RA was not questioned as a diagnosis; instead, its role as a life-preserving mechanism was investigated.
The treatment centered around a structured mind-body framework designed to help the patient decode the specific nervous system programming connected to her symptoms. Interventions included:
Each session included space for the patient to process memories and triggers as they arose, along with support in integrating daily practices to cultivate inner safety. Weekly assignments often focused on self-attunement: What do I want? What does my body need today? What does it mean to take a break without needing illness as an excuse?
Over several months, Jane self-reported more change than she had in decades. Her nervous system shifted from chronic vigilance to increased windows of regulation. She began to trust her own internal cues and slowly unhooked from the perfectionism and productivity patterns that had defined her adult life. Her schedule, which had previously been dictated by overwork and people-pleasing, was restructured to reflect her values. Her chronic symptoms became guideposts rather than enemies.
Perhaps the most profound outcome was her insight that RA had always been her body’s way of saying “no” when she could not. The illness had functioned as a socially acceptable excuse to step back from toxic environments when her conscious self could not yet set boundaries. As she learned to listen to herself more deeply, the need for symptoms as protection began to dissolve. She also began to grieve the identity she had built around being sick and released the story that her worth was dependent on her suffering.
This case highlights a critical reframe for naturopathic clinicians: illness is not always something to eliminate; sometimes it is the body’s wisest communication strategy. For patients with trauma histories, especially those with early-onset autoimmunity, symptoms may serve as embodied boundaries, protectors, or signals of misattunement and misalignment with the core self for survival purposes.
Naturopathic doctors are uniquely positioned to work at the intersection of body, mind, and soul. By expanding our approach beyond treatment protocols to include trauma-informed inquiry, we honor the full complexity of our patients. This case is not an argument against pharmaceuticals or conventional care, but rather a call to integrate emotional and somatic context into our treatment frameworks. In doing so, we can then consider the question: to what end are we helping our patients get well? If the goal is simply to restore functionality so they can return to the same life that contributed to their illness, we may be missing the deeper invitation entirely.
True healing requires reassessing the very architecture of a patient’s life—their relationships, obligations, environment, and internalized beliefs—all of which are often adaptations to trauma. These foundations must be questioned and reimagined. As this patient put it, “I finally feel like I’m not healing to get back to life. I’m healing so I can live a different kind of life.”
This case serves as a reminder that the aim of healing is not simply to return patients to the life they had before, but to help them create one that is more attuned to who they truly are—physiologically, emotionally, and spiritually. In this case, rheumatoid arthritis became the patient’s gateway into radical self-honesty, nervous system awareness, and a more aligned life. By treating the trauma that shaped her biology, rather than the biology alone, we were able to catalyze meaningful change. Naturopathic medicine, when applied through a mind-body lens, offers a powerful pathway for this kind of transformation.
Dr. Erin Hayford is a Naturopathic Doctor and Somatic Experiencing Practitioner® specializing in the mind-body connection, chronic illness, and trauma healing. Located in Missoula, Montana but serving clients virtually, she guides people to uncover the deeper messages behind their symptoms and realign with their authentic selves. Dr. Hayford blends neuroscience, nervous system regulation, and a profound belief in the body’s innate wisdom to help patients transform not just their health, but their lives. Find her at www.aurorasomatic.com or on Instagram @drerinhayford
Erin Hayford, ND
A case study demonstrating how treating complex trauma—rather than suppressing symptoms—led to profound healing and personal transformation in a patient with long-standing rheumatoid arthritis.
This case study explores a unique therapeutic approach to early-onset rheumatoid arthritis (RA) that centers on addressing complex trauma rather than directly treating the disease itself. The patient, a 30-year-old female diagnosed with RA in early adolescence, presented with a wide array of symptoms including chronic joint and muscle pain, fatigue, immune dysregulation, and dysautonomia. Having cycled through numerous conventional treatments—including disease-modifying antirheumatic drugs (DMARDs) and biologics—she sought care to explore the trauma-illness connection that had long been unaddressed. Interventions included nervous system education, Somatic Experiencing®, and guided self-inquiry through my own proprietary mind-body methodology. Over the course of several months, the patient experienced significant insight and functional improvements, reporting the deepest personal transformation of her life. This case challenges the dominant paradigm of treating chronic illness solely through symptom suppression and highlights the importance of trauma-informed care in naturopathic practice.
Note: Details of this case have been altered to protect patient confidentiality. The clinical trajectory and therapeutic outcomes remain true to the original case.
Rheumatoid arthritis (RA) is a progressive autoimmune condition that commonly affects the synovial joints and is frequently associated with chronic inflammation, pain, and disability. While pharmacologic interventions are often effective at symptom management, they rarely address the underlying psychosocial and emotional terrain that may contribute to the onset and perpetuation of disease. Emerging research has linked cumulative childhood trauma to an increased risk of autoimmune diseases in adulthood.1 Additional studies have highlighted the significant impact of early life stress on lifelong health outcomes, including autoimmunity.2
This case study offers a window into what is possible when chronic illness is viewed through a trauma-informed, mind-body lens. Rather than centering the treatment around reducing joint inflammation or modifying the immune response, this approach focused on the body’s innate intelligence, treating illness as an attempt to interrupt unsustainable nervous system activation and the resulting adaptive behaviors and beliefs. Here, RA served as a protective mechanism—a physiological expression of the patient’s internalized “no” when her external boundaries were not safe or allowed. This case offers valuable insight into how deep inner work, when guided with care and clinical skill, can catalyze transformation far beyond physical relief.
The patient, “Jane,” is a 30-year-old female who was diagnosed with RA at a young age. At the time she pursued care with me, she had been living with the diagnosis for over two decades. Her symptoms included fatigue, joint and muscle pain, cognitive fog, poor immune resilience, low libido, abnormal menstrual cycles, and chronic back and neck pain. She also reported feelings of disconnection, dissociation, difficulty concentrating, and a longstanding fear of being seen.
Though Jane had tried nearly every conventional approach—including methotrexate, prednisone, hydroxychloroquine, sulfasalazine, and low-dose naltrexone—she had been on biologics for the past decade, which controlled her joint inflammation but did not bring the full-body healing she sought. Her motivation to begin care was rooted in a desire to finally bridge the gap between an intellectual understanding of the role her nervous system was playing in her illness and embodied healing. She was familiar with nervous system-based tools but struggled to implement them consistently. She described herself as caught in a loop: highly capable of analyzing her symptoms and beliefs, but unable to change or embody new ways of being.
Jane’s symptom history and emotional narrative pointed clearly toward complex PTSD (cPTSD). Her childhood had been marked by emotional neglect, verbal abuse, and unpredictable explosions of anger and inconsistent support from her primary caregivers. Her nervous system had adapted by cycling between fawn and freeze responses. From a young age, her strategy for safety was to stay small, agreeable, and perform excellence—from elite gymnastics to Advanced Placement courses—in order to maintain any semblance of approval and connection.
Given the patient’s history and symptoms, differential diagnosis included fibromyalgia, chronic fatigue syndrome, generalized anxiety disorder, and dysautonomia. While the patient did indeed experience overlapping symptoms of dysautonomia and anxiety, the primary lens of this case was not to rule out one diagnosis in favor of another, but rather to reframe the diagnosis itself as a communication tool from the body. RA was not questioned as a diagnosis; instead, its role as a life-preserving mechanism was investigated.
The treatment centered around a structured mind-body framework designed to help the patient decode the specific nervous system programming connected to her symptoms. Interventions included:
Each session included space for the patient to process memories and triggers as they arose, along with support in integrating daily practices to cultivate inner safety. Weekly assignments often focused on self-attunement: What do I want? What does my body need today? What does it mean to take a break without needing illness as an excuse?
Over several months, Jane self-reported more change than she had in decades. Her nervous system shifted from chronic vigilance to increased windows of regulation. She began to trust her own internal cues and slowly unhooked from the perfectionism and productivity patterns that had defined her adult life. Her schedule, which had previously been dictated by overwork and people-pleasing, was restructured to reflect her values. Her chronic symptoms became guideposts rather than enemies.
Perhaps the most profound outcome was her insight that RA had always been her body’s way of saying “no” when she could not. The illness had functioned as a socially acceptable excuse to step back from toxic environments when her conscious self could not yet set boundaries. As she learned to listen to herself more deeply, the need for symptoms as protection began to dissolve. She also began to grieve the identity she had built around being sick and released the story that her worth was dependent on her suffering.
This case highlights a critical reframe for naturopathic clinicians: illness is not always something to eliminate; sometimes it is the body’s wisest communication strategy. For patients with trauma histories, especially those with early-onset autoimmunity, symptoms may serve as embodied boundaries, protectors, or signals of misattunement and misalignment with the core self for survival purposes.
Naturopathic doctors are uniquely positioned to work at the intersection of body, mind, and soul. By expanding our approach beyond treatment protocols to include trauma-informed inquiry, we honor the full complexity of our patients. This case is not an argument against pharmaceuticals or conventional care, but rather a call to integrate emotional and somatic context into our treatment frameworks. In doing so, we can then consider the question: to what end are we helping our patients get well? If the goal is simply to restore functionality so they can return to the same life that contributed to their illness, we may be missing the deeper invitation entirely.
True healing requires reassessing the very architecture of a patient’s life—their relationships, obligations, environment, and internalized beliefs—all of which are often adaptations to trauma. These foundations must be questioned and reimagined. As this patient put it, “I finally feel like I’m not healing to get back to life. I’m healing so I can live a different kind of life.”
This case serves as a reminder that the aim of healing is not simply to return patients to the life they had before, but to help them create one that is more attuned to who they truly are—physiologically, emotionally, and spiritually. In this case, rheumatoid arthritis became the patient’s gateway into radical self-honesty, nervous system awareness, and a more aligned life. By treating the trauma that shaped her biology, rather than the biology alone, we were able to catalyze meaningful change. Naturopathic medicine, when applied through a mind-body lens, offers a powerful pathway for this kind of transformation.
Dr. Erin Hayford is a Naturopathic Doctor and Somatic Experiencing Practitioner® specializing in the mind-body connection, chronic illness, and trauma healing. Located in Missoula, Montana but serving clients virtually, she guides people to uncover the deeper messages behind their symptoms and realign with their authentic selves. Dr. Hayford blends neuroscience, nervous system regulation, and a profound belief in the body’s innate wisdom to help patients transform not just their health, but their lives. Find her at www.aurorasomatic.com or on Instagram @drerinhayford
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It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.
The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making
The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy.
It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution
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