So sorry to hear that you are having such a rough time dealing with some heavy medical issues as well as SA.
I am assuming that you are in considerable physical pain (is the PDOC a pain specialist??). As someone who has dealt with chronic pain for the last 8 years, I can fully understand what you are going thru. In a nutshell, I have had 3 back operations from an injury that changed the entire course of my life and everything that is involved with day-to-day living. I'll share what my experience has been as well as what I've learned from my various docs.
First of all, physical pain, for me, brings about ANOTHER round of flashbacks, night terrors, and memories of SA flooding back. The is particularly evident when I not only have the chronic pain, but also if the pain has interfered with my sleep. for the past 2 months I have lived with fragmented sleep because I can only lie down for about 45 minutes at a time before the pain wakes me up. Then, I have to get up and walk around. By that time, I'm wide awake and have to try and get back to sleep.
If you're not under the care of a pain specialist, I may suggest that you seriously look into it. Many docs around the country are not comfortable dealing with chronic pain and fear working with certain medications because of the DEA questioning their licenses. Thank you to the media for blowing the whole oxycontin thing out of proportion... now there are thousands of people who live in chronic pain and are be UNDERMEDICATED because their docs are afraid of being scrutinized.
A pain specialist will try a host of different medications and/or procedures that will help you to live a more comfortable life in the physical sense. Let's face it... when you're in grave pain, you can't be productive (sometimes interferes with work) and sometimes can't function with just the daily activities that most people take for granted.
Some of these medications may include the opiate class of drugs (pain killers). If that track is taken, you will most likely be asked to sign a release statement indicating that you are willingly entering pain management and will be prescribed medications that WILL cause dependency. Let me digress for a minute to clarify terms: many people interchange the words "dependent" and "addicted". An addict is someone who uses a substance and seeks that substance solely for the purpose of getting a "high". "Dependent" means that a person is taking a medication prescribed by a doctor for the purpose of relieving physical pain. If this medication were taken away suddenly, the patient would develop withdrawal symptoms because the body DEPENDS on the medication to mask the pain.
Having said that, you will probably also be directed to a therapist or psychiatrist. Pain brings depression BIG TIME. Most people don't realize the depth and the damage that constant, unrelenting pain does to the psyche.
Finally, you need to develop a relationship of trust with the pain doc. He/she needs to be assured that you will not abuse the medications, will not take more than prescribed, will report all of your physical responses to changes in dose and will not use alcohol or street drugs in addition to what you are prescribed. Many docs will randomly drug test to assure that their patients are complying to this rule. It's a matter of their license as a doctor as well as the patient's well-being and safety.
Having said that, I hope you are able to find relief for your physical pain. There are many medications out there that can do wonders with pain relief. Of course, they have their nasty side-effects, but there is a careful balance that can be struck between pain relief, side effects and such so that you can feel productive and function in society. Isolation is the worst enemy of physical pain as well as SA.
Now, you are also dealing with SA issues. I know how full your plate is, my friend. Many times I have felt on the edge of sanity. I have reassured my wife AND my docs that though I am not suicidal, there are many times that I can understand WHY people get those thoughts and/or try to take their lives.
When I feel really despondent and question why i should be living, I remind myself that I would hurt a lot of people in my life. I would devasatate my wife of 22 years. Being an educator, I am well-known and loved by about 1200 students. They would be tremendously hurt. Then, I think of the very choice itself - it is FINAL. There is no taking it back or changing one's mind. And finally, I look at my abusers... they will have won. They would have the last word. Is that what I want? Absolutely not!
As I said before, when I am in severe pain cycles coupled with lack of sleep, SA issues creep in and become almost blown out of proportion. I become ultra sensitive to things on TV, have frequent nightmares and/or night-terrors, and become generally confused and frightened. Besides my wife, my T and this group help keep me "grounded". I openly ask questions and sometimes PM people for a "reality check".
The bottom line is to try and surround yourself with a circle of trusted friends, do everything in your lifestyle to ensure that you eat, get enough sleep and remain as much out of physical pain as possible. Since depression is a result of physical pain AND SA, it is possible that you may need an anti-depressant so that your emotional life is kept in check. And make good use of this forum...it's a valuable resource filled with many caring and compassionate members.
Again, you have a LOT to deal with. Try and live one day at a time, or sometimes (I have been in this spot) one MINUTE at a time if you have to.
I understand what you're going through as far as physical pain and SA are concerned. If I can be of help, please ask.... if it's nothing more than a sympathetic ear.
sorry for the long post, but I hope that I've answered your posted questions as well as some that you may have not mentioned.
There are no unresolved issues - they just didn't resolve themselves the way we would have liked. "Grinder and Bandler - Neuro-Linguistic Programming"