Lisa Find Love

More than 16 million cases of depression occur each year in the United States. Depression is scientifically linked to having lowered levels of serotonin, one of the primary chemicals produced in the brain that affects our happiness. A regular yoga practice is known to increase serotonin. Imagine that? One in six Americans take some form of medication to help reduce depression or anxiety, myself included. Yet something as holistic as yoga can raise serotonin similarly to how antidepressants can. I’m pro-medication in every respect, but it isn’t a cure-all. A multitude of other methods are often recommended to combine with medication to dispel those feelings of gloom and distress that mental illness can elicit.

I am a 29-year-old female who suffers from Generalized Anxiety Disorder, ADHD and Major Depressive Disorder. I also struggle with agoraphobic tendencies, resulting in a fierce panic when I leave the confines of my home. I took my first yoga class eight months ago. I’ve since attended 4 to 7 times weekly, as consistency is key. The studio is conveniently located one mile from my home, which comforted my apprehension. Midway through my first class, I felt at ease. My anxiety drifted away like a paper airplane in the wind. My first month of yoga practice was the beginning of my spiritual epiphany.

That mindfulness I experienced on my mat would stay with me for the remainder of the day. My perspective on life became more optimistic, my mood was uplifted with decreased daily anxiety, and I was actually leaving my house more frequently without the usual hesitation and panic attacks. As a woman who formally found it problematic to exit my front door, I am now a yogi leading a life that is filled with gratitude, peace and acceptance. These feelings of positivity aid me in facing my agoraphobia and fighting my depressive propensities. I find it is easier to accomplish tasks when I’m in a healthy mindset. I genuinely believe yoga is therapeutic based on my personal experience.

To help me clarify just how beneficial yoga is, I’ve conducted an an interview with Kanjana Hartshorne, Licensed Clinical Social Worker, C-IAYT Yoga Therapist and Reiki Master. In her work with clients Kanjana offers an evidence-based blend of traditional Western psychotherapy and neuroscience, as well as ancient Eastern comprehensive yoga therapy. Kanjana happily agreed to partake in this article to inform readers that yoga can be a powerful treatment option for many mental illnesses.

Q. Do you believe yoga can help balance the state of a person’s mental status?

A. Yes, I strongly believe that yoga and meditation can help to balance a person’s mental state. For me, the most powerful aspects of applying yoga for mental health (and how yoga helps us live) are:

1. Increased awareness about our bodies, minds, and selves. Because if we aren’t aware of where we begin, how are we supposed to make a shift?
2. Adding yoga skills to our toolkits for both emotional regulation (our ability to manage and respond to an emotional experience) AND down- or up-regulation of the nervous system (our ability to move from fight/flight to rest/digest or vice versa, as needed.)
3. Increase our ability to tolerate stress in all facets of life. Every time you practice tolerating discomfort on the mat or meditation pillow, whether it’s in a pose, being silent, or witnessing uncomfortable thoughts, you are practicing distress tolerance! The more you practice, the easier it gets. Just like riding a bike. And, eventually, you can ride that bike or tolerate lower levels of stress without much effort at all. Of course riding up a mountain or tolerating a higher level of stress will be more challenging and require more effort. But if you’ve been training for a while, you’ll have the confidence that you can use the skills you’ve built to get up that mountain.

Q. Have you had any past or present patients that practice yoga? If so, can you describe to me how they’ve relayed their experience?

A. I’d say the majority of my clients practice yoga or meditation. This is mostly because I’ve found it to be so impactful that I’ve built my career around it. My niche is yoga therapy as a modality for trauma and anxiety. I’m currently researching its impact as an add-on to traditional talk therapy. So this means I mostly work with people interested in bringing yoga into session. And it doesn’t hurt that I get to wear yoga pants to work everyday!

There are a wide range of experiences, but a few themes tend to come up again and again. People share how they now have the tools they need to manage their stress or anxiety on their own. They now have a better understanding of who they are and what they value and can use their values to live their best life. They are able to better tolerate uncomfortable emotions like anxiety, fear, sadness, and loneliness. When they practice yoga, whether that’s in little one minute practices throughout the day or an extended home/class practice, they notice an impact on their ability to tolerate stress and regulate mood. When doing deeper, long-term work with clients I hear things like, “I finally can be on my back without flashbacks to my assault”, “I feel safe enough to now bring up my trauma in therapy and start to process it”, “I am kinder to myself and my body both in my thoughts and actions.”

I feel so lucky that I am able to use yoga as a modality for mental and emotional wellness. It’s been years, but I still hear feedback that blows my mind and reminds me of the power of a somatic (body-based) approach to mental heath.

Q. In what ways do you believe living a yogic lifestyle can help uplift a person’s mood and reduce anxiety? Are there any other benefits you can think of that we haven’t touched on?

A. I believe a yogic lifestyle can help people to balance their mood. That could look different person to person, day to day, or even moment to moment. From helping to bring a little more energy and inner strength to a tough day to decreasing a racing heart and racing thoughts. Practices from yoga can help people with a variety of mental and emotional concerns. The wonderful thing about yoga is that it’s so holistic. It addresses the body, mind, emotions, intuition, and spirit, whatever that is for each individual. How can yoga cover all that? Those new to yoga may think it’s all about the poses. And while that’s a part of it, there’s so much more. There’s meditation, philosophy, nutrition, and unity — with self, body, beliefs, and community.

Q. Depression is known to also produce physical symptoms such as stomach discomfort, stress headaches, fatigue and digestive problems. Can you name a few poses that you would you suggest to someone suffering from these matters as a result of depression?

A. I always recommend ruling out a medical cause first. So hit the doctor’s office to make sure nothing else is going on. If the symptoms are then attributed to anxiety or depression, there are several practices from yoga that can be helpful. I have to be honest and say that I feel this is very individualized, and if someone has a history of trauma, often poses that are helpful to others can be triggering for them. Having said that, many people find the following yoga poses helpful. For sluggish digestion, many find wind-relieving pose and gentle spinal twists to help get things moving. For stomach pain, “legs up the wall” with a meditation for pain relief can be extremely powerful. For fatigue, gentle heart-openers such as reclined bound angle can be helpful. And for tension headaches, many find opening up the back, neck, and upper-chest area to be helpful. Some poses for this include cat/cow, thread the needle, eagle arms, cow-face pose. And I know we are talking strictly asana (yoga poses), but there are a LOT of other practices from yoga that can also be helpful for these concerns. If you feel lost or have a history of trauma or a health condition, I’d recommend working with a yoga therapist to figure out a practice personalized to your needs.

Lastly, I want to add that an ongoing study in the Netherlands has proven that yoga and meditation are linked to having a smaller right amygdala volume. The right amygdala is the part of our brain that sends out negative emotions within us, such as fear-inducing stimuli. The researchers conducted multiple MRI brain scans of 3,000+ participants over time. These scans are resulting in solid proof that the right hemisphere of our brain can actually shrink in size with something as natural as regular yoga and meditation practice. With that being said, I urge anyone who has been contemplating taking a yoga class to give it a try. The internet also offers wonderful tutorials for those on a low-income budget. I truly believe anyone who is skeptic will be highly impressed with just how glorious a yogic lifestyle can be, if they step out of their comfort zone and test the waters.

As a therapist working with clients who express having codependent tendencies, as well as being a recovering Type A workaholic and codependent who entered treatment in 1993, I am well aware of the dynamic of “savior behavior.“ I attempted to fix, heal and kiss all the boo-boos of the people in my life to make them all better. I had a mother who modeled that for me and did it so well.

While I know that kisses have medicinal properties, much like chicken soup, a.k.a. Jewish penicillin, I have come to accept that all the love in the world may not completely obliterate the scars left by traumas that some experience throughout their lives. I do have hope when I sit with clients who share stories of pain and redemption that they can find healing. One such is someone whose career puts her in a position to be of service and provide education. She needed to leave a volunteer position in another field, since she found herself taking on too much of the suffering involved. A more compelling situation is related to family dynamics. To her credit, she has begun to step back there as well, as guilt-inducing as it may be. 

I shared with her recently that as a lifeguard many decades ago, I learned this simple order of rescue tactics: “Reach, throw, row, go.” Translated, it means that you attempt to assist from a safe distance first if the situation warrants it, rather than diving in if the person is able to get to safety with lesser means of intervention. We were also taught to wait until the person stops struggling before diving in after them. Such is so in relationships, as doing too much for someone else might dis-empower them. If they continue to attempt to pull us under with them, we have a choice to either drown or swim away. How many times have you, with all good intentions, dove in head-first, not knowing how deep or shallow the water is, whether there were rocks, snakes or sharks beneath the surface? I certainly have done more than my share of high-risk rescue maneuvers.

A few years ago I had the opportunity to allow myself the freedom to leave the Mighty Mouse (“Here I come to save the day!”) facade behind. I attended a retreat called Woman Within which is an event I have been encouraged to experience for many years. Several of my friends have taken it and had marvelous breakthroughs. I was reluctant initially since I erroneously believed I had explored the issues that I imagined would come up such as family dynamics, assertiveness, romantic relationship patterns, and self-worth. What additional value could I possibly glean? What ultimately tipped the scales in favor of enrolling was my son who told the friend who was the most vocal in encouragement to be there, “Oh, she’ll never go.” When my friend related his message, of course I had no choice but to prove him wrong. Never underestimate the power of a dare, especially from one’s child.

Had I known then what I know now, I could have avoided years of emotional pain, however, the timing wasn’t right…until it was. My mother had died a few years earlier and my father 2 ½ years prior to her passing. I had submerged my feelings as those with co-dependency are wont to do, in the service of keeping on keeping on. My head and heart were a bit cluttered with the residue of grief left unfelt.

I welcomed relief and was delighted that when all was said and done, my transition from where I was to where I am, took all kinds of leaps; some of faith that I would safely land. I was determined to savor the time at the retreat just for myself; rare indeed for this woman who feels that nothing I do is for me alone. My healing heals the planet… all that stuff which may be true AND I really am permitted to have personal joy. Prior to the training, I filled out an extensive application and I told the organizers that if they saw me attempting to fix, save, heal or otherwise exhibit savior behavior, they were to call me on it. I was off duty. Within very short order, an opportunity arose to test my mettle. I was asked to take on a leadership role and as my ego chirped, “How cool! They know you are a natural born leader.” and my Sally Field Academy Award speech persona chimed in “And I can’t deny the fact that you like me. Right now, you like me!” My inner knowing creature, looked at me with kind and compassionate eyes, wagging finger and loving smile and said, “Don’t you dare.”  Saying no has not always come easily to me. It felt really good this time. Saying no to the request made of me, was actually saying yes to myself and my own needs.

Throughout the weekend, I faced multiple challenges to my resolve. Each woman there had her own particular story that had me wishing I could offer answers, wanting to charge in there to fix the situation. Knowing that I couldn’t do it, even had I not made the promise to myself since it was not my role, was painful, literally, head throbbingly so. I needed to sit with my emotional discomfort, and it wasn’t until I acknowledged my own loss, pain and sadness; my real human vulnerability that the headache dissolved, and I saw clearly that my help was not requested or required. One particular exercise had me coming face to face with the multiple losses in my life that opened to door to my own healing.

This poem by one of my favorite writers could have been written for me.

The Journey by Mary Oliver

One day you finally knew
what you had to do, and began,
though the voices around you
kept shouting
their bad advice—
though the whole house
began to tremble
and you felt the old tug
at your ankles.
“Mend my life!”
each voice cried.
But you didn’t stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do—
determined to save
the only life you could save.

I’ve been teaching writing for almost 35 years now.  They say the teacher sometimes learns more than her students.  

So what are some of the things have I learned over the past three plus decades about writing, college kids and life, in general?

Writing

Writing can be taught. There is a debate about this, but I can say for a fact that writing can be taught, and I’ve done it many times. Give the students the necessary tools, and they will write fabulous essays. What are the tools? Good, thorough discussions about thesis statements, paragraph development, specific details, transitions, grammar, organization, expression. Give them time to rewrite, to peer edit. Give them encouragement, and they will write. They will find their own way, along with your expert guidance.

“Write what you know” is a useful adage. This semester I had a student who was writing at a “C” level. But when the last paper came around, a research paper, he picked a subject that he knew inside and out — one concerning “Should college athletes be paid?” Using this topic, he produced an “A” paper. He told me after the fact that he felt passionate about this subject. He knew the details of his argument so well, that the paper virtually wrote itself.

Writing what we know can produce some of our most successful work. Incidentally, he picked the unpopular “side” of the argument; Will argued that collegiate athletes should not be paid. Wow, what an essay!

Sometimes a writer’s emotional life is too conflicted for her to write. The students in my classes who do well have relatively stable lives outside of the classroom. But sometimes a student’s home life, work life or personal life takes a turn for the worse. Case in point — Mary was doing perfectly fine in my class; she was on her way to getting a “B,” but then, her parents began divorce proceedings, and unfortunately, she couldn’t find it in herself to finish the last half of the course. She ended up dropping out.

Writing demands a clear head and when one’s life is in total turmoil, it’s hard to think clearly and create lucid work. Only the extremely practiced writer can produce fine work through life’s peaks and valleys.

Deadlines help some students. It was down to the wire for one student. He had to write a research paper by midnight. With my help, he produced an outline and then, went home and wrote a very average paper, but one that would allow him to receive a final grade of a “B-.” The lesson here is that some writers won’t write without the blood, sweat and tears that a tight deadline can give them. And college courses are all about deadlines.

College Kids

A teacher has many students with many different maturity levels in one classroom. Yesterday, I came into the class to see Joey running around scribbling on the board like a second grader, while Barbara watched him like a 45-year-old, with mild amusement. Both kids were 18-years-old. When all of these personalities become engaged with one another in a discussion or debate, the mixture of views is often interesting and thought-provoking. I wouldn’t want all of my students to be in the same place intellectually or emotionally. That’s just not possible. But no matter where they are, they can all bring something to the proverbial table.

Some students are too smart for their own good. These are the types who go all semester without purchasing a textbook. They think they can go it alone, that they don’t need to read anything to pass the class. Or they don’t even show up to class. I’ve had dozens of students fail a paper or the entire class because they miss the point of an assignment due to the fact that they were not present for weeks at a time. For instance, they’ll write an informative paper when they should have written a persuasive one. That’s a huge mistake, one that could have been avoided simply by showing up.

Life

Timing is everything. What I mean by this is that I’ve had brilliant writers, but it was the wrong time for them to flourish.  I had one student a couple of years ago who dropped out of my class. His writing was poor and he showed no enthusiasm for the craft.  He was sullen and was not involved in the academic process in the least. Three years later, he showed up in my class again, a different person.  It was finally his time to learn and engage himself in college life. He wrote with interest in his subject matter, and at times, even with joy. He earned a solid “A” for the semester. In another instance, I had a female student who could write circles around me. But she was simply in a bad spot in life. It was not her time to excel. She remained in my class, but she earned a “C,” when she could have aced the class. 

Everyone makes mistakes. This semester while critiquing a student’s paper, I made a whopper of a mistake. I told her that the title of her essay was “stupid.” This is not the kind of language a writing teacher should use when critiquing a student’s work.  It’s belittling and really says nothing about how to improve the issue in question. What did I do? I used the moment as a teachable moment, telling the class that teachers aren’t perfect and that sometimes we make mistakes. Sometimes we’re tired or unfocused or just don’t want to be in class. We talked about professionalism and how that should supersede negative feelings on the teacher’s part, but sometimes it doesn’t. Long story short, the girl forgave me for calling her title “stupid,” and she ultimately found a much better one for her essay. What teaching has taught me most is that no one is perfect.

In conclusion, the bottom line for me as a writing teacher is being able to display both strength and vulnerability while I teach, and appreciate each student for her unique personality and contribution to the delicate process of learning how to write, not in the comfort of her own room, but in a communal setting, in fact, in a writing classroom.

Holidays can be a very stressful time in general — but if you were raised in a dysfunctional family system, it can go beyond ordinary stress and enter the “danger” or  “crisis” zone very quickly, depending on how toxic your current family system dynamics are. In this article I share 10 strategies that have helped my psychotherapy clients feel more at ease during family events via careful planning, self-caring acts, and having realistic expectations.

Holiday Gatherings with Dysfunctional Family Can Be Stressful

It is common to have high expectations when thinking of family gatherings. Alternatively, you might fear that your worst expectations will be realized, if you get together with nuclear and/or extended family members for a holiday gathering of some kind. 

It can be especially mentally and emotionally stressful to have to face the holiday season when you have had acutely difficult experiences with one or more family members in the past — including during your childhood. Such complex dynamics can make this time of year fraught with difficult decisions and choices for adult survivors of dysfunctional families.

It’s critical that you remember that just because it is the holiday season doesn’t mean that anyone in your family has changed the way they behave or the manner in which they treat you. The one thing you do have control over is your own choices and responses. Below are my 10 strategies for surviving the holiday season if you choose to spend it with your family (#10 specifically addresses those who are not in contact with family at this time):

1. Ride the tiger — but know when to get off.

Engaging with your dysfunctional family system can be a bit like riding a multi-headed beast. Some ways of being and patterns of behavior have been going on in your family for decades-upon-decades and have been passed down unconsciously from generation to generation. Suffice it to say that there are tremendous psychic forces at play, and so, in some ways, you are “walking where angels fear to tread” when engaging with your dysfunctional family-of-origin, whether it is the holidays or not. 

Remember that you can only control what is in your power to control: Your own behavior and responses. Use any holiday experiences you choose to have with your family as a means of becoming an even stronger person.

Never forget that when you greet dysfunction with healthy functioning you are succeeding in not placing your well-being into someone else’s hands. And that is a true victory, and something to celebrate during the holidays when engaging with your dysfunctional family.

2. Plan for the typical and expected.

You likely already know what might trigger you or set you off at a family event (e.g., “Are you really going to have seconds? Aren’t you worried about your weight?”) Know what your limits are and do what you can to structure the time with your dysfunctional family in advance. For example, know your arrival time and know what time it might be best for you to leave (if you are in “light contact” with family, two or three hours at a holiday gathering should suffice). 

Consider renting a car if you are flying in, so you have the freedom to come and go. And do not stay with your family if you know that you cannot be around them for long — arrange to stay at a hotel or a short-term vacation rental, e.g., VRBO or Airbnb. Planning out your “survival strategies” ahead of time — before the family gathering — is something that you can work out with your therapist or coach if you have one long before the holidays ever arrive. 

Be sure you have some “go-to” self-care strategies in place long before you go. Some of my therapy clients arrange to meet family in a public place, like a restaurant, as it does not feel safe for them emotionally to go to the dysfunctional family members’ home, so this is something else you might try.

3. Accept the truth of who people are — and don’t expect them to change.

If a family member has behaved in a disrespectful or even abusive manner toward you in the past, don’t expect this behavior to change just because it is the holidays. In fact, family tensions can increase during special events, causing people to behave in unexpected (and sometimes harmful) ways. If someone drinks too much and becomes verbally aggressive or even violent, this won’t change just because it is supposed to be a “happy” time of year. 

Don’t expect people to be any different from who they have been, as they are unlikely to act any differently this year than they have in the past. Letting go of fantasies that “this year will be different” will help to protect you from further disappointment. If things go better than anticipated, enjoy it, but don’t count on it being this way in the future. 

4. Don’t try and discuss ways you have been wounded and hurt in the past.

Holiday gatherings with your dysfunctional family are not conducive to repairing past childhood wounds or hurts. The best thing to do when you are interacting with various family members is to keep the conversation simple (think “light and polite”). It is easy to get caught up in various family dramas and debates (political ones, especially) — but do your best not to fall into this trap or you’ll just find yourself “wrestling with a pig in the mud” — and everyone gets “dirty” in the end.  

If you feel yourself getting triggered (i.e., you might feel your heart-rate speeding up, notice you are getting anxious, feel dissociated or “distant”, and/or feel like you want to lash out in anger at someone) simply take a few, long, deep breaths and  excuse yourself from the conversation. 

Take a short walk outside, look at nature, count backwards by 7 from 100 (this gets the mind focused on something else less intense), or take a “time-out” in the bathroom away from everyone (it is a good idea to bring a daily meditation book that you can read so you can regroup while you are there). When you return, focus on those people you feel okay being around — ideally, people you genuinely like and who like you in return. And keep taking deep breaths!

5. Envision your energetic boundaries and stay in your “white bubble of light.”

If you come from an enmeshed and/or abusive family system, you may be used to family members violating your boundaries repeatedly; you may even avoid being around family because you are not sure how to protect yourself from such emotionally aggressive — even hostile — behavior. 

If you choose to be around family that you know may treat you badly at a holiday gathering, be prepared for the worst and plan accordingly. I suggest to clients that they imagine they are surrounded by a ball of white light — they are protected within this light and nothing but loving energy is allowed in. Any hurtful comments from others just bounce off this white shield of light. 

Remember, no one has the right to behave disrespectfully or abusively toward you. If someone tries to put you off balance, remind yourself that they are the ones that have the problem — not you. The manner in which people act and behave is a reflection of who they are and has nothing to do with you, in the end. 

6. Consider bringing an ally to help buffer dysfunctional dynamics.

If you know that your family is particularly aggressive in general, it is a good idea to bring an “ally” with you to the holiday gathering — a friend or significant other who loves you and can support you and even act as a ‘buffer’ when you are with your family. Even your pet can serve as an ally and a buffer, if it is possible to bring them with you and keep them safe.

I recommend that you and your (human!) ally agree upon a signal of some sort that you can use if you are feeling trapped or ensnared by family and need help to get away. For example, tugging on your ear or scratching your nose are ways to signal your ally that you are struggling and need their help and intervention. Your ally can interrupt and ask something like, “Seen any good movies lately?” to get the conversation on a different track. 

Even though it can be difficult, do your best to not personalize hurtful, insensitive comments. Remind yourself that the aggressor is simply being true to their nature and trying to get you to “wrestle in the mud” with them. See it for what it is and imagine yourself flying above it all, unharmed.

7. Help to structure the time — Charades, puzzles, and games!

Even the most dysfunctional family can sometimes find activities they enjoy doing together. Some families enjoy watching sports on TV or playing charades or cards. Think of how you might help your family structure time in a manner that invites positive interactions (board games? puzzles?) and then do your best to help make that happen. You might be surprised when you leave with a new holiday memory to cherish — one you never expected. “Believe nothing — Entertain possibilities!”

8. Gather family history — your therapist will thank you.

Holidays are also a great time to play “Family Systems Detective” and try and unearth some valuable family history, especially from any senior family members (going through photo albums often invites and encourages these types of sharings). The more you learn about your family, especially possible traumatic events, i.e., unexpected deaths, divorce, missing family members, addiction, suicide, etc., the more you (and your therapist, if you have one) may be able to identify multi-generational patterns that might increase your understanding of possible inter-generational trauma, as well as family system “roles” (who was the scapegoat, “golden child”, caretaker, clown, etc., in generations before you?), which all can be very helpful in regard to your healing and recovery process.

9. Breathe deeply…And practice “radical acceptance.”

Remember that dysfunctional families are driven by primal, powerful inter and multi-generational forces. You did not cause it, you cannot cure it, and you can’t control it. Know when to stop trying to “ride the tiger” and always act in a manner that serves you at the highest level. 

Although the aspiration to experience familial harmony is admirable, it is also important that you do not fall into the chasm that exists between the actual and the ideal.

Do your best to create moments that are meaningful to you. Arrive with your favorite holiday foods or decorations, for example. If the family gathering is at your own home, then leave time at the end of the evening after everyone has left to relax alone or with a loved one (pets included) and reflect upon the day while listening to your favorite holiday music. Or grab your journal and go over what you are grateful for about how you were able to move through what might have been a difficult, challenging day as you acknowledge and celebrate your own recovery from dysfunctional family dynamics.

10. “No Contact” during the holidays: A Special Note

For some, the only way to gain traction in their recovery from dysfunctional / narcissistic family abuse is to have no contact with their family-of-origin at all — And this does not change just because it is the holiday season. Those who are not in contact with family by necessity and/or choice often feel caught in a “double bind” (“damned if I do / damned if I don’t”) situation. The fact of the matter is, many adult survivors of dysfunctional family systems are shamed and stigmatized by society during what is, for them, often one of the hardest times of the year. 

Due to the importance of “no contact” concerns as related to the holidays, I will be doing a separate article to address the many issues that arise for those who choose not to engage with their family-of-origin. What is most important is that you do whatever you need to do to protect your own well-being and recovery, no matter what time of year it is. Reflect carefully on what will serve you at the highest level — And find people who will support you in your efforts. 

I am one-year post op from a life altering spine surgery — actually three of them. Prior to surgery, my doctor told me that this would be life-altering and he was right. It has been a roller coaster ride of ups and downs, challenges and victories. I am incredibly grateful that I have had a good recovery and a positive result. I can swim a 5K and can now run a 5K, I can travel for work and for play and even stand to do the dishes. I still have scoliosis, I still have limitations and I will manage this for the remainder of my life. I attribute my strong recovery to my doctor, physical therapist, swim coach, TRX coach, social support, positivity and optimism. 

I continue to share my journey, on social media as well as in the newly published book Thriving After Trauma: Stories of Living and Healing by Shari Botwin, LCSW. I have connected with many people in different stages of their journey with scoliosis and spine fusion surgery. Some have had a positive outcome, failed fusion or are still in the midst of trying to find the right option for them. This can feel like a very lonely journey so we all need to lift each other up. Much like I use my eating disorder and alcohol use disorder recovery to help others, I feel the need to help others with this as well. We need someone, who has been there, to get in that dark hole with us and walk through it together. Some of the feedback I have received is that people feel lost and forgotten after surgery. I get that. I was not alone. I had a lot of support, yet I still struggled emotionally. It is a long and difficult journey and absolutely an emotional one. Of course not everyone will have adverse emotional and mental reactions to surgery, however everyone can benefit from support.

Studies show the efficacy of support groups as well as the importance of connection in healing from trauma. “What is essential to keep in mind is that post traumatic growth is not a direct result of trauma but rather related to how the individual struggles as a result of the trauma (Tedeschi and Calhoun, 2004). There are a number of things that people who have experienced trauma and subsequent growth identify that was significant to their struggle. These include: having relationships where they felt ‘nurtured, liberated or validated’ in addition to experiencing ‘genuine acceptance from others’ (Woodward and Joseph, 2003). The ability to connect with people who are able to provide this level of assistance and support through active, attentive and compassionate listening can lead to not only to recovery but can foster post traumatic growth. This may include a therapist, close friend, family member, spiritual leader and/or mentor.”¹

This led me to reach out to my local hospital to start a support group there. Like most other hospitals, they host many types of groups including support for Parkinson’s, chronic lung disease, Crohn’s disease and many others. I was certain that they would not say no because of my experience as a therapist, my research and my personal experience with a successful spine surgery.  After 2 months of waiting, I was told no. I am sharing this because I am sad that mental health is not as much of a priority as physical health is — yet they are interchangeable. One cannot exist without the other. I must take care of my physical health every day with joyful movement, eating well and resting. I must take care of my mental health by reaching out for support, reading uplifting books, journaling and a variety of other things.

This is the letter that I sent, to the hospital, when I was asked what my qualifications were. I also included my resume and an abstract that I submitted to a spine conference, based on my research and response from 185 people.

I have over a decade of experience leading support groups, as well as individual and family therapy.  I have worked at all levels of care in eating disorder and substance abuse treatment including hospital eating disorder units as well as outpatient private practice.  I have created and led many groups, most of them focused on eating disorder and addiction recovery as well as trauma. My personal experience is as someone that has been sober for 22 years as well as recovered from an eating disorder for almost as long. That led me to returning to receive my MA in Clinical Psychology and becoming and MFT (Marriage and Family Therapist). I grew up with scoliosis and wearing a back brace and had 2 minor spine surgeries many years ago. Last year, I had a successful spine fusion surgery at your hospital. I am happy to say that my quality of life is far better than it was for years prior to surgery.

Making the decision to have surgery is a personal and emotional one. Post op, I struggled with symptoms of depression, anxiety and PTSD. As a therapist, I did what I would tell a client to do; I sought a therapist for myself pre and post op.  What I found is that there aren’t therapists that work with people with chronic medical conditions and most don’t have any knowledge of spine fusion and the emotional and mental impact it can have. It is my job, as an outreach manager, to find people help and, if I couldn’t find help for myself, how are others going to? I am someone that doctors, colleagues and our community reach out to for help and I was concerned that I couldn’t even find appropriate support for myself.  

I have always been open with my struggles and talked about my journey with friends, family, and colleagues and on social media. Many people have reached out to me for support, some of them are parents of children that need surgery and many of them are fearful pre op and struggling post op as well. I started to do research and created an online survey about scoliosis, spine fusion and mental health and received 185 responses. That tells me that there are many voices that need to be heard. Even with the best medical team, the emotional component needs to be addressed. Having a safe, nonjudgmental space to process emotions, fear and anxiety with someone who understands it is important.

Over the past thirty years, over 200 research studies with thousands of patients investigating psychological preparation for different kinds of surgery have identified several specific benefits.

The key advantages of preparing for back surgery as well as other types of surgery are:

• Less distress and anxiety both before and after surgery
• Fewer complications related to the surgery and recovery
• Less pain and less need for post-operative pain medication
• Less anesthesia requirements
• Quicker return to health²

Although I am frustrated that I will not be able to hold a support group at that hospital, I will forge ahead and hold one elsewhere as well as finding a good online platform for a confidential group. My hope is that I can educate doctors about the mental health needs of spine patients and that patients are offered mental health support.

References:

1. Manitoba Trauma Information & Education Centre (2013). Retrieved November 18, 2019 from https://ift.tt/2LKmpQB
2. Deardorf, W. (2000, August 30). Benefits of Psychological Preparation for Back Surgery. Spine-Health. Retrieved November 18, 2019. https://ift.tt/2RQonTB