Every Little Step

Featured Image:  “Early morning riser,” © Vincent Mumar (own work), Sep 2011. CC BY-NC-ND 2.0. (license)

“Sensations are not symptoms,” I tell myself as I place one blue-sneakered foot tentatively onto the concrete pavement. The words of my first psychiatrist return to me, though I can’t remember his precise phrasing. “How many times will you tell yourself you can’t do it before you do?

“Anxiety and fear do not provide solace for our pain but aggravate it, leading us to a kind of breakdown in courage and strength because it appears that our pain has no possible remedy.”

~ St. Francis de Sales

On this blog, though I recount forthrightly my struggles with depression and anxiety and I unabashedly discuss my recovery from binge eating disorder, there remain one or two subjects so steeped in self-judgment and shame that I continue to carefully avoid them. These issues are important parts of my identity, and I process them in-depth with my dietician, my therapist, and in my personal writing. Otherwise, I keep the stories to myself, with the persistent belief that, “There are some things that people just won’t understand.” The way that my mind processes thought through physiologic responses in my body is one of those topics that I eschew. It’s hard to describe the stress-induced symptoms that I can develop. They aren’t manifestations of an overactive imagination or an overwrought psyche, and I don’t suffer from what is commonly characterized (and stigmatized) as “psychosomatic” illness. Over-worked neurons send misdirecting signals into the muscles of my body, which contract irregularly, and – voila! – a knot in my shoulder or in my stomach, a rushed trip to the restroom, or a flare-up of an old tendinitis. Did you ever have a lump in your throat, tightness in your chest, or butterflies in your stomach when you were particularly anxious about something? In some people, that mind-body connection is a little over-developed. Different people may experience this process in a manner of ways, but for me, it is just that easy… and complicated.

My response to stress through these non-specific physical manifestations didn’t emerge out of nowhere. When I was in sixth grade, I was the target of some fairly serious bullying. (Those were the days before cell phones and social media. I can’t even fathom what children go through today.) By the end of the year, I was suffering from such frequent stomachaches and nausea that my pediatrician was convinced I was lactose intolerant. When all the tests returned with normal results, the symptoms eventually resolved. I was always a sensitive child and easily prone to worry. As I transitioned from elementary to middle school, the dysthymic depression that would persist for the next 20 years settled more concretely upon me.  I began to experience intermittent knee pains, which continued off and on throughout high school and college. I was diagnosed with patellofemoral syndrome, attributed to soccer and tennis. Before every tennis match, I lined up by the athletic trainer’s office so that he could tape my knees, but my ruminations about the sensation of pain only exacerbated and amplified the subjective experience. After college, I found my stride – literally and figuratively – becoming a short-distance runner and entering races. I completely forgot about my history of patellofemoral syndrome, and then I developed my first significant injury of adulthood. It was the fear more than the pain from the shin splints and possible stress fracture (I couldn’t afford the diagnostic test) that caused my depression and anxiety to spike. My thoughts lingered obsessively over my injury. In my fear and anticipation of pain, I could interpret almost any physical sensation in my legs as “hurt,” and my recovery extended beyond the expected six weeks into the range of six months. Eventually, when my bewildered doctor told me, “Either you are going to run, or you aren’t,” I screwed up my courage and forced one foot in front of the other. My mind reeled, but there wasn’t any inflammation in my extremities. When I forced my way through my dread and apprehension, both the emotions and their physical manifestations slowly melted away into… normalcy.

It wasn’t until nearly five years later, while I was recovering from my gastrointestinal illness and plantar fasciitis, that my therapist and I started addressing the role that my thought process was playing in my over-interpretation of physical stimuli. Anytime I noticed the slightest suggestion of a feeling in the area of my abdomen, I began to focus all of my attention on my stomach. As I over-analyzed every gurgle and squelch, I descended into self-blame, and my head swam with alarming and catastrophic thoughts. “Am I relapsing again? What did I do? I must have done something to cause it! What should I do? What if I really am getting sick again?” While my mood tanked, my stomach twisted into aching knots. At the same time that I was recovering from the terrible trauma of that prolonged GI disease, I was also in physical and emotional agony over a lingering case of plantar fasciitis, which made it difficult to enjoy many of the activities I once loved. The onset of the injury occurred during the peak of the colitis, at a time when I was weakened, malnourished, and desperately depressed. When my therapist and I discussed this history, I began to see how my anxiety and perseverations were understandable. It was so obvious when it was all laid out as if we were discussing the life of some stranger. Of course, I would be hyper-vigilant to any cues that might alert me to impending danger from these two conditions which, together, upended my entire existence! With my therapist’s coaching, I practiced responding to my pain and my fear with acceptance, gentleness, and self-compassion. “There’s that pain again,” I acknowledged. “There’s my brain worrying that something is wrong. But nothing is wrong, and I am ok.” As I gently closed my eyes and relaxed the little muscles of my jaw, I repeated to myself, “Deep breath. Ground myself in the breath. Ground myself in anything other than my stomach or my feet.”

Turning to principles of operant conditioning, I trained myself to act opposite my emotions. Rather than modifying my behavior to “protect myself” from further exacerbating the “pain,” I did exactly what I was afraid to do, within what a wise mind might consider moderate and safe. Instead of staying home from a bike ride, I would set out for a gentle cycle around the block, just to stretch my legs and prove to myself that I was capable of spending 10 or 15 minutes on a bicycle without hurting myself or causing some sort of massive GI upheaval. Instead of sitting on the couch and nursing my poor feet, lamenting my “disability,” I would tell myself softly that walking through the grocery store was not enough to trigger any sort of severe injury from which recovery was impossible, and off I went, frequently deep-breathing the whole way along while squinting my eyes tight and forcefully redirecting my attention again and again to anything other than the focus of my worry.

paralyzed
200.365 paralyzed by the same old antics,” © ashley rose (own work), Jan 2010. CC BY-NC-ND 2.0. (license)

“The best way out is always through.”

~ Robert Frost

During these days of rewiring my mind-body connection, I developed several mantras:  “Just because I feel pain does not mean I am injured. // Sensitivity is not the same as pain. // There is no way that this moderate level of (x,y,z) activity is causing permanent damage. // In the whole long course of my life, this will not last forever! I am ok, and I am going to be ok. // All of this is going to work out. // No matter what happens, God has a plan for my life.” I also expanded the vocabulary that I used to describe my physical sensations. From one word, “pain,” my lexicon multiplied to include pressure, twinge, niggle, rub, ache, sting, tenderness, smarting, soreness, prickle, tingle, pinch, throb, burn, and irritation. Sometimes, there was still no word that fit. “I just feel it. It’s just there,” I would tell myself. Just because I was aware of the presence of my feet, did not mean that there was anything amiss.

“Don’t trouble yourself. God didn’t make us to abandon us.”

~ Michelangelo

So… why am I now reflecting on a desensitization process that I undertook almost two years ago? Well, I still develop physiologic responses to stress, and I still rely on the same tools and skills to redirect the automatic thoughts that alarm my mind with fears that my body isn’t right. With my trip to Paris quickly approaching, I am discovering that there is much more to this jumble than I originally perceived. There are some fearsome monsters still slumbering peacefully in a dark corner of my closet. Until recently, I didn’t even know they were there. Now, they are yawning wide, stretching their claws after their long hibernation, and showing their fangs. They are knocking on the door, and I am timidly letting them into the room.

The truth is, by God’s grace I am blessedly able-bodied, and I always enjoyed a very active lifestyle. I grew up running, jumping, and playing. At parties, I loved to dance! I lived in New York City and Washington, DC and constantly walked everywhere. Until a couple years ago, my job was incredibly active, and I was on my feet for 12 to 16 hours a day. Where did she go, that girl who used to clomp and shuffle and skip and scurry? She never gave her feet much of a thought. “This trip is going to be good for you on many levels,” my therapist predicted during our most recent session. She was referring to the myriad ways I was finding myself hurtled out of my comfort zone. Her underlying assumption seemed to be that I would emerge intact and healthy from my visits with the beasties in the closet. She foresaw us all pleasantly sipping thé and eating gateau at some Parisian sidewalk café in May. I reminded her that there were only four months until my departure – not much time to rehabilitate myself. “And here I was thinking, ‘Wow, we have four whole months! Think of all we can do in that amount of time!’” she replied.

Ironically, it was my mother who offered me the centering words of reassurance that anchored me in acceptance and self-compassion. “If it hurts to walk, just sit down,” she spoke to me over the phone. I was so overwhelmed by how much walking I would have to do after I landed in Paris, that I never stopped to consider I didn’t actually have to do any of it. “There will be so many places to sit! There will be places to sit everywhere! You don’t have to go everywhere and see everything. Just do what you can, and then take a break.” I was a little stunned that these words of balance and wisdom were coming from the same driven woman who instilled my perfectionistic, neurotic restlessness in me. This was the bold, fearless mother whose sense of adventure and curiosity could never be dissuaded until she explored every nook and cranny of every city, street, neighborhood, beach, field, house, museum, shop, or parking lot into which she ever stepped foot. She never saw a “Do Not Enter” sign that applied to her. As I contemplated her message, I remembered that she was also the same one who gently told me, “Let go of your pride,” when I blushed with shame as I maneuvered a motorized scooter through Disney World two years ago. In both instances, she reminded me that it was ok to be flexible, that I was more than I imagined myself to be, and that in the acceptance of reality, there was nothing to fear.

“If we are intended for great ends, we are called to great hazards.”

~ Blessed John Henry Newman

“Do what you can. It’s going to be ok.” Both feet are planted on the sidewalk now. I close the front door behind me, turn the key, and drop the little brass ring into my jacket pocket. Unravelling a set of earbuds, I jam them into my ears, wedging them in extra-securely. I thumb through my music and hit the “shuffle” button on the same playlist that comforted me during those early days of transition after my partial hospitalization discharge. Pat Benatar blasts into my tympanic membranes, reverberating down my auditory canals into my brain, drowning out any other thoughts. Off go my feet – one, two, one, two – and I consciously slow them as I count my inhales and exhales. Clenching my fists and singing softly along with the lyrics, I turn the corner, and I lose sight of the house behind me. “My body can do this! My body wants to do this,” I think. “It is my mind that is weak.” At the end of the next street, I turn back. The loop is about a mile, all-told, and I finish it in about 30 minutes. I am ok. “It’s going to be ok.”

Backpacker in Cairns
Backpacker in Cairns,” © Jo Christian Oterhals (own work), Mar 2010. CC BY-NC-ND 2.0. (license)

“It’s a dangerous business, Frodo, going out your door. You step onto the road, and if you don’t keep your feet, there’s no knowing where you might be swept off to.”

~ J.R.R. Tolkein, The Lord of the Rings

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23 thoughts on “Every Little Step

  1. Thank you for sharing so much of yourself with us Lulu. Your mom is a wise woman and her advice is applicable to many situations. I’ll do what I can even when it’s just a little bit. And quit feeling guilty when I can’t do it all. Super helpful!

    Liked by 2 people

    1. Hi Jill, thank you so much for your comment! My mom is an… interesting person. It’s good for me to remember that she loves me and wants what’s best for me. Even though we have a good relationship, when I think of her, I usually think of all the emotional and psychological scars she left me with. This acceptance and willingness is atypical for her, but I think that is what makes it even more powerful for me. It stops me in my tracks when the message to, “Just do what you can,” comes from the person who was constantly reinforcing that I was unworthy and unloveable if I wasn’t perfect and was always pointing out the ways I wasn’t good enough.

      Thanks again for your support! It’s wonderful to have you here.

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      1. I had no idea. In my experience, people who make others feel unworthy and unloveable usually feel that way about themselves. No excuse of courses and every situation is different. You’re very brave to share and doing so is very helpful to those who read your words.

        Liked by 1 person

      2. Every situation probably is different, but I agree. A big factor that has helped me forgive my parents and has also increased my compassion is the understanding that these beliefs or patterns of thinking and acting/reacting are learned. It seems to be generational, but I’m determined to break the cycle!

        Liked by 1 person

      3. Yes. I believe that to be true. You WILL break the cycle. I’m in the process of breaking cycles myself. Doing so is exhausting. Therefore I am only doing what I can. Maybe that’s why your words reasonated with me so much.

        Liked by 1 person

      4. It takes a great deal of courage and tenacity to break free of old “stuff.” I think you are doing yourself a great honor by recognizing you can only do what you can, and thereby also acknowledge not only your limitations, but also everything that you accomplish! Wishing you the very best. xo

        Liked by 1 person

  2. You bring up some scenarios that seem extremely familiar. Intermittent, intense pain. Inflammation.
    I am going to ask my therapist about some of my continuing pain….

    Your mom has offered excellent advice. Do what feels right in the moment. You can’t plan for it. Just wait and see.

    Plus, a day at a table at a French cafe people watching beats a regular day!

    Mental, physical and emotional responses are all tried up together. It’s complicated.
    Thank you for sharing the steps on your journey. You help me a lot.

    Anne

    Liked by 1 person

    1. Anne, I debated for two weeks before I posted this. I was worried it was too “out there.” Knowing that you can relate to it is both a relief (I’m not crazy!) and also makes me sad, because I would never wish anyone else to suffer! Educating myself about exactly what is going on in my brain and in my body and learning new ways of responding to what I experience has been life altering. There is a lot of research on the role of learning/behavior in pain (I found a pretty decent website here http://www.bodyinmind.org/learning-and-chronic-pain-part-3/). I am also reading a really excellent book written by a physician on the role of stress in causing actual medical illness. I met the author at a conference last year and was very impressed with his expertise. Here’s a link to his website. http://stressillness.com

      I hope that you find some relief from your own pain and inflammation. You definitely deserve it! I’ll be trying my best to follow my mom’s advice, and will, of course, be blogging about it along the way. Take care, my friend! 🙂

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      1. About 10 years ago I had a period where I had a lump in my throat.
        It came and went, but was sometimes excruciating.
        My doctor at the time thought it was stress, which I refused to accept. I took many stomach meds.

        It was horrible. But it was just n example of strange physical ailments I have had over the years.

        I have a diagnosis of palindromic rheumatism…but it’s a hard thing to consider some of my physical pain may be mental…although I have read books on the subject and found this to be true.

        I am going to investigate further. Thanks for the reminder!

        Liked by 1 person

      2. That sounds miserable. If you weren’t stressed before developing the symptoms, then the pain alone is enough to cause anxiety and distress! In the book on stress illness, I think there is a chapter on “multifactorial” stressors, such as when one medical condition causes other stress-induced symptoms, but I haven’t read that far ahead yet. If you come across anything that you find particularly helpful, let me know! I wish you so much peace and comfort and relief from all your sufferings! xo

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  3. The mind can wreak havoc on the body. I used to worry about physical sensations, like maybe feeling lightheaded or if my heart skipped a beat, thinking they were the beginning of a panic attack. When in reality, they were not. It’s empowering to get through that, have the power over your mind to say ‘no, you’re not panicking/getting sick, this is normal, you’re ok!’ I love your mom’s advice. Do what you can, it’s fine not to do it all. Enjoy yourself in that beautiful city ( I love Paris!) and you’re going to be so happy and proud of yourself for making the trip! Take care xx

    Liked by 1 person

    1. Hi Jenny! I guess it is normal to have your body react to your mind, isn’t it? Today, I could feel a muscle spasming in my foot all day, but I went to the gym anyway. It was probably exactly what I needed to do to unload some stress! My mom is definitely a complex person, and many of her messages resonate in my mind with quite negative effects, but she does love me and some of her advice is spot-on. “Just do what you can,” is something she tells me a lot (now that I’m older… when I was younger it was more, “Just do it.”) Thank you so, so much for your encouragement, as always. Your comments mean a lot to me. ~ Lulu

      Liked by 1 person

      1. Hi Lulu! I can relate. There have been times I’ve felt anxious and didn’t want to go for a walk (what if this or that happens? What if I panic? Etc)…but I ‘made’ myself go, just to prove to myself I’d be fine and nothing bad would happen. When I’d finish my walk, I’d feel proud of myself and rejuvenated. The power of the mind is so strong. Good for you for going to the gym, as it was great for you to go and relieve stress. And nothing bad happened to your foot, the workout was probably good for it. And thank you, it’s my pleasure. You also encourage me, and I appreciate it so much! Have a wonderful week! Jenny

        Liked by 1 person

      2. Your story sounds very familiar! I was so hesitant to share this post, but I feel so reassured that other people have similar experiences. “What if…?” is definitely a phrase that I find myself using a lot. I’m going to try to pay more attention to that. Thank you! I hope you have a great week, too! ~ Lulu

        Liked by 1 person

      3. That reminds me… when we took our daughter to the child psych for panic attacks, he asked her if she “what ifs.” And told her not to 🙂 Easier said than done. But it’s true… life is full of what-if’s, but we shouldn’t worry about them, as most don’t even happen. But it’s hard to get rid of that internal conversation.

        Liked by 1 person

  4. Your words really resonated with me Lulu. Physical and mental health are so entwined. I’m glad that you’ve had this realisation and yes definitely sit down in Paris and watch the world go by 🙂 I’ve just returned from a break in Amsterdam and spent my last couple of hours in the city, sat in a pub, eating lunch and having a couple of drinks – mainly to keep warm! But also to rest and relax as my back, legs and feet were tired after lots of sightseeing x

    Liked by 1 person

    1. Thank you, Lauren! That sounds like such a lovely end to your trip! I hope that I remember this when my back, legs, and feet get tired! I just received the travel yoga mat that I ordered online in the mail. It is thinner than a standard mat and rolls up very small so that I can fit it in my suitcase. Definitely going to be taking time for self care during my trip! ❤️

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