What works for the body works for the mind?

This picture captures the actual feeling I had about
mindfully and consistently working toward my
physical therapy goals.

I’ve been receiving physical therapy for 4 weeks now and I'm getting ready to discharge.  I don’t think I ever anticipated needing physical therapy at 30 because it is for athletes and people who actually do physical things.

After a bad wind storm that hit my neighborhood hard, we lost the top 60 feet of a huge sycamore tree in my backyard- straight through the power lines and two sections of fence.  I kicked right into disaster response mode and got out to get to work.  The first day, I helped neighbors who were hit far worse than me clear big trees from their yards.  The next day, the powerline was put back in its proper place and I could get to work on my tree.

My wife will attest that I went about it in a foolish way, instead of waiting till an army of neighbors returned home from work, I got started cutting up the big tree and hauling it up a steep hill in our backyard to the curb by myself.  Long story short, I hurt my back badly.  I figured I’d been sore before and that this would go away within a week.  6 weeks later, the pain wasn’t getting better so I saw my doctor and ended up working with a very talented physical therapist.

I am a therapist who works with the mind, brain, spirit, relationships, etc. so seeing someone who I assumed worked only with the body was an interesting paradigm shift.  In our first assessment, my therapist outlined four stages we would be working through.  I thought “Ah, right, the road map… it’s good to know where I’m going so that when I feel like this is taking too long I can have some perspective and not get totally impatient." He then told me that A big part of this working is going to come from you changing how you think about your body and how you use it. If you can change what goes on in your mind, you can help your body. I wanted to shout Hallelujah! we believe the same thing, let's get started.

Then he told me we would accomplish this in about 6 sessions over roughly 3 weeks. After the first visit, I kept thinking about the timelines and his confidence in them. I thought how nice it would be if I could tell my clients we would be resolving their problems so quickly. Since becoming a therapist, I have really tried to be a good client. I try to do what my doctor asks me to do, I try to follow through and apply what I learn about human development and emotional health, and I really try to take all aspects of my health and wellbeing seriously. I am near discharge from physical therapy, pain free, and grateful for what taking care of my body has taught me about taking care of all other aspects of my life. This is some of what I have learned from physical therapy:

Going harder doesn't mean you will get there faster. If life isn't going 'as usual' you can't pretend that it is. Part of the reason it took me 6 weeks to see someone for my back pain is that I lived under the false belief that it would be better tomorrow. "I can put up with pain today, it won't last forever." When I did have a good day, I would go for a run or work in the yard and without fail I would pay for it.

So many of the emotional and relational problems we face are not helped by ignoring that they exist. When you come up against a barrier, it is important to understand exactly what the barrier is before you move into "knock it down" mode.

Practice and regular routines add up to results. Each time I go to the physical therapist, he gives me one or two new exercises to add to my routine that address where I am at in my recovery. We check in each visit on how frequently I have been utilizing the different exercises and how I am feeling. I have taken this homework seriously because I wanted relief. It was amazing at how quickly my pain subsided and how much stronger I am because I am doing some simple things each day to stay up on my health.

When it comes to mental health, there are several simple daily routines that make a big difference. A relatively few minutes of mindfulness meditation is shown to have impact on mood and change your brain. Exercise is wonderful for mood and for accelerating learning. Meaningful connection with others has the potential to release long-lasting and pleasurable levels of dopamine, serotonin, and oxytocin. Writing on a regular basis increases creativity and can help the brain to more thoroughly process information.

It is so easy to stop doing what helps when you start to feel better. This is where the 'getting better' process breaks down for many people. I have recognized a point where I am feeling so much better I am actually having to set reminders on my phone so that I remember I'm still not better and that I need to keep working to maintain the gains I have made.

Essential to this process has been someone who knows a lot more than I do and can see a bigger picture (my physical therapist). An essential ingredient of emotional health is having someone(s) in your life who know more than you and have walked the road you are walking. That is how we get to know our blind spots, people who care enough to tell us when we 'have food on our face.'

Having a general roadmap helps to get the most out of where I am at now. The first exercise the physical therapist asked me to do did not feel good and it seemed like it would compound the injury, not help it. He let me know that he could tell a lot about what might be going on in my back by how I responded to the initial stretches he asked me to do. I have been thinking a lot about the 4 phase process he is taking me through 1) diagnose the pain 2) get in front of the pain 3) build a strong foundation 4) build strength that will protect against future injury.

When we have a general sense of where we are going and why we are going there, it can lead to more investment in the journey (i.e. me doing my PT homework). Emotionally, when I understand that I am still reeling from pain, I can put the breaks on rushing into the next emotionally intense situation, instead I can focus on regrouping and coping with my pain. When I understand that some fundamental things need to shift in how I think and process my environment, I can relax a bit away from rushing to get to the 'destination' I have in my head.

The brain the the body are connected, you never go somewhere with one where you don't bring the other along.

Tips for Engaging in the Change Process

Change is a tricky thing to undertake.  

First, the term “change” is ambiguous- what does it really mean to change?  Some would say true and lasting change comes when what is within us shifts; others would say that change is doing things differently than you did before.  Understanding the type and scope of the change you are engaging in is key to success.

Second, the internal kinds of change are intangible- in many instances, it is difficult to quantify the results of the change that an individual is pursuing.  Trying to measure what is intangible by what is observable may miss the importance and the meaning of what one is trying to change.  

Third, behavior and its attending attitudes and beliefs get hard wired- the human brain is designed to make shortcuts, or what we know as habits and patterns.  Think of how much more complicated life would be if you didn’t have the mental shortcuts or heuristics that help you to do complex and familiar things without having to start from scratch.  Often, the changes one wishes to undertake are changes to behaviors and attitudes that come naturally, even reflexively.  It further complicates things when one considers that the behavior one develops to survive difficult situations often becomes very maladaptive when the initial need for the behavior has passed.

Last, it is easy to get overwhelmed when you contemplate affecting something that you may not even have a good sense of- if you are looking at changing something that has been a long standing pattern, has to do with your internal feelings and beliefs, and that will be hard to measure, it is understandable that the task will look too daunting and unattainable.  Often, one rushes into a solution without really understanding the nature of the problem and gets frustrated when things stay the same.  So how do you undertake change when an issue goes so deeply you may not fully recognize it?  Below are six suggestions for getting started:

1. Practice Mindfulness- mindfulness means slowing down the everyday operations and experiences to allow the mind and the body to fully be a part of them.  When you are contemplating undertaking change, it is one thing to feel that you are running frantically from whatever it is you are wanting to change and it is another to feel calm and assured, deliberate in each step.  When we are running scared, we are likely to run into a new situation just as distressing or more so than the one we are trying to leave.  

Practicing mindfulness allows the body and the brain to slow down and get deliberate.  In mindfulness practice, one is awakening a part of themselves that can observe what is going on within and without.  This “inner observer” can greatly aid in understanding what is happening without getting swept away by events and triggers.  

Notice that the word “practice” is used instead of “be.”  The ability to think and feel differently doesn’t come from flipping a mental switch, it comes from practicing a new way to live each day.  To begin with, one may not have the attention span or the skill set to practice being mindful for more than five minutes at a time.  Start where you are at, as you are consistent, your ability to slow down your body and mind will grow, which will leave more room for additional thoughts, feelings and insights.

Googling “mindfulness practice” will yield 33 million results, most of which are probably very good suggestions for starting the practice.  To get started today, here are a couple of simple practices:

Notice your breath- take 3 minutes to just focus on your breath going in and out of your body.  Don’t try to slow it down, speed it up, or hold it- just notice how you are breathing right now.

Mindful eating- take a few extra seconds when you eat to smell your food, feel its texture, and notice its flavor.  Give each bite 3 extra chews so you can get present with your eating.

Look out a window- give yourself 5 minutes to look out of any window or to sit outside and notice what is going on around you.  What are the colors, shapes, textures, and movement you can see.  Let your attention pass from one aspect to another like clouds passing through the sky.

If you would like to further your mindfulness practice, you can order a deck of cards with 50 mindfulness exercies to give variety and structure to your exploration.  Your Daily Intensive™ Decks: The Grounding Deck can be found at www.jontaylorlcsw.com

2. Talk to other people who have done or are doing what you are attempting- there is no need to reinvent the wheel.  If there is a problem you are facing, there are likely many people who have faced something similar before you and they are likely talking about it.  Search for books, blogs, websites, and groups that explore the issue you are working on.

While information is key to change, so is feeling supported.  In a larger support community, you will find people who know what it is like to struggle over and over again with attempting change and not quite meeting your goals.  You will find people who have had some success, you can learn from them, you can start to trust something bigger than you.

I have found a mixture of approaches (books, blogs, websites, groups, individual people) beneficial.  Recently, I made the decision to try my hand at beekeeping.  I find books and websites give me a great place to start in making a plan for taking care of my bees, but nothing can replace the benefit of being able to talk face to face with someone who has direct experience doing what I want to do in the setting I want to do it in.  

When it comes to changing behavior and attitudes that started a defence during difficult times of life, it takes being in a community of people that understand the pain to let your walls down enough to start seeing change.  This is one of the reasons that 12 step communities can be so successful in assisting in the change process.  Sharing the story, experiences, strength, and hope face to face does as much to get the change ball rolling as any practical information can.

3. Keep a log- once you can observe yourself and connect with a community to support your change, you can start to get to know your particular circumstances better.  Study after study shows that human beings are bad at accurately estimating patterns, quantities, and results.  Our brains are highly influenced by our emotions and biases, we tend to see what we have already seen and what we are comfortable seeing.

Hard data goes a long way in helping one to see what actually needs to change.  Here again it is easy to get started in changing something before we really understand it.  When you start keeping a log, all you are doing is observing the behavior.  You are getting to know your patterns, tendencies, and the scope of the problem.  Start by getting a calendar- the old kind- on a sheet of paper so you can see large stretches of time.  Each day, take note of 5 factors

The thing you are wanting to change- make it simple and observable- is it defined in a way that you will notice it when it happens (ie, viewing pornography, eating when not hungry, not working at work, yelling at children, negative self-talk, etc.)

Your main emotion for the day- what is the emotional temperature of the day?  How you feel can have impact on what you do- this is a good way to find out the role that your emotions play.

How likely are you to do the behavior tomorrow (low, moderate, high)?- many times, unwanted behaviors and thoughts come in cycles, just because you didn’t do it today doesn’t mean you are not preparing to do it tomorrow.  Check in on how much distance you feel from the problematic behavior or thought pattern each day.

Did you practice mindfulness (yes or no)?  Take this as an opportunity to see how your mindfulness practice may be relating to what you are wanting to change.  When one is putting their energies and resources toward something difficult, one can’t afford to waste resources.

Did you connect with others who are engaged in change and know about your change (yes or no)?  This is an opportunity to observe the impact that meaningful, intentional social connection has on your thoughts and behaviors.

There may be a temptation when you are tracking this information in the hopes to undertake change to make assumptions and connections prematurely.  Give yourself a good 90 days of observations before you make conclusions about which emotions, behaviors, patterns, and interventions are significant.  Remember- if you fully knew the nature of the problem you were wishing to change, you probably wouldn’t be in a position where you feel overwhelmed and under resourced to make the changes.  Give yourself enough time to gather data and to really look for what the data are telling you, not rushing to the conclusion you are hoping for.

4. Accountability- at different levels and stages of change, this term means different things.  Often, when we think of change, we think of accountability as the mechanism for letting another know that we have failed which will eventually lead to us not talking to anyone about what we are wanting to accomplish.

If one is going to be successful in their process of change, one has to re-frame what accountability means.  In the beginning, accountability means that you share what is going on with you, how you are feeling, and what you are wanting honestly.  

Now, if those are the requirements for accountability, it may be that not just anyone will serve to be your accountability partner.  It may be that you don’t have access to an appropriate “other” in the beginning of your change journey.  Start by spending some time with yourself on a regular basis checking in on how things are going.  Write about it, call a trusted friend, if you are utilizing a support or therapy group, share with your group what is going on with you.  Believe it or not, this can help to reduce your shame which is often one of the biggest barriers to change.

5. Be aware that denial will rear its head- many people can stick with something positive and life impacting for a little while.  It is not uncommon for me to hear from my clients “Oh yeah, that did seem to help, but I quit doing it for some reason.”  If you are undertaking change on something that causes you pain, it is likely that the initial stages of change will bring some relief.  Once one is feeling better, one tends to stop working on the source of the pain.

Dr. Patrick Carnes and others use the Stockdale Paradox to illustrate the frame of mind needed to sustain long-term change.  Jim Stockdale was a navy pilot shot down over North Vietnam during that war.  He spent 7 ½ years in a torture camp outside of Hanoi.  When he was released from the camp, he was asked why he survived when so many others didn’t.  He said something to the effect of “I had to realize everyday how bad things had gotten or how bad they could get.  I also had to have a clear picture, everyday, of what things would look like when they got better.”

Another feature of the brain that uses shortcuts to keep life manageable is that we have to work to see the whole picture all at once.  Denial will keep us in an extreme, seeing only how bad it has gotten or how bad it could get, or living in the fantasy that we have arrived and things are fine now.

6. Try a cooling off period- this is usually where one tries to start the change process; going “cold turkey” can be risky and a way of bypassing the difficult issues related to the behavior or belief one is desiring to change.  After one has adequately established a knowledge base, the ability to self reflect and soothe, and is actively using a support system the chances for long-term success are much greater.

In a cooling off period that is about more than just quitting, one can start to see why they held on to the problematic behavior or belief in the first place.  This in essence helps to get closer to the root of the problem (ie “I noticed when I stopped looking at porn, I felt lonely most of the time.” or “When i would eat only when I was hungry, I noticed how restless and anxious I feel.”)  The cooling off period is another opportunity to get a fuller scope of the effects of what one is desiring to change.

On one hand, the process of change can make life uncertain, daunting, or demoralizing.  On the other hand, change is part of what makes being a human exciting, because we can have an impact on our environment and relationships.