What if the healing within a patient wasn’t all about the patient? What if successful outcomes occur, in part, because we providers get our eyes opened to the bigger picture of the journey traveled by our patient? What if this enhanced awareness of the person we are trying to help, enables us to collaborate more skillfully and effectively, and results in our personal spiritual growth?
Early in my training, it seemed obvious that the quality of patient-therapist interaction was fundamental to the therapeutic process. However, there wasn’t a lot of evidence to support this. Today there are numerous studies reporting that when patients experience a sense of collaboration, warmth, and trust in, and support from a physical therapist who is skilled in verbal and nonverbal forms of empathic communication, patients are more successful in their recovery and more satisfied with their overall experience of physical therapy. Creating a safe environment is pivotal in this.
When the patient feels safe in sharing what is really bothering them, amid the context of their physical problems, we the health professionals witness the bigger picture of their physical malady and understand how to better advise them in their program. No, we are not providing in-depth counseling but can provide a space that recognizes the interfacing of the emotional and spiritual life with the physical. And in the process, the health practitioner can be humbled, and a little awestruck at the interplay of it.
Marci, a mother of two teenage girls, came to see me for management of her pain and fatigue. She was struggling with a specific autoimmune disorder that created inflammation of the blood vessels. In general, this condition can cause a variety of symptoms, ranging from sores that don’t seem to heal, to digestive system problems, to painful joints, to different forms of cranial pain. Her version of this disease combined inflammation in her brain with joint and muscle pain, with the nasty result of her physical energy being sucked away. Think of your car burning through its fuel, and you have to refill it every day. And you are driving a Suburban. And gas is 5 bucks a gallon. You can’t afford that, so you don’t use the car every day, even though you still have places to go. You are stuck. And you don’t have extra money for Uber or Lyft. Marci had to ration her activities and energy, trying not to trigger her symptoms. As a mom, this was nearly impossible.
Along with her severe fatigue, she experienced horrible bouts of knife-like head and neck pain. In my experience, the head and neck are highly sensitive to pain, and as one physiatrist told me, can drive a patient nearly crazy. Marci had responded very well with my therapy program of physical and mental exercises, coupled with my manual therapy, and was performing some of my techniques on herself. She had a rapid reduction in her pain experience and was naturally delighted that along with the diminishing of her pain, her energy also improved.
As often occurs in patients’ expectations of progress, she thought this recovery would be linear, and was surprised and discouraged when it proved otherwise. Her episodes of severe neck pain had disappeared for the first time in months. She expected this to be the new pattern. It wasn’t. There was still more recovery and healing ahead.
She came to me one day, visibly frustrated and disappointed. She had had a sleepless night, much like her old pattern.
I nodded sympathetically when I heard her frustration. I also was aware that a seemingly insignificant event can set in motion a “flare-up.” Gently I asked, “Well, what happened yesterday?”
As she went through her day and evening, she had an “aha” moment. “Well, there was a bit of emotional turmoil in the evening. Maybe that had something to do with it.”
My ears perked up. “Tell me more, if you feel comfortable.”
She did. Last night with her kids and husband, she watched an emotional family-friendly movie that touched on the topic of questioning one’s faith. She said that while it was very good, it also touched on issues she and her husband were dealing with. He was disappointed with God and angry with Him, which culminated a year before her illness manifested itself. She added that last piece of information as an aside.
That caught my attention. We now know about triggers and issues that flip the genome switches which control reactions to diseases or intruders or antigens, creating varying syndromes or expressions of illness. We call this field, epigenetics. Grief, especially if it is ongoing or unresolved, is one such switch flipper. I shared this with her.
Marci responded, “Well, this issue is ongoing, although we are working with it.”
Feeling safe, she waded into sharing how her husband had first told her of his crisis with faith. While he was committed to her and their kids, he was distraught, knowing this profound struggle with his faith in God was a game-changer for their marriage and their life as a family. Tearfully, he begged her to stay.
She described this scene as suddenly being caught In the middle of a storm. She was hurt, confused, angry, and oh so disappointed. And in the midst of this storm of emotions, she heard a voice, which she attributed to God, tell her, “This will be a long journey.” The message shot through her and reverberated. She clearly understood the message. Marci was to travel this road with her husband, and God would be with them the entire way. She could accept that.
But then she heard the Voice again, telling her the unthinkable. It was, “Accept his hug.”
While she could accept the first difficult message, the second one seemed unreasonable. Her husband was the last person she wanted to embrace, especially right now. Slap him? Yes. Embrace him? Absolutely not. She understood however that love is best seen in action, not emotion. And so, in humility and obedience, Marci obeyed the Voice, and received her husband into her arms, holding him while he sobbed, this time, from relief.
Since then, Marci and he have been through extensive counseling, which has created in her a better understanding of her own faith. She has no desire to leave him, understanding it is God’s will that she remain with him. They are working at making their marriage work, as they really do love each other deeply.
She didn’t say this, but knowing her as I do, I get that she understands God will show her husband His love and light through her love for him. If ever her husband would grow to understand what constant and faithful love look like, all he will ever have to do is think of her. She is God’s presence in his life, whether he knows it or not.
If you met her, you’d immediately be struck by how grace-filled and patient she is, and yet of course she struggles with this monumentally difficult road. Remarkably absent from her is anger and resentment (mostly, I suppose). She is filled with compassion for his struggle, which I find remarkable because she has not struggled with disappointment or anger with God; other things, but not that.
I was blown away. At that moment, in my little treatment room, God parted the curtain that hid the exquisite beauty of Marci’s soul.
16th-century mystic Teresa of Avila says in her “The Interior Castle”, we really don’t understand the exquisite beauty God has placed within each of us, beauty beyond anything like that of a diamond. That beauty lies at the very center of us because it is there He has chosen to dwell in us, through His Spirit. But when we do recognize it, we understand the beauty is all from Him. We behold this in complete awe.
That was a blessed moment in which my eyes were opened to His grace and glory. Clouds parted and I gazed upon what is His alone, from Him alone, manifested in His obedient daughter, Marci.
I was humbled by what I saw. And because of that, I knew how to better prescribe her treatment. I encouraged her in the principles of the neuroscience of pain with language intuitively geared to her. I explained how the brain can get overly concerned, create physical pain so we will take care of a perceived physical threat or problem. This can especially occur with deep emotional distress.
The information was communicated simply, with goals and a plan. Very quickly, she achieved them. This didn’t mean her symptoms disappeared entirely, but she was able to better manage them. That in turn allowed her more strength for the very real struggles at home.
I was deeply moved to be part of her journey, quietly helping her in the background of her heroic story. To me, Heaven broke through and lit up my office that day, and helped me become a more compassionate practitioner.