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October 11, 2017

What Physical Therapy Taught Me About Psychotherapy

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Last winter I couldn’t move my neck. My muscles just didn’t want to work. It started out slowly where I would wake up with shoulder pain or my neck was a little stiff. I tried to do yoga and take hot showers to relax my muscles but nothing seemed to work. It got so bad that I had to move my entire body when I was driving just to check my blind spots. I’ll be the first to admit that I sometimes struggle with self-care or even recognizing problems until they have gotten out of control. My pain became so normal, that as things progressed, I was less aware until I couldn’t move my neck at all. I finally went to a chiropractor who prescribed me some pain medication and told me to go physical therapy. I’d never been to physical therapy and was hesitant. I kept thinking the pain medicine and some rest would make everything fine. I had googled some stuff and by the time my first PT appointment rolled around, I was convinced there was nothing they would be able to help me with.

After the first day of PT, I was even more convinced it was a waste of my time and money. I spent an hour barely doing anything and didn’t feel any differently. I remember my physical therapist giving me a homework sheet with everything she wanted me to practice and a warning that if I didn’t, nothing would change. I remember reluctantly doing the homework and complaining the whole time. I remember feeling worse during my second, third, and fourth physical therapy appointments. I remember doing exercises that seemed so useless because it didn’t feel very hard. When she saw me getting frustrated, my ever patient physical therapist would always explain which tiny little muscles she was helping me make stronger and how without those muscles, my neck would stay stiff. I worked harder and still felt like I was getting nowhere when my physical therapist took a measurement of the movement of my neck. She was excited because I had gained some small movement back. Her excitement was enough to keep me working hard. Just as I had not been able to see my decline, I also struggled to see myself getting better until one day I woke up and was able to look from side to side without wanting to cry. I have found so much of this to be true with my own clients and in my own psychotherapy.

1. Sometimes it gets worse before it gets better.

Doing the work hurts. And it’s hard. We often feel worse because we are thinking about things we don’t want to think about. But if we don’t, those things often stay right below the surface and can wreak havoc on our bodies. It’s hard to trust the process when things feel like they are getting worse.

2. It’s really hard to see progress.

We just want to feel better. Right away. But it takes time and faith that the little steps we take build up over time. It’s important to spend time reflecting on progress even if it feels small or insignificant.

3. Medication is great but it’s not going to fix everything

I could not have handled another day with the pain I was in without some pain relievers. I also could not have handled going to physical therapy without the pain relievers. Medication can make things more bearable and make your brain and body cooperate with what you need it to do. But at the end of the day, you still have to put in some work if you want to feel better long term. For me, that meant working those small muscles. And in psychotherapy, that means strengthening the right synapses in your brain so your automatic thoughts become something like “I’ve got this” instead of “I suck at everything.”

4. There will still be bad days 

Even though I’m better now, I still have bad days where I can feel my muscles tensing. But I now have healthier ways to handle it and I am much more in tune with those little muscles. Psychotherapy teaches you those skills to use down the road to pull yourself out of a rough spot and the skills to be more aware of when things are starting to get bad.

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Last winter I couldn’t move my neck. My muscles just didn’t want to work. It started out slowly where I would wake up with shoulder pain or my neck was a little stiff. I tried to do yoga and take hot showers to relax my muscles but nothing seemed to work. It got so bad that I had to move my entire body when I was driving just to check my blind spots. I’ll be the first to admit that I sometimes struggle with self-care or even recognizing problems until they have gotten out of control. My pain became so normal, that as things progressed, I was less aware until I couldn’t move my neck at all. I finally went to a chiropractor who prescribed me some pain medication and told me to go physical therapy. I’d never been to physical therapy and was hesitant. I kept thinking the pain medicine and some rest would make everything fine. I had googled some stuff and by the time my first PT appointment rolled around, I was convinced there was nothing they would be able to help me with.

After the first day of PT, I was even more convinced it was a waste of my time and money. I spent an hour barely doing anything and didn’t feel any differently. I remember my physical therapist giving me a homework sheet with everything she wanted me to practice and a warning that if I didn’t, nothing would change. I remember reluctantly doing the homework and complaining the whole time. I remember feeling worse during my second, third, and fourth physical therapy appointments. I remember doing exercises that seemed so useless because it didn’t feel very hard. When she saw me getting frustrated, my ever patient physical therapist would always explain which tiny little muscles she was helping me make stronger and how without those muscles, my neck would stay stiff. I worked harder and still felt like I was getting nowhere when my physical therapist took a measurement of the movement of my neck. She was excited because I had gained some small movement back. Her excitement was enough to keep me working hard. Just as I had not been able to see my decline, I also struggled to see myself getting better until one day I woke up and was able to look from side to side without wanting to cry. I have found so much of this to be true with my own clients and in my own psychotherapy.

1. Sometimes it gets worse before it gets better.

Doing the work hurts. And it’s hard. We often feel worse because we are thinking about things we don’t want to think about. But if we don’t, those things often stay right below the surface and can wreak havoc on our bodies. It’s hard to trust the process when things feel like they are getting worse.

2. It’s really hard to see progress.

We just want to feel better. Right away. But it takes time and faith that the little steps we take build up over time. It’s important to spend time reflecting on progress even if it feels small or insignificant.

3. Medication is great but it’s not going to fix everything

I could not have handled another day with the pain I was in without some pain relievers. I also could not have handled going to physical therapy without the pain relievers. Medication can make things more bearable and make your brain and body cooperate with what you need it to do. But at the end of the day, you still have to put in some work if you want to feel better long term. For me, that meant working those small muscles. And in psychotherapy, that means strengthening the right synapses in your brain so your automatic thoughts become something like “I’ve got this” instead of “I suck at everything.”

4. There will still be bad days 

Even though I’m better now, I still have bad days where I can feel my muscles tensing. But I now have healthier ways to handle it and I am much more in tune with those little muscles. Psychotherapy teaches you those skills to use down the road to pull yourself out of a rough spot and the skills to be more aware of when things are starting to get bad.

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