A few months into my clinical internship, while a graduate student in mental health counseling, my back started to hurt. Just a little bit. It wasn't the first time my lower back had given me trouble and I brushed it off as a minor nuisance caused by my new therapist lifestyle in which work = sitting all day. I felt confident that a little bit of yoga, stretching and exercise would resolve the issue as it had in the past.

Two and a half years later, after seeing a sports medicine doctor, a DO, an acupuncturist and a chiropractor, engaging in physical therapy and daily stretching, the pain is still here. For the most part it is just a nuisance and it hasn't gotten worse, but it also hasn't gotten better in spite of everything I have tried. I'm still looking for solutions. Certainly stretching and exercise help and for now, I keep those self-directed (and free) exercises on board while I try different things. It occurs to me that I may find the most lasting relief from my own brand of movement therapy that incorporates the most useful of the things I've tried: basic pilates, yoga, stretching, core exercises, and better posture. Maybe a better chair? I'm aware that there may be a psychological component: trauma from breaking my leg twice as a child, attention to the pain leading to cognitive distortions ("my body is weak", "it's my fault I feel bad", "I'll never get better"), and even the possibility that I need to cultivate a sense that the universe "has my back" or I need to "grow a backbone" by cultivating greater confidence. There are a myriad of ways to approach physical health problems and the options can feel both hopeful and daunting.

 Like a Mother: A feminist journey through the science and culture of pregnancy might not seem like an obvious book for a mental health themed blog. Or, on the other hand, maybe it does? Maybe it makes a lot of sense. We talk about postpartum depression like it's a discrete thing that happens to some people (yes, men get it too) after a new baby is born. What about the idea that pregnancy, with all of its physiological and psychological effects on the mother, and on the entire family unit, actually causes changes and challenges that exist on a spectrum continually evolving over time. Existential and often paradoxical questions about what it means to bring new life into the world, realities of physical changes in the body, a whole range of psychological experiences (often including many mood states, not just depression) as well as cultural expectations all play into each person's unique experience of growing a family. Also, we need to take into account the harsh truth that pregnancy, birth, and life after can be dramatically different for those who have money and access to resource than for those who are poor, live in under-served communities, and, the statistics on this are clear, are not white. Increasingly we are talking about gender non-binary and transgender people having children in a medical system that does not always understand their needs. All of this will have much to bear on the mental health of the entire family.

After hearing an interview on Fresh Air with Angela Garbes, I decided to buy the book. For some reason, perhaps the tone of the interview, I thought it would be a light and intellectually stimulating read. In the end I actually found reading this book to be both inspiring and fascinating, and also hard. Everything she covers from the dramatic, and sometimes long lasting, physical changes to the mother's body, to the scientific community's inattention and relative lack of funding for this critical aspect of women's health, is eye-opening and intense. She doesn't sugar coat anything, and thank goodness, because what we are left with is a deeply honest look at what creating new life really means. So much of mental health work is about giving people a space to be witnessed and held while sharing the good, the bad, and the ugly of human life. It is resources like this book that help us feel less alone when things get weird (or slimy, oozy, sticky and stinky). 

The following excerpt is a taste of Garber's writing. It shows how fairly simple and straightforward research helps us identify small interventions that can make huge differences in the lives of new mothers. If you like what you read, give the whole book a go. It will open your eyes, soften your heart, and hopefully help you, and your loved ones, feel less alone in the gritty, visceral, emotional and very human task of giving birth.

In the early 1980s, after fifteen years of working in labor and childbirth, [Penny] Simkin, a physical therapist by training, was considering a career shift. 

Full disclosure, I haven't finished this book yet. I'm only on page 87 but I read something on page 68 that I thought was awesome and I want to share it now. For those of you who aren't familiar with Brené Brown and her work, I recommend checking her out. Click HERE and HERE and HERE.

Brené writes, "What I've learned from the research and tried to put into practice in my own life sounds way simpler than it is: Give yourself permission to feel emotion, get curious about it, pay attention to it, and practice. This work takes practice. Awkward, uncomfortable practice." She goes on to describe how she actually writes permission slips for emotions and puts them in her pocket to carry into a meeting, or event, or new situation.

So let's think about this for a minute. What if we could give ourselves permission to feel what we're feeling at any given moment? I give myself permission to feel nervous about giving a presentation. I give myself permission to feel angry about a decision a co-worker makes. I feel guilty about saying no to a friend. Permission granted. I feel anxious for no reason at all. Permission granted. 

This doesn't mean we act on those feelings. It doesn't mean we are right and someone else is wrong. It doesn't mean those feelings make sense. It just means that in any given moment, the way we are, what we're feeling, is OK. Acceptable. Respectable.

Once the permission slip is granted and we are able to allow what we're feeling to be what we're feeling, then we need to use our skills to figure out what to do about it. This is where some deep breaths, writing it out, going for a walk, or a myriad of other emotion regulation skills come in. But what Brené captures so simply here is that the first step is always to accept first and work through second. By allowing our emotions first we give them the respect and attention they deserve and we are able to learn the important information they impart. 

One of the things I have noticed by practicing this myself is that I often ignore or reject emotions that seem to be contradictory and yet are arising at the same time. For example, I can feel happy AND tired after a positive social experience. If I think happy is the "normal" or "acceptable" emotion to be feeling I may ignore the tired feeling which also needs to be attended to. Here are some examples of ways I've given myself permission to feel everything...

Do you ever get a good idea and then watch it quickly mature and flourish in your imagination? You are reading from your newly published book to an enthusiastic crowd! You are being interviewed on Fresh Air! You are invited to give a TED talk or, if you're a therapist, you see your schedule full of beloved clients whose evolution and growth feels deeply rewarding while your bank account fills with well-deserved inflow of money. When the fantasy fades, you are back where you were when you started: full of good ideas, and with the glow of fruition still a long way off.

There's where you are now, there's where you want to be, and there's everything in between. It's in the space between the dreaming phase and the successful outcome phase where we spend most of our time, and where we can struggle to stay motivated, inspired, and focused. Lynn Grodzki's book, Building Your Ideal Private Practice: A guide for therapists and other healing professionals, offers a bridge between vision and final product. She guides us through the nuts and bolts of advertising, handling money, building an online presence, keeping clients, and other aspects of running a private practice. What is so magical about the book is how she integrates these practical tools with meditations, positive affirmations, and intuitive exercises that help to clarify vision, develop an abundance mindset and engage our creative, passionate, playful sides so often left out of the day-to-day realities of running a business. When I feel stuck, bored, discouraged, or unclear, I open this book and am reminded of the possibilities inherent in each moment, and the practical tools that will help make those possibilities a reality. I highly recommend this book.

Here's an excerpt:
Send Love to Your Practice
Years ago I developed a meditation to enhance therapists' feelings of goodwill and love toward their businesses. I teach this same meditation in almost every presentation or workshop I lead because it does so much good so quickly providing therapists with a quick antidote to fear-based thinking. In the space of the five minutes it takes to complete the meditation, I see therapists make a shift. As they contemplate sending love to their businesses, their faces change. Furrowed brows become smooth, tense jaws lift up into soft smiles, hunched shoulders relax. Here's a written transcript of the meditation. Ask someone to read it to you or make your own tape. Then sit back, listen, and send love to your practice...