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Thursday, February 4, 2010

Therapy Hurts

Anyone who has been through any kind of therapy can tell you that it hurts; and not in an "ouch" way, but in a I'm-going-to-kill-my-f@#$$%%&*^-therapist-next-time-I-see-him-but-I'm-in-too-much-pain-to-do-it-right-now kind of way. I have had the opportunity to experience just that feeling many, many times in my life.

As a child of cerebral palsy newly fitted with a leg brace, I had a daunting task ahead of me: I had to learn to walk again. Learning to walk is no easy undertaking and I think that it is only because they are unaware of what's in store for them that babies even attempt it. As a five year old who had not had any problem with the way she was walking previously, I was frustrated and confused when I put on my brace for the first time and it was uncomfortable and foreign and rather than helping me walk the way all the adults in my life had told me it would, I found I couldn't walk in it. I remember crying in the clinic that day and feeling alone, because no matter how I cried and tried to explain how this thing--this brace that I would have to wear for the next 13 years or so--was not helping as promised, but was hindering me instead, I had no choice. It was there to stay, but my five year old self could not understand the long term rewards of the surgery and the brace in the face of the present confusion, fear, and frustration at the loss of a skill I had mastered (in my mind) as a toddler.

So began my therapy and my pain. It was necessary to exercise my leg and foot to keep my achille's tendon from shrinking back to where it had been before and to strengthen and re-train my muscles to walk properly. While I had previously walked toe-to-heel on my left foot, the brace forced me to walk heel-to-toe, which my foot did not understand at all, and my muscles did not appreciate. Though I couldn't articulate any of it at the time, it felt like both my body and my parents had betrayed me.

Through no fault of her own, my physical therapist was the arch enemy of my heart. As a naturally shy and obedient child, I did as I was told in my sessions with her, but I conjured up all sorts of torturous experiences for her in my head--things like having to spend time with my brothers, and wearing itchy wool skirts, and having gum in her hair and sand in her pants. All the stretching and exercises she made me do and the way she'd manipulate my foot this way and that in our sessions hurt and worse yet, she had my mom's support, which my mom demonstrated by making me do the exercises my therapist provided to work on at home.

As I grew older, of course my perspectives changed and I understood that the brace and the exercises and the therapy were necessary and that I was lucky to have them. And while that knowledge lessened my laothing towards my therapist and evaporated the emotional betrayal I'd felt, it never diminished the pain of the therapy sessions because the goal, always, was to make my leg/foot stronger, which required pushing the limits of what the muscles in my left leg could do to try to match the strength and agility of the muscles in my right leg and foot.

I do not have the same strength and agility in my left leg as I do in my right, but the efforts of the brace and therapy were definitely not wasted. I have seen those with my same condition who did not have the surgery, the brace, and the therapy for one reason or another and their physical abilities are limited far beyond mine. In fact, today only a trained professional can tell that I have cerebral palsy. I live with the effects and some limitations daily, but it is nothing I can't compensate for and nothing noticeable to those around me.

Therapy for depression is another beast altogether, but I have also found it to be necessary to my ability to cope with my mental illness. There are different therapies available and some are more helpful than others. There are times in my life where I really need individual therapy. I need the safety of having one person hear my struggles and help me find my way through them. I need help looking at past trauma with the knowledge I have as an adult rather than only the feelings I had as a child. Other times, group therapy is much more helpful. I need the support of my peers who are the only people that really understand what it's like to live with depression and all that it means. I need that group where I am "normal"--where the playing field is even, so to speak. I need to hear how others cope, what works and what doesn't, rather than hearing a doctor who does not face mental illness tell me what will help. Sometimes I need both. I need my individual therapy where the therapist is focussed only on me and not on keeping the group in a productive, healthy line of thought and I need the group that shares my experiences.

I know many people with mental illness who do not go to therapy. I used to wish I could be like them. I used to think they were stronger than I was and that I should be able to go without therapy as well. While I do believe that everyone must walk their own path and do what they think is necessary for their health, from my own experiences and what I've seen from those who have gone to therapy and those who have not--it is the difference between dealing with an illness that only a trained professional can see and having that illness exposed to the world because without the therapy, the disability is obvious.

More important though, than what the world can see is the quality of life. How miserable it would be to limp through life when a brace, some therapy, and exercises make it possible to dance. For me, the brace is my medication and the exercises are the coping skills I've learned in group and individual therapy.

I won't pretend that therapy is pleasant--it's not. It hurts and it is hard. Often there are days where after therapy, I feel like nothing at all was accomplished, I can walk no better than before and my heart aches from the work I've done. But that therapy that hurts so much now is slowly strengthening my health and teaching my brain to see things differently; to look a possibilities where I previously saw only problems, to hope in a future instead of putting my energy into a suicide attempt, to walk heel-to-toe instead of toe-to-heel.

In the case of my cerebral palsy, the leg brace and therapy I was forced into ended up saving me more than I realized. While my doctors had originally said I would have to wear the brace until I was 18, because of all the work I did, I was able to stop wearing the brace at age 12. It was a wonderful and surprising day when my doctors evaluated my progress and gave me the news and it would not have been possible without that painful period of therapy.

As for depression, I doubt that I will ever go without medication and I am ok with that. I don't know if I will always need theraputic support or if I will be able to cope without it. I am still learning about the limitations my mental illness brings in my life, but even when it's slow, even when there are setbacks, I know there is progress. And while therapy hurts, it also helps.

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