Healing after Trauma: Ten Steps Forward, Nine Steps Back

Editor’s note: When Will submitted this article I had a question about what he meant about how much healing from trauma is possible. I’ve posted our brief correspondence at the end of the article. 

By Will Meecham

mindfulMost of us have suffered psychological wounds. Just as the body can be damaged, so can the mind. But the similarity ends there, because mental and physical injuries heal by different means.

At another time I’ll explore physical healing in detail, but for now a brief outline will suffice:

A wound to flesh and bone heals through sequential processes of fibro-vascular ingrowth, scar formation, and remodeling. Early steps focus on restoring basic integrity. The first-responders are inflammatory cells that establish barriers and plug leaks. They patch the tissues temporarily, like homeowners securing a tarp over a leaking roof in a storm. Just as the tarp can be blown away by a strong wind, the initial repairs of injured tissue are delicate and easily disrupted. Later, after the acute emergency, more permanent work gets done. The roofing crew tacks down new shingles; the immune system sends in cells that lay down collagen to generate scar. In due time, remodeling follows. Perhaps sections of roof are replaced; scar tissue is strengthened in some areas and softened in others. Fractured bones knitted together with collagen grow harder and stronger across the break.
The body slowly settles on a new form. A minor injury may leave little trace. A major one will sport a permanent scar. But over time healing stabilizes. The pace of change slows, and a new equilibrium is achieved.

In comparison, psychological recovery is only loosely analogous to physical healing. It’s true that early steps differ from later ones, but there is no emotional sequence as predictable as fibro-vascular ingrowth, scar formation, and remodeling. Early on, the personality does its best to cope with overwhelming terror, grief, humiliation, or despair. Denial is very common. To outward observers, the rape victim or bereaved spouse may seem superficially normal, acting as if she or he is doing fine. In other cases, there may be an appearance of collapse; the traumatized person may spend hours sobbing hopelessly, or refuse to get out of bed. Rage is not uncommon, and since the cause or perpetrator of the trauma is usually out of reach, friends and family may endure outbursts and hurtful attacks.

Elizabeth Kubler-Ross outlined five stages of grieving (denial, anger, bargaining, depression, acceptance), while emphasizing that they don’t necessarily follow one another in predictable order. Depression may precede anger; bargaining may come before denial, and so on. There is great variability.

Response to mental as opposed to physical wounding is not stereotyped. It adapts to temperament, personal history, social expectations, psychological insight, maturity, and fatigue. The rape victim who was raised in a safe, loving home will likely react differently from one who was molested in childhood. The newly diagnosed cancer patient with a robust support network may look less fearful or enraged than one who feels isolated.
And yet, fairly consistent modes of adaptation can be identified. Kubler-Ross’s observations confirm that healing after major loss does not occur haphazardly, even if its precise contours aren’t predictable. Although the relative pace, emphasis, and ordering of denial, anger, bargaining, and depression are variable, people tend to cycle through most of them as they stagger toward acceptance after major loss or injury.

Another regular feature of healing after neuropsychological injury is relapse. Here we can compare trauma resolution with addiction recovery. Although Alcoholics Anonymous and other 12-Step groups often treat recidivists as failures who must start over at the beginning, professionals who work in the field know that ‘slips’ are common and sometimes even helpful. For instance, a chaotic relapse after a period of stability may help the addict see more clearly the damaging effects of his or her compulsive behavior.
Relapse can occur after physical injury, but it is less characteristic. Backs that have been weakened by repetitive stress may suffer periodic debilitating spasms. A person who heals after a badly sprained ankle may find the ankle gives way more easily in the future. But in many cases an injury heals almost completely. There may be residual weakness or ongoing pain but it is not common for wounds to reopen or bones to re-break spontaneously or after slight impact.

Yet in the psychological realm, a full-blown meltdown or flashback may follow what seems like a trivial stimulus, even years after the original trauma. The war veteran walking down a suburban street hears a car backfire and dives for cover. The young college student who suffered childhood sexual abuse goes rigid with terror when her new boyfriend places a hand on her thigh.

I have experienced emotional relapse with disturbing regularity, despite considerable improvement. Years ago, I was consistently jumpy and reactive, quick to lash out and slow to trust. Nowadays, I am calmer and less defensive, but I remain prone to regression.

In the face of too many frustrations, I lose my center. A friend’s ill-chosen words may disturb my sleep; and if some project I’m working on encounters obstacles the next day, the combined effect may leave me doubting the quality of my relationships and personality. Even as I try to breathe evenly and maintain perspective, I grow tense and grumpy. Sometimes it gets so bad I end up thinking death might be preferable to life. I no longer contemplate suicide, but the thought that a sudden heart attack might be welcome has a way of undermining confidence in one’s mental health.

This is discouraging, to say the least. Despite years of meditative work, psychological exploration, and journaling, despite my commitment to learning from hardship and embracing life on its own terms, I sometimes feel almost as despairing as in the old days.
The word almost in that last sentence is key. My thinking gets almost as unbalanced, my mood almost as foul, my faith almost as vacuous. I call this: ten steps forward, nine steps back. Because if I look closely, I see that although the despair feels familiar, it is less intense and stubborn than before. It doesn’t lead me to contemplate suicide, and it seldom lasts more than a few hours; usually I wake up the next day feeling back on track. What’s more, as time goes on relapses occur more and more rarely.

Ten years ago it wasn’t uncommon for me to be depressed and near suicide for days on end, with few ‘breathers’ between episodes. Nowadays I feel down only occasionally and for brief periods. Even better, my baseline is more optimistic and enthusiastic. Rather than living with a stubborn low-grade depression and rare hypomanic lifts, I now enjoy a background state of sweet (if slightly sad) acceptance with occasional hours of serenity–or even bliss–during meditation.

If you repeatedly move ten steps forward and nine back, after a few thousand cycles you can cover a lot of ground. It may seem unfair that others move faster, but in most cases the swift are less burdened by baggage. To walk one mile dragging a steamer trunk of sand may be more of an accomplishment than walking ten carrying only a canteen and an apple.

The fact that psychological recovery is fraught with relapse is explained by the science of learning. When an experimental animal hears a tone and then receives an intense electric shock, after just an exposure or two it will react anxiously to the sound of the tone alone. If thereafter the shocks cease, the animal will gradually lower its defenses and begin to ignore the tone. But even after a long period of safety, if the tone is followed by just a mild shock, the animal’s terrorized behavior is likely to return full-force. Th learned behavior, it appears, was displaced rather than erased. It remains at the ready should old threats return.

Unlike physical wounds that heal by means of steadily strengthening scar tissue that replaces weaker repairs, psychological wounds heal by the adoption of new patterns while the old, wounded reactions remain programmed in the nervous system. The reactive mode is not overwritten, and it remains in the background, perpetually vigilant. The person recovering from trauma may gain tools for reacting less strongly or settling more quickly, but deeply ingrained fears are never permanently extinguished. The best we can aim for is less frequent and intense reactions with quicker recovery.

It can feel discouraging to suffer a recurrence after months of stability. But as addiction specialists understand, the subsiding of reactivity does not proceed by a smooth trajectory. It’s more like a receding tide whose progress can only be seen over the long term, while in the short run outsized waves occasionally break upon the drying shore.
Despite the differences between physical and psychological healing, in both circumstances the organism can recover, especially if we arrange circumstances to favor healing. In the case of bodily wounds, one aims for good nutrition and appropriate patterns of gentle activity versus needed rest. In the case of psychological injury, one works to avoid repeated trauma while building up a sense of safety and support (for which I recommend Rick Hanson’s book, Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence, as a helpful tool). Of key importance is recognizing the patterns of normal healing, so that relapses aren’t viewed as failures but as steps along the path to wellness. Ten steps forward, nine steps back is the normal pace of recovery from psychological wounds.

***Editor’s correspondence with Will Meecham about this article:

Dear Will, Thanks very much for sharing.

I like your post but I don’t believe that one can’t erase past programming eventually…I do think that a life without fear is possible. I know people for whom it’s come to be and I see clear indications in my own journey that it’s possible.

I might need to put in an editor’s comment to that end.  Would you be comfortable with that? – Monica

Will’s response:

Hi Monica—To say that a life without fear is possible is not quite the same thing as saying that one can permanently erase prior neural programming. I agree with the former statement but not the latter. Like you, I find myself gradually growing beyond old patterns, as the post describes. I do hope that some day I will no longer experience regressions, and the trend appears favorable in that regard. But it’s a gradual (ten steps forward, nine steps back) process, precisely because of the durability of old programming.

Learning theory would imply that a person who has grown beyond fear will yet remain susceptible to more rapid learning of a fearful response, should new trauma intrude. This can then be gradually extinguished again (perhaps swiftly if one has developed solid mindfulness and related skills), but there will still be a difference in trajectory relative to others without earlier trauma histories. For instance, experiences of early life trauma are felt to explain some of the differential susceptibility to PTSD in adulthood.

It wasn’t my intent to write a piece that suggests one can’t transcend early trauma; rather, I wanted to reassure those who are working toward transcendence that relapses aren’t signs of failure but expected parts of the process.

Perhaps including your comment and my reply would clarify the piece? But if you prefer a shorter statement, that’s fine with me. Best Wishes, —Will

willIf you’re interested in more of Will’s work I recommend his work, now at Mindful Biology where he explores healing after trauma. 

Other posts by Will Meecham on Beyond Meds here

The soft animal of the body

By Will Meecham

Let the soft animal of your body love what it loves. — Mary Oliver

bodyBessel van der Kolk’s 2014 book, The Body Keeps the Score, reminds me of how strongly both my physical and mental condition have been shaped by trauma. Spinal arthritis, abdominal pain, chronic muscle aches, fatigue, depression, anxiety, and many other problems combine to form an inner ledger of the abuse, bereavement, and neglect of my childhood and the uproar, frustration, and terror of my adult experience.

Why should this be? Why should trauma have such profound effects on body and mind?

It’s useful to remember what it means to live as a human organism. There are many ways to explore this, but let’s try an outside-in approach.

  • Skin: Our bodies are covered with a protective surface that is highly sensitive and easily injured. The skin registers both loving caress and brutal blows. It is multilayered, with a relatively dry outer layer and a most inner layer, rich with blood vessels and nerves. It’s an exquisite interface, but also the one that suffers much under the hardship of life. And every message the skin receives travels throughout the human form, like ripples on a pond. Affectionate touch can build confidence, while violation instills shame.
  • Sense organs: Eyes, ears, nose, and tongue provide animals with vital information about the environment. The eyes register facial expression; they narrow slightly when we laugh among amusing friends, and they broaden in terror when a fist swings toward the face, or a car spins on a freeway, or a loved one suffers a bad fall, or an abuser stares at us with sadistic contempt. The ears are sensitive to volume, pitch, and cadence. The coo of a lover’s voice softens the heart, while the threats and insults of a cruel caregiver freeze us in states of lonely shame. Many animals can smell rage and fear, and perhaps we can too. The nostrils flare when we feel unsafe. What’s more, the scents associated with a terrible history remain imprinted forever. Long after we’re adults, the smell of alcohol on a person’s breath might transport us instantly back to the awful past.
  • Muscles: Think of how much tension gets stored in the muscles of the face, jaw, neck, upper back, lumbar region, and pelvis. Wilhelm Reich called the layer of tight musculature “armor,” and the word fits. In a vain attempt to protect itself, the body builds a wall. The safety the armor promises is an illusion, but the way it cuts us off from feeling spontaneous and affectionate is all-too-real.
  • Bone: The bone is our innermost strength. It stores some of the deepest physical scars as thickened areas where fractures have healed. It gradually thins with age, as hormonal shifts change the balance of buildup and breakdown. It also holds the imprint of our habitual posture. How many of us develop chronic slumps in the shoulders and upper backs, the stamp of chronic defensiveness and lack of confidence? How many of us feel ready to stand tall every moment of our lives? In this age of epidemic trauma, it doesn’t help that our lifestyles encourage collapse, as we hunch over LED screens. Our skeletons become maps of withdrawal and insecurity.
  • Lungs: In Chinese Medicine, the lungs are viewed as the reservoirs of sorrow. Depression and grief are reflected in breathing patterns, which become shallow and choppy. The lungs connect us most intimately, and also most vulnerably, with our environment. They open a vast surface to the atmosphere (about the size of a basketball court in every person), so that each breath is as intimate as lovemaking. How sad that our atmosphere is so often polluted, or that we feel so stressed we find comfort in inhaling the toxic fumes of cigarettes and vaporizers.
  • Digestive Organs: We are what we eat. We know this, and yet in the aftermath of a harrowing upbringing, or after a stressful day in a difficult job, we find ourselves swallowing oily, salty, sugary, and ugly junk food. Our stomach and intestines dutifully break down whatever we ingest, but potato chips and candy bars send shock waves through the blood stream, so that many of us suffer with high cholesterol, hypertension, and diabetes. How much healthier to fill the inner channel with what it craves: good, wholesome food that isn’t laced with pesticides, preservatives, and empty calories. Yet how difficult that can be!
  • Nervous System: The brain sits at the top of the spinal cord, like a king surveying his realm. Nerves come in from every inch of the skin, from the matrix of bone, the airway linings, the digestive organs, and everything else. It registers and remembers the sensations and–most importantly–their associations. Does a touch on the arm evoke the caress of a gentle mother or the groping of a drunk molester? Does the scent of detergent remind us of laundry drying in the sun or institutional cruelties? The nervous system can remain on high alert for decades, storms ever gathering on the mental horizon. Or, it can slowly settle down, it can find ease and safety despite the uncertainty of life. The nervous system elaborates our consciousness in all of its complexity, and it can create either a hell or a heaven, depending on our experiences and our responses.
  • Reproductive Organs: How confused our feelings become around these structures we all possess! Pathways of passion and ecstasy can so easily become coils of confusion. Does sex feel safe or threatening? Do others desire our bodies or ignore them? Does desire come with affection or is it nothing but narcissistic lust? Do our memories of early sexual awareness feel pleasantly nostalgic or sickeningly shameful? These sweet systems that carry life through time have become such hotbeds of unhappiness, it is truly sad. But we can imagine a better way, we can work to build a culture that celebrates sexuality without obsessing about it. One that views sex and reproduction with curious awe, rather than prurience and contempt.
  • The Heart: She is the queen of the body, sitting in her palace in the body’s core. The first organ to become functional, and the one that pulses with vitality from a few weeks after conception until the moment of death. She is hopeful but can become discouraged, radiant with affection at baseline but cold with terror or indifference when overwhelmed. The heart truly keeps the score, but in a way that remains optimistic. Luckily, it doesn’t take long for us to reawaken the heart to its natural state of wonder. We just need to let the soft animal of our bodies love what they love. Of course, to do that we have to learn what our bodies feel, to quit turning away from the discomfort within. This is a key task of trauma recovery, and in The Body Keeps the Score, van der Kolk points out that yoga, for instance, is a great way of moving through resistance to meet the body where it stands.

We tend to look at the body as a dumb beast or worse, as a machine. Modern medicine has convinced us it’s a mere mechanism. True, we can now replace hip bones with metal contraptions, and this is a boon to many. But that doesn’t mean the body is no different from the artifacts with which we repair it. The body is alive in every one of its cells. Each is a life form in its own right, just as every honeybee is an individual even as the hive is the unit that reproduces. The body is a society, with its cells, tissues, and organs each playing important roles in the drama of human life.

Trauma disrupts the body by obstructing the smooth communication and subtle rhythms that characterize life. We become disconnected and irregular, robbed of our birthright of intimacy and resonance.

And yet, the body’s reactions are its best effort to keep life moving. Armor is designed to shield us. Flashbacks are meant to keep us vigilant. Disconnection is meant to isolate us from danger. The intelligence of the body is doing its best, moment-by-moment. Trauma recovery depends on reeducating the organism, so it can respond to our situation as it is now and not as it was then. With slow and careful work, we can grow more accepting of our bodies. We can become more vibrant: appropriately protective when necessary and beautifully permeable when appropriate.

There is a growing collection of posts now that talk about The Body Keeps the Score by Bessel van der Kolk on Beyond Meds. It’s an important book that everyone who wants to deeply understand mental health issues needs to read.

willIf you’re interested in more of Will’s work I highly recommend his blog, WillSpirit where he explores growing and wellbeing after recovering from a traumatic childhood.

Other posts by Will Meecham on Beyond Meds:

Biology, Spirit, and Transcendence

By Will Meecham

If you’re interested in more of Will’s work highly recommend his blog, WillSpirit, where he explores growing and wellbeing after recovering from a traumatic childhood.

My blog’s tagline includes the word spirituality, which has devolved into a vague term that can mean almost anything. In the interest of clarity and to balance the two previous posts that emphasized material takes on human life, this essay will outline my spiritual path and beliefs. Readers may or may not be interested, but it helps me to spell out my philosophy from time to time, especially since it’s still maturing.

What follows rambles through my ideas about different metaphysical stances, to my own personal experiences with them, to a description of my current stage of development. Since my understanding of the world’s religions is superficial, at best, don’t be surprised if my statements about faith and practice sound obvious or naive.

Two posts back I stated that our animal identity constitutes “the most central and accurate description we could give of ourselves.” After all, it seems unarguable that humans are mammals with large brains. Even while writing that sentence, however, I remained aware that many resist considering themselves ‘mere’ biological organisms. Indeed, when I posted the same essay on my Psychcentral blog, the following comment came in:

Hmmmm, so we are reduced to “cycles of carbon and calcium?” I prefer that we are “fearfully and wonderfully made” by our creator. As a believer, I will be returned to Him.

This reader’s opinion probably resonates with many who consider themselves religious or faithful. Here’s an edited version of what I wrote in reply:

You bring up the other common opinion about ultimate identity: that we are best described as conscious entities (souls) inhabiting organic forms. But even if one takes that view, at death the body is still reduced to its constituent elements and recycled in the biosphere. The two viewpoints are not mutually exclusive. In fact, since our biological form is apparent, while our spiritual nature remains debatable, even believers should look for ways to interweave the two perspectives. To deny our biology is to deny material reality, just as to deny our divinity is to deny higher meaning.

Divinity, as I intend it here, is a loose term meant to suggest that we have inner measures of soulfulness that go beyond the solid, predictable qualities of organic matter.

In the opinion of Christians and Muslims, each person has an immortal soul that is born once to this world and then consigned to eternal bliss or damnation based on a lifetime’s accounting of virtue, sin, faithfulness, and redemption. The sensible person thus works toward righteous behavior in order to secure a place in Paradise.

According to many Hindus and Buddhists, a soul (or its equivalent) is reborn repeatedly through time because of karmic entanglements accrued in previous incarnations. The wise soul engages in right action to limit such attachments and thus escape the cycle of death and rebirth.

Not all religions postulate an eternal and personal soul. For instance, Western Buddhist teachers seldom mention reincarnation. They discuss the basic principles of detachment and right behavior without reference to rebirth. This obviates the need to discuss a soul-entity, and in fact the Buddha himself rejected the existence of a discrete soul, since he found no evidence for any consistent, fixed self in his deep explorations of mind. Most Buddhists in the USA seek direct, meditative insight into the nature of consciousness as the ultimate goal of practice and don’t worry about escaping the cycles of birth and death. The focus is on mental process without invocation of any divine or eternal soul. Continue reading

“Uneasy in good times and overwhelmed in bad. This is the legacy of childhood trauma.”

By Will Meecham

If you’re interested in more of Will’s work highly recommend his blog, WillSpirit, where he explores growing and wellbeing after recovering from a traumatic childhood.

The Body Didactic

Too many of us grew up in families wracked with pain. Emotional wounds accumulate in settings of neglect, abuse, bereavement, molestation, violence, and misery. As adults, these ancient injuries undermine our happiness. We often choose poorly in relationships, careers, and pastimes. Even if we don’t make gross mistakes, we lack the confidence to endorse our own choices. We feel uneasy in good times and overwhelmed in bad. This is the legacy of childhood trauma.

At times we shut down emotionally, closing ourselves off from the affection we crave. Other times we act out and hurt the ones we love or destroy our own reputations.

Still, healing can happen after even the worst of upbringings. It takes time, and backslides are unavoidable, but eventually we stabilize in greater maturity and emotional openness than we ever imagined.

In the last post we highlighted the body’s gentle wisdom and how often we ignore it. As I move further along the path to peace of mind, the importance of befriending physical nature becomes ever more obvious. The injuries of the past are stored in our biology, where they affect every aspect of our lives. Continue reading

Let Your Body Seduce You

By Will Meecham

If you’re interested in more of Will’s work highly recommend his blog, WillSpirit, where he explores growing and wellbeing after recovering from a traumatic childhood.

Let Your Body Seduce You

Imagine someone asks you this question: “What are you?”

We seldom get queried in this way, since the more typical questions are: “Who are you?” or “What do you do?”

So take a moment to answer the question of what you consider yourself to be, first and foremost. Some of us will answer with our careers: “I’m a physician.” or “I’m a writer.” Others will state an important social connection: “I’m a mother.” or “I’m an American.” A few will refer to religion: “I’m a Muslim (or Atheist, Christian, Jew, Hindu, Buddhist, etc).”

But few of us will reply, without forethought: “I am a warm-blooded animal that walks upright on its hind limbs and possesses an enlarged brain.” And yet, that is probably the most central and accurate description we could provide.

Look back in time some five-thousand generations, or one-hundred-thousand years. Anatomically modern humans walked the earth, but most contemporary roles didn’t exist. Concepts about personality and social function, if articulated at all, must have been of more limited scope. We have no way of determining the language environment of these beings. No doubt people back then related to others as parents, children, and tribal members. Some may have been Shamans; some may have been leaders. So as individuals they may have had feelings about basic categories of identity and perhaps even words for them. But my guess is that they were far more aware than we are of their kinship with other animals and nature at large. The biological urgency of nutritive, protective, and reproductive drives may well have dominated their consciousness in place of the concerns about money, time, and networking that occupy our lives in the information age. They probably understood much more intuitively than we do how similar humans are to bears, monkeys, wolves, and antelope.

Humans were living, breathing, eating, defecating, copulating, and nurturing as animals long before they were writing, analyzing, conceptualizing, and philosophizing as citizens. Despite this, today we give far more attention to our concepts, and our feelings about our concepts, than we do to the basic biology that keeps us in the game. How many of us read a newspaper at breakfast or a magazine while sitting on the toilet? How many of us listen to our iPods while running or watch TV while digesting dinner? All these practices act to divorce us from our bodies. However, unlike unions between lovers, matrimony between mind and body is always “’till death do us part!” There is no chance of divorce, only alienation.

The powers of silence that I touted in a recent post may offer a return to our native state of mind. Before we learned to escape into the constructed realm of symbols and society, we remained grounded in the given world of bodies and biology. Make no mistake, I believe that language can help people heal, as evidenced by my efforts in writing these essays. But even more healing is learning to live beyond words, to dwell as organic beings embedded in the biosphere and related to all other life forms through an elaborate, eternal interchange. The material of our bodies came from the earth and constantly exchanges with it. Every calorie that keeps us alive is owed to some other organism that preceded us. Once death meets us at the end of our days, our physical forms will be released so their elements can again enter the timeless cycles of carbon, calcium, and creation.

In the meantime, we can find simple, lovely contentment by embracing, in silence, our bodies with their constant throbbing, gurgling, aching, hungering, and aging. Rather than feeling beleaguered by our organismic limits and imperatives, we can learn to honor them. Rather than hating how time drains the bloom from our faces and erases the potency from our contours, we can honor the natural, inevitable, and majestic seasons of every life.

Whenever the opportunity arises, I like to watch insects and other small creatures. The delicacy of their movements, the purposefulness of their travels, and the incredible intricacy of their bodies all impress me. A warm feeling of affection for these little beings often follows. If even a gnat displays this miracle of life, imagine how impressive you are as an organism. Think of the formidable truth of your brain, with its thousand-trillion synapses mediating a torrential flow of information. Remember the marvelous fact that you grew from a single cell inside the body of another organism much like you in every way.

With the stillness of meditation one begins to feel the ticking of the body, the flow of consciousness in the brain, and the exchange of air in the lungs. These activities are never-ending while we live, and through them our bodies are continually inviting our affection. Our living processes can be seen as somatic seductions that can help us reconnect with our true forms and escape the complicated tangle of words. They reach out to us every moment, beckoning us back into the sublime experience of living as warm-blooded bipeds on this ancient and bounteous earth.

After a traumatic upbringing, Will Meecham, MD, MA studied ecology, zoology, biophysics, neuroscience, medicine, ophthalmology and reconstructive surgery. In 2000, neck disease prevented him from continuing to work as an oculoplastic surgeon. He spent many years in emotional, intellectual, and spiritual exploration, investigating how people cope with childhood trauma, adult disappointment, and mental distress. He now works as a physician acupuncturist, specializing in the promotion of mental wellness. More of his writings can be found at his personal website and blog, WillSpirit.com, and his acupuncture practice is explained at MarinMedicalAcupuncture.com.

More of Will’s work on  Everything Matters:

Treat the Body, Treat the Mind

By Will Meecham

If you’re interested in more of Will’s work highly recommend his blog, WillSpirit, where he explores growing and wellbeing after recovering from a traumatic childhood.

Treat the Body, Treat the Mind

This past weekend my wife and I participated in a Qi Gong retreat, which we found quite energizing and healing.

Ever since my decision to train as a physician acupuncturist, I’ve worked to learn more about bodywork. In addition to my Chinese medicine studies, I’ve dabbled in movement-based healing practices. I’ve done more yoga in the past year than ever before, I’ve tried a few Hindu-derived breathing techniques, and I’ve joined a Feldenkrais class. Qi Gong is a natural extension of this exploration, and is more relevant to acupuncture since it is based on the same meridian theory. I’ve tried it a few times before, and I’ve also practiced a little bit of Tai Chi, which is a subspecies of Qi Gong.

None of these activities come easily to me. Years ago, first as a graduate student and a little later in medical school, I took yoga and dance classes in alternating sequences. However, neither became regular practices. As I think back on why, it seems likely that my brain demanded too much dominance in my life. I had no problem reading or studying for hours, but even a fifty minute movement class felt like too much effort. And no way was I going to exert myself physically when no one was watching. My life seemed too busy to allow what I imagined an unproductive use of time.

It may be that my subsequent problems with neck arthritis and back pain were partly the result of this resistance. Perhaps if I’d taken flexibility training and movement more seriously, the musculoskeletal problems would not have progressed so far. Who knows, maybe I’d even still be a practicing surgeon.

Those choices reside in the past, and can no longer be changed. But I do have a decision going forward. My current age (52) is a time when most of us still feel relatively robust, although we can’t help but notice the looming shadow of old age. There is thus a motivation that I never felt before. My senior years could be relatively vital, or I could descend into decrepitude. Which direction my body goes depends somewhat on the choices made back in youth, but probably will be determined even more by how I behave from here on out. Do I continue to pursue a fairly sedentary lifestyle punctuated only by a few trips to the gym a week plus dog walking? Or do I commit to a healing movement practice like Qi Gong, and take my body seriously?

When I first began my acupuncture training, I had the plan of applying needles to mental health problems. It never seemed likely I’d make much progress treating severe psychiatric crises, but it seemed quite plausible that those with run-of-the-mill depression and anxiety might find significant relief. I soon learned that people aren’t yet inclined to pursue acupuncture for mental health. Instead, my business does much better when I announce treatment of musculoskeletal problems. But I still believe holistic, body-based healing has an important role to play in the future of psychiatry. Indeed, more books about integral and alternative mental health approaches get published every year, and most of these treatments are directed at the body at least as much as at the brain. Not only do somatic therapies and especially movement practices help with psychiatric problems, but research also suggests that physical activity reduces the incidence of dementia. Physical stimulation is good for the body and good for the mind. Continue reading

“Meditating through my depression has shown me the universality of pain, and the availability of Grace.”

By Will Meecham

If you’re interested in more of Will’s work highly recommend his blog, WillSpirit, where he explores growing and wellbeing after recovering from a traumatic childhood.

Riding on the Storm

Progressive forces within the mental health services encourage meditation. My personal experience convinces me that meditative practice can help a person learn to cope with dark moods and sorrow. It can teach one to appreciate the full spectrum of human emotion rather than always striving to feel ‘good.’

My meditative work began in 1987 soon after I first attended Alcoholics Anonymous and faced the program’s advocacy of spiritual growth. I realize now my good fortune in finding AA at age twenty-eight, since the twelve-step movement was perhaps the earliest major mental health program to advocate meditation as a tool for psychic wellness.

But AA’s theological language troubled me, because my scientist father had raised me as an atheist. I did not feel comfortable with overt references to God as a divine and omnipotent personality. In working through these conflicts, I tried a number of churches and spiritual traditions. I soon discovered a Quaker meetinghouse near my apartment. Because my maternal ancestors had all worshiped within the Religious Society of Friends, and because I’d been raised to respect the values of that group, finding the Fifteenth Street Meeting a few blocks from where I lived in New York felt like a Godsend. Sitting in silent worship without scripture or sermons worked perfectly for me. I became a committed meditator in the Quaker mode. The Friends’ emphasis on right behavior and the contemplative experience of spiritual presence helped me find direction and meaning in life. My more hopeful outlook helped ease my burdens, but my depression still frightened me, and I fought hard against it.

Much more recently I started to hear that meditation helps people cope with mood issues, and I expanded the goals of my practice. Rather than meditating solely for spiritual realization, I started practicing to improve my ability to tolerate and benefit from uncomfortable emotional states. I soon learned that addressing my relationship to moods actually helped my progress toward mystical transcendence. I began to understand, in a deep way, how my suffering with depression was a manifestation of a deeper spiritual confusion.

Interestingly, this wasn’t the first time I’d used meditation for a practical purpose. In 2000 I had taken classes in Jon Kabat-Zinn’s mindfulness techniques in order to deal with chronic physical pain. Through direct experience, I’d learned that inwardly observing somatic distress makes it more bearable. Rather than running from pain, I began to consciously explore it and found great comfort and relief in doing so. Physical discomfort ceased being a frightening enemy, and became a teacher.

However, sitting with depression proved more challenging than relaxing into pain. So much ancient sorrow lay buried in my soul that at first gales of grief threatened to blow me off my intended course. My tolerance for mood extremes started out low, so I could only endure a little sadness before needing to distract myself with pleasant visualizations or other calming techniques. But gradually I acquired the confidence to delve deeper into my depression. Because I worked hard and persisted, I grew able to move through the painful opening of my heart. It was necessary, I realized, to accept my bereavements and regrets rather than deny them. Healing would only come by allowing my emotional body to have its say. So I did my best to remain calm and allow my sorrows free reign.

The process reminded me of the Buddha’s experience under the bodhi tree, when he was assaulted by the forces of darkness intent on diverting him from his path toward awakening. As I sat still in my moodiness, every manner of despairing emotion rose up over time, feeling terrifying and destructive, so that I often wondered whether sitting passively in the face of agonizing moods really made sense. But I continued working, going as far as possible each time.

Gradually, I began to experience the seemingly overwhelming emotional states for what they are: transient feelings. They are not physical reality, they cannot kill me, and they always pass. If I just sit with them and don’t act out, they eventually resolve and my mental life gets at least a little easier. Afterward, I feel wiser and stronger for knowing I tolerated the onslaught.

One time, about eighteen months ago, the emotions felt especially dreadful. I suffered a nasty flu, my neck arthritis was causing severe physical discomfort, and I was withdrawing from an antidepressant. So my mood spiraled lower and lower. I lay in bed trying to move toward my feelings, but every cell in my body simply wanted the pain to end. I yearned to run away from my despair. I’d have welcomed death.

Then, a simple thought occurred to me: “I couldn’t possibly feel any worse.” At first, this seemed to be a complaint, but very quickly I recognized a profound truth. I was at my absolute lowest emotional state, and it turned out to be survivable. I realized that no matter what happens in the future, the worst I will ever experience could never exceed the pain I already survived. It was a moment of realization, of Grace.

This is what it can be like to meditate through depression. You get to meet your demons. In fact, they will rush at you with their most spectacular fury. But if you stand your ground you will see them as they truly are: illusory and transient. They cannot destroy you. Their only power lies in their ability to frighten you into taking action that could indeed be harmful. If you do not act, you suffer no injury. Eventually, you come out the other side with newfound strength and wisdom.

No doubt I have much to learn about meditation and the human mind. However, I already have discovered what matters most: I can tolerate my moods. I can live through them. They can instruct me. Oddly, I can even enjoy the emotional turmoil that so intimately connects me with humanity’s fate on earth. Meditating through my depression has shown me the universality of pain, and the availability of Grace.

Depression still surrounds me from time to time. Dark weather systems move across my psychic landscape, but rather than feeling tossed about by the tumultuous winds of moodiness, I sit quietly and enjoy the energy and majesty of emotional life. Such is the gift of meditation.

After a traumatic upbringing, Will Meecham, MD, MA studied ecology, zoology, biophysics, neuroscience, medicine, ophthalmology and reconstructive surgery. In 2000, neck disease prevented him from continuing to work as an oculoplastic surgeon. He spent many years in emotional, intellectual, and spiritual exploration, investigating how people cope with childhood trauma, adult disappointment, and mental distress. He now works as a physician acupuncturist, specializing in the promotion of mental wellness. More of his writings can be found at his personal website and blog, WillSpirit.com, and his acupuncture practice is explained at MarinMedicalAcupuncture.com.

More of Will’s work on Beyond Meds: