The physical therapy way


Until last year, I had never been acquainted with physical therapy.  My only brush with it was when I would tell a passerby I was a therapist and they would ask “physical therapist?”, or when people I knew would be going off to PT several times a week.  Last spring, my daughter began having some hip/foot issues from her dancing and the pediatrician sent us marching to this “PT” thing.   Once we got settled in at  Bodies in Motion, she and I were both hooked.  She for the individual attention and kindness of the therapists and me because it was so very fasciniating.

What was I fascinated by?  First there is a big room of tables with multiple therapists and multiple patients doing all sorts of body work together.  Bending, stretching, pushing, pulling, there are even people getting needles in their bodies right there in the middle of everything. Therapists and patients all chit chat amongst one another; be it type of injury, latest snow storm or lunch cravings – chatter and laughter abounds.

My mental health therapist head is thinking HIPAA?  We operate under strict  ethical codes highlighting all manners of confidentiality, conduct and boundaries;  I get antsy when one of my clients happen to bump into another in the waiting room and here we have the PT patients being assessed,  worked on and massaged in front of the entire patient population.

The other intriguing thing for me is the toys.  Not only are there stationary bikes and treadmills, there are bands and balls and gadgets for every last muscle.  My daughter was picking up marbles with her toes and placing them in a bucket.   I was struck by the creativity of it all.  I discussed it with her therapist and was amazed by all of the engineering technology involved in their “toys”.

Now it’s my turn.  I’ve been having a shoulder/arm issue that just won’t quit.  It started with pain and over the duration of the winter has turned into a nerve thing with tingling up and down my arm.  When I walked back into the ‘toy’ room for my first appointment, I was warmly greeted by the two PT’s that had worked with my daughter. How is she,  how is her dancing, let me see pictures etc.

One of these  kind gentleman was assigned to my tingling.   He took my history,  asked about the initial injury and then began touching my arm, shoulder and hand.  (Another bizarre thing for this mental health therapist, touching a client? If a client asks for a hug every clinical nerve in my brain is on “alert” due to our very rigid boundaries).

Push, pull, resist, stretch, turn, shrug – my PT is beginning to assess the tingle.  He checked mobility, range of motion and who knows what? The good thing is HE knows what he is doing, I am just the body on which he does his work.   And this is where my “aha” moment struck.  He is looking for the cause of the tingle;  by pushing and prodding at my muscles, assessing  where I am tight and when I loosen up, subtleties of  which I  am barely aware, but he understands the body and can figure out what is going on with my nerve.  He constantly asks me if I notice any difference, is the tingling more or less, rate it on a scale of 1-10.  The tingle can’t speak to him, thus he must rely on my evaluation.

The ‘tingle’ doesn’t talk; I feel it, it is uncomfortable and irritating, but I’m not sure of its source. It is inconsistent;  fingers, hand and arm depending on the moment or my movement.  How is this similar or not to the mental health therapy that I do? Sometimes I see a client that knows exactly what is going on.   “My mother died, I am heavily grieving and am having trouble getting my work done.”  PT patients can know the root cause; many of them are there for rehabilitation following surgery,  have specific injuries or various medical needs.

Often I get the ‘tingle’ clients.  “I’ve been feeling depressed”, “my daughter is cutting herself “, “our teenager is self-medicating with drugs”.  These symptoms have less of a clear source.  Sometimes they can be an offshoot of a trauma, root from a deeper depression or can be the beginnings of a chronic mental illness.  These symptoms, as the ‘tingle’, can be a mystery.  Like my PT, I begin to push and prod at the emotional muscles; I assess and ask and maneuver.  Unlike my PT, who can push a muscle really hard (AND hurt my inner arm like nobody’s business), I need to approach more gently.  If I push too hard, I may cause my client to shut down or even worse, scare him away. (Of course the PT could push the limit, but based on my first two appointments, he has more wiggle room with the idea of gentle).

Over time, building rapport and trust, my clients and I dig together towards the source of their symptoms.  Often, they too, find that their ‘tingle’ doesn’t speak.  Many of my clients struggle with identifying their emotions; they aren’t familiar with them,  can’t discern between sadness or anger, or just can’t find them.  I slow things down and help them to build an emotional vocabulary and learn to identify emotional triggers via body sensations.  Where do you feel it in your body? What does it feel like? Pressure/pain/shaky? All of these prompts help people to get in touch with their emotional temperature.

The word therapy, meaning curing or healing, comes in many forms.  While I am doing talk therapy, there are so many ways to heal us humans.  I am glad to know that both our bodies and our souls lend  to pushing, prodding and healing so that we can all achieve the mental, physical and spiritual peace that enable our days to be filled with  joy.


Good neighbors

Less than a mile from my synagogue is an elementary school with a very diverse student population.  There are kids that live in million dollar homes that attend the school as well as kids that don’t have enough food to eat.  Many first generation immigrants from Africa and Asia have settled in the apartments near the school and send their kids to learn not only basic academics, but also the English language.

Our synagogue has created a program to help feed these students during the time when they aren’t at school.  Many of the kids receive breakfast and lunch at school under the free and reduced lunch program, but sometimes don’t have enough food to eat at home on the weekends and on school break.

The synagogue regularly hosts a food gathering and packing of snacks to send to the school.  The kids in need of food receive the bags on Fridays to make sure that they have enough food to eat at home during the weekend.  Their teachers discreetly put the food in their backpacks so as to not make them feel self-conscious in front of their peers.

The leaders of the program, synagogue members who are volunteers, send a monthly email to the entire  synagogue. The email includes a detailed list of requested foods and volunteers sign up for certain items which they will purchase and bring in to the synagogue (popcorn, oatmeal, raisins, milk boxes, granola bars, etc.).  Once per month the elementary aged kids and many of their parents gather after Hebrew School on Sundays to pack food bags.  The  older kids (7th-12th grades) also meet for weekly education classes and designate a time each month to packing the food bags.

Two Fridays per month we provide bags for 225 kids at the school. On the alternate weeks that our synagogue does not give to the school another organization, Food For Others,  makes food available to the students.

I have participated several times and this past week as I was sitting on the floor collapsing boxes that the food had come in, I was really touched by what was before me.  There must have been more than twenty kids and almost as many adults sorting food, piling up the recyclables and assembling bags.  The leaders have it down to a science and the kids are all hugely invested in the process.  They sometimes race to see who can pack a bag the fastest, are concerned when we run out of an item wanting to insure that each bag has enough food and are excited by the bulk of product that we are creating for our neighbors.

I am proud of the program and of these kids whose families are teaching them about helping their less fortunate peers. The  Hebrew word, tzedakah, which literally means justice, but is commonly used to signify charity, is a large part of Jewish tradition. In Judaism, tzedakah refers to the religious obligation to do what is right and just, which Judaism emphasises are important parts of living a spiritual life.  A little tzedekah can go a long way and I am honored to be a little tiny part of this nice process.

Gathering the goods

Gathering the goods

Tons of mac n' cheese

Tons of mac n’ cheese

Assembly line of volunteers

Assembly line of volunteers

Almost complete bag

Almost complete bag

Many of these bins are filled to take to the school

Many of these bins are filled to take to the school

For old time’s sake: STAY SAFE and WARM

With another storm on the way, I was thinking about the derecho almost two years ago.  I thought I’d re-share with the hope that every one is safe and warm, able to charge and re-charge both their electronics and their relationships:

Click here

The Boomerang Teen Part 2


I said I would return with suggestions to avoid having your teen flop back into the house for an extended stay in the middle of a semester.  I make no guarantees, sometimes a one-way ticket home is inevitable and necessary, but here are some thoughts on how to prepare for a successful flight out of the nest.

I love the idea of sleep away camp. Any reader that has spotted one of my summer posts is aware of my proclivity towards all things camp.  I have promoted camp for infinite reasons (friendship, bonding, summer structure etc.) and one of the biggest reasons is for kids to get a taste of  being away from home.  There are many kinds of  camps that can meet this objective;   sports camps, Scout camps, academic camps and arts camps and they vary in length from a few days to an entire summer.

Camps provide a sense of independence for kids with the safety net of responsible adults who are not their parents to guide them.  At camp kids learn to manage their own clothes, toiletries and meals without mom and dad micromanaging all the details. If they miss a night of teeth brushing or lose a sock (or hundreds), it is all part of the process of learning to have some independence.  I have found that the kids that have spent time away from home for a period of time during their middle and high school years have had the easiest transition to college and have had  less risk for the boomerang swing.

When a teen has increased responsibility throughout high school, he will have an easier transition to college.  Freshmen start slowly, perhaps getting  more opportunities to socialize with peers in groups before they are juniors and driving independently. Many juniors and seniors obtain part-time jobs which teach them responsibility, time management and a bit about finances.   Extra-curricula activities also help a teen with independence; there are clubs with responsibilities, teams with obligations and bands and theater with commitments that the teen must learn to balance with academic and other expectations.

One of my biggest selling points with my clients and their parents is for the kids to become responsible for their own academics.  A freshman in high school should manage her own schedule by knowing when she has an exam, when papers are due and the status of her grades.  I encourage parents to be supportive and helpful WHEN ASKED, but to allow the student to manage his own work load.  The more autonomy a high school student has, the more success will occur in college.

Parents often tell me that their teen will fail if the parent lets go of the academic reins.  The best advice I ever got was at a back-to-school night when my oldest child’s teacher said “Parents, you have already completed second grade, it is their turn.”  Yes, it is their turn; their turn to learn,  their turn to succeed and their turn to fail.  I constantly stress to these parents that the fall is easier when they fail junior year before they are legal adults and still in high school than when they are half a state or country away, paying thousands of dollars for tuition and suddenly realizing that they don’t know how to manage their work load without mom leading the way. (Students with learning disabilities or attention challenges do require more parental supervision.  It is important to strike a balance between over-doing and supporting the student; not an easy task for many families).

My last thought is to address mental health issues if and when they present themselves.  If a child is predisposed to anxiety or depression and has struggled throughout her adolescence with symptoms of sadness, feeling overwhelmed or anger management issues, please GET HER HELP.   Sending a child off to college who is struggling emotionally can be a set-up for failure.  College is inherently stressful with its huge life transitions and rigorous academics.  If your teen seems to be struggling, getting him the help he needs before he leaves home can arm him with the extra tools he may need to have a successful college experience.

Again, sometimes things happen.  Unplanned trauma, anxiety or homesickness can occur; kids come home and it is okay.  There is always another path and other options, so don’t fret.

One last thought, have your kids learn to do their own laundry……if nothing else it will make for a more pleasant aromatic experience for the roommate.