Broken

Something is wrong with me; I am broken.

That narrative has been present for as long as I can remember. I guess you could say it’s a core belief (as described in Dr. LePera’s new book).

The year is 2001, and I am on a family vacation in Florida with my parents and my brother, predictably going to Disney World. I remember thinking to myself “make sure you smile a lot and make it seem like you are having lots of fun”, because that’s what my parents wanted and expected, I told myself. I remember a specific moment when I took a picture with Goofy, where I made sure I looked extra happy for the camera.

Flash forward to grade 6, a group of friends and I would spend our lunch hour practicing plays that we would later present to our class. There was a day where another group of friends was playing football, and some of us preferred to play football over practicing the play. A big blow up ensued; there was screaming, crying and our teacher eventually had to get involved to smooth over the situation. “Ouff”, I remember thinking, “I can’t wait to become an adult so there are no more fights like this”.

I share the above stories because I think they illustrate a few things:

• My innate sensitivity; I pick up on very small details, I feel deeply and I internalize a lot.
• My belief about “normal” emotional states; adults are supposed to be happy and calm. Big emotions are not normal, they are bad.
• My inability to tolerate big emotions; because big emotions were not something I believed was normal, I don’t think I was ever modeled or ever got to practice how to feel them and move through them.
• My belief about myself; others are good and normal, and I am wrong and broken.

When I start to look back at these older moments and start to understand what shaped me and my world view, it comes as no surprise that I have had to depress my emotions (and my true self) in order to survive in this world.

I recently started working with a new therapist who is trained in somatic psychotherapy. I am quite convinced he is a wizard.

A few weeks ago, during our second session together, he guided me through a process called dual awareness while I was experiencing some big emotions. I sobbed as I shared something with him. He invited me to pause, and asked me to describe what I felt in my body.

In all my life, never have I been invited and taught how to tune into my body when I would get overwhelmed with emotions (usually uncontrollable crying for me). The focus was always on stopping the crying, or talking about the thoughts that accompanied the crying.

So pausing to feel the sensations in my body was a very unfamiliar practice and honestly felt pretty weird. But I went with it. Tightness in my chest, I said, and a lot of constriction in my throat.

Ahh, he said, so there is anger present?

Hmm, I thought. It took me about a minute, but after searching within my self, I said to him, yeah, I guess I am mad at myself for crying (like you always do, you idiot – a part of me chimed in). A new wave of sadness washed over my body, and the sobbing started again.

He invited me to sit up, plant my feet on the ground, place a hand on my heart and one on my belly, then he guided me through a practice of dual awareness and micro movements to help me process and release the energy that was pent up in my body.

Emotion. Energy in motion. Huh.

After that session, he gave me home”play”, asking me to practice this dual awareness on my own every day, as often as I could remember.

I have been doing this for the past 3 weeks and, my friends, my life will never be the same.

Practicing this awareness, and connecting with my body throughout the day has enabled me to notice when I am “anxious” or “stressed” (the word dysregulated seems more fitting now). It helps me actually soothe myself (rather than distract myself with social media scrolling, food, planning, busy-ness, etc). It helps me think clearly. It helps me be present with myself/friends/family/patients. It helps me tune into a part of me I had long forgotten existed.

This is not magic, though. It is a practice and its hard work. It is something I have to think about and expend effort to do. Some days it seems more effortless. Other days I wrestle with myself and my monkey brain.

Still, connecting to this part of me – this part of me that just knows what I need, sees things clearly, is so calm and compassionate – is honestly kind of freaky. I guess its what we would call intuition.

And I think thats the part of me that I have been depressing all my life. Because I have believed that is is wrong, broken, undesirable. That is depression, folks.

I attended a presentation last week on the new obesity guidelines in Canada. The presenter was one of the lead physicians in Canada and in the obesity “management” world. Watching this presentation (and honestly just writing about it now, I notice) triggered SO much in me. My shoulders bunched up, my heart quickened and beat heavily in my chest, my body was flooded with heat and my palms got sweaty.

Part of me was clearly upset.

I was upset because there was no mention of the new definition of obesity that is so groundbreaking in the new guidelines (one that moves away from just using BMI and rather includes other measures and evidence of actual disease such as high blood pressure and insulin resistance). The presenter called for an irradication of stigma and weight bias, without acknowledging why these exist in the first place; without validating the helplessness most providers feel and all while focusing on the pharmaceutical products to “manage” obesity. There was only a brief mention of psychotherapy, unfortunately with a focus on cognitive behavior therapy.

In that moment, because of my new practice of dual awareness, I was able to notice how my body and my self responded *appropriately* to a very upsetting situation.

You see, in that moment, I realized how triggering medicine and our healthcare system can be for me. When it does not acknowledge our humanity and our complex nature. When it skips over the actual causes of our struggles (labeled here as a chronic medical condition), and instead focuses on rigid data and “fixing” broken people by the use of (sometimes less than optimal) man made drugs. When it ignores the obvious (and sometimes even the scientific data), and instead focuses on quick things we can do to solve a problem with the least amount of inconvenience on us and the system.

I may seem angry.

And its because I am! Medicalizing the normal human protective mechanism that is overeating is just not helpful, obviously. I don’t know the actual numbers on this but the presenter did touch on the fact that current medical “treatment” for obesity is humble, at best, and rarely delivers lasting effects. BECAUSE WE AREN’T ADRESSING THE ROOT CAUSE, sillies.

How can we expect anyone who is overeating to stop overeating without first helping them explore the unconscious mechanisms that are driving them to eat in the first place? Without actually supporting them in that process which is honestly a lengthy, challenging and messy one? For most, disordered eating is a deeply unconscious mechanism that our reptilian brain uses to regulate itself, regulate our nervous system and our emotional body. Without that lense, we can provide as much education and tools to help people change the way they eat, but we will never actually help them heal. As long as we focus on the behavior, without addressing the complexities that drive them, we will just further traumatize these folks who likely already feel like so much is wrong with them.

There is absolutely a role for certain western medical approaches here such as pharmacotherapy and surgery, especially when disordered eating has contributed to pathology in the body. However, this is akin to using a cup to frantically empty the water on a sinking ship, without ever finding out why the ship is sinking in the first place.

So, during the presentation, I took a chance and I asked the presenter to comment on trauma informed approaches to food addictions and how this is integrated in the guidelines. They did talk about it briefly, and admitted that they were not an expert in trauma, but that it was important to consider. Oh and also that food addiction would be added as a diagnosis in the next version of the DSM.

Great, one more diagnosis to add to our list of what is wrong with us.

It baffles me that the lead physician in obesity management, a condition that has significant underpinnings in trauma, has seemingly no training in trauma informed care. (Although, not really – I just recently started educating myself on trauma and its impacts on health because its not something we are taught in school, even though it literally impacts everyone and nearly all health conditions. More on that later).

Clearly, I was disappointed with the presentation. And it is no judgment on the presenter, nor any individual professional in our healthcare system who is most likely giving their entire soul to the cause of helping people.

You see, our problem is the system, yes the healthcare system, but mostly our entire societal system. And the reality is that changing systems is almost impossible. So we live and die within them, these broken systems.

And in that moment, I could clearly see why I have learned to depress my self. Because the opposite – to honor my self, and to speak up and live with authenticity – is just so painful when everything in the system is broken. It was immensely scary to question (with compassion) the presenter in the hopes of sparking a conversation about trauma. It is scary to write about this and think of my fellow healthcare professionals who may feel offended or enraged by my views. It would be so much easier if I just kept my head down and did not place myself in positions of possible conflict.

You are not broken because you’re responding appropriately to a broken world

Glennon Doyle, from Untamed

For most of my life, it has been easier to believe that I was broken, rather than to believe that our systems and our society are broken.

It’s like something has shifted now, and there is a reality there that I can’t unsee. I am noticing how much gas lighting there is in our western world, how much we blame individuals for their “issues” that are actually just symptoms of how much their needs are not met by our way of life.

I think of those who suffer greatly due to severe trauma and end up in the “correctional” services, as if their dysregulated response to their trauma was somehow their own fault, and not a complex yet totally valid attempt at self regulating (i.e. numbing or chasing a high to relieve their suffering).

I think of those of us who have been labeled as mentally ill, when again, our struggles are simply symptoms of our dysregulation, caused by a complex interplay of factors – biological, psychological, emotional, social/relational, spiritual and environmental.

As Dr. Gabor Maté points out, you can’t separate the individual from the larger environment.

The one contains the many. And the many contains the one.

Buddha

It’s really quite silly, because we are taught (at least some of) these things in health sciences and I assume in medical school as well. They are called the social determinants of health. I had a whole class about it in my first year of undergrad at OttawaU. I think psychosocial factors were even mentioned in later classes such as pathophysiology. But then we get out into the real world, where politics and the system make it nearly impossible to even begin to consider the complex factors that impact people’s health.

So our default is to focus on the individual. Because we can’t take it all on, we can rarely change their environment. So often we don’t mention or explore the environment because it is a herculean task in a system that (most often) just doesn’t allow the time for that. Unfortunately, in the process, we pass on the message to individuals that they are broken.

It’s tempting, to keep working and living that way, to not look at the bigger picture. Because when we do look at the bigger picture, when we open up our perspective to consider that the systems we live in are less than ideal, it literally throws our world upside down. We start to see things in a different light, we take off our rose colored glasses, it feels like waking up from a terrible nightmare – so disorienting. It impacts every single aspect of how we live our lives, and the desire for change becomes inevitable.

I am awake now.

And I am not going back to that nightmare. I don’t want to continue living my life, believing that I am broken, denying my truth and my reality, depressing who I am, just to avoid the discomfort of confronting our broken world.

Nothing is wrong with me; I am not broken.

I am just responding appropriately to a broken world.