On December 19, 2019 I went through a four-hour surgery to basically rebuild my right foot. I’d like to say I hurt it during an exciting vacation or doing some great activity. Nope. This is a combination of many years of stress on this foot and my foot finally saying, “I don’t want to work anymore.”
Prior to my surgery, I was babying my foot because frankly, it hurt. After surgery I was in a soft cast for two weeks, no weight bearing. I transitioned to a walking boot, but still no weight bearing for another four weeks. On January 29, 2020 I started to walk in my boot and just this week, I started PT with the hope that my doctor gives me the okay in a few days to put this boot back in the closet.
I expected once I started PT that my foot would hurt. What I didn’t expect was the extent my brain would react to walking again without the protection of my boot. I have conversations (not out loud 😉 ) between my foot, my frontal lobe of my brain that controls logic and my amygdala which controls emotions. My muscles also jump into the conversations and respond in their own way. My frontal lobe is ready to walk and even ready to handle the pain. My amygdala and my foot are joining forces in rebelling against my frontal lobe, expressing both comfort in staying in my big black boot and fear of what could happen if I step wrong. My muscles are just screaming and tightening up in protection mode which is why I’ve awakened the last couple of mornings in a lot of back pain and unable to stand up straight without a lot of convincing of those muscles to relax.
In talking to my physical therapist today, while she gently convinced my foot that moving is a really good thing, she said that our brain needs to desensitize to the stimuli that before immediately said “pain, stop!” When I walk barefoot and take confident steps without constantly testing the water (I know I mixed metaphors, but you get my point), my frontal lobe is telling the rest my brain and my foot that I can do this. When I am tentative in how I step or if I get a wince of pain, my amygdala is saying “told you so”.
What I am experiencing is what many of my clients experience, especially those with anxiety disorders. Our emotional and logical sides of our brains are in conflict and are sending strong messages to our bodies as to how we should respond. If we give in to the negative messages, the brain will respond in a negative, often fearful way. It becomes hard wired to respond negatively. If we respond positively, telling ourselves that it will be okay, we can take those steps, our brain thinks positively and we, well me, walk. This is the key to rewiring the brain.
I use the term “Rumination Loop” a lot with my clients. This is essentially the movie we play in our head and for those with anxiety or trauma, the movie is negative and has a predictable bad ending. If I tell myself (my own rumination loop) that my foot is always going to hurt; I can’t walk normally again; or I’ll never wear my cute shoes again, I am reinforcing that negative rumination loop. My movie will always turn out bad because I’ve pre-programmed myself into believing this. However, if my rumination loop starts out with concern for walking and subsequent pain, but I immediately tell myself that, “while yes, it will hurt some, the more I stretch and strengthen, the better my foot will heal. My doctor did a good job with the surgery and giving me a foot that now has the potential to work well..I just need to help it along,” I am changing what started out as a negative rumination loop to a positive one. I am also desensitizing my brain to these negative stimuli. (Desensitizing is a key step to EMDR, a therapeutic technique I practice.)
I realize that I’ve made this process sound pretty simple and it many ways it is. It’s not a hard concept, but it does take consistent work in changing thought patterns in order to change our negative rumination loop. Right now, every time I get up, I have to tell my foot that it can now walk without the boot. When I do my exercises, I am telling my foot that it has the capability to move like my other foot. I celebrate small successes to reinforce the good feeling. For example, the swelling in my foot was down 2cm today from just three days ago. This is a direct result to the exercises I am doing. I still have a ways to go, but this feels good. If I was doing EMDR on myself, I’d install this good feeling as part of my rewiring my brain.
Every time my clients start to talk negatively about themselves, I stop them and we reframe what they are saying. We practice self-affirmation. I love the smiles I often get from my clients the first time they affirm themselves and really feel the positive effects of that affirmation. I love it even more when they tell me that they took on an anxiety-producing situation and successfully set their anxiety aside. Each time they do this, the brain is being rewired.
If you are struggling with a brain that could use rewiring, give me a call and let’s talk. Or better yet, let’s walk! My foot is up for the challenge!
such struggles, both in my physical rehab efforts as well as in my recoveryfrom long submerged or repressed trauma. You have courageously shared this human condition and expressing your vulnerability is most helpful. Thank you, Jane McGill.