therapy

In the past week I've pursued both physical and mental therapy, with the thought that it's good to be active and mindful of what I want, of what grounds me, and of what pushes me in positive ways. In medical school we're taught how to fix things, and M pointed out that healthcare is often seen as interventions when things have gone wrong. He noted how people don't think about how to optimize their health, even when nothing is concretely wrong. Since I want to go into primary care, with preventative care more appealing than acute care, I was struck by the thought that this is true, that even for people interested in keeping people from being sick, that a lot of care is focused on intervention and even maintenance, instead of active improvement.

I went to physical therapy today for my hip issues. While this seems like, and is, an intervention for a problem I'm having, the problem arose because of poor maintenance. The therapist told me that I have an upslip, which means that my hip has moved up compared to the rest of my pelvis. This can be caused by falls and trauma, or in my case, long history of high-impact motion without proper optimization of the muscles supporting this movement. My therapy will focus on getting the hip back into place, and then keeping it there by strengthening core and thigh muscles.

The therapist asked me what my goal for therapy was, which was a nice and important question to ask. My immediate response was to go back to running and to feel normal again. But as I learned about the exercises and thought about the 6-8 months of weekly sessions that he says it will take for me to achieve this, I realized that I've been desperate for this therapy not just to re-attain my baseline, but to have the potential to be better. Not necessarily just to run faster and longer, but also to learn the nuances of my body better, to pay more attention to those neglected muscles, to more finely tune movements, to learn new things and not feel limited--not even to just my prior baseline.

Recognizing that baseline can always be better was also what made me think about talking to someone about some of the qualities I sometimes feel trapped by. I had a moment recently where I was thinking so strongly that I should do one thing, but was swallowed by feelings that wouldn't let me do what I wanted. It was frustrating in a way I can't articulate. While I've tolerated that frustration in myself for a long time, seeing it visibly affect someone else made me think, I can try to change this. While generally adjustable to my environment and more than satisfied with the state of things, I've always had this tendency to slip into intractable moods that make me less the person I want to be. Because I appreciate the strength of responses--because this contributes to things I like and dislike about myself--it's been hard to target the negative while keeping the positive in tact. As rational and healthy as it sounds, it's hard to selectively control the intensity of emotions.

So I decided to try therapy for that too, which I have never done for anything. It's not something I've talked in-depth with anyone about, in large part because I find it really difficult to express. I think part of what I'm seeking in this process is developing more clear verbal expression of the abstractions I feel. And another part is to understand what this can do for someone. In the same way that physical therapy comes back to my life in medicine, one of my first thoughts about this is that I've recommended therapy to so many patients for such a wide range of things. So wide, that it seems to me that it's not so much a medical prescription as much as it is a natural need.

In that sense, the word "therapy" becomes more nuanced. When talking about receiving talk therapy, a classmate of mine asked, what does it mean when an intervention is something that's good for everyone? It becomes less a solution to a problem. It's not intervention, it's sustenance.

Even though it felt kind of crappy at first to feel like I'm a little mixed up--to have at twenty-seven years old the joints and moodiness of a menopausal woman--it actually mostly feels good to pursue active change. I feel lucky to still be at a stage to feel potential to do things differently, to not be stuck. And as someone who will be recommending therapy, now loosely defined as means of improvement, for my career, it's useful to be on this end of things. It makes me think that care comes not so much from distance between providers and their patients (the distance created by difference in medical knowledge and training) and this idea that one can fix the other, as much from the shared desire to live as well as we can.