It is my fervent belief that yoga saved me from a life of chronic illness, but when my neurologist at the time, Dr. Purcell, suggested it, I didn’t have any idea of the healing powers that yoga offered. I was just so desperate to be well that I would have done anything that might actually help. It was only later that I came to understand why yoga healed me the way that it did.
It shocked me at the time that my nausea went away almost instantly after starting yoga classes. I couldn’t account for it, but I was grateful for it beyond words. The constant year-long nausea and vomiting had been the worst part of my illness, by far. After that, I quickly re-gained the strength, stamina and motivation that had abandoned me, and I began to live again.
It took years to obtain the diagnosis that eventually led to a coherent treatment plan. It wasn’t until well after I recovered that the label “spasmodic torticollis” came into my life. I had to google it to understand exactly what it described, having never heard of it before. It’s such an unusual and odd sounding term that when people ask for my diagnosis and I give it to them, they usually give me a blank look and say, “What was that again?”
In his book, Healing Yoga: Proven Postures to Treat Twenty Common Ailments—from Backache to Bone Loss, Shoulder Pain to Bunions, and More, Loren Fishman, MD has a fortuitous little blurb about my condition. He writes, “A third condition that occurs in the neck isn’t as common, but if you’ve had it or even if you’ve seen it on someone else, you won’t forget it. It’s called spastic torticollis—literally spasmodic turning of the neck. It happens when one group of muscles gets really tight and turns the neck. Sometimes the head turns in jerking motions, and sometimes it turns and stays in an unnatural place.” (Fishman 122-123).
For some time after recovering from the worst of my illness, I had the jerking motions Dr. Fishman describes above. My head would involuntarily turn to the right over and over. It was embarrassing. During the day, when I was in public, I would fight the head turning with everything that I had, and completely exhaust myself. At home, when I was alone, I would relax and let my head do what it would, leading to half watched TV shows and great difficulty in keeping my place when reading. Fishman writes, “This is a condition so painful and so intransigent that you may need a yoga therapist or a doctor who can give an injection that will alleviate it at least temporarily” (Fishman 122-123).
Dr. Fishman’s assertion that spasmodic torticollis is extremely painful is, I think, the reason that my diagnosis and treatment took so incredibly long to obtain. I don’t have much pain at all. I have the odd headache, and my neck and shoulders tend to be a little bit sore, but I really don’t have significant pain. In the very beginning of my illness, my ears and my scalp on the left side of my head hurt, making it difficult to sleep or wear a headset, but that pain went away fairly quickly.
Doctors kept asking me about pain, and when I said I didn’t have much, they immediately dismissed me as a “hysterical woman” trying to get attention for something that wasn’t really very bad. I would like to point out that pain is not the only thing that makes an illness terrible. In fact, I probably would have preferred pain to the ongoing nausea and vomiting that I endured for a year and a half. At least people that are in pain can eat, and they don’t starve to death.
However, Dr. Fishman is right about the injections. Every three months I go in to see my current neurologist, Dr. Matich, who is wonderful and warm and helpful, and she uses a machine to measure my involuntary muscle contractions. She does this by inserting a probe into each affected muscle and listening to the sounds they create through a special machine. Sometimes my muscles whoosh and growl like storms. Dr. Matich then injects botox into the extra loud muscles to help them relax, and I can hear the muscle-storms grow calm. Over time, this has been a helpful addition to my care, but I honestly don’t think it’s nearly as helpful as yoga.
In Healing Yoga, Dr. Fishman describes how “Laboratory and clinical studies have confirmed that pain from upper cervical joints and muscles can be referred to the head” (Fishman, 121). I think this was exactly the complicating factor in my own illness. I believe that what happened to me goes something like this: the whiplash injury that I endured caused the upper cervical muscles in my neck to go into spasm, which irritated muscles and nerves in my head, leading to migraine symptoms, but no pain. I had the visual disturbance, nausea, vomiting and cognition problems that go with severe migraine, but the pain never showed up, which confused everyone—including me.
If he had known about me and my illness, I believe that Dr. Fishman would have backed up my neurologist’s suggestion that I treat my symptoms with yoga. Dr. Fishman writes, “Appropriate yoga is good for almost anything that ails the neck and for pain referred from the neck to the head. . . It improves suppleness of the neck muscles and increases the versatility of the joints so they can move more easily in many different ways. It refines the coordination of the various muscle groups, so muscles aren’t pulling against each other with such ferocity” (Fishman, 123). I believe that these benefits are part of the reason that I began to feel much better quickly after beginning my yoga practice. With my neck muscles in spasm, I needed something to interrupt the process of pulling muscles irritating the tissues in my head, and yoga miraculously did that for me.
However, I think there was another contributing factor. I think that the muscles, nerves, and other tissues in my neck and my head were terribly inflamed by the whiplash injury, at least partially causing the migraine symptoms. Multiple studies have shown that inflammation is a leading factor in many of the chronic illnesses that people suffer from, such as fibromyalgia and chronic back pain. Treatments for pain often focus on decreasing inflammation using NSAIDs (non-steroidal anti-inflammatories), such as over the counter ibuprofen, or stronger prescription versions, like Naprosyn. Many people, including myself, take a daily turmeric pill, which is a spice used in some forms of cooking, because it’s been shown to have anti-inflammatory qualities.
I didn’t know it at the time that I started my yoga practice, but yoga decreases inflammation too. Dr. Fishman writes, “We physicians can’t do much apart from medication for swelling of joints; your body can do more by itself, using a molecule called PGC-1alpha. This is a potent endogenous anti-inflammatory that reduces swelling anywhere it occurs in the human body. Gentle activities such as yoga and tai chi, and especially yoga done for long periods of time, encourage the body to release this miraculous substance from your muscles” (Fishman, 122). The joints in my neck were certainly inflamed after the traumatic whiplash injury that I suffered, and I believe that getting involved in yoga significantly helped to reduce that swelling through the release of PGC-1alpha. How miraculous!
Because of its anti-inflammatory effect, I believe that yoga should be a frontline treatment for any physical ailment that is caused by inflammation. Can you imagine the wellness that would result if doctors would prescribe yoga for arthritis, fibromyalgia, back pain, and any of the other ailments that they usually prescribe pain medication for? I truly believe that the world would be a much healthier and happier place.
Speaking of happiness, I’d like to say a little about how chronic illness affects mood. Dr. Fishman writes, “. . .chronic pain does more than cause people to lose days of work. It’s depressing. It produces anxiety. It makes life so hard that sometimes it doesn’t feel worth living. I think it’s extremely important to address pain that could be or is becoming chronic and end it as soon as possible” (Fishman, 86). While Dr. Fishman talks about chronic pain being depressing, I would like to add that chronic illness is depressing whether pain is involved or not. Before my injury and subsequent illness in 2011, I was the happiest I’d ever been. I had found a group of people where I seemed to fit in completely for the first time in my life. I was active and social and enjoying every minute of it. Then, the whiplash injury happened, and my happy life became very small and extremely unpleasant.
As I sought help, doctors kept telling me that my symptoms were the result of anxiety, and they kept pointing out how anxious I was in the appointments, and how sad and alone I was. I argued that I was anxious because I kept seeking help from professionals who dismissed my symptoms, and I was depressed because I was terribly ill and unable to do the things that made my previous life so wonderful. But the doctors continued to insist that my symptoms were the result of anxiety and depression, not the other way around. I found this incredibly frustrating and demeaning, and it’s refreshing to have Dr. Fishman acknowledge that chronic illness leads to a life that doesn’t feel worth living, because it absolutely does.
However, it appears that the psychological effects of chronic pain and illness are even worse than I previously thought. Dr. Fishman writes, “. . . there is a less-recognized reason: chronic pain that lasts more than a year seems to have negative effects that last much longer. A study done at Northwestern University shows that a year of chronic back pain actually shrinks the gray matter in the brain by as much as 11 percent, the equivalent of ten to twenty years of normal aging, and that loss is directly related to the duration of the pain” (Fishman, 86). Ten to twenty years of normal aging caused by one year of chronic illness! Honestly, that blows my mind, but I’ve seen it happen.
In my own case, after my illness went into remission, and I got treatment that made sense, it took a couple more years for me to be able to focus on reading a book, or to be able to write the way that I had prior to getting sick. I’m sure that recovering from brain atrophy was one of the reasons that it took me almost 10 years to get my book project together.
My grandmother became ill within the past few years. Within a year of getting sick, she went from a vibrant older woman who managed a home of her own and loved to sew quilts, to a woman who needed 24-hour care and couldn’t recognize her own grandchildren. Now she’s living in a nursing home that specializes in dementia care, and I’m certain that her illness was a major contributing factor to her mental decline.
Truly, we must take chronic illness and chronic pain seriously. It not only decreases life satisfaction, causes anxiety and depression, it actually causes brain damage. The good news is that in addition to other wonderful effects we’ve already discussed, yoga can help with the terrible mood and brain problems brought on by illness. Fishman writes, “Clinical trials confirm that yoga helps reduce distress and depression and promotes a sense of calm well-being” (Fishman, 191). He also explains that yoga is being used to treat PTSD. “The Naval Medical Center in San Diego and other military VA hospitals are offering yoga to help Marines, soldiers, sailors and others wounded in Iraq and Afghanistan who are suffering from post-traumatic stress disorder. Preliminary military studies have found that the calming effect of yoga can assist PTSD patients in dealing with hypervigilance, flashbacks, depression and anxiety” (Fishman, 201). Honestly, I think yoga is the cure-all that people are looking for, but it is under-prescribed and under-utilized.
Please spread the word about the healing effects of yoga. Even though it’s more work than taking a pill, I think it’s more than worth the effort. It saved my life. It could save yours too. Dr. Fishman lists multiple ailments that he has personally and effectively treated with yoga, including: back pain (both neurological and musculoskeletal), rotator cuff syndrome, headache, weight control, bone health (osteoporosis), insomnia, scoliosis, premenstrual syndrome, depression, restless leg syndrome, bunion, and plantar fasciitis. While this is an extensive list, I’m willing to bet that there are many more conditions that would respond positively to treatment through yoga, and I encourage you to give it a try.
Over the weekend I went out of town to attend my 2-year-old niece’s birthday party. She was adorable, and I enjoyed spending time with my family, but the drive through LA can be brutal. On my way home, a man on a motorcycle whizzed by me and then flipped me off. I have no idea what I could have done to make him angry. I had been driving in the same lane at the same speed for miles.
Despite the knowledge that I hadn’t done anything wrong, I felt hot shame flush through my body, and I recognized the sensation as one that I’ve experienced frequently lately. It seems like every time I turn around these days, someone is suggesting that there is something wrong with me.
Whenever I make a comment online, dozens of perfect strangers attempt to shame me by calling me stupid in myriad ways. Partly, I think that people shame others in order to dispel some of their own frustration, but I also think that they do it believing that the shame will teach the other person a lesson.
I’ve seen parents shame their children for the same reason. Children who get bad grades or fail to do their chores properly are often shamed by their parents, who believe that the shame will get their children to behave better in the future.
Unfortunately, these parents’ efforts are misguided. Shame can’t teach anyone anything. Scans of human brains show that the learning centers shut down on shame. No information is getting in until the shamed person’s brain calms down. If the goal is teaching, it is much better and more effective to speak kindly to people, and help them to understand and practice. A relaxed brain is a learning brain.
Brene Brown, the renowned shame and vulnerability researcher, defines shame as the “intensely painful feeling or experience of believing that we are flawed, and therefore unworthy of love and belonging.” This sense of unworthiness is profoundly damaging to the human psyche. The more that people receive the message that they are unworthy of love, the more that they believe it. Much of my work as a therapist is helping people to undo the programming of shame.
While shame usually begins as damaging messages of unworthiness from the people around us, over time we tend to internalize the shame and begin shaming ourselves. We believe that we need the shame to motivate ourselves–to keep ourselves from becoming lazy couch potatoes.
However, the research shows that shame doesn’t actually motivate people. The more that we shame ourselves, the more depressed we become, which leads to lower levels of motivation, not higher. Giving ourselves kindness and compassion is a much better way to gain motivation.
If you’re thinking that you don’t have shame, think again. Shame is universal. The only people that don’t feel it are psychopaths. The more that we act like shame doesn’t exist, the more it grows. Speaking honestly with each other about the experience of shame is the only way to overcome it.
Brene Brown talks about shame being like a Gremlin. In the 1980s movie, Gremlins, the little green monsters that wreak havoc are only killed in the end by the sun. Shame is the same. It is only by exposing it to the light that it can be defeated.
I’m not suggesting that you start telling everyone you meet about your shame experiences. Doing that would likely just create more experiences to be ashamed of. Instead, share your shame with people who have earned the right to hear your stories, and have the emotional strength to bear the weight of your pain.
These are people who have stuck with you through good times and bad times, and have shown that they can be trusted with your secrets and your pain. If you can’t think of anyone like that in your life, I would suggest that you find a therapist who is trained to hear your shame stories and can help you shed necessary light on your pain.
There’s an important difference between shame and guilt that I’d like to discuss. While shame is the terrible feeling of being unworthy of love and belonging, which is harmful and leads to painful experiences of disconnection, guilt is the knowing that you have done something wrong that you need to make right somehow.
Shame is the sense of “I am bad,” and guilt is the sense of “I did something bad.” Unlike shame, guilt can help people to rebuild connections. When people realize that they have hurt others, they can apologize and seek forgiveness.
If you regularly speak to yourself in the language of shame, I would encourage you to begin practicing self-compassion. If you’re constantly shaming yourself, your nervous system is constantly in fight or flight mode, which is extremely damaging to your body and your nervous system. In this self-protective state, you will have difficulty learning new things, and your body will likely become depressed in order to deal with all of the stress.
Self-compassion is a wonderful way to begin the process of coming out of a self-shaming mind state. There are three components to self compassion: 1) mindfulness, 2) self-kindness, and 3) common humanity.
The mindfulness part is about paying attention to your experience and noticing your self-critical and shaming thoughts. The self-kindness part is really about telling yourself that both you and your feelings are OK. And the common humanity part is reminding yourself that the experience of pain and shame are what make us the same as others, not different.
A self-compassion statement might look something like this: “Wow, I’m feeling a lot of shame right now. It’s OK to feel that way. Many people would feel shame in this situation.” You can create a self-compassion statement that works for you as long as it has all three components. It doesn’t take a lot of time to use the statement, and it can dramatically shift the experience of shame, and reduce your stress.
Despite the messages that you may have received over the course of your lifetime, you are worthy of love and belonging. You don’t have to do anything to become worthy. You are already worthy simply because you are a human being. Babies know that they are worthy of love, and so do the people around them. It seems strange to me that people think that at some unknown point in human development this inherent worthiness goes away. It doesn’t. All people are worthy of love and belonging, including you.
For more information on shame, please look into the work of Brene Brown. She’s one of my sheroes, and I highly recommend her book Daring Greatly. She also has two great TED Talks: “The Power of Vulnerability,” and “Listening to Shame.”
For more information on self-compassion, I recommend the work of Kristin Neff, who has a wonderful TED Talk called “The Space Between Self-Esteem and Self-Compassion.”