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Invisible Scars

Invisible Scars

I got my first scar at five years old. I was playing at a friend’s house and bent down to pet their Scottish terrier. I accidentally surprised the terrier, and he greeted my advance by tearing flesh off my face. I remember warm towels and the feel of wiry stitches pulling through the skin above my lips. Today, this scar looks like a misplaced, poorly angled smile line.

​In third grade I loved playing soccer with all the boys at recess. I especially liked playing against Matt Cisek; the love of my elementary school world. One fateful day, Matt and I collided brutally on the field. His foot missed kicking the ball and connected directly to my shin instead. The strength of his kick was so forceful that it knocked cartilage off my bone. To this day, as my fingers trace my shin bone I can feel a divot left from the lost cartilage.

My stomach bears a variety of puncture marks. Some randomly scattered holes came from playing capture the flag on a moonless night when I was 17.  My best friend Robert told me to “run for the trees!” when the enemy spotted us. I ran full speed and never saw the barbed wire fence. Several people had to, literally, pick my body off the rusted coils and call my parents to make sure I was current on my tetanus vaccination.

Three other scars, right beneath my ribcage, bear witness to my emergency gallbladder surgery that took place just five days before my wedding. It turned out my stomach pains weren’t actually “pre-marital nerves.” The ER doctor told me that if I didn’t get my gallbladder out immediately, I wouldn’t make my wedding day. My stomach barely squeezed into my wedding dress later that week, still bloated from the surgical gas and wrapped in gauze.

Three more holes puncture my lower abdomen where doctors saved my life after an ectopic pregnancy burst my fallopian tube and tried to take me. These holes remind me of the miracle that is my preserved life and the life that was the twin baby safely nestled in my uterus. We both survived the trauma of emergency surgery and so much lost blood.

While scars manifest the physical impact life has on my body, my body also holds invisible scars deep inside her soft spaces. The creases around my eyes bear witness to years’ worth of smiles and laughter. The ache in my chest weeps my deep loss and empty arms. My upset stomach testifies of my vulnerabilities and yearning. The soft, gray hills inside my skull guard and protect my precious memories.

Scars and marks aren’t pretty, but they reflect truth. They reflect moments lived and the passage of time: a physical autobiography. My scars remind me that through all my living, my body has borne witness to my messy and wonderful life. My body was built for this. It was built to hold all that is me: every memory, emotion, and experience.  And isn’t that beautiful?  


Airplane Wings and Us

Airplane Wings and Us


“I just don’t let things bother me.” Ever heard someone say this?

Deep breath. I have reactions and thoughts, but first let me share a short story.

I remember one time I was on a particularly turbulent airplane ride. I had the window seat overlooking the wing. I felt frightened as I watched the wings bounce impossibly up and down. I remember worrying if the wings were going to snap off and this would be the end of my story.

The flight had been so scary for me that I called my dad upon landing and told him my experience. When I told him about watching the wings bounce with such intensity I thought they’d break off, he told me, “Anna, you want the wings to bounce. If they were too rigid, they would fall off.” 

This struck me then, and continues to be an important life lesson.

Resiliency is a big concept in the therapeutic world. Indeed, much of what I do with clients is help them build their own resiliency to life’s challenges.

Put simply, resiliency can be thought of as our ability to “bounce back” and adjust to life’s adversities. Intuitively we focus a lot on that “bouncing back” process. But equally important to resiliency is the impact in the first place.

The wind exerted incredible force on the airplane wing and the wing moved in response. The wing let itself be impacted by the events around it. This ability to move in the first place; indeed the ability to be moved in the first place, is key to its resiliency.

It is the same for us. There is no inherent resiliency in “just not letting things bother us.” There is no good life skill in this. In fact, resiliency comes from allowing events to impact us and move us. It is in these impacts that the challenge, insights, and growth happen. We need to be moved in order to grow and change. 

Glennon Doyle has wise words on this topic,

“Being fully human is not about feeling happy, it’s about feeling everything…It’s okay to feel all the stuff you’re feeling… You’re not doing life wrong; you’re doing it right. If there’s any secret you’re missing, it’s that doing it right is just really hard. Feeling all your feelings is hard, but that’s what they’re for. Feelings are for feeling. All of them. Even the hard ones. The secret is that you’re doing it right, and that doing it right hurts sometimes.”

People who have learned to “just not let things bother them” are missing out on valuable life lessons and growth that come from feeling the full range of emotions inherent in the human experience.

Those dark spaces full of struggle and intense feeling, that come from the impact of lived human experience, are sacred. They are where we truly learn who we are and what we are capable of. This is where we learn we can do hard things, which is the definition of resiliency.


The Longer Journey

The Longer Journey

Remember the sayings, “Rome wasn’t built in a day” and “anything worth doing, is worth doing well?” I know I, personally, haven’t heard these quotes in years…maybe even as far back as my prepubescent days.

More and more I feel surrounded by a culture that values big progress and instant solutions. The belief that radical transformation happens quickly taunts us in self-help books, podcasts, new medications, testimonials, and even therapeutic interventions. Hell, I want to try Ketamine too and see if a life-transforming “trip” awaits me.

We all love dramatic transformation. Why else did Eat Pray Love top the best seller market for years? If only we all had the luxury of abandoning our careers, families, and daily lives to go find ourselves in exotic, international locations.

But most of us have daily lives that claim us and it is within them that we do our work.

There is nothing sexy or glamorous about the changes that take place slowly, over years.

In fact, sometimes the glacial pace of hard change can feel demoralizing and depressing. Even writing about this topic feels lackluster.

One of the very first things I learned in graduate school came from my professor who was teaching us Psychotherapy Foundations. She said, “A lot of people think therapy is exciting and dramatic. People who have never been to therapy think only about the juicy secrets and trauma revealed in our confidential spaces. But the truth is: therapy is long, hard work.”

I have worked in settings that required short-term therapy models. I witnessed people change in limited time-frames. I don’t want to negate that work can happen in those spaces.

But, now I work in a place where I have the luxury of seeing clients long-term and the transformation I witness is so different. Instead of only journeying with clients for a short chapter of their life, I get to journey for a few chapters, maybe even an entire volume of their life series.

I have learned that beauty and sacredness are in the messy, painful, middle chapters. The courage required beyond big life choices.  The courage to simply get up and face another day. The courage to hope. The courage to believe that change is even possible.

I have one client that I’ve been privileged to know for 11 years. Her demons have been big and her progress hard fought. Over the years I’ve known her, there haven’t been grandiose turning points or mind-blowing insights. There have been shifts, and pivots and advances, and retreats, and breaking points and coping and medication changes, and Boost, and loneliness, and dreams and hundreds of dollars spent on scales she will throw away a month later, and fear, and vulnerability, and bravery. While there was no singular transformation, the person she is today is unrecognizable to who I met 11 years ago. She has changed herself and her life in profound ways, slowly, over time. Even though her work isn’t done, she continues to show up. She continues to work.  

The journeys of each of my clients almost exactly mirror the one I just described. Recovery from an eating disorder is long hard work. There aren’t short cuts or easy fixes. One hurdle is passed, only to be confronted with another. Progress often doesn’t feel like progress and what feels good is likely self-sabotage. The work is messy, and brave, and long.

This isn’t just unique to people working to overcome eating disorders. What about the messy, long work that confronts each of us in our lives? While crises or trials propel big growth and movement; the long, hard, lonely work, devoid of drama and fanfare, is just as transformative, if not more so. I know I struggle to value these slower and messier parts of myself and my experience. I know I can even sometimes feel shame about what feels like a lack of progress or honest confrontation around overt avoidance. Simultaneously, the work I witness from my clients reminds me to be compassionate and brave. It also reminds me to be grateful for the messy, boring, hard chapters that are part of my larger, beautiful, rewarding life.

From “Why?” to “What now?”

From “Why?” to “What now?”

We will call her “Kelsie.” I had the honor of working with Kelsie for several years as she worked toward recovery from a severe eating disorder. Kelsie had large, doe brown eyes, a beautiful smile, and a sharp mind. Her mind was so sharp and intellectual that anytime I’d ask her about her feelings, she’d inevitably respond with, “I think…”

When I met Kelsie a decade ago, she had been struggling with her eating disorder for more than half her life. She had very active, severe eating disorder behaviors and was simultaneously very high functioning. She was in a very competitive undergraduate program and by all outward appearances, was thriving. (Her profile is not unique to those struggling with eating disorders).

Kelsie was well-acquainted with inpatient settings. She even described repeated inpatient stays as welcome respites from her intense life and struggle to function with daily demands. It was a recurring pattern for her to discharge from inpatient and begin a slow, then fast march back into severe eating disorder behaviors. I watched her, repeatedly, decompensate. With each inpatient-outpatient cycle, Kelsie felt more hopeless and more entrenched in dark, suffocating shame.

For a long time, Kelsie kept ruminating on “Why” she had an eating disorder. She strongly hoped that if she could just understand why this was her experience, then somehow this would release her shame and help her take the right steps to overcome her struggle. While this absolutely feels like worthwhile insight to pursue and understand, it kept Kelsie stuck. Based on her own reflection of her life, family history, and trials, there was nothing that seemed to “justify” the degree to which she suffered.

She felt selfish and self-indulgent.

Her shame only continued to spiral as she compared herself to friends she met through her treatment journey. Their eating disorders were all “valid,” while hers was not. 

This shame cycle only perpetuated her need to understand the elusive “why” and she perseverated on this question with an OCD-like intensity for years. Kelsie never found a satisfactory answer and eventually our paths diverged.  Several years passed. 

When I saw Kelsie again, she had completely transformed. There was a lightness in her countenance that I had never witnessed. There was new and beautiful self-compassion, where once there was only shame.

She recounted a journey of intense humility and bravery as she submitted herself to the full treatment process and more. As a result of her willingness and dedication, Kelsie was finally, truly, living her life in meaningful and fulfilling ways. As I talked with her, I found she had relinquished her obsessive need to know “why” and had instead decided to focus on the “What now?” and “How?” that were in front of her.

While releasing “why?” was certainly not the only thing that gave Kelsie the momentum she really needed, it felt pivotal. Even transformational.

I think of Kelsie’s powerful journey and how there is a lesson in it for each of us.

It is so easy, and even tempting, to try to understand “why” we go through the things we do in this life. We are drawn to understanding and meaning. And confusion is an aversive experience. Perhaps we may have even found that if there is an identified “why” there can be some peace in that knowledge.

However, from personal experience, I find “whys” are extremely hard to come by. And sometimes the “whys” are deeply unsatisfying. The pursuit of “why,” like with Kelsie, can invite an emotional minefield that leads to paralyzing shame.

Even if you are lucky enough to find a satisfying why, does it truly help you take the next steps forward? When I think about the pursuit of “why?” I think about a deep look inside as well as in the past. Understanding yourself is valuable and can be helpful in knowing your strengths and vulnerabilities. However, one of the first things I learned in graduate school is that “insight is never enough; action is required.”

So, a more powerful question, especially in the recovery journey, is “What now?”

“What now?” invites you to look forward and upward. It invites you to action, growth and progress.

“What now?” is also easier to answer. All the clients I work with, when engaged in honest introspection, know what behaviors they can improve, and they know what fears they need to confront. It’s not easy, but this question illuminates a path forward.

A new year is here. My New Year wish is that each of us can release what no longer serves us and look forward, asking ourselves, “What now?” as we move into another cycle around the sun. While “What now?” can be scary, I hope it also excites you with the possibilities that await you.


It’s not about Trusting your Body

It’s not about Trusting your Body

It’s not about trusting your body. It’s about letting go.

Just this week I heard one of my clients reiterate her resistance to progress in recovery because she “just can’t trust [her] body.”

What she means is, she can’t trust that she won’t gain weight from nourishing her body. It means she can’t trust her recovered body to be a size she likes.

And this is where trust is misplaced. Because recovery isn’t about trusting your body to do what you want it to do and be the size you want it to be.

You may gain weight in recovery. Your recovered body, may not be a size that you want.

When I was a “budding” therapist, I used to try to motivate clients toward recovery by talking about how their bodies would be more stable when they are regularly nourished, than when they are deprived. When you move out of your body’s way, it will settle towards it’s set point and chill out. While this is true, it’s also not true.

Bodies are complicated. So much more so than we even know. And while set-point is a real thing, supported by research, I no longer want to align with the eating disorder mindset by asserting that bodies won’t change after they have been chronically nourished. I don’t want recovery to still be about weight.

Further, your body is not static but constantly fluctuating and changing.

As a mother to four children, my body has gone through a hell of a lot of change over the decade I spent birthing and nursing them. While pregnancy was an active choice I made, I witnessed how incredibly drastic my body could morph and shift in incredible ways.

Now, as I enter middle-age (turning 40 soon!) my body seems to be accelerating toward even more change. This time, it is not change I am choosing. I can honestly say I don’t love the combination of acne and wrinkles. And hormone shifts are no joke. My body is also shifting and morphing its shape. While it’s far more subtle than pregnancy and may be unnoticeable to others, it is indeed, changing.

So when I think about trusting my body, it’s not trusting her to always be what I want her to be or even show up for me in the ways I want her to. As I am aging, she’s getting less predictable and more demanding, and I’m assuming that only gets more challenging with time.

My relationship with my body is one of mutual respect and care. Respecting and caring for my body is a form of trust. But that trust is knowing she is doing the best she can to take care of me and has nothing to do with her size.

The bigger trust is not placed on my body, but rather in myself. Being in a place with body peace and food freedom, I trust that whatever my body does, I am ok. And I am ok, because I know my worth and contributions in this life are not related to the size of my body. My internal sense of self is stable, even as my earth-suit is always changing.

So I told my client who “just can’t trust [her] body” that, “It’s not about trust. It’s about letting go.” Recovery is relinquishing control in service of freedom. Recovery is understanding that your body has the right to change according to her needs and wellbeing. Recovery is understanding your body, by design, does, and should, continue to change across your years on this blue planet. Recovery is trusting that you are ok in the changes of your body, your life, and this world.