By Vicki Robinson
Featured photo by Hasmik-ghazaryan-olson on Unsplash
We’re designed to heal; it’s how our system works. The majority of people heal well from surgeries, and are able to move forward in their lives. There are also times when a past severe injury or surgery experience can continue to cause problems.
One example is a client ‘Tom’, who suffered from panic attacks 30 years after a bad car accident where he had to be resuscitated back to life. Another client had chronic pain after he woke up in the midst of a surgery. How might a somatic education approach support a person in healing?
Starting out confident and relaxed prior to surgery can support our best healing outcome. Going into surgery with high anxiety and dissociated nervous system states may possibly affect the anesthesia dosage. Working with a practitioner of The Feldenkrais Method® can help you prepare you for your surgery with tools that help facilitate relaxation and deeper presence within your body. Besides being a Feldenkrais® Practitioner, I am also a Somatic Experiencing Practitioner* and so I view my work through both lenses, along with the specialized field of surgical trauma. Let’s look at some ways to best prepare for before and after surgery.
Seek Feldenkrais® support prior to surgery.
Talk to your Feldenkrais practitioner and get at least a few movement lessons to support the balance of your nervous system state prior to surgery. This could include one – on – one visits (Functional Integration®) before surgery as well as some tips and tools to be relaxed the day of the procedure. Awareness Through Movement® lessons can help us decrease some of the anxious holding patterns in our systems, and allow for easier, relaxed breath and more capacity to ‘ride the waves’ of the stress. Your practitioner can offer small ten-minute movement lessons to have a daily reset, and I’ve included one below.
Be nervous-system informed, and have tools for support.
During challenges such as surgery, our nervous systems tend to bias either towards fight, flight, or freeze, and often bounce between these places. You may find you go between a racing heart, anxiety and panic, and then into feeling checked out, or dissociated, from your body. This is all normal under duress, and Feldenkrais® work can help you return to a more balanced state. When we’re living primarily in the states of fight or flight, our nervous system is running on high alert.
Let’s return to my client, ‘Tom’, who suffered from panic attacks for 30 years after a car accident. We had several Functional Integration sessions with a goal of helping him improve his breathing pattern, soften his rib cage and eliminate a protective pattern that originated from the accident. We also worked on balance. He literally was in this pattern since his accident, and within a number of sessions his panic attacks began to slowly disappear.
‘Jane’ also had experienced a near-death experience, and after this it was very easy for her to be ‘checked out of her body’. When we are in this dissociated state, we are no longer able to sense that we have any choice in life. Jane and I worked on lessons that supported being grounded in the body through the feet and pelvis, which increased her ability to be in present time and not ‘checked out.’ We also did quite a bit of inquiry into her ‘self image’, which I refer to as her ‘body map’. She continued to sense that she was more present within her body, which also supported her ability to protect herself and be safe in the world.
Meet with your surgical team, and have an advocate with you.
At the very least, this should include the surgeon and the anesthesiologist. Having a sense of safety and trust sets the stage for good outcomes. Let your intuition be your guide, and if there is any doubt, it’s important to get clarification beforehand. I had a client who had a history of at least a dozen complex surgeries, and trusting her medical team was crucial for her healing. Having a close friend or relative with you would also be very supportive in your preparation.
Inform your doctor if you have trauma history or a high Adverse Childhood Experience (ACE) Score*
‘John’ was a client who had a major cardiac event that put him into surgery without any preparation. Years later, he still suffered from exhaustion and night terror. When he first came in to see me, he mentioned all of his problems started after a surgery that he wasn’t prepared for; he went in for an out-patient procedure and then went immediately into a complex surgery. John had a very rough childhood, and his nervous system was in a state of emergency most of the time. Over time, the Feldenkrais sessions began to create some softening in his chest and breath and he came into greater rest and relaxation, and he could sleep without terror.
Another example is a person who had surgery at a young age. For several years I had a student, ‘Mary,’ who continued to hold her head in a strained position, and even though she could experience some changes after the class, she would revert to the old problem. During this time, I was studying Somatic Experiencing, so I asked her if she’d experienced any early trauma, and she revealed that she’d had multiple neck surgeries between the ages of 2 and 4. Up until the 1960’s, a child was most likely held down as they administered the ether mask, a terrifying and life-threatening event to a child. It made sense that she couldn’t retain the lessons, as her nervous system was still in survival mode.
Awareness is one of the hallmark elements of the Feldenkrais Method; once Mary connected the movement pattern to her early history, she then sought support from a somatic trauma therapist who helped reinforce the benefits that she had experienced through Awareness Through Movement lessons.
Do Feldenkrais lessons after your surgery.
People often assume they can’t have much movement soon after the surgery. Feldenkrais practitioners are trained to look at your whole system, and they can often work away from the surgical site to invite more breath, fluid movement and support the decrease of any bracing patterns related to the surgery. They can also provide tools soon after the procedure to support your healing journey.
As you get further along in your healing and you’ve gotten the medical team go-ahead, problematic patterns that developed prior to the surgery can be addressed. For instance, a person who had a hip replacement may still be carrying a holding pattern in their gait that occurred prior to surgery. These patterns are often reflected throughout the whole musculoskeletal system. The practitioner can begin to support your return to a more normal gait pattern.
Healing takes place when we are no longer in these states of emergency, and more in the parasympathetic state of ‘resting and digesting.’ Picture animals on the Savannah, slowly grazing and looking around softly to perceive their environment. When we can relax, and return to what’s referred to as a state of homeostasis where we’re in greater balance, our bodies can be in their best place. The Feldenkrais Method can help us decrease some of the anxious habitual tension in our systems, allow for freer breath, balance and presence in our bodies. This all supports our capacity to meet stressors in life with tools to return back to balance and health.
Some Healing Tips:
This is one of my favorite ‘go to’ short Feldenkrais lessons. It supports our ability to turn and orient to the environment, which stimulates our parasympathetic / rest-digest system. We also cultivate greater grounding support through the floor and in the chair, which supports us being present to the here and now. Our spine also begins to find greater length and capacity to support us through challenges. As you move through the lesson, allow your pelvis and sternum to orient to the direction of your head and eyes.
Awareness Through Movement (10 minutes.) Painting the Legs.
If this is your first Awareness Through Movement lesson:
- Make the movement as small and easy as possible.
- If there’s any discomfort, make the movement smaller.
- If the movement is impossible, no worries. Imagine the movement.
Take a moment to think of a mildly stressful situation. (A 2 on a 10-scale!)
Notice how your body responds to that stress. Is your breath affected? How do you hold your spine, your pelvis? As you gaze forward, where is your horizon? Knowing how our bodies respond to stressors is a biologically useful tool. When there is truly a threat nearby, we want to be able to choose the best actions to protect ourselves.
1) Sit on a flat chair, ideally a chair that allows your pelvis to be a bit higher than your legs. Have your legs about a hip-width apart, feet flat on the floor.
- Notice how your pelvis makes contact with the chair. Can you feel your sitz bones? (ischial tuberosities).
- How do your feet contact the floor?
- Begin to gently look left and right, and find out how you do this. Is it just the vertebrae of the neck? How far do you turn? Do you move your pelvis? Put your hands on your sternum. Does this move at all?
2) Slide your right hand down the outside of your right thigh, down the calf, down to the outside of your foot. Only reach as far as is easy and comfortable. Reverse back up with a long arm. Repeat 3-5x.
- Keep your arm long, almost like a piece of rope.
- Keep your spine relatively long and neutral. The bending occurs in your hip joints.
Pause a moment.
3) Slide your right hand down the inside of your right thigh, down the calf, down to the inside of your foot. Just do what is comfortable. Try different positions of the hand if you wish. Reverse back up. Repeat 3-5x. Again, arm like a rope, bending at the hip joints.
- Notice how your spine and ribs move. What happens to your head, eyes?
4) Slide your right hand down the inside of the left thigh, to the left calf, and the left foot. Reverse back up with a long arm. 3-5x.
- Observe how your spine and ribs are now twisting to the left.
- Invite your head and eyes to look to the left.
- Continue to have a long arm, bend at the hip joints.
- Notice how your feet are contacting the floor.
5) Slide your right hand down the outside of the left thigh, a more extreme twist. Reverse back up. Repeat 3-5x.
- Observe how this twist creates a different shape in your spine and ribs.
- Observe how your head and eyes look further to the left.
- Continue to have a long arm, bend at the hip joints.
- Continue to notice the hip joints, how your feet are touching the ground, how your pelvis is on the chair.
- Notice if your right leg lengthens away to support a greater twist. (It might or it might not)
6) Return to the original movement of looking left and right. See if this is different from your original movement.
- How do your feet support turning?
- How does your pelvis support turning?
- How does your spine, and ribs, respond to this movement?
- Does anything change when you allow your pelvis and sternum to turn in the direction you are looking?
7) Repeat above now with the left hand as your ‘paint-brush.’
Take a moment to return to the mildly stressful situation.
Notice how your body responds to that stress. Is your breath affected? How do you hold your spine, your pelvis? As you gaze forward, where is your horizon? What’s different now with your spine, your pelvis, your feet? Is the stressor a little less impactful on your body? Can you meet the stressor with a greater sense of presence in your entire self?
2) Orient to your environment.
Look around the room you are in. Notice colors, shapes, textures that draw your attention. Looking around and perceiving the environment is calming for the nervous system, and brings us back to the here and now.
3) Support peripheral vision.
Bring your hands out to the side so that you can see your fingers move in your peripheral vision. Wiggle your fingers and find out how far out your hands can be before the fingers disappear from view. Peripheral vision supports the settling of the nervous system.
4) Observe your breath.
Simply observe three breaths throughout the day
Square breathing is also useful.
Inhale 4 seconds – Hold 4 seconds – Exhale 4 seconds -Hold 4 seconds.
*Note: Somatic Experiencing supports the healing of trauma
*Note: Not all doctors know to ask about the ACE test. If John’s MD had asked him years prior to the surgery, he could have known to run more tests that might have avoided the emergency surgery. The medical team can also be much more sensitive to the needs of someone with a trauma history.
Vicki began her Feldenkrais® practice in 2001 and continues to see clients and teach classes in Seattle, Washington. In 2013, she expanded her toolbox by becoming a Somatic Experiencing Practitioner. (SEP). She’s also taken numerous advanced trainings that specialize in the healing of surgical, complex and developmental trauma. She gains great satisfaction supporting her clients and students to have optimal movement and connection to their bodies. Everyone should have the opportunity to feel safe and at home within themselves, and free to optimally move through life. Vicki utilizes both the Feldenkrais Method and Somatic Experiencing to support her clients.