Facing the Emotional Herx

Question: I have suffered with various painful rheumatic conditions for a long time. I felt like my life was over and I was barely getting through the day. Now on AP, I am seeing my health returning slowly. But, as I recover, I feel as though I am going through what I describe as post traumatic shock at how seriously disabled I was and how I had lost all hope. It is hard to tell someone that my getting better is bringing on this psychological state. Can you help me put it in perspective?

What an excellent question! Here you are feeling better physically, so why, you wonder, are you feeling shakier psychologically? Serious illness is traumatic, and to survive trauma, we have wonderful defense mechanisms that enable us to tolerate what we must be endure. These strategies are very helpful and central to emotional survival, yet they can rob you of opportunities for growth and the ability to be fully alive. Everyone who has been ill, and is recovering must take a deep breath, look back at ,and integrate their trauma into their personal histories.. And being the victim of a chronic disabling rheumatic disease is indeed a trauma. Illness threatens your sense of bodily integrity, which is simply the belief that you are safe from threats to your physical self. Reading between the lines of this specific question, it sounds as if the writer's inner self is signaling that it's time to process and integrate the trauma of having lived with active rheumatic disease. Typically, as time passes, the danger you perceive from your trauma lessens, you are often able to see the full emotional impact of your diagnosis more clearly than you could when you were sicker. As with art, distance gives you perspective; a painting or photograph looked at too closely lacks clarity and detail; standing back from the work enables you to immerse yourself in it more completely and see it in it's entirety. And the chance to look back and accept the tough, painful, and lonely times of illness is indeed an opportunity for growth. In fact, if you don't attend to these sometimes scary, generally unpleasant thoughts, feelings, and memories, they will become stronger and stronger until they get your attention! The energy needed to avoid facing them, will drain you emotionally, as your illness did physically, and will deprive you of the energy you need to work, play, and love. So think of it this way: facing those pre-AP memories is another stage of your total recovery. In fact, we can call this process an "emotional herx". When you follow the prescription introduced in this article for overcoming trauma, just like when you followed your physician's script for antibiotics, you'll likely feel worse at first. You can become anxious, depressed, and hopeless. At times, these feelings may be as strong as they were when you first learned your diagnosis or when your illness first started seriously affecting your ability to live the life you had known. And other people may not understand! Mental health professionals have just begun to fully understand the impact of traumatic stress on people, but great progress has been made in recognizing when people are suffering from this disorder and in treating them effectively. In more difficult cases, medications and techniques such as EMDR, a behavioral method to detoxify difficult memories, are available. But for most of you, blessed with varying degrees of recovery from AP, self-help techniques and understanding that what you're experiencing is normal, will be enough to get you through this emotional "herx". So what's normal? Going through a period of mourning. You need to mourn what you've been through: your loss of innocence (i.e. no longer believing that your body will always be reliable and healthy); the months or years or decades when you could not do the things you wanted to and missed so very much; and perhaps the way your body used to look before your diagnosis. Each of you will have different losses needing to be grieved. Please know this mourning is necessary, and may even be strongest when you are most enjoying your new freedoms. Going for a walk along the beach, for example, when you couldn't get up off the couch, can overwhelm you and bring you to tears both because of the wonder of your recovery, and the pain you feel for the person who was lying on that couch. When you cry at times like this, you are really showing compassion and empathy for your condition, just as you would do for a friend who was ill. Or when you rage, you are expressing healthy anger at the randomness and at times, unfairness, of the events that befall you. Keeping a journal during this period, just as you do when you start antibiotics, can help you monitor your progress, sort through your thoughts, and review areas that still need work. And during this process, you will likely come to terms with the impossibility of undoing the past. Yet when this challenging but important emotional work is done, you will find relief from pain and fear, and will be empowered to enjoy your healthier present. Over time, with new experiences, you will create a new vision of your future, and a new understanding of who you are in relationship to your diagnosis, and your current, improved level of functioning. If, however, you find yourself having difficulty dealing with these feelings on your own, or if you are experiencing depression or anxiety that interferes with your functioning, it is important to get a referral from your physician to a mental health professional to help you cope with this process. And don't forget the importance of seeking support from others, like you, who have traveled this bumpy road back.