How do you solve a problem like Maria?

I want to be in the Arena. I want to be brave with my life

and when we make the choice to dare greatly, we sign up to get our asses kicked. We can chose courage or we can choose comfort, but we can’t have both. Not at the same time. - Brene Brown

My two and a half year old calls the Sound of Music, the mountain-song movie. Right now it is one of his favorites. God bless Julie Andrews; she is a welcome departure from the cat and the hat a super loud cartoon narrated by Martin Short and parent patience killer. I make dinner a lot while he is bliss-ed out watching the hills come alive.

Chopping carrots and trying to shake my 10 month old off of my left leg while my actual dog begged for food on my right , I kept thinking about her. My patient, we will call her Maria, had a rough day in therapy. Typically, I don’t bring these thoughts home, but their are some people who touch your heart so completely that their victories and difficulties stay with you. She is this kind of precious human.

She’s the kind of patient that I want to know everything about and who unfortunately has great difficulty telling me. Maria has aphasia, which is when you have difficulty speaking after a stroke. When she first came to see me, she could barely say a word. She can now say small sentences, but still has trouble answering questions. Physically, Maria was a mess. She had to re-learn how to walk and use her right arm, trunk, and leg in any capacity. The thing is, through this entire messy difficult process, she has been a light. She is the person who gives life to my day no matter how difficult. Despite our communication difficulties, we have gotten to know each other quite well. Through a mixture of gestures, 20 questions, and laughter we’ve learned about one another. She never fails to ask about my boys and over time I have learned some fascinating pearls about, Mrs. M’s illustrious (she would laugh at this) life.

Maria is so engaging. She misses nothing and when she looks at you with her striking blue eyes she communicates exactly what she wants to say. I learned that she has a masters degree in English and History. When I was getting ready to go to New York for a wedding, I learned that she lived there “for a while” and she told me to go to the restaurant in central park with this flourish of her arms and torso that made me laugh. I think that was more movement than I had ever seen in her. After that, we began a ritual before therapy. She comes in and sits on the mat then we listen to whatever is playing and we dance around mostly hitting the room with some spicy shoulder shimmies. (sexy expression and everything) It is silly and ridiculous and a language of friendship that I appreciate more than she will ever know.

One time, Maria’s oldest brother came to therapy. I was a veritable font of knowledge. “Really?! A nun?!” Maria had the most coy delightful look on her face at my incredulity. Maria with the crazy shoulder/ hip action was a nun for 20 years. Okay, so full circle, it makes sense that I was thinking of her and this particular session, when the mountain song movie was on. She is my ex nun, bad ass, life giving, music-loving person.

I am in my kitchen making this beautiful connection amid genuine chaos and I kept thinking about my problem. Today, I pushed her beyond her limits. She always works hard, but doesn’t always believe that she can do it. She doesn’t believe she can actually lift that arm or ever use it again. She certainly doesn’t believe that she will ever be able to balance on her affected side. This is something I run headlong into, day in and day out. We got right to that edge today, where I looked into her eyes that were filling with tears and they told me something I wasn’t expecting. It wasn’t resignation, pain, or anger. It was fear. I see this a lot in even less expressive people and it never ceases to surprise me.

She’s afraid to fall, sure, but it is more than that. Healing from something as mentally and emotionally taxing as losing your ability to use your arm takes courage. It is beyond scary. It is vulnerable. Choosing not to compensate and to address the underlying weakness and pushing through that plateau amounts to some real come-to-Jesus moments. Maria wanted to quit, again I could go into many parallels with the mountain music movie, but I’ll spare you. She kept shaking her head and telling me she couldn’t, almost pleading with me. I made her do it until she was successful at reaching with her affected hand. Sometimes, my patients won’t believe this, but sometimes I have these crises of conscious when I really push someone hard. I try to look at myself and I wonder, if I am being too hard. Especially, if I come home and am still thinking about it.

Honestly, sometimes I am too hard. There is no rubric for when or how to push people or how to explain the joy of knowing what a client is capable of before they do. In some ways, children are easier to treat, because they don’t over think the change. They just show up. Change as an adult is hard and scary. One thing I can’t abide by is seeing my clients come to therapy but not show up. Change is uncomfortable and it takes bravery. Brene Brown, a famous researcher, sums it up:

I want to be in the arena. I want to be brave with my life. And when we make the choice to dare greatly, we sign up to get our asses kicked. We can choose courage or we can choose comfort, but we can’t have both. Not at the same time.”

I believe with every molecule of my being that stroke survivors do not have to suffer and are capable of change. I know that they are capable of BIG change through practice and showing up. Maria shows up. Her bravery is a light to everyone who works with her or exists with her in the arena.