“Trauma is an inescapably stressful event that overwhelms people’s coping mechanisms…” — Dr. Bessel van der Kolk 

I think it is fair to say that Cushing’s can be traumatic. For me the diagnosis itself was surprisingly calming but the years preceding it, while attempting to articulate the ever-mounting symptoms to numerous medical professionals and not feeling adequately heard, were traumatic. I had an intuitive sense that a switch had been flipped in my body and I was dying a slow death. I also had an equally powerful sense that I would live if whatever it was, was caught in time. I had my first surgery to have one ovary removed due to a complex cyst and concern about PCOS. At that time I knew it wasn’t PCOS (my ovaries had always been fine) but that something was terribly wrong. Then there was the left total hip replacement, pituitary surgery and the right total hip replacement. All of these occurred within two years. Following diagnosis and treatment, I finally had time to survey the “damage”. I have had time to begin grieving my losses and rebuilding my life. This article will begin to address what I have found helpful, gleaned from my own personal journey through Cushing’s as well as through my professional experience. Particularly, I want to address eight elements that I have found to be crucial in optimizing my recovery. My hope is that what I have to say may resonate with you, validate your own unique healing process and provide a source of hope and strength as you go about the very personal journey of healing and rebuilding your life and dreams. Future articles can cover more specific questions readers may have. I will look forward to hearing from you.

As a Marriage and Family Therapist, the last 22 years of my life have been spent treating individuals who have been traumatized and assisting couples and individuals in improving their most significant relationships, those we call attachment bonds. One of the greatest challenges in recovering from Cushing’s can be in the area of maintaining our relationships, our social support; our attachment bonds. Personally my relationships have been challenged by my new energy level, which is at a minimum, and my new mood, which is often “fussy”!

The mental health literature tells us that we all need four primary things from others to survive and thrive. We need: (here are 4 of our 8 elements)

1. To be “seen” accurately
2. To be “heard” accurately
3. Healthy touch
4. Eye contact

The psychiatrist Bessel van der Kolk puts it nicely when he says, regarding social support, “the critical issue is reciprocity: being truly heard and seen by the people around us, feeling that we are held in someone else’s mind and heart. For our physiology to calm down, to heal and grow we need a visceral feeling of safety. No doctor can write a prescription for friendship and love.”

We know that babies not held and touched can die despite being fed and clothed. Thus being responded to and comforted by another when distressed is crucial. It provides our sense of safety to calm and to heal. How do we as adults ask for what we need? How do others know how to give us what we need? This feedback loop depends on the following four variables: (and the last 4 of our 8 elements)

1. Are we able to ask?
2. Are our caring others able to respond?
3. Are we clear in our asking?
4. Are we able to receive?

Now, we could spend lots of time discussing how to clearly ask and receive so let me know if that would be helpful in the future. I, for one, have always been independent to a fault and learning to ask clearly and receive was more challenging than obtaining my Master’s degree. For today, our goal is just to notice where we are with these four variables. People often say they have married their partner because this individual really “gets” them. Best friends are often such because they are supportive and non-judgmental through the thick and thin of life. Both groups are describing this idea of being seen and heard, the safety van der Kolk is referring to that comes from love and friendship.

Here is a very personal and recent example of this. Following my most recent hip replacement I asked my husband if he would bring me an icepack to bed. I didn’t have the energy for the Cirque Du Soleil moves required of me at 10 P.M. to get out of bed and schlep down the hall with my walker after I’d finally accomplished the feat of tucking myself in. He quietly and kindly did so. With that I fell asleep. What I didn’t expect was to be awakened in the morning, the covers gently drawn back as I awoke, startled by the excruciating pain of the new hip, and being lovingly given a fresh ice pack and a kiss. In that moment, I felt seen and heard and touched. Now, had I never asked him for the original icepack, I may not have gotten the 8 A.M. one. See the feedback loop? Clearly I have to do my own healing, whether it is balancing cortisol levels or managing hip pain. But whom I allow in my life to bear witness to this and support my healing makes a fundamental difference in the quality of my recovery and perhaps even my healing time. It impacts my pain levels and emotional state. As we look at those last four elements then my question becomes, “Who do you have in your life that is there for you, helps you feel seen and heard? Who do you ask for an ‘ice pack’?” Is there a break down in any of those 4 elements? If so, together let’s find a way to repair that. If not, I am delighted that you can answer all four questions affirmatively.

Some of the most fascinating research has been done on the power of touch to diminish the experience of physical and emotional pain. Researchers have found that simply holding the hand of an intimate partner or close family member diminishes the experience of pain significantly compared to holding the hand of a stranger or no hand at all. Much of Cushing’s recovery seems to be related to calming the body as well as ameliorating pain. Who knew that a simple hug and hand hold could do this so well!? Sometimes in my work with trauma survivors, their caretakers, partners and loved ones will ask what they can do to help. They stand by feeling helpless as their loved one fights their battle. I always tell them, “Your presence, your nonjudgmental presence, is healing. Your gentle touch heals. No one else will do this as well.” It sounds so simple but is invaluable. For loved ones, ask these two questions: How can I support you? What do you need? Your eye contact and willingness to listen go so far.

In this article we covered 8 elements that may help recovery. For partners, friends and family members, please trust that your presence is the prescription. There is none other like it. When you give your loving eye contact and touch and patiently ask those two questions, you have given an invaluable gift. You have said, “I see you. I hear you.” For those of us surviving and reinventing our lives, we must remember to clearly ask for what we need, learn to receive it (perhaps an entirely different article!) identify those who hold us in their minds and hearts and those who would bring us ice at any hour. Who would you ask to bring you ice? I look forward to hearing from you and welcome your questions and comments.

By Dawn Herring, LMFT, Summer 2015

Editor’s Note: Dawn Herring is a licensed Marriage and Family Therapist with over 20 years of experience. She currently works for the Marine Corps in Oceanside, California. Previously Dawn has worked with civilian law enforcement and in private practice treating and intervening in family violence and trauma. Dawn has extensive public speaking experience in the areas of self-care, healthy relationships, family violence prevention, trauma and stress management. She speaks with the Heroes & Healthy Families organization throughout the Marine Corps and is trained in Eye Movement Desensitization and Reprocessing (EMDR).

The CSRF is delighted that Dawn Herring has agreed to write some articles and answer questions regarding the psychological and social difficulties associated with Cushing’s. As a licensed Marriage and Family Therapist and Cushing’s patient, Dawn understands the unique issues that Cushing’s patients face. She welcomes your questions and input on topics you would like to see covered in future newsletters. Please reach out to her by emailing [email protected].