Honor the Process

Each year, I ask the Lord to give me a word to bless the new year.  (Yeah, I'm cheezey like that.)  I was reflecting and meditating with a dear friend on New Year ’s Eve, hoping (as always) for a really positive word heralding achievements and abundance.  Alas, this year, I received a challenging phrase:  “honor the process.”

"Dude, that sounds like some sort of hippie dippie mantra" I thought.  "Are you serious?"

I’m pretty sure He’s serious.

I am not really into “honoring the process.”  I like my results to be fast and measurable.  I’m the kind of person who writes things like “brush teeth” and “finish to-do list” onto my to-do list, so I have something to cross off.  

This is going to be rough.

My patients and their families also express frustration when “the process” doesn’t seem to have a steady upward trend.  “I could to this yesterday!  Why can’t I do it today?”  “Why can’t she just learn this?”  “Why is this week worse than last week?”  I can definitely relate to this impatience, although my struggles are very different from their struggles.

A very wise person shared something with me, and I’m going to share it with you:

Progress does NOT look like this:

True progress looks like this: 

We have to get through the “bad” days to move forward. 

What does this look like?  Accepting when our progress looks like the clichéd one step forward, two steps back.  Allowing ourselves (and others) to mess up.  Practicing patience with ourselves, others, and God.  This is easier said than done, especially in a society that is obsessed with productivity and optimization.

This also means we should be kind to ourselves when we aren’t practicing patience.  Learning to “honor the process” is a process.  (oooh, meta)

I’m including a full page printout of the graphs above in the SLP tab.  SLPs and other therapists, I encourage you to give these to your patients.  The wise sage who taught me about what progress looks like gave me permission to put this printout on the website.

When Poo takes Precedent

(Letting go of our to-do lists and living in the moment in 2020)

I’m a huge fan of plans and to-do lists.  I love seeing everything I have to do laid out before me with cute little boxes I can check off. 

But here's a common narrative in my life:

I’m great at making plans.  But what about when more urgent things come up?

Maybe it’s time we step back and listen to what is needed in the moment.  When we listen to others and ourselves, we get done what actually needs to get done, even if it wasn’t in our plans.

One memorable session, I had an entire hour of therapy planned.  But the patient announced that they had soiled their briefs and bed linens and needed to change.  About twenty-five minutes later, the patient had cleaned themself* (with some help), the brief was changed, the bed linens removed, clothes changed, and the patient was seated in the wheelchair.  What great sequencing!  I thought to myself.  What a great cognitive workout for them!  And now we can work on my therapy plan.

And then the patient looked at me seriously, nodded, and announced that they needed to use the restroom again.

By the time all was finished, there were fifteen minutes left in the session to cover a few items in my Therapy Plan.

What I thought the patient needed was different than what the patient had actually needed in the moment.  

How often am I biased by what I think needs to happen, when I am actually being asked to do something entirely different?

I remember when I was studying abroad overseas, I encountered a lot of volunteers and NGOs doing charity work.  I was (am) no expert, but I did notice a pattern:  the projects that were the most successful were the ones that involved the locals in the entire process, including deciding what their needs were in the first place.  

I am reminded also of a sermon from years ago.  I don’t even remember who gave the sermon, but it was about a priest who was sometimes late for Mass.  Why?  Because if, on his way to Mass, he encountered someone asking for his help, he dropped everything to help that person.  He figured, this must be God asking him to do something more important.  And who was he to deny the requests of his Creator?

This year has been a wakeup call in so many ways.  We are being asked to put our own priorities aside to protect and support others and ourselves in new and different ways.  We are asked to set aside many of our social habits and planned events, to make economic sacrifices, and to wear uncomfortable masks in public in order to defend and protect those with underlying health conditions and immune compromise--and those who do not have the luxury of working from home.  We are asked to set aside our pride in order to listen to and support our Black brothers and sisters.  (Speaking of which, I’d love some help figuring out which adjective is the most supportive.  African American?  Black?  POC?)  We are finding out that even if we have long to-do lists, our mental/physical health may have to take priority sometimes.

This hasn’t been easy for me.  I’ve gone through this year kind of kicking and screaming.  I’m not a fan of constantly changing plans.

But maybe I’m being asked to set aside my to-do list and focus on more immediate priorities.  Like cleaning up some poo (either literal or metaphorical).  Or allowing myself to rest and heal.  Or allowing someone else to speak while I just listen.

Friends, I hope and pray that we will all have the strength and the courage to set aside our to-do lists in favor of the more immediate needs of ourselves and others.

 

****

*English speakers have used “they/their/themself/themselves” for a long time as a singular gender-neutral pronoun.  Let’s be descriptivists instead of prescriptivists :)

Let's rely on our strengths and resiliencies

As a speech therapist, I am sometimes tempted to focus only on improving my patients’ deficits.  After all, isn’t that what rehabilitation is about?  Fixing “broken” communication, “broken” cognition, a “broken” swallow?

 

This happens with writing too.  Growing up, I always thought that the best way to help a friend to better their story/poem/essay was to bleed red ink all over the page, pointing out what doesn’t work so they can fix it.

 

And don’t we all do this to ourselves sometimes?  Pull out the red pen, evaluate our shortcomings and limitations, focus on the "bad parts of ourselves" so we can become better, kinder, more efficient?

 

What if it’s just as important—maybe even more important sometimes—to acknowledge and nurture our talents and resiliencies?  Of course we must acknowledge our mistakes, shortcomings, and weaknesses.  But what if shift our language—what if we call them "challenges" instead—calls to action instead of traits we're stuck with?  Maybe we have the ability to overcome these challenges—or find a workaround or at least make some progress—by relying heavily on our STRENGTHS.

When I evaluate a patient’s language, thinking, and swallowing skills, I am sure to discuss their troubles with them.  But now I’m making a conscious effort to also tell them and their families about what they do really well too!  Maybe their memory isn’t working the way they want it to (a challenge), but they’re awesome at paying attention, which is going to help them to use their memory strategies.  Maybe they can’t swallow water well right now (a challenge), but they have a strong cough so we can work with that!  Maybe they have trouble focusing (a challenge), but by golly they are motivated and have a positive attitude.  Maybe they have a LOT of challenges, but their support system is working for their good.

 

Joseph Fink and Jeffrey Cranor, authors of the Welcome to Night Vale podcast and various spinoff novels and podcasts, emphasized once that in writing, a more motivating and helpful way to critique someone’s work is to point out what is working really well so they can bring out more of those aspects in their work.

 

Maybe this could work on a societal level.  When we encounter a negative societal behavior, like racism or sexism or selfishness or unwilling-to-listen-ness, first we must of course acknowledge the problem.  This takes work.  And obviously, merely acknowledging the problem is not enough—we must face it and work to overcome it.  So what's the next step?  

To face these problems, we can draw on our collective compassion and kindness as a society to work to overcome those obstacles.  By exploring and utilizing our positivities, we can fight our societal problems.  Will we ever truly overcome a societal weakness?  Probably not entirely, but a positive human trait I believe in strongly is perseverance.

This is something that I find so encouraging about the Black Lives Matter movement—I'm hearing a lot of rhetoric that readily acknowledges that we are going to make mistakes.  Everyone does.  It's uncomfortable to learn that we've made mistakes, but the emphasis is on apologizing and learning how to use our humility and kindness to do better.  Learning about our mistakes and weaknesses is not about shaming us—and it never was.  It's about creating positive change.  For a really genuine and heartfelt conversation about this, I recommend listening to Brené Brown's conversation with Austin Channing Brown on the podcast Unlocking Us.

 

I’d like to apply this principle to my own life, and I invite you all to as well.  I make TONS of mistakes—maybe even in this post you have found some mistakes.  It's easy for me to dwell on them without moving forward.

So here is my resolution:  when I recognize or am told that I’m behaving impatient or interrupty or selfish or racist or small minded or making silly mistakes or being ignorant, I’d like to label my predisposition toward a “less than ideal” or even just plain "bad" behavior as a CHALLENGE rather than a failure of character.  This way, I can be motivated to change my behaviors in the future.  If I don’t identify with my undesirable behaviors but instead see them as obstacles to overcome, I give them less power.  I’ll probably never be perfect at facing any obstacle.  But I can keep trying.

And how do I face these challenges?  By using my virtues and resiliencies to face the obstacle.  I strongly believe that all of these strengths come from God.  And He is bigger and stronger than any obstacle or challenge I could ever encounter.

 

 

Listening, Learning, and Answering the Call to Change (with links to empowering organizations)

I am sickened by the recent deaths of Breonna Taylor, Ahmaud Arbery, George Floyd, and now Rayshard Brooks—and all similar unnecessary deaths.  I am angry on behalf of my friends, family members, and patients who have been subjected to judgement, put at a disadvantage, or even put in danger because of their race.  I am afraid for patients of color (especially African American) with communication disorders, who are at higher risk of incarceration and being misinterpreted as hostile.

For the last few weeks, I have been extra intentional about listening and learning.  So far, these are the calls to change that I am hearing:  examine our own biases, follow the leadership of communities we wish to help, and support organizations that empower minorities, even when it’s not “trending”. 

Today, I'm posting a list of some empowering organizations led by (or working hard to empower) people of color--most especially African Americans and immigrants/refugees.  This list focuses on education and religious organizations.  

Remember, it’s no single person's job to support every organization; we are not “saviors”!  We are just humans accompanying other humans on a difficult journey.  With that in mind, please consider supporting some of these organizations with me.

Helping myself (and my patients) to grow: Treatment vs. Evaluation

I often set expectations for myself and fail to meet them:

~I want to wake up earlier.  But I continue to go to bed late.  

~I want to pray more.  But I fill my life with more and more distractions.

Of course I am not making changes if all I ever do is “check in” with myself, evaluating and re-evaluating without providing solutions.  

This reflection is *not* about self-optimization.  It’s about growth and self-acceptance.  It's difficult to grow as a person without lots of reminders, or a structured organized foundation for change.  If I “fail” to change, there is no need to shame myself—that’s just a sign that something isn’t working yet. 

As usual, I need to learn from my patients.

True Love: a Valentine's Day reflection

I have seen in the movies and read in books that true love is about finding joy in each other, about holding hands and giving roses and writing love letters.  I have heard in wedding speeches and sermons that true love is about staying faithful even when it isn’t fun. 

I believe that both of these are true.

And I have seen second-hand that true love is often about wiping dirty bottoms, and spoon-feeding, and encouragement to try one more time, to get up for another day.  True love is about staying faithful even when someone’s personality changes after a brain injury or during the onset of dementia.

This Valentine’s Day, I am reflecting about what I have learned about true love from spouses who take on the role of caregivers—and spouses who take on the role of patient.  Neither role is chosen, but when embraced, both teach us about true love.

Being Intentional (with an SLP freebie)

Many patients are surprised that my cognitive therapy sessions don’t involve logic puzzles or crosswords.  With me, cognitive therapy looks a lot more like intentional planning for daily life.  Most of the time, the “strategies” I suggest to my patients are practical habits such as repeating new information to themselves, using reminders in their environment, or making sure to double- and triple-check their work.  “But I already do those things,” they protest.

“Of course,” I reply, “these are normal ways of learning and remembering.  But as your body and your brain are healing, you may find you have to be more intentional about doing things that once came naturally or automatically to you.”

Maybe the same is true for soul-healing.

Liking my patients, my loved ones, and myself

Some days, I just don’t like myself.  From the outside in, I notice plenty of flaws.  I have acne, my hair is a wild mess, my posture is slouchy, my attitude is grouchy, I’m impatient and rude and arrogant—and I make plenty of mistakes. 

So I remind myself that even if I’m not likeable now, I’ve got potential.  I’m just in the caterpillar stage.  Someday, I’ll be a beautiful, virtuous butterfly.  I should like myself for my potential…right?

That’s not what Mr. Rogers says.

Pruning my Garden: from Tolkien to Pinker and beyond

I sat with my cousin on the floor in the corner of the bookstore, poring over Elvish grammar and the rich world of Tolkien’s languages.  A seed was planted.  Over the next few years, I tended to my little metaphorical garden, writing in Tolkien’s alphabets and languages, learning Spanish, practicing my broken Portuguese, and adding broken German to the mix.

Unfortunately, some of the plants in my garden grew thorns.  My love of words and grammar turned me into the grammar police, trying to “correct” everyone’s sentences, even in my own family.  “Don’t end sentences in prepositions,” I would say, or, “Mark all your adjectives with an LY.”  I wanted everyone to speak Academic English, and I was frustrated by deviations from the rules of Strunk and White.

Then I encountered Steven Pinker.  My friend Sofija lent me The Language Instinct.  Pinker's work exposed my metaphorical garden for what it really was:  full of toxic weeds.

Rest and Oxygenation: Why we all need to stop and breathe

Sometimes I do too much for too long.  Constantly taking on more and more tasks, I pretend to be a Type A overachiever who has her life together and can do it all.  But on the inside, I’m gasping for breath, wondering when I will find relief from the hustle.

Have you ever felt like you were drowning?

Deep breaths are essential.  Without them, even the brain cannot function well.  Put simply, it runs out of oxygen.  Allow me to illustrate:

Moving Forward Without Looking Back: Neuroplasticity and Hope

“When will our lives be back to normal?”

This is probably the most common question I receive from patients and their families.  I usually dodge it:  Instead, I estimate the timeline for reaching the patient’s goals and establishing a daily communication (or eating/swallowing) routine.  Because honestly, what is “normal”?

This isn’t a pithy rhetorical question.  Does “normal” mean following an established pattern with the resources you have?  That can start during the recovery process, although there may be great suffering in it.  Does “normal” mean a predictable life with no obstacles?  I can confidently say that will never happen.  What was expected yesterday may not be expected today.  Yet this clinging, this preference for the past over the future, is common.  We long for the security of the known.

How can we shift our expectations to allow for the changes that are happening in our lives?  How do I, as a therapist, talk about moving forward with my patients—and with myself?

The Power of Praise: Research-based ways to Encourage and Empower

Sometimes, I fail.  I don't finish my daily to-do list.  I overcook dinner.  My words fall flat, or worse, hurt someone’s feelings.  Too often, my response to myself is harsh:  I’m lazy, I am not a good cook, I’m a bad communicator.  My failures define me.

Conversely, when I succeed, I own a success as if it is a part of me.  I am a great planner, a gourmet cook, the next Madeleine L’Engle.

Praising and criticizing myself for my innate abilities can create the illusion that my successes and my failures define me and determine my worth.  That’s a lot of pressure!  Also, I am reinforcing the idea that my successes and failures are due to innate abilities, which are difficult to change. 

The good news is that our dignity is inherent, no matter how talented we are (or aren’t).  And we do have the power to try again if we want to.  So how can we use our words to remind ourselves—and others—that our successes and failures do not define us?  How can we use our words to encourage each other to keep trying even when things don’t work out the way we hope?

Stop Striving and Start Thriving (with feeding resources for families and SLPs)

Stop Striving and Start Thriving (with feeding resources for families and SLPs)

It’s easy to believe that if you provide the perfect care for your family, you can raise kids who never get sick, have genius IQs, perfect skin, perfect behavior, and amazing athletic abilities.  But is all of this optimization actually best for the children in our care?  I have seen too many parents in tears because they feel they are somehow failing to provide their children the “optimal” experience.  But what if what’s praised as “best” by society isn’t actually the best option for everyone?  What if by working so hard to meet a perceived societal standard, we are actually distracting ourselves from the ways we can thrive in our own unique situations?  And what if to thrive, we have to let go of control and allow ourselves to rely on tools, resources, and others’ helping hands?  

If you feel insufficient, it’s because we are all insufficient.  God doesn’t expect us to do everything on our own, or even to do everything an exact specific predetermined way.  He asks us to rely on His help, often offered through others, and sometimes using surprising resources.  And there are some decisions with neither a right nor a wrong answer.  What matters isn’t that your life looks optimal or perfect.  What matters is that you can find ways to thrive in whatever situation you are in.

To consider the many kinds of resources and choices God provides for us, let’s take a closer look at feeding kids. 

Welcome

Hello, and welcome to a place where words nourish even more than bread and every day we do the best we can—even when that means making mistakes and falling flat on our faces.