Author Archives: Meri Levy

Don’t Abandon Yourself this Holiday Season

For those of us who are susceptible to chronic pain or other physical symptoms, or who tend toward anxiety or depression (all of which can be neuroplastic, by the way), the holiday season can be a time when we need to be especially mindful. It’s all too easy to abandon ourselves in the rush to make everyone else happy.

There’s nothing wrong with caring deeply about the needs of the people we love. That’s a beautiful quality. But for some of us, prioritizing others can tip from caring into compulsion.

So what does it mean to have high personal agency in our lives?

It means we know what matters to us, and we make conscious decisions based on our own values and priorities. It means we can consider our wants and needs alongside those of the people we care about—and choose our actions based on what feels most aligned and meaningful overall.

Many people with a people-pleasing pattern feel obligated to keep others happy, even when it costs them something important. The thought of disappointing someone can feel unbearable, and abandoning ourselves can become the default.

Learning to cultivate high personal agency doesn’t mean you stop being generous or caring. It doesn’t mean you can never put someone else first. In fact, it doesn’t require changing your actions at all. What it does mean is that when you choose to do something for others, you do it from a place of clarity and intention—because, in your own honest assessment, the benefits outweigh the costs.

So this holiday season, what might shift if you chose not to abandon yourself? What could open up if you committed to honoring your own agency in every meaningful decision?

You deserve to be part of the circle of people you care for.

Medical Rule-Outs, Mind-Body Rule-Ins:

A Balanced Approach to Physical Symptoms in Therapy

Today, a fellow therapist asked me, “Aren’t you worried about treating someone as if they have neuroplastic symptoms when they actually have a serious medical condition?”

This question raised a lot of interesting thoughts for me. So welcome to my TED Talk!

Firstly, the vast majority of people who seek treatment for neuroplastic symptoms already have seen all the doctors. Rather than not being evaluated medically, the much more common scenario is that they have seen all the mainstream doctors they can get referrals for. They may also have seen a few nontraditional practitioners as well. They have likely heard from their doctors that there’s nothing that can be done medically, or have tried all the recommended medical treatments, or have gotten sick and tired of spending all their money and time on alternative treatments.

Moreover, some neuroplastic conditions present in a way that doesn’t lend itself to a medical diagnosis. Symptoms might move around randomly, from one part of the body to another. They might hurt the day after exercise, but not during it. Or pain might start right when they walk into the gym. Or symptoms may have started simultaneously in both hands or both shoulders. Or they may happen only when it rains, or during the full moon, or on Monday mornings. Those are conditions that doctors just shrug their shoulders at.

Or they may happen only when it rains, or during the full moon, or on Monday mornings. Those are conditions that doctors just shrug their shoulders at.

Furthermore, it occurred to me that therapists don’t worry about this very much when they’re treating neuroplastic conditions that appear psychological, such as depression – even though that can also be caused by a medical condition. I always make sure my clients with depression, anxiety or insomnia have had a full physical exam and labs done, since I don’t want to find out a year into treatment that a client is hypothyroid or has a deficiency. It’s always important to make sure our clients are getting adequate medical care – whether or not they are being treated for physical symptoms. 

When I developed debilitating neuroplastic dizziness, vertigo, nausea, vomiting and insomnia, my doctor spent months trying to figure out what was medically wrong with me. I had many rounds of lab tests done, a trip to a neurologist, and an MRI. Every test was normal. All that accomplished was delaying my recovery, and I ended up hospitalized with Major Depressive Disorder after being unable to eat or sleep for several months. 

That’s not to say that those tests didn’t need to be done, but it wouldn’t have hurt for me to be getting support from a mind-body therapist at the same time. 

The truth is that you don’t have to choose between being medically evaluated and receiving treatment for neuroplastic symptoms. Your doctor should treat your symptoms as legitimate, and should run any and all diagnostic tests needed and refer you to any appropriate specialists. AND, whenever it becomes apparent that there may be a neuroplastic component to your symptoms, mind-body treatments should be pursued. If they work, then it is clear that your symptoms were neuroplastic all along.

To find out if mind-body treatment can help you overcome your chronic symptoms, Contact Me.

Somatic Complaints During the Perinatal Period

Pregnancy and the postpartum period are very vulnerable times. Our bodies change in ways that can feel scary and uncomfortable. It’s also a time when a lot of birthing people experience somatic complaints. Symptoms often include morning sickness and the typical aches and pains of pregnancy and new parenthood. But they can also include sciatica, vertigo, migraine, heartburn, wrist pain, back and neck pain, and even Hyperemesis Gravidarum (severe nausea and vomiting during pregnancy). These symptoms can be scary, and they can make us believe that there is something seriously wrong with our bodies.

When we are experiencing symptoms that scare us, that fear turns up the dial on our perception of those sensations. And those of us who tend to experience these symptoms the most during pregnancy and the postpartum period are folks who “somatize” our stress and emotions — often those of us who’ve experienced childhood adversity and who are also susceptible to depression and anxiety.

I am one of those people. I’ve struggled with chronic symptoms since childhood, including asthma, IBS, TMJ pain, wrist pain, bladder symptoms, etc. But after the birth of my second child, my physical symptoms were the worst I had ever faced. My postpartum anxiety presented as somatic symptoms—constant, overwhelming dizziness and nausea that made it difficult caused me to be unable to care for my children. At the time, I didn’t connect these symptoms to stress or self-neglect, but in hindsight, they were clear signs that I needed better boundaries and self-care. With therapy and support, I learned to prioritize my own well-being, and slowly recovered.

I now know how common it is for new and expecting parents to experience both psychological and physical symptoms during the perinatal period. It’s an incredibly vulnerable time, and stress commonly shows up in the body. The good news is that these symptoms—whether depression, anxiety, vertigo, or pain conditions like headaches, dizziness, wrist tendinitis, neck pain or sciatica—are highly treatable.

As a therapist specializing in perinatal mental health and neuroplastic symptom recovery, I help clients heal both physically and emotionally, so they can return to the full, balanced life they deserve. How we engage with our physical symptoms can either exacerbate or heal them. Pain Reprocessing Therapy teaches us how to view physical sensations from a lens of safety, so sensations are not amplified. And Emotional Awareness and Expression Therapy helps us release strong emotions that can contribute to tension and symptoms in the body.

Psychotherapy can also support birthing people in learning to prioritize our own well-being as we are learning to care for our babies. Not abandoning ourselves while caring for our family helps us become healthy parents in body, mind, and spirit.

Take this Quiz to help you determine if your chronic symptoms are likely neuroplastic.

The Mind/Body Connection in Chronic Symptoms

neck pain

Pain and other chronic symptoms—like IBS, vertigo, tinnitus or bladder issues—can take over our lives. Physical symptoms naturally create fear, and symptoms and fear together can become the center of our attention, pushing everything else into the background.

When pain or symptom keep us from doing the things we enjoy, it’s common to feel anxious or depressed. In fact, most people who struggle with chronic pain also experience anxiety or depression. It’s not always clear which came first, because they are closely connected. Many people with chronic symptoms have experienced childhood adversity, and are likely to be perfectionists or people-pleasers—traits that can increase stress and make us more vulnerable to both physical and emotional symptoms.

While chronic pain and other physical symptoms appear to be based in the body, research shows that trauma, emotions and stress play a powerful role—even sometimes when pain seems to have a clear physical cause.

I experienced this firsthand. Years ago, I developed chronic wrist tendinitis that was attributed to  typing too much. My pain was real and constant, and I tried everything—chiropractic, physical therapy, massage, acupuncture, Alexander Technique, and Feldenkrais classes. Nothing helped for long. I had to stop doing many things I loved. I wore wrist splints, used voice-recognition software, and avoided cooking, gardening, and knitting. Despite all these precautions, I was in pain for more than two years.

Then I found Dr. John Sarno’s book Healing Back Pain. He discovered that many people who had  physical findings that might cause pain—like herniated discs or arthritis—had completely different pain experiences. Some had severe pain, while others with the same imaging results felt none at all. One large study of over 3,000 people found that spine changes seen on MRIs are usually a normal part of aging and don’t necessarily cause pain. His work with his patients demonstrated that emotional stress and repressed anger can create very real physical pain. He helped many thousands of people recover from chronic pain with his medical practice and his books. I was one of them. 

It’s important to note that pain or other symptoms are not “all in your head.” Chronic symptoms are  absolutely real. But all our experiences are mediated by the brain, and our brains interpret pain based on not only sensations sent from the body, but also based on expectation, and the perception of danger. If we’re afraid that something is wrong with our bodies, or of conflict, negative emotions, or anything else we experience, pain and other symptoms can begin or intensify. On the other hand, if we feel safe and confident in our body’s strength, and in our ability to handle our emotions and our relationships, they can fade—even when nothing physical has changed. This is why treatments that reduce fear and increase a sense of safety can be so effective. The fact that changes in in how we interpret the world impact our symptoms is why we call these symptoms “neuroplastic.”

Over the past several years, there has been increasing evidence supporting Dr. Sarno’s theory, and new treatments have begun to be proven to help patients overcome neuroplastic symptoms. In 2020, I completed training with the Pain Psychology Center to work with clients using Pain Reprocessing Therapy (PRT). A study at the University of Colorado found that people with long-term back pain experienced major or complete recovery after just four weeks of PRT.

PRT helps retrain the brain to interpret pain signals differently. It uses mindfulness, cognitive, and behavioral techniques to reduce fear, calm the nervous system, and build a sense of safety in the body. As fear decreases, pain often does too—sometimes permanently.

Chronic symptoms, as miserable as they can be, often serve hidden purposes. They may give us permission to slow down, rest, or seek care from others. They may distract us from emotions we’d rather not face. Understanding these patterns can help us reclaim our energy and our lives.

When we start to truly trust that our bodies are strong and resilient, and that we can handle our emotions and the stresses in our lives, we can stop letting pain dictate our choices. With the right tools and mindset, recovery is possible—and life can feel full and joyful again.

 

Take a test to see if your chronic pain or symptoms are likely treatable using a mind-body approach

References:

  1. Sarno, M.D., John E. Healing Back Pain: The Mind-Body Connection. New York, NY: Warner Books, 1991.
  2. Sarno, M.D., John E. The Mindbody Prescription: Healing the Body, Healing the Pain. New York, NY: Warner Books, 1998.
  3. AJNR Am J Neuroradiol. 2015 Apr; 36(4): 811–816.

    Published online 2014 Nov 27. doi: 10.3174/ajnr.A4173

 

Antidepressant Medication in Pregnancy

Pregnant Belly

The debate over the safety of psychotropic medications during pregnancy continues to spark strong opinions. Critics of antidepressants often cite numerous articles and isolated studies highlighting potential risks or questioning their effectiveness. What we’re seeing, in many cases, is a form of “splitting”—the tendency to categorize something as entirely good or entirely bad. When it comes to psychiatric medication, people often fall into one camp or the other and accept only the evidence that supports their viewpoint.

The reality is more nuanced. Yes, some psychiatrists make mistakes, and psychiatric medications can be overprescribed or misprescribed. Some people do not respond well to them. But many others experience profound relief, and for some, these medications are lifesaving. This is why clear, balanced, and evidence-based information about the use of psychotropic medications during pregnancy and breastfeeding is so critically important.

Many who oppose antidepressants advocate for natural or holistic approaches to treating depression and anxiety. These approaches can absolutely be helpful for some people. I’ve personally tried acupuncture, chiropractic care, homeopathy, craniosacral therapy, and herbal treatments, and at times found them beneficial. But, just as we rely on modern medicine for conditions like Type 1 diabetes, there are situations in which holistic measures simply aren’t enough.

In my own experience many years ago, no amount of holistic treatment or psychotherapy touched my severe postpartum anxiety and depression. I was eventually hospitalized when I no longer wanted to live. Six weeks after starting an antidepressant, I was able to function again and finally benefit from therapy. I know that medication saved my life, and I’ve heard countless similar stories from other birthing people.

Perinatal mental health disorders have both biological and psychological components. Hormonal shifts, physical recovery from childbirth or cesarean, and chronic sleep deprivation can all play significant roles. In my work with birthing people, I’ve seen again and again that those with severe perinatal depression, anxiety, or OCD often do best with a combination of approaches—psychotherapy, self-care, social support, nutrition, sunlight, and moderate exercise, and medication when needed.

Some parents choose not to take medication, and many do recover with therapy, support, and lifestyle changes. But some later wish they had considered medication sooner, regretting the weeks or months lost with their baby while they struggled to bond or function due to overwhelming symptoms.

Untreated depression and anxiety during pregnancy and the postpartum period carry real risks. They can affect birth outcomes and have lasting effects on the parent, the baby, and the entire family system.

The truth is that some new parents simply do not have the energy, motivation, or clarity to benefit fully from therapy or self-care until their symptoms are stabilized. In my experience, most of these individuals improve significantly once they receive the right medication. That practical reality matters far more than abstract debates about whether medication is “good” or “bad.”

New parents deserve balanced, compassionate information—not scare tactics, shame, or political agendas. Their health, their babies’ well-being, and their family’s future depend on access to accurate guidance and the full spectrum of effective treatment options.

Coping with Anxiety Using Mindfulness

anxiety

You know the feeling when it starts: an unpleasant burning in your chest or abdomen, a feeling of cold on the back of your neck, tingling in your arms, or tightness in the back of your throat. Anxiety is a physical phenomenon.

Many of us are unaware of the specific physical sensations associated with our anxiety, but it sends a signal to our brain that we are in danger. On its own, anxiety tends to pass quickly and without much ado. It is the way we attribute meaning to the sensations in our body that causes anxiety to feel unbearable and to stick around. We interpret our anxiety as being “out of control.” We look to our environment or our thoughts for signals that we really are in danger, either physically or emotionally. And we beat ourselves up for feeling anxious, telling ourselves “What is wrong with me?” “Why can’t I feel calm?” And even worse, “I can’t tolerate feeling this way.”

But in reality, we can tolerate anxiety. By tolerating it and observing, without fear, and without judgment, its physical manifestations, we rob it of its power over us. And over time, anxiety will diminish if we refuse to escalate it by letting it take over our thoughts and our decisions. The quickest path to diminishing anxiety is to accept it and not to catastrophize about it or let it make our lives smaller.

Mindfulness is one of the most powerful tools for coping with and transforming anxiety. While it may feel like WE ARE anxious, bringing awareness to our body and choosing to focus on the specific physical sensations we are experiencing allows us to see that we are the observer of anxiety, not its victim. We can choose to halt self-defeating thoughts by returning awareness to our body and reminding ourselves “Anxiety cannot hurt me. It is only a feeling, and it is temporary. I am in control of myself. I can choose to be aware of the anxiety without letting it take over my thoughts.”

Practice doing mindfulness exercises such as this one when you are not feeling particularly anxious, as a way of being ready for anxiety when it comes. Learning to focus your full attention on your body rather than your thoughts takes some practice, but only five minutes a day can make a huge difference in reducing anxiety and helping you cope with it when it comes.

Anxiety is often associated with depression, even if the depression is not severe. Taking steps to address negative patterns of thinking, grieving losses, and learning to take better care of ourselves physically and emotionally is another important step in dealing with anxiety. If you need help to learn to identify and challenge negative thoughts, work through with past trauma or loss, or learn to improve your self-care and relationships, finding a therapist you trust is a great place to start.