Grace S. Kao, Ph.D., ABPP
Assistant Professor, Baylor College of Medicine
Board Certified in Clinical Health Psychology
Pediatric Pain Psychologist
Pediatric Pain Medicine Division|Psychology Section
Departments of Anesthesiology, Perioperative, and Pain Medicine and Pediatrics
Texas Children’s Hospital
“What kind of advice would you give to other people going through this?”
She leaned back, her lower lip tightening slightly, giving much-appreciated thought to my question. It was a moment of reflection for both of us, as we were approaching the end of her pain psychology course with a “graduation” session. I remembered some of our earlier sessions, the ones when her voice would hold that monotone sign of fatigue, low energy, disengagement. I remembered the efforts to sustain calm in my own mind in response to the uncertainty of the ever-present question, “Will I be able to help?”
She refocused her gaze on me and shared insights from a journey with chronic pain. When the team and I first met her in our interdisciplinary pain medicine clinic, she had described how fluctuating muscle aches had gradually become severe and widespread, limiting participation in soccer, her sport of choice. Pain eventually impacted her ability to keep up with other enjoyed activities and friends and led to worsened depression, anxiety, and isolation. With pain medicine, physical therapy, and psychology support, she had impressively arrived back to a place of re-engagement and functional improvement. As she listed lessons learned, I worked on capturing these insights to debrief and send with her as she looked to transitioning to college, adult care, and beyond. Among the reminders she provided about finding meaning, connecting with others, and taking life “day by day,” she also mentioned a shift in focus from self to others.
With great wisdom, she said, “Now, I’m also realizing that there are people who do genuinely appreciate me. If I don’t focus just on myself, I can see it more, and seeing that feels really great.”
I nodded in understanding, recalling that just a few months ago, she had expressed great distress in feeling “left behind” by friends, “not good enough” because of her physical limitations, and uncertainties about her importance in loved ones’ lives. Gradually, she warmed to using cognitive strategies in response to discouraging thought patterns, intentionally invested in important relationships, and moved towards diversifying enjoyable activities rather than focusing singularly on soccer success.
I expressed appreciation for her willingness to share her thoughts. She gave a short bob of her head, smiling slightly in a way I had come to see more frequently over the past few months. We recounted her rehabilitative journey, progress, and strategies learned. We both said it. The road forward would not necessarily be perfect, the transition on from consistent therapy sessions would not guarantee a lack of challenges, but the sense of newfound confidence in her ability to better navigate her health journey was, undoubtedly, clear.
I was glad.
Not all therapy stories wrap in this way, with a beginning, middle, and as close to a resolution as you can get. Not all patients give the feedback and appreciation that ties my job as a health psychologist to a sense of meaning as well as she had. After our session, in reflecting upon and settling into cozy appreciation for this session, I contemplated my own past year. In a season of re-emergence from a global pandemic, the nagging question of purpose has loomed ever greater.
“Will I be able to help?”
I thought of the struggles of mental health clinicians in this season, through and following the worst of pandemic times, those working in chronic pain, and those facing personal challenges amplified by the domino effects of pandemic restrictions. I reflected upon times spent struggling with a sense of overwhelm and self-doubt with the ability to effectively contribute to what often felt like society’s growing emotional health burden.
Slowly, her words seemed to linger and find traction. “Now, I’m also realizing that there are people who do genuinely appreciate me. If I don’t focus just on myself, I can see it more, and seeing that feels really great.”
The road forward will not necessarily be perfect, will not guarantee a lack of challenges, but the sense of newfound confidence in this moment, in a lesson learned from a wise patient, is undoubtedly, clear.