Psychological Aspects of Recovery: Mental and Emotional Obstacles Faced with Musician's Dystonia (FTSED and FTSHD).

In the past I would have refrained from writing about this area of recovery because of the tendency of others to immediately hop on the psychological bandwagon belief that Musician's Dystonia is simply an underlying psychological or emotional disorder. As I have stated throughout many of my writings that I do not support that belief whatsoever, nor do I believe it is the true cause of this neurological disorder. That is not to say that there is no psychological effect involved that must be addressed.

It is what I consider one of the 3 major stages of rehabilitation; (1) Educating oneself on the disorder, treatments, rehabilitation methods, other related injuries/areas, the body (movement and anatomy), and literally anything involving musician's health. (2) retraining the mind (psychological cognitive restructuring). (3) Rebuilding Neuro-pathways (Physical Rehabilitation). 

These are my own opinions. However, it is safe to say that without a doubt anyone who has been marked with a major physical setback or injury naturally inherits emotional hurdles afterwards. As it takes a huge blow to ones self worth, it leaves us with doubts in our capabilities, dislike in our concept of sound, we start to over-analyze out of pure confusion and trying to fix what is going wrong with technique, and it leaves us overwhelmed and lost in the stages of grief. Sometimes we don't even realize that we are in grief or are in denial of it.

It is best to address the psychological aspects first and foremost before any musician tries to start physically rehabilitating. I believe they should be in a healthy frame of mind and emotionally stable. Many musicians who are hit with this disorder panic and want answers right away. They are very confused and don't want to accept the current state they are in. The only problem is that part of the answer IS embracing the current state. Mind you that embracing a temporary state/setback does not mean it defines you or that you're giving up. The disorder does not define who you are or who you will be. There is a difference.

Being diagnosed with what is considered a career-ending disorder is scary and devastating. It is hard to see the silver lining when it seems there are vague answers and not just one solution to overcoming it. It takes a great deal of courage and optimism to look at it in positive light, and no one is ready to do that until they've allowed themselves to grieve and face the possibility of their worst fears.

But I look at it as facing ones fears and saying, "Even though I believe I will beat this disorder, I'm not scared of the worst that could happen because here are the good things that can come out of it...." It's like facing your fear in order to overcome it. Once you experience it, it no longer holds a death grip on you.

I can already hear my musician friends saying, "What good could come out of this awful situation?" In order to come to that point, you have to go through the stages of grief. You must cry over the misfortune, get angry, yell, curse others, become bitter if you have to, go through highs and lows, desperately ask for help, ask "why me?"...whatever it takes to heal no matter how bad it feels. But then there comes a time where you do feel you have a choice; you can continue mourning or build up the courage and say, "I'm tired of being sad. I'm tired of hating the way I sound due to the spasms. I'm tired of fearing my instrument, being frustrated, confused, fearing the worst, and living like this in misery." Then you find the strength to fight. Once you are ready, there is a lot you must change about the way you think, and in a big picture type of way...

• The first and most important thing I have found is learning to separate your worth from the instrument and center yourself.

We are gifted with the love of (sharing) music. It initially started off as a feeling and transferred to an instrument that resonated with us personally. Yet this gift of the love of music is still with us, even if we can not play for the time being. The instrument does not define who we are or our gift, just like our disorder does not. We must believe that our knowledge of music and passion is meant to be shared, that all we've done in the field is not for nothing. Being gifted with music means we have the choice to share it in more ways than just one. Focusing on another area of music or field/activity that reminds us of that love surprisingly allows us to still remain connected to the gift. It may not give us as "full" of a feeling as we had before, but it can as time goes by and we find our confidence returning in something music or non-music related that we didn't know we had a talent for.

Having Dystonia allows us to focus on other areas of our lives that we didn't get to do while focused on performance. We have more time to build relationships, explore new areas, work on our health, study something we never got a chance to do.  Some are too afraid to try to live again, to seek out something similar out of fear that it won't be the same.

We are literally brought back to the major question of "Why do we love our instrument so much? and where do our priorities fall? It also makes us question what is success? Did we love our success more than the music? Dystonia really grounds us and brings us back to why we love music. Success and failure are one and the same. There are no rewards/praise for success. The reward we found in music when younger was that feeling of exploration. We could make a million mistakes and still love the way we sounded. Yet the more advanced you become you lose that sense of exploration, creativity, curiousity, and unconditional love and acceptance of how one sounds.

• That leads me to the second thing. You must embrace the way you sound and love it.

I am dead serious when I say it is vital that you revert back to that childhood state of mind in order to embrace your dystonia. Dystonia must be confronted with that same feeling of exploration, curiosity, and unconditional love and acceptance of how one sounds.

Seeing other people play music, even small children, reminds me of what a tremendous blessing music is in this world. It's meant to be used as a form of expression whether or not it sounds good or bad...it has meaning and that is all that matters. Technique no longer matters, all the blabbering about breathing, hitting the notes, using articulation, etc. All that matters is embracing the love of music and letting go of the ego, the success, or judgement, and really appreciating what a gift it is to have music in the world. I imagine my feeling is similar to that of someone who has lost one of their senses like sight or hearing. We don't realize how truly miraculous something is until it is gone. We appreciate it more, aim to protect it, and love it in a way that is no longer criticizing, demanding, or taking it for granted as we did before.

I'm serious when I say I absolutely love hearing beginning band students play.
I believe that is the kind of love it takes; to embrace music with no judgement, or at least an appreciation for it that is much deeper than before.

• Third. Shift your focus from the performance mentality to relaxed awareness. 

I learned to not fight my symptoms or judge them, but to let them happen and just relax into a state of awareness. (ex. "I'm noticing that it's easier to grab an F than a G, and the angle of my mouthpiece made a difference today"). That way you are focused more on feeling things out than fixing things with technique or judging the way you sound. Your body knows what to do and is trying to tell you something, so listen to it and get to know the symptoms well. I started taking an inventory of my symptoms and recording myself. The more I played with an open, loving, and aware mind, the more I discovered and adjusted my playing over time and saw improvement.

Performance mentality focuses on analyzing technique, physical agility, skills and accuracy. Relaxed awareness is what is needed instead. Focusing on embracing the symptoms, getting to know when they happen, looking at them with curiosity, exploring ways to lessen them through adjustments and modifications.It seems pretty simplistic and basic, but it works if you have patience and don't rush the process of recovery.

Though this may sound odd, there are some other things I did to help embrace my dystonia sound; telling my horn thank you and that I loved it no matter how it sounded, recording myself and listening to it with love, sympathy, and curiosity. Also practicing mantras, visualizations, building self-esteem, and treating myself like a survivor and not a victim were other major factors in changing my state of mind. Also farther down the road I liked listening to recordings of the horn before I fell asleep and visualized that my playing felt just as smooth and effortless. Pretty soon I started having vivid dreams about playing easily and this boosted my energy and happiness the more it occurred.

I started off practicing in a practice room with a piece of paper over the window. As I got more comfortable with accepting my sound, I removed the paper. Eventually I moved into a larger classroom, and then a stage. I adapted myself so that I did not fear the way I sounded in front of others. Whenever the thought that someone might be judging me popped up I would tell myself, "They are not judging me, I must be judging myself harshly to assume so. Even if they are, they do not know what they are doing. If they are, I feel sorry that they have been brainwashed to look down so shallowly on the act of making music which is a beautiful thing. I must remember I am now at a higher state of mind than what I had before and I love the way I sound no matter what. I must let go of the inner critic. I love myself. I love my sound. I accept it."

• This leads me to the fourth thing that I have learned. It is important to surround yourself with people and environments that help promote a healthy state of mind.

Teaching beginning band students helped me a lot, and this is actually why I'm going into teaching. I love working with students who are just starting to learn music because that is when I most clearly see the importance of music. In a way it is living my life up to my ultimate rule...that it's always about the expression of music and imagination more than anything else. It is similar to developing strong morals and values and sticking to them, living them, breathing them, becoming them.

My students never judged the way I sounded and instead thought it was the best thing on earth. It reminded me of how children are much more centered (mentally and emotionally) than adults can be. They are in that state of daydreaming and imagination all the time. I am happy to influence them in a positive way and help them find balance in not only their abilities, but way of thinking/approach too. It was much healthier for me to be around children with this state of mind than performing in a group full of adults that are way too hard on themselves and others.

Many Dystonic musicians who talk to me usually ask me how I feel about playing in a group. They hate it when I tell them that I am against people playing in an ensemble of high caliber or even of musicians that would not understand what they are going through. I think it is important at the beginning of rehabilitation to focus on yourself and spend time playing alone and not aggravating things. Later on as playing gets better, then maybe if psychologically prepared for it, but playing in a group can add even more anxiety, pressure, demands, fear, frustration, and stress that you already deal with when facing the dystonia symptoms; not knowing if things will come out correctly, or if you'll be able to play a passage, etc. Live concerts are the worst because it adds in adrenaline, and the adrenaline heightens the dystonic symptoms just like loud noise heightens or triggers a migraine. It's best to remove oneself from anything that worsens the symptoms for the time being.

Instead, surround yourself with a network of people who understand; whether it be the musician's dystonia group on facebook, write or visit with other musicians from the group or who you've come across online with dystonia, lean on a supportive teacher/mentor, etc. If you feel comfortable with talking to me, then by all means call me or message me if you need to. It's the least I can do for others.

If can, speak out about your dystonia. It is oddly relieving. Not everyone is comfortable with that, but for me it is a way of healing. Knowing that I am informing others (non-dystonic people) about this disorder that is rarely spoken of, makes me feel like I'm not wallowing in pain while keeping my mouth shut. I want others to know so that some day others who are in the same boat won't feel as alone or outcast. Yet, I always speak positively of it; never victimizing myself, but instead aim to promote awareness and understanding of the disorder.

I know this is not how everyone feels, but I believe that my dystonia was meant to happen for a reason. I may not understand the reason, but I choose to believe that it is because I am strong enough to handle it and navigate the tremendous loss, and that I am to help others and promote awareness about this disorder. I believe that what I'm experiencing is unique and it is rare to see anyone share their experiences about this disorder, so it must be done for the sake of healing and helping. I see a lot of injured musicians do this, and it makes me happy to see them channeling their love and support to others in need before themselves. This leads me to the importance of belief or hope....

• Last, but not least. Do your best to find the silver lining and say it out loud.

Physical rehabilitation tests your patience unlike any other. There are many days where you will get better, then relapse. There are many days where one adjustment might work and the next not. There are even more days where you just plain sink into depression again. The wound from losing what you love never truly goes away. It is not easy to stay optimistic about it all the time, and I don't suggest that anyone avoid their emotions; whether it be sad, angry, happy, excited, etc. It is important to go through the motions and let whatever you feel happen so that you can heal.

Creating some strong beliefs in yourself and your recovery will carry you further and support you when things get tough. When you are able to find the silver lining...even if it's not something you necessarily completely 100% believe yet...say it out loud no matter what. It could be something as simple as, "Maybe not today. But tomorrow." or "Can't have progress without some relapses." I always say it out loud, whisper it, or say it to myself in a mirror because it somehow feels more grounded and reassuring. I know I sound crazy for doing such things, but it makes a difference and that is all that matters. Whatever gives you strength, believe in it and hold onto it....not matter how ridiculous it may seem, look, or sound to others.

The psychological aspects of recovery are a huge obstacle to overcome! It is probably the most difficult part of rehabilitation. I see these psychological aspects as a very heavy fog that blinds us from the physical obstacles beyond that. Once the fog is lifted you can focus on the dystonic symptoms and alleviate them through physical therapy and rebuilding the neuro-pathways slowly over time. But first and foremost you have to be willing to embrace what is right in front of you and keep tremendous patience. Not everyone is ready to do that or needs help with it. Some good options to help find what centers you is meditation, hypnosis, or it could be something spiritual or religious like going to church, it could even be helping others...whatever allows you to reflect inwards and face the grief at your own pace and allows you to think about a meaningful purpose of this experience. The good news is that you will see progress without a doubt, and time really does heal both the mind, body, and soul.

Good Times: Friends, Horn Players, Traveling, and TENS unit therapy!

I've had a busier month than expected! A lot of great blessings despite several car problems. I currently work in Denver while living in Boulder. It's quite the commute, but I don't mind since I love driving long-distance. However, my car has broken down three times in the last month....let's just leave it at that and hope the terrible 3's are finally over. I'm so thankful for the many friends and family that have helped out throughout that stress-ball.

Back to the positive stuff! A fellow FTSED musician lent me their TENS unit to use! My neuromuscular dentist wanted me to undergo several sessions of using the TENS unit since it showed signs of improvement, yet I couldn't afford it. I'm literally a broke college student again. Boy am I grateful for this generous person to let me borrow their unit!!! It's helped tremendously. I'm already experiencing less pain. Even when the pain does happen it goes away quicker. I just have to make sure that I keep up the ice/heat packing and the TENS unit consistently especially after practicing.

They lent me four electric pads, so I've been using it on my face and my back shoulder and neck. My jaw is popping less, but still just enough to keep me worried. However, I have to say that my jaw feels more sticky in a good way...before I felt like it would pop or crack so easily by the slightest touch, and now it doesn't feel as loose or crackly or off. It's weird, the more I use the TENS unit along the line of my shoulder blade in my back, the more relieved I feel.

Another risk I'm taking is bringing back slight playing into my daily activities. My friend Thomas Jostlein the associate principal of the St. Louis Symphony is here in Boulder for the CMF festival and wanted to see where I was at playing-wise with my disorder. I'm VERY picky about who I play for because it requires a deeper understanding of the complexity of what I'm dealing with (a combination of injuries and disorder), and also an unorthodox approach vs standard lesson approach when giving advice or suggestions. But I trust him as a mentor.

The best thing is that I feel like I've contacted my inner horn geek again...which I've missed a lot! hahaha! It's therapeutic in a way feeling like I'm included in the horn playing world even if it's just talking to another horn player. Even better, one who isn't afraid of my disorder and is genuinely interested.

Many years ago when starting my (horn performance) grad school audition process by visiting campuses, the University of Illinois (Champagne-Urbana) was on my scheduled list. After visiting Thomas, I realized I favored his horn pedagogy and approach to music best out of any other schools, so U of IL became my top choice for schools to apply for. I liked that he wasn't like other typical professors; lost in technique or standard methods of solving playing issues, nor taught by the textbook....he had a unique and innovative approach due to his former teacher, Arnold Jacobs' influence. However, grad school on horn never happened due to my injury and then disorder. However, I consider him one of the best horn players of our time (if you haven't heard him, you need to...he really needs to make a solo recording), so it means a lot knowing he believes that I'll make a full recovery and has been supportive of all the hard work I've done to rehabilitate.

 I also had some of my closest friends in Colorado this summer! I went and visited my friend James at the Aspen music festival. He use to play principal clarinet in the orchestra I was in, and we played in a woodwind quintet together. My best friend Lizzie, also from my undergrad, visited me in Denver. She's working on promoting her artwork and trying to make it as a solo artist. I know she will because she has such a diverse set of skills!

For the first time in MANY years I felt complete....like myself again. Just being around people who get me, who have known me throughout my music endeavors and all the challenges, changes, and growth in life...it brought me a sense of relief being around what feels like family. My friends are family...even if I'm not the best at keeping up, I would do anything for the few close friends I have. Even my own family (except my twin sister) hasn't attended any of my concerts, recitals, performances, or tours after I left high school.

Music has always provided the family, support, and sense of purpose I strived for and needed. Even if I could play, it wouldn't mean as much if I didn't have others to share my pursuit of music with. I miss performing with friends, people that I love, and sharing good memories. No, the performance world is not always pretty, there can be drama, but in the end when I look back, it's my friends I miss the most. I proudly watch them grow into professional musicians, already establishing their names and professions. And while I wish I could share in the same things, I can't complain too much....it brings me tremendous joy seeing them shine and accomplish their dreams.

On a completely different note and change of subject, I'm in a committed relationship; something that is a huge milestone. It's taken a lot of courage on my part, but so far I feel like my heart has healed a lot and I'm ready to see the world through a more positive lens again and embrace whatever comes my way without fear.

I'm still learning how to let go of control and to not fear the worst, but I've come a long ways since then. In a way I felt like all these wonderful reunions with musicians I admire and friends I care deeply about, was a gift from God as a reminder of who I am, that everything that's happened in the past, all that I've accomplished, the gift of music I was given....it wasn't all for nothing, and it really did happen. I really could play. Just when I thought the former me was dead and gone, I was reminded that passion and fire inside is still alive. I just needed a jolt to wake me up again. I honestly haven't felt this alive in a very long time, and I'm grateful for it. I can daydream about the future and look forward to every day with the faith that my talent and skills will serve a purpose again.