PRT Part 2

PRT Intro

Weeks 3-6

Last night, my husband and I went to our favorite restaurant in Westport, CT to celebrate big career news. We shared a chopped salad and braised short ribs over these incredible, giant ricotta gnocchi with truffle cream sauce. Yes I am still a vegetarian—basically—don’t at me.

I have spent the past few weeks practicing the Pain Reprocessing Therapy method introduced by Alan Gordon, LCSW in his book called The Way Out: A Revolutionary Scientifically Proven Approach to Healing Chronic Pain, but I am stuck in a rut. So, for the first time in months, I treated myself to a beautiful glass of California Pinot Noir. Wine is a certain migraine trigger, but since I’ve had migraines every day with no breaks for weeks, it seemed moot. Why not enjoy the damn wine? I’m going to pay for it whether I drink it or not.

I used to drink wine to get drunk. Like a fine wine, I’ve matured and blossomed with age and now I enjoy pairing appropriate wines for the meal I’m having to enhance the flavor. I drink a lot of water between sips or glasses and rarely exceed two glasses. Migraines notwithstanding, this post-child bearing almost 40-year-old body has 0% interest in processing more than 12 ounces of wine.

The good news: the migraine didn’t resurface for several hours after the wine (usually it’s pretty instant). Bad news: I had to take a triptan in the middle of the night to sleep, and Excedrin in the morning. But that could happen any time.

Strategies

I recently went off Wellbutrin, a mood stabilizer, and replaced it with Abilify. My doctor and I felt that Wellbutrin might have been contributing to the migraine frequency and severity. It’s hard to say, but the ability to drink a reasonable amount of alcohol again without being debilitated for the next 2 days—2 weeks is progress.

As a sufferer of chronic daily migraine, it sort of doesn’t matter what I do, but what I do can affect how I feel, i.e. longer duration, more severe intensity, faster onset. I call her Marjorie and she comes by every day. Just like in a relationship, the more I get to know Marjorie, the closer we get. Pain begets pain.

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Herein lies the catch-22. Because of the volume of pain I experience, it trains the neural pathways to continue sending those pain signals. Every night I get into bed and, as part of my Pain Reprocessing Therapy, say, “No need, brain, there’s no danger here,” but the pain persists. Perhaps it’s because this way of practicing PRT is defensive, rather than offensive. It probably works well for people who have chronic pain, but maybe not constant pain.

Switch It Up

I’ve begun practicing PRT when I don’t have pain from medicinal relief. Those might be the most beneficial times to tell the brain, “See! We’re good. No pain signals, and everything’s fine, keep at it.” Positive reinforcement, like training a dog or a toddler. Instead of telling my brain not to do something, I’m now trying to tell it to continue doing what I want it to do.

With the proper mood stabilizer, it’s easier to do the other strategies, like catching my fears, and embracing positive sensations. This morning, I was transferring my seedlings to larger containers and trying out a new grow light for my plant terrarium. I knew what he was thinking, “Last year her tomatoes came too late, we got one head of broccoli, a mutant head of cauliflower, 18,000 zucchini, a lot of money and time wasted, and discouragement.

“Even if my garden fails again this year,” I told him, “I really enjoy this little hobby of getting seedlings going. It might fail again, but that’s ok.” I embraced the moment and even articulated it.

I confess, I've not been practicing the somatic tracking. Sometimes I feel too busy or too bored to focus on the thing, that damn Marjorie, that I wish would disappear. Out of sight out of mind. Except, in this case, it is an important practice. There are times I feel I’m almost “catching” myself feeling fake pain, and once I focus on it, the brain is like, “Oh shit, she saw us doing what we’re not supposed to do.”

Planning Ahead

Two changes to practicing PRT going forward:

1. Return to the somatic tracking when I’m experiencing migraine pain.

2. Practice retraining the neural pathways offensively, when I’m not actively in pain.

3. Make that 3: be more consistent with the first two.

It is hard practicing a mind-body therapy. There are no instant results. It can take weeks, or months, depending on how long the body has experienced pain. It’s easy to give up on it for those reasons, but the lack of results likely coincides with the lack of focus and possibly a change of strategy.

I shouldn’t—but I will—enjoy a lovely glass of $7 Kirkland Malbec because it’s stupid good and I want to. Before I do so, and while I’m actively enjoying it, I will reinforce to my brain that we are safe, we are operating exactly as designed, we are entitled to enjoyment, and comfort.

Leave a comment and let me know if you’ve tried Alan Gordon’s PRT methods and what you think.

Stay tuned for PRT Part 3… →

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Strategy and Suggestions

To get myself started, I came up with a game plan for each one of the techniques described in Gordon’s Pain Reprocessing Therapy (PRT).

1. Somatic tracking: So far, I seem to only do it in bed. After a hectic day of chasing a toddler, among other life responsibilities, I have more time to think. I focus on the pain with no agenda. I might think, “I feel the pain at the bottom of my skull in the back on the left. It’s piercing, but if I stay still I don’t feel it.” I continue describing the pain in full sensory detail for up to 5-minutes. Typically, when we are in pain, we think, “Ah, this is so excruciating, when will it end?” But we don’t take time to pay attention to what it’ really feels like, which reinforces the brain’s preconception that everything is bad when we are in pain.

2. Avoidance Behaviors: I have 2 known triggers for migraines that are not “Neuroplastic pain.” One is alcohol, so I stay away from it except on special occasions. The other is menstrual migraine. For me, those are the absolute worst. They don’t respond to meds and take me all the way out. To mitigate it, I take birth control consecutively so that I only have 3-4 periods per year. Another avoidance behavior is taking medicines that provide relief, even if it’s temporary. For someone with back or shoulder pain, you might avoid doing things that trigger the pain. Don’t try to muscle through it. Get comfortable asking for help.

3. Sending signals of safety: I have started compulsively telling my brain that “we are safe,” even in the face of stress and aggravation. When something comes up, I say to myself, “This is annoying/stressful/stupid but it is not threatening. We are safe.” Another thing you can say to yourself, especially with other types of bodily pain is, “My back/neck/foot doesn’t feel as comfortable as I would like it to right now, but it will be comfortable again.” The use of the word comfortable sends signals of comfort to the brain, instead of saying, “This is excruciating,” which reinforces the brain’s danger signals.

4. Reducing stimulation: I love news and knowing what is going on in the country and world. But it is too much. I can’t keep an unending loop of news, podcasts, articles, etc. going all day anymore. In the mornings, instead of listening to Morning Joe, I put on music. Later in the day, I allow myself 30-45 minutes to catch up on The New York Times and WaPo’s morning briefings, and read any linked articles that catch my attention. When I’m cooking or doing something mindless, I listen to an audio book. I have always kept my phone on silent, so that I’m not constantly triggered by incessant dings. If work, email, messages are a problem for you, email batching might be a good technique, and if you use an iPhone, turning on focus settings. You can also use apps, like OneSec, that make you think twice about opening social media apps, or even putting your phone in black and white, which makes it much less interesting to look at.

5. Avoid feeling trapped: this is a hard one because it means letting go of my social life. A chronic pain sufferer’s worst fear is the fear of pain, and being in a situation like a party or event where there’s alcohol, loud noise, and other triggers is hard. I’ve already been doing this technique a little too much, and need to find balance. I can’t let the fear of pain keep me home for the rest of my life. But for someone with other kinds of pain, it might mean booking an aisle seat on a plane so you can get up and walk around, and not literally be trapped at the window. Or if sitting for too long is a problem, get a stand-up desk, or invest in a better chair.

6. Handling uncertainty: this goes hand in hand with sending signals of safety. Sometimes my husband and I are too reactive to each other instead of staying calm and asking questions. It’s so hard to catch myself in that moment, but it’s easier to catch him in that moment! If I can say to him, “Hey, take a breath,” then it gives me time to do that, too. After we talk it out, I remind my brain it is safe. This is hard to do with family, especially kids when emotions run high, but not letting uncertainty overwhelm you is the key. You won’t always be successful at it, but the more you practice, there will be less opportunities for uncertainties—which are a statistical certainty in everyone’s life—to trigger pain.

7. Catching your fears: similarly, when I go down a rabbit hole of self doubt or fear of failure, I have to “catch” it, or catch myself in the act. “No one is reading my Substack!” I might think. “Should I just quit?” Then I remember no one is successful without practice, patience, tenacity, and consistency. Consistency is also important for PRT. When you have these fears, what if I get fired, what if I look like an idiot at the meeting, answer yourself. What if? What if you have spinach in your teeth while making a presentation to executive management? Well, it’ll be embarrassing and you may never forget it, but accept that it happened and move on. Don’t let it control your life even more by triggering pain on top of humiliation.

8. Embracing positive sensations: no matter how bereft we may be in life, there are always positive sensations. It might be that feeling of getting into bed after a long day, or how good warm water feels on your hands when you come in from the cold. Whatever it is, I make a point to not enjoy these moments unconsciously, but to deliberately acknowledge them. “This feels nice.” This one is especially important, because positive sensations can happen even while you’re having pain, and recognizing comfort while also experiencing discomfort helps the brain disentangle that negative-negative association. Good sensations can happen even when we are in pain.

Weeks 1-3

I picked up The Way Out from the library on Friday, December 15. I read it on Sunday night (it’s not long and is fluffed with cheesy analogies and anecdotes.) That night I didn’t sleep well. Every time I woke up, my head hurting, I compulsively somatic tracked. Somatic tracking is not to eliminate the migraine, but to better understand it. You can’t control what you don’t understand. As the days went on I was able to better control the constant impulse to focus on my pain.

The neural pathways I’m attempting to correct have been solidly in place for decades. There’s no reason to think that a couple days of positive thinking will be all it takes to make all the pain go away, so I must go into this process with openness and patience.

Gordon also warns against relapses. He says they are common and expected, and to not let that be discouraging. “Stay the course,” he advises.

How It Went

On an ill-timed drive for last minute shopping the Friday before Christmas, I noticed a spike in pain as I sat in traffic on Route 1. Thanks to the somatic tracking, I recognized that the pain increased at the same rate as my stress and aggravation. “This traffic sucks, but we are safe,” I told myself. Then I looked at my daughter snoozing in the backseat and made a point to appreciate the moment.

When Barnes & Noble had the book even Amazon did not, I made a point to appreciate the moment.

When I came home to find my dog hadn’t broken the baby latches and dragged the trash can out, debris strewn about, much of it eaten, I made a point to appreciate the moment.

At first, my migraines were milder than usual. I avoided rescue medications to see if I could do this all with my mind, but this naive thinking will only set me up for failure.

“This is the practice period,” I thought, while popping a Rizatriptan and 2 Aleve. The fact that my migraines were more like headaches isn’t a sign of anything, it just means they weren’t as severe.

A couple days after Christmas, I didn’t have any migraine pain for two days. It’s rare I get one day, much less two. I don’t know to what to attribute this relief, but sometimes a girl just gets lucky. Perhaps, if stress is as powerful as it is said to be, spending more quality time with my daughter and husband while he was off work played a part.

Algophobia

The word pain comes from the Latin poena, meaning "punishment, penalty, retribution, indemnification" (in Late Latin also "torment, hardship, suffering"). Pain doesn’t just mean “an owie.” Pain makes people feel punished, it is punitive. We often hear people say, “What did I do to deserve this?” We feel pain not just as discomfort, but unconsciously as a measure of our reputation and virtue, a barometer of our morality and integrity. But it is not. It is a signal that something is wrong in the body—an injury, or with chronic pain—the chronic fear of it.

I avoid taking rescue drugs when they aren’t absolutely necessary, which further compounds the “fear of pain.” It creates anxiety about what pills I can take, when, and how often. I wait until a migraine is so bad, it would be unreasonable not to medicate, but if I’d taken medicine at the onset, it never would’ve advanced and been easier to defeat. Excedrin has caffeine, so only take in the morning. Fioricet is a barbiturate, so don’t take before driving. Rizatriptan causes nausea so only take before bed. Zavzpret nasal spray tastes so bad, take it at least 30 minutes before lying down…

This constant mental maze increases the fear of pain because it is only when I’m in the most severe pain that I must navigate it. I figured one way to circumvent it is allowing myself to take whatever I wanted whenever I needed it. This turned into two-weeks of Rizatriptan every day. My neurologist would’ve had a stroke if he’d known. I got a prescription for tramadol, which does not cause rebound headaches, to hopefully break the pain cycle before using another migraine abortive. It got me through my week-long virtual residency with my Master’s program.

I confess, it was difficult to multi-task school with Pain Reprocessing Therapy. But what was effective, I suspect, is that I spent less time thinking about my migraines, while I got relief from tramadol and enjoyed the residency.

Now that it’s over, I’m revisiting some of the strategies. Avoidance, less stress and stimulation (less consumption of news), focusing on pleasant moments, facing uncertainty with the confidence of a stoned hippie, and constantly telling myself that I am safe.

Last night before we fell asleep, I told my 2-year old, “I know it sucks to go to bed now, but that’s ok. We’ll get up tomorrow and play again. For now, at least, we are safe.”

Stay tuned for PRT Part 2… →

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One afternoon after arguing about who should watch our baby and who gets time to themselves, I stomped up the stairs, sulking. I plopped down in my desk chair and googled, “why do men suck so bad?”

My search turned up a valuable result: An opinion essay from writer Darcy Lockman called, “What ‘Good’ Dads Get Away With” discusses how to-be parents expect they will coparent equally, vs. the reality once baby is born. This led me to her 2019 book, All The Rage: Mothers, Fathers, And The Myth of Equal Partnership.

In All The Rage, Lockman writes, “Mothers spent four times as many hours on child care as fathers in 1965, and only twice as many hours in 2010. Cross-nationally, between 1965 and 2003, men’s portion of unpaid family work went from under 20 percent to almost 35 percent, where of course it has remained ever since.”

Unpaid Labor

Let’s define unpaid family work: it’s everything that goes into running a home and a family. It’s the laundry—sorting, washing, drying, folding, putting away; meals— menu planning, grocery shopping, chopping, slicing, or preparing, cooking, then cleaning up—washing dishes, loading the dishwasher, putting dishes away; keeping inventory—shampoo, snacks, laundry detergent; diapers—changing them, packing and restocking the diaper bag; activities—researching after school sports or other programs, signing up, chauffeuring kids to soccer field or pottery class; vacations—researching and booking, then packing for kids and husband; researching pre-school/day care; getting kids fed and on the bus or driven to school; buying clothes and shoes for growing kids and husbands, the list goes on and I’m out of breath.

These tasks, and many more, constitute a tremendous amount of labor and none of it is paid. In our culture, domestic work is a woman’s job. Not only are women underpaid in the workplace, we are not paid at all in the home. But if it’s a mother’s job, why isn’t she paid?

I’m not here to argue women get paid to raise their families. What a socialist crazy idea! Though several European nations that do in the form of subsidized day care, pre-school, generous parental leave, affordable healthcare, etc. which allows mothers to pursue careers and manage childcare with less competition for time. In the US, we don’t have those subsidies and not every family can afford full time daycare. It is a dilemma because we cannot expect half of our population to work full time, manage a household, and take care of children, while the other half enjoys his downtime. Lockman writes, “Unlike housework, which goes down for women as paid work hours go up, mothers maintain their child care time almost regardless of their employment obligations They accomplish this by cutting back on leisure time, personal care, and sleep.”

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Thus, it’s up to parents to find an equitable way to address family needs, which might not always be “equal.” I keep track of my daughter’s clothes, shoes, seasonal items like swimsuits or coats, and when she needs new ones. Then I do the shopping and purchasing. My husband then washes and folds everything. Then it comes back to me to put everything away. We’ve never counted the hours each task takes, but we work in an equitable way to keep our kid dressed and clean. (Except when I don’t put the clothes away, which is almost never, and he becomes resentful of all his hard work wasted.)

Lockman writes, “The most recent time-use diary information collected by Pew Research and the Bureau of Labor Statistics consistently finds that women who work outside of the home shoulder 65% of childcare responsibilities, and their male partners 35%.” Not only is this not equal mathematically, but it’s not equitable because the study is predicated on fathers working outside of the home, too. My husband and I have never counted our hours of childcare, but we try our best to work in an equitable way to keep our household running. It’s when in-equitability cycles through, we become resentful.

Gender Roles For Parents

The current generation of fathers are more involved, but mothers still complain they don’t contribute enough to the home. If a couple is even loosely following traditional gender norms, not all of a mother’s labor is physical, rather much of the father’s is. Taking care of a family requires constant mental acuity, or what is called “emotional labor.” Scheduling doctors appointments and vaccines, writing shopping lists, signing permission slips, managing the whole family’s schedule, planning vacations, researching activities for kids outside the house, keeping inventory of dog food, and if there’s enough toilet paper in the house.

This mental, or emotional labor, is what drains many mothers because it is not shared labor. Even more infuriating, fathers are oblivious to the imbalance. The dog food and toilet paper magically appear, everyone gets their checkups and shots—what’s to notice? Everything is perfect. Also, fathers can be less reactive to children who are about to do something terribly dangerous or terribly messy because they are not in the same constant hyper-vigilance. When they take it upon themselves to “help” with some household chore, they ask their wives how to do it and then expect praise when it’s done—even if it’s not done well or correctly. We are supposed to be grateful.

An exception to the gender norms is same-sex couples with children. Because they are not dealing with a binary set of rules, these couples typically come to parenting with a more egalitarian approach. “‘…In the absence of sex differences telling us how to value various aspects of relationships, we can see how the division of labor might be explored in alternate ways.’”

In straight couples, fathers too often need repeated instruction. If a mother must instruct her partner in detail to, say, pack a diaper bag, she will often feel it’s easier to do it herself. Unfortunately this perpetuates the prophecy. Mothers equivocate, thinking at least he’s not as bad as so-and-so’s husband who doesn’t even take out the trash. Lockman, interviewing Shannon, a forty-two year old mother from Oklahoma City, writes, “My husband thinks he is supposed to bring home a check and do nothing else. He makes no bones about it. It’s not that bad. He doesn’t beat me. He doesn’t drink excessively…”

Lockman goes on to explain, “Given that there is always a nameless, faceless partner in the background whose laziness or inattentiveness is worse than your husband’s, women who appreciate their lives and their relationships feel reluctant to acknowledge their displeasure… Only when one feels more deprived than other members of her reference group will she feel entitled to adamant protest.”

Where Else Could You Get Away With This?

My husband and I share certain household duties. He does all the steps of laundry, including haranguing me to put my nicely folded clothes away, which, as you know, I ignore. I do (or intend to do) all the food shopping and cooking—or ordering. He cleans up the kitchen after dinner, puts the dishes in the dishwasher, hand washes pots and pans, wipes down the counters. Every morning I come down to a spotless kitchen to make our toddler’s breakfast. Like many other dads, he also takes full responsibility of the garbage and carrying heavy things I don’t want to wrestle with. He breaks down boxes, cleans the garage, and puts gas in my car. He is the breadwinner, bringing money in one door as I walk it out the other paying for grad school tuition.

My husband is a reservist naval officer. He went to the Naval Academy and served as an active duty officer for six years in Surface Warfare Operations (SWO). He has captured pirates and learned how to command cruisers (ships). Now, he is a director at Microsoft where he takes initiative, manages an entire team, pulls resources out of thin air. He gets shit done and he provides.

Until I read Rage, dinner time used to go like this:

Me: Dinner’s ready!

Me: Did you hear me?

Him: I’m in the bathroom!

Me: Can you set the table?

Him: Yeah. Typing on iPhone as he walks into kitchen and sits at the table.

Me: Can you get the highchair?

Him: Yeah, just a second.

Me: Can you please get the baby’s water cup and spoon?

Him: Complies.

US: Sit at table.

Me: Where are the napkins?

Him: Oh, I forgot.

Me: Gets up for napkins, exhausted from a long day on my feet.

Me: Sit back down.

Me: Oh my god, where are the knives?

Him: I didn’t think we needed them.

Me: Face palm, get up for the knife apparently only I need. Panting from all the ups and downs.

Me: Return to table, he has finished his dinner.

Baby: Squawking, throws noodle on dog, laughs.

Me: Takes first bite.

Him: Gets up to do the dishes.

Reading this book, I realized coparenting and cohabitating are two separate objectives. I talked it out with him and explained why I get so frustrated, even though he contributes in so many ways. I let him know that as a cohabitator, he’s excellent, perfect. I love that he’s my life partner and we get to share our lives. He’s a loving, engaged and interested father. In 22-months, he never missed a pediatrician appointment.

But as a coparent, we needed refinement. Using the dinner example, I asked him, “If you needed to be told the same instructions at work all day, every day, as if you’d never done them before, do you think you’d have the job you have now?” I saw the light bulb above his head flicker. “You’re right,” he said. So why are they like this at home if they aren’t at work?

Biological Myths

There’s a few reasons, and they are all the fault of our American culture.

First, we raise girls and boys differently starting in infancy. This goes without much explanation. Girls are groomed to be caretakers, with easy bake ovens, toy vacuum cleaners, dolls. We teach them to share their emotions and communicate. Boys are raised to be rough and tumble, to ram toy cars into walls and play war-themed video games. We do not teach boys effective coping skills, rather to eschew anything “girly,” like sharing feelings. Thus, they enter adulthood with profound anger and loneliness. In the US in 2022, the percentage of suicides by men was 80%. Though we have certain expectations of men, most notably that they are providers, masculinity is not clearly defined in our culture compared to femininity, which is why men prone to violence are are more likely to join extremist groups, like Incels.

Second, our culture believes in biological myths, like mothers make the best caregivers with their maternal instinct that men don’t possess. Lockman busts this myth writing, “Colloquially, we speak of maternal instinct, the presumably inborn, hardwired, and natural driver of the wisdom and devotion we ascribe to female parents alone. Biologists don’t use the term because it’s technically incorrect. By definition, an instinct is a behavior that does not have to be learned, shows almost no variation between members of its species and manifests in a rigid sequence of behaviors performed in response to a stimulus… [A]lmost every aspect of primate behavior is mediated by a larger and more developed brain.”

If you have given birth in the US, you probably had a birthing class, doula, midwife, or some other non-medical prenatal support. You were taught what to expect, how and when to react, like going to the hospital, or whether or not you want pain mediation. None of this is instinctual, rather our neocortex facilitates learning.

“In hunter-gatherer society of the !Kung San in Southern Africa, a woman gives birth alone, delivering the child into a small leaf-lined hole that she’s dug in the sand… In a Tanzanian tribe of hunter-gatherers called the Hadza, women give birth in huts, attended by their mothers and grandmothers.” These birthing traditions are radically different from Western ones. If mothering were instinctual, all women everywhere would know exactly what to do to give birth, and raise children without instruction.

Moreover, children of same-sex male couples do not wither away without a “maternal instinct” in the home, rather they grow up just like kids raised by straight parents. In 1970, a psychologist named Milton Kotelchuck said, “‘It did not seem reasonable that in a world where mothers often die in childbirth that we’d have a species where children can’t adapt to other people.”

Yet these fallacies persist through generations as if they are gospel. I suspect that by continuing to accept these impractical biological explanations, our culture tacitly agrees with the patriarchal status quo.

Entitlement

Fathers could take more initiative—especially when they see their partners drained, exhausted. Instead, they say things like, “Looks like you got this,” and walk away, they could step in without asking what to do or how to do it.

Darcy Lockman found a root of this discrepancy lies in the fact that men feel more entitled to and protective of their leisure time. Women, particularly working mothers (or students, like myself) don’t feel entitled to leisure time, though they need it. There is no impetus to change this imbalance because it would not be in men’s interest to do so. Lockman quotes a psychology experiment conducted by Tulane and University of California, Santa Barbara. The results indicated, “‘Elevated feelings of entitlement may… blind men to seeing when they are over benefited, allow them to justify their privileged position… In contrast, a depressed sense of entitlement among women may prevent them from seeing when they are targets of discrimination… In this way, gender differences in feelings of personal entitlement may serve to perpetuate and maintain gender inequality.’”

The question, of course, is, how do we fix it? Lockman calculates that it will be another 75 years before parity in relationships becomes a reality. It might be beneficial to change the conversations you’re having with your partner. Lockman doesn’t necessarily give an explicit “how-to” for readers, but in each chapter brings up different topics that might be specifically relatable to your relationship. Perhaps, your partner believes that he can’t do what you do because he doesn’t have a maternal instinct. Maybe you talk about that and not about how he’s oblivious, lazy or entitled (even if he is.)

My husband and I discussed the difference between co-living and co-parenting and that made a huge difference in how we communicate and operate in the home.

Lockman also suggests that part of the problem is that women do not feel empowered to ask for more from male partners, but this thinking prevents any opportunity for a father to improve coparenting skills. Instead it breeds further resentment among fathers who feel unappreciated for all that they actually do.

Men don’t need more privilege than they have, but they do need better emotional skills. Instilling confidence in men to be competent caretakers and fathers in addition to providers (yes, I know more emotional labor to explain to your partner how to do everything…) would prevent the complacent deference to mothers in the long term. Would this create an epidemic of kids going to school with mismatching shoes? Sure, but as long as they go to school with shoes, refinement can come later.

What If I Died?

I explained to my husband he is a great father, great man to live with, but then asked, “What if I DIED?” He should know exactly what to do in every situation, even though he isn’t responsible for every situation every day. I suspect that most men want to feel they are contributing, which feeds into their masculine ideal of providing. Most men I know strive to protect their families and would brag about excelling at fatherhood—and not in the half-assed way they currently think they are excelling. So what if all the mothers disappeared? Would they know what to do?

I suspect that they would figure it out.

This spoke to my husband and as a result, took on most of the responsibility for our daughter on the weekends so that I can write. We don’t argue about who gets time to themselves anymore because we both understand and agree that there is no time off from parenting. Instead, I take the lion share of childcare during the week, he does it on the weekends. If one day I wake up with a migraine, he will skip his morning workout and make our daughter’s breakfast. If he’s had an especially chaotic work day, I might cook dinner and clean up.

But, we don’t not deserve rest just because we are parents. I have a babysitter a few weekday afternoons, and on Sundays so my husband can watch NFL games, and I can work or take a breather myself. This is not equal, it is equitable, but it saves at least one argument a week about who is more deserving of time. Since he works full time and parents, and I parent full time and study, we both get what we need—as much a any coparenting couple can with a two-year-old.

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I have chronic daily migraine, which means exactly what it sounds like. Every day, I have a migraine. Alternatively, many people get infrequent, but severe episodic migraines. I also get severe episodic migraines, but at least the ones in between are not completely debilitating. I have gone through periods of success with prophylactic medicine, like Topamax, which I stopped because the side effects were too intense, and Emgality, a monthly injection that worked for a while, and then—didn’t. All the others, Botox, amitriptyline, Reglan, cyproheptadine, and whatever else I’ve forgotten didn’t work at all. Pregnancy and nursing offered unexpected relief for about eighteen months, but as soon as my daughter weaned last March, the migraines came back with a fury, as if to make up for lost time.

Before getting pregnant, my daily migraines were low-grade, maybe a 4-6 on a scale of 1-10, but now they’ve intensified. After all the hormonal and bodily changes following pregnancy, my old ways of coping are not working. I went to see a new neurologist, Dr. Dario Zagar, who has the most holistic approach to addressing chronic migraine that I’ve ever experienced (I’m medically promiscuous, so I know.) He prescribed new medicines to try, a newly released non-medical device called Nerivio (I’m skeptical), and he encouraged me to read The Way Out by Alan Gordon, LCSW, which professes chronic pain can be managed by retraining the brain. There is much buzz surrounding his book.

The Way Out

Alan Gordon is the founder and director of the Pain Psychology Center and author of the book The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain. Gordon is not a medical doctor, but he has dedicated his career to curing chronic pain, and has many more than nine hours of education on the matter. The premise of his book is that there is a mind-body connection that affects how the body experiences pain. No, this is not some kind of snake oil with weird supplements or unproven eastern medicine.

Gordon emphasizes that there are two kinds of pain. There’s the kind that you get when you sprain your ankle or get a cut. That pain indicates injury and healing and should go away in a reasonable amount of time depending on the injury. Chronic pain, or what Gordon calls “Neuroplastic pain,” is pain caused by the brain incorrectly sending pain signals to the body repeatedly until it becomes chronic. These misrouted signals are the product of fear, particularly the fear of pain, which becomes a loop.

In our culture, we experience a great deal of fear and anxiety at work, in the news, on our phones. According to Gordon’s premise, this constant hyper-vigilance can cause chronic pain in some people where there is no injury or biological explanation. For them, the brain is going haywire from all of the stressful input and sends danger signals to the body and is executed as pain. Even for patients who have a bulging disc in their spine, or pain from an old injury that won’t quit, it’s often not the cause of the pain. After all, many people have wear and tear on their bodies, including bulging discs, and don’t have chronic pain, but our culture is so indexed on finding tangible explanations for pain, that we prescribe all variations of solutions, cortisone shots, nerve blockers, anti-epilepsy drugs. According to The Way Out, the average patient suffering from chronic pain is unsuccessfully treated for ten years. Regardless of your position on the premise of this book, obviously what medicine is doing for chronic pain sufferers is not working.

Pain Reprocessing

Gordon’s solution, Pain Reprocessing Therapy (PRT), involves techniques that reframe thinking so that the brain can stop being constantly overstimulated, and to know that it is safe even when it is. Gordon and his team conducted a study to prove that his PRT theory using these techniques can cure people of their chronic pain using. You can read the study here.

PRT involves:

• Practicing somatic tracking: acknowledging pain when it is happening without bias, i.e. without thinking, “Oh God, this is miserable, why won’t it go away!” Instead paying attention to the specific sensations and locations of the pain and how it might change. Simple awareness, that’s it (to start).

• Avoidance behaviors: don’t push through the pain. If you have back pain and it hurts to sit, don’t force yourself to drive long distances without breaks.

• Sending messages of safety: reassuring yourself you are safe even when the brain is sending danger signals (like anxiety, frustration, anger, fear). You can say to yourself, “You are safe, brain, we’re ok.”

• Reducing overstimulation: probably the hardest and most important, finding ways to reduce the inundation of stressors every day.

• Avoiding feeling trapped: don’t put yourself in a position where you cannot deal with pain if it happens, for instance book an aisle seat on an airplane if you think you might need to get up and walk around.

• Handling uncertainty: don’t let the brain become too worked up when uncertainty occurs, reassure yourself that even if you are running late or missed a deadline, you will be ok.

• Catching your fears: catch yourself worrying about things in the moment before they have a chance to overwhelm. If you are running late, don’t catastrophize to the point that your entire life will be damaged. Remind your brain it is safe.

• Embracing positive sensations: make a point to acknowledge good feelings, like warm sun on your face, or how nice it feels to stretch in the morning.

These techniques are intended to create good new habits that create positive associations even when you’re in pain so that the brain doesn’t always consider pain a dangerous circumstance. These habits are intended to create new neural pathways so the brain can stop sending false alarm signals to pain receptors which cause pain despite a lack of injury. In my case, I’ve had migraines for most of my life, since childhood, and are not the result of any kind of accident or head trauma. Thus, it would seem I’m a good candidate for Nueroplastic pain and trying PRT.

Normally, I’d be skeptical, but since a medical doctor I admire “prescribed” this reading not long after another one of my medical providers mentioned it, I decided to give it a chance.

No Risk

If it doesn’t cure my migraines, none of the aforementioned techniques will be bad new habits to acquire. If I’m successful at implementing them, perhaps I’ll see improvement in my depression and anxiety, at the root of which, are always ruminating, negative thought patterns. It’s a no risk therapy, since there’s no cost (I borrowed the book from the library), no medicine, no side effects, no doctors appointments, no copays, no insurance pre-authorization: it is up to me to literally change my thinking patterns.

Subscribe to follow along on my journey as I track my pain days, how I cope, and how I implement the PRT techniques. I’ll be updating this series every week or so to let you know how I’m doing, if there are any improvements or relapses and how I generally feel about this therapy. If you have pain too, you can try it with me (but I recommend reading his book, as this synopsis is not enough to get you started.)

Stay tuned for PRT: Week 1…

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Netflix recently released their four-part miniseries adapted from Anthony Doerr’s novel, All The Light We Cannot See. No one in my literary circle is talking about this which blows my mind, because one: it couldn’t be more relevant today and two: it’s a gorgeous show, capturing the detailed imagery from Doerr’s descriptions, and powerful acting by perfectly cast actors.

This is one of the few novels that changed me as a writer with Doerr’s poetic language and unusual chronological structure. It made me think differently about how some stories should be told and how to conjure empathy for unexpected characters by creating impossible moral dilemmas.

This miniseries indexes on the last years of WW2 from the fall of Paris and German invasion until the Americans landed on the beaches of Normandy in northern France in 1944. This is not a Holocaust story, rather a committed WW2 story. Instead of focusing on the pain and suffering of Jews, this show materializes the incredible terror of an authoritarian dictatorship, a threat lurking for all of democracy today. Both the book and novel teach us lessons about how to treat others, including enemies, and the real human cost of radicalism.

Synopsis of All The Light We Cannot See

Both the novel and the show are crafted with a braided narrative that follows our two young heroes, Marie-Laure, who is blind and Werner, an orphan and student at a Nazi boarding school. Just as the Germans begin invading Paris, Marie-Laure and her father, Daniel, flee to the home of an uncle, Etienne, and his loyal maid, Madame Manec in Saint-Malo, a small seaside hamlet in northern France. Soon, Marie-Laure is stranded after her father—and constant companion—is arrested by the Nazis.

When Marie-Laure is a child, her father painstakingly creates a miniature model of Paris. She memorizes the streets and buildings to navigate the city alone. Daniel makes another one when they move to Saint-Malo. There is a radio at her uncle Etienne’s, which she learns how to operate. Every night she broadcasts on radio channel 1310, a risk and Daniel know she is safe and waiting for him.

Marie-Laure, now 18, reads Braille navigates without vision, without light, two skills that prove invaluable as the Germans hunt for her, the mysterious girl on the radio.

When we first meet Werner, he is a boy in a German coal mining town, living with his sister, Jutta, at an orphanage run by a benevolent French woman, Frau Elena. As a teenager, Werner gains a reputation as a genius radio repairman around town. After fixing the seemingly unfixable radio of a German officer, Werner is recruited to the National Political Institute of Education at Schulpforta, a Nazi military boarding school.

At first, he is excited to be accepted to an elite school. He looks forward to a future with security so he can take care of Jutta and the orphans at Frau Elena’s. He soon realizes that the Nazi culture he has folded into contradicts his compassionate nature. Unfortunately, he lacks the confidence to resist inhumane commands, to confront the violent bullying of his best friend, Fredde, or his fantasy of running away. Yet, we know he is good as he we watch him gradually fall in love with Marie over the radio.

As the story progresses, Etienne and Maurie-Laure take on a daunting responsibility. After all the radios in France had been confiscated by the Germans, Etienne saved one in the attic of his six-story Chateaux, which he later used to transmit secret, illegal messages across Europe. Since Etienne is crippled by debilitating agoraphobia, the two devise a plan where Maurie-Laure walks her memorized path to the bakery and asks for an “ordinary loaf,” in which a tiny scroll of paper with a message is baked.

Most of the messages contain series of coded numbers that Etienne transmits in the evening, followed by a few minutes of classical music for levity. One day, they received an ironically confusing message that read: “’Monsieur Droguet wants his daughter in Saint-Coulomb to know that he is recovering well.’… ‘What does it mean?’ Marie-Laure removes her knapsack and reaches inside and tears off a hunk of bread. She says, ‘I think it means that Monsieur Droguet wants his daughter to know that he is all right’” (346). 

Eventually, Etienne, too, is imprisoned by the Germans and Marie-Laure is left alone. When she can no longer retrieve and transmit messages from the bakery, she begins reading Twenty Thousand Leagues Under The Sea each evening from a book written in Braille over the radio. Werner, who secretly tuned into her evening readings was tasked with locating the rogue transmitter and killing the girl. He pretended not to locate it, and it was this connection that saved her life upon their chance meeting for just a single day.

There are some major changes to the miniseries from the novel, but I found them immaterial as the show maintains the same narrative arc overall, and conveys the book’s intent.

Just like the novel, the show is beautiful. Mark Ruffalo plays Daniel, a devoted and sweet father who enables a world that his daughter can easily maneuver. Hugh Laurie, aka House, plays Etienne, a serious, and mysterious man who has a remarkable character arc. And finally, the part of Marie-Laure is played by Aria Mia Loberti, a debut actor who is blind, herself. The film industry is gradually casting disabled characters with similarly disabled actors, which opens opportunities to those in our society who have been callously forsaken, particularly in the arts.

Enjoying All The Light We Cannot See

There are so many reasons one could point out that make this a “great book,” but I argue that there are three specific variables that differentiate it from one of the many historical novels about WW2.

First, the story alternates between these two protagonists one short chapter at a time. In masterful elegance, the author carries the narrative along in a non-linear timeline: past to future, to the past, to the future, until the past—moving forward—and the future—moving backwards—meet somewhere in the third quarter of the book at the present, and Marie-Laure and Werner’s lives intertwine, albeit briefly. Constantly switching back and forth can be a challenge for even the most sophisticated writers, causing unnecessary confusion and distraction for readers. The miniseries also uses the non-linear chronology. Both the author and the director, Shawn Levy, established characters with pasts, present, and futures so concrete, real people with real lives, the jumps in chronology always make sense. In fact, there’s no better way to arrange this story.

Second, is simply the writing. Doerr’s prose is beautifully lyrical and poetic. In a particularly omniscient passage, Doerr writes: 

“We all come into existence as a single cell, smaller than a speck of dust. Much smaller. Divide. Multiply. Add and subtract. Matter changes hands, atoms flow in and out, molecules pivot, proteins stitch together, mitochondria send out their oxidative dictates; we begin as a microscopic electrical swarm. The lungs the brain the heart. Forty weeks later, six trillion cells get crushed in the vise of our mother’s birth canal and we howl. Then the world starts in on us” (468).

In this quote, Doerr describes a biological event, using scientific language in a way that reads like poetry; not a science textbook. It is relevant to note that both Marie-Laure, who is fascinated by sea-life, later becomes a well-known scientist working at the museum where her father had been a custodian before fleeing Paris. Werner, himself, is a highly regarded engineer, who is later placed in the Wehrmacht, tracking enemy signals. This lyrical description of conception is the perfect complement to the characters’ interests in science.

Third, of many possible reasons to love All The Light We Cannot See is the unbiased reference to Nazi propaganda from a first hand source. When we read contemporary novels about WW2, they posit Nazis as a single entity, “The Nazis.” In ATLWCS, the Nazi “marketing strategy” is told from a perspective of fear and contrarianism in literature. It’s not often that we read about a sensitive protagonist, like Werner, who was coerced into being a Nazi. It reminds readers that the Nazis were comprised of people, some downright sadistic whose only goal in life was to destroy the lives of innocent civilians; and then Werner, a quiet boy with great talent, fearful of authority, a hero, but still—a Nazi.

Doerr describes Werner in class with the following dialogue:

“In technical sciences, Dr. Hauptmann introduces the laws of thermodynamics. ‘Entropy, who can say what that is?’

            The boys hunch over their desks. No one raises a hand. Hauptmann stalks the rows. Werner tries not to twitch a single muscle.

            ‘Pfennig.’ [Werner]

            ‘Entropy is the degree of randomness or disorder in a system, Doctor.’

            His eyes fix on Werner’s for a heartbeat, a glance both warm and chilling. ‘Disorder. You hear the commandant say it. You hear your bunk masters say it. There must be order. Life is chaos, gentlemen. And what we represent is an ordering to that chaos. Even down to the genes. We are ordering the evolution of the species. Winnowing out the inferior, the unruly, the chaff. This is the great project of the Reich, the greatest project human beings have ever embarked upon’” (240). 

Empathy For Unexpected Characters

This simple interchange, which clearly emphasizes the Nazi obsession with genocide in unrelated context, creates a counter-narrative to Marie-Laure. It also creates unexpected sympathy for Werner by showing the complexity of a disadvantaged boy who didn’t agree with the Nazis’ cruelty, but was also—for a time—freed by his Nazi “adoption.” By exposing the reader to Werner’s environment, we can empathize with him. He was manipulated to be a Nazi and we feel sorry for him. Then he follows Nazi commands that go against most readers’ worldview and we hate him for it. Then he saves our brave, committed, and blind heroine. She, too, saves him, and he is able to face his future.

If you are looking for a great show to binge this holiday week—or book to get immersed in—look no further than Netflix or the original novel. Get yourself a snack, some tea, or a glass of bubbly and settle in.

Have you read or watched All The Light We Cannot See? Leave a comment and let me know what you think.

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Ann started this novel as a short story while she was a cuentista student at the Vermont College of Fine Arts. She continued working on it over years until it became the Great Latin-American Novel. After earning her MFA, Ann worked at VCFA as director or recruitment, when I was lucky to have met her, and left recently to write full time. (Congrats, Ann, you’ve done the thing!)

Fear not, TSD is not spine-tingling horror of the likes of Shirley Jackson, though it is magical realism. Set in 1970’s New Jersey and Puerto Rico, our protagonist, Isla is haunted constantly by omnipresent tales transmitted to her as dioramic visions. They come at specific times of the day, every day. The visions appear when a relative dies and finally shares their secret. For instance, she learns her great uncle, Tío Ramon, had been mayor for one month, as she suddenly finds herself superimposed on a street lined with cars from the 30’s. Her smooth skinned, young uncle passes by on a parade truck, waving to the townspeople dressed in early 20th century garb. Once it’s over, she returns to the current place and time.

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This isn’t so much a curse, as a gift, if the the recipient knows how to deal with the constant barrage of life stories. The deceased elders want to ensure their lives are understood. No one in the Sanchez family talks about the visions they, too, see, or how they manage them, because if they did, too many family secrets would be unearthed. Thus, cuentistas are burdened by their ancestor’s pasts. Isla’s mother, Elena, so bombarded by the visions turns to alcohol to escape them.

Isla finds that by writing each story in her notebook, the visions stop. If her version of the story isn’t right, she’ll keep seeing it until she notices the detail she is missing and corrects the narrative. Except for one—the story of her great grandfather’s death, seen from a dangerous dimension.

The book takes us on a massive treasure hunt, story by story, vision by vision, to discover how her great-grandfather really died, a secret so scandalous no Sanchez will talk about it. Besides, no one knows the truth, except for one. And she’s dead.

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Isla travels to PR every summer from New Jersey to stay with her Tía Alma, oblivious of her privilege as a white gringa of wealthy European Spanish ancestry. While Isla is young, it is understandable that she would not notice the chasm between her world and that of native islanders, after all, her lifestyle doesn’t change much from her school year in New Jersey. Talking with Claridad, a local, she denies being from a rich family.

“Oh, we’re not rich! I’m—

Claridad slammed down the bottle of cleaner and the rag and looked at me with fiery eyes. “Those shoes, are they new?”

I looked down at my Reeboks, confused. “Yes, but—”

“Does your family live in a nice house? New car? Do you go out to dinner?”

“Well, yes, but I don’t see—”

“Have you ever seen anyone in your family clean a toilet?”

I stuttered at this seemingly ridiculous question, but then I stopped and thought about it. Once a week, I’d come home and the house smelled like ammonia and the bathroom was sparkling, the toilet water turned a magical blue.

This is the first moment she begins to recognize the racial caste system, unspoken by only the elite. It is ironic that such a proudly bigoted and self-righteous family would be so tight-lipped about discussing it, but secrecy is their best talent.

Dávila uses a naïve young character to represent uneducated readers unaware of the systemic racism and oppression in Puerto Rico due to the Spanish colonization, and American occupation after the Spanish-American War. Americans wonder why Puerto Rico doesn’t want statehood. But without the historical context, one wouldn’t know that hundreds of years of subjugation and slavery by outside governments and disallowed their own sovereignty, would make anyone wary of electing to be under the rule of an aforementioned government.

Earlier in the story, Isla finds herself at a rally for Puerto Rican independence, something she knows nothing about. She is drawn to it by the “crowd in the street moved like one being, rising and falling and waving their arms. The parade was a creature all its own, a boisterous, showy animal with a loud heartbeat.” As she enjoys what she perceives a celebration, she is spotted by a friend, José

“You shouldn’t be out here,” he said in the same loud whisper my aunt had employed to say the same thing.

“Why?” I hated how little my voice sounded, but my throat was tight.

“Because this doesn’t concern you.”

I felt the heat rise to my face with his patronizing tone. “Yes, it does! My family—”

“Your family are probably PNP, Isla".”

I looked at him blankly.

He rolled his eyes and looked like someone else entirely. “Pro-statehood, right?”

I hated ever more that he was right… Why hadn’t I ever inquired about the island’s politics before? What as the PNP, and why was there the assumption that I would blindly follow?

What I appreciated so much about this book is that while it was an enjoyable escape, the sensory details of Puerto Rican flora, food, and coming of age, it was also so very relevant to today’s politics.

American’s grapple with a racial hierarchy every day, while we have barely acknowledged the damage of our own colonization. Native Americans, exposed to a near genocide, live today in poverty and violence. Black Americans are killed every day by the very police institution that was created in the 18th century to do just that. Anti-Asian sentiment has risen since Covid-19, meanwhile if the average American knows anything about Japanese internment, I’d be surprised. Anti-Muslim sentiment comes in cycles, particularly after the War in Iraq, while pro-Hamas organizations are recreating an atrocious war on Jews. All of these nightmares are oozing out of the open wound of forceful colonization and exploitation.

Davila brings us a beautiful story of love, mystery, death, ghosts, family, self-discovery, and important history in this poetic literary escape. The novel implies empathy and understanding for undervalued peoples without the pendantics employed by other authors.

Ann says she has been writing this book for her whole life. I suspect even though The Storyteller’s Death has been typed up and published, this cuentista is still writing this story.

Buy The Storyteller’s Death here