Verified by 
Few things in the world are more powerful than a positive push. A smile. A world of optimism and hope. A 'you can do it' when things are tough.
Few things in the world are more powerful than a positive push. A smile. A world of optimism and hope. A 'you can do it' when things are tough.
Richard M. DeVos
Richard M. DeVos, Sr. may have a lot of reasons to smile but what he says is still true. Mr. DeVos is an American businessman, co-founder of Amway along with Jay Van Andel, and the former owner of the Orlando Magic NBA basketball team. In 2012, Forbes magazine listed him as the 60th wealthiest person in the United States.
This past week I discovered how affirming the power of a smile can be. Monday was my first day back at work after having spent three weeks at The Cleveland Clinic’s IMATCH (Interdisciplinary Method for Assessment and Treatment of Chronic Headaches) program being treated for my severe and chronic migraines. I’ve had migraines for seventeen years, but they started getting more frequent and intense when I took a job near where I grew up and where my father still lived. I began doing his grocery shopping for him and having to interact with him whereas prior, I had minimal contact with him. These frequent exchanges with Dad raised a plethora of issues from my childhood which I chose to shove into my unconscious and the emotional pain erupted in physical pain in the form of migraines.
Five years later, in the spring of 2013, my father had just passed away which brought up a whole new set of problems. I was still at the same job, but missing a lot of time due to the migraines. Either I’d go into work and try to tough it out, but end up leaving early, or I would call in sick from the emergency room where I’d gone to try to get some relief. My office — and my apartment — had become virtual caves, with the blinds drawn and only one lamp lit due to necessity.
At work, there were some days that I’d shut my office door, putting my head down on my desk and cry from the pain. I’d try to get through the migraine, telling myself that I couldn’t leave yet again. Hours would go by and I wouldn’t emerge from my office and my work wouldn’t get done. Finally I would have to come out. I hate to think about the expression that must have been on my face — for the last I don’t know how many years.
When I walked into the office after three weeks in Cleveland I was aware that I was standing taller and straighter (thanks in part to physical therapy and in part to simply feeling better), and I was conscious of the grin that I couldn’t keep off my face. It was good to be back home and back at work (I had gotten a little homesick toward the end of my stay), but mostly it was an incredible relief not to be in so much pain.
“It’s great to see you smiling again.”
Every colleague that greeted me said that as a reaction to my expression. They asked me how I was feeling to which I replied “terrific,” and as I verbalized those words, a vast smile spread across my face. I couldn’t help it. It just felt fantastic to feel good and I felt compelled to let everyone know in response to their questions.
This experience has got me thinking about my patients. I know they are hurting, but as I walked around with an off-putting expression, then that is what they (and I did) will get in return and that feedback will exacerbate the negativity they already are experiencing internally.
One of Marsha Linehan’s tenets in DBT is “Act Opposite.” When I felt like doing anything self-destructive from cutting to skipping a meal, I was supposed to act opposite and persist in engaging in a positive behavior.
Smiling is no different. Instead of moving through the day with a frown or scowl, the first step would be for the patient to become aware of the expression on his or her face. Once that process has come to fruition, the next step would be to smile. It may feel unnatural at first or forced but smiling would come to be more comfortable over time. And the reactions that the patient receives from others would reinforce the hard work that it takes to cement the change.
My patients are aware of the circumstances under which I took my leave of absence. I’m going to tell them about the reactions I got from others when I started smiling and kept smiling.
The doctors and nurses at IMATCH impressed on us from Day One, that we were not to show any pain behavior; if they saw us rubbing our temples or grimacing they would point it out to us and expect us to stop. That practice is serving me well at work as everyone believes I’ve been pain-free this whole week — which I haven’t.
I keep hearing my co-worker’s words reverberating inside my head. “It’s great to see you smiling again.” And that makes me smile. :-)
