Hunched over, Sally sits on the sheet-covered folding table in the medical tent. She has just completed the Toronto Marathon on a cold, wet, windy day.

As a member of the Psyching Team for the event [see  and for descriptions of the Psyching Team], I stand to one side, observing as the nurse takes initial medical information and checks Sally's vital signs. The nurse then stands by Sally's side, rubbing her back. My sense is that the nurse is not medically concerned about Sally.

Confirming this differentiation, the nurse moves away as I come over to talk with Sally. Our non-verbal dance says it all: Mind-body territory.

Sally is feeling alarmingly uncomfortable. She's not sure if she's queasy or if she has pain in her stomach. In her next sentence, she mentions that her boyfriend's mother had a heart attack two days ago....The implication: am I now experiencing a heart attack?

I'm relieved we're in a medical facility, temporary though it is. Sally is very worried, for sure. Yet triage has reassured me that this is not a medical event.

Sally looks pretty miserable. There's a pallor to her face; her lower arms are rigid, her hands curled as if in spasm.

I ask Sally if she would be more comfortable lying down. She stretches out, moving her body with surprising ease given her just-completed 26.2 mile run. Nathan, her boyfriend, has been standing quietly by her side. He too has completed the marathon. He seems calm-a solid presence. He says that Sally has been stressed: She hasn't been sleeping well, she hasn't been hungry for the past couple of days. It seems apparent to us all that stress-a combination of concern about Nathan's mother, fatigue, the stress of anticipating and then running a first marathon, with all the physiological and psychological depletion that it includes-is the problem.

But why are Sally's hands so rigid? That's what she's focused on now.

I choose my favorite immediate stress-buster method: diaphragmatic breathing [see and for descriptions of diaphragmatic breathing]. In this somewhat busy medical tent, Sally, Nathan, and I have created a bubble of privacy. I speak with her quietly, asking her to just focus on her breathing. I encourage her to slow her breathing down. I can see her abdomen expanding as she inhales and contracting as she exhales. I am confident that this re-balancing of oxygen and carbon dioxide will do their magic.

We have plenty of time, I tell Sally. There's no hurry. Just breathe. I add in the suggestion that she say "Calm" to herself with each exhalation.

We do very little talking, either about the race itself or the stressors in her life. With someone else, that might be the best direction to go. With Sally, I am working on the assumption that if she can re-connect to her body, her internal resources and external supports will be available to her.

Color begins to return to Sally's face. She appears less tense. Her arms have even moved to her sides-though her hands are still curled.

I do some progressive relaxation with Sally. Typically, I start with people's hands, encouraging them to tighten, hold, and then release, and then move to that same sequence from head to toe. This time, the hands will be the last muscle group we tackle. I start, instead with Sally's legs: they've been through a lot, but she seems easily able to tighten and release various muscle groups. Finally we return to her upper body. She tightens and releases her shoulders, biceps, full arms-and then...her hands.

And her hands do unfurl.

As she lies there, tightening and releasing various muscle groups, we talk a bit about stress and the ways that it can manifest itself in one's body. With all that's been going on with her, I comment, isn't it amazing that ultimately it was her hands that took on the burden of carrying all her stress?! Sally smiles. She's very willing, at my suggestion, to thank her hands for their hard work. (The initial stomach discomfort and fleeting heart attack worries have long since disappeared.)

I talk a bit with Sally-and Nathan-about the mind-body connection, the ways in which our bodies and minds are so intrinsically involved. The mental and physical stressors Sally experienced showed up in this concentrated form of tension in her hands. The process of letting go occurred through calming her mind and body. If this were a clinical situation, I would go on to explore more of Sally's thoughts, Nathan's coping, their strengths as a couple. I would encourage them (after some recovery time!) to use running as a stress management tool. For now, though, Sally is sitting up, happily touching the hard-earned medal draped around her neck. She's getting ready to get on with her life. I wish them well.


May is Mental Health Month. This vignette (masked to protect the privacy of "Sally" and "Nathan", of course) is intended to celebrate the powerful interaction between our mind and body. Mental health affects everything we do, all aspects of our lives. How are you celebrating Mental Health Month? Today is the American Psychological Association's "blog party." Read all about it @

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