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My Gifted, Shaky Hands

Living fully with an essential tremor.

Key points

  • Essential tremor affects millions of people and can be embarrassing at times.
  • Essential tremor is often idiopathic, without a known cause, and can be hard to treat.
  • Essential tremor need not define a person. Your hands are still wonderful.
istock credit acyerth5
Beautiful Hands
Source: istock credit acyerth5

By guest contributor Stuart Kamenetsky

My name is Stuart. I’m a 57-year-old white male and I live in Toronto, Canada. I am tall and have dark hair. I’m married and I have three adult children. I work as a Professor of Psychology at the University of Toronto.

But there’s something else I’d like you to know about me:

My hands shake.

Essential Tremor

I don’t have Parkinson’s Disease but my hands, nevertheless, shake. When someone passes me a soft disposable plastic cup I have a hard time grabbing it. Since I cannot get a sturdy grip, my hands shake with the cup, and I spill its contents. It’s embarrassing.

During the first class presentation I had to make as a university student, my hands shook so hard that my notes fell on the floor. It was humiliating. I had to ask for permission to deliver my presentation sitting down. I put my notes in front of me and kept my hands under the table and got through it.

Psychology and Shaky Hands

Throughout my life, people have asked me, “What’s wrong with you? Your hands shake like an old man.” When I was young, I was offended, as being old is not considered to be a good thing when you are young, but as I get older my shaky hands increasingly fit the old man stereotype, so it does not bother me as much.

Does this all sound awful? Am I sick? Disabled? Diseased? Do I need medication? Surgery? A cure? Perhaps I do. But let me share with you how wonderful my hands are, too.

These hands gently held my children when they were young, with love and affection. They play Beethoven Piano Sonatas and they fix cars. They even enabled me to ride the 469-mile long Blue Ridge Parkway on a motorcycle. And right now I am using them to type this article. Yes, they shake at times and frustrate and embarrass me, yet I owe them so much!

Modern medicine came up with the term “Essential Tremor” for this condition. The APA Dictionary of Psychology defines this as the:

“trembling of the hands, head, or voice that appears to be hereditary. It is the most common type of movement disorder and is thought to be a benign condition, although its etiology and neurological substrates remain unclear.”

Millions are affected, and, according to the Cleveland Clinic, it is sometimes caused or worsened by the consumption of alcohol or nicotine, by side effects of medications, as well as by low blood sugar, thyroid problems, Multiple Sclerosis, and other medical conditions. It can also be idiopathic, with no known cause. Sometimes there's no cure, especially if the cause is unknown, but treatment can improve one’s quality of life through symptom relief. Drug therapy with Beta-blockers is available (but not without side effects) as are surgical procedures for individuals whose Essential Tremor is debilitating.

Fortunately, I don’t have any of these risk factors and, as such, the cause of my essential tremor remains unclear. My tremor is not debilitating, so surgery is not for me, and, in general, I prefer leaving medication as a last resort.

Healthy Advice

If you are among the millions of Americans who have an essential tremor I would like to offer you a few strategies that might make your prized hands easier to handle:

  • First and foremost, own this “condition.” Your shaky hands are part of you and who you are. Others may have hands that shake less or don’t shake at all, but perhaps their hands are not as capable or versatile as yours are. It's up to you whether you accept your hands the way they are or see them as neuropathology, requiring medical treatment. I highly recommend trying the first option first.
  • Start with the basics: Be aware of the impact certain substances have on your tremors and accordingly reduce or avoid alcohol and/or caffeinated drinks, especially before socially threatening situations. Make sure not to cut back on sleep and relaxation. See your family physician for annual checkups.
  • In many cases, tremors worsen with emotional stress. Do your best to reduce stress and confrontation as well as anxiety-provoking situations, especially if they showcase your shaky hands. I’m not suggesting, of course, that you avoid anything uncomfortable. I developed a public speaking career and my hands stop shaking once I feel comfortable with the group I’m speaking to. I had to do this in order to teach! But for the most part, I don’t play the piano in front of others. Perhaps one day I’ll overcome this, too, but if not, that will be okay!
  • Share your “condition” with people around you. You’ll be surprised at how happy they may be to accommodate you. If they aren’t, maybe it’s time to look for a more accepting crowd. When I fly, I often tell the flight attendant that I have shaky hands and kindly request that he place my beverage on my tray instead of handing it to me. At social engagements, I may ask my host whether we can sit at a table rather than on a sofa and have my coffee served in a large, sturdy mug filled only halfway. The answer is always very positive and often leads to a more open and meaningful conversation. I must admit that being older helps build confidence in making such requests, but looking back I wish I had been less worried and more forthcoming about my “condition” when I was younger.

I have to admit that sometimes I still get frustrated and wish that the tremors would just go away. There will be those times that, regardless of what I do, I’ll find myself in an awkward and embarrassing situation because my hands just won’t stop moving. I then remind myself that I’m not alone, as there are so many others who have shaky hands just like mine.

Fortunately, we live in a time and place where people tend to be more accepting of differences and imperfections than ever before.

My essential tremor has no known cause nor a cure and is just part of who I am. Experience has shown me that the more I internalize and accept this, the more relaxed I feel and the less my gifted hands shake!

Stuart B. Kamenetsky is a professor in the Department of Psychology, University of Toronto Mississauga. Correspondence about this article can be sent to: