I work with a patient who is a marathon runner. One session, he was talking about the ways running has helped him move through difficult times in his life – divorce, the death of his parents, and other painful experiences. He described the process of running as enlivening – once he gets into a flow state, any intrusive thoughts melt away, and he feels light, focused on the road in front of him. We explored the many strengths in his ability to challenge himself in this way, including his vigor, endurance, and persistence.

Two weeks after our discussion about marathons he limped into my office, crutches and ankle brace distracting from his customary sharp attire. The hairline fracture to his ankle meant that he needed to stay off his feet for weeks to allow his body to heal. My vivacious marathoner all of a sudden looked diminutive and defeated. “What am I going to do?” he implored, looking at me with terror in his eyes.

It was this moment wherein I had a realization: running can be a great coping mechanism, but as with most things, there is a duality – on the other side of strength is struggle – when we over-rely upon one means of coping it can become brittle and no longer effective, at times to the extent of becoming harmful. In this manner, while running provided positive benefits, it also served as a mechanism of avoidance of the struggles in my patient’s life. In pushing his physical body to its limit he was distancing himself from his insides and emotional pain. His body might be as strong as the Hulk but his emotional self was crying for attention and care.

My patient was empty of empathy for himself. Slowing down and sitting with his thoughts and feelings felt more painful than any physical pain he had ever experienced. And so slowly, we mapped out a new path forward together wherein he could open to himself. Small steps instead of sprints would allow him to breathe into the moment and be present with whatever was coming up.

Months after his injury, healed and ambulating easily, my patient paused in session, a pensive look on his face. He shared that while inconvenient and painful, his injury ended up being a gift of sorts. Without his injury, he stated, he would have kept running, not even aware that he was running away from himself. He marveled at how he has been allowing himself to heal emotionally for the first time in his life. While he’ll keep moving forward on the uncertain path in front of him, he now has his full self – inner and outer – to help him navigate it. There’s nothing stronger than that.

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