By Emily Schottman, OD, FCOVD, MA, LPC [Warning: Many visual puns ahead!] I started my counseling program as a bald-headed, chemo-brained Optometrist looking to fulfill my dreams from a business plan I had written twenty years earlier that said when I turned forty, I would return to graduate school in Psychology. People often asked me “What made you become an Optometrist?” but rarely do they ask why I became a Counselor. This change to my professional life began auspiciously when I was told I could not enroll in an eye movement training unless I was a mental health care provider. My younger self told the thirty-nine year old cancer survivor version of me, with time on my hands and fearlessness on my side, that this obstacle was an opportunity to expand my “vision” and control my destiny.
I define “vision” as the eye-brain-body connections that allow us to collect information and make meaning of our lives. Our eyes are intimately connected to over 80% of our brain input and processing and they are the only part of our brain that we can move around! In fact, your eyes do not tell your brain what to see, it is your brain that tells your eyes where to look (1). When we look and understand visual information (ranging from our smart phones to our partner’s faces), we want to know that what we are seeing is accurate and in sync with the world around us.
My journey from eye doctor to counselor began with a cancer diagnosis in 2010. It was a stand still, shocking moment that did not seem real. My vision tunneled and I became hyper fixated on survival. My world collapsed from sharp-focused business owner, mom and wife to a two year limbo state in which I had no predictability or relief from ongoing stress and anxiety. It became difficult to know if what I was perceiving was accurate or had meaning. My treatment was successful. My health was good, but I was no longer the same.
One of the reasons I had chosen Optometry over my true love of Psychology in college was because of my take charge personality and need to be in control. It was fun and fulfilling to “fix” people’s vision and a perfect antidote to a lot of brokenness and chaos I had witnessed growing up. You become quite good at reading individuals and meeting their needs when your own needs are neglected or invisible to others.
Vision evolves from experiences and is personal and ubiquitous to each individual, infinitely more complicated than a fingerprint! When I became a survivor, my perspective on how to help a patient’s vision changed radically. I began to seek the connections between what we see and what we feel. I realized a patient reading an eye chart is “looking out” and eye doctor checking eye health is “looking in”. It is the “looking together” that generates a successful eyeglass prescription. This is similar to the interaction between the therapist and client (i.e. dual attunement) that creates true therapeutic change. Our eyes are the windows to our souls because they reveal our very core emotions and attachments to one who takes the time and careful insight to see and understand us in our state of uncertainty, sadness and authentic self.
When I mirror my clients in a counseling session, I truly witness their lack of clarity, fear, desperation and pain, as well as joys, growth and successes. Our clever brains use visually-driven mirror neurons to read and reflect eye and facial reflexes of others, all without words. This relationship begins at birth when an infant’s eyes can focus only as far as a caretaker’s face and their acuity is 20/200, the size necessary for facial recognition of emotions. When the baby cries and the mother shows empathy, the child is soothed. If a child cries and the mother does not mirror the emotion, psychological distress ensues (2).
Professionally, I am able to mimic this developmental relationship through a process known as Brainspotting (3), which uses external visual points in space (i.e. brainspots) that correspond with internal stressful memories or physical symptoms, such as back pain or chest tension. Brainspotting was originated by Dr. David Grand as an evolution of Eye Movement Densensitization and Reprocessing (EMDR), when he realized that holding our eyes in one point in space while a therapist tunes into our struggle can create powerful and fast processing of our psychological pain. He has worked with 9/11 and 2015 Paris attack survivors to find individualized and attuned positions that hold and process trauma through the visual system. Since I know that there are more areas of the brain dedicated to vision than all the other senses combined, this inspired me to become Brainspotting certified to treat my clients in Austin, Texas.
When our mental wellness is threatened by stress or crisis, we rely on relationships to become our “eyes and ears” for sensing the world. And yet, under fire, we can lose our ability to see others and be seen ourselves. In fact, our functional blindspots can grow bigger when we are under stress (4). We cannot see our way out of the black hole of fear without the vision of our loved ones: family, fellow survivors and therapists who really “get it”.
My hero, researcher/therapist Brene Brown says “to love is to be seen for your vulnerabilities and strengths” (5). When I heard this, I knew I had to return to graduate school to pursue the uncertain, and often heartbreaking goal of creating more love for myself and my clients. It was time to turn post-traumatic stress into post-traumatic growth (6). The way I see it, Brene Brown’s recommendation regarding vulnerability: “To not puff up or shrink but stand your sacred ground” are visual words. I do not need to magnify my need for control or certainty nor minimize my cancer-inspired directive of living well with uncertainty. I just need to be me.
So, why would I change from eye doctor to counselor? It is the most healing thing I can do to honor my journey through cancer by witnessing the sacred and vulnerable stories of my clients who face mental and physical crises along their journeys. I use my eye-brain-body connections to see and understand how your stress and pain can be healed to feel better and function better in a visually (and mentally) intense world.
“You must be the change you wish to see in the world.” -Mahatma Gandhi
(1) Quote attributed to Dr. Larry McDonald, Behavioral Optometrist.
(2) Mary Ainsworth Strange Experiment, http://www.simplypsychology.org/mary-ainsworth.html