Exhausted, my heart was racing. It was in these moments when I felt most alive. Somehow, physical exercise and going to the gym had a direct correlation with me feeling healthier and stronger. Study after study tells us that serotonin is released in our brains when we exercise, and that feeling empowered physically can often translate to feeling empowered emotionally. From the time that I had been regularly going to the gym, this sentiment was extremely powerful and palpable. The more I went to the gym, the more addictive it became. The harder I worked my body, the stronger I felt. The more muscles I had, the less connection I had to being sick. Nobody this strong could be sick. Each time I was on the elliptical machine, I felt empowered. With every step and pull of the handlebars, I was exerting control in the world, control over my body, control over my destiny. I also met several people at the gym who had their own stories, often health-related. I met a fifty-eight-year-old woman who had heart problems since her early thirties. I met people who had back injuries, knee injuries, osteoarthritis…I met a woman who had been hospitalized as an adolescent for anorexia nervosa, and used exercise to maintain a healthy and strong body. She grew to love muscles instead of thinness. I met people who just wanted to feel and look better. I even met a female personal trainer who was formerly in a physically abusive relationship. After she found the emotional strength to leave her aggressor, she strengthened her body and ensured that nobody could ever physically overpower her again.

As time progressed, I found myself constantly speaking to my middle-aged therapy patients, and purporting the benefits of physical exercise to combat their feelings of depression. I would advise them to try to do squats while watching American Idol, and to do leg lifts while they were on the phone at work. I was buying hook, line, and sinker into the belief that our bodies and minds are connected. The more I exercised, the more I wanted to exercise. The stronger I felt, the healthier I felt. The more care I exerted with the foods I ingested, the more I felt in control of my body. This developed a level of self-care that I had not possessed before cancer.

I was talking to my friend and colleague, Paul, whose wife had gone through the same cancer experience as me. He became a confidante, and someone I could talk to on Saturdays, as he rented the office next to me. I told him how much I loved exercising, and that I was considering becoming a personal trainer. I recounted that it made me feel healthy and strong, and that it was the best medicine for me. Trained as a neuropsychologist, he told me that exercise was proven to have protective factors against dementia. He suggested that I incorporate personal training into my practice, and that I work with patients with dementia. Wow, he is onto something, I thought. That is where the idea of incorporating personal training into my private practice emanated from. I was convinced that exercise had helped me so significantly, that the mind-body connection could surely help my patients. Exercise could help anyone. I often advised children, especially those with low self-esteem, to take up a sport or go to the gym. I would tell their parents that when children appeared vulnerable and fragile in the world, being an active agent on their environment would make them feel stronger and more empowered, both physically and emotionally. I encouraged kids who were bullied to take up exercise. The process of growing muscles enabled them to get in touch with a mental strength they did not know existed. This also applied to individuals who had anxiety or depression. I have come to know that physical exercise can instill a sense of personal prowess within any individual.

I began my personal training with Jodi, a professional figure competitor. It was only for half an hour, but I figured it was a good introduction to personal training. I wanted to watch and see how she did it, so I could know how to start with my own clients one day. She had me do lunges across the floor with eight-pound weights. She had me do frog jumps and squats with a medicine ball pressed up against the wall.

She had me step up and down onto a pedestal with weights as well. I was so exhausted, but getting strong made me feel healthy.

Exercise began to become a large part of my life. In order to feel centered, calm, and strong, I relied on my daily workouts. I signed up to become certified as a personal trainer. I studied a 1,000-page book when I was waiting in the car for my daughters at dance, in the waiting room of Kumon, or sitting on the bleachers at gymnastics practices. I became really interested in what I was reading, and it felt intrinsic to the journey of health and empowerment that I had embarked upon. My goal was to eventually incorporate a full mind-body paradigm, where I worked with patients on their emotional issues, and simultaneously worked with them on their bodies—becoming stronger, healthier. I hoped to target certain populations that deal with chronic illnesses, such as women with breast cancer, as well as children who struggle with obesity. Exercise had become such an integral part of my life that I literally got a high when I looked in the mirror and saw my muscles growing. I now know that this high is a real factor related to serotonin.

I walked around like a six-year-old kid, asking people to “feel my muscle!” I used to do that when I was little. I would make a muscle with all of my might, struggling to conjure up all the strength in my bicep. My face would contort, and I probably turned red. My brother would then respond, “Okay, let me know when you make it.”

Now, I find myself as a forty-year-old woman walking up to my husband and saying, “Do you want to feel my muscle?” I get in the same position, rolling up my sleeve, concentrating all of my effort on my bicep.

He responds, “Let me know when you make it.”

Psychological Theory

Research tells us that exercise is pertinent for a plethora of health problems. Traditionally eschewed by physicians for many medical conditions, exercise has now become critical to combat these very same health issues: arthritis; fibromyalgia; hypertension; cardiac disease; diabetes; and cancer (Cormie et al. 2017), to name just a few. Exercise has also been cited as an effective adjunctive treatment for post-traumatic stress disorder (van der Kolk 2014). Exercise reduces anxiety, depression, and negative mood (Kim and McKenzie 2014), and improves self-esteem, body image, and cognitive functioning. Exercise is also associated with improvements in quality of life. Exercise can help control weight; boost the body’s immune system; reduce one’s risk of cardiovascular disease; reduce one’s risk for Type 2 diabetes; reduce blood pressure and bad cholesterol; and reduce one’s risk of getting some cancers (women who exercise regularly can expect a twenty to thirty percent reduction in the chance of getting breast cancer compared to those women who did not exercise). Women who exercise moderately—thirty minutes of physical activity a day, five days a week—significantly reduce their risk of breast cancer recurrence (Hamer and Warner 2017). Additionally, exercise improves learning; can boost brain function; and may help to minimize cognitive decline associated with neurodegenerative diseases like dementia (Behrman and Ebmeier 2014).

Chemo Muscles: Lessons Learned from Being a Psycho-Oncologist and Cancer Patient © 2020 Renee A. Exelbert, Ph.D. All Rights Reserved. Excerpt provided by Mascot Books.

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  • Renee A. Exelbert, Ph.D., CFT, is both a licensed psychologist and certified personal trainer. She is the Founding Director of The Metamorphosis Center for Psychological and Physical Change, where she integrates psychotherapy and exercise with a focus on the mind/body connection. She maintains a private practice in New York City, Manhasset and Nyack, New York for the treatment of children, adolescents, adults and families. Dr. Exelbert is also an Adjunct Professor in the Department of Applied Psychology at the New York University Steinhardt School of Culture, Education and Human Development where she teaches Masters-level psychology courses. She previously served as Staff Psychologist at the Winthrop University Hospital Cancer Center for Kids, working with children and adolescents diagnosed with cancer.