Do you see what eye see?

4/21/20  Within the first week of Optometry school in Southern California, we walked as a class down the hall to a large laboratory set up up with 10 black exam chairs, phoropters and biomicroscopes. Each of these were arranged as separate exam stations, separated by curtains. We spent many days, nights, weeks and months in this dark room, taking turns being doctor and patient, learning to measure vision and see inside the eye. It was 1992 before the first pop-up restaurant or makeshift hospitals like we are seeing for COVID-19.

The biomicroscope is by far my favorite piece of eye equipment. It allows you to see the front and back surfaces of the eye in rich color with different lights and magnification. It sits on a table that slides in front of the patient and aligns their eyes with yours. As you peer inside, it feels as if you are landing on the moon or the bottom of the sea.

The first recognizable landmark is the iris, the colored part of your eye that surrounds your pupil, which just a big black hole. You drop immediately into craggy views, webby tissues, and almost volcanic or coral looking types of creation. The terrain of each iris is like a fingerprint, only 3D and never touched. You hold your breathe a little, because you are very close to your patient and it is an awesome sight. Short of a runaway blood vessel or a mineral deposit, there is lots to see in the iris but little that is clinically relevant.

The most important part of the front of the eye is the cornea. It is the clear dome front of the eyeball where you might place a contact lens. It is completely transparent which is good because otherwise you could not see clearly out of it. You know you are looking at the cornea when you swing your microscope light at a side angle to illuminate it’s nothingness. It looks like…Nothing. This was so frustrating to me. How do I know I am seeing the nothing when I see nothing?  Everyone clucked their “ooh’s” and “aah’s”, and I did as well, but I could not for the life of me see the damn thing. 

“It’s okay, just click up the magnification”, said my patient partner. It’s always great when your patient knows more than you. I click the magnification up. The sounds are how I knew I was getting close but all the clicking and clucking around me made me feel like a fraud. I was convinced that this first surface where light bends to enter the eye, travel the optic nerve, and create the miracle of vision was lost on me. Nothing there usually also means nothing is wrong for the patient but it did not feel right to me.

Pretty much the only time you can see something in the cornea is when there is a problem: a scratch, a fog, a degeneration. It was exciting when we could finally see some pathology so we knew we were focused on the right tissue but it also meant the patient was in pain, blurry and maybe even going blind. I much prefer the artistic view of the iris to the pathology that most doctors live to treat (I am thankful they do, as well).

Years later, as a Counselor, you would think I see less visual problems and solutions, but I actually see them more than ever. The same terms I learned then also apply now. I see and hear patients as they discover their unique and deep awareness, like their stunning iris, and their shifts in perspective, however invisible at first. It is a joy to build a personal narrative from a nothingness place, both for myself and now my clients.

I was never happy to be a doctor who had to inform patients of a dire diagnosis. I am much more alive showing up in creative ways, with vision and insight, in my makeshift guest-room-now telehealth office, with lots of hope as we build a vision for the future together.

Quarantine Eye Exam

4/7/20 Many of us want to operate at our highest level right now. When I was a regular eye doctor, that was 20/20 vision, the bottom line of the eye chart. What someone else can see 20 feet away is what you can see, as well. You are perfect. Today, as a therapist, I see highest function as the attainment of the ultimate in physical, emotional and mental health. This means you have more than enough toilet paper, carbohydrates and Netflix. You do more than cruise Facebook, have 3 panic attacks a day, yell at your dog or spouse before falling into a fitful sleep just to wake up and do the corona-lifestyle all over again. You are handling your pandemic like a champ!

My Stars In Your Eyes offices closed for routine eye care until it was safe to administer puff of air tests and “which is better, one or two?” questions that would truly set you over the edge now. Until then, I determined your visual acuity by a 4-step virtual reality quiz from the comfort of your home, with some suggestions to try in upcoming weeks.

1. Can you blur out covid-19 pop up ads on your laptop equally with both eyes? You may need to work on increasing the size of your blind spot. Don’t worry, you haven’t driven in so long, your blind spots are not being checked. The best way to increase your blind spot is to dive under your covers and go back to sleep. 

2. Can you read the tiny ingredients on the wrapper of your eighth piece of easter candy eaten today before noon? Really? Without reading glasses? Your eyes may be fine but your blood sugar may be off.  

3. Can you focus on anything for more than 20 seconds? Hmm, I don’t believe you. Mental and visual focus are phantom symptoms right now. Wash your hands and try answering that question again.

4. Have you been crying daily or unable to visualize life after covid-19? I hear you. I see you. This is a new normal. If you are crying, your tear ducts work. If you are not crying but feel like you need to, reach out to a friend or old therapist or make your favorite chili with extra onions. Any tears count. 

If the eyes are the window to the soul, we are missing eye contact and soul contact right now. Your prescription is to fill your eyes with beautiful colors, indoors or outside. Take a break from screens. 2020 has not been what we expected, so try this 20/20/20 exercise: Focus your eyes 20 feet away, for 20 seconds every 20 minutes. Take a break from your screen is the best way to prep your vision to be ready for post-apocalyptic seeing and thriving.

This is incredibly hard. We are supposed to have tunnel vision in a crisis. There will be a light at the end of your tunnel (vision), hopefully this year. 20/20 vision may not be relevant now but your wellness is. If you can see 5 things in your room or out your window, then you have 5/5 (same as 20/20) vision in my book and you rock the quarantine eye exam.


Love, “Dr. Emily”

Spatial Not Social Distancing = What Your Friendly Therapist Is Ordering

3/31/20  Ok, maybe it’s the eye doctor in me: what we need to be safe from COVID-19 is NOT social but spatial distancing from others. Visually, the z-axis is what we use to regulate our nervous systems, from the moment a new born can focus only 12″ to her mother’s face all the way through our “mature” years when someone who is sitting too close is too blurry! Our social closeness, not distance, is what we need for physical and mental wellness.  Make some visual spatial changes but do not lose your social connection. Please reach out to me, your colleagues, Insight timer peers or anyone in the world since we are all struggling with this harsh new reality.

If you grew up not talking about or having expressive feelings, you might want to read this from Dr. Jonice Webb. You may be noticing a greater sense of being insecure, lost and alone while staying at home, away from normal routines and, yes, even for you introverts, people! Isolation recreates and exacerbates regular levels of anxiety, depression and post-traumatic stress.

I am increasing my posts because I am walking proof that immune systems need emotional support to be healthy and protected. I was diagnosed with a unique cancer over ten years ago which inspired a career change from eye doctor to psychotherapist. I love my work because it keeps me and clients well through post-traumatic growth.

I am pleased to report telehealth is working wonderful for Brainspotting and Light/Color Therapy. You can notice a visible difference in stress levels even through a 2-dimensional computer or smartphone screen. Please read more on my website and refer isolated friends and family for a telehealth session today!

Self-Kindness In Kind

3/11/20 When life stress gets larger than life, I tend to go back to the basics. Staying well from COVID-19 and global, let alone local, paranoia and pathology can be exhausting. I see an uptick of clients wanting to figure it all out, or better yet, make it all go away!

My basics include anything written by Drs Brene Brown and Kristin Neff, now both on staff at University of Texas. Kristin shared these Myths of Self Compassion which I found timely this week. The most shocking thing I had to learn about trauma (as a client and therapist) was how critical self-compassion is to healing. Since when do I have to be freaking kind to myself to get over it? Ain’t nobody got no time for that!

If you are sheltering and spinning out on news and worry, take a moment to invest in global self-care that starts with you. Neff’s free, 5 minute Self Compassion meditation is a very good start. These are the times to be nice to your head and heart while it is protecting your body from illness. It is not selfish, self-pitying, or narcissistic; it will not make you weak or complacent. It will simply help you be…well.

Election pop rocks!

Earlier this year, I referred to pop rocks in Coca Cola as a way that neural networks create change. As we go into an election day of dense fog in Austin, I feel that similar draw to know results AND need to self protect to avoid more stress. It’s election pop rocks! No shaking required.

I love this visual because it conjures a memory of sensory overload when we were kids. Your thoughts, emotions and behaviors actually come from a mental map that is built before you even have words or memories. This Map is the result of your DNA and how well you were Seen + Heard, as well as feeling Safe and That You Matter. This map can lose its GPS when we are stressed or feeling mixed emotions.

Do you feel you matter in the midst of ongoing political trauma and chaos? I call it trauma because it is a sense of being overwhelmed and alone, which is common in my clients and magnified by news, angst and worry.

Your sense of self worth and self-esteem depends on having a reliable anchor for your own mental mapping in relationships and career success, let alone to feel safe and heard in your city, state and nation during difficult news cycles.

On a day, week, month, year like this, you can try the pop rock in soda solution or take a stab at finding an important person to See + Hear you . Cheers to however “You do You”!
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The Emotional Impact of Chronic Illness

My colleague, Bridgett Wallace, PT had me as a guest on her Talk Tuesday show. We are seeking to create a bridge between trauma (things forced upon us by our parents, partners, careers or health) that creates understandable stress and the growth that is also possible with neuroscience and compassionate clinicians.

Forgive the first 20 seconds or so of audio challenges…

See Yourself Better

My gift to myself in 2018 was joining a bookclub on the Neuroscience of Counseling.  I know, I am a nerd! 🙂 We talk about how your mind works in order to help clients fast and easy. It makes my brain explodes like pop rocks in Coca-Cola. For those non-Gen Xers who are confused right now, these guys will help you out (“Yes, your stomach will explode but you will live forever.”)

Last week, we learned how our thoughts, emotions and behaviors come from a mental map that is built before we even have words or memories. This Map is the result of our DNA and how well we were Seen + Heard, as well as feeling Safe and that You Matter.

I am using Capital letters and BOLD since it is so important to create a reliable GPS for your own mental mapping in relationships and career success. This is what I do for you.

When you feel Seen + Heard by the important people in your life, you “feel Felt” to quote my favorite neuroscientist Dan Siegel. As a counselor to very awesome clients, I can literally see differences in those who have a strong sense of self-esteem and self-worth after being seen and heard in my counseling sessions.

Learning how to feel safe in counseling allows you to live your life easier with more success, find true love, leave your mark on the world. When you are off, you feel like empty, alone, numb and in trouble all the time!

My colleague, Dr. Jonice Webb describes this well here.

If you are ready to change your brain as a gift to yourself this year, please reach out, ask me a question or set up an initial consultation. My heart and mind are ready for yours!

Post Traumatic Growth

I was honored to speak to a group of awesome Austin Career Coaches about Post-Traumatic Growth (PTG) last week. Their 1:1 work with individuals usually involves life transition inspired or thrust upon us by our bodies, minds, partners or traumatic events.

Our struggle is not our identity, it can just feel like it.

The resilience we desire is not just back to a “new normal” but beyond into PTG which can exist alongside PTSD (post traumatic stress). Below is my most recent take on PTG personally and professionally.

Message me or share with a friend or family if the message in this blog post could resonate or relieve stress for you or your loved one. Family 2020 2016

“Until you make the unconscious conscious, it will direct your life and you will call it fate.” -Carl Gustav Jung

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Summer School

If you are looking for an air-conditioned, cost effective alternative to therapy this summer (note: I will be traveling a bit in July so email me for exact dates if you need to schedule), check out this resource that closely fits my way of practicing. It is neuroplasticity as a self-paced, at home program. I can do an introductory session before you begin and then quarterly as you complete the program to keep your accountability and outcomes successful. It is great for health professionals as well as “normal” (ha!) people. Online Course for Emily Schottman clients

How does it work?

If you are wondering what great therapy looks like or how it might work for you, this article does a lot to describe the journey.

Dr. Flanagan talks about how traditional therapy works and reveals some life secrets to explain why the “work” we do in session can carry over to less “work” in your relationships and quest for happiness. I love that when we realize how to work smarter not harder in our lives, we learn more about (not just) how to be human but how to enjoy the highs and lows. The right counselor is your tour guide and author to the owner’s manual that is your unique life. It not only feels good, it makes sense!

PS Here is another great summary of how I help anxiety sufferers. The somatic experience in office quickly translates to better quality of life for clients asap!