struggling with failure healing functional medicine karyn shanks md

It’s Not Failure: Applying the “Three Tack Rule” of Healing

Sometimes our healing doesn’t go just as planned.

My own recent healing from low back and shoulder injuries was a long journey of self-discovery that took many twists and turns, required a team of experts and supporters and required deep faith and commitment. I had to commit to myself and to my therapy every single day, not knowing what the outcome would be. There were encouraging steps forward followed by the disappointment of setbacks. It was frustrating and fatiguing at times. I chose not to lose faith and made the decision to keep searching for answers when it seemed I wasn’t getting anywhere–when the pain continued or got worse with what I did. In the end, the synergy of my work with a variety of methods of healing, the tremendous support I received from my team, and my own determination to stay positive and work hard led to healing. After three years of hard work, I am mostly pain free and have a solid maintenance plan to take through life with me.

I’m Working Hard to Heal and Not Feeling Better.

We’re all going to find that many of the things we try in order to heal don’t work for us. That may not mean that they aren’t good for us. It may mean that there is more to do. I had to stay mindful of this fact throughout my own healing journey.

The Three Tack Rule

One of my Functional Medicine mentors, the venerable Sidney Baker, MD, speaks of what he calls “the three-tack rule:” If you sit on three tacks, it hurts like hell and no amount of symptomatic treatment will make it feel better. If you take one tack away, or better yet two, you’ve taken care of two-thirds of the problem, but you still don’t feel better. It’s only when you remove that third remaining tack that the pain goes away. Yet removal of each tack was critical to resolving the whole problem. We often have to address many aspects of a complex illness before the suffering person feels relief or healing occurs. This doesn’t mean that each step in the process isn’t important. It just means that we are complex beings and we must tend to the whole to make real progress. If you and your health team believe that what you are doing is important to your overall health and healing, hang in there. There is more to do before there is enough recovery for you to actually feel better. Keep the faith.

There are also times when not only is there more to do but the treatment plan is wrong for us. This is not a failure. It is often impossible to know what treatments are right for us until we embark on our healing journey and make a commitment to a particular strategy. It is important that we stay alert and aware of our bodies as well as our feelings. We must communicate about what we are thinking and observing about ourselves with our team, and remain resolute and determined about our eventual healing. We may need to change course or call in the expertise of someone new. We must always stay committed to ourselves and steadfastly committed to our recovery goals.

Our Healing is a Process of Discovery

Here’s the deal. Our healing is a process of learning and discovery about ourselves. It’s a huge, lifelong, ever-changing undertaking. We are each taking responsibility for the most important thing in our lives—ourselves. We have to explore, learn, implement, experiment, and observe outcomes carefully. Nothing will work out exactly as we expect or plan and it is far better that way. We will fall down. We will drop the ball. We will have the best of intentions and not follow through. Or we will follow through and won’t get the desired results, we won’t feel better. This is all fertile ground for self-discovery. We didn’t fail to follow through because we’re worthless people. Maybe we just need more information or support. Perhaps we like to do things on our own and do better when we find our own way (rather than follow someone else’s suggestions). Whatever the circumstances, we are the awesome creators of ourselves and our healing and everything that happens informs our next move.

Karyn Shanks MD


Karyn Shanks, MD, is a physician who lives and practices in Iowa City. Her work is inspired by the revolutionary science of Functional Medicine, body-mind wisdom, and the transformational journeys of thousands of clients over her twenty-eight year career. She believes that the bones of healing are in what we do for ourselves.

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