Who Am I When I No Longer Have to Brace? A Personal Reflection on Spine Surgery, Surrender, and Transformation
In 10 days, surgeons will open my body from front and back and restructure my spine.
Two days of surgery. On the first, they approach from the front to fuse L4 to S1. On the second, through the back — fusing T9 all the way down to the pelvis. A long, complex fusion. I feel profoundly fortunate to be in the care of a surgeon who specializes in cases like mine. That doesn’t make it less frightening.
Leaving my practice has been one of the harder parts of this. I love this work. I love sitting with people inside their grief, their longing, their transformations, their unravelings. Stepping away from that (even temporarily) has brought its own grief. I hadn’t fully anticipated that.
I don’t usually write this personally on my professional website. Even when I write about grief or the unconscious, there’s often still some protective distance between the words and my actual life. A way of writing beside experience rather than from inside it.
But something keeps pressing through that distance now.
The closer surgery gets, the more emotionally porous I become. Not only frightened — though I am frightened — but tender. Raw in ways I didn’t entirely predict.
So I’m writing from inside it.
A great deal of how I’m understanding this experience has been shaped by years of training in depth psychotherapy and by mentors and teachers who taught me to think symbolically about suffering, transformation, the unconscious, and the body. That way of seeing does not make this easier. But it does help me feel that what is happening is larger than a medical procedure alone.
Initiation Phases
Across many ancient initiation traditions, there is often a movement through separation, descent, and return. Not as neat stages, but as territories of transformation.
Something removes you from ordinary life. The structures you relied upon begin to dissolve. You enter a liminal space where the old self no longer fully exists, but the new self has not yet arrived. Only afterward comes the possibility of return — not as restoration, but as someone altered by what they survived.
Separation.
I have been in the territory of separation for weeks already.
Leaving my clients, stepping back from my practice, handing care over to colleagues — this has been its own form of separation. The identity that held me, the work that gave shape to my days, has been set aside. I am not, right now, the therapist. I am the patient. I am the one being accompanied rather than accompanying.
That inversion is strange and disorienting in ways I’m still finding words for.
And then there is the body. Surgery will enact a literal separation from my spine as I have always known it, curved and compensating, from the axis that has held me upright, even crookedly, for my entire life.
That particular form of me is ending.
The second territory is descent. The underworld. The in-between.
The old stories and myths are about what happens when the old self has dissolved and the new self has not yet arrived. When there is no ground beneath you that you recognize.
The descent is where I will meet what has been hidden beneath competence, beneath holding-it-together, beneath chronic bracing.
I will be in this territory during surgery and the weeks after: Unconscious. Opened. Restructured. Waking into pain, disorientation, and radical dependence. Unable to perform capability. Unable to hold everything together.
The descent asks for surrender. Not the spiritual-bypassing kind; not everything happens for a reason. Just the willingness to stop trying to control what cannot be controlled. To let what is happening actually happen.
Part of me desperately wants certainty right now. Another part recognizes that healing sometimes asks something else entirely: humility, trust, and the willingness to let ourselves be changed.
And then there is return.
Not going back, not restoration, but emerging into ordinary life carrying something you could not have carried before. I don’t know yet what my return will look like.
I don’t know who I will be when I no longer have to brace constantly against my own body. I don’t know what reorganizes in me when compensation is no longer structurally necessary.
These are not rhetorical questions. They feel genuinely open to me.
The axis I have always known (built around decades of adaptation) is being remade. I do not yet know the axis that will emerge.
What I do know, from sitting with people through their own descents, is that surviving a threshold and allowing it to change you are not the same thing.
I intend to let this change me.
Writers like Clarissa Pinkola Estés have written beautifully about initiation as a return to something instinctual and essential that gets covered over by ordinary life.
I’ve been thinking about what has been covered over in me: the fear, the smallness, the profoundly human need for comfort and help. The parts of myself I don’t usually show because I learned long ago to manage them quietly, to keep them tucked beneath competence and forward motion.
Surgery is already beginning to undo that.
I am being brought into contact with all of it. And unexpectedly, there is something almost like relief in that. Because what cannot be admitted cannot be integrated. What is finally seen (even in its fragility) can begin to be held with compassion rather than managed from a distance.
Lately even ordinary things feel strangely vivid: walking my dog, standing in the kitchen, rolling over in bed without acute pain. Everything becomes more precious near a threshold. The body gets your attention.
I am standing at the edge now.
Not enlightened or prepared in any way that makes this easier. Just human. Frightened. Trying to meet what is coming with the same quality of presence I try to bring to others.
Knowing the map does not make the territory less real.
The axis mundi was never static. The sacred tree grew. The pillar was sometimes torn down and rebuilt on the same ground, but changed. What made it sacred was never permanence. It was its function: to orient, to connect, to hold a world in relation to itself.
I am about to have my central column taken apart and reconstructed. The axis that held me — curved and compensating and mine — is being remade.
I don’t know what it will hold when it’s finished. But I’m trying to trust that something can be built there. That the bones will fuse. That return is possible. That some deeper instinct in the psyche knows the way through dark woods better than the frightened mind does.
I’ll meet you on the other side.
I am on medical leave through late summer, and possibly into fall 2026. I am not currently accepting new clients. Please check back for my availability.
About the Author
Sara Ouimette, LMFT is a depth psychotherapist in Oakland, California who specializes in working with highly sensitive people, healthcare professionals, and individuals seeking grief counseling or trauma therapy while navigating major life transitions. Her work is grounded in Jungian depth psychology and focuses on helping people develop deeper self-understanding and compassion for the unseen parts of their lives. Sara also offers psychedelic integration therapy, supporting individuals in making sense of meaningful psychedelic experiences and integrating those insights into everyday life.