Essential tremor (ET) is a neurological disorder that causes involuntary shaking of the hands, head, voice and other parts of the body. Trembling hands are most obvious giveaway that something isn’t “normal”. Despite the estimated 7 million people who suffer with ET – a number that far exceeds the number of patients with Parkinson’s disease – there is widespread lack of awareness about ET. People without ET can be unwittingly cruel and even humiliating. If ET begins in childhood, youngsters with ET must grow up enduring teasing and taunts. If self-esteem had a similar rating system as intelligence, we might find that even when a kid’s IQ (intelligence quotient) is average or above, his or her SEQ (self esteem quotient) is often below average from being dented and dinged.

Hand tremors interfere with tasks that are simple for non-ET individuals. Early childhood tasks involving hands such as tying shoes, buttoning buttons, learning to write or color with crayons, and managing a spoon or fork. Even with much support at home, a child’s identity becomes associated with being an outsider, a scapegoat, or a loser. As one matures, there is an opportunity cost when the appearance of being uncontrollably “nervous,” “anxious,” “insecure,” etc. means surmounting childhood challenges only to grow up and find oneself passed over for a new job or promotion due to the quaking of one or both hands. So how do ET patients acquire self esteem despite their tremors?

One way is to learn from others who have risen to the task, many of them from childhood onward. The International Essential Tremor Foundation is a good starting point for accessing the experience of others. The Foundation has an excellent quarterly magazine, Tremor Talk, in which personal stories model confidence and courage that can stimulate personal creativity, determination and confidence. For example, an aspiring stand-up comedienne named Robin Hetro shared how she transformed her feelings of humiliation, disappointment and vulnerability by incorporating her ET into her stand-up material. Of course, not everyone wants to be on stage, but her increasing commitment to tell the truth with a positive, humorous spin gained the respect (and laughs) of her audience. Her story, “Truth-Telling about ET with a Comic Touch,” is a paradigm for not allowing ET put a dent in self esteem.

The Foundation’s brochure on coping tips for everyday living provides many concrete tips for daily life, but it also contains wisdom about the less tangible psychological aspects of living with hand tremors and other quivering body parts. Suggestions like these are sure to add points to one’s SEQ level:

• Maintain a positive, upbeat attitude and put a smile on your face. It will reduce tension and lighten your mood.
• Talk to people about ET and explain what it is. Education raises awareness and fosters understanding.
• Don’t be afraid or embarrassed to ask for help. Tell others you have ET and ask them to help you reach for groceries on high store shelves, ask cashiers in cafeterias to help bring the tray to your table, or ask relatives or friends to cut meat or lettuce for you.
• Take an active role in your local support group. Ask if you can assist the leader in any way. Sometimes when we help others, we end up helping ourselves.

Sperling Neurosurgery Associates understands the need for those with ET to connect with others as a source of sharing, problem solving, and hope. We sponsor a Facebook group, Essential Tremor Awareness & Support Group, and invite you and your loved ones to join. It is a positive experience that we believe provides many members with an SEQ boost from the understanding and encouragement they receive.

Life is a journey, and each person must discover unique navigational skills. Christopher Columbus was denied funding for his voyage by three monarchies before Spain bankrolled him, and experts told him his calculations were wrong and his voyage would take much longer than he was equipped for (it turns out they were right, but he bumped into the Western Hemisphere rather than his goal of Asia). In any event, Columbus is quoted as saying, “By prevailing over all obstacles and distractions, one may unfailingly arrive at his {or her} chosen goal or destination.”

Regardless of which parts of the body are affected by tremor, achieving one’s dreams often requires embracing confidence and self esteem even when one is also tossed on the inner waves of self-doubt. Turn to others and embrace their positive example, and hopefully your life voyage will sail more smoothly as your SEQ rises.

Keep in mind that if hand tremors become unmanageable by conventional interventions, Sperling Neurosurgery Associates can evaluate whether MRI-guided Focused Ultrasound (MRgFUS) is an appropriate treatment consideration for you.