Essential tremor (ET) is a neurological disorder that causes involuntary shaking most commonly of the hands, head and voice. Despite the millions of people who struggle with ET, there is rampant lack of knowledge about it. People without ET can be unwittingly cruel and even humiliating. And although childhood ET is relatively rare, for youngsters who have it the teasing and taunts begin during the early years when their self image is forming.

If a child’s hands are affected by tremors, tasks like tying shoes, buttoning buttons, learning to write or color with crayons, and feeding oneself become daunting. A preteen carrying a jiggling tray in the school cafeteria exposes him or her to embarrassing assumptions and remarks. Even with much support at home, their identity becomes associated with being an outsider, a scapegoat, or a loser. Having survived the teen years, flash forward 10 years, and there is an opportunity cost when the appearance of being uncontrollably “nervous,” “anxious,” “insecure,” etc. means finding oneself passed over for a new job or promotion due to the quaking of one or both hands.

Self esteem with tremors

So, how do ET patients acquire or maintain 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 often features personal stories that model gaining confidence. For example, an aspiring stand-up comedienne named Robin Hetro incorporated her ET into her stand-up material as a way to overcome years of vulnerability and humiliation. 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, “The Healing Power of Comedy,” is a paradigm for dent-proofing one’s self worth.

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. Among their suggestions:

• 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.

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.

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.