Why Aren’t You Kinder To Yourself?

I’m going to be right upfront and say it, we do not treat ourselves as kindly as we treat other people. I’ll also admit that as much as I’ve worked on self-compassion over 4 years of going to therapy, and a 2.5 year master’s program to become a therapist, I still have moments where I don’t talk to myself kindly. But it has dramatically improved for me. People with chronic illness and/or chronic pain tend to be even less kind to themselves than other people, and those other people struggle a lot too. Think about your latest self-judgment or self-criticism. Just take a moment to get it. Now imagine you have this friend, Friend A, and he/she/they started to call you that judgment or criticism or label and said you’ll never change that’s just who you are. Now imagine Friend B, and this friend says to you, hey, I noticed you’re having a really hard time right now and going through all this difficult/painful stuff, and I just want to be here for you. Which friend would you rather have? I’m guessing you said Friend B, so think about whether or not you’re friend B to yourself.

Image from: https://www.wikihow.com/Avoid-Mean-Friends

If that brought up some emotion I’m not surprised. So let’s talk about self-compassion (or just kindness or friendliness if you don’t like the term self-compassion). According to Kristin Neff, the world’s leading researcher on it, self-compassion is made up of three parts.

1. Mindfulness, which includes being present with our thoughts and feelings.
2. Kindness, or acting with care and understanding opposed to judgment.
3. Common Humanity, or acknowledging that all human suffer.

Image from: https://amydeespeaker.com/2021/01/28/self-compassion-3-steps/

Kristin Neff also talks about some common blocks to self-compassion. And that’s what I want to talk about here. Because asking you, why aren’t you kinder to yourself, probably brought up something from this list, or a general, “I don’t know.” So let’s just address these now, in the context of chronic pain/illness.

Block 1: “It’s a sign of being weak.”
I can see how you got there, especially if you’re a male (because let’s faced it boys are socialized to believe emotions and compassion make them weak or girly). The research actually shows that people who are kind to themselves have more internal strength, better coping, and are more resilience. This includes if you have chronic illness or pain. This is so important for being able to live a good life when you have chronic illness/pain.

My internal resources also make it easier for me to do the things I love.

Block 2: “I’m being selfish.”
I’ve actually had a client say this to me before as a reason not to engage in self-kindness. This is another thought that isn’t compatible with the research, because what the research shows is that people who are self-compassionate are more compassionate to other, are more supportive of others, engage in more forgiveness, and are better at taking the perspectives of others. This is especially important if you have a chronic illness/pain and are also a partner or parent or caregiver. I have to say that as a therapist, practicing self-compassion has made me so good at building rapport with my clients because they feel more compassion coming from me.

More compassion for others.

Block 3: “I’m being self-indulgent.”
This implies that you’re using it as an excuse not to do hard things. And yet, what does the research show? People who are self-compassionate actually engage in more healthy behaviours. For chronic illness/pain this means they exercise more, have better nutrition, and regularly attend doctor’s appointments and follow doctor’s advice (podcast on that here). All of this has been shown time and time again to improve people’s lives when they have an illness.

Healthy behaviours like exercise.

Block 4: “I won’t be as motivated.”
I think this goes hand-in-hand with the last one, where you think you’ll just sit back and chill if you’re kind to yourself. Notice I said kind and not easy, because there’s a difference. Regardless, what does the research show this time? It increases our motivation. Why? Because we have less fear of failure AND get less upset when we do fail, and we take more responsibility when it comes to repairing our mistakes. Which means if you’ve struggled with certain parts of your illness before, you will be more motivated to fix them/do better in the future.

Increased motivation

Where do we start with self-compassion? I’m going to leave these three meditations: lovingkindness, kind hand, and compassion with equanimity here. But if you don’t like meditation, that’s okay it’s not necessary. My favourite way to easily engage it in is to just take one of my hand, imagine it’s filled with kindness, the same that I’d give a loved one, and place it on the part of my body (usually my chest) that needs it the most. And I just hold myself kindly (sometimes with a half smile). That’s it.

I hope you’re kinder to yourself and keep making the most of it.

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Video: Daily Yoga – Supported Fish

https://videopress.com/v/nmJnQeGU?resizeToParent=true&cover=true&preloadContent=metadata

I find yoga to be helpful for chronic pain and my mental health. This is another one of the yoga poses I really like for my upper back. Please speak to your healthcare team about any changes to your exercise routine. This content is for educational purposes only.

How resilient have you been feeling lately? Anything less than an 8/10, then check out this podcast episode on how to cultivate resilience.

Keep making the most of it!

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How to Manage Your Chronic Illness Through the Holidays

Let’s face it, we all stress through the holidays. It’s rarely an “easy” time of year for anyone. Over the years I have spent many holidays working in retail; I have had to share time between families (back when I was married); I’ve had to spend some Christmases all alone. And then there’s all the things we normally have to do like cook, and clean, and buy gifts (sometimes with limited money) and almost always with limited spoons (for those of you who use Spoon Theory). How can we be expected to manage all of this? And many of you may not handle it well. So, here’s what I’ve learned.

Do you like my Star Wars Ugly Christmas Sweater?

The most important thing to do is PACING. For those of you unfamiliar with my blog post on Pacing earlier this month, it basically comes down to doing the same amount of activity every day (so no over-exerting) regardless of how you feel. What usually happens, especially at this time of year, is we have a good day so we go ham and do as much as possible on that day (cooking, cleaning, etc) and then we end up not being able to do anything for day(s) after. If we do just 1 activity on that “good” day and then also do just 1 activity the next day, regardless if we feel better, the same, or a little worse, we will more easily avoid a string of “bad” days.

My only physical activity on this particular day in 2018 was ice skating.

The other most important thing is setting boundaries. Who says YOU have to host dinner? If you do host dinner, then maybe you don’t need to be the one to cook (can everyone bring a dish?) or clean by yourself (if you have a partner, can they help with the cleaning and prep). When shopping for presents, have you done it online? If you do have to go to the store, just use that as your 1 activity for the day (and wrapping the presents being an activity for another day). Tell your support system what you can do, and what you need help with. Stand up for yourself and don’t let them bully you.

It’s okay to say no, even if you have to say it to Santa himself.

If you don’t have a strong support system, which I know sometimes happens, then again, revert back to pacing, and say NO if you can’t do something (again, this could be hosting dinner, cleaning, etc), and see what other help you can get. Maybe there’s a neighbour or friend you can pay to help you cook or clean (that way it’s less expensive then hiring a professional). We need to use some flexible thinking and get outside the box.

I also recommend cuddling with your pet (if you have one) as they can help to reduce stress (RIP my little Spike).

The holidays are stressful, so we need to do what we can to manage our stress levels and take care of ourselves, while still living by our values (and hey, self-care may be one of your values). Have a Happy Holidays and keep making the most of it!

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Video: Pacing & Action Planning for Exercise

https://videopress.com/v/av2lsTh9?resizeToParent=true&cover=true&preloadContent=metadata

If you’re thinking about exercising to help with your chronic pain or overall health, it is important to consider two things: (1) pacing – so that you don’t over exert yourself one day and pay for it the next; and (2) action planning or goal setting so that exercise is realistic for you. Also, remember to always talk to your healthcare team before starting any new exercise routine! If you’re having thoughts about your ability to exercise that are causing you distress, check out this podcast episode.

Keep making the most of it!

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What’s the Difference Between Chronic Disease Distress & Depression?

Despite my educational and practicum background in counselling, I hadn’t heard the term “chronic disease distress” before I attended the World Pain Summit this past October. When we think of mental health issues in relation to chronic illness and chronic pain, only anxiety and depression come up. This makes sense since the rates of anxiety and depression in those with chronic illness are slightly higher than in the general population (reports vary exactly how much, and it does depend on the condition). Learning about chronic disease distress, I realize that’s actually what I had – not anxiety – when I was first dealing with my illness and attended therapy myself. I don’t know what my therapist would have defined my condition as, but I fit the description better than anxiety or depression.

During the hight of my chronic disease distress I had the best support (RIP).

What is chronic disease distress? This is distress that comes with the stress of having a chronic health condition. It has some overlapping symptoms with both anxiety and depression, which can include anxious (catastrophizing) thoughts, rumination, sadness and crying, difficulty sleeping, etc. In CDD this is more related to the illness itself, rather than other areas of life. Now, that’s not to say that it doesn’t impact other areas of life. Having a chronic illness clearly does, but the distress all relates back to the illness at the end. If you’re able to go into remission or get a handle on your physical symptoms so they are less impactful, typically the distress goes down as well (the distress itself can also be treated but I’ll get to that in a moment).

Chronic Disease Distress doesn’t have to last forever.

What is depression? Clinical depression (major depressive disorder) is a set a symptoms that include, but aren’t limited to, feelings of sadness, worthlessness, guilt, loss of interest in activities, difficulty sleeping, difficulty with thinking, lack of energy, thoughts of suicide, and so on. Not everyone who is depressed has clinical depression (you can have some symptoms but not enough to get that diagnosis). Depression is a world wide epidemic and has a significant impact on people’s lives.

Image from: https://theconversation.com/depression-its-a-word-we-use-a-lot-but-what-exactly-is-it-122381

Some researchers have come up with a scale to measure chronic disease distress. This scale includes measures for emotional burden (of the illness), regimen distress (lifestyle impacts), patient-provider distress (medical gaslighting would fall in this category), social support distress, and then a total score. Only a qualified mental health professional can diagnose any mental health condition. Personally, I try not to worry too much about a diagnosis (unless a medication is warranted) and otherwise focus on the symptoms and distress facing you, me, or anyone else.

What do we do about chronic disease distress? Obviously seeking counselling/therapy from a qualified mental health professional (preferably one who specializes in chronic illness) is going to be the best route to go. Otherwise, certainly self-help sections in your library or bookstore, or listening to podcasts on the topic are good ideas. Support groups as well can be very helpful. In the meantime, personally I find mindfulness a good place to start. There is a lot of evidence of it being helpful (plus I’ve personally found it helpful!). Mindfulness doesn’t have to mean meditation, but if mindfulness is the muscle, meditation is the best exercise for the muscle. I have formal (meditation) and informal (non-meditation) mindfulness practices on my YouTube channel.

Image from: https://www.npr.org/sections/health-shots/2014/01/07/260470831/mindfulness-meditation-can-help-relieve-anxiety-and-depression

I hope this helps you understand the difference between CDD and depression. If you have questions, feel free to reach out. For now, keep making the most of it!

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Video: Daily Mindfulness – Guided Light Imagery

This week’s mindfulness activity is a guided meditation that uses imagery of light to help us centre, ground, and sometimes it can even be relaxing. Notice what comes up for you while you do this practice. For more guided meditations, subscribe to my YouTube channel.

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Critical Coping: Problem-Focused vs. Emotion-Focused

I used to always use problem focused coping. Like 99.9% of the time. And it usually served me well, but not always, and certainly not always after my chronic illness snuck up on me. Then I started to use more emotion-focused coping, a totally different coping style. And here’s the thing, I now use both and you probably need to as well. But hold on! What the heck are problem-focused and emotion-focused coping anyway?

Image from: https://www.verywellmind.com/forty-healthy-coping-skills-4586742

Problem-focused coping is typically used for solvable problems, ones that can be fixed, and make the problem go away. For example, if we lose our job due to company restructuring (this happened to me back in the day) then we would use problem-focused coping in order to find another job and make sure we can support ourselves in the meantime.
Emotion-focused coping is what we use when the problem can’t be fixed, and the problem will not go away. It is dealing with emotions that arise from an unfixable problem. Kind of like what happens when you have a chronic illness.
Both of these skills are necessary in life, but the problem is, most of us are taught more about problem-focused coping that emotion-focused.

Problem-focused would be how to get out of the canyon you and your friend went hiking in.

Let’s look at problem-focused in the context of chronic illness or chronic pain. What are some solvable problems or areas in which we would use problem focused coping? Well, lifestyle changes are one area. We are told or we read up on different “diets” or exercise routines or incorporating meditation, etc that will help us with some of our symptoms. Or maybe it’s just taking medication as prescribed. We would use problem-focused coping because lifestyle changes and medication adherence are fixable problems. We’ll likely use SMART goals (specific-measurable/meaningful-attainable/adaptive-relevant/realistic-timebound) or other techniques to make these changes. And, while nothing is a guarantee, there is a lot of evidence supporting that certain lifestyle changes will help with symptoms, essentially “fixing” (I use that term loosely) the problem.

Emotion-focused is more about accepting emotions and pain.

How about emotion focused coping in the context of chronic illness or chronic pain? While, chronic disease distress, anxiety and depression are all common in those of us with chronic illness. Our illnesses likely won’t go away and our emotions – well, we’re meant to have them. So with this I see a lot of acceptance practices being used and needed (here’s a link to one of my favourites). Self-compassion is another area where we are utilizing emotion focused coping (here’s a link to one of those practices). We have to learn to live with difficult emotions that come and go, and difficult sensations, such as pain. If you’re not good at this, I want to normalize it for you – most people aren’t! This is a skill set most people need help with.

It is essential for people with chronic illness to have both types of coping skills.

Who can help you add these skill sets? Well, there are lots of places to go. A counsellor/therapist or health coach is one place. I would say the health coach would help more with problem-focused and therapist with emotion focused (as well as problem-focused). You can also look in the self-help section of your local library or bookstore. Those meditations I linked are another place, and I’ve done a number of episodes on these in my podcast (check out this episode on acceptance for example).

Once you have and start using both types of coping skills, you can start making the most of it!

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Video: Daily Yoga – Sphinx Pose

https://videopress.com/v/ir6PbocK?resizeToParent=true&cover=true&preloadContent=metadata

This week we’re exploring one of my favourite yoga poses. I find it to be a great stretch for my back as well as my chest as it acts as a back bend and chest opener. Make sure to check with your healthcare team before doing any new exercise routines. The information in the video is based solely on my experiences. Stretches can be great for pain that is muscular – check out this podcast interview with Dr. Yass about muscular pain. As always, keep making the most of it!

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How I Use Pacing to Make the Most of My Day

When I moved across the province at the end of October, I did NOT do a good job pacing myself. Granted I had help for the physical moving but not the packing or unpacking or the putting together of furniture – that was all on me. I started out with the best intentions. I actually started packing by pacing. It was more the last minute stuff, the physically carrying items in the truck, and then everything after that was a disaster. And of course, that caused a flare (luckily it only lasted a week or so). However, that’s not what I normally do. Normally I pace myself, which is part of the reason why I can consistently be as active as I am.

Definitely explored my new neighbourhood as soon as I could.

What is pacing? Pacing is doing the same amount of activity everyday – whether it’s a “good” day or “bad” day. Now, this doesn’t mean you’re not listening to your body. There are of course days that Chronic Illness Warriors are going to need more rest. What it does mean is not over-exerting yourself on the good days and therefore creating more bad days. For example, I go for a walk everyday. It’s about an hour long. Even on days where I feel a bit more tired, I get my walk in. I also try to do some yin yoga everyday. It’s definitely movement that is easy to get in on days I don’t feel as good, because it is slower movements and stretching. But let’s say that I didn’t go for a walk today. Maybe I cleaned the house and did laundry instead. It’s about the same amount of activity – and maybe it’s more necessary or I have the thought that it’s more reasonable, depending on how I feel. Get what I mean?

Back in the summer, my pacing allowed me to be able to have a great visit with my friend.

There is A LOT of evidence that pacing works. Not just for me, but from other chronic pain and illness warriors. I’ve interviewed a ton of people on my podcast and have noticed that many of them use pacing. I attended the World Pain Summit earlier in the fall and 2 of the presenters, who were both people with lived experience (not healthcare professionals) talked about pacing and how it’s helped them. Heck even look at these search results on Google Scholar and you can see all the academic journal articles written on the subject. Pacing works – even with fatigue.

We did this by alternating activity with rest.

But how do you figure out what your pace is? Here are some key suggestions when it comes to pacing:

• Plan your day. We all have an idea of how we’re feeling when we get up in the morning, so having a plan of what sounds manageable for the day is a good place to start.
• Break up your activities and alternate at rest. For example, if you decide to clean the house, just do 1 room at a time and take a short break (30 minutes) in between.
• Prioritizing your activities. I align this with Values-Based Living. What is most important for me to do today? Why is it important? For me, my health is important (yes, even having a chronic illness) so doing some kind of movement that will keep me active and ultimately decrease pain (I’ve done many posts on movement for pain management) is essential.

Values-based living is engaging in activities that align with your values.

Even if you’re having thoughts that pacing seems impossible, just note that those are just thoughts. There are many people who can help you get started with pacing (occupational therapists, psychotherapists/counsellors, physical therapists, etc.) and the whole point is to improve your well-being so you can keep making the most of it!

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