This is a metaphor I often use when explaining anger. It has a specific purpose and function for us, but there is almost always something beneath anger. I hope this piece of psychoeducation helps you to understand yourself better. Remember, the content on this blog does not replace seeking help from a licensed mental or other healthcare professional in your area.
For a meditation on working with anger, click this link.
There is a Taoist parable that tells of an old man who fell into a river that swept him toward a dangerous waterfall. There were people watching who feared for the old man’s life. By some miracle, the old man came out of the water at the bottom of the falls completely unharmed. The onlookers asked him how he managed to survive, and he replied, “I accommodated myself to the water, not the water to me. Without thinking, I allowed myself to be shaped by it. Plunging into the swirl, I came out with the swirl. This is how I survived.”
If the old man had struggled against the water, he may not have survived the fall. At least that’s how he sees it and is what the parable is suggesting. This is non-contention. I came across the parable when I was… well if you read this blog regularly then you can probably guess it… meditating. I was doing a guided meditation and at the end, the meditation teacher told this parable. It really spoke to me because I have heard this idea spoken in many different ways already, and it’s something I have been practicing for sometime. I notice that in my day-to-day life, when I am swept up by my pain or symptoms of my illness or thoughts about my pain or emotions such as anxiety that arise, when I struggle with these things, it just makes the day worse. It makes the pain (physical and emotional worse) and I feel less resilient. When I do the opposite – accommodate – then my days are pretty good. Thankfully I’ve gotten good at accommodating.
While I’m sure some of you are also good at accommodating, there are probably many of you who are not. It takes a lot of work and practice to be able to do this. It’s way more natural for our minds to struggle because our minds think that it’s the best way to survive – I mean, thousands of years of evolution have told them this. Yet in modern times, the struggle often ends up being less helpful (but try telling that to the primitive part of your brain). I find that meditating is helpful for accommodation but I totally get that it’s not for everyone. I also find similar mindful practices like body scans, observing-breathing into-making room for-and allowing my feelings to also be helpful. And engaging in those values-based behaviours that I love. That doesn’t mean I push through my inner experiences. There is a delicate balance between pacing and going to my edge. And on days that I go to far and do too much, I offer myself some compassion because it is hard to be human, and it is hard to be a human with a chronic condition.
So, here’s what I suggest:
try out some mindfulness practices, like the ones found on my YouTube channel
incorporate more self-compassion into your life: kind words, soothing touching, remembering that it is human to have pain
engage in values-based activities that allow you to pace and don’t take you past your edge
seek mental health (and physical health) help from a licensed professional as often as needed.
Curiosity and nonjudgmental awareness are important tools for healing when you have a chronic illness. I’m not saying, cure the illness, but rather to increase our pain tolerance, decrease our stress levels, and heal from any associated wounds from our illness. This becomes even more important if you have a trauma background, which as we know from all the research on the subject, is very common when you have a chronic illness. Myself included in that statement, “little t” trauma that lasted for 5 years in elementary and junior high, something I initially scoffed at as possibly being considered trauma until I learned more about what trauma is, and how it has contributed to my current health. I didn’t process any of it until I was an adult, seeking psychotherapy for pain and stress, and it eventually came out because I was having difficulties in adult friendships… all stemming back to the “little t” trauma from my childhood (let me know if you want more information on little t and big t trauma, I’ve written about them before but can again).
What should we be curious and nonjudgmental about?
I mean a part of me just wants to say EVERYTHING! Because there are definitely huge advantages to approaching life this way. However, it is completely unrealistic to think we could experience life this way all the time. We’re human and it’s totally normal to make judgments (evolutionarily, it helped our species stay alive!) When it comes to chronic illness there are 4 things I think are really important to be curious and nonjudgmental about (this is, as always, based on my own lived experience as well as what I’ve seen in clinical practice).
Our Thoughts – even the ones that are “judging” in the first place. Can you notice your thoughts without thinking about them or getting swept away by them? I find it interesting to see not only the content of my thoughts but also how they come and go, with some being more sticky than others.
Our Emotions – like our thoughts, they tend to come and go, but typically can stick around for longer periods of time. Not only should we explore what we are feeling, but where we are feeling it in our bodies. All emotions have related sensations. What can we notice about them by just sticking to the facts?
Our Behaviours – why do we do the things we do? It’s fascinating to notice how I act in certain ways or do certain things and how that changes with time or on a different day. It’s equally as fascinating to observe how my behaviours change when my thoughts and feelings are in different states.
Our Sensations – not only the ones associated with our emotions, but all the sensations in our bodies – hunger, fatigue, pain. Noticing the quality, where it is, what it feels like, even what we imagine it looks like.
How can we become more curious and nonjudgmental?
There are a lot of ways we can learn to become curious and nonjudgmental. I think of myself as being a curious child, discovering something new for the first time, and approaching whatever it is – thought, emotion, behaviour or sensation – just in that way. But I’ll be more specific:
Describe it – using only facts, not your interpretations or judgments. Here is anxiety. Here is a sharp sensation in my leg. Here is a worry thought.
Notice and Name it – I am noticing the thought that… or I’m noticing the feeling of…
Send your breath into it – rather than judge the sensation or emotion as good or bad, see if you can just pause and send your breath to the area of you feel it the most, giving it some room.
Practice meditation – in meditation all you’re really doing is noticing your experience as it comes and goes. This can be a good way to learn to interact with your thoughts, feelings and behaviours nonjudgmentally because the whole point is to be open and nonjudgmental. Check this one out.
Do a body scan – this is another way to really be open to any feelings and sensations present in your body. We often notice that the intensities change and that sensations do often come and go. Find a short version here.
Offer yourself some kindness – it’s so easy to be harsh and judgmental about your experience. Kind self-talk or kind self-touch can be useful to counteract what our minds are doing. Check out this kind hand exercise.
It can be hard to think that things can get better, but I’ve had the first-hand experience of my life improving from doing these kinds of practices and really just changing my experience of life. I hope this helps you to keep making the most of it!
When we learn to make room for our difficult emotions, we give ourselves the opportunity to react in different ways. Often with anger we yell, swear, throw things (including punches), etc. and typically don’t act in ways that align with our values. When we make space for anger we can clearly communicate that we are upset without doing any of those things.
I was listening to a podcast a few weeks ago and the guest was talking about the physiology of our fight-flight-freeze response and how it can specifically relate to certain chronic illness. The guest used the following examples: lupus as being the fight response, and CFS/ME as being the freeze response. I had never thought of it this way and it made me interested in this topic. (The podcast is called Therapy Chat if anyone is interested but I can’t remember the specific episode number, sorry!). Fight-flight-freeze is also known as the stress response, which is a product of evolution that kept our species alive for a long time, however, if you ask many people with chronic illnesses (especially autoimmune diseases) you’ll have a lot of people tell you about chronic stress, trauma history, and attachment issues, all of which can dysregulate our stress response. Usually this occurs in childhood, and I can specifically remember 5 years where I had chronic stress (at school only, due to a traumatic friendship).
I’m going to try to explain the stress response in the easiest, most non-technical way possible (because honestly my eyes glaze over when I have to read about brain anatomy, and I’m guessing I’m not alone in that). So there are a few different parts of our autonomic nervous system, most notably the sympathetic nervous system (fight and flight) and our parasympathetic nervous system (freeze). There is also our vagus nerve which is really important in understanding the nervous system but I’ll leave polyvagal theory for another time. Sympathetic activates us to either fight or run away in order to survive, whereas the parasympathetic suppresses everything in order to keep our bodies alive when we can’t fight or flight. The problem is that when our stress response is chronically activated, it can impair our physical and mental health. I want to put a caveat here for the rest of this post, correlation does not mean causation, however, most theories do point to chronic stress as being causation (at least partially – biopsychosocial approach) for a lot of illnesses.
I think it’s also important to talk about stress-related disorders, because they tend to also be diagnosed in people with autoimmune diseases. Examples include acute stress disorders (same symptoms as PTSD but only lasting between 3-30 days), posttraumatic stress disorder (which most people seem to have a basic understanding of), and adjustment disorders (occurs during major life changes). Attachment disorders can also contribute. One study I looked at found that people with a stress-related disorder were more likely to not only develop an autoimmune disease, but to actually be diagnosed with multiple ones, and had a higher rate of them if they were younger when having the stress-related disorder.
Let’s talk about chronic stress – when our stress response is activated for a long period of time (i.e., daily stress as opposed to one major stressor) – because a lot of research has been done in this area. Here is a bunch of things that chronic stress can do:
contribute to high blood pressure
contribute to anxiety, depression, OCD, anorexia nervosa, and substance use disorder (and withdrawal)
contribute to obesity (increase appetite, leading to weight gain)
suppress or dysregulate immune function (leading to inflammatory disorders and hyperactive immune systems such as in RA and lupus)
suppress the reproductive system
suppress growth in children (lots of studies of children in orphanages)
switch off disease-fighting white blood cells, increasing risk of cancer
worsen symptoms in lupus patients
contributes to malnutrition
contributes to poorly controlled diabetes
contributes to hyperthyroidism
So that’s a lot. I mentioned ME/CFS as the beginning of this post as well, which is associated with the physiological state of freeze, as examined by metabolic changes. Some research indicated that people with ME/CFS are “wired,” meaning a combination of both the fight/flight and freeze responses, leading them to feel wired and tired at once. I hope this gives you some understanding of what is going on with you if you have any of the illnesses mentioned in this post. Understanding is one thing, but what can we do to help ourselves, especially if we are in a chronic stress response? While there is no right answer, there are definitely things we can try (and a bunch have worked for me!)
Deep breathing (into the diaphragm) – for many people this lowers stress (it sometimes increases anxiety for me, so I personally find it more effective to do mindful breathing)
visualizations and guided imagery – try this one out.
Prayer – this is a mindful activity that many people find helpful
Yoga and Tai Chi – mindful movement can be very grounding – listen to this podcast episode about it.
Walking (and other forms of exercise) – for many people this lowers the stress response, for some people it can increase it due to heart rate increases
Journaling – you have to like to write/journal for this one but it can be helpful to get your thoughts out of your head
Biofeedback – this is a technique in which you can learn to control some of your bodily functions (i.e., heart rate)
Even when we are limited in what we can do (because of our illness or pain) we should still live by our values and take actions that we can. If you play an instrument, that might mean playing your instrument! Or if you’re unable to play at the moment, maybe it means listening to some music that you love. What can you do to live by your values?
This is just one way to keep making the most of it!
Which would you rather do – something (a behaviour) to give yourself short-term symptom relief or something (a behaviour) that aligns with your core values, even if the goal isn’t to bring you symptom relief? The first option, by the way, isn’t necessarily connected to your values. There was a time for me that I probably would’ve done the later. Hell, I did do the latter! I definitely acted in ways that weren’t indicative to what was important to me at all but did help me out in the moment. Things like lying in bed, avoiding exercise, asking my partner to rub my back or just stay near me for hours, missing work, and on and on and on. And I’m not even saying that any of these are bad things. They were just bandaids that made that moment better, but didn’t help my pain long term and ultimately had a lot of costs (like the end of that relationship, feeling physically weak, and making work more difficult). Over time, reconnecting with my values became a much more viable response – and in some ways, even helped to decrease my pain.
What are values? They are our principles or standards of behaviour that we want to engage in. They represent what is important to us. Some examples are:
and on and on and on
Different values can also show up in different areas of our life, like work and education, relationships, personal growth and health, and leisure. Values often motivate how we behave in different situations. Sometimes we just live by our values without thinking about them. However, sometimes, when we find ourselves dealing with chronic pain and chronic illness, we can get removed from our values, like I did. There are two things we can do to figure out if we have been removed from our values while dealing with the terribleness of chronic pain and illness.
Figure out what our values are – using a checklist and/or a bull’s eye.
Figure out (nonjudgmentally) what “unworkable action” we are engaging in that is acting as a “bandaid” but isn’t really lining up with our values and how we want to be long-term.
Okay, but why should we do all that? You might be wondering why not just stick wth the bandaid solution. And you can. But typically we have better overall quality of life if we live by our values. We engage in behaviours that are more fitting to the person we want to be and the life we want to live. And, what research finds (plus just looking at my own life and the lives of my clients), is that pain and other symptoms bother us less. It doesn’t mean they go away, they just don’t really interfere with our lives anymore. The research finds that our self-care for our illnesses and pain improves when we are motivated by our values (everything from self-direction, pleasure, and health to responsibility and socialization). We become more willing to “make room” for our difficult sensations (and thoughts and feelings) when we live by our values.
I’ve shared in a number of posts different ways that I live by my values. Here are a few consistent ways I do in my life.
Presence (aka mindfulness) – I meditate daily, do yoga several times a week, and just try to fully engage in as many activities during the day that I can.
Fitness/health – I eat healthy (gluten-free, dairy-free, meat-free – though I do allow myself some cheat days) and I exercise daily (walking and/or strength training, and/or physio exercises)
Creativity – I’m writing a book, I play the piano, I write screenplays with a friend
Adventure – I travel (looking forward to getting back to that), hike, kayak, try new restaurants, meet new people
And those are just some ways I live by my values even with an autoimmune disease and chronic pain. It took a lot of work to get here though, so be kind and patient with yourself (hey, that’s the value of self-compassion). I hope this helps you to make the most of it!
This may seem like an odd topic for a blog about chronic illness and pain, but trust me it’s relevant. The same way you survive quicksand is the same way you can learn to thrive with chronic pain. And no, it’s not an easy process, nor is it something you can learn to do in a few days or weeks, but take it from one warrior that it is possible.
The metaphor and skills are based on Acceptance and Commitment Therapy.