How to Combat Loneliness

I’ve been thinking about loneliness the past few days because I’ve noticed a shift in my mood. It’s a bit lower than normal and when I think about why that might be, it comes back to feeling lonely. A year and a half ago I moved from a big city where I had spent 6 years making some wonderful friends, to a small town where I only had my brother in a town over. Then 6 or 7 months ago I moved to another big city, where I have my other brother, his wife, and a close friend I’ve known for many years and his partner. While I do see my brother and sister-in-law fairly often, I haven’t seen my friend much due to schedules, etc. I also don’t have any other friends here and it seems to be harder to make new friends at 37 than it was at 30. I also haven’t had a serious romantic relationship for several years.

Loneliness can feel like waves pounding over you. You can learn to swim through the waves.

Loneliness is also something commonly experienced by people with chronic pain and chronic illness. This can be due to not being able to engage in activities you once could. It could be a lack of understanding from friends and family, perhaps even lost contact with them because of it. It could be an inability to work. And so on. While some people are totally content being on their own (and for the most part I’m totally fine being on my own), most of us crave connection. It’s part of our evolutionary history. Humans have always lived in groups, supported each other. And yet we’re always alone…

One of the four “givens” of the human condition, according to existentialism Irvin Yalom, is isolation. It’s something we fear and dislike, and yet it exists for all of us. I think of it this way, who is the only person you spend 24/7, 365 for your entire life with? YOURSELF. No one else. And so, chronic pain or illness or not, loneliness is something we need to be able to deal with. But how do we do that?

Here are some suggested ways to deal with it:

• join activities that you can do – this is something I’m personally looking into right now. Is there a sport you can play? An art class you can take? Some other activity you can engage in with other people, even with your pain? Sometimes this involves making room for your pain, which you can learn to do here.
• reach out to friends and family – even if you can’t see them in person, connect via text or phone calls or video chats. I talk to one of my best friends every week via Skype. A couple of my other good friends I video chat with every few weeks and text with regularly. It’s not the same but it’s something.
• join online support groups – well I have a love-hate relationship with these, they can be a great way to connect and remember that you’re not alone. Friendships can even develop online. Listen to this podcast about it.
• Speaking of making friends online, try online dating – okay, if you’re in a relationship this may not be the best idea, but you could try Bumble BFF in which the sole purpose is to make friends. Otherwise, I have made plenty of friends in the past via online dating (though that was pre-pandemic and it does seem to be a little harder now).
• Become your own best friend – while this doesn’t completely take away feelings of loneliness, it can help you in the in-between times of being with other people. I’m definitely my own best friend. And yes, I do still get bouts of loneliness but they are few and far between (I just happen to be in one of the few).

No one likes to feel lonely, especially when paired with other emotions like sadness and anxiety. While chronic pain and illness can make loneliness more common, there are definitely a few ways you can combat it so that you can keep making the most of it.

Video: Daily Mindfulness – There Go Your Thoughts

In this short exercise, we work on developing our “noticing self” in order to help create some perspective. The “noticing self” can be extremely helpful to develop when you have a chronic illness and/or chronic pain. Rather than get overwhelmed by our sensations or try to get rid of them, it can help us live more effectively with our current, present-moment experience. If you have questions or comments about this, feel free to comment on the video and I’ll try my best to answer. I did do a podcast episode on this concept back in the day, here’s the Youtube link.

Keep making the most of it!

Why Music Might Increase Your Resilience to Chronic Pain

I’m a musician. Not professionally of course, but it is definitely part of my identity. I began playing the piano at age 5. I took lessons until I graduated from high school. I took practical and theory exams with Conservatory Canada (formerly the Western Board of Music) to the point that I have Grade 8 practical and Grade 4 theory. In junior high and high school I played the alto sax in band and jazz band. In high school I sang in the choir, played they keyboard for one of our vocal jazz groups, sang in another vocal jazz group, and always had a role in the school musicals. To this day, I still play my piano daily and sing along with songs as they come on the radio. I can play about 3 chords on the guitar, and I swear I’m going to take lessons one day! As a mental health professional I have also learned a lot about music and resilience.

Check out this podcast episode with singer-songwriter Sarah Luby who has T1D and UCTD.

Resilience can be defined as the ability to adjust to change or difficulties in life. Resilience utilizes our emotional strengths and our awareness of and ability to use our coping mechanisms to overcome adversity (Merriam-Webster, 2021). Resilience is also key to dealing effectively with chronic illness and chronic pain. Why? Because things are constantly changing and adapting. We have strong emotions and thoughts about our situations and these can often lead to depression and anxiety as well. We need to and want to be able to cope with what is happening. Yet many of us struggle with resilience for several different reasons, from childhood experiences to the pain itself and a lot in between. The good thing is we can learn to develop more resilience.

There is a ton of research on the benefits of music, such as increasing self-awareness, being more socially connected to others, and it helps to regulate mood (Schafer et al, 2013). It also enhances self-regulation, initiative and helps to strengthen relationships with others, not just connect us with them. Resilience skills in general do the same with our self-regulation, awareness, mood, initiative and relationships. There is a lot of overlap, so it makes sense that music would be helpful for this. In terms of how music builds resilience specifically, there is the idea of ‘musicking’ or our musical life in terms of an I-Thou relationship (this is an interesting existential idea that allows us to engage in perspective-taking, which in itself increases resilience as I’ve seen first-hand with my clients). The relationships of sounds, bodies, and psyches as presented in musical compositions/song builds this perspective-taking ability (Malloch & Trevarthen, 2018). Beyond this, musician can communicate musicality in order to enliven both themselves and listeners. (Malloch & Trevarthen, 2018). Therefore, listening to music, not just playing it, can build reslience.

In a clinical setting, music can be used in two different way. Music Therapists use specific music interventions to help individuals with their specific goals, mood regulation, resilience, etc. in an individual or group therapy setting. There is specific training to be able to do this. The other is “music for wellness” which is having musical experiences – listening, playing, etc. – for the purpose of wellbeing and general functioning. As I’m not a music therapist, I encourage my clients to engage in the latter, which is also how I engage with music.

I have since had my actual upright grand piano shipped to me. So much better to play on!

Music for chronic pain has also been studied. For example, in a palliative care setting, music was found to actually decrease chronic pain in patients, which I found super interesting. This really ties into the resiliency. Typically when we are more resilient our pain either actually decreases or just doesn’t bother us as much. Honestly, I’m fine with either scenario. The last few days my knee has been hurting a lot. I’m not sure if it’s related to my UCTD or my hyper-mobile knee joints (my physio thinks they’re related to each other). I do notice that when I play the piano, or even just listen to music while I’m on a walk, my pain is less noticeable. Perhaps because of distraction or perhaps because the music is building my ability to be resilient, not just in those moments but throughout life. Take a listen to this podcast episode with musician and music teacher Melissa, who has multiple chronic illnesses.

Pick a song to listen to, play, or sing along with today and see if that helps you to keep making the most of it!

Video: Daily Exercise – Foot Arches

Strengthening the arch of your foot can help with a number of foot and toe problems, including trigger toe.

Always consult with appropriate healthcare professionals before starting any new exercise.

Keep making the most of it!

What Foods are Good for My Mental Health & Chronic Illness?

I was reading an industry magazine put out by my association (British Columbia Association of Clinical Counsellors) and this issue was heavily focused on mental health for chronic illness, which I was obviously excited about. In it there was a 1 page article/ad for a book about BRAIN Foods, or which foods are specifically good for mental health. I noticed some overlap with foods that are good for autoimmune disease as well, so I decided to do a little more research and try to figure out which foods would be good for both. While having this knowledge can definitely help my clients, it is also helpful for myself.

Vegan dark chocolate mousse was my birthday dessert in Costa Rica in May 2019.

Before I get into what I’ve found as overlap (not everything does overlap to be clear, there are a lot of foods that came up for one or the other), I want to state that a lot of this depends on what kind of diet you follow. Someone who does AIP vs. Paleo vs. Keto, etc. will all look at this list and find things they can or cannot eat. What I’ve found works for me is to just cut out foods when I notice they don’t make me feel well. So I don’t eat gluten or dairy or meat (except fish) because those are the main things that bother me. However, knowing what can have more benefits from the list of things I do eat is helpful to know. I also want to say, that I am not perfect, nor do I try to be. I went to my brother’s wedding in another city, and while I did try to eat from my go-to list as often as possible, there were times (like at the wedding itself) where I did indulge in dairy, meat and gluten (I surprisingly didn’t hurt too badly after). I personally find it easier to stick to my diet (or rather, way of eating) if I don’t put pressure on myself to be perfect all the time (when I cook for myself I really do stick to it though).

All that being said, here are the overlap mental health and autoimmune foods I found from several lists and articles:

• Fruits, such as blueberries, strawberries, blackberries, etc. (basically all the berries) – I love berries
• Vegetables, such as broccoli, kale, and cauliflower – broccoli is often a staple for me
• Fish, such as salmon, mackerel, herring and sardines – all of which are high in omega-3s and salmon is my fave
• Nuts and seeds – sunflower seeds specifically came up on a list and I was like ooh reminds me of playing softball as a kid.
• Sweet potatoes – literally another staple for me
• Healthy fats, such as avocados, olive oil and coconut oil – I usually cook with avocado oil and I love avocados
• Turmeric – my former naturopath recommended turmeric tea, which I find to be a lovely way to have more of it.
• Green tea – I go through periods where I drink a lot of green tea
• Dark chocolate – pretty much the only “snack” food on the lists and honestly, I got used to the taste (though I still prefer milk chocolate)
• Whole grains – again, not something I eat anymore, but it’s definitely a better option than “white bread,” etc.
• Coffee – I was surprised by this one, and I do love me my morning coffee. I do recommend no coffee after 2pm though as it can drastically affect sleep.

So, while you don’t have to eat everything from this list, it is probably helpful to try to include some of these foods regularly to improve brain functioning, decrease depression (depression is linked to inflammation in the brain much like AI is linked to inflammation in the body), and decrease illness symptoms. It can also be really helpful to practice mindful eating – check out my guided version here.

I love food, so hopefully this also helps you to make the most of it!

Video: Your Mind Thinks It’s a Mind-Reading Machine

We tend to believe everything our minds tell us. This is completely natural. However, our minds are not actually great mind readers. Watch the video for more on that.

As always, keep making the most of it!

Why Do You Feel Shame About Your Pain?

During my last supervision session with my clinical supervisor (which is recommended for all practicing therapists/counsellors to have), she asked me to think about how I address shame in session with clients and we could discuss it next time (unless I have more pressing topics I need to talk about). Interestingly, just a few days later I stumbled upon an article about shame, and then a podcast. Both around shame and illness. Shame is a natural human emotion that we all experience. Myself included. I’m trying to remember if I felt shame around my chronic pain/illness and if I did, I would say it was near the beginning of my healing journey, which almost feels like a distant memory. Yet, I think it’s really important for us to talk about shame because it is one of (if not the) most uncomfortable emotions to experience.

Shame, like all of our emotions is important. We wouldn’t have evolved all of these emotions if they weren’t useful in some way. If we go back to that caveman mind metaphor I’ve written about before, shame helped to keep us alive. As cave people, if we got kicked out of the clan, we would die because there would be less protection. So shame helps keep us in check with the expectations of those (clan members) around us so that we don’t get “kicked out.” The problem with that is, we will probably physically survive if we do get “kicked out” in 2022. It also, maybe even more importantly at this point in our history, lets us know when we’ve done something that contradicts our values (those qualities of action that determine how we treat ourselves, others and the world). When we don’t follow our values, we often experience shame.

Shame and chronic pain can often coexist. Many people with chronic pain experience higher levels of shame than in the general population (Boring et al., 2021). Part of the reason this happens is because chronic pain, especially if the cause isn’t quite yet known, is often invalidated – by family, friends, and healthcare professionals (especially medical doctors). When our pain is constantly invalidated by others, we are more likely to question the severity of our pain, hide our pain, and disregard our pain and other feelings. The more we do this, the more internalized shame develops. There are several problems with this:

• shame can lead to depression – there is a huge correlation between depression and chronic pain as they can amplify each other. If shame leads to depression then…
• pain not only increases but can also stick around longer – yes chronic pain means it’s sticking around, but to what intensity, to what end? and does it have to be that bad all the time?
• it can also change our beliefs about ourselves – this can lead to increased substance use and other behavioural problems that just increase shame and pain
• shame also causes stress, and we know from research by people like Gabor Mate and Bessel van der Kolk, this can cause physical symptoms such as chronic pain, as well as a myriad of other illnesses

How do we deal with shame? I mean, I’m always going to say that therapy/counselling (they’re interchangeable terms) is a good route to go because many therapists can help you talk through and give you skills to deal with these feelings. Brene Brown, who has done a ton of research on shame, has said that empathy is the best cure for it. Empathy is our ability to share in the feelings of others. Based on the definition of empathy, we need that support from others. What can we do for ourselves though? Kristin Neff, who has done a ton of research on self-compassion, has unsurprisingly found that self-compassion is an effective antidote to shame. As a clinical counsellor I am able to offer empathy to my clients, while not hiding away from shame when it comes up in session, which is generally effective. And then I teach my clients to be more self-compassionate so that they can deal with those feelings when they come up when they are alone. Try any of these self-compassion practices from my Youtube channel.

I hope this helps bring you an understanding of the natural experience of shame you may be feeling with your chronic illness. Keep making the most of it.

Video: Daily Mindfulness – for physical sensations

Learning to make room for physical pain sensations has really helped me lead a more fulfilling life and has enabled me to do more of the things I want to do. A big part of this was utilizing my mindfulness practice to make room for these sensations. If you have chronic pain or a chronic illness that causes you sensations you don’t like, starting these types of practices can be very helpful for many people. That way you too can keep making the most of it!

3 Ways to Reduce Rumination, Worry, and Attachment to Self Stories

Have you ever found yourself caught up in thoughts about the past? What life was like before your chronic illness/pain? Ruminating over and over about that old life… What about thoughts about the future? Worrying about what will happen to you and how your health will affect you, maybe even getting worse? Perhaps you are also really fused with the idea that you are just a sick person now and that is all your life will be. These are all common thought processes when you have a chronic illness or chronic pain. I’ve certainly dealt with these before. The problem with this dominance of the conceptualized past or future, or the conceptualized self, is that it often takes us away from living right now. It makes life worse. It increases suffering.

Rumination and worry are like the fog. Can you come back to the present?

I remember having the thought that I don’t want to suffer any longer. This was in the fall of 2016. My very recent ex blamed me for all the things that were wrong in the relationship because of WHO I was. What I quickly came to realize was that I was ruminating and worrying and fused with having an autoimmune disease. We didn’t break up because of who I was (trust me there were a lot of other issues that didn’t stem from me at all). However, the dominance of my thought processes wasn’t helping me at all. It was taking me away from the life I wanted to live and away from the person I wanted to be.

The Conceptualized Past & Future
I don’t think that being able to reflect on our pasts or contemplate our futures is inherently problematic. Our brains have evolved to be able to do this. Initially to keep us safe and alive. We just don’t run into as many instances of life-and-death situations anymore. When we excessively focus on the past, or ruminate, we tend to feel overwhelmed and depressed. When we excessively focus on the future, or worry, we tend to feel overwhelmed and anxious. Both anxiety and sadness can increase pain and set of flares for those of us with autoimmune disease, which in turn tends to lead to more sadness and/or anxiety. It’s a vicious cycle.

The Conceptualized Self
We all have stories we tell ourselves about ourselves. Like who we are, where we came from, and why we act the ways we do, essentially why we are the way we are right now. Often being sick or in pain is a large part of this story. The problem with these stories is that while they do contains some objective facts, they are also chalk full of our own subjective interpretations. When we are really fused with these stories about ourselves, we forget that life is constantly changing, most of it is not predictable, and we can also create change for ourselves. And yep, I know this is really hard to grasp when you have a chronic illness.

Why we need to contact the present moment
We we are stuck in the past or future, and when we dwell on our stories about ourselves, we are definitely not experiencing the here-and-now. The benefits of being present are plentiful, including the ability to gain more self-knowledge and self-awareness, enjoying our experiences more, feeling less pain (emotional and physical), and being more flexible in our interpretations of ourselves and of life. I meditate daily because it helps me become more present (and it took me so long to get into a daily routine). I also notice myself being able to come back to the present much faster throughout the day, even when I notice physical pain.

How do we counteract rumination, worry, and attachment to our self stories?

• Mindfulness – it can be meditation, but really mindfulness means contacting the present moment, being here-and-now. So it can also be yoga, or mindful walking or eating. It can be fully engaging in an activity. It can be noticing your thoughts/feelings/sensations and then coming back to the present by noticing your feet on the floor. It can be many, many things, but it is always: being curious, open and nonjudgmental about your present moment experiencing. Check this out.
• Noticing Self – the idea that there is a part of us that can step back and notice. Like the sky and the weather. The sky always has room for the weather. Even when the weather is thunderstorms and hurricanes, the sky is not bothered by it because eventually the weather changes. We can use this same part of ourselves, to just step back and watch our experiences without being swept away. It’s a safe place that just notices. This is particularly helpful for attachment to our conceptualized self.
  Check this out.
• Creating Distance Between Ourselves and Our Thoughts – we can’t stop our minds from thinking, but we can notice when our thoughts are unhelpful and learn to let them pass like leaves on a stream. The more distance we can create, the more psychological flexibility we can have in order to return to the present. Check this out.

I know that was a lot of information! I’m a big believer in seeking help from a mental health professional in your area if you are really struggling with your mental health. Many people with chronic illness, chronic pain, TBI, etc. find it hard to cope on their own. One of the best things I ever did was go to therapy. I learned a lot of skills to help me cope and felt I had nonjudgmental support as I continued down this path we call life. And on that note, keep making the most of it!