What is the Chronic Pain Cycle and How Do I Break It?

The chronic pain cycle is essentially what happens to us when we are in pain and let it consume us. First off, this is normal! I totally remembering being there myself. Usually we try to address only part of the cycle, without managing the whole thing (i.e., we like those prescribed medications from our doctors but still get frustrated when they don’t fix everything). I thought today we could talk about a few different versions of the cycle, and address a few ways to address them so that pain is less consuming and we can get back to a life that is closer to what we want.

First off, some of the examples of the pain cycle are pretty basic. Pain leads to sleep problems leads to mood problems leads to decreased activity leads to low energy leads to decreased pain. Or pain leads to muscle tension leads to reduced circulation leads to muscle inflammation to reduced movement leads to pain. And any case, you can start pretty much anywhere in the cycle, but you always end up with more pain. A more comprehensive version of this cycle is shown in the diagram below.

Here’s the problem: our brains tell us that we shouldn’t move, we shouldn’t be active, that things will never be good for us, that we will never have normal lives, etc., etc. because they are trying to keep us safe. Unfortunately, all the research shows that our brains are incorrect and that these thoughts really don’t do us any service. They keep us trapped in the cycle. I remember when I first decided to start making changes for myself. I took myself to physiotherapy (physical therapy for you Americans), the chiropractor, the naturopath, massage therapy, and psychotherapy, because I wanted some relief. What I was encouraged to do was break the pain cycle. How?

  1. Psychoeducation/Health education about chronic pain. I know most of you won’t read scholarly journal articles (as I do) about all of this and that’s fine, but there is a wealth of information on the internet (think clinic websites: Mayo Clinic, John Hopkins, etc.). Also, if you talk to health care provides (your specialist, or any of the above that I’ve mentioned) they will be happy to provide you with the knowledge you need to start making different choices. You just have to be open and willing to listen.
  2. Increase fitness and exercise. This might be as simple as stretches and easy exercises given to you by the physiotherapist, chiropractor or massage therapist. It might also include actual cardio and/or strength training. This should of course be paced, and you should come up with a plan with your healthcare specialists. I went to the gym and got a personal trainer who had worked with people with autoimmune diseases before.
  3. Take your medication. Inflammation in particular is often best addressed with some sort of medication. Of course, there are alternative ways to address it as well, such as through diet or supplements. I like the approach of doing both. I take my medication as prescribed and then balance that with diet.
  4. Address side effects of medication, such as weight gain or others. This might be with your doctor – adjusting doses or which medication you take – or it could be done holistically through other therapies (as mentioned above), exercise, and diet.
  5. Address the cognitive issues that arise. This means anxiety, depression, sleep issues, stress, fear, frustration, anger, negative thinking, rumination, etc. While these are normal experiences, they can make it harder for us to make changes. These can be addressed through sleep hygiene, meditation, and psychotherapy.
Going on adventures even with pain.

Where am I in the pain cycle? Look, to be honest, some days it’s not perfect and I fall right into the cycle. However, most days I can openly and curiously acknowledge and accept my pain, breaking the cycle before it begins. I use all of these tools and healthcare providers because it helps. I know from experience that chronic pain does not have to be life consuming.

I’ve linked episodes of the podcast and my meditation channel throughout this post if you want more information. Until next week, keep making the most of it!

Video: The Struggle Switch & Chronic Pain

Watch this video first:

Video by Dr. Russ Harris. Find his YouTube channel here: https://www.youtube.com/channel/UC-sMFszAaa7C9poytIAmBvA

Now watch this one to see how the struggle switch relates to chronic pain:

For me it always comes back to this question: Is it easier to struggle or to accept? And I guess also this question: Is the struggle helping you out long term or just short term?

Just some food for thought. Keep making the most of it everyone!

Effective Ways to Challenge Chronicity Thoughts

How much time do you spend thinking about your pain or illness? Does it consume most of your day? Just a little bit? I remember the time when I was spending a lot of time thinking about being in pain, and wondering “why me” or what my life would be like going forward etc. These are often referred to as chronicity thoughts. Happily, this was the past for me and is not my experience anymore. I know that many of you may be having this as your current experience though, so I wanted to take sometime to talk about it.

As human beings, we spend a lot of time thinking.

First of all, I want to say that this is a totally normal experience for anyone with chronic pain or a chronic illness. Our minds are literally trying to help us (or they think they are trying to help us, which is what they evolved to do). The problem is, this kind of constant thinking about pain makes our lives worse, not better. There are three types of common chronicity thoughts: (1) ruminating about being in pain/sick – I keep thinking about it, it’s all I can think about because it hurts; (2) magnifying our pain/illness – it will get worse, something terrible is going to happen; and (3) thoughts of helplessness – nothing I do makes it better, nothing I can do will ever make it better.

Are your thoughts making your life better, worse, or the same?

If you went to a doctor (Western or functional) or a therapist, they’d likely assess this with a tool called The Pain Catastrophizing Scale (PCS). My commentary is that I don’t like the name because “catastrophizing” sometimes has the connotation that it’s all in your head, but that’s not what it means in this case – it’s really referring to chronicity thoughts. The questions on the scale include:

  • I worry all the time about whether the pain will end
  • I feel I can’t go on
  • It’s terrible and I never think it’s going to get any better.
  • I wonder whether something serious will happen.
  • and so (there are 13 questions total, and you self-report on a scale of 0-4 for each question, with 0 meaning not at all and 4 meaning all the time.)

So what can we do about all these chronicity thoughts? First, I will always suggest that working with a therapist is the way to go. Remember this blog is educational and not mental health/medical advice. We all have unique situations and unique thoughts, so having someone you can work with one-on-one (or in a small group) is always the way to go. I will let you know about a few different approaches. First, let’s talk about classic Cognitive Behavioural Therapy approach, where we challenge thoughts.

  • Notice and name the thought: I’m having the thought that “It’s terrible and I never think it’s going to get any better.”
  • Review evidence for and against the thought: For might include things like, it occurs frequently, has high intensity, a doctor’s prognosis, etc. Against might be things like, there are times of day when I don’t notice it or it’s less intense or my doctor said with this medication or these lifestyle changes it will improve
  • Replace the thought with a more accurate one: This doesn’t mean being optimistic or denying anything that’s true. Instead it’s incorporating the evidence against the thought (not just for the thought which is what we tend to do). So a different thought might be: “It’s really unpleasant right now, but it might not always be this bad/constant.” (You choose a thought that works for you, this is just what might work for me.)

As a therapist, I am well-trained in CBT but I prefer to use Acceptance and Commitment Therapy (ACT) on myself and with clients, especially those with chronic pain/illness. There is no step-by-step way to challenge thoughts in ACT because we don’t challenge them, but here’s now I might work with them.

  • Contact the present moment: ground myself my noticing and acknowledging my thoughts and feelings, while noticing what I can touch, taste, smell, hear, and see. (Here’s a guided version of this).
  • Use my noticing self: the part of me that notices everything and even notices my noticing. And the similar part of me that can put myself in my shoes on the days when my pain is less. (Here’s a guided version of how to learn to do this).
  • Creating distance between myself and my thoughts: This might be noticing and naming the thought. It might be reminding myself that my brain is just trying to help me and saying “thank you mind.” This might be just watching my thoughts come and stay and go in their own time (guided version of this one is here).
  • Accepting my experiences: particularly physical and emotional pain that I might be going through. This could be actual sensations or emotions such as sadness or anxiety. For this I often just observe what the sensation/emotion looks like, where it is in my body, and so on. Then I send my breathe into the part of my body I feel it most intensely. Then I make some room for it, noticing that my body is bigger than it. Finally, I just allow it to be there without consuming me. (Guided version here).
  • I connect with my values: what qualities of being are important to me? I know that compassion (for myself and others) is a big one that is often helpful in moments of pain, sadness, anxiety, etc. (Here’s an exercise on connecting with your values.)
  • Taking an action to live by my values: So if we’re going with my above example/value than it might be doing some self-compassion work. (Here’s a guided practice). It could also be setting goals to make some of those lifestyle changes that might help. It doesn’t matter what the action is as long as it is rooted in your values. (podcast episode on how to do this available here).

So that’s it. A bunch of different ways to work with your chronicity thoughts so that hopefully you can improve your life and keep making the most of it!

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6 Ways I’m Managing a Weather-Caused Flare (+ 5 More Ways I Could)

Long title, I know. But nonetheless I thought I’d share some of my tips with you, plus a few other evidence-based ones I found online as I’m trying to get through this. I’m writing this exactly one week before it will be published so fingers crossed that it’s over by the time you’re reading it, but if not, then I’ll just have to accept it as it is. My flare is likely caused by a few things. First, I recently moved and moving is stressful (even a relatively easy move like I had) and stress can cause a flare. Second, I moved from a dry climate in the interior of British Columbia to the wet, lower mainland of BC. I always notice my symptoms, especially pain gets worse when it rains… but then I knowingly moved to a rainy climate (*face palm*). All jokes aside, my symptoms are increased pain, increased fatigue, really bad jaw pain, my left foot is super veiny and sore (my calf is fine though so unlikely anything super serious). How the heck can I manage all of this?

Even on a flare I’ve managed to explore my new neighborhood.
  1. Acceptance. Yes, I know some of you are rolling your eyes or saying that this is ridiculous or unlikely to work. But I find it does. I accept that my pain is here, while knowing that the intensity changes hour by hour, sometimes even minute by minute, and I know that when my flare is over I’ll go back to baseline. Acceptance is helpful. I’ve been doing body scans and other mindfulness activities to help with the acceptance, but honestly just acknowledging my experience without getting wrapped up in it is helpful. Check out this acceptance practice.
  2. Exercise, Movement and Stretching. If you read this blog regularly you know that I like to exercise. And I still pace myself by trying to stay consistent with what I do. I definitely increase my stretching during flares. Particularly I focus on the areas that seem to hurt or need it the most. For example, my jaw is the worst today as I write this, and I’ve made sure to do jaw stretches throughout the day. For more on jaw pain specifically, check out this podcast episode with Dr. Shirazi.
  3. Warm Baths. I LOVE my baths. I literally take a bath 4-5x a week in the winter months. And with the rain, I’m definitely needing them. They help relax my muscles, keep me warm, and are very relaxing. Trust me when I say I could never (and would never) live in an apartment without a bathtub. Knowing what is vital to your self-care is essential to dealing with a flare. Check out this podcast episode on it.
  4. Dressing Warmly and in Layers. Vancouver, if you’ve never been, is a city where everyone dresses in layers. It will likely rain at some point during the day, though you never know exactly when. It could also start off cool and warm up, or vice versa. So I’ve been making sure to put on 3 layers when I go out, and have a pair of mittens on me. I need to remember a hat and/or an umbrella, but I’m working on it!
  5. Hydration. I tend to drink a lot of water. Admittedly more when I’m working. Staying on top of my water intake is so important to managing my flares and really my health! I’m trying to drink 5 full glasses of water a day minimum. I basically keep a glass of water next to me all day and every time it’s empty, I refill it. Listen to my podcast conversation with Beau Berman about gut health and how important drinking water is to him.
  6. Omega-3’s and Vitamin D. I typically try to get these from the foods I eat. Lots of fish mostly (rich in both), as well as mushrooms, spinach, avocado and tofu and really a variety of others foods are rich in vitamin D. These are really important for reducing inflammation naturally and honestly are just really good for you! Also, Vitamin D is a way to combat with the “winter blues” (which I often get) and the more severe, Seasonal Affective Disorder.

So those are the 6 things that I am doing, but what are the 5 things that I’m not but probably should be?

  1. Acupuncture. This is actually an evidence-based and recommended treatment for chronic pain. I’ve had it in the past and I’m hoping to start back up with bi-monthly sessions next month. Listen to the podcast episode on recommended treatments for chronic pain for more info.
  2. Massage. I miss getting massages. It’s been nearly a year since I had one, and this is also a service I used to get bi-monthly. I’ll likely also start these back up soon as well. Clearly I need to. The benefits of massage can be heard in the podcast episode with Danielle Potvin.
  3. NSAIDs. I’m not a fan of these drugs to be honest. They can cause stomach problems when on them long term. I’ve drastically cut back on them and only take them to supplement the more natural medications I take (i.e., CBD). If you’re aware of the risks and find them helpful then this can be a helpful solution.
  4. Natural supplements. The only natural supplement I currently take is magnesium bis-glycinate which is a muscle relaxant (and I mainly use it when I’m menstruating). Other recommended supplements are fish oil, ginger (which I sometimes have in food and/or tea), turmeric (which I sometimes have in tea), and gingko. These are definitely worth checking out to use in addition to some of the other suggestions.
  5. Limit Stress. Oh I can’t wait until I’m passed the stress of the move and starting up new counselling practices. The truth is there is always some kind of stress in our lives and it really comes down to how we manage stress. I typically do a good job with mindfulness, meditation, yoga, and relaxation practices. So this might just be a reminder to do a bit more of that. And also, if you are able to avoid stress then that’s a good plan (I do not plan on moving again for quite some time!).
Taking it easy on Halloween. Needed some time to relax after the move.

So that’s it! 11 ways in total to manage a flare. Keep making the most of it everyone!

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Video: Daily Mindfulness – Observation of Body & Breath

It It is extremely therapeutic for chronic pain and chronic illness warriors to get into our bodies. Yes, this is the opposite of what we want to do (run away from being in our bodies) but there is a lot of research that shows this is far more helpful for both our physical and mental health. In this practice we can gently get into our bodies, while using the breath as an anchor. If you haven’t listened to this episode of the podcast on achieving a sense of accomplishment (with Darren Radke), check it out.

I hope you enjoy this practice, and keep making the most of it!

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How do body scans help chronic pain?

I love body scans. I find them a great way to get into my body, sometimes helping me relax, but more often helping me with pain management. I do remember the first time I did one though. The thought I had, “this sounds terrifying! Why would I want to move towards the pain that I’m already experiencing?!” And yet, there is a ton of research showing that many, many, many other people with pain conditions have had the same experience as I have. As with any mindfulness practice, the goal isn’t actually pain relief. It’s 5, 10, 15, 20 or more minutes of doing nothing but noticing what’s happening within, as you move through different parts of your body.

If you’re not familiar with mindfulness and have no idea what a body scan is, don’t run away yet (actually no one should be running away at all – that’s the opposite of what we want to do here!). A body scan is a mindfulness practice in which you are lying down (or sitting, depending on what type of mindfulness you’re doing). You begin by focusing on your breath, and then slowly move through each part of your body beginning with either the top of your head or your toes, just noticing what is happening in your experience. Once we’ve moved through every part of our bodies, we notice the entire body as a whole, and then usually return to our breath before finishing. You can also breathe into parts of your body that feel tense or have more pain, using your breath as a way to help them release (though that’s not always possible, and I personally don’t normally use my breath this way). Here’s a quote from Jon Kabat-Zinn (Full Catastrophe Living), “another way to work with pain when it comes up during the body scan is to let your attention go to the region of greatest intensity. This strategy is best when you find it difficult to concentrate on different parts of your body because the pain in one region is so great. Instead of scanning, you just breathe in to and out from the pain itself.”

I highly recommend reading this book.

What I think the body scan really teaches us, and why it can be so powerful (with regular practice) for chronic pain is that it is really about acceptance. We learn to accept sensations more easily when we can just notice them, without being over taken by them. When we learn that we can move our attention to other areas of our bodies, and see that the pain isn’t always as great as we think it is. Yes, I said think it is, because we all have thoughts about our pain. Acceptance, and turning towards pain can help us improve a number of things, according to the research: reducing pain-related distress, our perceived ability to participate in daily activities, our perceived likelihood of pain interfering with our social relationships, and even desire for opioid (and other pain medication) use (not to say we will use less though). Most of the research comes from people practicing for 10-20 minutes/day for anywhere from 2-8 weeks. Now, imagine long-term regular practice. One of the explanations for why this works is that it increases our interoceptive (inner) awareness and stimulates the parts of the brain involved in that process.

You can practice the body scan sitting or standing, and anywhere you are.

Sometimes when I practice a body scan, I do notice pain that I didn’t before. Very subtle pain in my hands, or a bit of a headache I didn’t even realize I had. And I get that can be distressing for some people. This is why I approach it with curiosity. How did I not notice that before? What am I noticing instead? Is any of my pain really as bad as I sometimes think it is? And sometimes I fall asleep during the body scan (especially if I’m laying down, so I recommend sitting) because the process can be relaxing, even though that’s not the point. Again, I must emphasize the goal of any mindfulness is to do nothing! Not to achieve a certain result (like less pain). Just do nothing (or in this case scan your body) and see what happens! Try it out and let me know your thoughts. Keep making the most of it everyone!

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Daily Mindfulness: An Acceptance Practice

Sometimes we use mindfulness as a way to help us cultivate acceptance. This can be acceptance of difficult emotions or physical sensations. We can do this by observing and acknowledging the painful emotion or sensation is there as if we were a curious child; breathing into the feeling; making room for it by expanding around it; and allowing it to exist. This practice, if done regularly, can help lessen the intensity and hold these have on you. I often use this meditation with clients who have depression, anxiety, and chronic pain or illness. It is based on Acceptance and Commitment therapy. Give it a try and let me know what you think. My full range of meditations is available on my YouTube channel. Keep making the most of it everyone!

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How Can I Become More Resilient?

This isn’t the first time I’ve posted about resiliency on this blog. The truth is, it’s a topic that comes up often. I see it on online support groups, on Instagram, and hear it in conversation with people. I also read it on other blogs, and many healthcare organizations post about it on their sites. Here’s the thing, if you have a chronic illness and you’re not feeling resilient, just know that you are not alone. A lot of people feel that way. Are people born resilient or do we develop resilience? I think it’s an interesting question and possibly a bit of both. Children tend to be more resilient than adults, suggesting we can lose some resilience as we age. In one of my courses for my graduate degree we had to more-or-less do a family tree. Except this family tree was supposed to trace something like a mental health or substance use issue. I chose to trace resilience, and found that going back just to my grandparents generation (that was the requirements for the project) there was a strong theme of resilience (my maternal grandmother/baba faced abuse, neglect, lost 2 children, and she and my mother were trapped in Siberia for a week during the Cold War – I know it sounds too crazy to be true). Yet she not only survived but was a loving parent to her other children and an amazing grandparent. Had my mom not shared my baba’s history I would not have know. She was that resilient.

Three generations of resilience in my family.

The good thing is, that even people with chronic illness can develop resilience. Warning: it does require work on your part. Luckily, some of the work may not feel like work at all… it just requires consistent commitment to it. I want to add, that many of these suggestions overlap with what the National MS Society suggests, in case you don’t want to just take my word for it.

  • finding meaning and committing to that action: what is the reason you get out of bed in the morning? If you don’t have a reason it will be difficult to do so. Is it your family? Or work? I know a lot of people with chronic illness go on disability, but work provides meaning and purpose for people. If you are on disability what is your purpose going to be instead?
  • improvisation/adaptability/problem solving: I think these all kind of overlap and go together. We often have to improvise in order to do things we enjoy. Maybe we can’t go on the 5k walk with our friends, but we could meet them for coffee afterwards. How flexible and adaptable are you to changing plans? Or asking others to? What’s an alternative way you can participate or do the things you like to do? I would go as far to make a list of ideas (remember when brainstorming there is no such thing as a dumb idea) and try out some to see if they work.
  • Self-care: we all know I love self-care, and this includes the basics (getting out of bed, making breakfast, taking a shower) and then doing activities like relaxation techniques, yoga, meditation, or prayer. What hobbies do you enjoy that you can participate in? Pick one a day. Reading is an example of something that is low energy and can be fulfiling.
  • Being able to tolerate “negative” emotions: I personally don’t categorize emotions as negative or positive. All emotions are important because they tell us very important things. If you’re not used to be able to just sit with emotions, try out this mindfulness practice that aims at helping people do just that.
  • Self-efficacy: I did a post on this recently, and you can read it here. Do you believe you can cope with your illness? Part of this is being a realistic optimist, being hopeful.
  • Using skills such as curiosity and humour: When is the last time you laughed? Are you able to have fun and joke around (and not in a self-deprecating way)? Do you get curious about your situation or feelings or sensations or emotions? What are you noticing about them right now as you read this? The noticing self is a helpful skill to develop. We touch on it in this podcast episode (about half way through).
  • Radical acceptance: This is a skill from Dialectical Behaviour Therapy (DBT) and essentially the same used in Acceptance and Commitment Therapy (ACT). It is about fully accepting your situation/thoughts/feelings/sensations/etc. Fully. Accepting. It doesn’t mean you have to like it. It’s hard to do a lot of the above without this kind of acceptance.
My curious, nonjudgmental, accepting, “what am I noticing” face.

I hope this helps give you some ideas for building resilience some more. Well-being and a good quality of life do require us to be resilient, and trust me, it is possible even with chronic illness. Here’s the link to the MS Society page on resilience. Take care, and keep making the most of it!

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What has your pain taught you?

I don’t know if you’re familiar with quicksand, but probably most of us have seen it in the movies or on TV. Our hero is on an adventure in some kind of jungle and they (or someone in their party of merry men and women) falls into what turns out to be quicksand. And they struggle and struggle and sink faster and faster. Usually in the movies the hero saves the day. Struggling in quicksand is a lot like what we do with our pain – both physical and emotional. We fight against it, struggling more and more, sinking deeper and deeper. But do you know how to actually get out of quicksand in real life? Like if you fell in it? Struggling makes you sink, and doing nothing – literally putting yourself into the floating position (arms and legs out, with zero resistance) will help you float to the top. From there you can take very slow, gentle strokes and get yourself out.

What the quicksand metaphor shows is that if you do the opposite of what you think you should do, you can often get to safety. In the case of pain, it means looking at it differently, changing your relationship with it. So that brings me to the question, what are your pain taught you? The answer can be many things. Maybe it’s taught you something about yourself. Or your relationships. Or your values/what’s important to you. Maybe it’s taught you something about the meaning of life. Or helped you set goals. Before straight off answering this question, really take a moment and ponder it. Because often the immediate answer is NOTHING! or THAT LIFE SUCKS! or something to that extent. But is that true? Is that all it’s taught you? Those answers often take us back to the struggle. You’ve fallen in quicksand by responding quickly with the first thing that comes to mind, rather than taking some time to really explore if there is something more you can get out of your experience.

Look, I get it, there is nothing fun about physical (or emotional pain) but that doesn’t mean it can’t do something good for us.

I’m going to use my experience as an example. And trust me, there was a time I was struggling in the quicksand and those would have been my answers. But here is what it has actually taught me, when I’ve taken the time to think about it:

  • I’m stronger – both physically and emotionally – then I thought I was, but it took a lot of work to get here.
  • Being treated with love and respect in romantic relationships and friendships is incredibly important to me.
  • I can do anything that I put my mind to, even if that means I have to adapt some things to what I can do.
  • Loving myself is the most important thing to me.
  • I want to have as many life adventures as possible despite chronic pain.
  • Everything I need is in the present moment, and sometimes the present moment isn’t great and sometimes it is, but that is how life is for everyone.
My first adventure after my diagnoses was to Vienna in 2017.

I’ve probably learned more lessons than that from my chronic illnesses and chronic pain, but should give you a picture of what it can teach you. Your answers will likely be different from mine. This is a key piece to acceptance, and if you can’t accept, you can’t really improve your well-being and quality of life. I want to make a few additional things clear with this post. First, I am not saying that your loss of health is a blessing or that you should be grateful for it. Sometimes as we move through illness grief, gratitude does appear, but that doesn’t mean you have to start looking for it. Also, meaning is not found in loss – it’s what you do after the loss. So the things I listed, are really about things I’ve done after I got sick. This is also not an exercise I’d recommend if you’ve just been diagnosed, because you won’t have had a chance to go through enough to be able to do it.

If you’re interested in contacting the present moment, check out my YouTube channel. This week’s podcast episode is on externalizing language, which can also be quite helpful – find it on Apple, Spotify, and everywhere else you get podcasts. Until next week, keep making the most of it!

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How to Self-Esteem & Self-Worth Effect My Chronic Illness?

Back when I was first diagnosed with an autoimmune disease, I noticed that my own self-esteem dropped. The person I was in a relationship with at the time didn’t help that, but then again, it wasn’t really up to her to help it. The disability I had from my illness was also very intense at the time. I missed a lot of work, I couldn’t go on long walks, I felt a lot of pain, and that all definitely hurt my self-esteem and self-worth. And that’s where my story ends…

That was then (June 2016).

Just kidding, if you’re reading this then you know that is not where my story ends! Actually, it’s where it begins. I was reading something a few weeks ago about self-esteem and chronic illness, just a brief paragraph, and it got me interested in doing a little more research on the topic, because, well, I noticed a correlation between my own self-esteem and self-worth and disability in my illness. I can’t be the only one, right? First of all, let’s define self-esteem and self-worth so we are all on the same page.
Self-esteem: our individual universal positive and/or negative feelings about ourselves.
Self-worth: basically another word for self-esteem.
In general, self-esteem effects our quality of life, which includes our overall life satisfaction as well as how much positive and negative affect (emotion) we experience.

On the journey (June 2017).

When we are looking at chronic illness, there are some important considerations. First, how we evaluate and view our own bodies is important, often because of the changes our bodies go through because of illness (and/or medications we have to take). Having a perception of body-self unity and positive thoughts about our illness can improve self-esteem (we’ll get to how to do this in a minute). Second, acceptance of disability is related to self-esteem in people who have disabilities (chronic illness is a disability). Acceptance doesn’t just include accepting the diagnosis, but acceptance all that comes with it (pain, lifestyle changes, loss, etc.). The better we are at accepting… the more we are able to do? (Well, yes, but that would actually be another post, so back to the main topic)…

It continues (June 2018).

People tend to use different coping strategies when dealing with illness. Though none of these strategies should be categorized as “positive” or “negative” I prefer to think of them as “toward moves” (helping me live a good life) or “away moves” (taking me away from the good life). Away moves would include things like catastrophizing, which has been linked to pain-related disability (yes, it makes your pain worse), higher levels of depression, and overall lower health and well-being. Other away moves include avoidance strategies, like using drugs or alcohol to cope, denial of illness, or staying in bed all day everyday. If you do these things, understand that no one is judging. These are probably natural coping strategies for you as they are for many, many people. However, if we want to improve self-esteem (and thereby improve quality of life with our illness) we want to look at toward moves.

I can even see the change in these pictures, can you? (June 2019)

These toward moves coping strategies include hope (goal-directed energy plus planning to meet goals), humour (reframing distress), psychological appraisals (meaning of the stressor, ability to cope, and emotion-focused coping, such as seeking support), and approach behaviours such as seeking social support and positively reframing the situation (yes, the research supports mindset). These are all associated with better well-being, better mental health, and better illness outcomes. This all comes from the cognitive adaptation to chronic illness theory, which in addition to self-esteem, looks at making meaning of illness, and regaining mastery.

Just last year (June 2020).

I think it’s important to assess which coping strategies you are using, and make changes if needed. If our self-esteem improves, and therefore our disability decreases, then our quality of life is also better. Sounds good to me! To finish my beginning story, I did a lot of personal development work, that led me to starting this blog, and along the way my self-esteem and self-worth drastically improved again, and my levels of disability have shrunk and shrunk and shrunk. My illness may not be cured, but my quality of life is so much better. This experience is also known as posttraumatic growth, which happens when positive change results from adversity, giving the individual better mental health.

I continue to use “toward moves” coping strategies to this day (June 2021).

New season of the podcast (totally revamped show!) coming June 28. Check out the trailer here.

Keep making the most of it!

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