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!

Ways to Improve Your Stress Response: and the correlations to chronic illness

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).

Image from: https://www.chconline.org/resourcelibrary/fight-flight-freeze-anxiety-explained-for-teens-video/

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.

Image from: https://www.youtube.com/watch?v=DPWEhl7gbu4

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.

Image from: http://traumadissociation.com/trauma-stressor

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)
• digestive problems
• 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

Stress always worsens my UCTD symptoms.

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)
• Progressive Muscle Relaxation – try this one out.
• Massage – I personally find massages to be both relaxing and therapeutic
• Acupuncture – there is research showing it helps with both stress and chronic pain
• Social Support – from friends, family, colleagues, support groups (in person or online), and pets!

Furry friend social support.

Hopefully that gives you a few ideas for how to lower your stress response. Keep making the most of it!

Book Review: When the Body Says No

If you haven’t heard of this book and you have a chronic illness you need to get in the know. And to be fair, and I hadn’t heard of the book until about a year ago, and I didn’t actually read it until recently. The author I had heard of. Dr. Gabor Mate. He has written several books over the years on topics ranging from chronic illness to substance abuse to ADHD, and he’s quite well-known in both the self-help and medical communities. So, now that I’m done reading this (must-read) book, let me share some thoughts and opinions, and hopefully help encourage you to also give it a read.

It’s available at all major book sellers
(I got mine from Amazon)

First, for those of you unfamiliar with Gabor Mate, he is a Canadian (now retired) doctor who spent his career in family practice, palliative care, and working with people who use substances in Vancouver’s East End. And he’s touted as being an expert in these areas. The book, When the Body Says no is about how “stress” influences chronic illness. Now, stress encompasses a lot of things here, which is why I put it in quotations. It includes life stress, attachment, coping styles, trauma, adverse early childhood experiences, adult relationships, and so on. Basically a lot of stuff, though Dr. Mate posits that it’s our early life stresses that have the greatest impact on us. The book takes a biopsychosocial approach. This means it includes biological, psychological and sociocultural influences on health and illness. This is the approach that science is backing when it comes to both physical health and mental health (literally my first class in grad school was “A Biopsychosocial Approach to Mental Health”). What’s interesting, if you go online to research most illnesses (come on, we’ve all googled our actual illnesses, as well as other potential ones) usually only biological causes are listed. And I will agree with Dr. Mate, that biological causes don’t tell the whole story (and neither to strictly psychological or sociocultural). For example, he writes (based on scientific research) that some people with biological markers for illnesses never actually develop one. Why? If it was strictly biological then everyone with the biological markers would clearly develop it. Again, there is more to the picture.

Image from: https://www.physio-pedia.com/Biopsychosocial_Model

Like I said, I agree with a lot of the content in the book. I mean, many autoimmune diseases are diagnosed after a person has gone through a stressful experiences. It makes sense that the body would take on what our minds don’t want to – such as a repression of emotions. And clearly trauma can manifest in many, many ways (illness, substance use, psychiatric disorders, etc.). Many people will read the book and find themselves very well represented for whatever illness they have (and he covers a lot of illnesses from cancer to a variety of autoimmune diseases to Alzheimers and so on). My only problem with it is that he asserts that attachment issues (to parents) are the #1 determinant of illness, and that virtually all people with illnesses have more than one of these issues. And this is where I didn’t find myself represented. My attachment style with my parents has always been healthy. My early childhood experiences were really good. In fact, the first trauma I suffered was ongoing between the ages of 8-13 (being bullied at school). At the time, yes, I did probably repress a lot of my emotions, but as I got older, and certainly by the time I was diagnosed with my illnesses, and I was not repressing emotion (at least as often) anymore. Now, that being said, maybe all it took was that experience to account for the psychosocial part of my illness. I can’t say either way, but regardless I don’t feel I perfectly represent the picture Dr. Mate paints in his book, though I can appreciate that a lot of people do.

My brother and I, circa 1988-89.

All of that said, I do highly recommend reading this book if you have a chronic illness OR if you have a loved one with a chronic illness. It gives insight into the causes, which some people find helpful. And if you’d rather live in the here-and-now, rather than try to decipher what caused your illness, the last chapter is called the “Seven A’s of Healing” and it really resonated with me, because for the most part, it is exactly what I work on with clients, and it is strongly evidence-based. So, go read When the Body Says No, it’s definitely worth it.

My podcast episode this week is on Creative Hopelessness, so if you’re finding it difficult to make changes in your life and/or you’ve been feeling hopeless, please check it out. Until next week, keep making the most of it!

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