Ways to Determine Acts of Self-Care From Acts of Health Care

First off, the media’s portrayal of what is self-care is VERY different from what mental health care professionals think of as self-care. Self-care in the media is bubble baths and spa days and bottomless brunches. I am not against any of this! In fact it all sounds quite fabulous. Counsellors and therapists such as myself think of self-care more in terms of activities of daily living (ADLs) like getting showered and dress and eating meals, etc. And then there is this weird grey area of overlap. For example, I see meditation as a form of self-care. It’s not an ADL, and the media would categorize it as self-care, and yet it can be extremely beneficial for mental and physical health. So I see things like that really as acts of health care.

Relaxation and meditation.

Here are some activities that I see as health care (that are sometimes categorized as self-care):

  • meditation and mindfulness – contacting the present moment to be here-and-now
  • self-compassion – taking a moment to be kind to yourself through touch or words
  • massage therapy – having a registered massage therapist do deeper work (than just purely going to the “spa”)
  • acupuncture – it has been around around for thousands of years and sessions are usually between 20-45 minutes
  • swimming and other forms of exercise – water therapy, strength, cardio
  • baths – more water therapy!

For all of these, research actually supports that they are important for health and mental health. Mindfulness and self-compassion can release tension in the body, make us feel calm and centred and present. Massages and acupuncture can reduce physical sensations of pain and also create relaxation in the body. Exercise reduces pain and increases strength. Baths, swimming and in general water therapy is supported for pain because of its strength, flexibility, heat and relaxation effects (depending on what you’re doing).

Thinking in terms of how these things will benefit my health, as opposed to just being things to enjoy (I mean, these are all things I do also enjoy) makes me more motivated to do them. It’s funny, because the idea for this topic came to me as I’m having a massage later today (I write these about a week before they’re posted). Getting a massage purely for pleasure hasn’t occurred to me in the longest time. Instead I always consider my massage therapist part of my healthcare team. I’m just like, hey, it’s time to take care of those muscles, especially because I have fibromyalgia and I’ve been neglecting them recently! And honestly, this type of health care is also self-care. I think we can get pulled into all these labels, rather than just going with what we need, regardless of whether it’s real self-care or media self-care or health care or anything else. What will make your mind, body and spirit feel better today? Do that, and keep making the most of it!

How to Cope With Colds & Chronic Illness

It’s been 84 years and I can still smell the fresh paint… No, just kidding. But it has been at least 2.5 years (possibly longer) since I had the common cold. Clearly the social distancing and masks and everything not only helped protect me from Covid (which I have managed to avoid thus far) but also the cold, flu and everything else. Then, on May 2, I caught a cold. Sore throat and all. And it was pretty bad. For me, it’s worse because of one of my chronic illnesses.

Life with chronic illness.

Getting any kind of additional illness usually sucks when you have a chronic condition. Example, if you have an autoimmune disease and you’re on immunosuppressants, that can also make you much more vulnerable to more severe illness and symptoms. It’s one of the reasons most people I know with chronic conditions have been so careful during the pandemic. Lucky for me, I’m not on immunosuppressants (I take antimalarials) so I don’t have to worry as much about that part, but still. What I do have that makes catching a cold particularly rough for me is glaucoma. Glaucoma is a degenerative eye disease that can eventually lead to blindness (luckily there are amazing treatments so the chances of going blind if caught early and treated are fairly small). My paternal grandmother had glaucoma and was virtually blind by the time she died. Both of my parents have glaucoma. And when I was 29 I was diagnosed with glaucoma, which is incredibly young (most people are 50+ when they develop it). The leading feature of glaucoma is high eye pressure.

So on May 2, before I started having cold symptoms, I actually happened to have an appointment with my new ophthalmologist. My eye pressure was pretty good and there was no degeneration. He actually made two comments that I found quite funny. First, “You are extremely near-sighted.” Yes, I know (that’s literally how I responded too). He actually informed me about possibilities of retinal tears, and what to look out for. His second funny comment, “Well, I guess we’ll be seeing you from now until indefinitely.” Yep, pretty much true. So, why is catching a cold worse when you have glaucoma. Well, over-the-counter cold medications actually increase your eye pressure. Therefore, I can’t take cold meds (other than cough drops).

Okay, so what happens to me when I can’t take cold meds and have a bad cold is that I get extremely wimpy. Basically life sucks for a few days. Unless I catch myself in these thought patterns, which is what I did recently. I know that “this sucks” and “everything is terrible” thoughts leads to more negative mental and physical health outcomes. It increases body aches and pains, it can keep me sick longer, and it can make me feel depressed (and there’s lots of research out there to back all of this – just type a few key words into Google Scholar and you’ll find it). To be effective I had to “manage my mind” (which is a phrase a life coach who’s podcast I listen to uses). I notice the thoughts, place them on a leaf and let them go. Or I notice and name the thoughts or name the story my thoughts are trying to tell me to create some distance. And then I take comfort in pleasurable activities that I can do. For example, I love movies and being sick is an excuse to watch them. But I don’t just pick any movie. I have some favourites that I used to watch all the time as a kid when I was sick… and then continued to watch into my adulthood when I’m sick. My favourite is Jurassic Park. So that’s what I did. I created distance between myself and my thoughts, acknowledged any emotions I was experiencing, made some tea and watched JP.

The other thing I did recently that was helpful, was talk to my ND about natural cold remedies. Now, I’m lucky in that I work at the same office as my ND (we actually share a room, just work on different days), so for me it’s a quick text and I realize that’s not the case for everyone. But if you see a naturopath, it’s worth asking about. Here are some suggestions she gave me for the common cold (sinus and cough):

  • Vitamin C: amount can depend on your bowel tolerance – I bought the chewables and used about 3g per day.
  • NAC supplement – I think you have to go to a natural health store to find these. I didn’t try them this time, but I’m keeping it in mind for the future.
  • Peppermint tea – which I love anyway, and interestingly it’s the only type of tea she recommended
  • Eucalyptus inhale: basically boiling water with some essential oils and inhaling with a towel over your head – I found this extremely helpful
  • wet stock treatment – I did not try this because my feet hate the cold, but apparently it is very effective.

Alas, I survived my first cold in 2.5 years and realized that the best things for me to do is use some natural remedies paired with some psychological coping skills. If you’re like me and unable to take cold medication, I hope this helps you to keep making the most of it!

Why You Should Be Curious & Nonjudgmental About Your Illness

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).

  1. 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.
  2. 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?
  3. 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.
  4. 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!

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).

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.

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!

How to Figure Out Your Values When You Have a Chronic Illness

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:

  • acceptance
  • adventure
  • assertiveness
  • authenticity
  • caring/self-caring
  • compassion-self-compassion
  • cooperation
  • courage
  • 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.

  1. Figure out what our values are – using a checklist and/or a bull’s eye.
  2. 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.
Unworkable action occurs when: (a) the solution is short-term, and (b) the behaviour takes you away from your values.

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.

There are many ways we can live by our values. For example, when I travel I balance the adventure/activity part with rest.

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
Actively living by my values doesn’t take the pain away, it takes the hold the pain has on me away.

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!

Video: How to Survive in Quicksand

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.

Keep making the most of it!

Why You Shouldn’t Avoid Your Pain

Today I’m giving you a choice.

  • Option A: you never have to feel pain again. No physical pain. No sadness. No anxiety. No guilt, fear, or anger. But… you can also never feel physical relaxation. No joy. No happiness. No love, pride, or serenity.
  • Option B: you still have to feel pain, both physical and emotion. But you also get to feel relaxation, joy, happiness, love, pride, serenity, etc.

What do you choose?

I know Option A is super tempting, but I’ve found that most people choose option B, because no one wants to permanently get rid of the things that make us feel “good.”

We don’t like to feel “blue” so we resist it.

When it comes to pain – and throughout this post when I refer to pain, I mean both physical and emotional – we tend to try to block it or avoid it at all costs. Literally, people will drink alcohol, take illicit drugs, take prescription drugs and over-the-counter drugs, mindlessly scroll on their phones for hours, and so on, just to avoid or get rid of the uncomfortable things we really don’t like to feel. Here’s the problem: when we do this it tends to make all the pain much, much worse. (And yes, there has been a TON of research done on this).

PAIN X RESISTANCE = SUFFERING

This formula has been said by meditation teachers, such as Shinzen Young, psychologists, such as Tara Brach (who is also a meditation teacher), and researchers, such as Kristin Neff. And I’ve found both personally and through my work as a therapist, that it’s true. I’m literally in more pain when I resist it, avoid it, distract from it, push it away. And when I just let it be, I’m okay. This morning I woke up with so much anxiety. Anxiety about finances, anxiety about work, anxiety about my life and things I could have done. At first I did try to resist it. I instinctively grabbed my phone and scrolled. I decided I wasn’t going to have a workout and that I’d eat an extra waffle for breakfast while I watched YouTube videos about horror movies. But none of that made my anxiety go away…

We naturally want to hide from pain.

Here’s the thing about emotional pain specifically, it can actually lead to several additional problems (or increase the intensity of them if you already have them):

  • More anxiety
  • Lower mood
  • Increase risk of heart disease
  • Gastrointestinal issues
  • Headaches
  • Insomnia
  • Autoimmune Disease Flares

We experience all types of pain for a reason. If we didn’t need our emotions (both the ones we like and dislike) and if we didn’t need physical pain, then we would have evolved without them. Our ancient ancestors needed them to stay alive. To protect us from life and death danger. To keep us safe. Instinctually, our brain and bodies still try to keep us alive the same way, it’s just that we encounter a lot less life and death situations now. And yes, all this applies to chronic pain too. Our bodies are telling us something is wrong, it’s just often not what we think. We think it’s telling us to stay in bed and not move and give in or up on all that’s important to us. In reality, it’s often telling us that we might need to stretch and move our bodies. To do something meaningful with our day – not as distraction but as a way to bring meaning and value to our lives.

Doing something meaningful is much more effective than trying to get rid of something that is a natural part of being human.

…This morning when I decided that I was done resisting my emotional pain, I sat down to meditate. I did my full 20 minutes (meaningful activity) and then I went for an hour walk (moving my body, and a meaningful activity). Then I did my workout that I had put off from the morning. I didn’t do all of this with the intention of distracting myself from my pain (emotional or physical) but to make room for it. I used some practices that I help my clients use to: like observing my pain, breathing into it, expanding around it, and just allowing it to be there WHILE I did things that were important to me. Guess what happened? Not only did it no longer control me, but it actually lessened a lot – to the point where it’s barely noticeable. I also noticed that my drive and creativity and all these things that I’ve been lacking lately came back full force. My suggestion to all of you is to make room for your pain, just to help you make the most of it.

Try this mindfulness exercise out to learn how to make room for pain.

Video: Cooking with Kels – Healthy Pumpkin Cookies

Having healthy snacks is always a good idea (and I love snacks). These cookies are super customizable depending on your dietary needs (though you do have to like pumpkin to enjoy them). They are very soft cookies so that is also important to consider. Here’s the recipe: https://runningonrealfood.com/healthy-pumpkin-oat-cookies/

Enjoy the cookies and keep making the most of it!

Video: Cooking with Kels – Sweet Potato Bowls

I’ve been eating a lot more plant-based lately and it seems to be helpful fr my digestions, so I decided to share one of my favourite recipes with you. The recipe was also shared by my guest, Kathy A. Davis on my podcast. Listen to it here.

Until next time, keep making the most of it!

Video: When Our Thoughts, Feelings & Sensations Hook Us

“Soul Surrender” composed by Music of Wisdom – licensed from http://www.meditationmusiclibrary.com

This video is meant for psychoeducation only. Please consult appropriate healthcare/mental healthcare professionals as required. When we have difficult and painful thoughts, feelings and sensations, we can easily get swept away from them, as they pull us from what’s important to us and how we’d like to be. We can also learn to effectively manage ourselves when these thoughts, feelings and sensations arise.

Keep making the most of it!

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