Video: Are You Being a Good Friend to Yourself?

Building resiliency is extremely important when you have chronic pain or chronic illness. One of the best ways to do that is through self-compassion, and yet most people cringe when they hear that word. Self-compassion is treating yourself the way you would treat a friend. Would you treat a friend the way you’re currently treating yourself?

Keep making the most of it everyone!

Ways to Recognize Anxiety When You Have Chronic Pain

I wrote a blog post for my therapy blog on recognizing the physical symptoms of anxiety. The information is also relevant for recognizing the physical symptoms when you have chronic pain or illness because some of these issues are overlapping, which makes it hard for us to figure out if it’s our illness or anxiety, and then what to do about it. Also, remember the mind and body are deeply connected, which means anxiety = more pain/illness symptoms and more pain/illness symptoms = more anxiety. Vicious cycle. Check out the post:

https://www.kelseylharriscounselling.com/post/how-to-recognize-the-physical-symptoms-of-anxiety

If the smokey image is anxiety, this is me trying to hide from 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!

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!

My Ultimate Pain Coping Skills Part 3: Compassionate Self-Talk

If you’re just tuning in this week, we’re halfway through a 4-part series on some of my favourite pain coping skills. Why are they my favourites? Well, for one, they all have worked for me so direct experience is useful. Two, they are all evidence-based – there has been scientific research on them (and yes, I’m nerdy enough to spend the time reading the articles published in scientific journals). Third, I see them work with my clients in my counselling practice. And as such, I thought it was about time I shared them all with you. This week we’re talking about self-talk and changing that from the harsh inner critic to something a lot more compassionate.

Compassionate self-touch is also helpful.

Recently I wrote a post about being kinder to ourselves, which seems to be quite popular, so we can think of this as an extension of that. Most people have a harsh inner critic, or voice in their heads, telling them that they aren’t good enough, or shouldn’t have done this or that, etc. The voice is there for evolutionary purposes (see the video below on the caveman mind) but it unfortunately isn’t too helpful in our modern world. When we have chronic pain, the voice often shows up as “you’ll never be able to do anything again,” “this is what your life is now,” “no one will ever love you if you’re like this,” etc. Sound familiar? If it does, know that you’re not alone. This is extremely common. But what if we could combat this voice somehow?

Dr. Russ Harris is my hero.

The great thing is, we can learn to respond to it with a compassionate voice. No, that inner critic voice probably won’t just go away (remember, we evolved to have it). But we can learn to respond to it differently. We don’t have to just listen to it, give into it, get hooked by it. This takes some practice though.

We can definitely learn something about compassion from our animals.

I recently went through the Mindful Self-Compassion Workbook by Kristin Neff and Christopher Germer. In it there is an exercise on developing your compassionate voice. You are supported to think about a behaviour you’re struggling with. Then notice what your inner critic is saying. So example, with chronic pain this might be getting up to go for a walk or clean the house, etc. Your inner critic might be saying “you’re never going to be able to do these things again.” Then you are to try out a few self-compassionate phrases. Such as “I am here for you, and will take care of you.” or “I know you are suffering. I love you.” And so on. It should be something you really need to hear. Then when that critical voice appears, we can use our new phrases to respond to it.

You can purchase this on Amazon.

What does this do for us? Well for one, it greatly improves our mood. The relationship between low mood and chronic pain has well been documented (low mood creates more pain, more pain creates lower mood). So by improving our mood, we may actually have less pain (I find this is very true for me). It is also more motivating to respond this way. Yes, it may be hard to engage in the behaviour, but by being here for yourself, supporting yourself, you may be able to take some steps (however small) toward doing that behaviour.

I hope this helps with your chronic pain coping. As always, keep making the most of it!

My Ultimate Pain Coping Skills Part 2: Relaxation

This is part 2 of my 4-part series on my favourite coping skills for chronic pain. These are all things that I use and find helpful. Additionally, they all have scientific evidence supporting them as being helpful. This week we’re going to talk about relaxation: how it can be beneficial and some ideas for incorporating relaxation into our daily lives.

Time to get our relaxation on.

Let’s start with what the research says is helpful about incorporating relaxation into our “treatment” for chronic pain. Relaxation enhances our ability to tolerate pain. But how does it do this? First, it increases our brain’s ability to respond to endorphins, which are our body’s natural pain relievers. Second, it reduces inflammation, which is often a cause of pain. Third, it allows our muscles to relax, and tense muscles tend to cause more painful sensations than relaxed muscles. Fourth, it reduces hypervigilance and desensitizes our central pain pathways, meaning that it helps to decrease our sensitivity to painful sensations. Fifth, it improves our mood and makes us less emotionally reactive to our pain, and since we know the mind-body connection is a thing, this makes sense. I also want to point out that the research states that mindfulness skills are more effective than relaxation skills. However, I think having both is important, and the research seems to support that as well.

I want to be as relaxed as this dude.

So, let’s talk about a few different relaxation skills we can access, learn, and some other ones that I use that aren’t necessarily research based but are helpful for me.

  • Progressive Muscle Relaxation: in this practice we tense each muscle group, one at a time, and then release the tension allowing for relaxation. I love this one and feel very relaxed afterwards. There’s been a lot of research on it, and it’s one we can do on our own as there are a ton of guided versions. Here’s a guided version I made from my YouTube channel.
  • Guided imagery is another practice we can do on our own. I personally like “safe place” imagery, which I haven’t made for my YouTube channel yet but any guided imagery that uses peaceful, soothing or symbolically therapeutic mental images has evidence that it enhances relaxation from physical and emotional pain.
  • Yoga is another practice that I normally associate with mindfulness, though I will admit that I find it relaxing as well. Yoga emphasizes a number of processes including acceptance, attention, mediation and relaxation, which is likely why many people find it effective. Here’s an interview I did with MS Warrior and Yoga Instructor, Clarissa, on the podcast.
  • Hypnosis in an intervention that I haven’t tried, however there is growing research that it shows promise as being helpful for chronic pain. It alters our perception and cognitive patterns that occur in chronic pain syndromes through the use of relaxation. Here’s an interview I did with physical therapist, Sam, who uses hypnosis with his patients.
  • Biofeedback is another intervention I haven’t tried but has a lot of research support it’s use and was discussed at the World Pain Summit I attended last fall. It increases our physical awareness and induces relaxation through the use of markers of the stress response. I definitely think it’s worth looking into.
  • Pick any activity you find relaxing! Okay so this doesn’t have specific scientific evidence but if it induces relaxation then it can’t be bad. For me, that is taking a bubble bath (or epsom salt bath) and reading a book. I find it incredibly relaxing and definitely helpful for me.
Summertime, outdoor yoga definitely relaxed me.

As a therapist, I’m always surprised how many of my clients don’t have a lot of relaxation skills, which makes me wonder how many people actually actively use relaxation skills in general. So, I hope this gives you some helpful options, and I encourage you to try to make some time each day to actively do something relaxing. Keep making the most of it!

References:

Mind-body therapies Use in chronic pain management
Mindfulness-Based Meditation Versus Progressive Relaxation Meditation: Impact on Chronic Pain in Older Female Patients With Diabetic Neuropathy
Hypnotic Approaches for Chronic Pain Management

Why Aren’t You Kinder To Yourself?

I’m going to be right upfront and say it, we do not treat ourselves as kindly as we treat other people. I’ll also admit that as much as I’ve worked on self-compassion over 4 years of going to therapy, and a 2.5 year master’s program to become a therapist, I still have moments where I don’t talk to myself kindly. But it has dramatically improved for me. People with chronic illness and/or chronic pain tend to be even less kind to themselves than other people, and those other people struggle a lot too. Think about your latest self-judgment or self-criticism. Just take a moment to get it. Now imagine you have this friend, Friend A, and he/she/they started to call you that judgment or criticism or label and said you’ll never change that’s just who you are. Now imagine Friend B, and this friend says to you, hey, I noticed you’re having a really hard time right now and going through all this difficult/painful stuff, and I just want to be here for you. Which friend would you rather have? I’m guessing you said Friend B, so think about whether or not you’re friend B to yourself.

If that brought up some emotion I’m not surprised. So let’s talk about self-compassion (or just kindness or friendliness if you don’t like the term self-compassion). According to Kristin Neff, the world’s leading researcher on it, self-compassion is made up of three parts.

  1. Mindfulness, which includes being present with our thoughts and feelings.
  2. Kindness, or acting with care and understanding opposed to judgment.
  3. Common Humanity, or acknowledging that all human suffer.

Kristin Neff also talks about some common blocks to self-compassion. And that’s what I want to talk about here. Because asking you, why aren’t you kinder to yourself, probably brought up something from this list, or a general, “I don’t know.” So let’s just address these now, in the context of chronic pain/illness.

Block 1: “It’s a sign of being weak.”
I can see how you got there, especially if you’re a male (because let’s faced it boys are socialized to believe emotions and compassion make them weak or girly). The research actually shows that people who are kind to themselves have more internal strength, better coping, and are more resilience. This includes if you have chronic illness or pain. This is so important for being able to live a good life when you have chronic illness/pain.

My internal resources also make it easier for me to do the things I love.

Block 2: “I’m being selfish.”
I’ve actually had a client say this to me before as a reason not to engage in self-kindness. This is another thought that isn’t compatible with the research, because what the research shows is that people who are self-compassionate are more compassionate to other, are more supportive of others, engage in more forgiveness, and are better at taking the perspectives of others. This is especially important if you have a chronic illness/pain and are also a partner or parent or caregiver. I have to say that as a therapist, practicing self-compassion has made me so good at building rapport with my clients because they feel more compassion coming from me.

More compassion for others.

Block 3: “I’m being self-indulgent.”
This implies that you’re using it as an excuse not to do hard things. And yet, what does the research show? People who are self-compassionate actually engage in more healthy behaviours. For chronic illness/pain this means they exercise more, have better nutrition, and regularly attend doctor’s appointments and follow doctor’s advice (podcast on that here). All of this has been shown time and time again to improve people’s lives when they have an illness.

Healthy behaviours like exercise.

Block 4: “I won’t be as motivated.”
I think this goes hand-in-hand with the last one, where you think you’ll just sit back and chill if you’re kind to yourself. Notice I said kind and not easy, because there’s a difference. Regardless, what does the research show this time? It increases our motivation. Why? Because we have less fear of failure AND get less upset when we do fail, and we take more responsibility when it comes to repairing our mistakes. Which means if you’ve struggled with certain parts of your illness before, you will be more motivated to fix them/do better in the future.

Increased motivation

Where do we start with self-compassion? I’m going to leave these three meditations: lovingkindness, kind hand, and compassion with equanimity here. But if you don’t like meditation, that’s okay it’s not necessary. My favourite way to easily engage it in is to just take one of my hand, imagine it’s filled with kindness, the same that I’d give a loved one, and place it on the part of my body (usually my chest) that needs it the most. And I just hold myself kindly (sometimes with a half smile). That’s it.

I hope you’re kinder to yourself and keep making the most of it.

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Critical Coping: Problem-Focused vs. Emotion-Focused

I used to always use problem focused coping. Like 99.9% of the time. And it usually served me well, but not always, and certainly not always after my chronic illness snuck up on me. Then I started to use more emotion-focused coping, a totally different coping style. And here’s the thing, I now use both and you probably need to as well. But hold on! What the heck are problem-focused and emotion-focused coping anyway?

Problem-focused coping is typically used for solvable problems, ones that can be fixed, and make the problem go away. For example, if we lose our job due to company restructuring (this happened to me back in the day) then we would use problem-focused coping in order to find another job and make sure we can support ourselves in the meantime.
Emotion-focused coping is what we use when the problem can’t be fixed, and the problem will not go away. It is dealing with emotions that arise from an unfixable problem. Kind of like what happens when you have a chronic illness.
Both of these skills are necessary in life, but the problem is, most of us are taught more about problem-focused coping that emotion-focused.

Problem-focused would be how to get out of the canyon you and your friend went hiking in.

Let’s look at problem-focused in the context of chronic illness or chronic pain. What are some solvable problems or areas in which we would use problem focused coping? Well, lifestyle changes are one area. We are told or we read up on different “diets” or exercise routines or incorporating meditation, etc that will help us with some of our symptoms. Or maybe it’s just taking medication as prescribed. We would use problem-focused coping because lifestyle changes and medication adherence are fixable problems. We’ll likely use SMART goals (specific-measurable/meaningful-attainable/adaptive-relevant/realistic-timebound) or other techniques to make these changes. And, while nothing is a guarantee, there is a lot of evidence supporting that certain lifestyle changes will help with symptoms, essentially “fixing” (I use that term loosely) the problem.

Emotion-focused is more about accepting emotions and pain.

How about emotion focused coping in the context of chronic illness or chronic pain? While, chronic disease distress, anxiety and depression are all common in those of us with chronic illness. Our illnesses likely won’t go away and our emotions – well, we’re meant to have them. So with this I see a lot of acceptance practices being used and needed (here’s a link to one of my favourites). Self-compassion is another area where we are utilizing emotion focused coping (here’s a link to one of those practices). We have to learn to live with difficult emotions that come and go, and difficult sensations, such as pain. If you’re not good at this, I want to normalize it for you – most people aren’t! This is a skill set most people need help with.

It is essential for people with chronic illness to have both types of coping skills.

Who can help you add these skill sets? Well, there are lots of places to go. A counsellor/therapist or health coach is one place. I would say the health coach would help more with problem-focused and therapist with emotion focused (as well as problem-focused). You can also look in the self-help section of your local library or bookstore. Those meditations I linked are another place, and I’ve done a number of episodes on these in my podcast (check out this episode on acceptance for example).

Once you have and start using both types of coping skills, you can start making the most of it!

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Why Zebras Don’t Get Ulcers: A Book Review

Did you know most animals do not get ulcers? Or suffer these kinds of physical ailments from stress? To be honest I never really thought about this before reading this book. If you’re not familiar with Why Zebras Don’t Get Ulcers by Robert M. Sapolsky, I can’t say I’m surprised. I only heard about the book when I was taking an 8-hour online course during my practicum. But it sounded interested. The subtitle is The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping. If you have a chronic illness then this may be a good read to get some more understanding.

I bought it off of Amazon, but it should be available at your local bookstore or library as well.

What I liked about the book:
To start off, the subject matter is interesting. We hear a lot about how stress is involved with chronic illness, but how exactly does that work? That’s what this book aims to explain. It also gives anecdotes from the animal kingdom in every chapter, explaining how different animals react to stressors. The primary focus of the book is certainly on the physiological responses to stress, so there is a lot about the brain in their, with a touch of psychological responses (I would’ve preferred more). Overall it uses the biopsychosocial approach, which I definitely stand behind. There is also a chapter on stress-management, which is helpful.
The chapters are as follows: (1) Why Don’t Zebras Get Ulcers? (2) Glands, Gooseflesh and Hormones, (3) Stroke, Heart Attacks and Voodoo Death, (4) Stress, Metabolism, and Liquidating Your Assets, (5) Ulcers, the Runs, and Hot Fudge Sundaes, (6) Dwarfism and the Importance of Mothers, (7) Sex and Reproduction, (8) Immunity, Stress and Disease, (9) Stress and Pain, (10) Stress and Memory, (11) Stress and a Good Night’s Sleep, (12) Aging and Death, (13) Why is Psychological Stress Stressful? (14) Stress and Depression, (15) Personality, Temperament, and Their Stress-Related Consequences, (16) Junkies, Adrenaline Junkies, and Pleasure, (17) The View from the Bottom, and (18) Managing Stress.
If any of this sounds relevant to you, it may be worth checking out this book.

One of my stress management techniques (since childhood).

What I Didn’t Like About the Book: There are a few drawbacks to the book in my opinion. First, it’s pretty sciency. He does try to make it readable for lay people, but even with my masters in counselling psychology, I got a little overwhelmed by the neuroscience aspect of the book, which was a lot of it. So be prepared to wade through if you want to read it. The other thing I didn’t like was his use of language, which was very outdated. For example, he constantly referred to people with depression as “depressives,” which is stigmatizing and just not right in my opinion. He did this with other conditions as well. It brings up with the people first vs. illness first argument, which I’m not going to get into here, but it bothered me, as a person (and as a mental health professional).

Would I recommend it? Yes. Look, overall I think there is a ton of great and interesting info in there. Will it make you feel better? Not necessarily, but I’m all for having a better understanding of what’s going on in my body, that way I can take appropriate steps to help myself. For example, mindfulness has a large evidence base of helping with stress, and I therefore, practice meditation and other mindfulness techniques on a regular basis.

A mindful moment.

As I keep reading, I’ll keep sharing. And I hope you all keep making the most of it!

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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.

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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