Video: Passengers on a Bus (Dealing with Chronic Illness Thoughts)

Our difficult thoughts and feelings are like disgruntled passengers on a bus that we are driving. What do we do with those passengers? Is it working? What can we do instead?

Working with our thoughts is one way to keep making the most of it!

How to Have a Better Attitude Toward Fitness (When You Have Chronic Pain)

We all know that the majority of the research says exercise = less pain. Honestly, I’m a supporter of this idea. Why? Because it has literally worked for me. I’ve managed to get off one medication, which happened when the only major lifestyle changes I had made were daily exercise (strength and cardio/waling) and daily meditation (plus yoga 2-3x/week). No more Lyrica for me! Now that doesn’t mean that I no longer have pain. It’s just more manageable. I notice that when I don’t exercise, my pain actually increases. Of course, this all seems totally backwards to our brains., mine included. When exercise was initially presented to me as an option for reducing pain, I was like “no way I’m going to do that! I’ll be in more pain.” Then I tried it and the rest is history.

yoga!

The thing is, even if you believe that exercise will help (and I’m aware that some of you don’t believe it, and that’s okay)the problem becomes, how do we reframe our minds so that we can actually start to engage in some physical activity? There are a way different ways we can approach this (or use all of these ways, depending on what you need). The very first thing I do is connect with my values. Why is this important to me? What values will I be living by? For me, when it comes to exercise this is often aligning with values of health, self-care, and independence. They might be the same for you, or totally different. The second thing I do is to just looking at my thoughts. I ask myself, are these thoughts helpful or unhelpful? Are they taking me toward the life I want to live or away from it? Then it’s helpful to create some distance from them. This can be anything from naming the story I’m telling myself, to speaking the thought aloud with the phrase “I’m noticing I’m having the thought that…”, to placing the thought on a leaf in my mind and watching it float down a stream.

At this point if I notice any sensations of anxiety or another emotion, I try to make some room for those. Maybe I send my breath into that area, or remember it’s normal to have anxiety, or drop an anchor which involves allowing my emotions to be there. By this point, I can usually do whatever activity it is I’ve decided I need to do (so in this case, exercise). While exercising there are a few more things I do so that I can improve my attitude. Firstly, I make sure my movement is mindful. I stay with the sensations of the movement, the smells in the air around me, what I can see and hear, all while exercising. This can be done on a walk or while doing strength training. You could also try yoga as a form of mindful movement that allows for stretching and exercise as added benefits. All my stretching in general is also done mindfully. I also make room for sensations while exercising. DO NOT exercise if it’s actually causing you extra physical pain. A little discomfort though is completely normal. I might do a quick body scan to check in with myself and make room for physical discomfort. I definitely use my noticing self to step back and just notice if it’s actually pain I’m feeling or if it is just discomfort that comes from exercise.

Lastly, I commit. I started out just going to the gym 3x/week. During the pandemic I built it up to strength training at home and going for walks to get fresh air and yoga a few times a week. The point is, you can start slow. And it’s probably better to if it’s a big change. You can also work with a physio/physical therapist, kinesiologist, occupational therapist, or personal trainer to help you get started (I worked with my physiotherapist, chiropractor and a personal trainer when I started). Here’s a podcast episode about exercise for chronic pain. So hopefully, this gives you some ideas on how to improve your attitude toward fitness with chronic pain. Until next week, keep making the most of it!

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

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

As always, keep making the most of it!

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!

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!

My Ultimate Pain Coping Skills Part 4: Connection

Welcome to the fourth part of my 4-part series on coping skills for chronic pain! Of course, there are way more than these ones out there. The reasons I’ve been focusing on these is because I have personally used them, and there is a ton of research supporting them. This week we’re talking about connection. By connection, I mean social connection – spending time with others. I know this is a tough one for many warriors for a variety of reasons. Many of you may not have a good support network, you may have pulled away from friends or had friends pull away from you because of your pain. You may not be close with your family or they may not understand. This happens to a lot of people with chronic pain and illness. It is important for us to find ways to connect with others, so let’s talk about why that is.

I find it important and helpful to connect socially with my friends, even if I don’t see all of them often.

There is a surprising amount of research in this area. I did a search on Google Scholar and got a lot of results. One area the research has focused on is the actual neural pathways in our brains and there seems to be a connected between physical pain and social pain. What I take from this is that when we experience emotional pain – such as through the loss of social connections – our physical pain gets worse. I’ve touched in previous posts about the connections between physical and emotional pain (mind-body) and how that works. You can also listen to this podcast episode. Other research has found that people with chronic pain tend to perceive others as being hostile toward them. Because it’s perception it’s hard to determine if the others are actually being hostile, but this could be another reason for the increased physical pain when there is “social” pain.

Sometimes pain can make us want to bail on social outings, and yet having that connection can actually decrease our pain.

Okay so if that explains the connection between our minds and bodies in general, what are some of the things social connection does for us that are helpful?

  • Improves our self-esteem and self-confident
  • Increases our sense of control and empowerment
  • Improves our emotional wellbeing.
  • Decreases anxiety and improve mood
  • Changes our pain perception
  • Improves coping skills
I’m lucky to have great support systems, but sometimes we can look outside the box to find social conections.

How that we’ve settled what it does for us, what are some of the actions we can take? How do I get more socially connected when I have pain and illness and all the struggles that come with it?

  • Cognitive reframing, emotional expression, problem-solving, and distancing oneself from pain – this is literally what I work with clients on in therapy, and there are studies that show it increases satisfaction with your support systems, whether those are friends, family or your healthcare team.
  • Accessing pain resources – we’ve all heard the phrase, “knowledge is power” and even by just reading this blog, you may feel more socially connected with others, like myself, who experience pain.
  • Online support groups – even if you can’t find an in-person support group, having an online community is often very helpful for people. I’ve done a post on the pros and cons of these, but in general, if this is the only way you can socially connect with others, it can be enough.
  • Volunteering – if you are physically capable of doing any kind of volunteer work, I highly recommend it. There has been so much research showing that volunteering is good for all humans as it actually increases our happiness because we are helping others. And of course, we are interacting with others too!
  • Lovingkindness Meditation – the idea of this meditation is that we send out kindness to others, as well as ourselves. The others include people we care about, neutral people, people we don’t like, and all of humanity. Some of the benefits include stress reduction, being more compassionate, and better perspective-taking. You can find a version of this here.

I hope this helps you on your journey to be more socially connected and that it helps with your pain tolerance. Keep making the most of it everyone!

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!

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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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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Daily Mindfulness: Leaves on a Stream

This meditation can help us distance ourselves from our thoughts, feelings, sensations, urges, or memories. The point is not to get rid of these, but to create some space so we can go on with our lives. This meditation is helpful for anxiety, depression, substance use, chronic pain, and other physical and mental health conditions.

“Deep Into Nature” composed by Music of Wisdom – Licensed from http://www.meditationmusiclibrary.com

For more of my guided meditations, relaxation exercises, grounding techniques, and acceptance practices, check out my YouTube channel: Kelsey L Harris Meditations.

Keep making the most of it!