Can Acting “As If” Help Us With Chronic Illness?

No, we’re not talking about Cher from Clueless (did I date myself?). We’re talking about Alfred Adler, who was an early psychoanalyst, and whose work has contributed to the development of current psychotherapeutic techniques, including Cognitive Behavioural Therapy. CBT, it turns out, has been incredibly helpful for people living with chronic pain and illness. One of the many techniques Adler developed was acting “as if” which got me wondering, can this help with chronic illness and pain? I’m going to start off by saying, there is not a lot of research in this area, so we don’t really know, but I’m going to do a bit of theorizing today, with the research that I did manage to find on the subject.

Great movie, but not what we’re talking about today.
Image from: https://www.refinery29.com/en-us/2015/07/90743/best-clueless-quotes-movie

First, let’s maybe determine what acting “as if” means. This technique has the client make up a new story about themselves, their lives, their ability, or whatever else, for themselves and behave in the way that they would need to in order for this story to be true on a daily basis. (If you’re familiar with CBT you might recognize the cognitive and behavioural components here). Initially it was used for things like giving empathic responses, and being more assertive, or making decisions. The idea is, that by acting differently, and getting different responses from other people in your life because of it, your brain changes so that you can be more like this “new” person. I kind of thinking it as a mindset change.

Okay, I have a story before we move on. I was always a very shy person. To the point where I had some social anxiety as a child (literally would never answer questions in class, and was terrified of doing presentations, though I always had friends). That continued right into my twenties. In my twenties (and early thirties) I worked in retail, so naturally some of that social anxiety went away, but to be honest, a good portion stayed. That is, until I was in my early thirties. Then I decided I didn’t want to be so shy anymore. I set myself down a path where I would either be in situations where I couldn’t be as shy, or I would force myself to just talk more in situations I normally wouldn’t. I was essentially acting “as if” I was outgoing. Guess what? At 36, I can say that while I do get some butterflies in new situations, I definitely would not be considered “shy” or “awkward” or “socially anxious” anymore.

Little me.

But can this apply to chronic illness? And if it does, how exactly does that work? When we’re looking at chronic illness treatment, it’s always best to take a holistic, biopsychosocial approach. Typically, you’ll have a doctor (or team of doctors) that focuses on the biological aspects. Having a mental health care professional can assist with the psychosocial parts. There is a known association between self-efficacy, which is our beliefs about our ability to handle life’s challenges, and chronic illness and chronic pain disability. In other words, if we believe we can’t handle our illness or pain, then we won’t be able to and our illness and pain will actually be worse. This is where I think acting “as if” applies to us. We need to shift our mindset and starting acting “as if” we can handle the pain, we can handle the illness and the symptoms that go along with it. We replace self-pity with self-compassion. We are mindful of what we are doing and saying, and we start to take control of treatment (as holistically as possible). By doing so, our self-efficacy grows, and our pain lessens, and our illness has less control over our lives.

I would not be able to do most of what I can without self-efficacy.
2 years after diagnosis. Toronto -> Los Angeles. Solo Trip.

Okay, full stop. I know this might be a lot to take in, and you can’t even necessarily do this work on your own (though depending where you’re at with that self-efficacy thing, maybe you can). This is where having a support team, including a mental health professional might be helpful. At the very least, working on growing that mindfulness muscle and noticing what we’re doing is free to do (here’s the link to my meditation page which can help with that), until you can find (or afford) to have a professional help you. I truly believe in our abilities to live great lives, even with pain and illness. And, so, keep making the most of it.

New season of my podcast, Chronically Living and how to make the most of it, coming June 28, 2021.

Daily Mindfulness: Mantra Meditation

Royalty Free Music From Bensound (www.bensound.com)

Though mantra meditations are often associated with religious meditation, I come to mindfulness from a secular perspective. My mantra, for example, is “I am, I can, I will.” Mantras have been associated with meditative practices in every major religion, including Christianity, Judaism, Islam, Hinduism, and Buddhism. This 5-minutes meditation is meant to help you focus, become present, and remember what you believe in. I have talked about mindfulness in a few podcast episodes. The ones I would recommend you checking out are: Episode 6 Mental Health and Chronic Illness, Episode 22 How Anxiety and Stress Manifest in the Body, and Episode 31 Mindfulness and Health.

I hope you enjoy this meditation, and remember to keep making the most of it!

Keeping Track of Your Mental Health

As my many of my fellow chronic illness warriors know, mental health struggles such as depression and anxiety are real…ly common . Not that they are necessarily constant, though the can be. I actually do a whole episode of my podcast on mental health and it’s relation to chronic illness, so feel free to check that out for more info. For today however, I want to take a look at one element of our mental health, which is commonly experienced by everyone (seriously everyone) whether or not they have another underlying physical or mental illness. Negative automatic thoughts (or NATs).

download.jpgImage from: https://www.cbtcognitivebehavioraltherapy.com/what-is-automatic-negative-thoughts-ants/

NATs are those subconscious thoughts that you don’t realize you’re having until you do (and even then you may not realize that’s what they are). It’s the thoughts of “I suck,” “how could I be so stupid,” “what an idiot I am,” “why am I dumb enough to say that,” etc, etc, etc. Are they accurate thoughts? Usually not. But we all have them from time to time (or more often, but we’ll get to that in a minute). These thoughts, according to cognitive behavioural therapy, can lead to anxiety and depression. Why? Because our thoughts cause our feelings. If we keep telling ourselves that we are “stupid” or “not good enough” or whatever terrible thing we say to ourselves, we will (a) start to believe it, and (b) feel upset about it. Makes sense right?

viciouscircle1
Image from: https://iveronicawalsh.wordpress.com/2012/03/18/the-vicious-circle-of-negative-auto-pilot-thinking/

If you’ve gone to a CBT therapist, you may have experience with thought records. Basically, this is a sheet (or note on your phone) where you record your thought and your feeling every time you have one of these negative automatic thoughts. The point is twofold. First, it’s to see how often you are having these thoughts and what emotions are connected to them. Second, it allows you the opportunity to begin changing these thoughts. If you can catch yourself saying “I’m stupid” then you can change it to, “you know that may have not been the smartest choice to make but I’ve learned from it so I won’t do it again.” Or more simply, “I’m not stupid, I’m smart, I just did a silly thing.” To be honest, this is a much harder skill to learn than it seems, but it can be done.

unnamed.gifImage from: http://www.allaboutdepression.com/workshops/CBT_Workshop/CBT_12.html

Changing these thoughts into positive ones instead of negative is an ultimate act of self-love. To be honest, since I started to practice this a few years ago, I have less NATs than I did before. Yes, they still pop up, but I can catch myself and reframe the thought because I know that the thought isn’t true. I encourage everyone to try to keep track of your thoughts for awhile so you can catch these nasty little NATs and try to take some ownership of your mental health through self-love.