This is a metaphor I found at this website. I love what the writer of it did here. It’s an alternative to spoon theory, where the biggest different is that spoon theory only focuses on energy, and this metaphor – a knight in battle worn armour – looks at all aspects of having chronic pain/illness. At the end of the day, you can prefer whichever metaphor you do, but I like to bring some psychoeducation and alternative methods of thinking to you, because I like when they are brought to me! Stay strong and keep making the most of it!
This is a metaphor I often use when explaining anger. It has a specific purpose and function for us, but there is almost always something beneath anger. I hope this piece of psychoeducation helps you to understand yourself better. Remember, the content on this blog does not replace seeking help from a licensed mental or other healthcare professional in your area.
For a meditation on working with anger, click this link.
Keep making the most of it!
It’s common to get overwhelmed by your emotions, and equally common to get overwhelmed by sensations when you have chronic pain or chronic illness. I know, because I’ve been there with you. Today I’m giving some psychoeducation on these storms and one way you can learn to deal with them so you don’t get swept away.
Keep making the most of it!
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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If you’re thinking about exercising to help with your chronic pain or overall health, it is important to consider two things: (1) pacing – so that you don’t over exert yourself one day and pay for it the next; and (2) action planning or goal setting so that exercise is realistic for you. Also, remember to always talk to your healthcare team before starting any new exercise routine! If you’re having thoughts about your ability to exercise that are causing you distress, check out this podcast episode.
Keep making the most of it!
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Plus who is this blogger and why should you care what I have to say?
I think that I sometimes give off the impression that I’m 100% fine 100% of the time, which as anyone with a chronic illness or dealing with chronic pain knows, is simply not true. What is true, is that I’ve learned several strategies over the past 5 years to improve my well-being, even on my days of struggle. Let’s take this morning (Saturday) as a write this. I had some pain in my hips (both of them). I live alone and needed groceries and don’t have a car, so I walked to the grocery store. My arms killed on the way home because I accidentally bought more than I could carry. Then the apartment building door whacked my right hip (the less sore of the two) which obviously caused more pain. And then I became angry. Like swearing, yelling, grumbling, angry. I got text messages and was annoyed at the people texting me even though they weren’t saying anything bad. Then I noticed what was happening. Was this anger helpful? No, if anything it was making my pain worse. So I took a moment, watched my breath flow in and out of my body, and calmed down mentally… and then it helped my body to calm down physically.
So… who am I? I’m Kelsey. I’m a person with lived experience. I have diagnoses of undifferentiated connective tissue disease, fibromyalgia, and glaucoma. I’m also someone who meditates daily (over 100 days in a row – my longest streak). I’m someone who has bad days, and good days. I make it my priority to have way more good days than bad ones. I’m a person who went to psychotherapy among other treatments (physio, chiropractor, naturopath, massage, etc.) and found it helpful for my anxiety and ultimately my pain. And then I became someone who went back to school to get my Masters in Counselling psychology, which I have now completed, despite the fact that I was working full time and in pain. I am someone who is committed to helping others who are struggling. And I am someone who wants to share what I’ve learned – and what I’m still learning – with all of you. I am me.
Why should you listen to what I have to say? Well, there is no particular reason and it’s completely up to you! What I can say, is that I try to bring my personal, lived experience, with research (yes I actually do a ton of reading of scholarly journal articles for my posts) and clinical experience so provide you all with different ways to improve your well-being. Take me this morning for example. Would it have been helpful to stay angry all day? Likely I would’ve had to spend it in bed and probably wouldn’t have written this post. I’ve found this to be helpful for me, so it just might be helpful for you. Along with this blog, I have other resources too. Like my podcast and YouTube channel, which you should definitely check out if you haven’t yet.
Okay, so I thought we’d end on a fun note. Two truths and a lie. I’d love to hear in the comments which one you think is a lie.
1. I have spent the evening hanging out with a celebrity.
2. I recently got a new puppy.
3. Pineapple is my favourite fruit.
My podcast topic this week was utilizing your authentic self, and next week is about evidence based treatments for chronic pain. My YouTube channel has a new video for building self-awareness (which is how I knew to calm myself this morning!). Until next week, keep making the most of it!
If you’re anything like me, you may have wondered why pain medications aren’t working well. Aren’t giving the relief we’re told they should. I’ve been taken off NSAIDs because they hurt my stomach – has this happened to you to? I’ve been offered opioids after surgery but decided against it for fear of addiction even though I’ve been in a lot of pain – do you relate? I’ve also tried lowering doses of medications and found they’ve been as effective on a lower dose as they were on a higher one, because I’ve added holistic approaches to pain control – what about you?
There were some interesting recommendations out of the National Institute of Health and Care Excellence (NICE) in the UK that came out of a meta-analysis (review of scientific studies) on treatments for pain/pain management. The part of the study and recommendations that really blew my mind what was that not a single pain medication was said to have enough evidence to support its effectiveness for treating chronic primary pain. Now, I will say that they reviewed about 22 studies per type of pain management – each medication and each holistic approach – that they looked at, so not super extensive but definitely enough to be a good indicator. I’m going to do a podcast episode on the 5 suggested treatments (exercise, acupuncture, 2 types of psychotherapy, and anti-depressants) for pain so stay tuned to the podcast for that episode in a few weeks. On the blog this week, I thought we’d talk about what they said about all these pain meds that we take!
Opioids – I know that these are commonly prescribed, and as a mental health professional, I also know that there is an opioid crisis in North America (that being said, just because you take opioids does not mean you’ll become addicted as we need to look at other biopsychosocial factors). NICE states that there is not enough evidence that shows long-term opioid use actually helps with chronic pain, plus they note the risk of addiction (for some people) in the short- and long-term. Conclusion: Maybe not a good idea.
Benzodiazapines and NSAIDs – also commonly prescribed, and as I said, I used to be on strong NSAIDs that hurt my stomach, now I have a less strong one that I’m to take “as needed.” Benzos were cautioned as not being effective for chronic pain, AND leading to poorer functioning. And NSAIDs, these were said to also not improve pain, distress, or quality of life and increase the risk of gastrointestinal bleeding. Conclusion: Maybe not a good idea either.
Antiepileptics (Gabapentinoids) and Pregablin – these are only shown to be effective for neuropathic pain and CRPS. However, NICE cautions that they can be highly dependent and are known to be addictive. Again, one needs to consider biopsychosocial factors, but if you have other risk factors for addiction, possibly not a good choice. Conclusion: Depends on your condition and your risk factors for substance misuse.
Local anaethetics – Short-term use indicates they may actually make things worse, except for CRPS. So again, this might come down to your specific diagnosis. Luckily there was nothing mentioned about them becoming addiction. Conclusion: A go for CRPS but not anything else.
Paracetamol, ketamine, corticosteroids, anaesthetic/corticosteroid combinations and antipsychotics – again there is insufficient evidence for all of these, and NICE cautions that harm could actually come from taking these, though they don’t specify what the harm is. Conclusion: Maybe not a good idea.
So, what have I done to supplement lowering my pain medications (which may not be that effective anyway) so that I can continue to have better quality of life and well-being? A lot of the recommendations made by NICE and some others. I exercise daily (any movement is good movement if you’re starting out), I eat healthy, I use approaches such as acupuncture, chiropractor, physiotherapy, mindfulness, etc., and I have been to psychotherapy (and I currently use psychotherapy to help others). You can check out NICE’s study here. ALWAYS, check with your physician and healthcare team before changing medications or doses or adding holistic care to your plan. I started by adding holistic approaches first, and then cut back on meds. We are each unique individuals and this information is for psychoeducation/health education purposes only.
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Boundaries are super important for all of us. With work, relationships, even ourselves. While boundaries are important for everyone’s mental health, I think that for Chronic Illness Warriors, the key is to be able to set boundaries that still allow you to ask for help when needed. I would say that I am pretty good at setting boundaries, but that was definitely a skill that I developed over time. I was reminded of boundary setting as I was preparing for group counselling that I’m co-facilitating as part of my practicum. So I’ll admit I’m borrowing some of this information from Marsha Linehan’s Dialectical Behaviour Therapy (DBT). The group has a few pscychoeducation components as well as counselling, including mindfulness (you know that’s my favourite), emotional regulation, distress tolerance, and interpersonal relationships. Though I’m not a “DBT-er” (I’m clearly happy to be co-facilitating the group though and learning all of this) I think that many bits of information from DBT and this course have great applications for many of us! (For those of you wondering I am drawn to existential therapy as well as Acceptance and Commitment Therapy).
Okay, so why should we set boundaries? Boundaries allow us and others to know what we are okay with and what we are not. For example, some people are huggers while others don’t like to touch (granted Covid, so many of us are in the non-hugging category right now). The person who doesn’t like to be touch needs to tell the other person (politely, if possible) that they are not okay with that. The tough part with boundaries is that if they are crossed, it can be awkward or feel rude to point that out. However, your mental health is important and if you’re really not okay with something it’s good to be vocal about it. Another example is a work one. Is it okay for your work to contact you when you’re not there? I was in a position about 6 years ago where I told my work it was totally okay for them to contact me when I wasn’t there. About two years ago (same company, different store) I told them I wasn’t okay with it. I set the boundaries and stuck with them based on the level of stress I was able to handle at the time.
When it comes to chronic illness, setting boundaries can revolve around many different areas, but I’ve found two are the most important: others, and ourselves. With others, you can decide how much or how little information those in your lives get about your illness/health, mental health, etc. I totally believe in sharing but everyone has different comfort levels with sharing, and I totally respect that, as I expect others to respect mine. Boundaries can also include what other people get to help you with. I loosened my boundaries after my hip surgery because I acknowledged I needed more help. Now granted I found myself feeling more grumpy at the time, but it wasn’t because I changed my boundaries, it was because I couldn’t as much myself! And that ties into our boundaries with ourselves. What are we okay doing? Saying? When we push our boundaries are we doing it to help ourselves or because we “think we should”? Sometimes it’s okay to push personal boundaries. With phobias for example, it’s possible to get over them by stepping out of your comfort zone and confronting the feared animal/situation/whatever it is (best to do it with a professional but I’ve known people to do this on their own). Getting over a phobia can be helpful for overall mental health. Saying yes to a night out with friends when you’re not feeling up to it is an instance of crossing your personal boundaries when it is not okay.
I’ve been sharing example from a “personal bill of rights” (Linehan, 2015) throughout and if you’re struggling with boundaries, I would say create your own (or use which ones of these resonate with you). Even stick it somewhere that you’ll see it often. Remember, that boundaries while important should be flexible because they lead to healthier relationships (including the one with yourself). I would love to see what you come up with so feel free to share on Instagram and tag me (@janeversuspain)!
Have a great week and keep making the most of it!