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.

Image from: https://www.nettl.com/ie/incorporating-brand-values/

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!

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).

Image from: https://theconversation.com/putting-nigerian-neuroscience-research-under-the-microscope-101396

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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My Experience at the World Pain Summit ’21, Part I

This past weekend I attended the World Pain Summit ’21, which is put on by the Pain Society of Alberta, and has speakers and attendees from around the world. I attended as an Allied Healthcare Professional with Lived Experience (the options were: Physician, Physician with Lived Experience, Allied Healthcare Professional, Allied Healthcare Professional with Lived Experience, and Person with Lived Experience). By the way, this was free to attend for non-healthcare professionals with lived experience (only about 150 people with lived experience only attended out of 1600ish attendees). The summit was 3 days, had incredible expert physicians/allied healthcare professionals/researchers, giving the latest and important information on treating chronic pain and chronic pain research. I attended a lot of sessions, so I decided to make this into 3 posts so that I could relay as much as possible. Part 1 is a recap of Day 1 of the summit.

Image from: https://www.facebook.com/hashtag/wps21

Social Media & Pain. There were 3 presenters on this one – a researcher, a physiotherapist, and a person with lived experience. Much like last week’s blog post, they went over the good and the bad of using social media, both as a person with lived experience and as a healthcare practitioner. The good includes learning, community knowledge, knowledge construction, combatting isolation, raising awareness, and validating common experiences, among others. Again, they recommend not using social media for medical treatment and to be careful when sharing personal information online. The part of this that I want you to take away is when they talked about this: “Pain is normal. If you expect to be outside of pain 100% of the time, you’re wrong.” Because that’s impossible. Pathologizing pain to the extent we do (especially online) is like pathologizing blinking. It’s not something we necessarily can (or need to) fix but rather live alongside. We need to view our normal responses to an abnormal situation (chronic pain) as just that.

Two of the social media presenters are members of GAPPA, which I’m looking into joining as well.
Image from: https://twitter.com/keith_meldrum/status/1364123971914919938

Head Injuries & Migraine/Migraine Disease Management. These were 2 separate sessions, with some overlapping content so I decided to talk about them together. Post-traumatic headaches from head injuries often resemble migraines, and migraines themselves can be considered a disease because there are changes in both brain structure and function. There are some non-modifiable risk factors for migraines (female, low SES, head trauma, genetics/epigenetics, childhood abuse) and some modifiable ones (these are important): obesity, medication overuse, caffeine overuse, and depression/anxiety. There were several recommendations for treating migraines, using the acronym BRAINS. Biobehavioral therapy/biofeedback/mindfulness/CBT/physical therapy; (which includes coping sills like self-monitoring, pacing, relaxation, self-talk, connection, and treatment of trauma/mood/cognition). Risk factor modification and lifestyle (diet, exercise, sleep). Adjunctive therapies (neuroceuticals, neurostimulation). Injection therapy/onabotullnumotoxin A/extracranial nerve blocks. Neuropharmacology. Support and Education. AND SLEEP HYGIENE is important (check on my podcast on that here.)

Image from: https://msktc.org/tbi/factsheets/headaches-after-traumatic-brain-injury

The Painful Implications of Psychological Trauma. There is, as I’ve written before, a strong correlation between trauma and chronic pain/illness. This was an important session for my as a psychotherapist. Mental health treatments for chronic pain & trauma should include healthy coping skills, CBT for pain, radical acceptance, trauma-focused therapy/exposure therapy, mindfulness, trauma processing, body awareness, somatic treatments, and behavioural activation. Two really important pieces came out of this. The first was for physicians: the most powerful thing you can say to clients is “I believe you.” I hope that they take that seriously. The second is for those of us with lived experience: pain is a psychological phenomena but that doesn’t mean it’s not real. The example given was how temperature is experienced by different people differently (for example, my mom is always hot and my dad is always cold). Our brains are involved in everything we think, feel, sense, etc. But all of that is also real.

It doesn’t matter if it is Big T trauma, little T trauma, PTSD, or any of the other terms used – they are all trauma and should be treated as such.

How Our Brains Make Unconscious Judgments and What We Can Do About It/Social Innovation on Equity and Diversity Inclusion. There were 3 sessions in the afternoon. I attended two of them and watched the Q&A. This session was presented by a trans woman. The other two were by Indigenous peoples. This was the social justice, diversity, and inclusion part of the weekend. There was so much great information that I hope all healthcare practitioners learned from. The part of this particular session which is helpful for everyone are the strategies to reduce our bias (because we ALL have bias – unless you literally without a brain). Avoid blame or guilt. Focus on the impact, not the intent. Choose a positive attitude. Recognize bias in action and take action. Micro-affirmations. Active listening. Be intentional. Avoid generalities. Question the reliability of sources. Treat people as individuals, avoid assumptions. Get to know people who are different than you. Practice the Platinum Rule – do unto others as they wish to be treated. The last session had to do with patterns of change and what some healthcare organizations are doing to make these changes.

Pride 2019. We are all human. Our pain (physical or emotional) is all real. We deserve to be treated as such on both of those counts.

Okay, so that was a lot of information (and that was just Day 1). I will likely be doing more individual posts and/or podcast episodes about some of this information in more detail as it might be relevant to chronic pain/illness warriors. If you have any requests from anything from this post, let me know by commenting or DM-ing me on Instagram. Part 2 comes next week. Keep on making the most of it!

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What’s the Matter? —> What Matters to You?

When you have a chronic illness, there is always something that is the matter with yourself. I have chronic pain every day, throughout the day, that ranges in intensity from a 1 to an 8 (though it rarely gets to an 8 nowadays). I can get tired easily, have the occasional brain fog. All that kind of stuff that comes with having UCTD and fibro. I also have to wear glasses or contacts, and not use cold medications when I have a cold because of my glaucoma. But I feel like I have choices. Give in to all of this stuff that is “the matter with me” or do what matters to me. I’m not saying that this is always an easy choice to make, and sometimes we do have to “give in” in the sense that we have to have balance where we take care of our needs, though I posit that doesn’t necessarily mean fully giving up on what matters to you.

Spending time with family is definitely important to me.
(Vienna, Austria, 2017)

What this is called is values-based living. You’ve probably read this on this blog before, and heard about it on the podcast if you listen to that too. It really has two parts. First, values. Second, committed action, which yes, even as Spoonies we can do (it’s about allocating the spoons wisely if you like that metaphor). I read a post in a Facebook group recently about someone asking how others with autoimmune diseases manage to go on vacations. They had recently gone on a weekend trip with family and really struggled. I replied that I have gone on trips with my family (Europe), friends (NYC, Europe, Costa Rica), and 2 solo trips (LA, Vancouver), since being diagnosed. Travelling, and adventure/exploration are part of my values, so I’m not letting my illness dictate this part of my life. However, I do plan appropriately, alternate high activity days with low activity days (think going ATV-ing one day, and then lying on the beach the next), and I only go with people who are considerate about my illnesses. But let’s back up for a minute.

ATV-ing in Costa Rica (2019) aligns with my value of adventure!

We need to start by clarifying our values. “Values are words that describe how we want to behave in this moment and on an ongoing basis. In other words, values are your heart’s deepest desires for how you want to behave – how you want to treat yourself, others, and the world around you.” (Russ Harris, ACT Made Simple). I have many values including compassion/self-compassion, trust, loyalty, health (I know that may sound weird to say considering my health conditions, but taking control of them as much as I can falls into this for me), and so on. There are lots of ways to figure out your values. I often give my clients values checklists with a list of ideas. You can also think about your character strengths:

• what strengths and qualities do you already have?
• which ones would you like to have?
• what does all of this tell you about what is important to you?

I also like the magic wand question:

• Let’s say I have a magic wand and when I wave it all of your painful thoughts, feelings, memories, and sensations stop being a problem for you. What would you do with your life?
• What would you start, stop, do more of or do less of?
• How would you behave differently?
• How would others know (i.e., what would we see and hear) that things were different for you?

Image from: http://blog.theaawa.org/3-steps-to-finding-your-orgs-core-values/
I would add authenticity, challenge, contribution, creativity, determination, friendships, growth, happiness, kindness, meaingful work, optimism, openness, resilience, and self-respect to the list I’ve already mentioned for myself.

Once you figure out what’s important to you, you can move on to the committed action piece of the puzzle – doing what is important. “Committed action means taking effective action, guided and motivated by values. This includes physical action and psychological action. Committed action implies flexible action: readily adapting to the challenges of the situation and either persisting with or changing behaviour as required. In other words, doing what it takes to effectively live by your values.” (Russ Harris, ACT Made Simple). I think the last part of this – the flexible action part – is really important for Chronic Illness Warriors. There are often ways we can adapt in order to live by our values, sometimes we just have to be creative. Some of this action might actually be uncomfortable for you, at least at first. It might challenge your thoughts and feelings about your illness, perhaps even your sensations. When I was in LA on my solo trip, I decided to take a surfing lesson because I had always dreamed of doing so. Surfing is super hard! And I wasn’t very good (granted it was just one lesson) and I hit the ground under the water so many times. It was such a challenge to keep going and I was super sore after. But… it was worth it. It falls into my values (adventure, challenge) and while I may not be super keen to jump on it again (I declined taking a lesson in Costa Rica) I’m so glad I did it, and yes, it was worth being sore and tired afterwards.

Post-surfing I was sore but happy. (Los Angeles, 2018)

How will this improve your wellbeing? Feelings of accomplishment, of doing what we love to do, and keep busy with activities that engage in our values have been shown to be helpful for our mental health. And a lot of research in this area has been done with chronic illness and chronic pain. I’m not saying it’s easy, but it is worth it.

Keep making the most of it everyone!

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How Did I Prevent a Flare?

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.

These are my favourite days.

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.

Just waiting for my final mark, but it looks like a therapist now!

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.

On Halloween I was a badass like Buffy.

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!

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Why is Emotion Regulation Important For My Physical Health?

I’m going to be the first to admit that when I was younger I often struggled with my emotion regulation. This often came to the forefront in the context of relationships, because I had a “short temper.” I would get angry and yell, pretty quickly. I could always calm down, but I came to realize the older I got that I had to remove myself from the situation in order to get myself to be more calm. I had a really bad breakup geez, almost 5 years ago now, that I also had a difficult time controlling my emotions, especially sadness and rumination. That last time, that was the lesson for me. But we’ll get to that in moment…

A transition from a poor emotion regulation period to a better one.

First, let’s talk about what emotion regulation is, because I know that some of you may never have really heard the term before. Emotion regulation is our attempts to control the experience, expression, time and scale of our emotions. It has been long known to be important for our mental health, and only more recently explored for physical health. These are also skills that many of us learn as children, but often do require practice throughout our lifetimes. I worked in retail for a long time and as I reflect back I can see how customers yelling at me, for let’s be honest, very small things (I had a lady yell at me once because a competitor had an item for a dollar less but she didn’t tell me before she paid – I happily would have matched it… and by yelled I mean screamed bloody murder) and I realize they were exhibiting very poor emotion regulation, which is more harmful for themselves than the stress it caused me.

If you’re yelling at retail workers (or servers, etc) you might want to check on your emotion regulation skills.

Here’s what we know about emotion regulation and physical health:

1. better emotion regulation impacts our overall physical health positively
2. difficulties with emotion regulation, especially with prolonged negative emotion, can make you more at risk at developing heart disease
3. emotional suppression and rumination (part of poor emotion regulation) cause lower energy, greater physical pain, greater disability, and overall lower quality of health
4. difficulties with emotion regulation make it difficult to engage in self-care and health-related behaviours necessary for managing chronic illness
5. better emotion regulation makes it easier to manage stressors in our lives, meaning less flares and relapses of illness
6. better emotion regulation increases medication adherence and sticking with diet and exercise regimes

Back to my story. So, I had this breakup and this very poor emotion regulation following it, and then I had a flare so terrible I ended up in the hospital for pain. I was released the same day, and the pain came down a bit, but it really went back to normal levels when I was able to come out of the depressive funk I was in. I can safely say I have not had a problem regulating my emotions since… and I mean really who wants a flare like that again? So, we’ve answered the question why, and there are lots of “how tos” in regulating emotions, but I’m going to leave you with one to try out.

A much more emotionally regulated period

Learning to self-soothe. Again, many of us learn this skill as children, but not everyone does, and often we do less of it as we get older. Some ideas for practicing self-soothing are to do meditations such as loving kindness (click here) or a relaxation practice like progressive muscle relaxation (click here). Expressive writing about the experience (click here), breathing exercises (click here), and self-care strategies like taking a bubble bath, are more ways to lear to self-soothe. There are many other strategies online so I suggest a Google search if you’re looking for more!

Take care, and keep making the most of it!
–Kelsey

The Half Smile

The concept of the half smile is part of two things I’m passionate about: psychology/psychotherapy and mindfulness. But how can this help people with chronic illness? Surely smiling will make no difference on my health, so why force myself to do this half smile thing? If this is not your first time reading this blog then you know that I don’t write about finding cures, I write about ways to improve the overall quality of our lives. Health and mental health are so intrinsically tied together. If our physical health is poor, our mental health tends to suffer. If our mental health is poor, we are more susceptible to physical health problems. And so, I present to you a small way to improve your mental health, as part of this overall, holistic way of viewing health.

The Half Smile.

In psychology, we look at the half smile as a way to regulate emotions and improve mood. For one, it’s almost impossible to be angry if you’re smiling. Try it. Very unlikely that you can stay mad while having a half smile on. Same goes with many other emotions. Most people have a difficult time at some point in their lives, or just consistently, regulating their emotions. It can be difficult when you’re in the heat of the moment. And there are many, many aspects to learning how to regulate them if you’re currently struggling in that area (and these vary slightly depending on which form of psychotherapy you subscribe to). The half smile is one technique you can try out. It is probably most helpful with anger and frustration, but can work with other intense emotions. I want to caution you and mention that it is not meant to be a way to get rid of your emotions. Emotions are good! It is a way to help get them to be more appropriate in intensity to the situation you are experiencing. The byproduct of this is often mood improvement. Plus, as I’m sure many of you have heard before – it takes more muscles to frown than to smile.

Image from: https://www.justonenorfolk.nhs.uk/digital-health-profiles/resilience-and-wellbeing/emotional-regulation

The idea of the half smile originates from Buddhism. Now, I’m not religious, but more spiritual. So if the idea of this coming from Buddhism throws you, I get it. I personally practice mindfulness from secular approach. However, if you look at statues of Buddha, he does have a half smile. And actually, if you look at the Mona Lisa, she also has a half smile, which is interesting. When we are mindful of our emotions, body sensations, facial expression, thoughts, and all other cognitions, we have the ability to control our behaviour. When we are aware, we can be present. When we are present, we can find some peace. When we are peaceful, half smiling comes much more naturally. Sometimes when doing guided meditations, the person delivering them might even suggest a half smile. Notice how that changes the practice for you. For me, I find it helps me become a lot lighter. I also want to point out that there is a lot of research supporting mindfulness being helpful in lessening the intensity of chronic pain and other physical ailments. Here’s the podcast episode about it that goes into some of the research.

She’s half smiling too.

My suggestion here is to just try it out. Whether you’re struggling with mood, emotional regulation, chronic illness, or all of the above. There might be even a small improvement in your life, and we should celebrate all wins, including the little ones.

Don’t forget that I’ve got a self-care challenge coming up in a few weeks. It’s only $5 to subscribe to that content and will contain support, information, action planning, and overall upping your self care game!

Keep making the most of it!

Top 10’s: Ways to Improve Your Physical Health When You Have a Chronic Illness

I will start off by saying that a “top 10” is no way a comprehensive list, because there are lots of ways you can improve your health (or at least keep it at base line) when you have a chronic illness. A lot of this I’ve learned through my own trial-and-error, through my studies and work in psychology/psychotherapy, and from conversations with other Spoonies and healthcare professionals. So, this is basically my Top 10 list, and I’m hoping you can pull a few things out of it if you haven’t been doing these already. I’m also going to link some of my blog posts and podcast episodes if you want to have a deeper dive into these topics. Also, I couldn’t determine an order for these, so they are not necessarily in order of importance (assuming there is one)!

Are you ready for my Top 10?!

Eating healthy. This is so important and often overlooked. Eating food that is organic and free-range is ideal, though if you’re like me this might not be affordable. If that’s the case, throw in some of that where you can and otherwise focus on the food groups, especially lots of green veggies. Limit your red meats, and of course limit any food that makes your symptoms worse (for some people that’s gluten or dairy). Be open to trying out different diets (Paleo, Keto) or fasting – but always consult with your healthcare professionals first. Check out this blog post on eating healthy, and this podcast episode on living with allergies.

Drink lots of water. 6-8 cups a day is ideal. I’m currently doing a challenge through Shape and Foster and part of that challenge is drinking 1.5L of water per day. Honestly, some days I really struggle but I also notice that the days I drink that much water, I drink less other stuff (that’s not healthy) and I feel the best. Water is important for our overall health and can’t be overlooked! I’ve got a blog post about it, and it is an essential of health which I discussed on the podcast.

Eat healthy, drink water.

Take your meds! Medication management can be super annoying but you’re being prescribed them for a reason, and there is typically a lot of science around them. I sometimes forget to take my meds (not going to lie) but again, I do feel best when I take them as prescribed. This doesn’t just go for Western medication either, try out some Eastern ones (head over to a naturopath, chiropractor, or other practitioner) to get some holistic care going. I’ve got a blog post about health management, and a podcast about holistic options.

Sleep hygiene. It’s so important for our physical (and mental) health to get a good sleep. Our bodies need to feel energized and rested when we wake up. Spoonies definitely have extra challenges with sleep. I often toss and turn because I’m never comfortable. However, doing proper sleep hygiene can at least minimize some of these problems and get your a better sleep. When I have proper sleep hygiene, I notice a 50-80% improvement in my sleep! No jokes! Check out the blog post and podcast episode for more.

Take your meds, get some sleep (or end up looking like this!)

Exercise. Yes, exercise definitely helps with pain reduction, and can increase things like mobility. There is a ton of science behind it. That being said, you have to be careful not to go over your limits (i.e., just push yourself to your edge but not beyond it) because you don’t want to hurt yourself. Low impact is recommended for chronic illness (walking, swimming, etc). If you’re not exercising, then just experiment with small amounts and gradually work your way up. This is another area that it is important to consult with a professional on. I do an exercise vlog post every 3 weeks, and I did a full podcast episode on exercise too.

Spend some time outdoors. Interestingly I just did a post on this last week that got very few views despite the fact that there is again science supporting how much this can benefit both our physical and mental health. Step away from the city if you can, even if just a few hours. Take the opportunity to breathe in fresh air. Tie it into exercise by going for a walk. Tie it in to stress reduction and just let yourself be. Though I don’t have an episode specifically about this, there is a podcast on holistic approaches that ties in nicely.

Exercise and spend time outdoors (my solo trip to LA, 2018).

Reduce your stress. Being calm, and having as little stress as possible (which I get it, sometimes just having a chronic illness is stressful!) is so important. Stress is a common cause of flares in many autoimmune diseases and in generally, always manifests into nasty physical ailments of one kind or another. This is a good reason to learn some mindfulness skills (which I do a vlog post on once a month). I did a whole podcast episode on how stress and anxiety manifest in the body as well – find it here.

Get involved in your care. This often means we have to be our own advocates for our health. That can include being a little “pushy” with our doctors (I mean it’s ridiculous that we have to sometimes but medical gaslighting is a huge problem). It also means that you may have to create a healthcare team for yourself. I’ve found this to be extremely beneficial for me. For more on getting involved check out this blog post and this podcast episode.

Reduce your stress and get involved in your care (and no this is not actually how I meditate lol)

Self-care. There are 5-6 dimensions of self-care (depending on who you ask) and physical self-care is one of them. A lot of the things from this list apply to physical self-care, but you can also add a lot more, depending on what you like – I like Epsom salt baths! I also mentioned that challenge with Shape & Foster earlier which this month is putting an emphasis on physical self-care. Hear more about them on the podcast. I do monthly premium blog posts for self-care which you can sign up for here.

Goal setting. No one can be expected to make any changes to any part of their life – including the physical aspects – overnight. That’s why setting goals can be really helpful. If you’re not currently exercising, then committing to 3 1/2 hour walks per week might a good place to start. Or increasing your veggie intake four times a week. Or spending time outdoors once a week. Whatever it is, make a plan and make it one that is challenging and yet you can stick to. I recently did a blog post on goal setting. This is the podcast episode it ties most nicely in with.

Spend time on self-care and set some goals (my goal to be a llama – jk!)

Okay, this was a longer post than normal but I hope you have a few takeaways! Keep making the most of it everyone!

Optimism, Pessimism, Mental Health & Chronic Illness

“Positivity is not about how to maintain a positive attitude, but how to produce positive emotions.” – Frederickson, 2009.

“Research indicates that pessimism correlates with depression, lowered achievement, and health problems.” – Martin Seligman, 1998.

If you don’t know who Seligman is, that’s totally okay and to be honest totally normal if you haven’t studied psychology. He’s the founder of positive psychology (which does not say that positivity is the cure to mental health, just to be clear) and has done a lot of research in this area. For me, the interesting part of the statement isn’t the mental health aspects, which are a bit less surprising, but the physical health part, because what does that mean for people with a chronic illness?

Are you an optimist or a pessimist?

Okay, so here’s a quick overview of some research of optimism vs. pessimism and chronic pain or illness. According to Forgeard and Seligman (2012) disease may progress slower for optimists than for pessimists. Optimists typically have better cardiovascular (heart) functioning and less heart disease, and they may have better immune functioning (though the research is more mixed on that the later). They also found that cancer patients had better survival rates one year after diagnosis if they were optimists, and that in general optimists are about half as likely to die from whatever disease they have than pessimists are. They do caution that some studies don’t show this effect and/or the results are negative, but it’s theorized that the stage of disease may play into this. They also theorize that unrealistic vs. realistic optimism plays a role. (I’ve often said that you can be – and that I am – a realistic optimist).

Life of a realistic optimist.

In terms of chronic pain, Ramirez-Maestre et al. (2012) found that optimism leads to better overall well-being and this might have to do with coping strategies that optimists and pessimists use. Basically, pessimists are more likely to use passive coping strategies such as avoidance and optimists are more likely to use active coping strategies such as acceptance. Active coping leads to lower pain severity, less depression, and better daily functioning.

I don’t know about you, but less pain always sounds good to me!

I can hear some of you saying, “But I’m naturally pessimistic! I can’t help it!” Positive psychology actually shows that we can have learned helplessness and learned optimism – yes, I said it, we can learn optimism. It’s not necessarily a fixed part of personality and there is research to support that. Basically, if we learn to combat negative self-talk, we can become more positive. Pessimism is caused by selecting our attention to certain things as well as a lack of internal confidence in our abilities to control or change parts of our lives (learned helplessness) so when we fail at something, we blame it on something within us we can’t change. I hope I didn’t lose anyone during this.

Seligman explains this way better than I do.

If you want to be more optimistic here’s something things you can do, according to Seligman:

• utilize gratitude (maybe use a gratitude journal or write a gratitude letter)
• help others in need (by volunteering for example)
• challenge your negative thoughts and believes (what’s the evidence for and against them)
• tackle your negative self-talk (trying changing it)

In the Science of Well-Being course taught by Yale professor Laurie Santos, she explains that only 50% of our happiness comes from genes. So, if you’re still believing that you can’t change from being a pessimistic to an optimistic because it’s how you are born, then remember that. 10% of our happiness comes from our circumstances, and the last 40% comes from our actions and thoughts. Which means, you can still improve your levels of happiness (and thereby some aspects of your health) even if you’re not naturally inclined to optimism.

If you haven’t checked out The Science of Well-Being course yet (it’s free), then I highly recommend it!

I hope this was helpful for some of you! Let me know how it goes with those four techniques to learning optimism! Keep on making the most of it!

Integrating Health with Mental Health

Recently I read an article in a psychotherapy magazine put out by the BCACC (British Columbia Association of Accredited Counsellors) about how therapists can and perhaps should integrate health promotion into their clinical practice. Being interested in health psychology anyway, and wanting to work with people with chronic illness as well as mental health problems, I devoured the article. Then I did a quick google search to see what others are saying. And while there are not a ton of journal articles on the subject, there are a few, all pointing to the same thought – this is something therapists should do. What makes it difficult is that psychotherapists, whether they hold a Masters or PhD (or not, depending on where you live they may not need either), typically don’t have a lot of training in health outside of mental health (always a little bit as it relates but rarely a large amount). This makes me curious as to what everything thinks about therapists encouraging health promotion, in some way, during counselling.

Article from Insights magazine (Spring 2017 issue)

What this article really looks at is not just physical health or mental health but all components of health. A holistic approach. Sometimes people go to therapy for things like weight loss, which in that case, health promotion and education seems necessary. Other times someone might bring it up as a secondary concern. There’s also, of course, the interrelation between things like exercise and nutrition and mental health. As well as sleep and mental health. See where I’m going with this? It actually might be almost impossible for therapists to not integrate health into counselling. So, while I usually save this kind of stuff for my premium blog, I thought I would share some health behaviours I’m going to put extra effort into this week, and I hope everyone reading thinks about some that they can as well! Body-mind connection week indeed!

• nutrition: I’m going to go with making sure I eat fruit everyday (which I typically do but sometimes stumble on the weekends)
• exercise: putting yoga back back into my routine at least 2x/week
• sleep: ensuring I don’t have anything to drink after 8pm (part of sleep hygiene!)
• other (social, hobbies, gratitude, mindfulness): playing the piano daily (I haven’t been playing as much as I would like)

As you can see, integrating health is rather inclusive and definitely extends beyond just physical aspects. Medication adherence can be another really important one for chronic illness warriors. The article I read speaks about Maslow’s hierarchy of needs, which I’ve mentioned in previous posts. We need to take care of our basic needs in order to take care of our higher needs. The three basic components of physical health I mentioned above are so important. So here’s my question (and I’d love answers in the comments), would you want your therapist to help you with aspects of health promotion that you are neglecting? Why or why not?

Family hike in the summer.

Until next week, keep on making the most of it!