The difference between the media’s version of self-care and healthcare’s version of self-care is huge. In the media we see bubble baths, spa days, “me time,” wine nights, and girls trips. In healthcare we talk about activities of daily living – showering, getting dressed, eating nutritious meals, doing light exercise, etc. I mean, I’ll admit that I definitely engage in all of the media’s version of self-care as well (well, I prefer solo trips to girls trips, just sayin’). And that’s fine. It’s totally all well to do all of that. As a person with a chronic health condition, I find it more beneficial to make sure all of my ADLs are done on a regular basis. Why? Because it helps not only my physical health (I’m literally more mobile when I do them), it also helps my mental health (mood is better, anxiety is less). Yet it can be hard to do these activities when we’re feeling low, when we’re super anxious, when we’re in a lot of pain. The thing is, doing them can help with all of these things.
First off, the media’s portrayal of what is self-care is VERY different from what mental health care professionals think of as self-care. Self-care in the media is bubble baths and spa days and bottomless brunches. I am not against any of this! In fact it all sounds quite fabulous. Counsellors and therapists such as myself think of self-care more in terms of activities of daily living (ADLs) like getting showered and dress and eating meals, etc. And then there is this weird grey area of overlap. For example, I see meditation as a form of self-care. It’s not an ADL, and the media would categorize it as self-care, and yet it can be extremely beneficial for mental and physical health. So I see things like that really as acts of health care.
Here are some activities that I see as health care (that are sometimes categorized as self-care):
meditation and mindfulness – contacting the present moment to be here-and-now
self-compassion – taking a moment to be kind to yourself through touch or words
massage therapy – having a registered massage therapist do deeper work (than just purely going to the “spa”)
acupuncture – it has been around around for thousands of years and sessions are usually between 20-45 minutes
swimming and other forms of exercise – water therapy, strength, cardio
baths – more water therapy!
For all of these, research actually supports that they are important for health and mental health. Mindfulness and self-compassion can release tension in the body, make us feel calm and centred and present. Massages and acupuncture can reduce physical sensations of pain and also create relaxation in the body. Exercise reduces pain and increases strength. Baths, swimming and in general water therapy is supported for pain because of its strength, flexibility, heat and relaxation effects (depending on what you’re doing).
Thinking in terms of how these things will benefit my health, as opposed to just being things to enjoy (I mean, these are all things I do also enjoy) makes me more motivated to do them. It’s funny, because the idea for this topic came to me as I’m having a massage later today (I write these about a week before they’re posted). Getting a massage purely for pleasure hasn’t occurred to me in the longest time. Instead I always consider my massage therapist part of my healthcare team. I’m just like, hey, it’s time to take care of those muscles, especially because I have fibromyalgia and I’ve been neglecting them recently! And honestly, this type of health care is also self-care. I think we can get pulled into all these labels, rather than just going with what we need, regardless of whether it’s real self-care or media self-care or health care or anything else. What will make your mind, body and spirit feel better today? Do that, and keep making the most of it!
How many times have you said, “I am sick” or “I am a Spoonie” or “I am in pain” or “I am depressed,” and so on? And how often do you feel that is really so? That is what you are? If your answers to one or both of those questions is “a lot,” then know you are likely not the only one answering that way. I rarely use those phrases for myself anymore because I find them unhelpful, but before you run away I want to explain why they are unhelpful. Not just from my perspective from my lived experience, but also what theories in Acceptance and Commitment Therapy (ACT) and related research suggests, particularly when it comes to chronic illness.
First I think I need to introduce you to a few terms. The first is event centrality. This can be described as the degree to which a person perceives an event (often traumatic but can also work for being diagnosed with an illness) as central to their identity. In other words, being a sick person is who you are because of your diagnosis. The second concept is the conceptualized self. This refers to who we think we are (in fancy ACT terms we call this self-as-content). The conceptualized self can take on all the identities we have such as being son or daughter, a parent, a spouse, a friend, and of course a sick person. It also includes our self-evaluations, so whether we describe ourselves as smart or dumb, happy or sad, fun or boring, and so on. What sometimes happens is that we get fused with one (or a few) of these aspects of our identity. In other words, we hold it tightly, are attached to it, and in the long-run doing so usually causes us more problems.
Now this attachment to the conceptualized self can happen to anyone, and we often see it in depression and anxiety as well as chronic illness and chronic pain. There has been some research suggesting that our illness self-concept is a predictor of our adjustment to chronic illness. When we are attached to the identity of being ill we tend to have a lower overall quality of life. I talked about the use of language once on the podcast, and you should listen to that episode if you haven’t already. I want you to think about these pairs of phrases:
“I am anxious” vs. “I am experiencing the feelings of anxiety.”
“I am depressed” vs. “I am experiencing the feelings of sadness”
“I am sick” vs. “I am experiencing the symptoms of lupus” (or whatever illness you have)
“I am in pain” vs. “I am experiencing uncomfortable sensations”
You’ll likely notice that you attachment to that identity changes. And when we aren’t overly attached we actually can take better care of ourselves (health behaviours, self-caring, etc.) and our quality of life improves because we find we are able to do more values-based activities that we enjoy (yep, even with illness and pain). When we remove the attachment to our conceptualized self we are more willing to allow our experiences and see them as passing.
There’s a few ways we can learn to do this. First, we can just start to notice and name are thoughts and feelings – “I notice I’m having the feeling of an uncomfortable shooting sensation in my hip” or “I notice I’m having the thought that I’m always in pain.” There are tons of ways to create some space between us and our thoughts and feelings when we are attached to them. This is just one way. The other process we can use to change this attachment to the conceptualized self is to develop self-as-context. This is what is also referred to as the noticing self. The part of us that just watches and notices all our experiences: what see, hear, smell, taste, touch, think, feel, do, etc. It’s a part of us that never changes. It’s like the sky and all of the thoughts and feelings and sensations are like the weather. The sky sees the weather but the weather cannot hurt the sky. And if you go above the clouds, the sky is still there, even when it can’t be seen. I’m going to encourage you to follow along with the video below to get an idea of what it is like to experience the noticing self.
I personally find this really helpful (and so do many of my clients) in creating a new relationship with my thoughts, feelings, and sensations, and forging out new identity, where I’m not limited by any of these things because I can notice them. They are not me. I am not chronically ill, I have the experience of having a chronic illness.
Here’s how I see it: in my life there are things that are out of my control. No matter what I do, I cannot change them. And then there are things in my life that are totally within my control, and I do what I can to change them. Seems pretty simple, right? Well, yes and no. There is this concept in psychology called ‘locus of control’ that has been vigorously studied. It basically describes how people make sense of different influences on their life. There are two types of locus of control. The first is internal, in which we believe what happens to us is caused by our own actions. The second is external, in which we believe that what happens to us is caused by outside forces. Would you believe that having a high internal locus of control is helpful? Especially for those of us with chronic illness or pain? Well, that’s what the research says…
There have been a ton of studies showing that people with high internal locus of control tend to have better health habits overall, are more likely to be screened and tested for health conditions, and actually have better mental health after being diagnosed with an illness. Janowski et al. (2013) found this was the case across chronic health conditions in their study. According to a study by Brown et al. (2018), people with high external locus of control have a lower quality of life, in their study on cancer patients. The great thing is, this is information we can utilize to make our lives better with our chronic illnesses. But how, you might ask?
I want you to take a moment and ask these questions to yourself. What do I have most control over in my life? What do I have the least control over? We often focus on things that are not in our control, such as the behaviour of others, actually getting an illness, and our difficult thoughts and feelings that are associated with all of this (and are an important part of being human). When we focus on these things we end up feeling helpless, hopeless, angry, anxious, guilty, sad, and so on (the struggle switch). We get stuck on these stories of “if I wasn’t sick my life would be good” or “my life will be great when I’m not in pain anymore, and will be miserable until that day comes.” This is common when you have an illness or a severe injury (like a concussion for example). The problem is, we don’t know if or when we will ever be without our illness or pain or injury, etc.
What we can do instead is start focusing our time and energy on what is in our control, such as our actions/behaviours/whatever you want to call it. Self-empowerment is one of those now almost silly terms that was hijacked by the self-help life coach world, but essentially, having a high internal locus of control and then taking control of what we can is the epitome of self-empowerment. The better health behaviours we have = the better quality of life we have (even with illness and pain).
What can we do to take control?
Unhook from our difficult thoughts and feelings – try this or this.
Connect with our values to determine how we want to act even with the challenges that we face – listen to this.
Take action, behaving like the sort of person we want to be, so that we can live the sort of life we want to live – listen to this.
If you currently have a high external locus of control and a low internal one, this switch might be difficult to do. You may need the extra support of a psychotherapist/counsellor, and you will definitely want to give yourself patience, time, and kindness. We all have the opportunity to live a great life, regardless of our health status, so let’s see if this helps us make the most of it!
I used to always use problem focused coping. Like 99.9% of the time. And it usually served me well, but not always, and certainly not always after my chronic illness snuck up on me. Then I started to use more emotion-focused coping, a totally different coping style. And here’s the thing, I now use both and you probably need to as well. But hold on! What the heck are problem-focused and emotion-focused coping anyway?
Problem-focused coping is typically used for solvable problems, ones that can be fixed, and make the problem go away. For example, if we lose our job due to company restructuring (this happened to me back in the day) then we would use problem-focused coping in order to find another job and make sure we can support ourselves in the meantime. Emotion-focused coping is what we use when the problem can’t be fixed, and the problem will not go away. It is dealing with emotions that arise from an unfixable problem. Kind of like what happens when you have a chronic illness. Both of these skills are necessary in life, but the problem is, most of us are taught more about problem-focused coping that emotion-focused.
Let’s look at problem-focused in the context of chronic illness or chronic pain. What are some solvable problems or areas in which we would use problem focused coping? Well, lifestyle changes are one area. We are told or we read up on different “diets” or exercise routines or incorporating meditation, etc that will help us with some of our symptoms. Or maybe it’s just taking medication as prescribed. We would use problem-focused coping because lifestyle changes and medication adherence are fixable problems. We’ll likely use SMART goals (specific-measurable/meaningful-attainable/adaptive-relevant/realistic-timebound) or other techniques to make these changes. And, while nothing is a guarantee, there is a lot of evidence supporting that certain lifestyle changes will help with symptoms, essentially “fixing” (I use that term loosely) the problem.
How about emotion focused coping in the context of chronic illness or chronic pain? While, chronic disease distress, anxiety and depression are all common in those of us with chronic illness. Our illnesses likely won’t go away and our emotions – well, we’re meant to have them. So with this I see a lot of acceptance practices being used and needed (here’s a link to one of my favourites). Self-compassion is another area where we are utilizing emotion focused coping (here’s a link to one of those practices). We have to learn to live with difficult emotions that come and go, and difficult sensations, such as pain. If you’re not good at this, I want to normalize it for you – most people aren’t! This is a skill set most people need help with.
Who can help you add these skill sets? Well, there are lots of places to go. A counsellor/therapist or health coach is one place. I would say the health coach would help more with problem-focused and therapist with emotion focused (as well as problem-focused). You can also look in the self-help section of your local library or bookstore. Those meditations I linked are another place, and I’ve done a number of episodes on these in my podcast (check out this episode on acceptance for example).
Once you have and start using both types of coping skills, you can start making the most of it!
When I moved across the province at the end of October, I did NOT do a good job pacing myself. Granted I had help for the physical moving but not the packing or unpacking or the putting together of furniture – that was all on me. I started out with the best intentions. I actually started packing by pacing. It was more the last minute stuff, the physically carrying items in the truck, and then everything after that was a disaster. And of course, that caused a flare (luckily it only lasted a week or so). However, that’s not what I normally do. Normally I pace myself, which is part of the reason why I can consistently be as active as I am.
What is pacing? Pacing is doing the same amount of activity everyday – whether it’s a “good” day or “bad” day. Now, this doesn’t mean you’re not listening to your body. There are of course days that Chronic Illness Warriors are going to need more rest. What it does mean is not over-exerting yourself on the good days and therefore creating more bad days. For example, I go for a walk everyday. It’s about an hour long. Even on days where I feel a bit more tired, I get my walk in. I also try to do some yin yoga everyday. It’s definitely movement that is easy to get in on days I don’t feel as good, because it is slower movements and stretching. But let’s say that I didn’t go for a walk today. Maybe I cleaned the house and did laundry instead. It’s about the same amount of activity – and maybe it’s more necessary or I have the thought that it’s more reasonable, depending on how I feel. Get what I mean?
There is A LOT of evidence that pacing works. Not just for me, but from other chronic pain and illness warriors. I’ve interviewed a ton of people on my podcast and have noticed that many of them use pacing. I attended the World Pain Summit earlier in the fall and 2 of the presenters, who were both people with lived experience (not healthcare professionals) talked about pacing and how it’s helped them. Heck even look at these search results on Google Scholar and you can see all the academic journal articles written on the subject. Pacing works – even with fatigue.
But how do you figure out what your pace is? Here are some key suggestions when it comes to pacing:
Plan your day. We all have an idea of how we’re feeling when we get up in the morning, so having a plan of what sounds manageable for the day is a good place to start.
Break up your activities and alternate at rest. For example, if you decide to clean the house, just do 1 room at a time and take a short break (30 minutes) in between.
Prioritizing your activities. I align this with Values-Based Living. What is most important for me to do today? Why is it important? For me, my health is important (yes, even having a chronic illness) so doing some kind of movement that will keep me active and ultimately decrease pain (I’ve done many posts on movement for pain management) is essential.
Even if you’re having thoughts that pacing seems impossible, just note that those are just thoughts. There are many people who can help you get started with pacing (occupational therapists, psychotherapists/counsellors, physical therapists, etc.) and the whole point is to improve your well-being so you can keep making the most of it!
Long title, I know. But nonetheless I thought I’d share some of my tips with you, plus a few other evidence-based ones I found online as I’m trying to get through this. I’m writing this exactly one week before it will be published so fingers crossed that it’s over by the time you’re reading it, but if not, then I’ll just have to accept it as it is. My flare is likely caused by a few things. First, I recently moved and moving is stressful (even a relatively easy move like I had) and stress can cause a flare. Second, I moved from a dry climate in the interior of British Columbia to the wet, lower mainland of BC. I always notice my symptoms, especially pain gets worse when it rains… but then I knowingly moved to a rainy climate (*face palm*). All jokes aside, my symptoms are increased pain, increased fatigue, really bad jaw pain, my left foot is super veiny and sore (my calf is fine though so unlikely anything super serious). How the heck can I manage all of this?
Acceptance. Yes, I know some of you are rolling your eyes or saying that this is ridiculous or unlikely to work. But I find it does. I accept that my pain is here, while knowing that the intensity changes hour by hour, sometimes even minute by minute, and I know that when my flare is over I’ll go back to baseline. Acceptance is helpful. I’ve been doing body scans and other mindfulness activities to help with the acceptance, but honestly just acknowledging my experience without getting wrapped up in it is helpful. Check out this acceptance practice.
Exercise, Movement and Stretching. If you read this blog regularly you know that I like to exercise. And I still pace myself by trying to stay consistent with what I do. I definitely increase my stretching during flares. Particularly I focus on the areas that seem to hurt or need it the most. For example, my jaw is the worst today as I write this, and I’ve made sure to do jaw stretches throughout the day. For more on jaw pain specifically, check out this podcast episode with Dr. Shirazi.
Warm Baths. I LOVE my baths. I literally take a bath 4-5x a week in the winter months. And with the rain, I’m definitely needing them. They help relax my muscles, keep me warm, and are very relaxing. Trust me when I say I could never (and would never) live in an apartment without a bathtub. Knowing what is vital to your self-care is essential to dealing with a flare. Check out this podcast episode on it.
Dressing Warmly and in Layers. Vancouver, if you’ve never been, is a city where everyone dresses in layers. It will likely rain at some point during the day, though you never know exactly when. It could also start off cool and warm up, or vice versa. So I’ve been making sure to put on 3 layers when I go out, and have a pair of mittens on me. I need to remember a hat and/or an umbrella, but I’m working on it!
Hydration. I tend to drink a lot of water. Admittedly more when I’m working. Staying on top of my water intake is so important to managing my flares and really my health! I’m trying to drink 5 full glasses of water a day minimum. I basically keep a glass of water next to me all day and every time it’s empty, I refill it. Listen to my podcast conversation with Beau Berman about gut health and how important drinking water is to him.
Omega-3’s and Vitamin D. I typically try to get these from the foods I eat. Lots of fish mostly (rich in both), as well as mushrooms, spinach, avocado and tofu and really a variety of others foods are rich in vitamin D. These are really important for reducing inflammation naturally and honestly are just really good for you! Also, Vitamin D is a way to combat with the “winter blues” (which I often get) and the more severe, Seasonal Affective Disorder.
So those are the 6 things that I am doing, but what are the 5 things that I’m not but probably should be?
Acupuncture. This is actually an evidence-based and recommended treatment for chronic pain. I’ve had it in the past and I’m hoping to start back up with bi-monthly sessions next month. Listen to the podcast episode on recommended treatments for chronic pain for more info.
Massage. I miss getting massages. It’s been nearly a year since I had one, and this is also a service I used to get bi-monthly. I’ll likely also start these back up soon as well. Clearly I need to. The benefits of massage can be heard in the podcast episode with Danielle Potvin.
NSAIDs. I’m not a fan of these drugs to be honest. They can cause stomach problems when on them long term. I’ve drastically cut back on them and only take them to supplement the more natural medications I take (i.e., CBD). If you’re aware of the risks and find them helpful then this can be a helpful solution.
Natural supplements. The only natural supplement I currently take is magnesium bis-glycinate which is a muscle relaxant (and I mainly use it when I’m menstruating). Other recommended supplements are fish oil, ginger (which I sometimes have in food and/or tea), turmeric (which I sometimes have in tea), and gingko. These are definitely worth checking out to use in addition to some of the other suggestions.
Limit Stress. Oh I can’t wait until I’m passed the stress of the move and starting up new counselling practices. The truth is there is always some kind of stress in our lives and it really comes down to how we manage stress. I typically do a good job with mindfulness, meditation, yoga, and relaxation practices. So this might just be a reminder to do a bit more of that. And also, if you are able to avoid stress then that’s a good plan (I do not plan on moving again for quite some time!).
So that’s it! 11 ways in total to manage a flare. Keep making the most of it everyone!
This week I decided to share with you some stretches that I like for my shoulders (that also give a bit of a stretch in the upper back and biceps). Stretching is so important, so I encourage you all to incorporate more of it into your lives. As always, please consult with your healthcare professionals to ensure you are doing stretches properly and safely.
Take care and keep making the most of it!
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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.
This week’s podcast episode is on nutrition for chronic illness – check it out: Apple, Spotify, Web. Everyone, keep making the most of it!
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This isn’t the first time I’ve posted about resiliency on this blog. The truth is, it’s a topic that comes up often. I see it on online support groups, on Instagram, and hear it in conversation with people. I also read it on other blogs, and many healthcare organizations post about it on their sites. Here’s the thing, if you have a chronic illness and you’re not feeling resilient, just know that you are not alone. A lot of people feel that way. Are people born resilient or do we develop resilience? I think it’s an interesting question and possibly a bit of both. Children tend to be more resilient than adults, suggesting we can lose some resilience as we age. In one of my courses for my graduate degree we had to more-or-less do a family tree. Except this family tree was supposed to trace something like a mental health or substance use issue. I chose to trace resilience, and found that going back just to my grandparents generation (that was the requirements for the project) there was a strong theme of resilience (my maternal grandmother/baba faced abuse, neglect, lost 2 children, and she and my mother were trapped in Siberia for a week during the Cold War – I know it sounds too crazy to be true). Yet she not only survived but was a loving parent to her other children and an amazing grandparent. Had my mom not shared my baba’s history I would not have know. She was that resilient.
The good thing is, that even people with chronic illness can develop resilience. Warning: it does require work on your part. Luckily, some of the work may not feel like work at all… it just requires consistent commitment to it. I want to add, that many of these suggestions overlap with what the National MS Society suggests, in case you don’t want to just take my word for it.
finding meaning and committing to that action: what is the reason you get out of bed in the morning? If you don’t have a reason it will be difficult to do so. Is it your family? Or work? I know a lot of people with chronic illness go on disability, but work provides meaning and purpose for people. If you are on disability what is your purpose going to be instead?
improvisation/adaptability/problem solving: I think these all kind of overlap and go together. We often have to improvise in order to do things we enjoy. Maybe we can’t go on the 5k walk with our friends, but we could meet them for coffee afterwards. How flexible and adaptable are you to changing plans? Or asking others to? What’s an alternative way you can participate or do the things you like to do? I would go as far to make a list of ideas (remember when brainstorming there is no such thing as a dumb idea) and try out some to see if they work.
Self-care: we all know I love self-care, and this includes the basics (getting out of bed, making breakfast, taking a shower) and then doing activities like relaxation techniques, yoga, meditation, or prayer. What hobbies do you enjoy that you can participate in? Pick one a day. Reading is an example of something that is low energy and can be fulfiling.
Being able to tolerate “negative” emotions: I personally don’t categorize emotions as negative or positive. All emotions are important because they tell us very important things. If you’re not used to be able to just sit with emotions, try out this mindfulness practice that aims at helping people do just that.
Self-efficacy: I did a post on this recently, and you can read it here. Do you believe you can cope with your illness? Part of this is being a realistic optimist, being hopeful.
Using skills such as curiosity and humour: When is the last time you laughed? Are you able to have fun and joke around (and not in a self-deprecating way)? Do you get curious about your situation or feelings or sensations or emotions? What are you noticing about them right now as you read this? The noticing self is a helpful skill to develop. We touch on it in this podcast episode (about half way through).
Radical acceptance: This is a skill from Dialectical Behaviour Therapy (DBT) and essentially the same used in Acceptance and Commitment Therapy (ACT). It is about fully accepting your situation/thoughts/feelings/sensations/etc. Fully. Accepting. It doesn’t mean you have to like it. It’s hard to do a lot of the above without this kind of acceptance.
I hope this helps give you some ideas for building resilience some more. Well-being and a good quality of life do require us to be resilient, and trust me, it is possible even with chronic illness. Here’s the link to the MS Society page on resilience. Take care, and keep making the most of it!