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

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

As always, keep making the most of it!

Why Are You Attached to Your Illness Identity?

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.

How do you conceptualize yourself?

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.

We want to have room to engage in values-based activities, because that’s what makes life meaningful.

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.

Keep making the most of it!

Video: How to Deal with Emotion & Pain Sensation Storms

Video in video by Gram Film from Pexels

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!

Critical Coping: Problem-Focused vs. Emotion-Focused

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.

Problem-focused would be how to get out of the canyon you and your friend went hiking in.

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.

Emotion-focused is more about accepting emotions and pain.

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.

It is essential for people with chronic illness to have both types of coping skills.

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!

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Daily Stretches: Shoulders

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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How well do our pain medications work?

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?

Some medications and supplements I’ve been on (and this isn’t even all of them).

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!

NICE didn’t comment on CBD/Medical Marijuana, other than to say they didn’t really review the research in this area.

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.

I find it best when I combine holistic approaches, like exercise, with Western medicine, like pain meds.

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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What has your pain taught you?

I don’t know if you’re familiar with quicksand, but probably most of us have seen it in the movies or on TV. Our hero is on an adventure in some kind of jungle and they (or someone in their party of merry men and women) falls into what turns out to be quicksand. And they struggle and struggle and sink faster and faster. Usually in the movies the hero saves the day. Struggling in quicksand is a lot like what we do with our pain – both physical and emotional. We fight against it, struggling more and more, sinking deeper and deeper. But do you know how to actually get out of quicksand in real life? Like if you fell in it? Struggling makes you sink, and doing nothing – literally putting yourself into the floating position (arms and legs out, with zero resistance) will help you float to the top. From there you can take very slow, gentle strokes and get yourself out.

What the quicksand metaphor shows is that if you do the opposite of what you think you should do, you can often get to safety. In the case of pain, it means looking at it differently, changing your relationship with it. So that brings me to the question, what are your pain taught you? The answer can be many things. Maybe it’s taught you something about yourself. Or your relationships. Or your values/what’s important to you. Maybe it’s taught you something about the meaning of life. Or helped you set goals. Before straight off answering this question, really take a moment and ponder it. Because often the immediate answer is NOTHING! or THAT LIFE SUCKS! or something to that extent. But is that true? Is that all it’s taught you? Those answers often take us back to the struggle. You’ve fallen in quicksand by responding quickly with the first thing that comes to mind, rather than taking some time to really explore if there is something more you can get out of your experience.

Look, I get it, there is nothing fun about physical (or emotional pain) but that doesn’t mean it can’t do something good for us.

I’m going to use my experience as an example. And trust me, there was a time I was struggling in the quicksand and those would have been my answers. But here is what it has actually taught me, when I’ve taken the time to think about it:

  • I’m stronger – both physically and emotionally – then I thought I was, but it took a lot of work to get here.
  • Being treated with love and respect in romantic relationships and friendships is incredibly important to me.
  • I can do anything that I put my mind to, even if that means I have to adapt some things to what I can do.
  • Loving myself is the most important thing to me.
  • I want to have as many life adventures as possible despite chronic pain.
  • Everything I need is in the present moment, and sometimes the present moment isn’t great and sometimes it is, but that is how life is for everyone.
My first adventure after my diagnoses was to Vienna in 2017.

I’ve probably learned more lessons than that from my chronic illnesses and chronic pain, but should give you a picture of what it can teach you. Your answers will likely be different from mine. This is a key piece to acceptance, and if you can’t accept, you can’t really improve your well-being and quality of life. I want to make a few additional things clear with this post. First, I am not saying that your loss of health is a blessing or that you should be grateful for it. Sometimes as we move through illness grief, gratitude does appear, but that doesn’t mean you have to start looking for it. Also, meaning is not found in loss – it’s what you do after the loss. So the things I listed, are really about things I’ve done after I got sick. This is also not an exercise I’d recommend if you’ve just been diagnosed, because you won’t have had a chance to go through enough to be able to do it.

If you’re interested in contacting the present moment, check out my YouTube channel. This week’s podcast episode is on externalizing language, which can also be quite helpful – find it on Apple, Spotify, and everywhere else you get podcasts. Until next week, keep making the most of it!

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Daily Mindfulness: Mindfulness of Daily Activities

Mindfulness doesn’t always have to be formal meditation. We can practice any time, anywhere, doing pretty much anything. It just requires us to engage in the activity we are doing with full awareness and presence. To live this way can have real benefits for mental and physical health.

For my full repertoire of mindfulness practices, check out my YouTube channel: Kelsey L Harris Meditations.

Keep on making the most of it!

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Book Review: Man’s Search for Meaning

This month I read the book, Man’s Search for Meaning by Viktor Frankl. The book is actually one of the top selling “self-help” books of all time. I put self-help in quotations because I’m not sure if that was the original intention behind Frankl writing it, but it seems that he might have recognized what it became between the years it was first published in 1946 and his death in the late 1990s. The first half of the book chronicles his experiences as a prisoner in concentration camps during the second World War, including Auschwitz. While this could be just read as an intense, heart-breaking story (and it is), the way that Frankl writes about his life experiences doesn’t come off that way. Instead, you can see his reflection and growth in his writing. It’s kind of hard to explain how that works, unless you read it for yourself. The story is also not chronological but instead jumps back and forth across his timeline in the camps to highlight pieces of the story that are connected to each other in some way.

While I don’t want to give away too much from the story, because I highly recommend that everyone read it, there were two main takeaways that I had from the first half of the book. First, is that if we believe our lives have no meaning, then we are more likely to give up when faced with difficult circumstances – and that meaning doesn’t have to be grand or anything, as the beauty of a sunset or holding the hand of a sick friend can bring some meaning for that day. Of course, as Frankl admits, in the concentration camps there was a huge element of dumb luck that you ended up in this line instead of that line (whereas that line led you to the gas chambers and this one didn’t), but for those with that luck, meaning became important. The other takeaway I had is that meaning is created by each other us, and is different for each person. It is solely up to us what that meaning is.

The second half of the book is about Logotherapy, which is a psychotherapy modality that Frankl (who was a psychiatrist) invented. It was kind of based on psychoanalysis, but with a heavy emphasis on existential philosophy, particularly meaning-making. During the second half of the book, Frankl does tell more stories from his time in the camps, integrating it with his theories about human existence and how helping people find meaning can aid with the treatment of many mental health problems. Frankl is considered one of the leaders of existential psychotherapy. Though logotherapy isn’t really used anymore, as there isn’t a huge amount of empirical evidence supporting it, it has influenced many other existentially-based therapies, including Acceptance and Commitment Therapy, which I practice. My personal beliefs are that life meaning is incredibly important, as are other existential concepts, which all humans ultimately deal with, and our ability to deal with contributes, at least partially, to our overall well-being.

Even if you aren’t interested in psychotherapy or existentialism, I highly recommend giving this book a read. There’s a reason that this is a best-selling self-help book. Many people struggle with finding meaning in their lives, especially at transitional periods, and this book can really open your eyes on how to find meaning, even in incredibly difficult circumstances. There are so many amazing quotes from this book, but I’m going to leave you with this one: “The helpless victim of a hopeless situation, facing a fate he cannot change, may rise above himself, may grow beyond himself, and by doing so change himself – he may turn personal tragedy into a triumph.”

For a podcast episode on meaning making with chronic illness, check out this one. Everyone, thank you as always for reading my posts. If you end up reading this book, let me know what your takeaways were. For now, keep making the most of it!

Choice, Growth, Freedom, Values & Acceptance

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” – Viktor Frankl

Viktor Frankl

For those of you who are not familiar with Viktor Frankl, he is a psychiatrist, author, existential philosopher and Holocaust survivor. His belief system, which was seemingly helpful to him while he was in a concentration camp, is that life can have meaning even in the worst possible circumstances (like he himself faced) and we are motivated to continue to live when we find that meaning. Like many other existentialists, Frankl believed we had the choice to do what we wanted with the circumstances we are given, even if we don’t always get to choose the circumstances ourselves. When it comes to chronic illness – physical or mental – it can be hard to always see the choices available to us, and sometimes those choices may be more limited, but they are still there. If I am in pain today, I can choose to lie on the couch or I can choose to do some stretches. I can choose to do nothing, or I can choose to sit at the computer and write a blog post that will hopefully help someone else. Depending on your situation, your choice options will look different than mine and that’s okay. The last part of Frankl’s above quote says that “In our response lies our growth and freedom.” Personal growth, and healing journeys (check out my podcast about healing here and personal growth here) are difficult but necessary if we want to live full and rich lives, if we don’t want to give up and into our circumstances. There is so much overlap between chronic physical illness and mental illness and feelings like hopelessness and helplessness play into both. Breaking ourselves out of the cycle is the key. That often takes the form of reaching out for help, and/or using our own self-help and self-care skills to propel us forward (for example, reading self-help books about these topics can be helpful if you don’t want to or can’t afford therapy).

Meaning, choice, freedom – even with chronic illness.

Recently I have been learning a lot about Acceptance and Commitment Therapy as that is what I would like my practicum to focus on (I have to pick something that is CBT – cognitive behavioural – focused and ACT is “third-wave” and combines a lot of mindfulness). Here is a quote from the ACT training I’ve been completing.

“In this moment I’m holding my pain so that I can choose to do the things I care about.” – Timothy Gordon

Values and meaning look different for each of us.
(Vienna, 2017)

ACT is very values focused and as you can see values are closely related to life meanings which stem from growth and freedom, which stem from choice. This is a therapy with a lot of efficacy for chronic pain and chronic illness because it asks us to acceptance our pain, and helps us to move toward our values. I personally accepted my pain and my illness a long time ago. That acceptance has allowed me to do more with my life, like go back to school and start a new career, travel, exercise, write a book, and help others. These are all values of mine and they all bring my life meaning. But I didn’t have to choose to move toward any of these. I could have stayed where I was, but truth-be-told, I wasn’t happy. That realization of unhappiness sent me down this growth path which in many ways started with the acceptance piece. If you’re not happy, or you don’t know what your life meaning is or what you want it to be, I would suggest just starting with your values. What’s important to you? And then what your life would look like if you were living for those values. Now, this work is of course best done in the context of therapy, but if you’d rather some reading on the subject I would say check out the book The Happiness Trap by Russ Harris.

Acceptance can lead to new realities.

Your pain and illness don’t have to control your lives if you don’t want them to. Keep making the most of it everyone.