Only do this practice if it is safe for you to do so (as determined by a physician). If you are already feeling dizzy, you don’t have to engage in the steps to make yourself feel dizzy, engage with how to be more okay with the sensations.
Sometimes we can’t control the sensations in our body (as we warriors know), and yet it causes us less suffering to just let the sensations be than to try to push them away or get upset that they are happening. That’s where I find these willingness exercises to be helpful.
Also, please note the disclaimer at the beginning of the video.
We all know that the majority of the research says exercise = less pain. Honestly, I’m a supporter of this idea. Why? Because it has literally worked for me. I’ve managed to get off one medication, which happened when the only major lifestyle changes I had made were daily exercise (strength and cardio/waling) and daily meditation (plus yoga 2-3x/week). No more Lyrica for me! Now that doesn’t mean that I no longer have pain. It’s just more manageable. I notice that when I don’t exercise, my pain actually increases. Of course, this all seems totally backwards to our brains., mine included. When exercise was initially presented to me as an option for reducing pain, I was like “no way I’m going to do that! I’ll be in more pain.” Then I tried it and the rest is history.
The thing is, even if you believe that exercise will help (and I’m aware that some of you don’t believe it, and that’s okay)the problem becomes, how do we reframe our minds so that we can actually start to engage in some physical activity? There are a way different ways we can approach this (or use all of these ways, depending on what you need). The very first thing I do is connect with my values. Why is this important to me? What values will I be living by? For me, when it comes to exercise this is often aligning with values of health, self-care, and independence. They might be the same for you, or totally different. The second thing I do is to just looking at my thoughts. I ask myself, are these thoughts helpful or unhelpful? Are they taking me toward the life I want to live or away from it? Then it’s helpful to create some distance from them. This can be anything from naming the story I’m telling myself, to speaking the thought aloud with the phrase “I’m noticing I’m having the thought that…”, to placing the thought on a leaf in my mind and watching it float down a stream.
At this point if I notice any sensations of anxiety or another emotion, I try to make some room for those. Maybe I send my breath into that area, or remember it’s normal to have anxiety, or drop an anchor which involves allowing my emotions to be there. By this point, I can usually do whatever activity it is I’ve decided I need to do (so in this case, exercise). While exercising there are a few more things I do so that I can improve my attitude. Firstly, I make sure my movement is mindful. I stay with the sensations of the movement, the smells in the air around me, what I can see and hear, all while exercising. This can be done on a walk or while doing strength training. You could also try yoga as a form of mindful movement that allows for stretching and exercise as added benefits. All my stretching in general is also done mindfully. I also make room for sensations while exercising. DO NOT exercise if it’s actually causing you extra physical pain. A little discomfort though is completely normal. I might do a quick body scan to check in with myself and make room for physical discomfort. I definitely use my noticing self to step back and just notice if it’s actually pain I’m feeling or if it is just discomfort that comes from exercise.
Lastly, I commit. I started out just going to the gym 3x/week. During the pandemic I built it up to strength training at home and going for walks to get fresh air and yoga a few times a week. The point is, you can start slow. And it’s probably better to if it’s a big change. You can also work with a physio/physical therapist, kinesiologist, occupational therapist, or personal trainer to help you get started (I worked with my physiotherapist, chiropractor and a personal trainer when I started). Here’s a podcast episode about exercise for chronic pain. So hopefully, this gives you some ideas on how to improve your attitude toward fitness with chronic pain. Until next week, keep making the most of it!
So, the question is, do you want to hold that beach ball under the water, or would you rather be able to deal with it effectively in the moment? This is a question we often need to ask ourselves when we deal with painful emotions and sensations.
As always, I hope this helps you to keep making the most of it!
Have you ever found yourself caught up in thoughts about the past? What life was like before your chronic illness/pain? Ruminating over and over about that old life… What about thoughts about the future? Worrying about what will happen to you and how your health will affect you, maybe even getting worse? Perhaps you are also really fused with the idea that you are just a sick person now and that is all your life will be. These are all common thought processes when you have a chronic illness or chronic pain. I’ve certainly dealt with these before. The problem with this dominance of the conceptualized past or future, or the conceptualized self, is that it often takes us away from living right now. It makes life worse. It increases suffering.
I remember having the thought that I don’t want to suffer any longer. This was in the fall of 2016. My very recent ex blamed me for all the things that were wrong in the relationship because of WHO I was. What I quickly came to realize was that I was ruminating and worrying and fused with having an autoimmune disease. We didn’t break up because of who I was (trust me there were a lot of other issues that didn’t stem from me at all). However, the dominance of my thought processes wasn’t helping me at all. It was taking me away from the life I wanted to live and away from the person I wanted to be.
The Conceptualized Past & Future I don’t think that being able to reflect on our pasts or contemplate our futures is inherently problematic. Our brains have evolved to be able to do this. Initially to keep us safe and alive. We just don’t run into as many instances of life-and-death situations anymore. When we excessively focus on the past, or ruminate, we tend to feel overwhelmed and depressed. When we excessively focus on the future, or worry, we tend to feel overwhelmed and anxious. Both anxiety and sadness can increase pain and set of flares for those of us with autoimmune disease, which in turn tends to lead to more sadness and/or anxiety. It’s a vicious cycle.
The Conceptualized Self We all have stories we tell ourselves about ourselves. Like who we are, where we came from, and why we act the ways we do, essentially why we are the way we are right now. Often being sick or in pain is a large part of this story. The problem with these stories is that while they do contains some objective facts, they are also chalk full of our own subjective interpretations. When we are really fused with these stories about ourselves, we forget that life is constantly changing, most of it is not predictable, and we can also create change for ourselves. And yep, I know this is really hard to grasp when you have a chronic illness.
Why we need to contact the present moment We we are stuck in the past or future, and when we dwell on our stories about ourselves, we are definitely not experiencing the here-and-now. The benefits of being present are plentiful, including the ability to gain more self-knowledge and self-awareness, enjoying our experiences more, feeling less pain (emotional and physical), and being more flexible in our interpretations of ourselves and of life. I meditate daily because it helps me become more present (and it took me so long to get into a daily routine). I also notice myself being able to come back to the present much faster throughout the day, even when I notice physical pain.
How do we counteract rumination, worry, and attachment to our self stories?
Mindfulness – it can be meditation, but really mindfulness means contacting the present moment, being here-and-now. So it can also be yoga, or mindful walking or eating. It can be fully engaging in an activity. It can be noticing your thoughts/feelings/sensations and then coming back to the present by noticing your feet on the floor. It can be many, many things, but it is always: being curious, open and nonjudgmental about your present moment experiencing. Check this out.
Noticing Self – the idea that there is a part of us that can step back and notice. Like the sky and the weather. The sky always has room for the weather. Even when the weather is thunderstorms and hurricanes, the sky is not bothered by it because eventually the weather changes. We can use this same part of ourselves, to just step back and watch our experiences without being swept away. It’s a safe place that just notices. This is particularly helpful for attachment to our conceptualized self. Check this out.
Creating Distance Between Ourselves and Our Thoughts – we can’t stop our minds from thinking, but we can notice when our thoughts are unhelpful and learn to let them pass like leaves on a stream. The more distance we can create, the more psychological flexibility we can have in order to return to the present. Check this out.
I know that was a lot of information! I’m a big believer in seeking help from a mental health professional in your area if you are really struggling with your mental health. Many people with chronic illness, chronic pain, TBI, etc. find it hard to cope on their own. One of the best things I ever did was go to therapy. I learned a lot of skills to help me cope and felt I had nonjudgmental support as I continued down this path we call life. And on that note, keep making the most of it!
The idea here is that we can develop this “noticing self” or the part of us that can truly just observe our experiences without them taking control of us. I think that I’ve gotten pretty good at this over the years, to the point where not only do I not get swept away, but I am also just curious about my thoughts, feelings, sensations, etc. If you want to try the meditation I mention in the video, check it out here.
It’s been 84 years and I can still smell the fresh paint… No, just kidding. But it has been at least 2.5 years (possibly longer) since I had the common cold. Clearly the social distancing and masks and everything not only helped protect me from Covid (which I have managed to avoid thus far) but also the cold, flu and everything else. Then, on May 2, I caught a cold. Sore throat and all. And it was pretty bad. For me, it’s worse because of one of my chronic illnesses.
Getting any kind of additional illness usually sucks when you have a chronic condition. Example, if you have an autoimmune disease and you’re on immunosuppressants, that can also make you much more vulnerable to more severe illness and symptoms. It’s one of the reasons most people I know with chronic conditions have been so careful during the pandemic. Lucky for me, I’m not on immunosuppressants (I take antimalarials) so I don’t have to worry as much about that part, but still. What I do have that makes catching a cold particularly rough for me is glaucoma. Glaucoma is a degenerative eye disease that can eventually lead to blindness (luckily there are amazing treatments so the chances of going blind if caught early and treated are fairly small). My paternal grandmother had glaucoma and was virtually blind by the time she died. Both of my parents have glaucoma. And when I was 29 I was diagnosed with glaucoma, which is incredibly young (most people are 50+ when they develop it). The leading feature of glaucoma is high eye pressure.
So on May 2, before I started having cold symptoms, I actually happened to have an appointment with my new ophthalmologist. My eye pressure was pretty good and there was no degeneration. He actually made two comments that I found quite funny. First, “You are extremely near-sighted.” Yes, I know (that’s literally how I responded too). He actually informed me about possibilities of retinal tears, and what to look out for. His second funny comment, “Well, I guess we’ll be seeing you from now until indefinitely.” Yep, pretty much true. So, why is catching a cold worse when you have glaucoma. Well, over-the-counter cold medications actually increase your eye pressure. Therefore, I can’t take cold meds (other than cough drops).
Okay, so what happens to me when I can’t take cold meds and have a bad cold is that I get extremely wimpy. Basically life sucks for a few days. Unless I catch myself in these thought patterns, which is what I did recently. I know that “this sucks” and “everything is terrible” thoughts leads to more negative mental and physical health outcomes. It increases body aches and pains, it can keep me sick longer, and it can make me feel depressed (and there’s lots of research out there to back all of this – just type a few key words into Google Scholar and you’ll find it). To be effective I had to “manage my mind” (which is a phrase a life coach who’s podcast I listen to uses). I notice the thoughts, place them on a leaf and let them go. Or I notice and name the thoughts or name the story my thoughts are trying to tell me to create some distance. And then I take comfort in pleasurable activities that I can do. For example, I love movies and being sick is an excuse to watch them. But I don’t just pick any movie. I have some favourites that I used to watch all the time as a kid when I was sick… and then continued to watch into my adulthood when I’m sick. My favourite is Jurassic Park. So that’s what I did. I created distance between myself and my thoughts, acknowledged any emotions I was experiencing, made some tea and watched JP.
The other thing I did recently that was helpful, was talk to my ND about natural cold remedies. Now, I’m lucky in that I work at the same office as my ND (we actually share a room, just work on different days), so for me it’s a quick text and I realize that’s not the case for everyone. But if you see a naturopath, it’s worth asking about. Here are some suggestions she gave me for the common cold (sinus and cough):
Vitamin C: amount can depend on your bowel tolerance – I bought the chewables and used about 3g per day.
NAC supplement – I think you have to go to a natural health store to find these. I didn’t try them this time, but I’m keeping it in mind for the future.
Peppermint tea – which I love anyway, and interestingly it’s the only type of tea she recommended
Eucalyptus inhale: basically boiling water with some essential oils and inhaling with a towel over your head – I found this extremely helpful
wet stock treatment – I did not try this because my feet hate the cold, but apparently it is very effective.
Alas, I survived my first cold in 2.5 years and realized that the best things for me to do is use some natural remedies paired with some psychological coping skills. If you’re like me and unable to take cold medication, I hope this helps you to keep making the most of it!
Curiosity and nonjudgmental awareness are important tools for healing when you have a chronic illness. I’m not saying, cure the illness, but rather to increase our pain tolerance, decrease our stress levels, and heal from any associated wounds from our illness. This becomes even more important if you have a trauma background, which as we know from all the research on the subject, is very common when you have a chronic illness. Myself included in that statement, “little t” trauma that lasted for 5 years in elementary and junior high, something I initially scoffed at as possibly being considered trauma until I learned more about what trauma is, and how it has contributed to my current health. I didn’t process any of it until I was an adult, seeking psychotherapy for pain and stress, and it eventually came out because I was having difficulties in adult friendships… all stemming back to the “little t” trauma from my childhood (let me know if you want more information on little t and big t trauma, I’ve written about them before but can again).
What should we be curious and nonjudgmental about?
I mean a part of me just wants to say EVERYTHING! Because there are definitely huge advantages to approaching life this way. However, it is completely unrealistic to think we could experience life this way all the time. We’re human and it’s totally normal to make judgments (evolutionarily, it helped our species stay alive!) When it comes to chronic illness there are 4 things I think are really important to be curious and nonjudgmental about (this is, as always, based on my own lived experience as well as what I’ve seen in clinical practice).
Our Thoughts – even the ones that are “judging” in the first place. Can you notice your thoughts without thinking about them or getting swept away by them? I find it interesting to see not only the content of my thoughts but also how they come and go, with some being more sticky than others.
Our Emotions – like our thoughts, they tend to come and go, but typically can stick around for longer periods of time. Not only should we explore what we are feeling, but where we are feeling it in our bodies. All emotions have related sensations. What can we notice about them by just sticking to the facts?
Our Behaviours – why do we do the things we do? It’s fascinating to notice how I act in certain ways or do certain things and how that changes with time or on a different day. It’s equally as fascinating to observe how my behaviours change when my thoughts and feelings are in different states.
Our Sensations – not only the ones associated with our emotions, but all the sensations in our bodies – hunger, fatigue, pain. Noticing the quality, where it is, what it feels like, even what we imagine it looks like.
How can we become more curious and nonjudgmental?
There are a lot of ways we can learn to become curious and nonjudgmental. I think of myself as being a curious child, discovering something new for the first time, and approaching whatever it is – thought, emotion, behaviour or sensation – just in that way. But I’ll be more specific:
Describe it – using only facts, not your interpretations or judgments. Here is anxiety. Here is a sharp sensation in my leg. Here is a worry thought.
Notice and Name it – I am noticing the thought that… or I’m noticing the feeling of…
Send your breath into it – rather than judge the sensation or emotion as good or bad, see if you can just pause and send your breath to the area of you feel it the most, giving it some room.
Practice meditation – in meditation all you’re really doing is noticing your experience as it comes and goes. This can be a good way to learn to interact with your thoughts, feelings and behaviours nonjudgmentally because the whole point is to be open and nonjudgmental. Check this one out.
Do a body scan – this is another way to really be open to any feelings and sensations present in your body. We often notice that the intensities change and that sensations do often come and go. Find a short version here.
Offer yourself some kindness – it’s so easy to be harsh and judgmental about your experience. Kind self-talk or kind self-touch can be useful to counteract what our minds are doing. Check out this kind hand exercise.
It can be hard to think that things can get better, but I’ve had the first-hand experience of my life improving from doing these kinds of practices and really just changing my experience of life. I hope this helps you to keep making the most of it!
Pain – both physical and emotional – are parts of life. They are also inevitable with chronic illness and chronic pain syndromes. The more we try to fight or resist our pain, the more it comes at us. So, let’s talk about why that is and what to do about it. Because, really, we can’t keep making the most of it if we struggle. Check out this podcast episode for more about this.
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.
I decided to do a 4-part series on some of my favourite pain coping skills. They are all either my favourites because I have found them to be particularly useful for me, or that reason plus I have seen them be useful for other people. I will also add that I always double check to see if there is any scholarly literature on the subjects I write about, and there definitely is for all of these coping skills. So, without further ado, lets start off with self-monitoring.
You might be asking, what is self-monitoring? It is a part of our awareness (executive functioning in the brain) that we all have, that tracks our behaviours and the impacts they have on us and our environment so that we can alter our behaviour in the future if we choose to. We all use this pretty often. For example, adjusting to social norms would be using self-monitoring. So would reviewing your work for mistakes (because ideally you won’t want to make the same ones in the future). We can break self-monitoring down into two types. Qualitative – or what I’ll call subjective monitoring – which is how our emotions, sensations and behaviours change throughout the day and during different situations. Then there is quantitative – or what I’ll call objective monitoring – which is the frequency, duration, and difficulty of our behaviours.
What the heck does this have to do with chronic pain? Sometimes people with pain over-self-monitor in that we overthink our pain and our behaviours which is typically not helpful (I’ll get to that in a minute). When done properly, self-monitoring can be used to help us accept our emotions and sensation, create some distance between us and our thoughts about pain, and get us to do behaviours/actions/set goals/whatever you want to call it, that will improve our lives or just in general fulfill us! And this is what I see is often difficult for chronic pain warriors. For example, if I notice that a certain activity causes me more pain than normal, I would mentally note that as well as the frequency, duration and difficulty of the activity so that I can make adjustments in the future (i.e., not to the activity, do the activity for less time, do the activity less – or more, depending on the situation – often, or do a similar activity that is less difficult). A few years ago I did a pole dancing class. Super fun and a great workout. However, I did notice that my hip pain increased, especially after the class was over. I decided that while though it was fun, the friend I went with and I have lots of other activities we can do together and I exercise in other ways, that maybe this wasn’t the workout for me. I adjusted. Another example is hiking. I know how long a hike I can do (about 75-90 minutes max.) before I have expended too much energy and/or crossed my pain threshold. What does that mean? I still hike because I LOVE hiking, but I do it for 90 minutes or less, followed by rest.
Earlier I mentioned that when we over-self-monitor we often do things that aren’t helpful. This also happens when we don’t self-monitor our pain at all. Let’s tie it into that pain cycle I wrote about a few weeks back. In the pain cycle we see that being less active leads to a loss of fitness, weak muscles, and joint stiffness. If you self-monitor and notice that if you lay on the couch all day this happens but if you go for a (short) walk it doesn’t lead to these specific symptoms, that might lead you to do the walking. Pain cycle again says that then we create lists of “no go” things we cannot do, and this leads to sleep problems, tiredness, and fatigue, which also leads to stress, fear, anxiety, anger, and frustration. Okay, so doing less isn’t necessarily helpful even though our brains say it will be. We can also skip ahead in the cycle and go to negative thinking and fear of the future and how that leads to depression and mood swings. Monitoring our thoughts is helpful at this stage. And then there is time off work, which inevitably causes money worries and often ties into relationship concerns. And then everything leads back to more chronic pain. I want to point out with the activity portions of the above paragraph, that pacing is essential and I did a whole post on that a few weeks ago.
What can we do to start self-monitoring in an effective way? First thing is to keep track of your pain. This can be mentally, but if you have brain fog or just tend to forget it can be more effective to write it down in a journal. There’s a few ways you can track it. Just a general 1-10 score for the day and a list of what you did during the day. Or, if you want to be more effective with your activities, you could write a score before and after each activity you did to track changes. That will also tell you when there was no to little change so you know if you can keep doing the activity the same way, for the same amount of time. The other important thing to track in the journal can be other triggers to pain. For this one, I would suggest tracking emotional pain (sadness, anxiety, anger, etc.) as much as physical pain. Why? The body-mind connection. Often the more depressed we are, the more pain we have (and vice versa). Same with anxiety. It’s easier to make adjustments when we know what’s going on.
Okay, longer post than I anticipated but I hope that it’s helpful for all of you warriors! Keep on making the most of it!