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!
This is a metaphor I found at this website. I love what the writer of it did here. It’s an alternative to spoon theory, where the biggest different is that spoon theory only focuses on energy, and this metaphor – a knight in battle worn armour – looks at all aspects of having chronic pain/illness. At the end of the day, you can prefer whichever metaphor you do, but I like to bring some psychoeducation and alternative methods of thinking to you, because I like when they are brought to me! Stay strong and keep making the most of it!
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!
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!
This video is meant for psychoeducation only. Please consult appropriate healthcare/mental healthcare professionals as required. When we have difficult and painful thoughts, feelings and sensations, we can easily get swept away from them, as they pull us from what’s important to us and how we’d like to be. We can also learn to effectively manage ourselves when these thoughts, feelings and sensations arise.
This meditation can help us distance ourselves from our thoughts, feelings, sensations, urges, or memories. The point is not to get rid of these, but to create some space so we can go on with our lives. This meditation is helpful for anxiety, depression, substance use, chronic pain, and other physical and mental health conditions.
I love writing (hello, this is a blog after all) and I’ve always found it to be helpful for me in my own life (and health) journeys (that and music). I came across some research on the mental and PHYSICAL health benefits of expressive writing, so I did a bit more digging and damn, we should all be doing more of it! And hopefully, this post will inspire you to do some. Hearing that there are mental health benefits is probably less shocking than that there are physical health benefits to expressive writing, so we’ll start there, but before we get into that, let’s quickly establish what expressive writing is. Expressive writing is simply writing about our deepest thoughts and feelings about an event or situation, without holding back. When people do this, it is often through journaling, and is often free-writing, without too much thinking about it. It can be done on the computer or by hand, really whatever you prefer. The leading pioneer in this research is Pennebaker (too many articles to site them all), but I’ll site some of the other research on the subject (which also references him) at the end of the post.
Okay, so the mental health benefits:
reduces symptoms of depression
reduces post-traumatic symptoms
improves focus and concentration – including in people with ADHD
improves working memroy
improves emotion regulation (which is our ability to control the quality, frequency, intensity and duration of our emotional responses to situations)
and it increases our self-awareness
If these aren’t good enough reasons to do some expressive writing, then maybe the physical health benefits will convince you:
decreases the number of doctor’s visits you’ll have
reduces the number of days spent in the hospital
reduces the overall number of hospitalizations – i.e., people with cystic fibrosis
reduces blood pressure
reduces chronic pain – i.e., cancer and chronic pain conditions
reduces the severity of inflammatory conditions – i.e., rheumatoid arthritis, lupus (SLE)
improves immune functioning – i.e., cancer, HIV
improves lung functioning – asthma
improves liver functioning
improves and speeds up post-operative recovery
improves overall physical well-being
And then, if that’s still not enough for you, there are some other general benefits:
reduced number of “sick” days from work plus faster return to work if you were layed off
increased GPA in university students
improved sporting performance in athletes
Okay, so how does this all work? I mean, I understand how it can improve some of the mental health problems we may experience, because we’re writing about our thoughts and feelings. But how does it improve our physical health? Well, actually the two are related. Remember that stress has a HUGE impact on our physical health, and the mind and body are connecting, meaning that anxiety and depression can also feed into (and trauma can cause) physical health problems. The processes of expressive writing are as follows:
it allows for cognitive processing and restructuring of painful events and situations – cognitive restructuring changes how we perceive emotional stressors (both internal and external)
it allows for repeated exposure – which is controlled re-experiencing of events and situations so that they have less influence over our minds and behaviours
Improving our bodies, improves our minds and vice versa. Here’s the podcast episode on it.
How do we engage in expressive writing? According to the experts we need to write about our deepest thoughts and feelings, without holding back, about situations or events or really anything relevant to us at this moment that are painful. This could be anything from having cancer, to spending time in the hospital to going through a traumatic event. When we sit down to write, it should be for 15-20 minutes at time, without stopping, and be done on 4 consecutive days. Just doing that is enough to lead to all the benefits I listed earlier. It’s possible that more consistent writing could have more improvements, but I honestly didn’t find much on that. So, I’m curious, who’s going to try out some of this expressive writing to see if it helps?
I want to remind everyone that in addition to this blog, if you’re looking for more information to improve your health, I have a podcast: Chronically Living and how to make the most of it, which is available on Apple, Spotify and everywhere else you get podcasts, including this web link. I also have a YouTube channel for those of you looking to incorporate more mindfulness as it has a number of benefits for your physical and mental health as well: Kelsey L Harris Meditations. Until next week, keep making the most of it!
Baikie, K.A., & Wilhelm, . (2018). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment, 11(5), 338-346. https://doi.org/10.1192/apt.11.5.338 Lepore, S-J., Greenberg, M.A., Bruno, A., Smyth, J.M. (2002). Expressive writing and health: Self-regulation of emotion-related experience, physiology and behaviour. In S.J. Lepore & J.M. Smyth (Eds), The writing cure: How expressive writing promotes health and emotional well-being (p. 99-117). American Psychological Association. https://doi.org/10.1037/10451-005 Stanton, A.L., Danoff-burg, S., & Huggins, M.E. (2002). The first year after breast cancer diagnosis: Hope and coping strategies as predictors of adjustment. Psycho-Oncology, 11(2), 93-102. https://doi.org/10.1002/pon.574
When I was first diagnosed with a chronic illness, my mental health started to suffer. I actually tried to hide that, even from myself, but my anxiety increased over the first 7 or 8 months until I started seeing a therapist (and thus my journey to becoming a therapist began). The thing is, I’m not alone as far as my story with my chronic illness taking a toll on my mental health. Many, many chronic illness warriors have been through the same thing. So, if you’re reading this and you’re struggling, know that it is normal and it is okay to struggle. Also note that change is slow. I can give you these 10 ways to improve you mental health (as I did a few weeks ago with physical health) but you aren’t going to feel better overnight, or after the first time you do these. It takes repeated practice and effort on your part (I still practice all of these!). If you’re ready for that commitment then let’s get into it!
Support and Connection – this is pretty much the opposite of isolation, which is common with chronic illness, and mental health issues such as depression and anxiety. Support and connection can come in the form of joining formal support groups (which are likely still mostly online due to the pandemic, but may be in person depending on where you live), or informally by talking with your family and friends, or connecting with others in the Spoonie community via social media. As we’ve seen from the pandemic, isolation is not good for our mental health so do what you can to stay connected. Check out this podcast episode.
2. Mindfulness – I know this comes up a lot but there are many, many studies showing that this has powerful effects on both physical and mental health. It can be formal meditations, but it doesn’t have to be. Mindfulness can be fully engaging in an activity, such as mindful eating or mindful walking. If you’re present you’re unlikely to be ruminating about the past (depression) or worrying about the future (anxiety). Take a listen to this podcast.
3. Assemble your healthcare team – that includes someone to help you with your mental health. If you can’t afford to see someone in private practice, check out community settings. I’m currently doing my internship in a community setting, where our services are free. There is a bit of a longer wait time, and is usually brief/short-term service, but it is definitely a good option for many people. Check out this podcast on depression and this one on anxiety.
4. Use holistic approaches – what I’m talking about here are approaches that utilize the body-mind connection. If you’re lucky you can find several practitioners that do so. For me, my physiotherapist has a BA in psychology so she always takes a body-mind approach (podcast with her here), and I also saw a naturopath before I moved, which is all about the body-mind connection. They can give you more ideas for how to take care of your mental health and understand it interacts with your illness. This podcast is with my naturopath.
5. Get moving – movement, of any type, is helpful not just for your physical health but for your mental health to. There have been studies to show that exercise decreases depression. Even if you’re not super mobile, going for a walk, doing some yin yoga, or taking up Tai Chi (podcast here) are good options to increase those endorphins and other neurotransmitters in your brain.
6. Connect with your values – who and what is important to you? If you can figure that out, then try to brainstorm some ways you can continue to live by your values, even with chronic illness. I’ll give you an example from my life. It is important to me to have adventures. Obviously travel is harder with a chronic illness, but it’s not impossible. So my friend and I (pre-pandemic) went on an “adventure vacation” to Costa Rica and for every “adventure day” we did a “rest day.” Honestly, it worked out super well, and we both felt more mentally and physically healthy that trip then we had in a long time. Check out this podcast.
7. Do what matters – this ties into this above, connecting with your values. Once you have done the brainstorming, it’s important to do the things that matter to you. So for me, it was travel. It might also be spending more time with family and friends, or being creative. Doing the things (what therapists call behavioural activation) actually decreases depression (lots of evidence here). Check out this podcast for more.
8. Find an outlet – this might tie in to doing what matters for you. My main outlet is writing (probably no surprises here), but I have other ones too, such as playing the piano and colouring. I know a lot of people use art or photography or music or dance. It doesn’t necessarily have to be a creative outlet, but creativity can be useful, because a lot like exercise, it gets those helpful brain chemicals to increase.
9. Distance yourself from thoughts, feelings, sensations, etc. that are “hooking” you – what I mean by hooking, is the ones that pull you away from your values, the ones you can’t stop thinking about and make your anxiety/depression/etc worse. If you think of it like fishing, when you cast, and then hook a fish, you immediately start to reel it in, and the fish struggles, flopping around. This is what some thoughts, etc. can to do us – make us struggle and flop around, doing things that are unhelpful. By putting some distance between ourselves and them can help decrease their power (this includes physical sensations of chronic pain).
10. Acceptance – whoa I know this is a big one because no one really wants to accept that they have a chronic illness. And yet this might be the most powerful part of the list for Spoonies. Not just accepting that you have a chronic illness, but allowing your to sit in the physical sensations of pain (without getting “hooked” by them), and allowing yourself to sit in feelings of sadness and anxiousness, etc. These are all adaptive for us. They are part of our evolutionary history. They are here for a reason, and we can learn to allow them to be without it stopping us from doing what matters.
I’m sure I’ve given you a lot to think about, so that’s all from me for this week. Keep on making the most of it!
And don’t forget, the self-care challenge starts for premium members on April 24. If you haven’t signed up yet, it’s just $5 CDN for 4 weeks of posts and check-in around self-care!
As my many of my fellow chronic illness warriors know, mental health struggles such as depression and anxiety are real…ly common . Not that they are necessarily constant, though the can be. I actually do a whole episode of my podcast on mental health and it’s relation to chronic illness, so feel free to check that out for more info. For today however, I want to take a look at one element of our mental health, which is commonly experienced by everyone (seriously everyone) whether or not they have another underlying physical or mental illness. Negative automatic thoughts (or NATs).
NATs are those subconscious thoughts that you don’t realize you’re having until you do (and even then you may not realize that’s what they are). It’s the thoughts of “I suck,” “how could I be so stupid,” “what an idiot I am,” “why am I dumb enough to say that,” etc, etc, etc. Are they accurate thoughts? Usually not. But we all have them from time to time (or more often, but we’ll get to that in a minute). These thoughts, according to cognitive behavioural therapy, can lead to anxiety and depression. Why? Because our thoughts cause our feelings. If we keep telling ourselves that we are “stupid” or “not good enough” or whatever terrible thing we say to ourselves, we will (a) start to believe it, and (b) feel upset about it. Makes sense right?
If you’ve gone to a CBT therapist, you may have experience with thought records. Basically, this is a sheet (or note on your phone) where you record your thought and your feeling every time you have one of these negative automatic thoughts. The point is twofold. First, it’s to see how often you are having these thoughts and what emotions are connected to them. Second, it allows you the opportunity to begin changing these thoughts. If you can catch yourself saying “I’m stupid” then you can change it to, “you know that may have not been the smartest choice to make but I’ve learned from it so I won’t do it again.” Or more simply, “I’m not stupid, I’m smart, I just did a silly thing.” To be honest, this is a much harder skill to learn than it seems, but it can be done.
Changing these thoughts into positive ones instead of negative is an ultimate act of self-love. To be honest, since I started to practice this a few years ago, I have less NATs than I did before. Yes, they still pop up, but I can catch myself and reframe the thought because I know that the thought isn’t true. I encourage everyone to try to keep track of your thoughts for awhile so you can catch these nasty little NATs and try to take some ownership of your mental health through self-love.