Video: Values-Based Activities – Colouring

What are values-based activities? They are actions, activities, hobbies, practices, etc. that align with our values (how we want to treat ourselves, others, and the world/what is important to us). Colouring may seem like a silly one, but here me out! You can also check out this podcast episode I did on values-based living.

Try out a values-based activity for yourself so that you can keep making the most of it!

Video: Values-Based Activities – Music

Even when we are limited in what we can do (because of our illness or pain) we should still live by our values and take actions that we can. If you play an instrument, that might mean playing your instrument! Or if you’re unable to play at the moment, maybe it means listening to some music that you love. What can you do to live by your values?

This is just one way to keep making the most of it!

How to Figure Out Your Values When You Have a Chronic Illness

Which would you rather do – something (a behaviour) to give yourself short-term symptom relief or something (a behaviour) that aligns with your core values, even if the goal isn’t to bring you symptom relief? The first option, by the way, isn’t necessarily connected to your values. There was a time for me that I probably would’ve done the later. Hell, I did do the latter! I definitely acted in ways that weren’t indicative to what was important to me at all but did help me out in the moment. Things like lying in bed, avoiding exercise, asking my partner to rub my back or just stay near me for hours, missing work, and on and on and on. And I’m not even saying that any of these are bad things. They were just bandaids that made that moment better, but didn’t help my pain long term and ultimately had a lot of costs (like the end of that relationship, feeling physically weak, and making work more difficult). Over time, reconnecting with my values became a much more viable response – and in some ways, even helped to decrease my pain.

What are values? They are our principles or standards of behaviour that we want to engage in. They represent what is important to us. Some examples are:

  • acceptance
  • adventure
  • assertiveness
  • authenticity
  • caring/self-caring
  • compassion-self-compassion
  • cooperation
  • courage
  • and on and on and on

Different values can also show up in different areas of our life, like work and education, relationships, personal growth and health, and leisure. Values often motivate how we behave in different situations. Sometimes we just live by our values without thinking about them. However, sometimes, when we find ourselves dealing with chronic pain and chronic illness, we can get removed from our values, like I did. There are two things we can do to figure out if we have been removed from our values while dealing with the terribleness of chronic pain and illness.

  1. Figure out what our values are – using a checklist and/or a bull’s eye.
  2. Figure out (nonjudgmentally) what “unworkable action” we are engaging in that is acting as a “bandaid” but isn’t really lining up with our values and how we want to be long-term.
Unworkable action occurs when: (a) the solution is short-term, and (b) the behaviour takes you away from your values.

Okay, but why should we do all that? You might be wondering why not just stick wth the bandaid solution. And you can. But typically we have better overall quality of life if we live by our values. We engage in behaviours that are more fitting to the person we want to be and the life we want to live. And, what research finds (plus just looking at my own life and the lives of my clients), is that pain and other symptoms bother us less. It doesn’t mean they go away, they just don’t really interfere with our lives anymore. The research finds that our self-care for our illnesses and pain improves when we are motivated by our values (everything from self-direction, pleasure, and health to responsibility and socialization). We become more willing to “make room” for our difficult sensations (and thoughts and feelings) when we live by our values.

There are many ways we can live by our values. For example, when I travel I balance the adventure/activity part with rest.

I’ve shared in a number of posts different ways that I live by my values. Here are a few consistent ways I do in my life.

  • Presence (aka mindfulness) – I meditate daily, do yoga several times a week, and just try to fully engage in as many activities during the day that I can.
  • Fitness/health – I eat healthy (gluten-free, dairy-free, meat-free – though I do allow myself some cheat days) and I exercise daily (walking and/or strength training, and/or physio exercises)
  • Creativity – I’m writing a book, I play the piano, I write screenplays with a friend
  • Adventure – I travel (looking forward to getting back to that), hike, kayak, try new restaurants, meet new people
Actively living by my values doesn’t take the pain away, it takes the hold the pain has on me away.

And those are just some ways I live by my values even with an autoimmune disease and chronic pain. It took a lot of work to get here though, so be kind and patient with yourself (hey, that’s the value of self-compassion). I hope this helps you to make the most of it!

Why You Shouldn’t Avoid Your Pain

Today I’m giving you a choice.

  • Option A: you never have to feel pain again. No physical pain. No sadness. No anxiety. No guilt, fear, or anger. But… you can also never feel physical relaxation. No joy. No happiness. No love, pride, or serenity.
  • Option B: you still have to feel pain, both physical and emotion. But you also get to feel relaxation, joy, happiness, love, pride, serenity, etc.

What do you choose?

I know Option A is super tempting, but I’ve found that most people choose option B, because no one wants to permanently get rid of the things that make us feel “good.”

We don’t like to feel “blue” so we resist it.

When it comes to pain – and throughout this post when I refer to pain, I mean both physical and emotional – we tend to try to block it or avoid it at all costs. Literally, people will drink alcohol, take illicit drugs, take prescription drugs and over-the-counter drugs, mindlessly scroll on their phones for hours, and so on, just to avoid or get rid of the uncomfortable things we really don’t like to feel. Here’s the problem: when we do this it tends to make all the pain much, much worse. (And yes, there has been a TON of research done on this).

PAIN X RESISTANCE = SUFFERING

This formula has been said by meditation teachers, such as Shinzen Young, psychologists, such as Tara Brach (who is also a meditation teacher), and researchers, such as Kristin Neff. And I’ve found both personally and through my work as a therapist, that it’s true. I’m literally in more pain when I resist it, avoid it, distract from it, push it away. And when I just let it be, I’m okay. This morning I woke up with so much anxiety. Anxiety about finances, anxiety about work, anxiety about my life and things I could have done. At first I did try to resist it. I instinctively grabbed my phone and scrolled. I decided I wasn’t going to have a workout and that I’d eat an extra waffle for breakfast while I watched YouTube videos about horror movies. But none of that made my anxiety go away…

We naturally want to hide from pain.

Here’s the thing about emotional pain specifically, it can actually lead to several additional problems (or increase the intensity of them if you already have them):

  • More anxiety
  • Lower mood
  • Increase risk of heart disease
  • Gastrointestinal issues
  • Headaches
  • Insomnia
  • Autoimmune Disease Flares

We experience all types of pain for a reason. If we didn’t need our emotions (both the ones we like and dislike) and if we didn’t need physical pain, then we would have evolved without them. Our ancient ancestors needed them to stay alive. To protect us from life and death danger. To keep us safe. Instinctually, our brain and bodies still try to keep us alive the same way, it’s just that we encounter a lot less life and death situations now. And yes, all this applies to chronic pain too. Our bodies are telling us something is wrong, it’s just often not what we think. We think it’s telling us to stay in bed and not move and give in or up on all that’s important to us. In reality, it’s often telling us that we might need to stretch and move our bodies. To do something meaningful with our day – not as distraction but as a way to bring meaning and value to our lives.

Doing something meaningful is much more effective than trying to get rid of something that is a natural part of being human.

…This morning when I decided that I was done resisting my emotional pain, I sat down to meditate. I did my full 20 minutes (meaningful activity) and then I went for an hour walk (moving my body, and a meaningful activity). Then I did my workout that I had put off from the morning. I didn’t do all of this with the intention of distracting myself from my pain (emotional or physical) but to make room for it. I used some practices that I help my clients use to: like observing my pain, breathing into it, expanding around it, and just allowing it to be there WHILE I did things that were important to me. Guess what happened? Not only did it no longer control me, but it actually lessened a lot – to the point where it’s barely noticeable. I also noticed that my drive and creativity and all these things that I’ve been lacking lately came back full force. My suggestion to all of you is to make room for your pain, just to help you make the most of it.

Try this mindfulness exercise out to learn how to make room for pain.

What Can We Control When We Have 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.

I didn’t have control over getting sick, nor can I stop my thoughts and feelings from occurring (they’re part of being human).

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.
I can take control over my actions and lead a values-based life.

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!

Effective Ways to Challenge Chronicity Thoughts

How much time do you spend thinking about your pain or illness? Does it consume most of your day? Just a little bit? I remember the time when I was spending a lot of time thinking about being in pain, and wondering “why me” or what my life would be like going forward etc. These are often referred to as chronicity thoughts. Happily, this was the past for me and is not my experience anymore. I know that many of you may be having this as your current experience though, so I wanted to take sometime to talk about it.

As human beings, we spend a lot of time thinking.

First of all, I want to say that this is a totally normal experience for anyone with chronic pain or a chronic illness. Our minds are literally trying to help us (or they think they are trying to help us, which is what they evolved to do). The problem is, this kind of constant thinking about pain makes our lives worse, not better. There are three types of common chronicity thoughts: (1) ruminating about being in pain/sick – I keep thinking about it, it’s all I can think about because it hurts; (2) magnifying our pain/illness – it will get worse, something terrible is going to happen; and (3) thoughts of helplessness – nothing I do makes it better, nothing I can do will ever make it better.

Are your thoughts making your life better, worse, or the same?

If you went to a doctor (Western or functional) or a therapist, they’d likely assess this with a tool called The Pain Catastrophizing Scale (PCS). My commentary is that I don’t like the name because “catastrophizing” sometimes has the connotation that it’s all in your head, but that’s not what it means in this case – it’s really referring to chronicity thoughts. The questions on the scale include:

  • I worry all the time about whether the pain will end
  • I feel I can’t go on
  • It’s terrible and I never think it’s going to get any better.
  • I wonder whether something serious will happen.
  • and so (there are 13 questions total, and you self-report on a scale of 0-4 for each question, with 0 meaning not at all and 4 meaning all the time.)

So what can we do about all these chronicity thoughts? First, I will always suggest that working with a therapist is the way to go. Remember this blog is educational and not mental health/medical advice. We all have unique situations and unique thoughts, so having someone you can work with one-on-one (or in a small group) is always the way to go. I will let you know about a few different approaches. First, let’s talk about classic Cognitive Behavioural Therapy approach, where we challenge thoughts.

  • Notice and name the thought: I’m having the thought that “It’s terrible and I never think it’s going to get any better.”
  • Review evidence for and against the thought: For might include things like, it occurs frequently, has high intensity, a doctor’s prognosis, etc. Against might be things like, there are times of day when I don’t notice it or it’s less intense or my doctor said with this medication or these lifestyle changes it will improve
  • Replace the thought with a more accurate one: This doesn’t mean being optimistic or denying anything that’s true. Instead it’s incorporating the evidence against the thought (not just for the thought which is what we tend to do). So a different thought might be: “It’s really unpleasant right now, but it might not always be this bad/constant.” (You choose a thought that works for you, this is just what might work for me.)

As a therapist, I am well-trained in CBT but I prefer to use Acceptance and Commitment Therapy (ACT) on myself and with clients, especially those with chronic pain/illness. There is no step-by-step way to challenge thoughts in ACT because we don’t challenge them, but here’s now I might work with them.

  • Contact the present moment: ground myself my noticing and acknowledging my thoughts and feelings, while noticing what I can touch, taste, smell, hear, and see. (Here’s a guided version of this).
  • Use my noticing self: the part of me that notices everything and even notices my noticing. And the similar part of me that can put myself in my shoes on the days when my pain is less. (Here’s a guided version of how to learn to do this).
  • Creating distance between myself and my thoughts: This might be noticing and naming the thought. It might be reminding myself that my brain is just trying to help me and saying “thank you mind.” This might be just watching my thoughts come and stay and go in their own time (guided version of this one is here).
  • Accepting my experiences: particularly physical and emotional pain that I might be going through. This could be actual sensations or emotions such as sadness or anxiety. For this I often just observe what the sensation/emotion looks like, where it is in my body, and so on. Then I send my breathe into the part of my body I feel it most intensely. Then I make some room for it, noticing that my body is bigger than it. Finally, I just allow it to be there without consuming me. (Guided version here).
  • I connect with my values: what qualities of being are important to me? I know that compassion (for myself and others) is a big one that is often helpful in moments of pain, sadness, anxiety, etc. (Here’s an exercise on connecting with your values.)
  • Taking an action to live by my values: So if we’re going with my above example/value than it might be doing some self-compassion work. (Here’s a guided practice). It could also be setting goals to make some of those lifestyle changes that might help. It doesn’t matter what the action is as long as it is rooted in your values. (podcast episode on how to do this available here).

So that’s it. A bunch of different ways to work with your chronicity thoughts so that hopefully you can improve your life and keep making the most of it!

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

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

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

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

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

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

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

I also like the magic wand question:

  • Let’s say I have a magic wand and when I wave it all of your painful thoughts, feelings, memories, and sensations stop being a problem for you. What would you do with your life?
  • What would you start, stop, do more of or do less of?
  • How would you behave differently?
  • How would others know (i.e., what would we see and hear) that things were different for you?
Image from: http://blog.theaawa.org/3-steps-to-finding-your-orgs-core-values/
I would add authenticity, challenge, contribution, creativity, determination, friendships, growth, happiness, kindness, meaingful work, optimism, openness, resilience, and self-respect to the list I’ve already mentioned for myself.

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

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

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

Keep making the most of it everyone!

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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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10 Ways to Improve Your Mental Health When You Have a Chronic Illness

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!

How’s your mental health right now?
  1. 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.

Being mindful take practice.

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.

Make sure your healthcare team is able to help you with all aspects of your health.

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.

Connecting with my values and doing what matters to me.

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.

Being in nature also matters to me and is an outlet as well.

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.

Acceptance can feel peaceful.

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!

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.