Archive for the ‘Coping with Illness’ Category

Happen to Something

IMG_1595

I was recently talking with a client who is dealing with some very difficult PTSD and depression concerns.  She was describing her sense that many of her goals have been interrupted, and her struggle to take any action since she couldn’t see how it would connect to a goal.

I think the feelings she described are true for many folks who have been affected by illness or trauma.  When life is severely disrupted, when the things we thought we would be doing begin to feel out of reach, it can be hard to see why we should bother engaging at all.  We struggle to see the point.

What I have learned is that sometimes, when we are in the dark, action and engagement are the point.  Trauma and depression are emotional experiences that provide us with a constant litany of all the ways that the world is dangerous or that we have failed.  In a misguided effort to protect us from pain, depression and anxiety can tell us that we should just not bother trying anything.  Here are some common messages you might be getting from your depression or anxiety:

  • It’s just going to backfire anyway.
  • I have already missed my deadline to do this, so doing it later will still feel like a failure.
  • Nothing ever works out for me.
  • I don’t deserve to succeed.
  • Doing this small self-care won’t get me a job (finish my degree, fix my relationship, etc.), so why bother?

When my clients share thoughts like this with me, I remind them of two things.  First, that we can appreciate the work our depression and anxiety put in on trying to protect us from harm.  That is true. What is also true is that depression and anxiety will use lies to try to reach that goal. They will lie using pieces of truth.  And the fundamental lie that they will tell is that lack of action keeps you safe.

Lack of action doesn’t keep you safe. It keeps you stuck.  So, today I am going to invite you to engage with your life in some small way that brings you joy.  I know that you may be facing pain and challenge.  I know that the future may feel too complicated to face.  So don’t face the future.  Don’t worry about where your action is taking you.  If the struggle to understand how this makes change is keeping you frozen, step around the struggle. Do something because you can and because you like it.

Today, this moment, do something that you love.  Happen to the world instead of the world happening to you.  It doesn’t have to be huge.  Cook something delicious. Stand in the sun.  Do a 5 minute lovingkindness meditation. Snuggle your pet. Watch something funny. Take a long shower. Do something that you can start, even from a place of darkness, something small and manageable. But happen to the world.  Happen to yourself.  Create a ripple of joy and connection.

If you’re willing to share how you happened to the world, I’d love to hear about it in the comments.  If you need some help getting started–click on that appointment button to the right.

Advertisements

Truth or Complaining?

When I published my post earlier about the ways we keep our pain silent, one of the patient advocates I deeply admire responded to my post.  And what she said reflects a truth I often hear in the office.  It still hurt to hear.

There are those that think we are complaining because you can’t “see” pain and other side effects but still disabling 4 us. 

When did our attitude shift so that telling the truth about painful experiences or pain itself is identified as complaining?  How did the “positive attitude” become a mandate rather than a goal?  Listen, I’m a psychologist.  I am a brain science geek.  I truly believe that finding and fully experiencing the moments of joy and comfort in our lives is important.  I use gratitude journals and happy moments practice as therapy homework assignments. I am passionate about the possibility of people moving toward more brain and body health.  I understand that sometimes we have to challenge ourselves to move and reach and risk–even in the face of pain.

But here’s the thing.  While I believe that pain does not have to be the complete definition of our existence, I understand that pain is real.  I understand that fatigue, depression, pain, and anxiety are not going to be banished by our will alone.

The expectation that people who are coping with chronic illness, of any stripe, should  never talk about the hard parts of their life experience is just absurd.  Chronic illness is a constant companion.  If you are fortunate, your chronic illness may be well managed by lifestyle choices and medication.  But even “well-managed” illnesses take a toll.  So many of my clients are choosing between the progression of their illness or taking a medication that has significant negative side effects.  And when you live with chronic illness, you can never be certain that you won’t have a “crash” day.

It does not support health to dismiss people’s experiences as “complaining.”  It does not support health to diminish someone’s truth because it does not match your expectation of how things go.  It does not support health to buy into healthy privilege and the assertion that health is a manifestation of virtue.

It is expectations like this, that people should suffer in silence in order to deserve our support, that further the many layers of stigma surrounding physical and mental illness.

So let’s talk about how we can create moments–in health care and in society–where we truly listen to the experiences people are having.  When we trust that they are describing the truth of their experience.  And where we choose to offer compassion instead of judgment.

Invisible Does Not Equal Imaginary

This week’s posts have developed a bit of a theme. Health is not a virtue, pain shouldn’t be hidden in silence.  Here’s another corollary of this line of thought.

When it comes to your health–invisible experiences are NOT imaginary.

There is a wonderful online movement based on the work of Christine Miserandino of the ButYouDon’tLookSick Foundation.  In an effort to explain the challenge of living with fibromyalgia, she wrote an essay that she called “The Spoon Theory.”  Essentially, the theory suggests that we each have a finite number of emotional & energetic “spoons” to get through our day.  Some days, it takes every single spoon we’ve got to get out of bed.  Other days we have to ration our spoons to participate in something important.

The reality behind the spoon theory, and the #spoonie movement that has grown out of it, is that a majority of the most painful and debilitating illnesses that we face (Crohn’s, lupus, depression, diabetes, cancer, MS, anxiety, & RA–just to name a few) don’t have any visible signs.  With the right makeup, clothes, and effort, a person with intense physical & emotional pain can sometimes look “just fine.”  Looking just fine doesn’t mean that we feel just fine.  In fact, that “just fine” face may hide a world of pain and suffering.

Since we live in a society where we are supposed to ignore our pain, many of us have bought into the story that we should feel fine.  That our pain is a sign of our weakness.  That if we were strong enough, courageous enough, hard-working enough, virtuous enough, we would be able to do all the things that a healthy person can do, in the same time that a healthy person could do it.  In short, we have bought into the story that maybe our invisible pain isn’t real pain.  We begin to feel that maybe our invisible pain is “just in our heads” or a sign of our failure.

This makes me so angry.  Unless you have  a broken bone with a cast, a wheelchair or another dramatic physical marker like hair loss, most illnesses don’t have a visible indicator.  There isn’t a pain rating scale flashing above your head.  Fatigue and depression don’t show on your face.  Almost all pain and suffering is invisible.  AND it is real.

People who are struggling to get through a “normal” day because of pain or other invisible health issues do not need to have their struggle questioned or discounted.  That kind of behavior is healthy privilege in action. So, let me state this clearly.

Invisible suffering is real suffering.

Instead of questioning the validity of people’s pain, let’s work on creating support systems that help them move through pain in healthy ways.

Health is NOT a Virtue

I think it is safe to say that my most popular posts since I began writing were the series I put together about what health stigma and healthy privilege are–and how seriously they affect us.  I still stand by the ideas I shared in that series.  Recently, as I have talked to clients, and I have participated in conversations online, I have realized that there is an issue that is directly linked to healthy privilege and health stigma that I didn’t explicitly address in my earlier posts.  And it is this:

Having the privilege of health is not reflective of your virtue as a person or the value of your choices.

Let me be clear about this.  I certainly believe that we have the ability to make healthy choices.  We can strive for good food, rest, and movement.  We can choose relationships that support us instead of relationships that tear us down.  We can seek appropriate physical and mental health care to be sure that we stay as healthy as possible.  We can make healthy choices.  But those healthy choices do not guarantee our health.

We live in a culture that is very focused on individual control.  We want to believe that good choices lead to good outcomes.  And that means that if you struggle with health challenges–emotional or physical–you must not have made good health choices.  Right?

WRONG.

This unspoken idea that good health is a reward for healthy choices is one of the pillars that supports the ongoing stigma of health challenges.  The belief that good health is the result of good choices is a reason that so many people feel blamed or shamed for the illnesses they live through.

The truth is, that no one is guaranteed good health.  Athletes in peak condition die of undetected heart conditions. People who have eaten perfectly their whole lives get cancer.  People with great mental attitudes struggle with depression or anxiety. People with strong work ethics get multiple sclerosis or rheumatoid arthritis.  Making healthy choices certainly improves our odds of experiencing health in life.  But we don’t get a guarantee.

We would like a guarantee.  We want to feel that good is rewarded.  We want to believe that our choices ultimately control our experiences.  But we live in a world where our genes, our environment, and sometimes, just our spin of the luck wheel determine our experience.  And I think that our society sometimes takes that wish for a guarantee and uses it to shame and blame people who are facing health challenges.  Because if other people can make healthy choices and still face illness, then we might be at risk for illness too.  Because we want to deny the fact that sometimes good health is good luck.

Since this lightbulb went on, I have seen this attitude in so many places.  And I think that we need to call it out.  Health is a goal.  It is a gift.  But health is not a virtue.  

Let’s have that conversation.

Oh–and just to have some outside perspective, check out this long list of “Virtues of Moral Personhood (note that health isn’t on there anywhere):”

Is it Time for a Break?

One of my best mental health breaks is getting outside.

Next Monday, August 24th, I’ll be joining the #BCSM (Breast Cancer and Social Media) community again for their Monday night tweet chat.  Our topic is going to be “mental health breaks.”  I’ve been kicking this idea around in my head for a while, and one of the things that has come up for me is that many of the clients I work with in the office, as well as people that I interact with in health communities really struggle with the idea of taking a break.

Living with cancer can be a consuming experience.  It can feel like a full-time job to manage early treatment, and a very different job to cope with ongoing fatigue, chemobrain, and other long-term treatment effects.  In addition to that, cancer and other illness can be like an earthquake in your relationships and work life.  It makes a lot of sense that trying to create mental health breaks can feel unattainable or like a chore.

And all of that is why making space for breaks matters.  When your body has taken huge hits, and so much of your experience has been wrenched out of your control, it becomes really important to focus on what you can control.  And investments (big and small) in your overall mental health are definitely under your control.

So let’s look at some of the reasons we aren’t getting these mental health breaks.

Reason 1: I don’t have time to do that stuff.

Baloney.  Mental health breaks don’t need to be a week-long vacation. or an hour of meditation.  Not that either of those are bad.  You can give yourself a mental break in under one minute.  Try focusing for 10-12 seconds on a sensation of comfort, connection, or pleasure–the taste of your coffee, the sound of kids laughing, the warmth of a favorite blanket.  For that 10-12 seconds, really immerse yourself in how good that moment feels. Try to identify how you are seeing, hearing, smelling, tasting, or feeling that goodness. This is an exercise that neuroscientist Rick Hanson calls “taking in the good.”

Reason 2:  Treatment has taken up so much of my time, energy, money, etc that I don’t have any resources left over to take care of my mental health.

It can be easy to think of mental health & self-care as luxury items, but they aren’t.  Not only are they absolutely essential to our overall health, but you can take a break for your mental health in ways that don’t take up more of your resources.  You can change your scenery (get outside, get to a lovely indoor space, add a plant to your desk or bedroom).  You can move around–even some gentle stretches can begin to release endorphins & lift your mood.  You can breathe–3-5 deep breaths are enough to reset a stressed out-brain.

Reason 3:  It’s not fair to my spouse/kids/family/friends/employer if I focus on me. Isn’t that selfish?

Nope. No way. Not at all. Not even a little. Self-care is not selfish.  Focusing on mental health actually helps you be a better partner, parent, friend or co-worker.  Just think about how you act and feel when you are exhausted or upset.  Is it your best self? Can you make good judgments and extend compassion? I can’t.  I need to have a basic foundation of rest, self-care, and mental health time outs, so that I can be the best person possible in my relationships.  Taking mental health breaks helps me (and you) to be the person that others count on.  Without those breaks, we are all more brittle and likely to, well, break.

This is just a tiny sampling of how you can challenge the blocks to your own mental health breaks.  Want more? Join us on Monday night for the #BCSM Community tweet chat.

 

Don’t Drown in a Cup of Water

Okay, true confessions time. Sometimes, I like watching creation-based reality shows. Things like Top Chef or Project Runway. I know, contrary to their title, that there’s not much reality in these shows. I know that they are heavily edited to amp up the drama. I know all of this. But I love watching people make things. I think that making things is good for you, and the research would back me up on that.

But this post isn’t about my no-longer-secret vice. Anyone who has worked with me will tell you that I don’t hesitate to use popular culture to help my clients really grab my point (remember the “Princess Bride” post?). My family and friends will tell you that I am constantly making blog-related notes to help me remember those pop culture moments, and that happened recently while I was watching an episode of Project Runway. One cast member turned to another, and said:

Read more here.

Shift Perspective

IMG_3217Back in October, I wrote about the fun we had re-discovering the wonder in everyday items. For today’s post, I’m using another image from the City Museum of St. Louis. This particular photo does a great job of illustrating an idea that I often talk about with my clients. It is important to look at our situations from different angles. When we are facing stress, hurt, loss, or other challenges, it is really easy to get stuck in our assessment of a situation. We begin with an assumption about what is happening, and that assumption tends to get stronger over time.

Our assumptions matter. They matter because they shape the possibilities we see. Our perspective affects our sense of who we are in the world. Our view of the world determines how we define problems, and what solutions we see.

For example, the picture above looks like a collection of rusty junk. Admittedly, it’s rusty junk that has been laid out in a tidy way, but it’s rusty junk, nonetheless. And as we consider rusty junk, the appropriate response is usually to pitch it in the trash.

But, at the City Museum, the rusty junk is actually part of this:

IMG_3216 It’s a fantastical tree structure, including a musical dragon. The artists at the City Museum have been able to look at rusty junk, the things that the rest of us would ignore or pitch, and envision something amazing. It’s a clear reminder that things can be more than they seem.

I love this.

I am so excited when I find reminders that we aren’t stuck with the way things initially appear. We aren’t trapped with the original presentation. Even in the face of illness, or pain, or loss–we retain the ability to change our perspective.

When we change our perspective, we change our possibilities. We create the chance to change our experience. To see the world in new ways, to have new experiences. And that’s where we gain some power in life. Because pain, illness and loss happen to all of us. They are unavoidable. But being paralyzed by the pain, illness and loss is not unavoidable.

So, what rusty junk in your life can you transform into musical dragon trees? What shifts in perspective might open up new possibilities for you? Please feel free to share in the comments.

And if you need help shifting perspective, you know where to find me.

davidwcovington.com

Beyond Behavioral Health

hcldr

Healthcare Leadership Blog

Figuring. Shit. Out.

life seems to dish it out. i seem to write about it.

wellfesto

hacking health, designing life

Just Talking Podcast

A free-flowing conversation with purpose. There's no pressure, we're Just Talking

A Consequence of Hypoglycemia.

What good is an incurable disease if you can’t share it with the rest of the world.

inDpendence

Sometimes Diabetes Takes Center Stage

regrounding

of chemo, cancer and facing life head-on

Dr Catherine Rose

Inspiring Hope

Telling Knots

About 30% of people diagnosed with breast cancer at any stage will develop distal metastasis. I am one.

Ann Becker-Schutte, Ph.D.

Help at the Intersection of Physical and Emotional Health

eatbreatherun

Eating, Running & Fighting Against Lung Cancer

Is it Possible?

Making it Possible in 10 steps or less!

Warm Southern Breeze

"... there is no such thing as nothing."

health communication source

curating the people & organizations that make health com happen

The Musings of a Cancer Research Advocate

It's All About the Evidence...

shadow7788

The greatest WordPress.com site in all the land!

Tonya Miles, PsyD

Mental Health Matters

The Pollock Group

Professional Psychology Services

Voice in Recovery (ViR)™

Prevention, Advocacy, Intervention, Recovery (PAIR)™