Your Mindful Guide to Surviving The Holiday Season With a Chronic Illness

Celebrating the holiday season presents many challenges for people with chronic illness, which can be very stressful. I’d like to share three easy mindfulness practices that have helped me to not only survive the holiday season, but get the most out of it. Mindfulness  is a practice of “paying attention, on purpose, in the present moment, non-judgmentally.”

Your Mindful Guide to Surviving the Holidays

It’s early December and that means we’re about to crash straight into the holiday season. As the shortest days of the year approach, many of us are anticipating gluttonous feasting, exchanging gifts, enjoying the company of family and friends and celebrating everything we have to be grateful for this year. Others are also anxious about the hectic schedule, financial strain or encountering certain crazy relatives (most families have at least one).

Chronic illness can complicate the holiday season further. Some people with chronic conditions feel like their family members don’t fully understand their limitations. Even the pressure to “just stay a little bit longer” or “pop by for a short visit” can cause us to push through when we really need to pull back – often resulting in a flare later on. If there are underlying conflicts with family members or friends, then spending a lot of time together attempting forced cheerfulness can also add stress. Constant fatigue, brain fog, food intolerances and pain can make frequent, large get-togethers focused around eating quite challenging, to say the least! Somehow we’re supposed to do it all without crashing from fatigue, badly flaring or getting a virus.

How To Get the Most Out of the Holidays By Using Mindfulness to  Manage the Stress

The consequence of having too much to do and too little time to do it in is stress. The symptoms of emotional and cognitive overload that accompany stress worsens chronic illness and  is a real challenge to manage this time of year. Emotional stress symptoms include irritability, anxiety, and low mood. Cognitive overload results in having trouble remembering things, difficulty concentrating, indecisiveness and constantly ruminating on what’s bothering you. If you find yourself feeling this way during the month of December, you’re not alone! My question this time of year is: how do I get through all of the challenges in order to be able to enjoy the holiday season?

I’ve come across many helpful posts challenges written by bloggers with chronic illnesses explaining how we can pace ourselves through the holidays, delegate responsibilities, adjust expectations and mitigate potential challenges. I’d like to contribute one more strategy for surviving the holiday season with a chronic illness – mindfulness.

I’m not talking about anything new-agey, religious or fringe. Mindfulness is a practical, evidenced-based approach to managing stress and reducing the symptoms of chronic illness. According to Jon Kabat-Zinn, a pioneer in the field of mind-body medicine, mindfulness means “paying attention, on purpose, in the present moment, non-judgmentally.”

Meditation is a way to practice being mindfully present. During meditation, the aim is to focus our attention by concentrating on a particular object, like breathing,  scanning the body, or repeating a mantra. Inevitably, we lose focus and become distracted by thoughts, worries, plans or emotions. When we realize this has happened, we gently bring our awareness back to the present moment – this breath, this moment.

“That sounds great,” you might say, “but the last thing I have time for is learning mindfulness meditation right now.” Do you have five minutes a day to watch television? Then you have five minutes to sit and listen to a guided mindfulness practice. Just sit. Just breathe. Just listen. That’s it. Here are three easy mindfulness practices that have helped me to not only survive the holiday season, but get the most out of it.

1) Take A Mindful Pause

One of the first casualties of a hectic schedule is time to process your experiences. The brain needs rest so that it can effectively take in information, process emotions and make good decisions. Otherwise we can become mentally and emotionally overloaded by trying to push through the stress and get on to the next thing. Mindfulness is a switch from the ‘doing mode’ (thinking, planning, worrying, shopping, baking, visiting… you get the idea) to the ‘being mode’ (think watching a sunset or savouring the taste of a great meal). Taking a few mindful breaks throughout the day gives us the mental rest we need to prevent becoming overwhelmed.

A mindful break can be as little as 1 minute but is usually 3 to 5 minutes. It involves intentionally shifting your attention to just sitting and breathing in the present moment. This year I’m planning on incorporating these pauses into my day. If I’m visiting, I might take a few extra minutes in the washroom just to breathe. Even if there’s nothing I need to do on a particular day, mindful breaks can still help reduce anxiety about future tasks and plans I’m worried about, by bringing me back to the present. The Free Mindfulness Project offers a number of excellent guided mindful pause meditations to download (as well as longer mindfulness meditations).

One of my favourite meditation teachers finishes his guided mindful break meditation by asking “what’s the next best thing you can do for myself right now?” Sometimes you can’t solve all your future worries but you can do something to improve things right now, such as making a cup of tea or delegating a task.

2) Put Love & Kindness at the Centre of Your Holiday Celebration This Year

Every year I face a battle with my own expectations about what the holidays should be like. It’s very easy to internalize expectations about what you ought to be able to do and feel guilty if you can’t live up to those self-imposed standards. Maybe you wish you could give your kids the perfect Christmas morning, go to every holiday party you’re invited to or cook the perfect traditional meal for your entire extended family. When you have to cut back on your activities, it can be hard to feel like you’re letting down some of the people you care about most in order to look after your health.

Unrealistic expectations, whether internalized or externalized, only cause unnecessary stress. Instead of trying to have a holiday worthy of a Lifetime movie, what if we refocus our energy on putting love, kindness, gratitude and giving at the centre of our celebrations? These practices can be incorporated into traditional family celebrations – like this idea of having each family member dedicating an ornament to something they are grateful for before hanging it on the tree.

But how do you stay in the spirit of the season despite the pressure of expectations? The ‘loving-kindness meditation’ can help you deepen compassion, and increase your feeling of connectedness to the people around you. In the guided meditation, we are invited to focus on our feelings of love and compassion for people we are close to by repeating wishes for their health, happiness and well-being (“May they be happy, may they be healthy, may they be free from suffering, may they be peaceful”). Then, we extend those feelings to strangers and people we may have difficult relationships with. Finally, we practice extending love and kindness to ourselves – a powerful and important component of the practice, especially if we are feeling guilt over our limitations. Here is an additional guided practice, along with the script, from Mindful Magazine.

3) Take in the Good

Are you more likely to remember compliments or criticism?  If you’re like most people, you pick the latter.  That is because the human brain has a built in “negativity bias”, which allows us to learn from and protect ourselves from bad experiences. Unfortunately, it can also make us stressed and anxious. During December, I often spend most of my time worrying about how I will make it through all my plans . Once it’s over, I sometimes feel like I’ve missed out on enjoying the best moments because I was worried about the next thing. One way to rewire your brain so that it takes positive experiences into account, along with the negative, is to be intentional about what Rick Hanson calls “taking in the good”. This is akin to the old saying to “stop and smell the roses”. But exactly how do you go about making this a habit?

The first step is to be mindful of positive moments (to notice the roses) – the warmth of a good fire, sharing a laugh with loved ones, the taste of turkey and mashed potatoes. Practicing mindfulness meditation can help with this part, but you can also just start with the intention to take in the good today. Second, pause for 20-30 seconds and focus your attention on savouring the experience, instead of moving on to the next thing. Then, let the positive experience sink into you.  You can do this by visualizing a warm feeling spreading through your torso or by mentally recognizing that by doing this exercise you’re rewiring your brain to tilt towards positive experiences.

If you do this several times a day, you can change the neural pathways in your brain so that positive experiences are ‘registered’ more in your overall outlook on the day.  This practice has been really helpful for my mental and emotional health while I deal of the challenges of chronic illness. Sometimes symptoms get in the way no matter how much pacing or stress management we practice. This can be disappointing. But I have found that taking in the good and enjoying the small moments really helps me to balance out the disappointments. One year I was too sick to leave home and had to miss Christmas Day with my family, but eating homemade cookies at home, with the tree lit up, while watching a Christmas movie was still a nice, cozy evening.

 

 

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Book Review: ‘Memory of Health’ by Edie Summers

book review_memory of health

I have been given this product as part of a product review through the Chronic Illness Bloggers network. Although the product was a gift, all opinions in this review remain my own and I was in no way influenced by the company.

I was recently given the opportunity to review a new book by Edie Summers called Memory of Health. Edie Summers is both a wellness coach and chronic illness patient expert, with 20 years of experience in the alternative health field.

 

If I had to sum up Memory of Health in a sentence, I would say that it is essentially a manual of self-care for people living with chronic illness. The approach that Edie Summers takes to health and healing is truly holistic, which I think is perfectly summed up by a quote she includes: “Health, wholeness and holiness … all three share the same root word and all three share the same state of harmony or disharmony (Deepak Chopra).”

So what can you expect to find in this book? First, Summers shares her personal journey living with chronic illness, including how she recovered. She emphasizes the power of storytelling for well-being. Many of us with chronic illness can feel very alone in our experiences living with these conditions. Connecting with each other over our shared experiences is empowering. From making us feel less isolated in our experiences, to learning from each other, storytelling is very impactful. And there is much to learn from Summers’ story. One thing that really resonated with me was her relentless detective work to find what helped her to heal. The other was how Summers identified mental, physical and spiritual causes that contributed to her illness, and then made changes to effect her recovery.

Secondly, this book covers a wide range of factors that may contribute to chronic illness, and how to address each in turn, including:

  • identifying and removing environmental toxins that may exacerbate your condition
  • causes of chronic fatigue, including changes to the thyroid, anemia, microbiome, immune health, inflammation, depression, etc.
  • improving nutrition, restorative movement, relaxation, mindfulness, improving sleep etc.

In covering all these topics, Edie Summers keeps her focus on the systems that keep the body in balance. In her own words: “This is why I’m fascinated with systems biology which notices patterns, watches for the surfacing of self-organizing models, and observes healing from a holistic point of view. The thing is, nature is a dynamic system, which learns, evolves, and grows (p.120).”

In the final sections of Memory of Health, Summers provides a roadmap to self-care in order to help readers improve their well-being. The book includes detailed summaries of tips to improve physical health including diet modifications, supplements, super foods, relaxation, de-stressing, sleep support, yoga and many other important topics.

I think the most powerful section of the book is dedicated to mental, emotional and spiritual healing. Summers writes “The problem is, you cannot heal if you are not present in your body. This is your first step: get back into your body and stay there. It bears repeating: health resides in your body (p. 336).” Summers believes the road to greater presence is founded in self-love. Finally, she emphasizes connection– to loved ones, to activities that give us joy and to a sense of purpose.

Ultimately Summers sees all these different threads of wellbeing being woven together to effect synergy. She explains: “Synergy, then, is how health occurs, when the total is greater than the sum of “its” parts. A great example of synergy is the experience of listening to a symphony orchestra vs. hearing each individual instrument played on its own (p.280).”

At times I found reading this book challenging because the way it is written is very dense. Some sections interweave scientific explanations, personal observations and spiritual reflections in a way I sometimes found hard to digest all at once. I think the best way to read this book is to focus in on the sections you think are most applicable to your situation, rather than trying to read the entire thing in one go. There is a very detailed Table of Contents to help you identify the sections that you feel are most relevant to you, which is very helpful.

The other caveat is that all of these suggestions are based on Edie Summers’ personal experiences and should not be taken as medical advice. Make sure you consult with a healthcare practitioner before trying to implement any of these tips.

So, ultimately, who is this book for? I think it is ideally suited to anyone living with a chronic illness who feels like they have tried everything and nothing has worked. Memory of Health opens up many new avenues to pursue and can provide hope to people who feel stuck. It is also an inspirational read. If you are feeling in need of guidance on how to live with more purpose, joy or connection, even if you have a chronic illness, then I think this is the book for you.

Click here to see more reviews on Amazon

Click here for a 40% discount on Memory of Health from Lulu.com

Click here to visit Edie Summers’ website

Mind Games: How I Cope During a Chronic Illness Relapse (Part 2)

 

Coping with chronic illness and fibromyalgia relapse using mindfulness and other mental strategiesIn my last post, I wrote about my fatigue relapse last winter and my present pain progression this winter. My aim in writing these two posts is to share how I cope with illness setbacks, using ‘mind games’, in the hope they help someone else experiencing a relapse.

In essence, what I have learned is that I have the power of choice over what I focus my attention on each day. Through challenging negative patterns of thinking, being present, taking in the good, and pursuing an enjoyable hobby, I try to emphasize what enriches my life and let go of what doesn’t. Of course there are always bad days and I don’t believe any amount of positive thinking frees us from ever experiencing difficult times. I personally have found, however, that changing my worldview has dramatically lessened the amount of suffering I go through during relapses and has improved my quality of life. In Part I, I discussed 1) challenging negative patterns of thinking and 2) cultivating presence.

3) Take in the Good: Are you more likely to remember compliments or criticism?  If you’re like most people, you pick the latter.  That is because the human brain has a built in “negativity bias”, which allows us to learn from and protect ourselves from bad experiences.[i] Unfortunately, it can also make us anxious, irritable and depressed.  One way to rewire your brain so that it takes positive experiences into account, as well as negative, is to be intentional about what Rick Hanson calls “taking in the good”.[ii] This is akin to the old adage to “stop and smell the roses”. The first step is to be mindful of positive moments (to notice the roses) – the taste of a good meal, sharing a laugh with a coworker or hugging your partner. Practicing mindfulness meditation can help with this part, but you can also just start with the intention to take in the good today.  Secondly, pause for 20-30 seconds and focus your attention on enjoying the experience, instead of moving on to the next thing (focus on how pleasant the fragrance of the roses is). Finally, let the positive experience sink into you.  You can do this by visualizing a warm feeling spreading through your torso or by intellectually recognizing that by doing this exercise you’re literally rewiring your brain to tilt towards positive experiences.  If you do this several times a day, you can change the neural pathways in your brain so that positive experiences are ‘registered’ more in your overall outlook on the day.  This practice has been really helpful for my mental and emotional health while I deal of the challenges of chronic illness, especially during a relapse.

4) Pursue an Enjoyable Hobby: After my fatigue relapse, I withdrew from school because it was too demanding. With time on my hands, I decided I wanted to learn something creative. I looked for a hobby that wouldn’t hurt my painful upper back, and eventually settled on modern calligraphy. Last winter, calligraphy practice was often the one activity I did on a daily basis. Seeing my improvement as I wrote out the letters was a bright spot during that difficult period. This time around, I am learning how to digitize my calligraphy, with the hope of opening an Etsy shop sometime next year. Having a sense of personal accomplishment means so much to my mental wellbeing. Dr. Caudill notes that “Some patients feel so bad about their pain and their lack of a ‘productive life’ that they … feel they don’t deserve any pleasure” (2002, p. 83).[iii] Not only is it ok to pursue enjoyable activities, it’s actually critical for your mental health and stress management, which are important components of any treatment regimen. I can’t encourage fellow spoonies enough to find a hobby or creative outlet to focus on during a relapse or flare. Other activities I enjoy include online learning courses (free!) and writing/blogging. In order to get the most out of an enjoyable hobby, be present during these activites. Take in the good moments when you finish a project or learn a new skill. And focus on recognizing what you were able to do today, rather than what you weren’t. Negative thinking habits aren’t changed more easily than any other habit, but routinely practicing positive mental habits is a powerful way to improve your quality of life during a relapse.

[i] http://www.rickhanson.net/take-in-the-good/

[ii] http://www.rickhanson.net/take-in-the-good/

[iii] Margaret Caudill. (2002). Managing Pain Before it Manages You, NY:     Guilford Press.

Mind Games: How I Cope During a Chronic Illness Relapse (Part 1)

Coping with a chronic illness by making smart choices. Focus on what you can enjoy, do and learn, in the now.

Around the holidays last year, I got a bad cold which left me exhausted. Of course, I assumed that once I got better, my (limited) energy would return. It didn’t. I spent months in a state of brain fog and fatigue. By the mid spring, the relapse gradually began to ebb, although I still haven’t returned to pre-virus levels. This holiday season, my endometriosis pain has increased substantially. Most likely, it is a progression of the condition. As I wait for a laparoscopy, I worry about how I will cope with this ‘new normal’, which is interfering with my sleep and restricting my movement to the length of my heating pad cord!

I felt completely overwhelmed at the outset of my fatigue relapse last year.  First, there was the emotional reaction to a new situation: anxiety about whether it was here to stay, frustration that life was about to get more difficult, and grief at the prospect of losing what abilities I still had.  Secondly, there was the practical challenge of figuring out how I would cope, like what new treatment options to try or how to manage my daily routines and responsibilities.  Lastly, I faced the impact of a relapse on my relationships, such as the increased caregiver burden on my partner, and feeling less able to be present with family and friends.

My relapse brought me back to the beginning of my illness journey and how I coped after my diagnosis. I was able to use many of the lessons that had been learned the hard way the first time around. Now that I’m facing a similar situation, yet again, I wanted to write them out for myself –  I hope they may help someone else out there too. In essence, what I have learned is that I have the power of choice over what I focus my attention on each day. Through challenging negative patterns of thinking, being present, taking in the good, and pursuing an enjoyable hobby, I try to emphasize what enriches my life and let go of what doesn’t. Of course there are always bad days and I don’t believe any amount of positive thinking frees us from ever experiencing difficult times. I personally have found, however, that changing my worldview has dramatically lessened the amount of suffering I go through during relapses and has improved my quality of life.

1) Challenge Patterns of Negative Thinking: About a year after my diagnosis, I participated in a Cognitive Behavioural Therapy program for pain management. One of the core parts of the program was learning to identify negative thinking traps, or ‘cognitive distortions’.  These are thoughts that “sound rational and accurate, but really only serve to keep us feeling bad about ourselves”.[i] For example, if you think in “all or nothing” terms – a cognitive distortion – you might believe “if I can no longer pursue my career, I am a failure” (click here for a list of other cognitive distortions). A common belief among the participants in the group (me included) was: “Since I don’t work during the day, all I do is sit around the house wasting time”. The facilitator asked us to challenge this belief by making a list of all our daily activities. I was surprised to have a long list that included, for example, preparing my meals, going for a walk, reading a book, writing a blog post, doing my strengthening exercises, etc. I actually do quite a few things each day, and I rarely waste my time. Now I try to identify when a negative thought is actually just a distortion and then challenge it with the reality of the given situation.

2) Be Present: One of the most powerful tools that has helped me to cope with my illness setbacks is practicing mindfulness, usually defined as “non-judgemental, present moment awareness”.  I attended a Mindfulness-Based Stress Reduction course at my pain clinic that introduced me to how cultivating presence could help me manage my pain.  Much of our anxiety comes from worrying about the future or reliving difficult moments from the past, rather than from anything going on directly in front of us at this moment in time.  Through mindfulness meditation, I have become better at recognizing when my mind as dwelling on the past or projecting into the future, and bringing my attention back to the present.  For example, I’m currently waiting on a laparoscopy to diagnose whether I have endometriosis and to reduce my pain levels.  I’m worried about what it will mean if they find out I do not have endometriosis, as well as whether the procedure will relieve my pain. Just thinking about it makes me anxious and upset.  However, I won’t know anything until after the procedure, which is several months away.  Worrying about it now only makes me suffer more.  It’s better for my quality of life if I return my focus to the next best thing I can do for myself in this moment.

[i] http://psychcentral.com/lib/15-common-cognitive-distortions/

Beginning Again: Living with the Ups and Downs of Life with Chronic Illness

 

My new article on Prohealth is about learning to relate differently to the inevitable ups and downs of life with chronic illness, through letting go, drawing on the inner strength all spoonies cultivate, and beginning again. 

Watching my goals, plans, and self-care routines careen out of control is sometimes harder for me to accept than the symptoms that come with a flare-up. Maybe it’s because I have always been a control freak, but the sense of helplessness, frustration and self-doubt that accompanies this situation is one of the most difficult aspects of living with fibromyalgia for me. This time, as I was venting about how it felt like my daily life had come tumbling down like a house of cards, a question occurred to me: What if the problem isn’t a failure to control or manage my schedule during a flare-up, but a failure to understand that living with chronic illness inevitably involves ups and downs?

My practice of mindfulness meditation has helped me find answers to this question. Renowned mindfulness teacher Sharon Salzberg writes that, in contrast to our conditioned belief that self-blame and fear of failure help us succeed, “ease in letting go and kindness in starting over is a lot more effective.”(1)

Finish reading here…  http://www.prohealth.com/library/showarticle.cfm?libid=29692

Self-Care as a Mindset: What I Learned at the #SelfCareMvmt Summit

SelfCare Mindset

 

On Monday evening I attended the first ever Self-Care Movement Summit in Toronto, Canada. We arrived at the Mars building, a downtown hub of innovative tech and entrepreneurial companies, to register and enjoy catered refreshments, before taking our seats in the auditorium. The audience, of around 250 people, represented the diversity of the people who live with chronic illness – young and old, with visible and invisible chronic conditions. We were there to listen to a series of panelists and speakers talk about their personal or professional experiences using self-care strategies to meet the everyday challenges of life with chronic illness. As these informative and engaging speakers discussed the multifaceted aspects of this topic, I came to new realization about the meaning of self-care. Self-care is both a set of practical strategies, and a mindset, a particular way of understanding and relating to the activities of everyday life.

The core of the self-care mindset that emerged throughout the evening was acceptance of life with chronic illness. As Margaret Trudeau, the keynote speaker, summed up – coming to the realization that “this is the hand you’ve been dealt and the hand you have to play”. But finding acceptance is a long process. Margaret Trudeau shared her health journey living with bipolar disorder and how she experienced the five stages of grief after her diagnosis – more than once. She said that, in her experience, the first step towards accepting life with chronic illness is forgiving yourself. Your illness is not your fault. During the patient panel, Kirstie Shultz discussed self-care as being kind to yourself, every day. In her presentation on mindfulness practice, Dr. Lucinda Sykes talked about the importance of observing and learning from our daily experiences, without judging ourselves. Overall, humor was woven through many of the talks as a way to live positively with chronic illness. For example, John Bradley named his book on Crohn’s disease the Foul Bowel. Kristen Coppens described her eight illness as a “chronic party”. These insights into the self-care mindset are about relating to ourselves in a new way as we address the daily challenges of life with chronic illness, in a compassionate, forgiving, non-judgmental, humorous way.

The second theme that emerged about self-care as a mindset was finding balance in the activities of everyday life. In the patient panel, Marinette Laureano talked about a holistic approach to her self-care practice, by balancing her faith, family, friends and fun in her daily life. Kirstie Shultz described the zero-sum game of fatigue and chronic illness – working to find the balance between activity and rest. Kristen Coppens discussed the challenges of balancing work and illness. In his talk on this subject, John Bradley discussed achieving success against your own measures, rather than letting your goals be defined by the external world. He described his own experience working with chronic illness, and how he found balance by trying to “be the tortoise and not the hare” in achieving work goals. Balance as part of the self-care mindset is more of an intention rather than a constant state, a learning process of respecting the limitations of chronic illness while participating in the daily activities of life.

The third aspect of the self-care mindset is becoming an advocate in your community. Robert Hawke reminded us that, as patients, we are experts with our own wisdom about our health. Dr. Lucinda Sykes discussed mindfulness as a practice of developing insight about ourselves and cultivating the collective wisdom of people living with chronic illness. She said the summit was a celebration of human potential and our heritage of resiliency down the generations. Grace Soyao, of Self-Care Catalysts, explained that the voices of people living with chronic illness need to be heard and that we have the knowledge to drive change. Change like patient-centred care in the healthcare system, increasing research about chronic illness and reducing stigma about living with chronic mental or physical illness.  It can be hard to share our illness stories. Robert Hawke noted that we prefer to share our shiny selves with the world, rather than our difficulties and challenges. But when we do share our stories and everyday self-care strategies with each other, as Filomena Servidio-Italiano said, “The ordinary becomes extraordinary.” As part of the self-care mindset, advocacy is about self-empowerment, connection with the chronic illness community and society at large, and celebrating the greatness in ordinary accomplishments that we face every day.

Acceptance. Balance. Advocacy. Connection. These are all critical elements of self-care as a mindset and a way of relating to the ordinary activities of daily life with chronic illness. We can learn to pace our efforts, to eat nutritiously, to exercise more, to use practical self-care strategies. These are important wellness tools. But underneath, cultivating a self-care mindset is the key to improving our health and wellbeing as we live with chronic illness.

I want to thank Self-Care Catalysts and Health Storylines for an inspiring and informative evening. I’m looking forward to participating in advocating for self-care as a movement!

 

Back to class: Mindfulness Based Stress Reduction

Meditation

Meditation (Photo credit: holisticgeek)

I am about to go to the second class of my Mindfulness Based Stress Reduction (MBSR) course. In the summer I wrote several posts on reading the Mindfulness Solution to Pain and practicing meditations described in the book.  Mindfulness involves “paying attention on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment to moment”, as defined by Jon Kabat-Zinn, founder of the MBSR program. I also posted on research showing how effective mindfulness practice is for chronic pain.

I have really enjoyed doing the assigned “homework” from the first class. The first part was to do a 30 minute body scan from the course CD. (A body scan meditation involves paying attention to different parts of your body for a few moments and observing the sensations you feel). This is the longest meditation I’ve ever done. The practices I have done before were breath meditations, usually only for a max time of 20 minutes. I really like the body scan because I am able to really focus and feel more in touch with what’s going on in my body. I feel like my mind wanders less then when I am doing breath meditation (focusing on your breath). It is very relaxing to have a break from your mind!

Of course, I’m not always in such a good mood when I go to meditate. Before I was meditating when I felt like it, which was usually when I already felt relaxed or calm. The idea of the MBSR program is that you commit to practice seven days a week for eight weeks – as Jon Kabat-Zinn says “you don’t have to like it, you just have to do it”. It sounds a little bit rigid but it’s really important while you are trying to establish meditation has a habit. When you go to practice and you realize you are stressed, agitated, and your mind is wandering everywhere, focusing can seem like the last thing you want to. But that’s when you realize how helpful mindfulness can be! It doesn’t necessarily produce calm every time. It does give you a chance to observe what is going on inside your head. Usually that helps me to figure out a more helpful way of dealing with things then spazzing out, or to recognize stressful patterns of thinking.

One thing I do have to keep working on is not to judge myself when I realized my mind has wandered off or I’m not feeling calmer/better after meditating. As the facilitator of my class says “if you have a mind, it’s going to wander”. You really can’t get into mindfulness with expectations about what it “should” do for you.

The other part of our homework was to try to eat mindfully at least once everyday. It’s really nice to realize how many sensations and moments are available to you if you stop to enjoy them. I love food, cooking and eating. When you realize how many times you just wolf down delicious meals… I always feel like my life is so limited now that I have fibromyalgia, so I think it’s really good for me to realize how much I do have around me to enjoy!

Mentally Mindful

Image

In the past two weeks I finally moved into my new apartment and it is starting to feel like home. The silence and the space are so much more conducive to learning mindful living then the construction zone I lived in before. I did not feel very Zen during the move or unpacking, but that’s what I’m working on now. No time like the present!

The second part of chapter 2 in The Mindfulness Solution To Pain by Dr. Jackie Gardner – Nix talks about mental attitudes related to mindfulness. (I’m going to keep summarizing the key points that jumped out at me, and connections I made to my own life; I don”t want to put citations everywhere). Attitudes can be enabling or harmful to our well-being, and awareness about these attitudes can help us to strengthen positive ones and change negative ones.

The first attitude associated with mindfulness is being nonjudgmental. This is something that I have a long way to go to achieve! On Monday I was listening to Dr. Jackie Gardner – Nix’ guided meditation (more on this in a moment) and my practice was not going as well as last week. Every other breath I caught myself thinking things like “my breathing is too fast and shallow”, “why can’t I stay focused today?”, “I don’t think I’m ever going to get this right”. In the book, the authors point out that judgments about whether something is positive or negative are very black and white, and often miss the ‘gray’ nuanced part of experiences. Bad experiences can have silver linings, and good things aren’t always what they seem. Negative judgments can begin a domino effect of reactive emotions, tension and increased pain. Given the changeability and impermanence of things, judgments can really be a waste of time. I’m going to have to work on this in meditation practice and in the rest of my life too! Being off work on disability leave, as I’ve mentioned before, definitely leads me to be very judgmental about the lack of accomplishment, purpose, etc. I think they called this the inserting “superwoman overachiever cycle” in the last chapter!I really liked the observation made in the book that it can be freeing to experience situations or encounters with people and not judge them.

The second attitude associated with mindfulness is the beginner’s mind. To achieve this mental stance, you have to try to overcome your own biases, prejudices and preconceived notions, and not bring them to present situations or encounters. This reminds me of what my anthropology professors called ‘reflexive thinking’. Anthropologists believe that it’s impossible to cultivate a purely objective stand point, but by being aware of your own subjective point of view, you can still produce valuable insights and new knowledge about the culture you are studying. So this mindful attitude sounds to me like being an anthropologist studying yourself!

The third and fourth attitudes to cultivate are trust and patience. Trust that developing awareness will lead to change over time, and patience regarding how long that will take.

The next chapter (chapter 3) is about beginning a formal meditation practice. The authors define this as “intentionally setting aside a specific period of time… In your day to systematically cultivate mindfulness by focusing your attention moment by moment on some particular aspect of your experience, and actively noting when your mind wanders – as it always will – and then bringing it back to the focus” (Gardner-Nix and Costin-Hall, 2009). Usually breathing is the focus of mindfulness practice. I decided to buy Dr. Gardner-Nix’ CD of guided meditations, called ‘meditations for the mindfulness solution to pain’, which is available on iTunes. I thought it would be best to go with this one because it is designed to specifically accompany the book. The authors also recommend Andrew Weil’s “meditation for optimum health”, available from Sounds True (Google for website).  I also really like John Kabat-Zinn’s disc of guided meditations called “mindfulness meditation for pain relief”.  I’m not going to give a detailed summary of how to meditate because I think these resources to a much better job than I ever could. I did just want to mention the advice given at the end of this chapter to pace yourself while incorporating meditation into your daily routine – start with 5 min., slowly work up to 10, then 20, and so on. I’m at 10 minutes right now. I’d like to work up to 20, eventually without the guide, but for now I like listening 😉 p.s. I don’t sit cross-legged in serene white while meditating. I have to lie down with pillows under my legs on the couch or on the floor – fibrostyle. My body wouldn’t put up with that kind of sitting!

image courtesy of photostock at FreeDigitalPhotos.net

Zen master, not so fast

Hello again,
I was hoping to write a little bit sooner, but my plans were foiled by the construction zone that has sprung up outside of my apartment building. Thank God we are moving next week to an oasis of quiet – at least, I hope that’s what it will be! Maybe it’s just me, but since my fibromyalgia diagnosis I sometimes dream of living in a soundproof room. Barring that, hopefully some of this mindfulness work will make me Zen enough not to get woken up by every dripping tap, licking cat and snoring husband. On that note, on to chapter 2 of The Mindfulness Solution To Pain.

Dr. Jackie Gardner – Nix defines mindfulness as “the awareness that arises when we pay attention to what is happening in the present moment, nonjudgmentally”. I was struck by the poignant message made at the beginning of this chapter that many of the people who live mindfully, live with with a terminal illness. The authors say that it shouldn’t have to come to this extreme for you to pay attention to your life as it unfolds, rather than “realizing at some point that somehow you may have missed large swathes of life while it was passing you by”. Moreover, the chapter points out that mindfulness is not just about being aware of the pleasant moments. The authors claim that ignoring strong, negative feelings can deepen their affect on your health.

This really struck a chord with me. Although I haven’t really begun practicing mindfulness yet, the previous chapter (which was about the impact of childhood stressors on chronic pain in later adult hood) stayed in my mind during the week, and led to some interesting observations. I realized that every couple of hours I say something really negative to myself, and that a lot of these things relate to how my family operates. For example, I found myself saying things like “am I ever going to do anything with my life?” or “I haven’t done anything productive today!” In my family, personal worth is attached to accomplishment, and there is a lot of suspicion about long-term illness (that it is ‘all in your head’ and really about some kind of not yet dealt with emotional problem). I often struggle with feeling like my fibromyalgia is a failing rather than a misfortune and I guess I am repeating that daily by trying to accomplish things to make up for it. I think this is also why I was resistant at the beginning of the book when the authors gave some examples of people who were healed by realizing they had emotional issues. These examples repeat what I grew up with and cast doubt on the biological realness of my illness. In fact, the authors give a more complicated explanation for chronic pain. They claim that issues from your childhood (experiences, parental deficiency, or poor parental role modeling) might well be affecting you, but right down to your gene expression, immune function, nervous system reactivity and other biological operations. In that sense, it is both “all in your head,” in terms of negative patterns of feeling or thinking that elicit the body’s stress response, and real biological dysfunction (including slow healing, activating predisposed illness and pain signals), which can occur partly as a result. I think I’m starting to be aware of some of my own negative patterns.Dr. Jackie is reassuring though, when she says that “just seeing …[destructive habits] clearly is the first step by which they can change”. And also that “this too shall pass”.

I think that I will leave it there for this week. It has been pretty heavy stuff so far, so I may have to get some treats and watch some trashy reality TV tonight (I’ll confess that my guilty pleasure is watching keeping up with the Kardashians – don’t judge!). I’m looking forward to learning more about starting meditation in the next chapter. Have a great weekend!

Thoughts on Chapter 1, Mindfulness Solution to Pain

This is blog post number two about my journey reading The Mindfulness Solution to Pain by Dr. Jackie Gardner-Nix and Lucie Costin-Hall. In the first chapter the authors try to answer the question: why are some people more prone to disease, chronic pain or poor healing than others? The key take away from this chapter is that a combination of genetic predisposition and childhood stressors increase the probability that challenging life events in adulthood can activate illness or prolong healing. The underlying mechanism is the stress-response system, which is an important part of the mind-body connection.

Nature: Some of us are born with genes that predispose us to certain diseases, such as psoriasis or rheumatoid arthritis. However, we  may not “express” those genes unless adverse life experiences trigger them. Others may be born with a genetic makeup that makes them a “highly sensitive person”. This is based on the work of Elaine Aron, who has demonstrated a biological basis for a highly sensitive personality trait, which includes having a sensitive nervous system, being aware of subtleties in the environment and being overwhelmed in very stimulating surroundings.* Dr. Jackie Gardner-Nix argues that being highly sensitive can also mean being more sensitive to pain (supported by genetic research that shows that variations in the COMT gene can produce higher pain sensitivity in certain individuals). Furthermore, highly sensitive persons may be more negatively affected later in life by adverse events in their childhood. This discussion completely resonated with me – all my life people have told me that I’m too sensitive. Sensitive to too much light, too much noise, too many people, lack of sleep, lack of food, criticism, other people’s suffering, and now pain and touch… After I finish this book, I’d like to go on and read Elaine Aaron’s book, because I think it might explain a lot (I’m sure other chronic pain patients identify with this personality trait too).
Secondly, the authors talk about the negative physical effects of chronic stress. The stress response cycle includes increased heart rate, breathing, tensing muscles and increasing energy, while also slowing down the immune system and the gastrointestinal system. Stress can then slow healing, disrupt sleep and eventually disrupt your body’s ability to restore itself – leading to anxiety, depression, muscle tension, diarrhea and/or constipation, weight gain or loss, headaches, fatigue, and poor concentration, among other problems (Caudill, pg. 46). In turn, all these consequences of stress can worsen the perception of pain. In particular, I think that the stress – immune relationship is really important for fibromyalgia patients to keep in mind, in light of recent research that shows that people with fibromyalgia have immune depression at the cellular level.

Nurture: This book emphasizes that childhood stress is an important contributing factor to chronic pain in adulthood. This section was hard for me to read because it forced me to go back and re-examine difficult things that happened while I was young. The authors argue that childhood stressors can even affect gene expression, cause a weakened immune system or sensitize your nervous system to go on high alert “easily and frequently”. Challenging life events in childhood, parental deficiency, or poor parental role modeling can all affect a person’s ability to cope with stress as an adult. One of the core reasons is that negative emotional patterns or highly stressful thinking trigger the nervous system, and can cause a cascade of negative bodily effects through the stress response system. In my own childhood, my parents had an ugly divorce before I was five, which was characterized by loud,  angry fights, betrayals, and ultimately, nervous breakdowns. Although my parents each went on to recover and start over, the uncertainty and hostility left lasting scars. I thought I had left that all behind, and went on to become what Dr. Jackie calls the “superwoman high achiever”, determined never to make the same mistakes my parents made. Dr. Jackie says that a critical childhood caregiver can lead to this pattern of behavior. She says that the decreased function caused by an injury or disease in adulthood can, in turn, lead to anxiety about not getting ahead, causing greatly increased anxiety and heightened stress response, which can further prolong disability. This almost exactly describes my last year in which I went from starting a difficult graduate school program to crashing and burning because I tried to stick it out, even though my body was slowly falling apart due to my worsening fibromyalgia. I definitely made things worse by continuing, and causing more damage to my body – eventually getting to the point of having panic attacks because of the growing gap between what was expected and what I could do. Now I know that the high degree of anxiety was probably affecting my immune system, and impairing my ability to heal.

The book explains that mindfulness can help to repair the mind-body connection by helping you to manage stress and overcome negative emotional patterns of thought. I can’t wait to begin to learn these tools and a little bit more about what mindfulness means. Hopefully my blog post will be more about my personal experiences, and less about summarizing in the near future!

Caudill, Margaret A. (2009). Managing Pain Before it Manages You. TheGuilford Press: New York, New York.

Gardner-Nix, Jackie & Lucie Costin-Hall. (2009). The Mindfulness Solution to Pain. New Harbinger Publications: Oakland, CA.