Three Facts About Chronic Pain

Chronic pain is generally defined as pain that has gone beyond tissue repair, lasting longer than six months, and pain that is not responsive to usual treatment. It can be intermittent, such as migraines, or continuous, such as a back pain. Because chronic pain tends to be insidious, we don’t often realize that chronic pain and mental health disorders tend to go hand in hand.  Three useful facts:

  • Our brain is able to cope with acute pain as it is a part of our survival mechanism. When dealing with chronic pain; however, an emotional component becomes connected to the experience of pain and this leads to suffering and a greater tendency to experience negative emotions.
  • When emotions become intense and sustained over a long period of time, this can lead to mood changes. Over time, this can gradually lead to mental illness; research suggesting that 30 to 50% of people who live with chronic pain also struggle with depression or anxiety.
  • Chronic pain tends to automatically move people into working from a pain centered life. With pain always taking center stage, this can create feelings of helplessness. Moving to a function centered life becomes part of a self-management strategy to working with chronic pain.

Tomorrow’s post will look at how a function centered life can be a healthy approach when living with chronic pain.

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The Anger Iceberg; a visual way of understanding anger

In the article entitled “The Anger Iceberg” by Kyle Benson and featured on The Gottman Institute Relationship Blog, Benson writes: “Think of anger like an iceberg. Most of the iceberg is hidden below the surface of the water. Similarly, when we are angry, there are usually other emotions hidden beneath the surface. It’s easy to see a person’s anger but can be difficult to see the underlying feelings the anger is protecting.”

In therapy, one of the most useful bits of information I provide to clients is about anger. Learning that anger is an emotion that tends to come after a feeling sets up a good understanding for why we use it; it keeps us safe. Safe from the other emotions that as Benson points out, hide under the surface. Beginning to recognize what feelings are prompting the anger is a good first step in beginning to process not only the anger, but the hidden feeling as well.

Benson includes a downloadable PDF graphic image of the Anger Iceberg that is worth checking out. To read the full article: https://www.gottman.com/blog/the-anger-iceberg/

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Are Opposite Sex Friendships Okay?

Yesterday’s blog post touched on jealousy and how it can erode relationships. But are opposite sex friendships okay? The short answer…..they can be, but proceed with caution. Our attachment system works in such a way that we can easily attach to more than one child, more than one friend, more than one sibling or family member. When it comes to our partners, however, our attachment system tends to need full investment; when we begin relying on an opposite sex friend on an emotional level (instead of our spouse), we risk becoming attached to them, leading potentially to thinking that the grass is greener on the other side. It is a slippery slope; hence the caution.

The reality of our intimate relationships is that they ebb and flow from times that we are content to times that we are frustrated and feeling vulnerable. Leaning into our opposite sex friend instead of working to fix what is unhealthy at home can lead to infidelity if one is not very aware of their actions.

In order to maintain a friendship with someone of the opposite sex, transparency is a must. Both partners have to be okay with the friendship and adopt the philosophy that there is “nothing to hide.” When we work as a team with our partners, making sure their feelings take priority, we make the ground underneath us more even, and therefore, more secure.

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Jealousy and How it Damages Relationships

Secure attachment is a safe place; one in which we feel a sense of reciprocal loyalty to our partner. Within the context of a healthy relationship, there may be times when we feel a bit territorial; if you are at a social event and it appears that someone has decided to put the charm on your partner, you may get a little prickly feeling, a natural response to someone invading your space.

But what happens when it moves to jealousy? And what does that do to a relationship? The short answer…..it erodes it. Jealousy is a feeling that can border upon and include emotions such as envy, resentment, and bitterness. Jealousy is about unentitled ownership, mistrust, and suspicion; all of which will do nothing to contribute to the health of a relationship. Jealousy is about feeling insecure and placing that vulnerability on the shoulders of your partner; clearly not their job.

When feeling jealous, it is our job to ask ourselves why; to begin to take ownership for how those feelings developed and what we can do to change them. If our partner is excessively flirty or there have been questionable moments of infidelity in the past, that becomes a relationship problem; jealousy may be growing out of what now has become unhealthy.

In any case, jealousy is an emotion we need to keep in check. Leaning into it not only erodes the relationship, it also wears away at our own sense of a confident and secure self.

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The Wisdom of Mother Teresa

Mother Teresa continues to be a source of inspiration to me; her ability to be gracious, her benevolent nature and the wisdom she found in living a charitable life is something we can all benefit from. Three of my favourite quotes from Mother Teresa include:

  • “Do not think that love, in order to be genuine, has to be extraordinary.” – Mother Teresa
  • “If we have no peace, it is because we have forgotten that we belong to each other.” – Mother Teresa
  • “Help one person at a time and always start with the person nearest you.” – Mother Teresa

Mother Teresa lived a life in service of others; yet her words reflect our ability to begin with love and kindness in our own lives, in our own hearts and homes; moving outward as we grow in courtesy and compassion.

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Procrastination; Why we Engage in it

Through an article entitled “Procrastination” featured on GoodTherapy, we are able to begin to see the difference between the natural tendency to put things off  and chronic procrastination:

“One common misconception about procrastinators is that they have poor time management skills. While this may sometimes be the case, there are often deeper issues at play. Some research indicates that those who are prone to chronic procrastination may find help with emotional regulation and stress management more valuable than skills-training for time management. This is because procrastination may stem partly from an inability to cope with difficult emotions in the moment or from a fear of being unable to cope with negative emotion.”

This makes perfect sense; if we tend to have difficulty regulating our mood, or find a particular emotion upsetting, avoidance is one of the ways that we cope. The effects of chronic procrastination can create a defeatist-type cycle; one in which can affect our overall quality of life.

Two ways that the article featured on how to begin to reduce the tendency to procrastinate I particularly resonated with:

  • Find accountability. This can include asking a friend or partner to help keep you on track; the process of doing so will help to create a sense of agency and accomplishment.
  • Start small. Very often, breaking down a bigger issue in smaller steps helps us stick to the task at hand and not feel overwhelmed.

To read the full article which included effects of chronic procrastination and additional coping strategies: https://www.goodtherapy.org/blog/psychpedia/procrastination

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Observe and Describe; Getting Back to our Emotions

Our emotional system is quite amazing. We are born with a set of emotions that innately work for us and yet that same emotional system is shaped by the world around us. The experiences and lessons we have been taught by our caregivers will influence and guide us into our emotions and our reactions to those feelings, healthy or not.

In a ‘Working with Emotions’ group that my colleague Darlene and I run, we start out by addressing this very system, and how emotion trumps reason every time. In reclaiming our emotional system so as to begin to feel more emotionally regulated, the first step is to simply observe and describe our emotions at any given time in our day. This is easier said than done 🙂

Our emotions as adults often come with judgement: “Crying is a sign of weakness,” “I go from 0 to 60 when I’m angry and I know its wrong,” “I feel guilty because I disappoint people.” Judgments,; however, tend to be a precursor to action; so we are much better served to set our goals on observing and describing: “I feel sad right now,” “I can feel a tightness in my chest,” “I can feel my anger rising.”

This may not be easy, but with practice and patience, you will begin to see your emotions in a different light. Freeing them from their cages, you will feel lighter and less tied to developed patterns; giving you a sense of agency and direction in your own emotional world.

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Criticism and It’s Internal Voice

“It is all my fault.” “There is something wrong with me.” “Nothing I ever do is good enough.” Clients who come to therapy struggling with self-worth say these things to themselves. And pretty much every one of them had a parent who was critical.

The need to criticize another person is about control. What better way to control someone than to oppress them; if they feel lesser than you, they will most likely do your bidding and you feel safe and secure in top position. Unhealthy? Absolutely.  When we grow up with a critical parent we get these messages honestly; when we become adults, our internal voice takes over and we begin to repeat the messages to ourselves, usually acting in ways that reinforce the way we feel.

We can challenge our inner critic by identifying  the messages, then asking ourselves “Who does this really sound like?” (It doesn’t usually take much exploring to get to the answer.) From there, we can begin to ask ourselves “Could it be different?” And the answer is unequivocally “Yes.”

Your inner critic is yours; it is yours to keep listening to or it is yours to challenge.  You can allow it to keep its throne, or strip it of its power. The choice, ultimately is yours; perhaps that realization is the first step in quieting your internal voice and putting it in its place.

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Authenticity and its Value

Be yourself. We hear that everywhere. And yet what do I tell my young client, a woman in her early thirties, when she tells me that she doesn’t know who she is. Parentified at a young age, she was left in charge of her younger siblings; forever the caregiver, never the one being taken care of. There was no time in her young life to discover who she was as an individual, and she carried the weight of an absent father and her mother’s emotional troubles.

We have done much work; exploration as to how her childhood has affected her and she has come to accept the limits of her parents. She has put much needed boundaries into place, and ended a romantic relationship that was unhealthy. We have now moved into the place where she can become curious about who she is, what her qualities are, her interests, values and so forth. Where she was stunted in her emotional growth as a child, she is moving to reclaim.

Authenticity as defined by the Webster’s dictionary is: genuine//true//reliable. I believe that authenticity is a feeling; found in the calm regions of our core. As we gain more confidence in who we are, we have greater access to that feeling, relying on the ability to be genuine rather than on trying to be something we are not. Feet on the floor, take a few deep breaths and bring the thought, “just be yourself” into that space. The calm will guide you to be true. 

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A Classic Poem; forever timeless

My friend Nathalie once shared this poem with me and every so often I look it up and remind myself of its timeless and wonderful value.

Desiderata 

    • Go placidly amid the noise and haste
    • and remember what peace there may be in silence
    • As far as possible without surrender
    • be on good terms with all persons.
    • Speak your truth quietly and clearly;
    • and listen to others,
    • even the dull and the ignorant;
    • they too have their story.

Avoid loud and aggressive persons,
they are vexations to the spirit.
If you compare yourself with others,
you may become vain and bitter;
for always there will be greater and lesser persons than yourself.
Enjoy your achievements as well as your plans.

Keep interested in your own career, however humble;
it is a real possession in the changing fortunes of time.
Exercise caution in your business affairs;
for the world is full of trickery.
But let this not blind you to what virtue there is;
many persons strive for high ideals;
and everywhere life is full of heroism.

Be yourself.
Especially, do not feign affection.
Neither be cynical about love;
for in the face of all aridity and disenchantment
it is as perennial as the grass.

Take kindly the counsel of the years,
gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune.
But do not distress yourself with dark imaginings.
Many fears are born of fatigue and loneliness.
Beyond a wholesome discipline,
be gentle with yourself.

You are a child of the universe,
no less than the trees and the stars;
you have a right to be here.
And whether or not it is clear to you,
no doubt the universe is unfolding as it should.

Therefore be at peace with God,
whatever you conceive Him to be,
and whatever your labors and aspirations,
in the noisy confusion of life keep peace with your soul.

With all its sham, drudgery, and broken dreams,
it is still a beautiful world.
Be cheerful.
Strive to be happy.

Max Ehrmann, Desiderata, Copyright 1927.

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