One Perspective: I’ve learned to live with my mental illness

There is an old saying…”We can’t climb into another person’s skin.”  The meaning I take from this is that, while we can show empathy to others, we don’t know their intimate experience–mental health included.  That’s why it’s useful to hear directly from others.  The following First Person article, was published in the July 23, 2018 issue of the Globe and Mail.  First Person is a daily personal piece submitted by readers.

My disquieted mind is like a party I was invited to, but I don’t know who sent the invitation. Trading cloaked glances across the open bar, ice clinking audibly in swirling glasses, olives skewered onto toothpicks with a tidy, yet menacing accuracy. The conversation becomes hushed around me as I move about the room. I look to the door, but can’t navigate my way to exit. None of my bipolar highs or lows or my various anxieties have ever been gracious hosts. Yet, the invitation remains, unavoidable and persistent.

Is it natural for your most complex relationship to be with yourself? Some nights, I fall asleep in the bed of one likeness and awake in another. Some mornings my visage looks like an offence, as if the mirror is trying to disparage me. Other days I see the face of an old friend, my heart swelling and breaking concurrently as I ask, “Why am I so hard on myself?”

Everyone wants to be free of themselves at some point, counting down the minutes to the weekend to intoxicate ourselves and create moments we won’t remember. It’s easier to say, “I love you” when drunk, faded, high or rolling anyway. Many of us will gladly sacrifice a slice of control for a helping of chemically induced simplicity. The small become large, the indifferent become invested. But what is perspective without a window; what is scale without reference?

Perhaps internal peace is meeting one’s self in no man’s land, between the trenches, caked in grime. Looking up and recognizing the resemblance, breaching the gap that separates us from our real selves – a silent pause, commanding in its stillness. To catch and maintain our own gaze is powerful. We hide our darkest corners most aptly from ourselves.

I want to fall in love with myself, but it’s never been that simple. At 27, I find myself on a fulcrum, feeling the past behind me, a soundless breeze on the back of my neck reminding me of everything I’ve lost, every object dropped, every person who removed themselves from my life.

I don’t fear these accusations of inferiority and inadequacy as I used to, but I admit to my trepidation surrounding them. My most difficult endeavour was admitting my deficiencies, confused by what strength actually was.

My faith in myself never falters, except when it does. I live with self-doubt, all-encompassing and seemingly endless, waiting for a day that may never come. Grand victories may be rare, but with patience and perseverance they arrive. I gave a speech at my grandfather’s memorial service and it was enthusiastically received. I probably wouldn’t be writing this essay had that not occurred. It was a victory in an unexpected place from unexpected people with unexpected consequences. I was able to exhale and breathe for another day. My grandfather would have been proud.

I’ve discovered that it’s not the elimination of so-called shortcomings that leads to self-improvement. It’s more about sensibly maintaining composure when that composure is called into question, especially when it’s me who’s doing the questioning.

I know there is no cure for my mental illness, no dusting hands off and settling down after a job well done. There is balance and consistency. The world doesn’t change; you need to change within it. I suppose that’s why I take my medication every morning and every night without fail. I’m recovering from whispers and shadows. My pills come in handfuls – my anxieties I consume single file.

It’s been years in the making, but when I have a good day, it’s mine. In these moments, I control as much of my destiny as possible. My social anxiety has kept me on a short leash my whole life and my mental health has at times taken my legs out from under me. But when I wake up early, start writing, survive another yoga class and lay down for an early bedtime, it adds another solitary brushstroke to the canvas that is the true, unflinching and unremitting me.

So, here I stand. I’m not a boy, but I’m not far divorced from boyhood. I’m intelligent, but applying that intelligence has proven a difficult and layered struggle.

I was never successful in school; my attitude was loud and my interest quiet. My indifference about formal education did not evaporate over the summer between Grade 12 and my first year at Concordia, which in retrospect is about as shocking as the sunrise. Since turning 20, I’ve been in and out work, missing multiple years cumulatively, because of my mental health. I have a lot of love in me, but I’ve never been able to make any of my relationships last at least a year. Life is complicated: My friends’ lives are complicated, my life is complicated and my family’s is as well.

I am the cat who climbed too high; those closest to me bring the ladder and carry me down.

As far as we travel, we never leave ourselves. We might lose ourselves around a dark corner, but we will always be there. My faith is to no deity or prophet; my faith is a manifestation that exists between the gaps of my ribs, looking out, viewing the world with colourful inquiry and nervous anticipation. I suppose I’ve found no god and no ego to be a worthwhile forfeit. Between the heart and the heavens, warmed by a lack of expectations, I find peace and feel courageous in my lack of understanding.

The truth is what happens between the lies. Back at the party, in my mind, the hostility suddenly abates. I can recognize old friends I simply could not see before. We will greet each other happily. When a round of socializing leaves me dizzy, I retreat to the bathroom for a brief reprieve. I wash my hands and look to the mirror. I love you, Jack.

Jack Altman lives in Vancouver.

6 Simple Things You Can Do To Improve Your Mental Health

Thinking about improving our mental health can feel overwhelming–especially when we’re under the influence of negative emotions such as anger, sadness or anxiety.  However, there are a few simple things that you can do in the moment that can help…and, if you practice these things on a regular basis, you may see an improvement in your overall well-being.  So, what are they?

1.  Stop and Breathe

As humans, we are under a lot of stress.  Our stress levels encourage us to be ‘shallow’ breathers–instead of taking deep breaths; we take short,  shallow breaths.  If we pay attention, we may notice that most of our inhales barely make it past our collar bone!    This way of breathing encourages panicky feelings as we’re not getting enough oxygen to our brains–it’s as if we’re hyperventilating.   If that’s our normal, how should we breathe?

Have you ever watched a baby breathe?  They  naturally ‘tummy’ breathe…slow, deep, relaxed breaths.  Tummy breathing helps to calm the nervous system, which puts the breaks on the ‘fight, flight or freeze’ response.  You can practice this type of breathing by gently placing your hands on your stomach and inhaling until you feel your tummy rise and fall.

If you are interested in practicing your breathing as a way to cope with difficult emotions, a meditation/breathing download is available on the Welcome Page of Blaikie Psychotherapy.  The exercise takes 20 minutes and includes instructions.

2.  Eat Something Healthy

Are you familiar with the ‘hang over’ from a greasy, high-fat, calorie-dense meal?  I know that I am!  If I have made a stop at my local fast-food palace as a way to cope with negative feelings, I can pretty much guarantee that I won’t feel better afterwards.

Our brains and bodies are connected.  There is now a branch of science called Nutritional Psychiatry that looks at the effects of food on our mental health.  Scientists are recognizing the interplay between mental health and a healthy gut (the microbiome).  When we provide our bodies with healthy nutrients, we are encouraging brain health.  This article from the Harvard Medical School explains how eating a diet high in vitamins, minerals and antioxidants helps to increase serotonin levels in the brain. Serotonin is a neurotransmitter that helps regulate sleep and appetite, mediate moods, and inhibit pain.

So, if you’re feeling down, grab an apple instead of a doughnut!

3.  Move

We have known for a long time that exercise is a good way to improve our mood.  There’s nothing like a good stomp around the block after an argument!

The great thing is that it doesn’t have to be a big deal…just 150 minutes of moderate exercise a week will provide benefits.  While 150 minutes may sound like a lot, it’s only a 20 minute walk per day.  And the 20 minutes can be spread out over the day…park the car a bit farther from where you’re going…take the stairs when possible…hit replay on your favourite tune and keep dancing.  When we’re mindful of ways to increase our amount of movement, it’s easy to find 20 minutes.

4.  Enjoy Nature

Not only can we add 20 minutes of movement into our day, we can do it outside.  While spending time in a forest or at a lake is ideal, the benefit is in getting outside.  Is there a park or other green space in your area?  What about your backyard?

A recent trend called “Forest Bathing” encourages us to benefit from the healing properties of trees.    According to a CTV News article,  the forest bathing movement is all about immersing oneself in the healing properties of trees and plants.  It involves simply walking — quietly, slowly and deliberately — in a forest, and taking in the sounds, scents, colours, forms and general vibe of nature.

The concept is inspired by the Japanese practice of shinrin-yoku, which translates to “taking in the forest atmosphere.”  The certified forest therapy guide quoted in the article stated that “studies in Japan and Korea found forest bathers after their walks had an increased number of “natural killer cells,” immune system cells that combat disease and may even help prevent some kinds of cancer. The researchers believe natural killer cells are boosted when people breathe in organic compounds called phytoncides released by trees.”  Apparently, forest bathing helps to lower cortisol levels, thereby lowering your stress levels.

If you’re curious about nature therapy or forest bathing, you can read more about it here.

4.  Count

We’ve all heard the advice about counting to 10 before losing our temper, and for a good reason as it often works.  However, sometimes we need more than that.

When we get overwhelmed by big emotions like anxiety or anger, our limbic system (or lizard/emotional brain) is over-stimulated.  This means that the logic part of our brain (pre-frontal cortex) is not in charge.  By counting, which is a ‘thinking’ activity, we put that part of our brain back in the driver’s seat, and we stop the flooding of emotions.  While counting our breaths may help, it can be more helpful to count something that is external to us.

One suggestion that I often give to clients is, when needed, look at what is around and find something to count.  In a meeting room?…count the number of pens or paperclips on the table.  In a store?…How many items are on the rack or shelf in front of you.  At home?…Count the number of books on a shelf, spots on the carpet, dust bunnies on the floor.  Outside?  Count trees or cars.  We can always find something to count.

6.  Talk to Someone

One of the signs of depression is self-imposed social isolation.  We don’t feel like interacting with other people, so we don’t.  The more we keep to ourselves, the deeper we fall into our negative thoughts and the less we want to spend time with others….and the pattern repeats.  I’m not talking about the bigger problem of a chronic lack of friends, but the turning away for others.

Social interaction is important for our mental health.  We are social creatures and need contact with others.  So make a point of talking to at least one person during your day…maybe it’s the person who makes your coffee or tea…smiling at someone who crosses your path…asking a co-worker about their plans for the weekend.  It doesn’t have to be deep, just a sharing of humanity.

This post provides 6 simple ways to improve your mental health.  However, if you are dealing with a significant mental health challenge, these may not be enough.  If you would like to get in touch to talk more about what you are experiencing, you can reach me through my contact page.

And now, since humour is also good for mental health.  Here is some classic Monty Python.  Enjoy!

“Find Your Passion”…Apparently Not a Good Idea!

Whether you are in the process of finding your first or twenty-first career, we are often told to “Find your passion” and all will be well.  According to the following article published in the July 12, 2018 on-line edition of The Atlantic, following this advice may not be a good idea.

This is such a good article (and timely as the new University and College terms are fast approaching), that I’ve included it in it’s entirety.  Enjoy!

‘Find Your Passion’ Is Awful Advice

A major new study questions the common wisdom about how we should choose our careers.

A person wearing white gloves holds up a violin
Toby Melville / ReutersWhat Dweck asked her students is a common refrain in American society. The term “Follow your passion” has increased ninefold in English books since 1990. “Find something you love to do and you’ll never have to work a day in your life” is another college-counseling standby of unknown provenance.

Carol Dweck, a psychology professor at Stanford University, remembers asking an undergraduate seminar recently, “How many of you are waiting to find your passion?”“Almost all of them raised their hand and got dreamy looks in their eyes,” she told me. They talked about it “like a tidal wave would sweep over them,” he said. Sploosh. Huzzah! It’s accounting! Would they have unlimited motivation for their passion? They nodded solemnly. “I hate to burst your balloon,” she said, “but it doesn’t usually happen that way.”

That’s why he and two co-authors—Dweck and Greg Walton of Stanford—recently performed a study that suggests it might be time to change the way we think about our interests. Passions aren’t “found,” they argue. They’re developed.

In a paper that is forthcoming in Psychological Science, the authors delineate the difference between the two mind-sets. One is a “fixed theory of interests”—the idea that core interests are there from birth, just waiting to be discovered—and the other is a “growth theory,” the idea that interests are something anyone can cultivate over time.To examine how these different mind-sets affect our pursuit of different topics, the authors performed a series of studies on college students—a group that’s frequently advised to find their passion in the form of a major or career path.

First, students answered a survey that would categorize them as either “techy”—slang for interested in math and science—or “fuzzy,” meaning interested in the arts or humanities. They also filled out a survey determining how much they agreed with the idea that people’s core interests don’t change over time. They then read an article that mismatched their interests—a piece on the future of algorithms for the fuzzies, and a piece on Derrida for the techies. The more the participants endorsed a “fixed” theory of interests, the less interested they were in the article that mismatched their aforementioned identity as a techy or fuzzy.

The authors then repeated a similar procedure, but they had students read first about either the fixed theory of interests or the growth theory. Again, those who learned that interests are fixed throughout a person’s life were less captivated by an article that mismatched their interests. The authors believe this could mean that students who have fixed theories of interest might forgo interesting lectures or opportunities because they don’t align with their previously stated passions. Or that they might overlook ways that other disciplines can intersect with their own.“If passions are things found fully formed, and your job is to look around the world for your passion—it’s a crazy thought,” Walton told me. “It doesn’t reflect the way I or my students experience school, where you go to a class and have a lecture or a conversation, and you think, That’s interesting. It’s through a process of investment and development that you develop an abiding passion in a field.”

Another reason not to buy into the fixed theory is that it can cause people to give up too easily. If something becomes difficult, it’s easy to assume that it simply must not have been your passion, after all. In one portion of this study, the students who thought interests were fixed were also less likely to think that pursuing a passion would be difficult at times. Instead, they thought it would provide “endless motivation.”

Dweck, one of the paper’s authors, has previously studied different types of mind-sets as they relate to intelligence. People who have a growth mind-set about their own intelligence tend to be less afraid of failure, according to her research, because they believe smarts are cultivated, not inherent. Interests are related to, but distinct from, abilities, the study authors told me: You can be interested in something but not very good at it. “I’ve been playing guitar for 25 years, but I can’t say that my abilities have gotten that much better in the past 10 years,” O’Keefe said.

Dweck told me that “find your passion” has a laudable history. “Before that, people were saying, ‘Find your genius,’ and that was so intimidating. It implied that only people who were really brilliant at something could succeed,” she said. “‘Find your passion’ felt more democratic. Everybody can have an interest.” But this study suggests that even the idea of finding your “true” interest can intimidate people and keep them from digging further into a field.

The authors also had students learn about either fixed or growth theory and then exposed them to a new interest: Astronomy. First, they had them watch a video made by The Guardian for a general audience about Stephen Hawking’s ideas. It was easy to understand and entertaining. Then the authors had the students read a highly technical, challenging article in the academic journal Science about black holes. Despite saying just moments ago, after viewing the video, that they were fascinated by black holes, the students who were exposed to the fixed theory of interests said they were no longer interested in black holes after reading the difficult Science article. In other words, when you’re told that your interests are somehow ingrained, you give up on new interests as soon as the going gets tough.

This study was a preregistered replication, meaning the authors stated at the outset what their hypothesis and methods would be. This process is meant to prevent p-hacking, a shady data practice that has cast a shadow over many psychology studies in recent years.

Ann Renninger, a professor at Swarthmore College who was not involved with the study, has researched the development of interests and said that “neuroscience has confirmed that interests can be supported to develop.” In other words, with the right help, most people can get interested in almost anything. Before the age of 8, she said, kids will try anything. Between the ages of 8 and 12, they start to compare themselves with others and become insecure if they’re not as good as their peers at something. That’s when educators have to start to find new ways to keep them interested in certain subjects.

Though the authors didn’t examine adults, they told me their findings could apply to an older population as well. For example, people’s interest in parenthood tends to escalate rapidly once they have a real, crying baby in their house. “You could not know the first thing about cancer, but if your mother gets cancer, you’re going to be an expert in it pretty darn quick,” O’Keefe said.

A different study done on adults’ views toward passions suggests that people who think passions are found tend to pick jobs that fit them well from the outset. They prioritize enjoyment over good pay. People who think passions are developed, meanwhile, prioritize other goals over immediate enjoyment at work, and they “grow to fit their vocations better over time,” the authors of that study write. “In conclusion,” they add, “people who have not found their perfect fit in a career can take heart—there is more than one way to attain passion for work.”

How to cultivate a “growth” mind-set in the young, future-psychology-experiment subjects of America? If you’re a parent, you can avoid dropping new hobbies as soon as they become difficult. (Your kids might take note if you do, O’Keefe said.) Beyond that, there’s not a clear way to develop a growth mind-set about interests, other than knowing that it’s a valid way to think, and that your passion might still be around the corner.

“We’re just trying to pull the veil back on the hidden implications of things like, ‘find your passion,’” Walton said. “Is that really how things work? A little bit of knowledge is power.”

Are You In a State of Lykke?

Libraries are magical places.  Unlike looking for books on Amazon or Chapters.com where you are presented with book selections based on previous choices; wandering around a library allows you to stumble upon all sorts of interesting things that you had no idea existed.  And, if you have a library card, it’s all free!  Such was the case the other day when I stumbled upon the little gem entitled The Little Book of Lykke by Meik Wiking, CEO of the Happiness Research Institute in Copenhagen.

What is Lykke?

Lykke is the Danish word for happiness.  According to Wiking’s research (based on the combined average of World Happiness Reports 2013-2017) Dane’s are the happiest people on the planet…followed by Swedes and Norwegians to round out the top three.

Wiking suggests that the reason for Denmark’s high happiness rating is due to community norms around togetherness, freedom, trust, and kindness; as well as those around money and health.  If you are interested in learning the details of Wiking’s theory, I recommend his book as an enjoyable, thought-provoking read.

A Definition of Happiness

As discussed in last week’s post on balance, the definition of happiness is also individual.  What makes me happy, may be misery to my neighbour.  That being said, Wiking provides a helpful framework to look at happiness.  He suggests that happiness can be divided into three categories:  the affective dimension, the cognitive dimension and eudaimonia.

When we are operating in the affective (or hedonic) dimension we’re thinking short-term.  What was our mood today?  Sad, scared, anxious, happy?  In the cognitive dimension we take a step back and look at our live overall.  Wiking asks:

“How happy are you in general?  Think of the best possible life you could lead, and the worst possible.  Where do you feel you stand right now?”  “When trying to evaluate happiness, the important information is what your dream is and how close you feel to living that dream.”

The concept of eudaimonia takes happiness one step further.  Eudaimonia is the Ancient Greek work for happiness and is based on Aristotle‘s perception of happiness–i.e. happiness comes from living a meaningful and purposeful life.  If you’d like to read more about the ‘meaning of life’ you can check out this previous post.

Chasing Happiness

I think that it’s safe to assume that we all want to be happy.  In fact, it’s often a motivating factor in why we behave the way we do.  In some cases, we even go so far as to believe that we have a right to be happy.  In at least one country, the right to happiness is codified in their founding documents.    The United States Declaration of Independence  gives citizens the right to “Life, Liberty and the pursuit of Happiness”.

As with most things that we want very badly, we are seldom content to let them come to us–instead we chase them.  Advertisers know this.  Consumerism is based on the idea that we will buy things that we think will make us more popular, thinner, fitter, smarter…ultimately happier.

Not only do we chase happiness, but in today’s world of ‘fitbits’ and other ways of constant monitoring, there are ‘happiness apps’ that use results of research into brain science and happiness to give users daily exercises that will help to improve their overall state of happiness.  If you’re interested, you can check out Psychology Today’s review of the Best Happiness Apps of 2018.

Unicorns

What if happiness is like a unicorn?  In fairy tales, we learn that if we are looking for a unicorn we’ll fail if we chase them directly. Instead, we need to sit quietly and wait.  She will come to us, and not usually full-on, but  glimpsed out of the corner of our eye.

I like the idea of happiness being somewhat mystical–like unicorns.  It comes when we’re not looking for her.  We can put things in place to encourage her to visit, but we can’t force her to come…or stay forever.

If we measure happiness from the affective standard, it’s easy to look at happiness as something to grasp and get attached to. This can only lead to disappointment.  However, if we think of the long game, happiness over time, we can relax and not get so caught up in our ‘internal weather’.

Happiness and Depression

There is a time when we do need to be aware of our daily happiness–if we suspect that we may be suffering with depression.  One of the symptoms of depression is the absence of happiness or no longer finding joy in activities that used to fulfill us.

Symptoms of depression include:

  • sadness
  • tiredness
  • trouble focusing or concentrating
  • unhappiness
  • anger
  • irritability
  • frustration
  • loss of interest in pleasurable or fun activities
  • sleep issues (too much or too little)
  • no energy
  • craving unhealthy foods
  • anxiety
  • isolation.

If you have been experiencing any of the these symptoms for more than a few weeks, you may be dealing with depression, and need to seek medical support.

Happiness…individual, illusive and part of what makes life worthwhile.  May she find you!

And now what is happier than a baby goat and kittens?  Enjoy!

 

The Precariousness of Balance

When people find out that I publish a blog post on a regular basis, they often ask where I find ideas to write about.  I share that the inspiration can come from lots of different areas.  Sometimes it’s a book or article that I’ve read. Sometimes a discussion with a friend, colleague, client or stranger has been the spark.  And then there are posts that  I write as a way to wrestle with a topic that I am puzzling with…such as today’s post on balance.

What is Balance?

The Merriam-Webster dictionary defines ‘balance’ in a number of ways…

  • as a piece of equipment used for measurement
  • physical equilibrium (keeping your balance on a sailboat)
  • the equal space between two opposing elements (junk food vs. exercise)
  • in the context of art, balance is an aesthetically pleasing integration of elements
  • an amount in excess especially on the credit side of a bank account
  • mental or emotional stability.

The ideas of physical equilibrium, space between opposing elements and mental/emotional stability are somewhat helpful, but they don’t quite fit what I’m looking for.  They are describing an exact point, but life is made up by a series of ‘points’ or moments.

Balance as a Concept

At some point during the time that a client and I are working together, we will talk about how things may be different when they have finished therapy.  What is their picture of life after ‘the change’?   In order to discover your view ‘balance’, substitute ‘balanced’ for ‘finished therapy’ or “What is your picture of life after you have achieved a level of balance?”  I suspect that each of you will answer differently.

When we recognize that what is an ideal balance for one person, is completely out of balance for someone else, it becomes clear that ‘balance’ as a concept is incredibly individual.  Also, what a balanced life looks like at one stage of life no longer fits at a later stage.  To complicate things, that sense of being balanced can change from one day to another depending on energy levels, weather, people contact, or an endless bunch of other factors.

Finding Balance…By Paying Attention to the Opposite

I wonder if being able to live a balanced life requires a certain level of self-awareness…knowing not only when we feel balanced, but also being aware of when we feel ‘off-balance’.  Feeling ‘off balance’ is one of the most common reasons that people begin to see a therapist.  They may not be sure what is going on, but they don’t feel ‘right’.

Similar to the old saying, of “If it isn’t broken, don’t fix it.”, maybe we don’t recognize that we are living a balanced life, because everything is ticking along nicely.  We are living our lives with few problems.  We look for balance only when we become aware of it’s non-existence.  Then we play the game of adding more of this and less of that in an attempt to bring back feelings of equilibrium.  How many of us have thought that “I just need more sleep… or less work, or more fun, or less … and life will be better”.

Once we can imagine what a balanced life looks like for us…what we are aspiring to…how do we get there?

Tools for Living a Balanced Life

It appears that the search for a balanced life has been a human activity for a long time.  Here are some of the tools that I have found:

  • The 80/20 Rule:  The idea behind this tool is that when looking for balance it’s unnecessary to micro-manage things in your life or constantly correct when things feel a bit off-kilter.  People use this as a way to balance spending (80% of total income) and saving (20%), or managing food.  If 80% of your diet is healthy, don’t worry about the rest.
  • The Buddhist Idea of the Middle Way:  The Buddha came to this idea after living a life of extremes.  In his youth, he was a wealthy prince, and then chose to give it up to live as a ascetic.  As a holy man, his practices were so extreme that he almost died.  As part of his spiritual journey, he discovered the value of living between the two extremes, or the Middle Way.
  • Everything in Moderation:  This tool fits with the Middle Way as the search for balance doesn’t preclude anything–just don’t do too much of it!
  • The One in/One out Rule:  This tool helps to maintain balance once it has been reached.  Basically, for every new thing you add into your life, something else must leave.  This could apply to things, people (in some cases) or activities.
Can We Have It All?

One of the reasons that many people search for a balanced life is their desire to have/or do it all.  But is this possible?  Maybe, but not at the same time.

Perhaps one piece to the search for a balanced life is that we need to expand the time-frame.  Rather than asking if we’re balanced in this week, month or year; maybe we can ask if we are living a balanced life at this stage.  Or what if the Merriam-Webster definition is right and balance takes place in the moment, only to shift out of balance so easily?  Hmmm….the search continues….

And now…an amazing display of balance–elegant, graceful and inspiring….Enjoy!

 

The Benefits (and Challenges) of Slowing Down

Now that summer has truly arrived with a vengeance–+40 degrees with the humidity anyone?  Slowing down is something to think about. 

The following is from the archives.  Enjoy! 

A few weeks ago, I wrote about self-care and it’s importance for mental health. Part of self-care is giving ourselves permission to slow down. But what does “slowing down” look like?  I suggest that it will look different for everyone and that there are no shortage of resources to help us find our way.

 The Popularity of “Slow”

The first time I heard of “slow” was in the context of slow food.  In 1986 Carlo Petrini, an Italian, started a group that celebrated the concept and practice of enjoying local food, that is lovingly prepared, and shared with friends and family.  This group was in protest to a McDonald’s restaurant that was being built in his town.  Part of his plan, against what he saw as the encroachment of fast food into his fellow neighbours’ way of life, was to dismantle the McDonald’s at night (himself with a band of followers)–while it was being built.  The legal repercussions of this are another story, and included in the creation stories of the Slow Food Movement.

Since Petrini’s start in 1986, the Slow Food Movement has become an international institution that not only includes the founder’s initial plan, but also the idea of local eating, organic foods and beverages, as well as preserving various food preparation skills.

The slow movement has spread to the idea of slow money, slow fashion, slow cities, slow schools…the list goes on.

If you are interested in finding more information on this concept, the following books are worth checking out.

In Praise of Slowness:  Challenging the Cult of Speed by Carl Honore
Slow is Beautiful:  New Visions of Community, Leisure, and Joie de Vivre by Cecile Andrews.

 Sounds Interesting, But What Gets in the Way of Slowing Down?

Recently, a colleague and I were discussing self-care and why it’s so difficult to slow down–especially when it would be in our best interest to do so. She suggested that it comes down to being attached to outcomes. When we have a fixed idea of how things should be, we can become incredibly invested in making situations, people, etc. fit our ideal.

One way that outcome attachment is visible is when we have a picture in our mind of what we should be doing and how productive we should be.   This attachment can become a problem when we are fixed on a certain plan or idea and then react negatively when we can’t fulfill that plan.  Often our answer is to speed up rather than slow down in an effort to shape our world.

 How Can We Slow Down?

While slowing down looks different for each person, I suggest that in each case it involves letting go of our attachment to outcomes.  In Buddhist psychology, attachment (to states of mind, situations, our plans for the future) leads to suffering (pain in our lives). What would happen if we allowed ourselves to be less in control?  Would our lives start to have room for some ease?

The act of slowing down often takes deliberate effort.  In the April 22, 2017 issue of the New York Times International Weekly, there appeared a brief article by David Leonhardt entitled:  You’re Too Busy.  You Need to a ‘Shultz Hour’.  The article describes the habit of George Shultz (US Secretary of State in the 1980’s) to carve one hour each week for quiet reflection.  During that time he would think about the strategic aspects of his job, and ponder larger questions.

Similar to the book reviewed last weekSolitude:  A Singular Life in a Crowded World–the individuals Leonhardt interviewed in the article would agree with Solitude’s author Michael Harris about the negative impact that technology has had on the practice of slowing down.

Leonhardt writes:

“Whether you decide a Shultz Hour makes sense for you, I’d encourage you not to fool yourself into thinking that you can easily change your habits in little ways here and there. The ubiquity of smartphones, together with our culture of celebrating busyness, makes ad-hoc approaches difficult.  You are much more likely to carve out time for strategic thinking by making concrete changes to your habits.”

The author’s suggestion? Hide your phone…sounds easy, but how many of us could actually do it?

There are lots of bloggers that explore and chronicle their experiences of slowing down.  I recently discovered Cait Flanders, a blogger out of British Columbia, who has decided that 2017 will be her ‘year of slow living’.  Her posts are insightful and provide great tips.  I encourage you to check our her blog.

Slowing Down and Self-Care

Slowing down can be a key component of self-care.  However, the guilt we feel about taking things at a quieter pace, may defeat the purpose.  Often we have a fixed idea of what we want self-care to look like–get to the gym six days/week, floss our teeth daily, get to bed before 11 p.m…. The list can be endless, and we beat ourselves up when we haven’t been able to meet our self-care goals.  How will we be able to maintain the outcome we desire of being able to fit into a size 8 dress if we don’t push ourselves? How reasonable is this?

My friend and I decided that perhaps a better question is:  What do we need right now?  If the answer is something less healthy, spend the time to slow down and explore the feelings underneath the desire.  Am I really hungry, or do I need to sleep or talk to a friend about the challenging day I’ve had?

The Benefits of “Slow”:  A Real-life Example

In researching this post, I encountered a clip that told the following story.  An ambulance driver was taking part in a community group focused on the idea of ‘slow living’.  He decided to see what would happen if he drove slightly slower when rushing to an emergency call.  (I assume that he did this when it wasn’t an actual emergency!).  He found that by slowing down, he gave the drivers ahead of him more time to get out of the way, and he was able to reach his destination in less time than if he had increased his speed. Interesting… I wonder how much more productive we would be if we weren’t in such a rush.

To borrow a great line that I recently heard:  “You ain’t going to get all your possums up the same tree.”  My addition is, why rush around trying?

Now, if you have 20 minutes to spare, I invite you to take some time and listen to a Ted Talk from one of the ‘masters of slow’–Carl Honore.  Enjoy!

Happy Canada Day Weekend!

For those of us who live in Canada…Happy Canada Day weekend!

Whether you choose to celebrate with family, friends, good food (lots) or spending the time in quiet contemplation, I wish you a restful and enjoyable weekend.  See you next week.

 

The Caregiver’s Journey–Part 3

In Part One of this three-part series, we explored the specific parts of the Caregiver’s Journey–the beginning, middle and end stages–what can be expected at each stage and ways to cope.  Last week, in Part Two, we looked at caregiver burnout–the risk factors and warning signs.  Today, we’ll look at what happens when the caregiver journey is over.  This is the last in a three-part series on care-giving.

A Review of the Journey

If you have reached the end of the caregiver journey, you have gone through some difficult terrain.  You and your loved one have moved from an initial diagnosis and all the thoughts and emotions that this entailed.  As their illness became more severe you have adjusted your lifestyle to take this into account.

You have learned to ride the ebbs and flows of medical, community and family/friend support.

Along the way you may have experienced burnout, loneliness and the possible adjustment of adding ‘caregiver’ to your identity of spouse, partner, child, sibling or friend.  You have navigated the decision of either keeping your loved one at home, moving them into a hospital or made other arrangements for their care.

Now, with the death of your loved-one, the caregiver journey is over and you are embarking on a new path–grief.

The Grief Journey

Grief is hard. It’s messy, unpredictable and exhausting.  Grief is never experienced the same way twice.  It’s one of the most difficult things you will ever do.  And…grief is an opportunity for growth, a chance to develop resilience and discover strengths that you didn’t know that you had.  While grief may feel like depression, it isn’t…it’s grief.

When working with a client who is on the grief journey, I’m often asked “How long does this last?”  “When will I be done?”.

Grief is as individual as those who are experiencing it.  We all grieve in different ways, and there is no set time frame.  Just like a hike down an unknown trail, we’re not completely sure how long it will take to reach the end or what we’ll encounter along the way.  One thing is certain…we’re not the same people starting the journey as we are when we finish.

The Tasks of Grief

While everyone has different ways of grieving, J. William Worden in his book Grief Counseling and Grief Therapy, suggests that the following four tasks are part of the grieving process.

  1. We need to accept the reality of our loss.  Whether the loss is a person, place or thing; we need to accept the fact that the loss has occurred, and what was lost, is not returning.
  2. We need to process the pain of grief. Sometimes people experience grief as physical pain or develop anxiety/panic attacks.
  3. We need to adjust to the world without our loved one. Externally, this may mean adjusting to living alone, or developing a new routine.  Internally:   developing a new sense of self…”Who am I know if I’m not ….?”  Spiritually:  looking for meaning in the loss and determining the nature of the world (Is it kind or harsh?).
  4. We need to maintain a connection with who we’ve lost, while at the same time starting a new life. How do we remember, when we’re moving on?

While these are the ‘standard’ tasks of grieving, is there something specific to the grief journey if we have been a caregiver?

A Caregiver’s Grief

We come to the grieving process in different ways.  Sometimes the person we are grieving  has died suddenly, sometimes unexpectedly and sometimes with anticipation.  As a caregiver, all three can apply, and usually we know that death is coming.

When much of our life has been taken up with taking care of someone, even if they have moved into a care facility, their loss can leave a large hole in our life.  Our schedule may have revolved around our person.  Perhaps we visit the care facility on a daily basis, spending many hours each time.  The other residents and staff have started to feel like family, and visiting has given us a sense of purpose.  With death, we have not only lost someone, but also the opportunity to see the new friends that we have made.  This may be why some caregivers become volunteers at the care facility once the initial upheaval of grief has subsided.

There may be some ambivalence around the loss of our loved one.  On one hand, we may feel relief that they are no longer suffering.  If we are experiencing exhaustion or burnout from our care-giving role, we may also feel relief .  On the other hand, guilt may be our companion because of our relief.  “How can I feel such relief because my loved one is no longer here?”  “I am being so selfish!”  “How can I miss them so much and still be happy that I have ‘my’ life back?”

Grief can be a roller coaster,  cycling through the ups and downs of various emotions.  It’s all normal.  According to Buddhist thought, you are not your emotions or your thoughts.  Just like a roller coaster, the key is to hang on and ride through the highs and lows…without judging yourself.   Easier said than done!

Ways to Cope

If you are a caregiver, grieving the loss of the loved one you cared for, here are some ways that may help you to cope.

  • Take time to rest and adjust.  Chances are that you have been spending more time with your person during their dying process.  This can be overwhelming and exhausting–especially if you are already tired from long-term care-giving.
  • If you find that you are having trouble with physical issues, consult your doctor for support.  Sometimes at the beginning of the grief journey you may have trouble sleeping, or have an increase in the severity of your own medical issues.  Your doctor may provide short-term medication or at least put your mind at ease about what you are experiencing.
  • It’s ok at this point to be ‘selfish’ and take care of yourself.  When we have been taking care of someone for any length of time, we often put their needs before our own.  Now is time for you.
  • Ask for help.  There may be tasks that need to be done…some can wait and others need to be done as soon as possible.  If you don’t feel that you are able to complete these on your own, see if friends or family members can help.  Consult with care providers, financial and legal supports or funeral home staff to determine what can wait, and how to proceed.
  • Speak to someone that you trust about your emotions.  If you are having trouble dealing with feelings of guilt, anger, sadness, etc. talk to a close friend or family member.  If you don’t feel comfortable with this, or feel that it is appropriate, you can speak to a therapist to help you to sort out these difficult feelings.

And now…a caregiver’s tale… Enjoy!

The Caregiver’s Journey–Part 2

In last week’s post, we explored the specific parts of the Caregiver’s Journey–the beginning, middle and end stages–what can be expected at each stage and ways to cope.  Today, we’ll specifically look at the burnout that can be experienced by some caregivers.  What are the risk factors?  How do you know if you’re feeling burnout?  What can you do to prevent burnout?  This is the second in a three-part series on care-giving.

The information in this post is a partial summation of  information that was presented by Dr. Virginia Wesson, Psychiatrist and Dr. Rhonda Feldman, Psychologist.   Both Drs. Wesson and Feldman see patients, and their families, at The Cyril & Dorothy, Joel & Jill Reitman Centre for Alzheimer’s Support and Training.

A Story…

Dorothy and Marion (both aged 74) have been together for 40 years.  Ten years ago, when they retired from their careers (Marion was a teacher, Dorothy an operating room nurse) they had plans to travel.

Shortly after Marion left her job, she developed a cough that wouldn’t go away.  She lived with it, but became concerned when she started to experience a tightness in her chest and shortness of breath.

Rather than visiting the doctor, Marion decided that maybe a change of climate would be helpful, and the couple planned a trip to Arizona to visit friends.  “Perhaps the heat and rest would improve Marion’s symptoms”, Marion thought.  Unfortunately, there was no change in her health.  In fact, once out of her home environment, Marion became easily tired and was unable to join Dorothy and their friends on day trips.

When the pair returned home, Marion agreed to seek medical advice.  She was diagnosed with the Chronic Obstructive Pulmonary Disease (COPD)–a chronic inflammatory lung disease that causes obstructed airflow from the lungs.

Marion and Dorothy were shocked by the diagnosis.  Both had been smokers at various times in their lives, but had quit ten years earlier.  However, one of the causes of COPD is smoking and the habit had left its mark on Marion’s lungs.

At the beginning, after the shock wore off, the couple found ways to cope with the changes in Marion’s health and her decreased energy level.  Long-distance travel was out of the question, and with Marion’s new medication, they were able to make the most of day and weekend trips.  Because they were both retired, Dorothy found it easy to take over some of Marion’s tasks.  The women were able to cope in this first stage for a long time, adjusting as Marion’s health slowly deteriorated.

Risk Factors for Burnout

As explored in last week’s post, burnout often starts to appear during the middle stage of the care-giving journey.  In the beginning, the illness is a consideration in lifestyle decisions, but not a main component.  However, as the illness becomes more severe, it becomes a major factor in how the person who is ill and their caregiver function on a daily basis.

As the caregiver continues on this path of support, they may be at risk for burnout depending on:

  • the severity of the illness or behaviour of the person they are supporting
  • if they feel able to handle situations that arise
  • the type of relationship the caregiver has had in the past with the individual (i.e. it is often easier to take care of someone with whom you have had a loving relationship)
  • degree of knowledge about the illness
  • level of quality support (informal, formal and professional).  The more support, the less risk for burnout.

Based on what we know about Marion and Dorothy, we can assume that Dorothy may not be at a great risk for burnout, if she is careful.  When Marion was first diagnosed, both women did a lot of research into COPD.  Because of Dorothy’s connections in the health care field, she was able to put supports in place well in advance of them being needed.  The couple had been in a loving, stable relationship for a number of years and were committed to supporting each other through the illness journey.

However, not every caregiver has the resources that Dorothy was able to access.  What are the symptoms of burnout?

You May Be Experiencing Caregiver Burnout If…
  • You have developed a new health problem.  If we don’t practice self-care, taking care of a loved one can stress our immune system, causing our own health to suffer.
  • Depression.  At times we can feel that the situation is hopeless–especially if we know that our ‘person’ isn’t going to get better.  Feelings of being overwhelmed, overtired and under appreciated can all lead to depression.
  • Anger.  While anger is a normal response to life not turning out as we had wished, excessive anger is a warning sign of burnout.
  • Substance Use.  Care-giving is difficult and we all have our own ways of coping or self-soothing.  However, using substances as a way to make yourself feel better is not a healthy way of self-care.
  • Social Isolation.  Social isolation can be a vicious circle.  We may have to stay home all the time in order to be there for our ‘person’–especially if there are no supports in place to give us a break.  However, the more isolated we become, especially if depression sets in, the less time we want to spend out in the world.
  • Loss of Relationships.  This is directly related to the degree of social isolation you may be experiencing.
  • No interest in self-care.  If you are not eating well, taking time to exercise or spend some time doing activities that you enjoy, burnout may be the reason.
The Story Continues…

Through forethought, planning, good communication with Marion and lots of support, Dorothy was able to avoid experiencing serious burnout.  Of course there were days or weeks when she felt overwhelmed, but because she felt that the care she was providing for Marion was important, she was able to get through the rough patches.

By this time, Marion was housebound due to exhaustion.  Her medication wasn’t as effective as before and for various health reasons she wasn’t a candidate for surgery that is sometimes an option for COPD patients.  Due to her lack of energy, Marion spent a lot of her day sleeping.

If someone had asked Dorothy how she was doing (we don’t often ask the caregiver, but instead focus on the person who is ill), she would have responded that she is able to handle the medical piece because of her nursing training, and the house chores as they can afford to hire help when needed.  Her biggest heartache is that she misses Marion (the ‘old’ Marion).  She misses having someone to go out with and share experiences with.  Marion isn’t psychically absent, but she sleeps most of the time, so isn’t always available.  Dorothy wonders when she stopped being Marion’s partner and became her full-time nurse.

This sense of loss is common for caregivers.  Even if they have support for the practical things, the grief experienced around this is often lonely and hard to explain to others.

What’s a Caregiver To Do?

Does the above list describing burnout sound like you?  Can you relate|?  If so, there are things that you can do.

  • Ask for help from other family members, friends, medical supports, etc.  As humans we often feel that we can do it all by ourselves, or that no one else is able to take care of our ‘person’ as well as we can…and we can’t and other’s can (though it may look different from how we would take care of them).  Do yourself and them a favour and get some support.
  • Check into support groups for the type of illness/condition that your loved has.  Many groups, such as the Alzheimer’s Society and Hopespring Cancer Support Centre offer support groups for patients and their caregivers.  Your medical supports may be able to provide advice on where to look or check out the web.
  • If you are feeling housebound due to your care-giving role,  and are computer savvy, there are on-line support groups available.
  • Let your doctor know that you are struggling–especially if you are feeling depressed, using substances or other unhealthy means as a way to cope.  There are things they can do to help by suggesting medication or referrals to other professionals.
  • No matter where you are on the care-giving journey, counselling is always an option as a tool to help you cope with negative emotions (such as anger) that can come up, inappropriate ways of coping, feeling socially isolated.  Having an impartial third party to talk to about what is going on, can release some of the stress and pressure that you feel.
The Story Still Continues…

Marion and Dorothy are still living in their home.  Marion’s health continues to decline, and Dorothy has come to terms with her ‘new’ relationship with her.  At Dorothy’s request, family members have started taking on a more active role in Marion’s care.  More and more household duties are being done by paid help or family members.

Dorothy is still grieving the loss of the ‘old Marion’ and recognizes that this is reality. She is thankful that she is able to provide so much care for her partner.

And now, let’s lighten the mood.  For those of us who are trying to figure out summer plans for our children, here’s a classic camp song from Alan Sherman…Enjoy!

 

 

 

The Caregiver’s Journey–Part 1

I recently attended a one-day conference (organized by Hospice Waterloo Region) for caregivers and professionals who support them.   As I sat with the other participants, and heard the stories of people who are actively being a ‘care partner’ for a loved one(s), I was struck by the love and dedication that helped them to make meaning of the difficult role that they had agreed to take on.  I was also aware of the feelings of exhaustion, frustration, fear and loneliness that many bravely shared as they told their stories.  This is the first in a three-part series on Care-giving.

The information in this post is a partial summation of  information that was presented by Dr. Virginia Wesson, Psychiatrist and Dr. Rhonda Feldman, Psychologist.   Both Drs. Wesson and Feldman see patients, and their families, at The Cyril & Dorothy, Joel & Jill Reitman Centre for Alzheimer’s Support and Training.

The Caregiver’s Journey

According to data presented that day, there are 3.3 Million caregivers in Ontario.  Of those, 500,000 of them are ‘young’ caregivers (falling between the ages of 6 and 25).  If as a society we were asked to pay for the caregiving services provided free-of-charge by loved ones, the bill would be in the Billions of dollars.  Wow!

Based on the numbers, if we are not personally affected  by the need to take care of a family member or friend, then we know someone who is–a friend, co-worker, other family member…the list goes on.  As people in our circle, how can we support them as they support others?  I suggest that a first step is to understand the path that they are walking.

Dr. Wesson believes that there are three stages to the caregiving process:  the early stage, the middle stage and the late stage.

The Early Stage

When a partner, spouse, close friend or family member has been diagnosed with a debilitating illness we often experience shock and grief.  While we may have suspicions that our ‘person’ has been struggling, having it confirmed can still be devastating.  We don’t know what the future really looks like, and we may feel that we are starting an ‘endless’ journey.

If we are the primary support, we can be overloaded with information by medical staff or our own research.  On the other hand, we may feel that we are being provided with little information and not sure where to turn.

Once the initial emotions subside, and if the disease in question is progressing slowly, the illness may intrude in our life, but we are able to carry on with a sense of normality.  You may be providing more emotional support vs. physical support for your loved one, taking on more of the hands-on chores that may now be more difficult and becoming a ‘manager’ of the care required by your loved one (i.e. managing medical appointments).

Coping Strategies for the Early Stage

It is during the early stage that you can start to put supports in place for the future.  Will there be physical changes that need to be made to your surroundings?  Are you aware of community organizations that can be called upon when needed?  How may other family members or friends can be asked for help?  What do you need to take care of yourself–such as self-care activities?

This is the time for planning.

The Middle Stage

By the time you have reached the middle stage, you have realized that your loved one isn’t going to get better.  Their illness is a constant consideration as you plan your day–both personally and professionally.  Some people may have decided to leave their jobs, or scale back their hours of work.  Many may be coping with the financial stresses brought on by the illness–either through loss of income or rising expenses.

Feelings of loneliness and overwhelm can be common at this stage–especially as your world is shrinking due to care-giving responsibilities that never seem to end.

Coping Strategies for the Middle Stage
  • Be realistic about what you are able to do.  Don’t be afraid to ask for help.
  • If you have not done so already, now is the time to call on your support system for help…friends, family members, outside organizations.
  • To the best of your ability, keep up with your self-care practices–eating well, exercise, and any activities that help you to cope.
  • Be aware of the abilities of your loved one, due to their illness.  It may be less frustrating when we understand that their actions are due to physical challenges vs. negativity.
  • Try to find any positive aspects or meaning  in the care-giving role.
The Late Stage

By this stage, caregivers may be feeling that “I can’t do this anymore”.  If they have had little or no support, they may be suffering from burnout.

There may be feelings of both internal and external conflict as the need to make decisions start to arise.  Internally, there’s the struggle between the guilt you could be feeling as it becomes more difficult to take care of your loved one in their home and the possibility of them moving into a place with full-time paid staff; and the recognition that continuing the current way of doing things is becoming impossible.

Family conflict may come into play if family members are not agreed on next steps, or resentments have come out regarding the sharing of care-giving duties.

Coping Strategies for the Late Stage
  • As above, be realistic about what you can do…physically, mentally and emotionally.
  • Look to your medical supports for information about what can be expected during the late stage of illness and how much care will your loved one require.
  • Access mental health support either privately or through community organizations that specialize in your loved one’s illness.  Organizations such as Cancer Support Centres, Alzheimer Society, etc. have care-giver support groups.

While it may seem like it, as a care-giver you are not alone…no matter where you are on the journey.

Next week, we’ll look at care-giver burnout and further ways to cope.

And now…a TED talk on the positive effects of exercise on the brain…Enjoy!