You wake up and it’s still there; that dull pain in your body that reminds you of your chronic condition. You feel like staying in bed all day, but you know that would leave you in even worse shape. So, what can you do to get through the day? Here are five ways to manage daily chronic pain:
Begin to breathe – with intention.
Yes, breathing is essential to live, but doing mindful breathing can calm our body, focus our mind, and alleviate stress. Sit comfortably with your eyes open or closed. Start by breathing in and out, noticing the rise and fall of your breath, and the sensations in your body (shoulders, stomach, nostrils). Notice all the sensations all around you (smells, sounds, presence). Take deep breaths through your nose as slow and controlled as possible, and exhale through your mouth as slow and controlled as possible. Try to make this process of breathing in and out last for a total of 7 seconds or more. Refocus your gaze to end the exercise.
Be realistic of daily goals.
The busyness of life doesn’t stop for someone who has chronic pain. Those of us who have daily pain, however, need to prioritize daily activities and goals based on how we are feeling on any given day. It’s a hard pill to swallow realizing that we can’t do it all. Start with having just one or two things on your “to do,” list for the day, week, or month. Empty the dishwasher, check. Pick up library books, check. Starting small and completing a short list of manageable goals will reward you with a great sense of accomplishment.
Get moving.
Even though our natural tendency is to want to curl up in a ball when we are in pain, staying stationary is one of the worst things we can do. Our brain and body need stimulation and range of motion to heal and to cope with pain. Staying active may look different to people based on their pain. For some, a successful active session can be as simple as walking down the block and back each day and for others, doing moderate cardio activity for 20 mins a couple times of week is right for them. Change it up every once in a while to make exercise fun and interesting. Don’t forget to add some intensity or to lengthen the duration of your exercise sessions every now and then. Doing too much too soon may backfire, but test your limits – you never know if you can do something until you try!
Rest well
Alternate your day between periods of activity and periods of rest. Start by setting aside just 30 mins of your day to rest your body and mind well. By well, I mean ‘set the stage’ to help you have the best rest possible. Based on your pain, find a comfortable place to rest with some of the following: low light, heat pack, ice packs, eye patches, soft music, a mindfulness meditation app or even have a hot bath. Maximize your time of rest and it will help get you through other parts of your day!
Tap into your spiritual side
Yes, this may be uncharted territory for some, but reading, journaling, praying, making art, or listening to something meaningful can help you to self-reflect, manage your emotions, set goals, and can really put things in perspective. There are times in your chronic pain experiences where you will need to draw inner strength, so make sure to build it up!
For many of us, chronic pain is here to stay so we might as well learn how to cope….HAVE HOPE.
Want to learn a new way to cope with your chronic condition or chronic pain? I am leading a new course on chronic condition and chronic pain management through mindfulness based art practices in January. See below and check it out, I’d love to have you!
Meg Neufeld, (MA) is the co-founder of Alongside You, an integrated health clinic that offers yoga, pelvic rehab, registered dietitian services, clinical counselling, group therapy, and therapeutic arts. As a cultural anthropologist and an artist herself, Meg seeks to make art accessible to people of different abilities, diagnosis and age. She is trained in Mindfulness-Based Art Therapy practices and has a particular interest in using art as a pain-management strategy in her own life.
Whether you have kids or not, you’re likely aware that the parenting experience is often extraordinarily challenging. Young children are wonderfully headstrong, and their deep sense of fairness ensures that rules, when enforced (regardless of their rationality), carry the risk of tears, screaming, or both. The temptation to rationally explain to an upset four-year-old why he “can’t” hit his baby sister, or draw on the floor, or keep the dead bird he found in the backyard, is a trap many of us fall into – and it turns out not to work very well.
Kids often appear selfish, and rightly so: they haven’t had a chance to develop the higher order brain structure that adults have (the human brain generally takes until the age of 25 to fully develop). Consider this long developmental span (and the frustration that means for parents!), a trade-off for humans being so incredibly awesome; other species’ brains develop quite quickly by comparison. Childhood is the time when our brain does almost all of its developing.
From the time we are born, our “base” brain is the most active, controlling all of our necessary biological functions such as breathing, heart rate, thirst, temperature and so on. As we go through childhood, our “emotional,” brain develops: it controls emotion, facilitates the formation of our significant trusting relationships, assigns significance and memory to events, and determines much of our motivation, among other things. It isn’t until late childhood and early adulthood that we really begin to develop our executive brain, which allows us to reason and act appropriately and flexibly to the situations we encounter. Since the “emotional,” brain is associated with survival functions, negative emotions feel intensely painful and threatening to children, and trivial issues may seem like a matter of life and death. We can’t expect kids to simply “behave,” because we have told them something 1000 times – biologically, they are in survival mode.
Another fun fact – kids have very little conscious awareness of when they’re tired, or hungry, have extra energy that needs expanding, or have had enough attention (which is a real need for all of us). They also aren’t yet endowed with the ability to ask for what they need when they need it: rarely will you hear your child politely ask you for “a moment of your time at your earliest convenience.” We have the responsibility of ensuring their four “tanks,” are as full as possible: their hunger tank, their sleep tank, their exercise tank, and their connection tank. Kids’ appetites for attention are great, but not insatiable; often once they’ve had their fill of it, they will generally run quite nicely on their own.
A central task of what we call brain-based parenting is that of building resiliency – preparing our child’s brain for the stressful situations it will encounter as an adult; i.e., not getting what they want, or enduring conflict, sadness, and heartbreak. We can do that with consistency, love, and warmth, amongst other things. It’s important for us to remember during a meltdown that our child’s brain is overloaded; they couldn’t behave, even if they really wanted to. Young children, especially, are physically incapable of holding mixed feelings. The best thing we can do is provide the connection and safety they need to make it through. They may not be able to regulate alone, but we can help them to do so.
When your child has a meltdown, or you sense one coming, remind yourself that this is normal, which will be especially difficult in public if you’re feeling the acute shame of the scene you might be creating. Then, try some of these techniques:
Take a moment to gather them with eye contact or touch and warmth when possible (Gordon Neufeld calls this “collecting”). By doing this, you activate the attachment response, inviting them into relationship and reinforcing your unwavering desire to understand them.
Crouch to at or below their eye level. Dan Siegel and Tina Payne Bryson, authors of The Whole-Brain Child, show how getting down to a child’s level keeps threat-level low (imagine being confronted by someone four times your size!). By towering over a child, we risk activating and overloading their mid-brain circuitry beyond what it can handle.
Listen to their screams or cries with as much empathy as you can muster. Pretend, if it helps, that the two of you are teaming up against the tantrum. Hold them if they need to be held, hear them if they need to be heard, no matter how inane their words might seem. Sometimes a warm and simple, “I can tell that you really, really want to keep that dead bird,” goes a long way towards making them feel heard.
The calmer you are, the easier your child can use your calm to help regulate their own emotion. If the normally safe mom and dad are in panic or anger mode, it’s hard to blame kids for feeling overloaded. You can also teach your kids to breathe deeply when they are feeling overwhelmed, sad or stressed. Our bodies respond very well to deep breaths when stressed.
Be curious about what is going on in yourself and in your child. This is a teaching moment for both of you. See if you are able to notice and observe your own impulsive reactions to your kids’ actions. These situations can be seen as a challenge to overcome, rather than a disaster to stop or avoid at any cost.
Suffering through tantrums alongside your child will help you understand and know their needs at a deeper, more intimate level, which will strengthen the bonds between the two of you and help you to see the signs earlier next time. I use the word suffer intentionally; these situations aren’t fun. We’re going to feel like we’ve screwed up time and time again, are going to acutely feel the disapproving glares of strangers at the supermarket, and may try the techniques in this post only to find they often don’t seem to work. Above all, try to find some grace for yourself. Maybe your own tanks need refilling, or your brain needs a break – we’re all just learning. Maybe this time he can just keep the stupid bird, and when he’s asleep, it will miraculously find its way to bird heaven.
If you have questions about this, or you’d like to learn more, there are many resources for brain-based parenting across the lifespan. Search the web, check out the list below, or email me directly at john@alongsideyou.ca.
One of the questions I get quite often is, “You’re a counsellor, why do you have all of these other people in your office?” These questions have become more frequent over the years, especially when we opened our yoga studio this past March. What on earth does yoga have to do with mental health? The simple answer? Lots. We have been very intentional about the disciplines we’ve incorporated into our clinic and there is a research based-rationale for everything. The bottom line answer as to why we have all the various disciplines we do is because they work – and moreso, as much as I am a counsellor and believe in the type of work that we do, I know that it is only one way to approach a difficulty, and to fully help the clients we have, an integrated approach is most helpful.
The Body and the Mind
Throughout history, the body and the mind have mainly been thought of as two separate entities. Dualism has been a predominant thought for centuries in many cultures, particularly Western. Eastern cultures have had less of a dichotomous view, and Western culture and medicine are starting to take a more unified view of the body and mind. This is being supported by much of the research on human anatomy, physiology, psychology, and the therapeutic techniques available to us.
Although once thought to be separate entities, the body and the mind are indeed very connected. There is new research being done on the Vagus nerve and autonomic nervous systems, driven by the Polyvagal Theory of Stephen Porges, that is showing just how connected the body and the brain are and how this impacts treatment. Without getting bogged down in neuroscience and human physiology, what is the implication for us at Alongside You and you as our clients?
There is more that one way to treat mental health, and counselling, while effective, is only one part of the solution.
Nutrition
If the body and the mind are so intimately connected, then it would stand to reason that what we consume matters! We already know that what we eat has a direct impact on our bodies; well, if that’s true, then we can assume that it affects our brains as well! One of the examples of this in my own life is when I discovered how much water intake impacted my wellbeing. Common sense would suggest that since our body and brain are comprised primarily of water, making sure that my water intake was up to par would be important. I am not always a smart man. However, I was having difficulty staying awake at my desk in the hospital, and maintaining focus. I don’t remember how I got the idea, but I consciously made an effort to drink 2 litres of water a day and suddenly I had more energy, could focus better and felt human again! Needless to say, it’s been about three years and I’ve continued this practice and can tell you that it’s one of the best changes I’ve ever made. For more information on the importance of nutrition, you can see our article here and here.
Yoga
Brenna and I have both written on the subject of yoga before, but what I want to point out is the bi-directionality of influence between the body and the mind. We know that the mind affects the body. Using guided imagery, meditation, and other techniques can help regulate heart rate, blood pressure, and more! I know from my own practice that mindfulness helps me keep these in check better than almost anything else.
Similarly, the body helps regulate the mind and our emotions. This isn’t new – I remember learning in undergraduate psychology at UBC that simply smiling will actually help us feel subjectively happier. Similarly, our breathing can impact our anxiety levels significantly. A technique I use with clients is one that I picked up from Dr. Marsha Linehan at a conference a few years back – it’s simple: breathe out slower than you breathe in. Try it – it works. It actually works so well that she gives a medical disclaimer that if lowering your heart rate or blood pressure could be a bad idea, don’t do it! Consider yourselves warned!
What I’m most excited about with yoga is the research coming out, primarily from Besel Van Der Kolk and David Emerson, showing that Trauma Sensitive Yoga is a very effective adjunct to psychotherapy and can sometimes be just as effective, if not more effective than counselling for recovery in people who have experienced trauma, even on its own. This is so promising for clients who are nonverbal, clients who are stuck in the symptoms of PTSD, clients who are not able to talk about their trauma, and more! You can read more about what we do with yoga here. I cannot be more excited about the results we’re seeing with our clients in our yoga program.
Art
One of the most common questions I get is “Why do you have an art studio in a health clinic?” The answer is simple: because it helps people recover. It is not about being the best artist (thank goodness or I wouldn’t be allowed to set foot in there), becoming the next Picasso or Monet, or painting the perfect sunset. It’s about finding a way to express your emotions, build community, meet new people, encourage each other, and so much more in a non-threatening environment where you’re free to simply create, explore, and restore your sense of self, your relationships, and your passions. I get to see teens engage in new creative mediums, families bond over art and communicate with each other, seniors join with the younger folks to enjoy an activity and pass on some of their wisdom, and people of all abilities working together, and around each other, and being accepted. Art heals. If you want to read more about it, check this article out, or maybe this one!
Conclusion
I could go on forever about why integrated care is so important, but the bottom line is because the body, the brain, and the soul are all integral parts of healing and we need to pay attention to all of them if we want to help people. We’re still a young clinic and we can’t do it all, but we’re trying to take a well-rounded approach to care. If we can help the body, and we can help the brain, and we can help the soul, people recover.
If you’d like to talk further, please feel free to give us a call. We’d love to connect with you. If you’re not sure what the right way to go is, we’re happy to explore that with you.
If you’re interested in exploring Mindfulness, check out this article by Brenna and our upcoming workshop on July 28th!
If you’d like to try some art, we have our Open Studio Sessions and a series of pop-up workshops on various topics this summer, check out our events calendar here!
Something that I hear consistently from parents of teenagers is a concern that their teens are engaging in certain behaviours “for attention.” Sometimes they reference the way their teens are dressing or acting, the company they are keeping, the level of emotion on display, or even behaviours they have had the misfortune of witnessing, such as cutting, destructive eating habits or threats of suicide.
The level of fear and frustration is understandable when you witness your teen engaging in behaviours such as these, specifically those that are destructive. However, I have noticed that the way in which many parents choose to address behaviours they perceive to be “attention-seeking,” is to not “give in to them,” which is to ignore them. The belief is that by giving in to it, they are “rewarding,” the behaviour. Further, if they dry up the well of attention the logic is that the teen will discontinue the behaviour. The reality is that most of the time, this is not a very effective strategy. Often what happens is that the behaviour goes into high gear, or the teen turns to others – peers, online connections, social media – to meet the need for attention. So, what can parents do to parent an “attention seeking,” teen? The answer is relatively simple:
GIVE YOUR TEENAGER ATTENTION
Since as a culture we seem to abhor the idea of attention-seeking, we often don’t realize how healthy a cry for attention really is and how it is actually a basic human need. We can liken the need for attention as humans to our need for air, water, and food. It is an emotional need that is as valid as any and all of our physical needs. When people can’t satiate their need for attention, and if they don’t have the ability or maturity to recognize this need and seek it in healthy ways, they will instead turn to unhealthy means of attention-seeking to meet the need. The alternative to meeting the need is just shutting down emotionally and “not caring,” anymore. Often this is when suicide is a higher risk and other destructive means of coping become more out of control because there is nothing left emotionally to pull oneself back from these options.
Our teens will seek attention naturally, and we need to give it to them. The parent-child relationship is one that will form the foundation for every relationship they have for the rest of their lives. There is no investment of time that is more important than this. This is what much of the literature out there refers to as attachment and its importance cannot be overstated.
When parents first tell me that their teen is attention-seeking in unhealthy ways, one of my first thoughts is of gratitude that the teen hasn’t given up on life, on attempting to meet their needs at least in some way. My second thought is, how can I help this parent reframe the need for attention as a healthy, life-seeking need, and then how do I help them learn how to meet this need in healthy and successful ways. Because the primary issue is not that they are seeking attention, but that they are doing so in unhealthy, potentially dangerous ways. So how do we give them attention in healthy ways as parents? Here are some ideas:
Find out what they are interested in, and engage them in that. If they are into music, listen with them, ask them about it. Video games? Play with them. The outdoors? Take them out for a hike. Lavish them with the love and attention you have for them in a language they will understand and respond to the most.
Listen to them, and when they speak, hear them. Don’t write off their big feelings and emotions – the teenage years are a hard time of confusing feelings and big developmental changes – make space and time for these feelings, and be understanding.
Don’t wait for them to come to you – go to THEM. Many parents will say things to their teens like, “If you ever have any questions about anything, feel free to ask!” This has a lovely intention, but here’s the thing: 9 times out of 10, they won’t take the initiative. Go to them and ask questions, make contact, show them you are interested in their thoughts, ideas, future plans, hopes, dreams. Ask them how they’re coping, and if they need some support. Be present.
DON’T give up.
And finally, if there is anything that we can do to support you at Alongside You, don’t hesitate to reach out or call604-283-7827 ext. 707.
Case Studies in Metro Vancouver, bases on real life experiences
Case Study#1: Ten year old Motor Vehicle Accident (MVA) resulting in the following chronic symptoms:
Soft tissue injury in upper back and neck, exacerbated by a fall onto the left elbow.
Results after one month, using Physical Yoga Therapy and Techniques:
Easing of pain in shoulder, which has resulted in improved sleep at night
Greater mobility in movement of shoulders and arms
Greater mobility and range of motion in neck
Improved posture
Improved mobility in hips
Arthritis in facet joints, brought on by MVA:
Results after one month, using Gentle Yoga Therapy and Techniques:
Nurture and maintenance of spine flexibility
These improvements have resulted in our client having more energy, and mental clarity, being free from the exhausting pain. The client also now knows and has the ability to self-regulate and correct as necessary. The client will move forward with back strengthening techniques, but for now is just enjoying being relatively pain free.
Case Study #2: Lung surgery in adolescence – Resulting in severe Apnea until present age of early sixties, including misaligned left shoulder and hip due to compensating for breathing imbalance.
Results after two and a half months, using a combination of Physical Yoga Therapy and Trauma Sensitive Yoga Therapy Techniques:
no longer anticipating the next breath
improved posture, increased lung capacity for the breath
shoulder position greatly corrected with posture
increased left hip mobility with a greater range of motion
client demonstrates greater confidence and a lighter, happier state of being
Case Study #3: Previous student of yoga for many years. No longer able to practice due to fibromyalgia, depression, anxiety, resulting in tension in jaw & neck.
An example of how what happens in the mind is reflected in the body.
Results after 3 months, using a combination of Physical Yoga Therapy and Trauma Sensitive Yoga Therapy Techniques:
Noticeable decrease in anxiety. The client demonstrates a lighter presence where there used to be heaviness
Release techniques have greatly reduced the jaw and neck tension
Gentle therapeutic program, designed for the client’s particular needs, has allowed for a return to home-based practice and resulting in becoming comfortable in one’s body, and eventually returning to group sessions
Trauma Sensitive Yoga Therapy breathing techniques and guided meditation to rest the body and mind, enables the client to stabilize and stay grounded
Gain key ability to tune in and listen to one’s body in order to be able to self-regulate at first sign of tension, anxiety and stress
Letting go of anxiety and tension using gentle therapeutic yoga practice, the aches from the fibromyalgia have decreased due to improved circulation, and the release of uptight muscles and joints
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Our yoga focuses on addressing the root of the issue before deciding, alongside you, what the goal of your yoga practice is and how to address this through therapeutic yoga. Your planning with our professionals will look at your overall physical, mental, emotional, and spiritual wellbeing and how therapeutic yoga can help you address these areas.
In honor of world book day, we thought we’d give you some examples of awesome books we’re using in the art studio! Check out your local bookstores for some of these titles and maybe you’ll find other gems out there! Feel free to share books you are reading, we’d love to hear from you!
1. Living Artfully: Create the Life You Imagine by Sandra Magsamen (2006) is about how to enrich your daily life in new and creative ways.
2. Imagination in Action: Secrets for Unleashing Creative Expression by Shaun McNiff (2015) shares stories and insight from therapists and educators who are using artistic and creative activities as a way to spark the creative process. Different techniques are described and case studies are explored.
3. Kesu’: The Art and Life of Doug Cranmer Jennifer Kramer (2012) records the life and times of Doug Cranmer, a renowned Kwakwaka’wakw artist know for his big personality and with a fierce love for his culture, his community, and teaching others. Meg Neufeld had the pleasure of meeting and interviewing Doug Kranmer in Alert Bay, BC, and her research has been incorporated into parts of this publication as one of his last interviews before he died.
4. Knitting Stories: Personal Essays and Seven Coast Salish-inspired Knitting Patterns by Sylvia Olsen takes a close look at Cowichan-style knitting designs through personal stories about history, family, culture, community and more recent fusions of the art. It contains beautiful photographs of both ancient and contemporary knitting designs that are interwoven with personal stories.
5. Journaling As a Spiritual Practice by Helen Cepero (2008) is book for beginners as well as experience journal writers that helps you go beyond the surface and guide with your relationship to God. Based on the authors own experience, each chapter contains journaling practices and helps to sharpen your focus on your spiritual journey.
6. Creating Together: Participatory, Community-Based, and Collaborative Arts Practices and Scholarships Across Canada (2005) by editors Diane Conrad and Anita Sinner explores newly developed approaches to research that combines art practices into community-based collaborative projects. Outlining several case-studies, contributors discuss art forms such as writing, mural projects, photography, and expressive arts, highlighting the positive and more challenging issues that arise during the process of creating and sharing collective knowledge.
7. Micawber by John Lithgow and illustrator C.F. Payne (2005) share a delightful children’s story about a squirrel who loves to paint. In order to explore his passion for painting, Micawber becomes a stow away in a painter’s bag, creating beautiful works using the tip of his tail. This inspiring stories shares that everyone can create, even a squirrel!
8. The Artist and Me by Shane Peacock and illustrator Sophie Casson (2015) explores the eccentric life of Vincent can Gogh in France in the 1880s who was mocked for looking unusual and creating strange paintings. No one was buying his paintings, yet he continued to paint. Using some of van Gogh’s famous paintings as a backdrop, this fictional story follows a young boy and his negative attitude towards the painter. By following van Gogh around, the boy’s attitude changes as he learns that everyone’s point of view is valuable.
