Healing Mommies is a subset of my practice dedicated to helping women with the unique issues that pregnancy and motherhood can bring up. Pregnancy and motherhood is supposed to be a joyous time but for some women it brings up feelings of fear, loss, anxiety, and doubt. For example:
• If your mom was absent physically or emotionally as you were growing up due to mental illness, jail, alcohol or drug abuse.
• A mother that was abusive or was unable to protect you from abuse.
• Sexual abuse survivors often feel out of control or anxious during pregnancy and lactation due to their changing body and the potential of medical intrusion.
• Women who have lost their moms at a young age.
In these situations and similar situations women feel anxious about their ability to mother, memories of abuse can re-surface, or the grief of losing your mom can come back once you begin to mother. These feelings are normal and with proper help most women can get relief. Addressing these feelings can allow you to better bond with your baby or child, feel more comfortable during pregnancy and labor, and reduce chances of postpartum depression or trauma. It’s my belief that happier moms = happier babies = happier families = happier communities. So taking care of yourself is really a very self-less thing to do! I offer a $10 new family discount for pregnant moms and families with children under the age of two. Please watch my website www.lindseyplumer.com and blog for more updates.
Thursday, August 19, 2010
Thursday, August 12, 2010
"She said yes...now what?"
“She said yes…now what?”
I want to thank Jackie Belau aka the Maternity Maven for a fantastic networking event where I finally got to meet some awesome care providers and businesses that cater to women, pregnant moms, little kids, and families in the Sacramento/Placer county area. Many of these care providers are midwives and doulas who routinely ask their clients about a history of trauma whether it be childhood abuse or adult abuse. 99.99% of the time I hear that the midwives, doulas, and OBs do a good job at following up when a history of trauma is indicated by a woman in their practice, but I wanted to write this as some reassurance and suggestions and reminders about how to proceed.
First of all asking and truly listening to the response can be a very healing moment for somebody that has been through abuse. By not treating that moment as another box to check off and really actively listening you are providing unconditional positive regard and support. That can be healing in and of itself. But beyond that what are some specific things that caregivers can provide?
Ask the woman where she is in her healing process. Note that I didn’t call her a victim or ask if she had been in therapy. Not all women feel like victims or even need therapy. Some women are in denial about the effect that the abuse has had on them and starting off by using words like victim or automatically referring to therapy can push her further down the path of denial or traumatize her. Moving through abuse is truly a healing process that can take on many facets and it is important to acknowledge that there are a wide range of responses to being abused.
If a woman is struggling help her identify resources in her life. These resources could range from family and friends, a spouse or partner, a counselor, a spiritual advisor, even pets and coping skills such as journaling.
Know as a provider that it is not unusual for feelings that were thought to be resolved to re-emerge as any survivor goes through developmental milestones. Milestones such as pregnancy and children are no different. This doesn’t mean that a client is “back at square one” or there is something wrong with them. In my experience as a person evolves her understanding of significant life events also has to evolve. If those life events are very difficult ones she may need a bit of additional work or support but because she has “been there, done that” with her abuse history she will already have coping tools she can use.
Ask your client if any counseling that she had in the past was helpful or not. It isn’t always helpful. Sometimes the fit between counselor/client isn’t right or the timing is off for a woman to fully process her issues. Ask her what was helpful and what was not helpful and take the time to truly listen, as this answer will give you vital information about what the woman needs right now and how you can help her get there. Have referrals available if your client chooses counseling. Make sure the referrals are trustworthy and have some ideas about a variety of sliding fee clinics if necessary. Feel free to contact me for specific suggestions on this.
Remind her that the healthier she is the better start she can give her babies, her children, her partnership, her marriage, everything. Many women feel they are too busy to re-visit these issues and that they are selfish for “indulging” in the time and money it takes to fully process a history that has come and gone. A happier mom means a happier baby, a healthier attachment for mom and baby, a healthier attachment between father and baby, a healthier family unit and I dare say that that lays the foundation for a healthier community and world. I can’t think of a better investment of time or money. Pregnancy is a time that I refer to as “emotionally porous.” So while we absolutely work with our clients to “do no harm” and provide a safe space for them to create a new life remember that we can also plant seeds of well-being and healing that can take root and blossom.
I want to thank Jackie Belau aka the Maternity Maven for a fantastic networking event where I finally got to meet some awesome care providers and businesses that cater to women, pregnant moms, little kids, and families in the Sacramento/Placer county area. Many of these care providers are midwives and doulas who routinely ask their clients about a history of trauma whether it be childhood abuse or adult abuse. 99.99% of the time I hear that the midwives, doulas, and OBs do a good job at following up when a history of trauma is indicated by a woman in their practice, but I wanted to write this as some reassurance and suggestions and reminders about how to proceed.
First of all asking and truly listening to the response can be a very healing moment for somebody that has been through abuse. By not treating that moment as another box to check off and really actively listening you are providing unconditional positive regard and support. That can be healing in and of itself. But beyond that what are some specific things that caregivers can provide?
Ask the woman where she is in her healing process. Note that I didn’t call her a victim or ask if she had been in therapy. Not all women feel like victims or even need therapy. Some women are in denial about the effect that the abuse has had on them and starting off by using words like victim or automatically referring to therapy can push her further down the path of denial or traumatize her. Moving through abuse is truly a healing process that can take on many facets and it is important to acknowledge that there are a wide range of responses to being abused.
If a woman is struggling help her identify resources in her life. These resources could range from family and friends, a spouse or partner, a counselor, a spiritual advisor, even pets and coping skills such as journaling.
Know as a provider that it is not unusual for feelings that were thought to be resolved to re-emerge as any survivor goes through developmental milestones. Milestones such as pregnancy and children are no different. This doesn’t mean that a client is “back at square one” or there is something wrong with them. In my experience as a person evolves her understanding of significant life events also has to evolve. If those life events are very difficult ones she may need a bit of additional work or support but because she has “been there, done that” with her abuse history she will already have coping tools she can use.
Ask your client if any counseling that she had in the past was helpful or not. It isn’t always helpful. Sometimes the fit between counselor/client isn’t right or the timing is off for a woman to fully process her issues. Ask her what was helpful and what was not helpful and take the time to truly listen, as this answer will give you vital information about what the woman needs right now and how you can help her get there. Have referrals available if your client chooses counseling. Make sure the referrals are trustworthy and have some ideas about a variety of sliding fee clinics if necessary. Feel free to contact me for specific suggestions on this.
Remind her that the healthier she is the better start she can give her babies, her children, her partnership, her marriage, everything. Many women feel they are too busy to re-visit these issues and that they are selfish for “indulging” in the time and money it takes to fully process a history that has come and gone. A happier mom means a happier baby, a healthier attachment for mom and baby, a healthier attachment between father and baby, a healthier family unit and I dare say that that lays the foundation for a healthier community and world. I can’t think of a better investment of time or money. Pregnancy is a time that I refer to as “emotionally porous.” So while we absolutely work with our clients to “do no harm” and provide a safe space for them to create a new life remember that we can also plant seeds of well-being and healing that can take root and blossom.
Feelings...nothing more than feelings...
The next two cognitive distortions I would like to look at are “Jumping to conclusions” and “Magnification/Minimization.” Each of these distortions has subtypes. “Jumping to conclusions” has the subtypes of mind reading and fortune telling. “Magnification/Minimization” has the subtype of catastrophizing.
An example of jumping to conclusions and mind reading would be:
“I called in sick to work twice this week because of my pain. My co-workers must think I’m lazy and hate me for having to pick up the slack.”
A thought that might be more rational and healthier would be, “I will let my boss know the chronic nature of my illness and find out what I can do so I can do my share. I will also check in with my co-workers to ensure that I can cover what I missed.”
For fortune telling the thought might go along the lines of:
“I will lose my job for sure if I keep calling in sick!” Think about the feelings this thought would bring up. Anger at your body, fear of the future and for your income, helplessness over the situation.
A healthier thought would look like, “I will communicate with my boss to see what I can do to preserve my job, including getting a doctor’s note for accommodations if need be.” A thought like this is just as rational and real as the last thought, but gives the individual power and hope.
Magnification looks like this:
“This is the worst pain ever. Everyone else is out living their lives and being healthy and I am stuck at home and in pain.”
Well….actually there are lots of people out there with varying degrees of difficulty, pain and strife that they are dealing with. A thought like this can make a person feel physically worse and helpless. A healthier thought might be:
“This is difficult but I know I’m not the only human being who deals with adversity. I will also focus on positive things going on in my life right now such as….”
Many of these distortions are so automatic we don’t even challenge them as the truth when in fact they are not completely true. When we look at these distortions in a more balanced life we free ourselves from a self-imposed set of limitations and allow for more hope, health, and healing in our bodies and lives.
Here is a wonderful book from one of the founding fathers of cognitive behavioral therapy:
An example of jumping to conclusions and mind reading would be:
“I called in sick to work twice this week because of my pain. My co-workers must think I’m lazy and hate me for having to pick up the slack.”
A thought that might be more rational and healthier would be, “I will let my boss know the chronic nature of my illness and find out what I can do so I can do my share. I will also check in with my co-workers to ensure that I can cover what I missed.”
For fortune telling the thought might go along the lines of:
“I will lose my job for sure if I keep calling in sick!” Think about the feelings this thought would bring up. Anger at your body, fear of the future and for your income, helplessness over the situation.
A healthier thought would look like, “I will communicate with my boss to see what I can do to preserve my job, including getting a doctor’s note for accommodations if need be.” A thought like this is just as rational and real as the last thought, but gives the individual power and hope.
Magnification looks like this:
“This is the worst pain ever. Everyone else is out living their lives and being healthy and I am stuck at home and in pain.”
Well….actually there are lots of people out there with varying degrees of difficulty, pain and strife that they are dealing with. A thought like this can make a person feel physically worse and helpless. A healthier thought might be:
“This is difficult but I know I’m not the only human being who deals with adversity. I will also focus on positive things going on in my life right now such as….”
Many of these distortions are so automatic we don’t even challenge them as the truth when in fact they are not completely true. When we look at these distortions in a more balanced life we free ourselves from a self-imposed set of limitations and allow for more hope, health, and healing in our bodies and lives.
Here is a wonderful book from one of the founding fathers of cognitive behavioral therapy:
Monday, August 2, 2010
Disqualifying the positive and knowing when to get professional help
The next cognitive distortion I would like to examine is "disqualifying the positive." This one is an easy trap to fall into. For example, if you had 10 tasks to do in a day and did 8 of them perfectly and 2 you had a tough time with you don't go home and think about the 8 ones you accomplished with ease, you obsess on the 2 that were difficult. An example of disqualifying the positive when it comes to coping with chronic pain would be:
"I have felt awful for the past week. It is awful living with fibromyalgia!"
Well, yes, living with fibromyalgia is really unfun at times. But a statement that would be just as accurate and more helpful to your ability to cope would be:
"I have felt awful for the past week but thankfully for four weeks prior to that I felt fantastic and it feels as if I am coming out of this flare-up. All of my flare-ups have passed at some point and this one will too."
See the difference? By looking at the big picture you give equal weight to all facts-including the fact that the days where you feel good are just as valid as the days you don't. This isn't being pollyanna-ish it is being rational. Through this rationality we can improve our ability to cope with pain and not allow it to rule our lives.
So...obviously this blog is not a substitute for professional, individualized mental health help. How do you know it's time to seek help? If you are suicidal immediately get help via an emergency room or doctor's visit. That aside, if your significant life activities are hampered by your mood it is time to get help. If it is tough to get out of bed, go to work, enjoy your relationships and hobbies due to your mood it's time to invest in yourself.
A good self-help book for depression:
"I have felt awful for the past week. It is awful living with fibromyalgia!"
Well, yes, living with fibromyalgia is really unfun at times. But a statement that would be just as accurate and more helpful to your ability to cope would be:
"I have felt awful for the past week but thankfully for four weeks prior to that I felt fantastic and it feels as if I am coming out of this flare-up. All of my flare-ups have passed at some point and this one will too."
See the difference? By looking at the big picture you give equal weight to all facts-including the fact that the days where you feel good are just as valid as the days you don't. This isn't being pollyanna-ish it is being rational. Through this rationality we can improve our ability to cope with pain and not allow it to rule our lives.
So...obviously this blog is not a substitute for professional, individualized mental health help. How do you know it's time to seek help? If you are suicidal immediately get help via an emergency room or doctor's visit. That aside, if your significant life activities are hampered by your mood it is time to get help. If it is tough to get out of bed, go to work, enjoy your relationships and hobbies due to your mood it's time to invest in yourself.
A good self-help book for depression:
Thursday, July 29, 2010
A mindbody connection to pain?
I wanted to take a little pause in the CBT series to examine a theory that addresses chronic pain. Dr. John Sarno is a professor of clinical rehabilitation medicine in New York. Dr. Sarno has written several books based on his successful cures of back and other chronic pain that he calls Tension Myositis Syndrome. Dr. Sarno believes, based on his work, that many chronic ailments are due to repressed feelings of rage and sadness. He does not suggest that these chronic pain problems are "in the mind" but says that they are very real and that the mind and body cannot he separated. Dr. Sarno's program involves first ruling out any physical acute diagnosis and then partaking in a workshop designed to help people express repressed feelings and educate individuals about this link. I have read two of his books and I admit he makes a very strong case. Either way it is important for people with chronic pain to examine their emotions and express them in a healthy way because this facilitates a reduction in pain. To find out more check out:
and
and
Monday, July 26, 2010
Coping with Chronic Pain-More Cognitive Distortions
Two more cognitive distortions I would like to discuss are "Overgeneralization" and "mental filter."
With overgeneralization people take a few instances of a certain outcome and use those instances to make wide generalizations about how life is. For example:
"That doctor wasn't empathetic or helpful. No doctor will be able to help me! It's useless to keep going back for appointments!"
A more helpful, rational statement might be something like, "That doctor wasn't very helpful. I will either make another appointment with that doctor and try again or get a referral for a second (or third) opinion until I find a doctor that I am comfortable with. My well-being is worth putting out the time and effort."
Mental filter is the next cognitive distortion I would like to discuss. With mental filter we focus on negative aspects of an event or situation while ignoring the other equally valid aspects of the event. This is like a single drop of ink tainting an entire glass of water.
An example of a mental filter distortion would be, "I had a fibro pain flare-up and I was in pain at my grandson's birthday party. The whole thing was ruined!"
A healthier, more self-preserving belief would be, "It's too bad I had to leave right after the cake was cut due to my pain, but it was so great to give my grandson a big hug and see his face light up when he opened presents. It wasn't perfect but I was glad to be there."
A person emailed me privately regarding this series and asked in essence how to adjust to a new life with chronic pain or illness after the "old" you is gone. This sort of depends on many factors but using a cognitive distortions perspective, I would encourage that person to explore what distortion is causing the most distress. For example-if you lose a bunch of weight you are no longer the "old" you but this situation is a happy, exciting one.
I would guess that there would be some all-or-nothing or mental filter distortions going on. For example,
"I was always happy before and I will never feel that way again." or
"I have a very miserable life since my diagnosis. I don't see an end to this."
More helpful and just as real thoughts would be,
"I had challenges before that took time and adjustment to learn to cope with. I will learn to cope with my pain until I can rid myself of it."
or
"I still have some great things in my life-a loving partner, good friends."
A great self-help book that is along the lines of cognitive therapy is:
Loving What Is: Four Questions That Can Change Your Life
As always this blog does not substitute the real, in person therapy that a trained doctor or mental health clinician can provide. If you are currently suicidal please call 911 or go to the nearest emergency room.
With overgeneralization people take a few instances of a certain outcome and use those instances to make wide generalizations about how life is. For example:
"That doctor wasn't empathetic or helpful. No doctor will be able to help me! It's useless to keep going back for appointments!"
A more helpful, rational statement might be something like, "That doctor wasn't very helpful. I will either make another appointment with that doctor and try again or get a referral for a second (or third) opinion until I find a doctor that I am comfortable with. My well-being is worth putting out the time and effort."
Mental filter is the next cognitive distortion I would like to discuss. With mental filter we focus on negative aspects of an event or situation while ignoring the other equally valid aspects of the event. This is like a single drop of ink tainting an entire glass of water.
An example of a mental filter distortion would be, "I had a fibro pain flare-up and I was in pain at my grandson's birthday party. The whole thing was ruined!"
A healthier, more self-preserving belief would be, "It's too bad I had to leave right after the cake was cut due to my pain, but it was so great to give my grandson a big hug and see his face light up when he opened presents. It wasn't perfect but I was glad to be there."
A person emailed me privately regarding this series and asked in essence how to adjust to a new life with chronic pain or illness after the "old" you is gone. This sort of depends on many factors but using a cognitive distortions perspective, I would encourage that person to explore what distortion is causing the most distress. For example-if you lose a bunch of weight you are no longer the "old" you but this situation is a happy, exciting one.
I would guess that there would be some all-or-nothing or mental filter distortions going on. For example,
"I was always happy before and I will never feel that way again." or
"I have a very miserable life since my diagnosis. I don't see an end to this."
More helpful and just as real thoughts would be,
"I had challenges before that took time and adjustment to learn to cope with. I will learn to cope with my pain until I can rid myself of it."
or
"I still have some great things in my life-a loving partner, good friends."
A great self-help book that is along the lines of cognitive therapy is:
Loving What Is: Four Questions That Can Change Your Life
As always this blog does not substitute the real, in person therapy that a trained doctor or mental health clinician can provide. If you are currently suicidal please call 911 or go to the nearest emergency room.
Friday, July 23, 2010
Coping with Chronic Pain-The first of a series
Many people live their lives in a silent day-to-day struggle. Right now it may be your friend, family member, or co-worker who is dealing with a diagnosis that causes chronic pain. These disorders can run from rheumatoid arthritis, back pain, fibromyalgia, migraines, or one of several chronic pelvic pain disorders such as vulvodynia, vestibulitis, or endometriosis. Some of these disorders share some common traits.
Most of these problems are known as invisible disabilities. An invisible disability is not obvious to the naked eye. The person looks healthy and yet they call in sick to work or school a lot, can't work at all or only minimally, and have difficulties in their relationships but because they appear normal people around them might pass judgment unfairly about why the person isn't working, going to school, or passing up on social invites. Many of these disorders are poorly understood not just by the public at large but also by the medical community. With vulvodynia (chronic horrible unremitting vulvar pain), for example, the average woman sees eight doctors before she receives a diagnosis. Even after a diagnosis is made many doctors who are so called specialists understand very little about how to provide relief so it can take months or years of trying different treatment or switching doctors to get relief. Additionally pain management is very poorly understood by many physicians. Because of this doctors can be reluctant to provide pain medications or even a referral to a pain management specialist despite evidence that pain medicine can vastly improve a person's quality of life and a person who is actually in pain is at a low risk for abusing pain meds.
To make matters more difficult more women than men suffer from chronic pain. This is little comfort to the men out there who are trying to cope with a chronic pain disorder. However, for many years women in chronic pain were dismissed or stigmatized by the medical community as being "hysterical" or that the pain is "all in her head" or she was "frigid" and needed to "loosen up a little." These attitudes are unfortunately still found all too easily in doctor's offices across the country, and most women who find a good doctor who is both compassionate AND competent knows that doctor is like gold. So thank you to all of you doctors, NPs, PAs, and clinicians who are both compassionate and competent.
I am going to use this series to go over some cognitive distortions that can make the emotional and relationship of pain disorders worse. I am also going to discuss how therapy can be of help and also discuss alternative therapies that you might not know about that might also offer you some emotional or even physical relief. I will go over how to make your own "emergency list" of coping tools of what to do in a pain flare-up so you can feel as if you have some control over your life. And hopefully through this I can encourage you to keep trying treatments and coping skills until you feel as if you get your life back or your pain disorder goes into remission-it does happen!
One of the best known psychotherapeutic techniques to help people who are suffering from chronic pain is cognitive behavioral therapy also known as CBT. CBT is also used to help people deal with depression, anxiety, trauma, and relationship issues. For the purpose of this series I will give examples that relate to chronic pain. There are ten common cognitive distortions and I will discuss a few per blog over the next several weeks. I encourage you, the reader, to journal about the distortion and examine your life to see if or where you are using any of these distortions in a way that is harmful to your well-being and I challenge you to substitute the distortion with more rational, healthy thoughts.
The first distortion I would like to discuss is called "All or nothing thinking." This distortion can contribute to depression and anxiety, thus making your pain physically feel worse AND having a devastating effect on your emotional well-being. It is true that somebody who is depressed or anxious about chronic pain actually experiences that pain more acutely. A clue that you are getting tripped up with all or nothing thinking is words such as "always" "never" or "ever." There are very few situations in life that are all-or-nothing.
A few examples of all-or-nothing thoughts are:
1. I will never feel better again.
2. This pain flare up will never end. I just can't cope.
3. I will always feel horrible.
4. I will never be able to work full-time because of this.
5. Nobody will ever love me if I am always sick (wow-there's TWO distortions for the price of one there!).
Some healthier examples of thoughts that are also true and more advantagous to coping are:
1. I may feel better again. After all, I have some days where I don't feel so well and some days where I feel fine. I can learn to ride out the ups and downs and be easy on myself when I am not feeling well.
2. Most of my pain flare-ups last six or seven days (or a month, etc. It is important to track your pain so you know what the REAL answer is to this question). Even if I am in daily pain some days are better than others. I have a list of coping tools that I can use to help make flare-ups more bearable such as relaxation, massage, acupuncture, and pain medications.
3. Many people who have chronic pain find some type of relief-even if it takes years. I will be one of those people and I will continue to plug away at this because my well-being and comfort is worth it.
4. It is ok to find a flexible or part-time job that will accommodate my health because my health is a priority. I will explore options such as job-sharing, self-employment, work from home, and even disability so I can remain self-sufficient. Because I'm not a fortune teller I don't know for sure that I will NEVER be able to work the future may hold physical relief or a job that fits my situation.
5. The vows of "in sickness and in health" also apply to me. I deserve to find somebody who is compassionate and mature enough to understand and be supportive of my limitations. Everybody comes to a relationship with baggage-it may be a chronic pain issue, a mental illness, a crazy family, or an annoyingly quirky love of stamp collecting. Just as I will be loving an accepting of my partner's quirks I expect my partner to work with me with mine.
These healthy thoughts in no way are meant to minimize the difficulties of living with pain. It is depressing, anxiety producing, angering, and upsetting to be in pain. But cognitive distortions don't serve us and taking an honest look at which ones we may be self-harming with help us break out of patterns of depressive or anxious thoughts and move forward to feel better both physically and emotionally.
Next entry will cover a few more cognitive distortions. Here are a few books/CDs that I think are helpful for coping:
Pain Free 1-2-3: A Proven Program for Eliminating Chronic Pain Now
Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach Workbook (Treatments That Work)
The Mindbody Prescription: Healing the Body, Healing the Pain
Most of these problems are known as invisible disabilities. An invisible disability is not obvious to the naked eye. The person looks healthy and yet they call in sick to work or school a lot, can't work at all or only minimally, and have difficulties in their relationships but because they appear normal people around them might pass judgment unfairly about why the person isn't working, going to school, or passing up on social invites. Many of these disorders are poorly understood not just by the public at large but also by the medical community. With vulvodynia (chronic horrible unremitting vulvar pain), for example, the average woman sees eight doctors before she receives a diagnosis. Even after a diagnosis is made many doctors who are so called specialists understand very little about how to provide relief so it can take months or years of trying different treatment or switching doctors to get relief. Additionally pain management is very poorly understood by many physicians. Because of this doctors can be reluctant to provide pain medications or even a referral to a pain management specialist despite evidence that pain medicine can vastly improve a person's quality of life and a person who is actually in pain is at a low risk for abusing pain meds.
To make matters more difficult more women than men suffer from chronic pain. This is little comfort to the men out there who are trying to cope with a chronic pain disorder. However, for many years women in chronic pain were dismissed or stigmatized by the medical community as being "hysterical" or that the pain is "all in her head" or she was "frigid" and needed to "loosen up a little." These attitudes are unfortunately still found all too easily in doctor's offices across the country, and most women who find a good doctor who is both compassionate AND competent knows that doctor is like gold. So thank you to all of you doctors, NPs, PAs, and clinicians who are both compassionate and competent.
I am going to use this series to go over some cognitive distortions that can make the emotional and relationship of pain disorders worse. I am also going to discuss how therapy can be of help and also discuss alternative therapies that you might not know about that might also offer you some emotional or even physical relief. I will go over how to make your own "emergency list" of coping tools of what to do in a pain flare-up so you can feel as if you have some control over your life. And hopefully through this I can encourage you to keep trying treatments and coping skills until you feel as if you get your life back or your pain disorder goes into remission-it does happen!
One of the best known psychotherapeutic techniques to help people who are suffering from chronic pain is cognitive behavioral therapy also known as CBT. CBT is also used to help people deal with depression, anxiety, trauma, and relationship issues. For the purpose of this series I will give examples that relate to chronic pain. There are ten common cognitive distortions and I will discuss a few per blog over the next several weeks. I encourage you, the reader, to journal about the distortion and examine your life to see if or where you are using any of these distortions in a way that is harmful to your well-being and I challenge you to substitute the distortion with more rational, healthy thoughts.
The first distortion I would like to discuss is called "All or nothing thinking." This distortion can contribute to depression and anxiety, thus making your pain physically feel worse AND having a devastating effect on your emotional well-being. It is true that somebody who is depressed or anxious about chronic pain actually experiences that pain more acutely. A clue that you are getting tripped up with all or nothing thinking is words such as "always" "never" or "ever." There are very few situations in life that are all-or-nothing.
A few examples of all-or-nothing thoughts are:
1. I will never feel better again.
2. This pain flare up will never end. I just can't cope.
3. I will always feel horrible.
4. I will never be able to work full-time because of this.
5. Nobody will ever love me if I am always sick (wow-there's TWO distortions for the price of one there!).
Some healthier examples of thoughts that are also true and more advantagous to coping are:
1. I may feel better again. After all, I have some days where I don't feel so well and some days where I feel fine. I can learn to ride out the ups and downs and be easy on myself when I am not feeling well.
2. Most of my pain flare-ups last six or seven days (or a month, etc. It is important to track your pain so you know what the REAL answer is to this question). Even if I am in daily pain some days are better than others. I have a list of coping tools that I can use to help make flare-ups more bearable such as relaxation, massage, acupuncture, and pain medications.
3. Many people who have chronic pain find some type of relief-even if it takes years. I will be one of those people and I will continue to plug away at this because my well-being and comfort is worth it.
4. It is ok to find a flexible or part-time job that will accommodate my health because my health is a priority. I will explore options such as job-sharing, self-employment, work from home, and even disability so I can remain self-sufficient. Because I'm not a fortune teller I don't know for sure that I will NEVER be able to work the future may hold physical relief or a job that fits my situation.
5. The vows of "in sickness and in health" also apply to me. I deserve to find somebody who is compassionate and mature enough to understand and be supportive of my limitations. Everybody comes to a relationship with baggage-it may be a chronic pain issue, a mental illness, a crazy family, or an annoyingly quirky love of stamp collecting. Just as I will be loving an accepting of my partner's quirks I expect my partner to work with me with mine.
These healthy thoughts in no way are meant to minimize the difficulties of living with pain. It is depressing, anxiety producing, angering, and upsetting to be in pain. But cognitive distortions don't serve us and taking an honest look at which ones we may be self-harming with help us break out of patterns of depressive or anxious thoughts and move forward to feel better both physically and emotionally.
Next entry will cover a few more cognitive distortions. Here are a few books/CDs that I think are helpful for coping:
Pain Free 1-2-3: A Proven Program for Eliminating Chronic Pain Now
Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach Workbook (Treatments That Work)
The Mindbody Prescription: Healing the Body, Healing the Pain
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