The Undertow in Chronic Illness and Disability

By Nancy Gordon (Guest Contributor)

Note from Dr. T: Although sometimes it seems you don't have much control over your medical situation (which is not really true in my experience), you do have control over how you view and respond to it. So although it's critical to address the physical causes of your pain, it's also very helpful to address your suffering — which is often tied to how you respond to the pain and stress.

I'm happy to share this article on stress management written by my colleague Nancy Gordon. She has "been there and done that," and is speaking from her own personal experience. Enjoy! — L&B, Dr. T

The Undertow in Chronic Illness and Disability

Is it all in your mind or is it in your body?

Your mind affects your body and your body affects your mind. It's like two sides of the same coin. So which do you deal with first when you don't feel well? Wrestling with this question itself may be one of the biggest stressors of having a chronic illness or disability.

I speak from experience. I've been in the same trenches as you. Years ago a car accident threw me into a sudden descent into the depths of disability — a devastating turn in the road that I never expected. It wasn't my intended path. I didn't sign up for the pain and depression tour. But in an instant, when the metal of our two cars collided, my path was forever changed.

In the years that followed, I struggled with the shattering impact that fibromyalgia and a mild traumatic brain injury imposed on every aspect of my life. I felt like I was imprisoned in my body, which I dubbed being a "Health Hostage™." I was consumed by the physical symptom management I needed just to get through the day. I felt an inordinate amount of stress in my prison on a daily basis.  

As a psychotherapist, I knew a lot about stress and stress management. What I didn't know was how inherently stressful it is to deal with chronic illness and disability — until I began to experience my own symptoms. I was consumed (shall I say, obsessed?) with focusing on symptom management. The endless search for pain relief was often more frustrating than the pain itself. Suddenly, all I knew about stress management seemed impossible to apply, and my body had total control of making these physical symptoms tremendous stressors.  My reaction was not good. I fell apart. My whole life fell apart. It was a life-defining moment when I finally surrendered, quit my private practice, and applied for disability.

This began my journey of redefining stress management.  Before my car accident, I relied heavily on "fixing the stress" by finding ways to eliminate it. But when you have a chronic illness or disability, you may or may not be able to fix it. And even if you do eventually find a way to heal on the physical level, you still have to deal with the stress inherent in that whole process. This is where mind and body intersect in such an intertwined way that true transformation and healing cannot really be realized without attending to all levels: mind (mental), body (physical), emotional (feelings) and Spirit (spiritual).

The word 'stress' in the Merriam-Webster dictionary is defined as "a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation." By definition then, stress affects the body and one's health. Perhaps it results in migraines/headaches, neck and shoulder pain, inability to sleep restoratively, or a worsening of other symptoms normal to your condition.

On the psychological (mind/mental) level, the Merriam-Webster dictionary defines stress as "a state resulting from a stress; especially one of bodily or mental tension resulting from factors that tend to alter an existent equilibrium." The "factors" referred to here are really what we call, in clinical terms, a "stressor." A stressor is a thing, an event, a happening (albeit not a fun happening!).  A stressor is outside of us. It is most often out of our control. There are always stressors. Pain happens. Accidents happen (by definition). Life happens.  But there is hope! How we respond (our choice) to a stressor is what we are in control of. Since life isn't without stressors, we're faced with the choice to experience the stressor as stress or not stress. In other words, while the stressor may be out of our control in this equation, our response to it is not.

Stress is a state of being that is our response to a stressor. That state-of-being response is within our control. We control our feelings of stress by our thoughts, our mind and our feelings. And therein lies our solution. Our hope. How we respond to a stressor can make the difference between merely surviving and living life to its fullest. Choosing to feel stressed often leads to depression, hopelessness, lethargy and a sense of powerlessness. This can dramatically affect your health. Experiencing so much angst about my condition for many years, my focus was on my physical symptom management.

Managing stress is about managing our thoughts and emotions as much, if not more, as is managing the stressor itself. In my case, depression became a state of angst.  My world wasn't as I intended, and I had a lot of anxiety about how to fix that. My reaction to the physical stressors (pain, lack of sleep) imprisoned me in a mindset that not only stressed me out, but also led me to believe I was powerless. That's when I lost hope…and lost my mind! And that's also how I learned to find it again, change my mind, and through practice, changed how I experienced my stressors, and freed the Health Hostage from my prison!

To help you get started, below is an exercise I created to show how to use your mind to mend your body. Give it a try and please let me know how it goes. I'd love to hear from you!

The Antidote: It's All in Your Mind

Step 1) Mind Your Mind: Awareness

Awareness is always the first step to change. Negative emotional and mental reactions (what feels like stress) can be dissolved by increasing awareness of what you think and believe. Your beliefs are everything. You can't change your mind until you know what's been lurking in the unknown shadows of your mind. This exercise has been designed to shine a light on your shadow areas.

Action: Find out what's lurking in the shadows in your mind.

• Pick one stressor you experience with a negative stress response. For instance, maybe you can't exercise anymore, and that leaves you feeling a sense of loss, depression and anxiety, maybe to the point of keeping you home bound with weight issues and other problems.
• Make a list of your beliefs about this stressor. For example, I get worse when I exercise. (You'll apply this list of your beliefs to your answers in Steps 2 and 3 below.)

Step 2) Mend Your Mind: Change Your Beliefs

While thinking about the stressor you chose in Step 1, ask yourself these questions:

• Is my belief entirely, absolutely true? For example, If you haven't actually gotten worse every time you've exercised in the past, then no, what you believe is not absolutely true.
• How can I challenge my belief? Are there conflicting facts and alternative possibilities to your belief? Ask your friends for their opinions.
• How is my current awareness of this belief affecting my behavior in a way that creates stress? Do I stay home, for instance, and allow myself to feel isolated?
• Can I modify my thoughts to change my belief? Why not, for instance, test my belief by simply choosing a different exercise than I've been doing and see how I feel?

Action: Based on these answers, create a list of modified beliefs and write them down:

• EXAMPLE: I enjoy exercising, and I only occasionally feel worse afterwards. That's a trade off worth making.
• EXAMPLE: Maybe if I drank more water during exercise and rested more immediately afterwards, then exercise wouldn't bring me down and would be fun again.
• EXAMPLE: Exercise can actually help reduce stress and anxiety, so I'm going to commit to doing it knowing that it will make me happier.
• (You get the idea. Now take a moment to write down your own list ...)

Step 3) Motivate Your Mind: Take Action

The experience of changing your mind often leads to changes in behavior. This is powerful because behavior can also change your mind, and that gives you three new tools to change your thoughts and responses. Consider this example:

1. You feel depressed. You decide not to get out of bed. You aren't moving, which may even worsen your physical condition.
2. You decide to change your mind. You get out of bed, get dressed, and go for a short walk at a pace that's good for you.
3. This walk increases your energy, starts to clear your mind, and fills your lungs with more air.
4. The next thing you realize is your mood has shifted a bit. Now that your mood has shifted, you start to respond differently to your physical symptoms and become more active.

Think about it. Changing your mind got you out of bed, and feeling better physically changed your mood. And your mood then changed how you responded to your body (symptoms). Therein lies the power of integrating healing in both the mind and body.

Action: Choose one behavior you can do to change your response and act on that today!

Become a courageous warrior and live life on your terms. Find out how at Nancy Gordon Global.