Living a Healthy Life with Chronic Pain (15 page)

There is strong evidence in the medical literature of the relationship between spirituality and health. According to the American Academy of Family Physicians,
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spirituality is a way to find meaning, hope, comfort, and inner peace in our lives. Many people find spirituality through religion. Some find it through music, art, or a connection with nature. Others find it in their values and principles.

Many people are religious and like to share their religion with others. Others do not practice a specific religion but do have spiritual beliefs. Our religion and beliefs can bring a sense of meaning and purpose to our lives. They can help us put things into perspective, set priorities, and find comfort during difficult times. Strong belief systems can help us with acceptance and motivate us to make difficult changes. Being part of a spiritual or religious community offers a source of support when needed and the opportunity to help others.

Recent studies find that people who belong to a religious or spiritual community or who regularly engage in religious activities such as prayer or study have improved health. There are many types of prayer, any of which may contribute to improved health. Asking for help, direction, or forgiveness is one form of prayer. Offering words of gratitude, praise, and blessing is another. In addition, many religions have a tradition of contemplation or meditation. Prayer and mediation are probably the oldest of all self-management tools. We encourage you to explore your own beliefs about what makes life meaningful and gives you hope. If you are religious, try engaging in prayer consistently. If you are not religious, consider adopting some form of reflection or meditative practice.

Also, if you are religious, consider telling your doctor and care team. Although they won’t ask, it is helpful for them to understand the importance of your beliefs in managing your health and life. Most hospitals have chaplains or pastoral counselors. Even if you are not in the hospital, these spiritual leaders will probably make time to talk with you. Choose someone you feel comfortable with. Their advice and counsel can supplement your medical and psychological care.

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   To order the Relaxation for Mind & Body CD, go to
www.bullpub.com/catalog/relaxation-for-mind-and-body

Consider employing these additional valuable techniques to clear your mind, calm your nervous system, positively shift your emotional state, and reduce your tension and stres

Mindfulness involves keeping your attention in the present moment, without judging it as happy or sad, good or bad. It encourages living each moment—even painful ones—as fully and as mindfully as possible. Mindfulness is more than a relaxation technique; it is an attitude toward living. It is a way of calmly and consciously observing and accepting whatever is happening, moment to moment.

This may sound simple enough, but our restless, judging minds make it surprisingly difficult. As a restless monkey jumps from branch to branch, our mind jumps from thought to thought.

To practice mindfulness, focus on the present moment. The “goal” of mindfulness is simply to observe—with no intention of changing or improving anything. But people are positively changed by the practice. Observing and accepting life just as it is, with all its pleasures, pains, frustrations, disappointments, and insecurities, enables you to become calmer, more confident, and better able to cope with whatever comes along.

To develop your capacity for mindfulness, follow the instructions below:

• Sit comfortably on the floor or on a chair with your back, neck, and head straight, but not stiff.
  

• Concentrate on a single object, such as your breathing. Focus your attention on the feeling of the air as it passes in and out of your nostrils with each breath. Don’t try to control your breathing by speeding it up or slowing it down. Just observe it as it is.
  

• Even when you resolve to keep your attention on your breathing, your mind will quickly wander off. When this occurs, observe where your mind went: perhaps to a memory, a worry about the future, a bodily ache, or a feeling of impatience. Then gently return your attention to your breathing.
  

• Use your breath as an anchor. Each time a thought or feeling arises, momentarily acknowledge it. Don’t analyze it or judge it. Just observe it and return to your breathing.
  

• Let go of all thoughts of getting somewhere or having anything special happen. Just keep stringing moments of mindfulness together, breath by breath.
  

• At first, practice this for just five minutes, or even one minute at a time. Eventually, you
  may wish to gradually extend the time to 10, 20, or 30 minutes.
  

Because the practice of mindfulness is simply the practice of moment-to-moment awareness, you can apply it to anything: eating, showering, working, talking, running errands, or playing with your children. Mindfulness takes no extra time. According to new scientific studies, the practice of mindfulness is linked to positive changes in areas of the brain associated with memory, learning, and emotion. Considerable research has demonstrated the benefits of mindfulness practice in relieving stress, easing pain, improving concentration, and relieving a variety of other symptoms.

The quieting reflex technique was developed by a physician named Charles Stroebel. It will help you deal with short-term stress such as the urge to eat or smoke, succumb to road rage, or react to other annoyances. By activating what’s called the sympathetic nervous system, this technique relieves muscle tightening, jaw clenching, and stops you from holding your breath. It should be practiced frequently throughout the day, whenever you start to feel stressed. It can be done with your eyes opened or closed.

To engage in the quieting reflex exercise, follow the steps outlined below:

1. Become aware of what is annoying you: a ringing phone, an angry comment, the urge to smoke, a worrisome thought—whatever.
   
2. Repeat the phrase “alert mind, calm body” to yourself.
   
3. Smile inwardly with your eyes and your mouth. This stops facial muscles from making a fearful or angry expression. The inward smile is a feeling. It cannot be seen by others.
   
4. Inhale slowly to the count of three, imagining that the breath comes in through the bottom of your feet. Then exhale slowly. Feel your breath move back down your legs and out through your feet. Let your jaw, tongue, and shoulder muscles go limp.
   

With several months’ practice the quieting reflex becomes an automatic skill.

Many of us suffer from what has been called “nature deficit disorder,” but it can be readily cured with regular doses of the outdoors. For thousands of years, exposure to natural environments has been recommended for healing. Taking a break from artificial lighting, excessive computer and TV screen time, and indoor environments can be restorative. A brief walk in a park or a longer visit to a beautiful outdoor environment can restore the mind and body. When the weather is poor, visit a garden nursery to inhale the fragrance of the flowers and see the color and beauty. Or bring nature indoors with plants, pets, and nature photography. Even a few minutes of playing with or stroking a pet can lower blood pressure and calm a restless mind.

Worrisome negative thoughts feed anxiety. But we can’t ignore negative thoughts forever. Ignored problems have a way of thrusting themselves back into our consciousness. You’ll find it easier to set aside worries if you make time to deal with them.

Set aside 20 to 30 minutes a day as your “worry time.” Whenever a worry pops into your mind, write it down and tell yourself that you’ll deal with it during worry time. Jot down the little things (Did Linda take her lunch to school?), the not-so-little things (What will I do if my pain gets worse and I can’t make my granddaughter’s birthday party?), and the big ones (Will our children be able to find jobs?).

Sometimes you can relieve stress and break the cycle of negative thoughts by shifting your perspective. If you find yourself upset, ask, “How important will this be in an hour, a day, a month, or a year?” This reframing can help you differentiate between things that are really important and need action versus the more minor annoyances that capture your attention.

During your scheduled worry time, don’t do anything except worry, brainstorm, and write down possible solutions. For each of your worries, ask yourself the following questions:

• What is the problem?
  

• How likely is it that the problem will occur?
  

• What’s the worst that could happen?
  

• What’s the best that could happen?
  

• How would I cope with the problem if it does occur?
  

• What are possible solutions?
  

• What is my plan of action?
  

Be specific. Instead of worrying about what might happen if you lose your job, ask yourself how likely it is that you will lose your job. And if you do lose it, brainstorm about what you will do, with whom, and by when. Write a job search plan.

If you’re anxious about getting seasick on a boat trip and not making it to the bathroom in time, imagine how you would manage the situation. Ask yourself if any of this is really unbearable. Tell yourself you might feel uncomfortable or embarrassed, but you’ll survive. Research ways to mitigate or avoid seasickness.

Remember, if a new worry pops up after your scheduled worry time, just jot it down for your next session. Then distract yourself by refocusing intently on whatever you are doing.

Scheduling a specific worry time can cut the amount of time you spend worrying by at least a third. If you look at your list of worries later, you’ll find that the vast majority of them never materialized. Or they were not nearly as bad as you had anticipated.

One of the most effective ways to improve your mood and overall happiness is by focusing your attention on what’s going well in your life. For what are you grateful? Psychologists have done research to demonstrate that people can increase their happiness by practicing gratitude exercises. We encourage you to try these three:

• Write a letter of thanks
  . Write and then deliver a letter of gratitude to someone who had been especially kind to you but had never been properly thanked. Perhaps it’s a teacher, a mentor, a friend, or a family member. In the letter, express your appreciation for the person’s kindness. The letter will have more impact if you include some specific examples of what the recipient has done for you. Describe how the actions made you feel. Ideally, read your letter to the person, face-toface if possible. Be aware of how you feel, and watch the other person’s reaction.
  

• Acknowledge at least three good things every day
  . Each night before bed, write down at least three things that went well today. No event or feeling is too small to note. By putting your gratitude into words, you increase appreciation and memory of your blessings. Knowing that you will need to write each night changes your mental filters during the whole day. You will tend to seek out, look for, and specially note the good things that happen. If doing this daily is too much or begins to seem like a routine chore, do it once a week.
  

• Make a list of the things you take for granted
  . For example, if your chronic pain has affected your knees, you can still be grateful that your elbows and hands are unaffected. Perhaps you can celebrate a day in which you don’t have a headache or backache. Counting your blessings can add up to a better mood and more happiness.
  

Make a personal inventory of your talents, skills, achievements, and positive qualities, big and small. Celebrate your accomplishments. When something goes wrong, consult your list of positives to put the problem in perspective. It then becomes just one specific experience, not something that defines your whole life.

This world is plagued by violence and suffering. When something bad happens, it’s front-page news. As an antidote to this misery, despair, and cynicism, practice acts of kindness. Look for opportunities to give without expecting anything in return. Here are some examples of kind actions:

• Hold the door open for the person behind you.
  

• Give an unexpected gift of movie or concert tickets.
  

• Send an anonymous gift to a friend who needs cheering up.
  

• Help someone with a heavy load.
  

• Relate positive stories about helping and kindness.
  

• Cultivate an attitude of gratefulness for kindness you have received.
  

• Plant a tree.
  

• Smile and let people cut ahead of you in line or on the freeway.
  

• Pick up litter.
  

• Give another driver your parking space.
  

Be creative. Acts of kindness are contagious, and have a ripple effect. In one study, the people who were given an unexpected treat (cookies) were later more likely to help others.

It’s hard work to keep our deep negative feelings hidden. Over time, this cumulative stress undermines our body’s defenses and seems to weaken our immunity. Confiding our feelings to others or writing them down puts them into words and helps us sort them out. Words help us understand and absorb a traumatic event and eventually put it behind us. Sharing our feelings gives us a sense of release and control.

In his book
Opening Up
, the psychologist Jamie Pennebaker described a series of studies about healing effects of confiding or writing.
One group was asked to express their deepest thoughts and feelings about something bad that had happened to them. Another group wrote about ordinary matters such as their plans for the day. Both groups wrote for 15 to 20 minutes a day for three to five consecutive days. No one read what either group had written.

The results were surprisingly powerful. When compared with the people who wrote about ordinary events, the ones who wrote about their bad experiences reported fewer symptoms, fewer visits to the doctor, fewer days off from work, improved mood, and a more positive outlook. Their immune function was enhanced for at least six weeks after the writing exercise. This was especially true for those who expressed previously undisclosed painful feelings.

Try the “write thing” when something is bothering you. It could be when you find yourself thinking (or dreaming) too much about an experience, when you avoid thinking about something because it is too upsetting, or when there’s something you would like to tell others but don’t for fear of embarrassment or punishment.

The following guidelines can help you use writing as a way to deal with negative experiences:

• Set a specific schedule for writing. For example, you might write 15 minutes a day for four consecutive days, or one day a week for four weeks.
  

• Write in a place where you won’t be interrupted or distracted.
  

• Don’t plan to share your writing—that could stop your honest expression. Save what you write or destroy it, as you wish.
  

• Explore your very deepest thoughts and feelings and analyze why you feel the way you do. Write about your negative feelings such as sadness, hurt, hate, anger, fear, guilt, or resentment.
  

• Write continuously. Don’t worry about grammar, spelling, or making sense. If clarity and coherence come as you continue to write, so much the better. If you run out of things to say, just repeat what you have already written in different words.
  

• Even if you find the writing awkward at first, keep going. It gets easier. If you just cannot write, try talking into a tape recorder for 15 minutes about your deepest thoughts and feelings.
  

• Don’t expect to feel better immediately. You may feel sad or depressed when your deepest feelings begin to surface. This usually fades within an hour or two or a day or two. The overwhelming majority of people report feelings of relief, happiness, and contentment soon after writing for a few consecutive days.
  

• Writing may help you clarify what actions you need to take. But don’t use writing as a substitute for taking action or as a way of avoiding things.