10 Coping Strategies for Dealing with Chronic Illness

1) Surround yourself with positive energy as much as possible. If you are seeing a doctor who thinks that you will never be cured or who is generally negative about your prospects of increasing health, find someone new. Find practitioners who believe in you and your healing. Create a network of different practitioners from all realms, Western Medicine, Alternative Medicine, Massage Therapists and Mental Health Workers.
2) Join a support group. You can do this in person and these days there are many online forums and support groups for both general autoimmune conditions and chronic illnesses and as well as groups that are more specific to certain conditions. Make sure that the group is actually supportive. How do you know? Trust your gut, you should feel better after you interact in these groups. You should feel that your feelings and your experiences are being validated.
3) Continue to seek out resources as much as your health allows. Many of these will be resources in your local community and many will be resources in the online community. Don’t give up. Find ways to keep your body, your mind, and your spirit moving in the direction of healing.
4) Remember the difference between pain and suffering. There is physical pain that is real and then there is the suffering that we add to this pain with our thoughts. Notice how in moments of distraction or in moments of focusing on something outside of yourself you might feel some relief from your symptoms. Even if it is for 5 minutes or for 30 seconds, try to allow yourself to receive the nourishment of these moments.
5) Breathe deeply. Take five full belly breaths. Place your right hand over your abdomen and your left hand over the middle of your chest and inhale for a count of five and exhale to a count of five. Make sure you exhale completely and pause before beginning the next exhale. Notice even subtle changes in the quality of your mind and body.
6) Practice Creative Visualizations and Guided Imagery. The most basic method of guided imagery is to focus on the area of discomfort or illness in your body. Create a picture of this area in your mind, use your imagination. The image does not have to be anatomically correct. In fact, the more creative you can be the better. Once you have this image in your mind try to notice other aspects of the area, is it hot or cold, rough or smooth, does it have a color associated with it? A smell? A taste? As you are becoming aware of these aspects begin to ask this part of you and the related imagery how it can move or change to create relief. Notice if the image, color, texture or any aspect of the image begins to change. Practice this guided imagery for up to 30 minutes at a time. Many people also find it very useful to do this exercise for shorter intervals throughout the day. There are many free resources for these practices online. There are additional resources in your local library and bookstores and also many practitioners who can support you in learning more about these tools.
7) Make time to be out in nature. Talk a walk. Step outside. Sit on the grass. If none of these are possible, bring nature to you. Buy plants and flowers. Create an atmosphere of vitality in whatever spaces you occupy. Learn about Feng Shui. Very often the spaces in which we live and work in contain stagnant energy that can be mirrored in the personal spaces of our bodies. See what you can let go of in your physical life that might make room for new energy, for healing.
8) Reflect on your relationships. Make decisions to be around family and friends who can be with you in a nonjudgmental way during your tough times. Again, create a support network so that you never feel that you are overwhelming any one person or burdening them in any way. You deserve connection and support.
9) Keep a journal. This does not have to be a formal diary. Create collages, make pictures that make sense to only you, write about what you are feeling. Collect quotes that feel inspirational or copy passages from books that have helped you through difficult times. Basically, this is a place for you to express whatever you want without having to worry about any ramifications. It is your book of healing.
10) Be grateful. One of the most difficult things to do when we are in the midst of illness, discomfort, or pain, is to see all the good in our lives. Keep it simple. You can be grateful for the bed that you can sometimes rest in. You can be grateful for the food you can eat, even if it is severely limited by your condition. You can be grateful to your animal friends, a piece of music, the leaves changing in the fall, the feel of the sun on your face. Let this grateful feeling move through your whole body. Every time you have a grateful thought and related feeling of gratitude you are giving your body relief from illness.

Coping With Death and Understanding Grief: For Children, Teens, and Adults

Coping With Death

There is an abundance of written material on the market to help people deal with death and dying in Western society, however,  it should be noted right off the bat that these materials must be sought out. I mention this because in other parts of the world and cultures, this is not the case. Instead, in other cultures, death and dying, is not a section in a Barnes and Noble, but rather a daily part of life. Therefore, we see that Western society, itself, and what has been labeled, a “death-denying” quality. Although, books can help people to deal with death and grieving, it is difficult when so much of the what they see and hear in daily living seems to suggest that keeping young is the highest priority and that death is to be feared and avoided at all costs.

However, there are many useful materials available for those who are grieving or who which to learn more about death. Clearly, each individual will find different material useful. Many books are in the format of a workbook, with activities to help mourners address the feelings that arise as they go through the grieving process. Although, this is helpful for many, I prefer the more informational route, that is to learn about what death means in different cultures and has meant throughout different points in history. In Elisabeth Kubler-Ross’s book, Death: The Final Stage of Growth, Ross has put together a collection of essays and articles of many different authors. These authors each present alternate depictions of death and grief, based on personal experience, religious or cultural perspectives. These essays offer information and comfort for mourners, those preparing for death, and those who are simply interested in learning about death.

Unlike many of the other adult materials available, Ross’s book leaves interpretation up the reader, in other words, this is not a “self- help” book but more of a “help yourself” book. It does not instruct you (for the most part) in step-by-step approaches but rather offers personal stories and cultural representations of possible ways of conceptualizing and of dealing with death.

In the essay entitled, A Mother Mourns and Grows, we hear the voice of Edith Mize who has lost her 26 year-old son: “Grief cannot be hurried, but eventually an emotional balance returns to the grieving person. You cannot bring back the one you love but you have to face reality. A change has occurred in my life, and my life must now have more meaning. I watched our son fight to live and stood by as he accepted death.” (Ross 101). Edith’s voice invites other people facing grief to share in her emotions and experiences. What is instructional here, is her recognition of the reality of the situation, and her own acceptance of the loss of her son. Therefore, it is significant to  point out that both the individual facing death and those left behind must slowly arrive at acceptance of death. Edith will use the experience of her son’s death to live more fully and with more bravery, instead of falling into a deep depression.

In additional essays, a number of authors address issues of dying and grief in various cultural contexts. In the selection Dying Among Alaskan Indians: A Matter of Choice, the author Murray L. Trelease, writes about his experiences as a priest serving the Alaskan Indians. What Trelease found was that he was often called to a home to pray for a dying person, where he would find the whole family gathered around the dying person, and hours later that person would die. Moreover, on most occasions, it was the dying individual him/herself that had called everyone together.

Trelease describes one particular story in which he was called to the Arctic village of Old Sarah, where Sarah’s whole family had gathered: “During the morning of the next day she [Old Sarah] prayed for all the members of her family. At noon we had a great celebration…in her cabin complete with hymns and prayers. Old Sarah loved every minute of it, joined the prayers and singing and was quite bright throughout the service. Then we all left and at six in the evening she died.” (34).  What is suggested here is that Old Sarah was aware that she was about to die and thus brought everyone together to celebrate her life. Obviously, this is quite a different picture than in Western society, where many people die alone and in the unfamiliar setting of a hospital.This story suggests that perhaps coping with death, would be easier for all involved if it were not in a hospital which is often associated with illness and disease.

“Unfortunately too many people think that the sentence of death, rather than death itself, is an end to growth. On the contrary, it may mark the beginning of the greatest growth of a lifetime in understanding, love, and faith,” for both the dying person and those who surround him/her. (37).

In the essay entitled, The Death That Ends Death in Hinduism and Buddhism, J. Bruce Long, Ph.D. addresses the attitudes and rituals surrounding death in these cultures. “Both [Hindu and Buddhist] traditions agree, in general, on the most effective method of conquering death: accept death as the chief fact of life and as the main signal that all you hope for will be utterly destroyed in due course and that once you come to be able to neither long for nor fear death, you are beginning to transcend both life and death…”(71). Although, this is a simplification of both traditions, what is emphasized is the prominent presence of death in one’s daily life. Western society  has produced a people who are very attached to material items and to the notion of permanence. These attachments make coping with death or loss of any kind very painful. If we can all begin to understand the impermanence of everything, death becomes a natural and necessary part of life. “As a man [or woman] desires, so he wills. As he wills so he acts. As he acts, so does he become. That person is bound in the chains of death, the fears of his own death, and the grief over the death of others, who tries to ignore death. That person is freed from the fetters of death and all its attendant anxieties, who meets death as a companion to life, in the spirit of rational and tranquil acceptance, without clinging to or fleeing it.” (71).

Ross’s book contains an overflow of possibilities of how to think about and to potentially cope with your own death or the death of a loved one. I have only provided the bare bones of what is contained in her book of collected works on death. Although, I feel that this is comforting and helpful, others might be looking for fewer stories and more information on what to do with their emotions in a more methodical sense. Additional books by Kubler-Ross and others offer this methodical approach to death and grieving.

The book entitled: When Someone Very Special Dies: Children Can Learn to Cope with Grief, written by Marge Heegaard addresses the needs of younger children facing the death of a loved one. The book begins by addressing the idea that “Change is natural [and that] people change too.” On each page of the book, the child is presented with the opportunity to draw a picture about various areas related to life, to change and to death. On the page entitled “People Change too.” The child is given three picture frames in which to draw pictures of themselves as babies, in the present and in old age. Other pages have similar exercises, for instance, having the child draw the picture of the person who has died. Although, these exercises seem instructional, they still use the word death  often without really explaining what that means.

One attempt to define death: “Death is the end of living. The dead don’t eat, sleep, think, or feel anything.”(7). I’m not sure if young children would really get this. Obviously, it would depend on each individual child. However, it would seem ideal, that another medium besides the written word might be more helpful in addressing the topic of death with young children. For instance, more focus might be put on what they are feeling by giving them a set of paints or a piece of clay with which to express themselves. In other words, perhaps more attention should be paid to the child’s expression of emotion rather then attempts to fill them with information that might upset them further or confuse them. This is not to suggest that adults should avoid answering the questions of young children in regards to death, but just to have a balanced approach.

Heegaard also includes many pages on what to do with different feelings, such as anger and sadness, where children might feel these feelings in their bodies and what color the feelings are. These exercises might be very helpful but I would prefer to see them being utilized in conversation with a child rather than in book form. Therefore, this book is probably best used as guidance in dealing with a child who is grieving rather then as the primary source of comfort. The child’s greatest comfort will be in knowing that there are still people who love and care for them.

Hence, when addressing a five-year old about death, it is important to use approaches other than verbal language. Physical activity as well as multiple artistic tools can be very useful in helping a child cope with their feelings. Taking a child for a walk in nature, can be extremely useful in demonstrating and explaining concepts of change, of life and of death, in a more tangible manner. These strategies are actually quite useful at any age and should not be discounted for talking with older people.

For the 15 year old, coping with death is likely to intermingled with many other mixed emotions about life at this transitional stage. It is important to address the whole person, and all of the feelings that they might be having about the death of a loved one, as well as in other areas of their lives. As with younger children, adolescences might need assistance in where to go with all of their emotions. Suggestions of  journal writing, exercise, or other artistic pursuits might be helpful in letting out emotions. By the age of 25, death is understood as a reality that we will all have to face. The young adult, still needs to know that they are loved and supported, and be given the opportunity to express honestly and openly what they are feeling. Open, honest, and loving communication seems to be the key to providing comfort to those who have experienced loss, at any age.

“So Nature deals with us, and takes away, Our playthings one by one, and by the hand, Leads us to rest so gently, that we go, Scarce knowing if we wish to go or stay, Being too full of sleep to understand, How far the unknown transcends the what we know.” (Nature, Henry Wadsworth Longfellow).

An Introduction to Gestalt and Body Oriented Therapy

In my work with clients, I have come to see Gestalt work as a great integrative approach in dealing with memories and traumas that are contained in the body.

Gestalt Therapy focuses its attention on the unfinished business of the past that consistently arises in the present. Since Gestalt therapy is a holistic approach, it does not separate the memories of the brain, (or stories), from the memories of the body, (or ones physical structure and unexplained chronic pain).

In Gestalt therapy there is an invitation for  the client  to have complete awareness of all that is present in the moment.  When we begin to be present in this way, unresolved energies in the body will often make themselves known.

For instance, I had a particularly intense Gestalt session(also called a “working”) with a client in which she was experimenting with her strong, protective part and her seemingly weak, child part, (better known as the top-dog/under-dog polarity). She was sitting upright working on being big and loud when suddenly she felt an overwhelmingly heavy sensation in her body, which I asked her to follow. As  she followed the sensations of her body she began to sob and literally collapsed her body onto her thighs and her hands onto the ground. This was her body’s way of remembering how it felt to try to be big and then suddenly being weighed down or crushed by emotional abuse and criticism. By folding her body over and allowing herself to feel that old, traumatic energy,  the client began a process of discharging lingering energy. In other words, the client was beginning to complete an old and unfinished cycle of experience. Clearly, the next step would be to move towards a discharge of the more powerful and less passive anger that is beneath the sadness.

Unlike other forms of body psychotherapy, Gestalt maintains the high priority of integration. This means that besides simply discharging energy, we also try to understand how we might repeat certain energetic patterns to protect ourselves or out of habit and how we may make new choices in the future about how we want to use our energy in life.  As  James I. Kepner points out in his work, Body Process, “Body structure can be seen as a frozen conversation or dialogue between conflicting parts of the self.”

Kepner sees these frozen aspects of the body, as energies waiting to be noticed, released, and healed. He writes: “The aim is not to remove structures, but to transmute them into the processes they represent, and to integrate that which has been disowned or unassimilated into the self.” (53).  In order to do this we must reorient ourselves in our bodies and make contact with ourselves.

This process of resensitization can be especially frightening when dealing with traumatic memories. However, when we are able to make contact with these memories and play them out fully in a safe environment, we can begin to heal. This safe environment is provided by a strong and trusting relationship between the client and the therapist.

7 Tools For Working With Anxiety

Here are some techniques to try out the next time you are feeling anxious:

1)      Try to unfreeze some of your energy.  Anxiety often feels like too much energy moving in the body without being released. Instead of trying to sit with the energy, you may try a physical activity. Take a walk, do twenty sit-ups, learn a couple of yoga poses and hold them for a few minutes each, basically move your body.

2)      Pay attention to your breathing. Most of us don’t breathe fully. Notice if your breathing is from your throat, your chest or your belly. When you’re feeling anxious you are most likely only using your throat and your chest. In order to breathe more fully, find a comfortable sitting position and place both hands on your belly. Take a few breaths so that your hands are being pushed out by your moving belly. This might take some practice as we are accustomed to not breathing fully. If you if see a baby breathing, watch their belly and remember that this is how we are all supposed to breathe.

3)      Try a mindfulness practice called “Touch and Go”. For ten or twenty seconds let your mind contemplate whatever is stressing you out or the conscious causes of your anxiety and then for the next ten or twenty seconds focus on just breathing. When a thought arises do not engage with it but instead simply say “breathing” and come back to the breath. Keep doing this for a few minutes.

4)      Similar to the above exercise, notice your internal landscape and then your external environment. Notice your breath, notice the sensations in your body, notice your thoughts (without judging any of the above), and then move outside of yourself and notice the color of the walls, notice objects or people in the room, notice the details in the physical environment. When you move back to the internal, observe any changes that might have taken place in your move from external to internal noticing.

5)      Close your eyes and visualize a peaceful place. What are smells, tastes, and feelings that you have in this place? Access your five senses to bring to peaceful place to life. Only include aspects which are relaxing to you.

6)      Work with your thoughts. Are you having cognitive distortions? Cognitive distortions are when what you are saying about yourself or some situation in your life is actually not true.  You can work with these thoughts by writing down the negative thoughts and then acting like a coach to yourself. Looking at your list of thoughts, ask yourself if everything you are thinking is really true? Are things really as black and white as you are making them? Then write a new list, in a separate column, next to the first, where you are more objective about what is going on and more optimistic.

7)      Finally, work with simply just being with your anxiety. Try to just sit and stay with the changing sensations arising and falling in your body. Notice every small change. Notice that “your anxiety” is not a static state but rather a constantly moving ebb and flow of energy. Even try to notice the moments, perhaps even seconds, when you actually forget that you were anxious. Keep in mind that noticing is an action of non-judgment, you are just aware of what is, without trying to change anything about your experience.  What you will find in being mindful and nonjudgmental, in this manner, is that awareness itself ultimately does change your experience. You can rest assured that your state of anxiety will change.

Understanding Your Anxiety

Many people describe anxiety as feeling of dread sometimes seeming to come out of nowhere and at other times associated with specific thoughts or situations. This uncomfortable emotional and physical state has been understood by science as a remnant of the primal area of the brain, the limbic system. You have probably heard the phrase: “fight, flight, or freeze”. This refers to the different ways that we can respond to danger or to perceived danger. Let me use a few different examples to explain.

It is dusk and you are driving up a mountain. Suddenly you stop short, as you come around a curve because there is a deer in the middle of the road staring right at you.  The deer is frozen in fear, hence the phrase, “like a deer in the headlights.”  In this case, what might be an adaptive, life-saving tool for the deer in the woods becomes a great danger when fast moving cars (human predators) are involved in the chase. Our own human, fight, flight, or freeze mechanism has throughout human evolution moved from physical action or inaction based on immediate physical threat, to a stress reaction, working on a cognitive/ mental level.  Anxiety is a manifestation of trying to work out the fight, flight or freeze response, a primal reaction, as a rational matter as opposed to an issue of physical survival. Many people recognize their anxiety as feeling like a matter of life and death when, in most cases, this level of danger is not truly present. In any case, our energy becomes frozen instead of released which creates an uncomfortable sensation to say the least.

To use another example from nature, imagine a cat chasing a squirrel. The cat is slowly approaching the squirrel, which has been scurrying about, unaware of the cat, as the cat comes into view the squirrel freezes, perhaps hoping that his dark fur will blend into the tree base and that he will go unnoticed. This is an example of an adaptive freeze response. But suddenly the cat pounces, but before he has had a chance to grab the squirrel, the squirrel has used the reservoir of frozen energy to dart up the tree.  He makes high pitched squeals as he reaches the safety of the branches and jumps to the next tree and the next.  The squirrel was thus both frozen and on the ready with a vast amount of energy and adrenaline. Now the squirrel has utilized his flight defense. It is interesting to note how quickly the squirrel was able to move from frozen into flight energy; this is unlike most people experiencing anxiety.  Anxiety might be experienced as a combination of fight and flight while still frozen. Instead of a release of energy, many people find themselves doing battle internally or trying to run away from their own thoughts and being unable to escape. The result for humans is that the energy of flight remains locked in the body, creating a physical sense of agitation related to what we call “anxiety.” These examples of animal reactions in nature versus our human experience of anxiety have much to show us about how we might better manage this feeling.

5 Ways to Start Improving Your Intimate Relationships Today

1. Slow down. When you feel yourself getting angry or going into reactive energy slow yourself down and begin to get curious and to explore what is going on for you. Is your reaction actually about what is going on in the moment or is this situation reminding you of something from your past, for instance, how you were treated by a former partner, or how you were treated by your parents or primary caregivers. Once you have taken your time to see more clearly what is happening, if necessary, respond and communicate from this place.

2. Communicate clearly. Don’t expect your partner to be a mind reader. Our culture has brainwashed us into believing that love means that our intimate partners always know what we need without us having to express anything. I’m sure you’ve heard people say things, at the beginning of relationships, such as: “he just knew what I was feeling, I didn’t have to ask, she just understands me without me ever having to explain myself.” Although, there is some truth in these statements, at some time in most relationships, there is a need to communicate one’s needs and not take it for granted that our partner “just knows.” Clear communication and the necessity to express one’s needs do not mean that you are no longer in love; it actually means that you are really beginning to trust yourself and your partner.

3. Create space. Contact and Withdrawal: all healthy relationships require that there be both togetherness and time apart from one another. Once again, we get a lot of cultural messages that seem to say that love is being together all the time, which is just a recipe for problems. Being comfortable with time away from your partner means that you have other relationships, hobbies, and interests that are independent of him/her. Spending time away from your partner allows you to bring new vitality and joy into the relationship.

4. Don’t be blameful. When you do get upset and need to express what is going on for you, practice making “I” statements. For instance, instead of saying, “you always ignore me when I’m talking to you”…you might try “I know that you are trying to multi task right now and I am feeling sad and wondering if you could stop what you are doing for a couple of minutes and just sit with me while we are talking.” Marshall B. Rosenberg elaborates on this kind of communication which he calls “Nonviolent Communication” or (NVC) in his book by the same name. He explains that the four components of NVC are “observation, feeling, needs, and request.”

5. Practice Forgiveness and Compassion. Relationships can be truly difficult. We are all trying to balance our relationships with ourselves with all the many relationships outside of ourselves. Each relationship seems to bring to light different aspects of ourselves, some of which are joyous and some of which are challenging. We are on a constant learning curve, always bumping up against where we need to grow. The most powerful relationships are those in which we can make mistakes and forgive ourselves and our partner(s). People usually feel that when they are repeating an old pattern that there is something wrong, however, each repetition is an opportunity to do something new and to heal old wounds. If you are in a relationship in which you see a familiar pattern emerging, get curious and creative about trying out new behaviors.

You do have choices about how you show up in your relationships. Good luck on your journey.

Allison Weliky, MA is a psychotherapist practicing in the Boulder/Denver area of Colorado. She is available for free consultations over the phone or in person. Please contact her at allison@bloomingedgetherapy.com for more information or to continue to work on improving your relationships.