Saturday, August 1, 2020

Life with Chronic Conditions: “Turn the Page” & Don’t be stuck


Recently, I was expressing concern for a person who was unable to make a decision, to which my friend noted,  “they don’t know how to turn the page.” Best description I’ve heard in a while about the inability to act.

When you are affected by a chronic condition, the disease can over take so many aspects of one’s life, it’s very easy to get stuck on the “last paragraph” and can’t quite manage to flip the page, whether it’s about how to manage one’s care, to telling your boss about your illness, making a move etc. So today’s post is all about “turning the page.”

What keeps us stuck: While each of us has a variation on the theme, being” frozen” is rooted in fear, which can lead to anxiety, depression and in action.  

Identifying fears: Fear can come in many forms including fear of: Rejection; Intimacy; Failure or success; Losing control; past events dictating a negative future; worse case scenarios, such as death, declining health; lost job; public speaking; making the wrong choice; what others might think; saying the wrong thing; being exposed as an imposter; commitment; missing out. Any of these ringing a bell?  This is by no means the end all and be all of fear lists, but it’s enough to help you start identifying what might be holding you back.  

Fears are Often Based in Our Judgement & Opinion: Our fears can be based in, as well as trigger, distortions in how we see things. Are any of these relevant to you?
• Ignoring all the positives and just focusing on the negatives
• It’s all or nothing, black or white no shades in between
• Over generalizing. A single incident causes you to think the same thing will happen again so you don’t try.
• Jumping to conclusions. Draw conclusions based on little or no information.
• Similar to jumping to conclusion, you make an event catastrophic when in fact that’s not the case. The opposite is also true, you under estimate what you might be doing that’s positive
• Believing that you are responsible for events that happen to others
• Believing that everything is in your control or believing you have no control and it’s all external forces
• Expecting that everything should be fair
• You’re never at fault. You always have a reason why you aren’t wrong.
• It’s important that you always be right
• Strong beliefs in how one should behave to the point of extreme frustration if others, as well as yourself, don’t act a certain way
• Believing that how we feel is fact-I feel it, therefore it must be true.
• Happiness depends on other people and their unwillingness to change or do what we want causes considerable frustration
• Sacrifice and self-denial pays off with a big reward

Page Turners: Consider some of the following to help you “turn the page.”

• Journaling/listing/writing: Whatever format works for you is fine, but identify the areas where you are stuck and what fears you may be associating with them is step 1.

As you look at your list, ask yourself the following:
-       What are the chances this will actually happen? Would you bet money on this happening?
-       What’s the worse/best that you could happen? Maybe you are in a turmoil about trying a new medication. Write down the worse-case scenarios (if I don’t try the new meds I could get a lot sicker; could spend a lot of money and it might not work). Now write down the best possible outcome (My health will significantly improve and I can once again do many of the things I couldn’t do before.).
-       Do I have the information I need to think what I’m thinking? For the example above, how much money would it cost for the new medication? Are their discounts? Have you discussed with your provider the benefits and risks of a new med?
-       Apply the one week to five year rule. Will the decision I make have an impact in a week, a month, a year or five years? If it really isn’t going to have much of an impact, let it go. You have better things to do with your time then worry about something that won’t matter in the long run.
-       Do I have control over the situation? Often times we obsess over things we have no control over. We have no control over the fact that Covid-19 is part of our life at the moment. Obsessing and being fearful isn’t going to help you, while wearing a mask, socially distancing, washing your hands, staying home if you are sick,  and other measures do make a difference.

Journaling can be helpful on multiple levels. Writing daily about what’s going on in your life can give you new insights and help to identify issues before they become major problems.

• The 5 second rule: When a decisions is needed, don’t think about it — just count 5-4-3-2-1 and decide. This approach combines both thinking from your heart and your gut, not allowing for overthinking.  This can definitely help getting over the fear of making decisions. It can also be used in a variety of situations- such as should I exercise now; call a friend; ask for help etc.

• Practice Mindfulness/STOP: When you feel particularly overwhelmed, practice
Stop, or pause
Take a breath
Observe how you feel-body, thoughts, feelings, emotions, and physical sensations
Proceed with awareness

Sometimes we get so caught up our bodies tense up and we don’t breathe properly. By practicing STOP it brings us back to center.

• Understand thoughts are just thoughts and not necessarily factual: Make a list of thoughts that you find yourself dwelling on. Which ones are opinions and which are facts?  e.g. If I stop taking my medication I’ll get sicker is most likely a fact. Thinking your doctor will hate you because you missed an appointment is an opinion. We have a lot of emotionally charged thoughts and ideas but when we take a closer look at them, they aren’t factual but rather emotional.

• Try the Ottawa Personal Decision Guide: TheOttawa Personal Decision Guide (OPDG) and Ottawa Personal Decision Guide forTwo (OPDGx2) are designed for any health-related or social decisions. They can help people identify their decision making needs, plan the next steps, track their progress, and share their views about the decision.  It’s free and available in PDF format (can print it out as many times as you need it) Personal Guide or Guide for Two 

• Enlist help: If you are really stuck consider talking to a therapist/counselor, particularly one who is trained in cognitive behavioral therapy (CBT). If it’s a health related decision that you need to make, check with your care provider if there is a shared decision office/counselor you can speak with. If you are part of a support group, talk to them, and/or ask a friend for help.

No comments:

Post a Comment