Soothing breathing

I have encountered soothing breathing exercises as part on my one-to-one counselling and when reading self-help Compassion Focused Therapy (CFT) books.  It’s not something that I persisted with though.  Developing a soothing breathing technique or form of imagery that helps us to feel calm, soothed and steady has been the main practical exercise for the first 5 weeks of my group therapy.  This soothing practice came alongside getting to grips with the theory and principles of CFT.

Now that we are getting into applying the theory to understanding our own experiences and fears I think I understand the importance of learning soothing rhythm breathing first.  Thinking about the lack of compassion I have for myself, how critical I am of myself and how I came to be this was raises a lot of sadness, and some fears to the surface.  Being able to calm myself is really helpful in being able to do think about and discuss these thoughts and feelings, without feeling overwhelmed or crushed by them.

I’ve practised soothing breathing rhythm on most days since we were introduced to it in the first week.  I’ve also experimented with scent, imagery and holding an object.  I’ve discovered I like the scent of lavender because I associate it with relaxation and it encourages me to inhale deeply.  I also like to hold a pebble in my hand.  The shape and texture gives me something to focus my attention on if I’m having a hard time settling down.  After practising for several weeks I have noticed I find it easier to calm myself and soothe the effects of anxiety or stress in my mind and body and to get a little relief.  I used soothing rhythm breathing during an extremely stressful event last week and coped much better than usual.

Pacing progress update

The aim of pacing is to find the approximate length of time that I can work at something without causing a flare up in my symptoms. The principles of pacing are to avoid a cycle of boom and bust and to stop before you need a break. A few months ago I worked out my starting baselines for various activities. I’m working on gradually increasing my baselines by one minute a week for two activities at a time.

Pacing:

Overall I’m starting to see benefits from pacing my activities to reduce flare ups in fatigue and pain. I still struggle with some of the drawbacks. For example, I can’t get into a ‘flow state‘ when I’m only engaging in something for a maximum of 8 minutes at a time. And it’s taking a lot of time, thought and energy to implement pacing in my life.

I’ve been doing some problem solving around the various issues as they arise which makes things a little easier. I can also see an improvement in terms of how comfortable I am as I’m aggravating the pain and dizziness less. This is particularly noticeable towards the end of the day. I have to go to bed less during the day to sleep. Though I still have scheduled rest breaks where I lie down to relax or meditate and I still do to bed at the onset of a migraine.

The changes:

Flow:

I’ve experimented with grouping tasks into sets of 4. I have a 3 minute break after each task to check in, and a longer relaxation period of around 25 minutes after each set of 4. I’m aiming to group activities so I keep some continuity in where my mind is at throughout each set, and variety in how I use my body from one task to the next. Pairing activities that I do regularly reduces the planning and decisions that need to be made each day.

  • Planning (computer) / Balance exercises
  • Reading or dictation / housework
  • Writing (computer) / dictation or thinking

Frustration with the timer:

Each morning I have started breaking down tasks I plan to do that day into smaller steps that match the time I’m allowed by my pacing strategy. This seems to reduce the frustration that comes from constantly being interrupted by the timer when I’m in the middle of something. Hopefully as time goes on I’ll get better at estimating the time needed for different tasks.

New baselines:

  • Housework
    • I’ve settled at 8 minutes at a time for general housework. I did try a week at 9 minutes but was getting very tired sometimes so reduced it back to 8 minutes. I’m planning to leave housework at this level for now.
    • I noticed I was getting very sore muscles after jobs involving stirring or scrubbing despite keeping to my time limit. I’ve made a separate category for housework involving intensive/ repetitive movement. This category has a starting baseline of 1 minute.
    • I’m alternating housework with reading or dictation which can be done with my feet up and head supported so I don’t overuse muscles. This allows me to process what I’m thinking about while doing the housework and to give my muscles a break while I read or record my thoughts.
  • Computer
    • Using wrist splints reduces pain.
    • Currently up to 8 minutes. I’ll see how that goes this week.

You can see how long it’s taken me to get to this stage in the pictures of my record sheets below. On the one hand, I’m happy that I have doubled the amount of time I can spend at the computer in two months. On the other hand, it’s taken two months and I can still only do 8 minutes which is a long way off what I want. This is where my self-compassion course, and the support of a health professional in setting and persevering with the pacing process has been so valuable. I’ve also appreciated encouragement and support from the people around me. I’m not sure I could have persevered without it.

Baseline Record Sheet: Computer
Baseline Record Sheet: Housework

Mindfulness:

  • More aware that I do need to pay attention when doing housework.
    • Thinking about how I’m going to lift something and if it’s a good idea
    • Noticing any muscles or joint aching or fatigue
    • Thinking about whether to continue with a plan or stop and change to another activity or rest.
  • I much preferred it when I could do housework on autopilot with my mind on something more interesting.

Finally – I can see some progress with pacing!

The aim of pacing is to find the approximate length of time that I can work at something without causing a flare up in my symptoms. The principles of pacing are to avoid a cycle of boom and bust by stopping before you need a break. A few months ago I worked out my baselines for various activities. I’m working on gradually increasing my baselines by one minute a week for two activities at a time.

The activities I have been working on are housework and using the computer. At the start of this week I increased the time spent on housework to 9 minutes, and time spent at the computer to 7 minutes

Using the computer is still comfortable, as long as I wear my wrist splint. This means I can increase the time allowed for the computer to 8 minutes. I do need to make sure I alternate using the computer with something away from my desk and making very light use of my hands. Dictation, reading, or using my whiteboard could all be good activities to alternate with the PC so I can keep my train of thought going while not aggravating any one particular symptom for too long.

I really want to increase time allocated to housework to 10 minutes as it’s a round number, but I felt tired few times after the 9 minutes this week. I also need to take care during the 9 minutes if I’m doing repetitive actions like stirring a saucepan or scrubbing or cleaning the bath. Several times doing activities like these within the 9 minutes has produced aching muscles and painful joints.

So I’m going to leave housework at an untidy 9 minutes. I’m also going to make a new category in my pacing list for repetitive housework tasks. I’ll start this at a baseline of 1 minutes and build up slowly from there.

Pacing like this is still frustrating although I am more accepting of it and it’s becoming a habit. I can see some benefit though. I’ve less pain in my hands particularly and while I’m tired at the end of the day, I’m not sleeping as much in the daytime.

Practising… Self-Compassion 4

Week 4: Compassion vs. Criticism

I believe that having self-compassion is essential if I’m going to live a meaningful life with chronic illness.  Unfortunately I’m not very good at it.  I think self-compassion is so important because it’s an attitude that encourages us to take good care of ourselves, to recognise how difficult life with a chronic condition can be, to be accepting of our limitations and appreciative of our efforts. 

For some of us (including myself) self-compassion isn’t something we developed as we grew up.  Instead we have an extremely vocal and opinionated inner critic.  This critical voice is always pointing out our failings, worrying about our weaknesses and generally making life even harder than it needs to be.  Continue reading Practising… Self-Compassion 4

Practising… Self-Compassion 1-3

I believe that having self-compassion is essential if I’m going to live a meaningful life with chronic illness.  Unfortunately I’m not very good at it.  I think self-compassion is so important because it’s an attitude that encourages us to take good care of ourselves, to recognise how difficult life with a chronic condition can be, to be accepting of our limitations and appreciative of our efforts. 

For some of us (including myself) self-compassion isn’t something we developed as we grew up.  Instead we have an extremely vocal and opinionated inner critic.  This critical voice is always pointing out our failings, worrying about our weaknesses and generally making life even harder than it needs to be.  Continue reading Practising… Self-Compassion 1-3

Making a ‘first aid kit’ for depression

I’ve been struggling with mild depression for the last five days or so. I’ve put into practice a couple of the techniques that I learnt during my counselling sessions and I’ve got support from my partner and friends. But I realised that I have forgotten several things that helped in the past. And I’ve made it harder for myself because they aren’t noted down anywhere. When I’m starting feel very down and hopeless it’s better if I don’t have to search through notebooks and folders or rely on my memory. To fix this I’ve made a list of my remedies for mild to moderate depression that I will use now and have to hand next time.

My own first aid kit for depression:

  • Kristen Neff’s Soften Soothe and Allow meditation for calming the physical sensations of depression in my body.
  • Chocolate.
  • Sunshine (if available), if not try and get outside for a bit anyway.
  • Get outside, visit my allotment. Go, even if you don’t feel up to doing anything when you get there.
  • “You have to pull yourself out of the swamp” –  Anitra Nottingham, writing for The Thesis Whisperer blog
  • Keep going if you can. Break your important tasks into tiny little pieces and focus on one mini-task at a time.
  • Postpone anything non-essential to give a yourself a little bit of breathing space.
  • Practise mindfulness and set a worry time to calm the churning thoughts.
  • Tell someone I trust that I’m struggling.
  • “This too shall pass”.  Because I have come through this before, I know I will come through it this time too.
  • “whatever your feelings – these reflect your brain state, are not your fault, and millions of others have these feelings too. Of course, knowing this does not make your depression any less painful, but it does mean that there is nothing bad about you because you are in this state of mind. It is a shift in brain state that is painful – depression pulls us into thinking and feeling like this, so these feelings are sadly part of being depressed.” Paul Gilbert, Overcoming Depression
  • Accept offers of help. I feel better when someone:
    • Sends messages that remind me that people do care.
    • Reminds me that I have got through this before and I’ll get through it again.
    • Helps me figure out how to tackle the things that seem to difficult, and to do a little at a time.
    • Keeps me company or helps me to do something that I find overwhelming by myself.
The things I put on my list are some quotes that I liked, advice I’ve read, and things that have helped me in the past. But it is a personal list and what helps me might not work for you. So I’ve put together a list of resources that might be useful.

Self-help resources for depression:

Here’s a few sources of help and advice for with coping with depression:

Where to go for immediate support:

In Practice: Making the most of small pleasures

Tuesday wasn’t a good day.  I  broke a glass while making breakfast and had to rush to my doctor’s appointment through the snow.  I struggled to cross the icy roads safely.  My migraine brain disliked the glare from the snow, the cold outside and the heat in the GP surgery. Later that day I got a crushing migraine and spent most of the afternoon in bed.

But in between I managed to take advantage of a couple of pleasant moments, and remembered to use a couple of techniques for making the most of small pleasures

It didn’t make the feelings of sadness or discomfort less intense but I’m glad I remembered to pause for a moment and enjoy these moments too.  I was reminded of the poem A Dust of Snow by Robert Frost.  It was a bad day – but there were happy moments too.

“Whatever else there is, there’s this as well” – Maitreyabandhu1

Adding to my happiness jar2

I wrote a note to add to my collection of happy memories that I keep in a jar on my desk.

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“Sharing a sweet funny moment with strangers before going on with my day.

I was walking through the park and saw small dog going crazy in the snow.  Wriggling on its back, kicking the snow up behind himself, scrabbling in it with his front paws, pushing his head in a snow drift.  I couldn’t help laughing out loud.  His owners were laughing so hard they could hardly stand up straight when he sat up his eyebrows and moustaches covered in snow and looked around puzzled before dashing about again.”

Pausing to enjoy the sensory aspects of a moment

On the way home walking through the same park I stopped for a moment.  Felt the warm sun on one cheek and cold air on the other.  Watched the gently swirling snow blown of the trees and felt it land on my face.  Heard the crunch of snow when I walked where no one else had.  Admired the imprint of boots in the snow.  Felt snuggly and warm in all my layers with soft fabric next to my skin.  Saw the pattern of the shadows made by the sun through the trees.  Appreciated the blue of the sky after the dark cloud earlier.  Heard children laughing and playing in the school yard next to the park.  Heard birds in the trees.  Experienced a sense of peace alone in an open space.

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Resources

1. ‘This’ by Maitreyabandhu,  Crumb Road, quoted in Burch & Penman Mindfulness for Health

2. Make a happiness jar Can you bottle happiness?

Today’s going to be a rest day…

I read this article sometime last year ‘The Difference Between Bad Days and Rest days’.  In it the author argues that rest days are for recharging and restoring when you are not ill, while bad days are time you have to rest because you have no choice.  She suggests that rest days may help prevent bad days and should be scheduled regularly.

I was really taken with the idea.  I didn’t really expect to reduce the number of bad days, because migraines cause my fatigue rather than the other way round.  But I could see that incorporating rest days into my schedule would give me time to recuperate and keep me from pushing myself too hard.

However, I never actually go to round to scheduling them, apart from the odd occasion when I know I’ve got something planned that is really going to test my limits.  Then I might plan to take the next day off.  Despite not scheduling them I still find the concept a useful one.  A rest day sounds nicer than a bad day.  It encourages me to take better care of myself.  To be more compassionate toward myself, and to feel more positively toward time spent ‘unproductively’.

I take rest days when I feel I need one.  On days like today when I’ve struggled to get out of bed.  Failed at my morning routine, and am struggling to write this now.  I had something of a migraine yesterday.  But for some reason instead of taking better care of myself than usual I abandoned my evening routine and then had a bad nights sleep followed by oversleeping this morning.  Today I am suffering with migraine symptoms, vertigo and fatigue.  This blog post and a 5 minute walk are the sum total of my achievements today and it’s mid-afternoon.

But that’s okay because at around 11.30 this morning, when I finally made it downstairs, today officially became a Rest Day.  On a Rest Day all I need to do is the basic, essential self-care like the 5 minute walk.  The rest of the time can be spent resting and lazing in whatever way suits me.  Or I can writ a little or read a little if I fancy it.   I still use my timer for pacing and tracking.  This time resting counts as time usefully spent.  And hopefully, tomorrow will be a better day because of it.

 

 

Bone Tired

Bone tired is the only way to describe how I feel today.  My skeleton is sleepy, my muscles sluggish and when required to speak or think my brain just shrugs.  I hate this feeling, it seems like such a waste of a day.  And I don’t feel like I’ve any control over it.  I’ve taken rest breaks, meditated, been to bed, fell asleep unintentionally and done a little exercise.  None if it has helped.  Each time I gradual fade back into drowsiness.

I was recently diagnosed with fibromyalgia in addition to the existing chronic vestibular migraines).  Poor sleep and fatigue are associated with fibromyalgia.  I’ll be getting advice on improving my sleep as part of my treatment.  In the meantime I think all I can do is try and get little tasks accomplished as best I can, interspersed with plenty of rest.

My Morning Routine

Waking Up Ritual (15 minutes)

  1. Start my timer
  2. Spend  few minutes following a guided ‘Welcoming the Day’ meditation from Stop, Breathe & Think
  3. Drink a glass of water
  4. Eat a handful of nuts
  5. Stretching and strengthening exercises from Arthritis Research UK.  I’ve put the exercises in order so I can do the first few still lying in bed, the next few sat on the edge of the bed, and lastly standing up.

Once I’m up I’ll get dressed, set the timer again, have breakfast, then start a little ritual to clear my mind and then another to started on focused work.  In practice these routines flow into one another.

Clocking In Ritual (15 minutes)

  1. Take a cup of tea up to my desk
  2. Start my timer
  3. Check my work and personal email and add items that need attention to my to-do list
  4. Brainstorm anything that comes to mind – worries, jobs that need doing, distractions and ideas I want to follow up.
  5. Add any items that are tasks to my to-do list.  If I’m worried, anxious or have anything on the list that’s likely to distract me I might do a little thinking or writing about it immediately, or add a task to my to-do list so I can come back to it later.
  6. Check the schedule on my calendar still looks sensible.
  7. Adjust my pacing timer to suit how I’m feeling today.

Deep Work (15-25 minutes)

  1. Play the same piece of music.
  2. Open a jar with a drop of bergamot essential oil in it.
  3. Write the question I’m trying to answer today on my whiteboard.
  4. Write out what I’ll be doing (reading x; thinking about y)
  5. “Un-icky” anything that still seems a bit vague or scary
  6. Make a start