Helpful versus unhelpful thoughts

What is your experience?

Managing flare ups

While I have been self managing my chronic back pain now for over 6 years, I still get flare ups. I was never under the disillusion that my pain would go away. So now when pain looms, I use my flare up management strategies. I know just what to do.

Even though it can be worthwhile to reflect on the reason (i.e. Did I over do it? Have I been neglecting my daily stretches? Did I stand or sit for too long without moving?) I am less focused on trying to figure out the cause of increased pain. I find it’s more important to launch into action.

So here is my step by step approach to managing a flare up:

Accept. Often my flare ups are still caused by overdoing it! Yes, I know all about pacing, taking breaks and have a good understanding of my own limitations but sometimes I still push through and over do it. But rather than beat myself up with guilt and blame and anger…I just stop, nourish, repair, move on. I also am much more willing to accept and just acknowledge that sometimes it is OK to have a bad day (I give myself a free pass - more on this soon). Also by simply accepting the pain, I am less likely to buy into negative, unhelpful thoughts which could develop into a snowball.

Plan. I need to make sure I communicate and get help if I need it. I know my bad flare ups last maximum of a day or two. I can deal with that. Two days is not a lifetime.While this may cause a problem if I have commitments/events, I just accept that my plans may need to be re-scheduled, re-organised or prioritised.   I will work simply from a daily plan worksheet, breaking my day into small manageable chunks with lots of breaks and only the necessary jobs (of which, walking, stretches and exercises get top billing!).

Act.  I have a list of activities I can do that I know will turn down my pain dial. I choose one of these and act. I don’t rest anymore or ruminate or wallow in my pain (that gets you nowhere or backwards - fast!). Your loved ones will soon recognize flare ups coming on too and if you share your flare up action plan with them, they can help. My daughter has told me I needed to do some stretches when I told her my back was sore. My husband often tells me it’s time to go out for a walk or he sends me to my room some meditation time. So I will go sit, stretch, breathe, relax. Remove some of the mental clutter. I need to do activities that turn the dial down. Here are some examples of things that work well for me:

Helpful thoughts

Relaxation/meditation

Stretching

Going for a walk

Listening to a motivating podcast/music or reading book

Awareness (posture, thoughts, activities)

Pacing (take breaks)

Carefully preparing a nourishing meal/snack

Be: I re-connect with the present moment, I cannot change the way things are right now so if I practice mindfulness and be aware of what I am doing, I can resume my normal day to day  activities much more refreshed and ready to cope with the current situation.

What do you do? A flare up action plan might be a good starting point. Take note of helpful thoughts or activities that you know turn down your pain dial and be aware of pacing cues, timing and taking breaks.

The Snowball Effect

A single snowflake lands on the snow. With a gust of wind it is carried along. It gathers other snowflakes to it (like attracts like) and as it moves it gets bigger. Its size now moves it further downslope and it gathers speed. It doesn’t not take long before it is hurtling down with a destructive force wreacking havoc in its path.

This can happen to me with a single negative thought about my pain. Let me give an example. I have overdone it and caused a pain flare up. Here is the potential progression of thoughts:

 

"I can’t believe I have done this to myself again. I should know better. I am so stupid. Now I need to get help with the (kids/house/work). I’m such a bad (mother/wife/friend). They must be so sick of me being like this. They probably hate me. I hate myself so why wouldn’t they? "

 

Anyway you get the idea? It was that first negative thought. I allowed it to attract more negative thoughts, continuing to catastrophise, I was then led on a destructive journey down a dangerous slope into self loathing and depression. And with this progression comes the associated physical reaction to these thoughts (stress, tension and more pain!). All from one single thought . One single mistake. My thoughts are powerful and this is my snowball effect.

 

When in this state my emotions are high (some would say even out of control!) and as a result my intelligence is low. I make poor decisions regarding my self-pain management techniques (e.g. choosing rest over movement, choosing to buy in to my unhelpful thoughts, choosing anger over just a simple acceptance of the way things are).

 

A less destructive approach is non-judgemental awareness of my own thoughts. I have control over what thoughts jump into my head, over what voices I choose to listen to. If I can stop a snowball at the snowflake stage I have the chance to break it down before it careers downslope. How do I do this? I need to be paying attention to my thoughts. A short breathing exercise or meditation might give me the clarity and awareness to deal with these thoughts. I can challenge or assess my thoughts before moving onto the next destructive level. Is this thought realistic or true? How can I be sure – have I asked that person how they feel? Is there another possible explanation? In addition to challenging the thoughts I also have an arsenal of more helpful thoughts that I can use to replace my initial unhelpful thought. As in my example above “I can’t believe I have done this to myself again” might become “habits take a while to be changed but it is possible” or “You are getting better at this, don’t give up”.  I can choose more helpful thoughts and be kinder to myself. Then the inner warmth will melt the snowball.

Once I have cleared out my headspace, I have the room and ability to implement the right actions. The pain still needs to be dealt with so I will go to one of the self pain management strategies that I know work – go for a walk, do some stretches, ask for help, pace planned activities etc.

It takes time and practice but snowballs do not need to gather strength and destructive force. A single snowflake can be a beautiful thing when it is simply observed.