Maintaining Relationships During Wellness Challenges

One of the "5 Key Concepts of Recovery" is support. When I think of support, I think of relationships and community. And yet, when I am struggling, positive interaction with other beings can be a challenge. What can we do to maintain our relationships and community connections when we or our loved ones are experiencing depression, pain, anxiety, and other difficult states? How do we keep from driving people away when we need them most? Here are some things I try to do to take care of my support system. I'd love to read some of your ideas.

1.  Breathe deeply, then respond. Taking a moment to clear your head could make the difference between a conversation and a fight.

See below for image source.

2. Avoid support system burn out. Love may be infinite, but time and energy are not.

• Spread the love around. The more people you can trust to help, the less pressure there will be on your closest supporters.
• Don't accept help you don't really need.
• Ask whether people are available to listen before verbally processing.
• Help your supporters. This will contribute to maintaining balance in your relationships, and helping others is a wellness practice that benefits the helper, too!
• Do self care together. My favorite self care to do with others are walking and eating nurturing meals.

3. Communicate!!

• Make agreements about how to communicate about helping each other when everyone is feeling well. Expressing preferences and setting realistic expectations before we need them can prevent problems in a crisis.
• Let people know you're struggling. Your supporters may not know how you're feeling. If your behavior changes in response to pain or suffering, knowing what's going on for you can help others avoid taking your actions personally. It also creates an opportunity to offer help.
• Ask for help specifically. You know what you need. Ask for help with the things you are least able to do without assistance.
• Receive suggestions with an open mind. Do you have concrete evidence a suggestion won't work for you? Will you be harmed by trying? If not, it might be worth a shot!

3. Use your insights into yourself to guide how you interact with others.

• Avoid flaking. Try to predict your energy level (spoon theory). You may not be up for going to a party after a therapy or bodywork session.
• Make flexible plans that can accommodate unforeseen changes. For example, if you'd planned to go for a walk, but you are experiencing a lot of knee pain, swimming or watching a movie could be better options that still give you a chance to be together.
• Make deliberate decisions about whether now is a good time to interact with people. Sometimes it's hard to be kind. Other times, someone else's company is just what the doctor ordered. You can always change your mind.
• Check in with yourself so you can offer help honestly - What are you realistically available for? Maybe you aren't actually free to listen to your friend process until 3am when you have work the next day, but you are available to have tea and listen after work.
• Try to recognize when you're acting like a jerk and stop! If you can't change your behavior, stop interacting. On your own or with a third party, think about what else is going on that might have influenced your behavior. Knowing what triggered your behavior can help you avoid acting rude in the future. 

5. Be courteous.

• Apologize if you were mean or rude. Keep it simple. apologize for your behavior, not your state of being.
• Express gratitude and appreciation. From a simple thank you to a thoughtful gift, gratitude is good for you and the person you are thanking.

What did I miss? Please share what you do to protect your relationships in difficult times.

Hand hexagon image source: http://www.chumans.com/blog/wp-content/uploads/2012/05/Supp-Sys-6-150x150.jpg

5 Key Recovery Concepts: An Introduction

Mary Ellen Copeland

To learn about ways to cope with her own symptoms, Mary Ellen Copeland asked many people in mental health recovery about what helped them the most. She learned that these 5 key concepts were helpful to almost everyone she surveyed: responsibility, education, self advocacy, support, and hope.

We need to take responsibility for our own recovery; we cannot expect someone else to be able to fix or change us. By educating ourselves about wellness and our own needs, we learn what might help us. Advocating for ourselves helps us get the care we need and change the systems we are a part of. Giving and receiving support from family, friends, spirituality and other sources outside ourselves keeps us connected with our communities and the world around us. Hope for continued recovery keeps us going when all else fails.

These concepts describe simple and necessary aspects of successful recovery. How do each of them contribute to positive change in your life? 

The Spoon Theory

But You Don't Look Sick is a site for people with invisible disabilities. In their words: "The mission of ButYouDontLookSick.com is to help everyone with a chronic illness or invisible disability, in order for them to live their lives to the fullest and not feel isolated and alone. We believe that our medical circumstances have put us in a unique and understanding position, so that we can help each other through similar difficult times. We hope the information and community on our site can aid people in leading better lives through knowledge, networking, friendship and most of all support."

My favorite page on But You Don't Look Sick describes "The Spoon Theory", a useful metaphor for how it can feel to live with the reduced energy capacity that can come from a chronic illness or disability. I believe this idea might be useful to anyone who may need to pay close attention to their stimulation levels such as Highly Sensitive Persons, people with autism, people with Asperger's Syndrome, or people with ADHD.

The Spoon Theory uses spoons to represent energy. We each get a limited allotment of spoons each day. When we use all of our spoons, our choice is to rest or take spoons from the next day. If we decide to take spoons from the next day, we will have fewer spoons to use tomorrow. This means we need to budget our "spoons" just like we might budget money or any other limited resource. This can be very useful for planning and prioritizing activities.

Here's an example of how I could use this idea to describe planning my day. Let's say I normally have 20 spoons per day. Taking the bus usually uses 2 spoons per trip, getting ready in the morning uses 1 spoon, and meals use 2 spoons per meal. (2 x 2 bus spoons) + 1 getting ready spoon + (3 x 2 meal spoons) = 11 spoons So, on any given day, I am likely to use at least 11 spoons. When I go to a street fair, I use 15 spoons for the fair in addition to 11 spoons I use every day. When I chose to go to a street fair on Saturday, I used at least 26 spoons. I had to borrow from the next day, so I only have 14 spoons for Sunday. If my friend invites me to go hiking Sunday (6 spoons), should I do it? Probably not, because I am likely to use at least 17 spoons, and I only have 14! I don't want to use spoons from Monday because I'm going to need all 20 spoons to work on Monday.

Another way to use the spoon theory is for prioritizing activities. I'll continue with the previous example. The Sunday after the street fair, I have 14 spoons. Hiking would take too many spoons, so I've chosen not to go. Can spend some time with my friend without taking spoons from the Monday? Yes! I can choose to spend fewer spoons with my friend. If my friend comes over, I don't have to take the bus, so I save 4 spoons! That means I'll only need 7 spoons for the rest of my necessary tasks. If my friend and I order take out, I could save 1 more spoon because take out uses 1 spoon instead of the 2 spoons it takes to cook. I'll still need to use 6 spoons for my day. There are plenty of fun things my friend and I could do with the remaining 8 spoons. The day is saved!

I can also plan ahead to save spoons for things I want to do in the future. I know that doing laundry uses a lot of my spoons. Going on a date also uses many spoons. This means I'd much less likely to choose to do laundry on a day that I have a date so I can save my spoons for what is more important to me. How do you prefer to use your spoons?

I find this metaphor most useful when I need to explain to others that I need to budget my energy like some people budget money or time. How is this idea useful for you?

The Story of Stress

When we perceive danger, our bodies' natural stress reaction (triggered by the sympathetic nervous system) increases our heart rate, blood pressure, shallow breathing, and muscle tension. Digestive action is decreased and our skin temperature decreases. These responses are designed to help us take action, such as fighting or fleeing. As well as saving us from the danger, taking action is one way to complete the cycle and reset our body back to equilibrium. When our ancestors faced dangers like animal attacks, this worked very well! However, in modern US society, it is usually inappropriate to respond to the danger we perceive by fighting or fleeing, so we internalize it. The ill-effects of stress are well documented. The effects of internalizing the stress reaction can lead to sleep disorders, chronic pain, anxiety, self destructive behavior in the short term. In the long term, it can lead to heart attack, depression, exhaustion, cancer, or increase your risk of problems you are genetically predisposed to.

Some of my favorite ways to reduce my stress are body-centered mindfulness practice, making art, spending time in beautiful natural places, avoiding news media, and enjoying the company of my cat. What are your favorite ways to reduce your stress?

Body Scan Meditation & Body Drawing

Since one of my favorite formal mindfulness practices is the Body Scan, and Body Drawing is one of my favorite body-centered expressive arts practices, it only seems natural to do them together!

The Body Scan Meditation is just what it sounds like: a meditation that focuses on mindfulness of the body by focusing on each part in turn. I've heard of Body Scans from several sources, but I've heard about it the most in relation to Mindfulness Based Stress Reduction (MBSR). For me, practicing body scans regularly has made a huge difference in how aware I am of my own body. Sometimes I find body scans useful for pain relief, relaxation, or as a sleep aid, however, the basic intention of the practice is simple awareness. Following the Body Scan Meditation with a Body Drawing is a way to record and integrate the experience of the body scan. And it's fun!

What you'll need:
a comfortable place to lie down (but not so comfortable you fall asleep!)
body scan recording or script (optional)
paper or other drawing surface (printed with a body outline, if you want)
colored pens, pencils, crayons, pastels, or other coloring media of your choice

Instructions:

1. Start with the Body Scan. I prefer to take at least 20 minutes, often longer; you can decide what's right for you. You can do the body scan in any supported position; many people find lying down to work best. It might be easiest to use a recording to guide you the first time.
   Once you find a comfortable position, begin by being aware of your breath. When you are ready, notice the contact points between your body and the surface supporting you. Now focus your awareness on your feet for a few breaths. Then move into your ankles, your lower legs, your knees, and so on, moving your awareness up through all of the parts of your body. You might imagine your breath going into each part you focus on. You might send each part of your body gratitude, love, or compassion. As you pass through each part, notice the sensations you find there. If you have thoughts or emotions, notice those, too. After you've gone through all of your body to focus on the top of your head, move your awareness outward to your entire body. Take a few moments to be aware of your breath and your entire body. When you are ready, open your eyes and gradually get up. Thank yourself for your nurturing practice.


2. Now you can record your experience with a Mini Body Drawing! The basic task is to fill in a body outline in response to your experience with the body scan. You can draw your own outline or use something like the ones below that I found using Google image search.

How was it for you? Share your experience or your drawings in the comments.


Online Resources
Free 10 minute guided Body Scan thanks to Greg de Vries
Free 30 minute guided Body Scan thanks to Ms. M. Cullen
Body Scan description and instructions thanks to NPR
body outlines, front & back, thanks to Oasis Acupuncture
body outline thanks to Lea Pearson, who teaches body mapping for flutists
"gingerbread" body outline thanks to Second Story Window, a blog of activities for children

Books & CDs with Body Scan Instructions
A Mindfulness-Based Stress Reduction Workbook, by Bob Stahl and Elisha Goldstein
The Mindful Way Through Depression, by Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn
The Relaxation and Stress Reduction Workbook, by Martha Davis, Elizabeth Robbins, and Matthew McKay

What is Expressive Arts Therapy?

It feels good to express ourselves, to give form to our experiences. When our expressions are witnessed in a safe environment, we have feelings of belonging and love. For these reasons and more, expressive arts therapists believe that creative expression in any form can be healing. Expressive arts therapy uses many different forms of expression including visual arts, writing, movement, crafts, and even things you may not think of as creative expression like cooking, planning a trip, gardening, building a sandcastle, or telling a story to a friend. Any expression can be art, and we are all artists.

As I listened to this podcast on CraftyPod called What Does Making Things Mean? Bridget Benton's definition of art resonated strongly with me. She said, "Art is a verb. It is the action of making something with meaningful mindful intent. ... Art is making with meaning." She added, "We are meaning making machines. Our use of symbols, stories, rituals is one of those things that distinguishes us as humans. We are all artists." These basic ideas are at the root of expressive arts therapy.

Symbolism in art helps us to communicate with the parts of ourselves that don't speak plain English, like our bodies, and the part of our minds we are not usually aware of. These parts already speak to us through dreams, emotions, and physical sensation. Through artistic symbolism, we can take part in this conversation with ourselves and get to know ourselves better. We become more aware of our whole selves when we pay non-judgmental attention to the processes and products of our creative expressions. Art and the self awareness it brings become ways to hold ourselves with love and compassion. When we practice caring for ourselves this way, we heal and grow.

What is your favorite form of creative expression? What is the process like? What is the result? What else?

Consider your answers to the above questions. If they have anything to do with a challenge in your life right now, what would it be? What else? What else?

One-Moment Meditation: "How to Meditate in a Moment"

Walk for Health, May 18th

Walk for Health

Show your Pride for Mental Health Awareness Month!

Take a Walk for Health! Join us for a 1.5 mile Walk for Health at beautiful Lake Merritt.

Join the Parade!  Meet at the Lake Merritt Bandstand at 9:30 am to register!

Open to all ages! Free! Register Today!

• Free Farmers Market when you walk or join in a class!
•  Express pride and support for mental health consumers and their family members!
•  Health resource tables, games, give-a-ways and lots of fun!
•  Zumba for Disabilities, Tai Chi, Line Dancing, Chair Yoga!

Second Lake walk starts at 1:00 pm (3.5 miles)

Transportation
Exit Lake Merritt BART Station or have a friend drop you off at 1221 Oak street
and meet them at the Wellness Village. Come with your Wellness Center or Support
Services Team.

Partial Sponsored:
The Walk for Health is brought to you by Alameda County’s 10 x 10 Wellness

Campaign, Behavioral Health Care Services, Health and Human Resource Education

Center, Asian Mental Health Services, PEERS, Pool of Consumer Champions, BEST NOW

For more information visit www.alamedacounty10x10.org or call 1-855-AC10x10 (1-855-221-0910)