How to set strong goals for your rehabilitation plan

How to set strong goals for your rehabilitation plan

It’s important to set strong goals for your rehabilitation plan to help you in your ongoing recovery from a serious health issue. Strong goals are the foundation of your plan. They provide a destination to work towards and even the direction to take to that destination. They become your road map to the best recovery you can get for yourself.

But what does a strong goal look like? How do you know if you are setting yourself up to succeed? To help you set strong goals for your rehabilitation plan, this blog takes you through a six-step plan to do just that.

This blog is part of a series on rehabilitation planning and you can read the first blog here on the principles of a good rehabilitation plan and the second blog here on what you need to include in your plan.

This blog (and the first two) will help you whether you are looking to create a full-on rehabilitation plan or you are further on – months, a year or years even – but want to tweak something you are doing or try something new.

As I’ve said before, rehabilitation is a life-long activity. Sometimes you may not make great gains in your rehabilitation several years after the health issue arrived into your life. But your rehabilitation can keep you from regressing, which is important. Also, rehabilitation is about self-care. And self-care is for life.

So let’s go through this six-step plan.

A woman is holding a map with the title 'My Rehabilitation Plan' at the top and at the bottom is written 'My Destination.' There are four goals on the map and the map shows the route from each goal to the destination. The woman is thinking, 'This rehabilitation map is a good example to follow. Looks like there may be some challenges. I need to visualise my ideal destination and start setting some goals.' The caption read: Set strong goals for your rehabilitation plan can help you reach your destination.

How to set strong goals for your rehabilitation plan

1. Identify what’s important to you

What is most important to you in your life? Now and what you want to be doing in the foreseeable future? How far you look into the future is entirely up to you.

Is it your family, your physical and mental health, your work, enjoyment you get from your hobbies and leisure activities, financial wellbeing, feeling calm and at peace, having a coffee first thing in the morning before everyone else gets up, or having a life purpose? Do you want to return to studying? Change careers? Retire? Doing more things independently? Something else? Make a list.

It doesn’t matter whether these activities are small or big, bring in money or not, involve other people or not, are mundane, are behavioural or just an internal feeling. It may be something you have to do or want to do. They can be from many parts of your life as I wrote about in the second blog in this series of rehabilitation planning. What matters is that they are important to you.

I will use myself as an example with a real-life issue.

What is important to me is maintaining my ability to move as freely as I can, to maintain my physical fitness (so I have to be able to exercise), and to push off having a knee replacement for as long as possible.

This picture contains an original quote by Return to Wellness - "Now that you are living with the impact of a serious health issue - What is important to you?"

2. Have you been able to make whatever is important to you happen yet?

Are you able to do what is most important to you? Have you made it happen yet? If there is anything getting in the way of doing what is most important to you, add that to your list.

If there is nothing that is an obstacle to working towards your goal, and it is something you have started or can get started on, write down what is enabling you to do that. This could be something about yourself, a characteristic, strength, skills and/or a passion you have. It may be support from other people. It could be anything.

The importance of this is it reminds you of what is going well for you, your strengths, and what and who are around you that are a form of support.

An example

I live with progressive osteoarthritis in my knees. My right hip is in pain and I am worried it may be starting there. Moving as freely as I can is a bit hit and miss. By the end of the day when my legs are tired, my mobility isn’t great and I can end up waddling from side-to-side.

I feel down and sometimes frustrated about the pain in my hip. I feel I need to look at how I am thinking about this issue too. Not sure why, but feel I need to.

I have made exercise happen. Finally! (You can read that story here and here.) And I’ve maintained doing the exercise nearly every day and only took breaks over the Christmas holiday and when I had a light injury to my knee. Being part of a group of people who had the same goal to make exercise a daily part of their lives has helped. So has my self-discipline, which I’m really proud of.

I am seeing a physiotherapist for my knees and hips. The exercises have helped my mobility. I waddle less. But I still have pain.

IMPORTANT TANGENT: It’s important to recognise yourself for your accomplishments and pat yourself on the back when you’ve done something well, or something you are proud of. Because there may be times when others won’t do that and you don’t want to constantly be in a place of waiting for praise from others to feed your sense of self-worth.

3. Now it’s time to set some goals. But first, inspire yourself

Look at what is important to you and what is getting in the way of you doing/feeling what is important to you.  What is getting in the way can sign post you towards goals you can be setting.

The pain in my hip and from an old groin injury is getting in my way. This inhibits that feeling of moving as freely as I can.

Now ask yourself this question. If there was something you could do to work with whatever was getting in the way, to work around that obstacle or even work with the obstacle, what would it be?

I think the physiotherapist was a little perplexed I was still feeling pain given my mobility was better and she said the exercises helped to build the required muscle mass I needed. Need to get a scan to find out exactly what is going on in my hip.* I’m wondering about doing a meditation on my hip pain. Use the tennis ball more to massage my hip. I need to sit with my mental state around all this and figure that out.

Don’t judge your ideas now as good, do-able, bad, or not feasible. You’re aiming for as many ideas as possible. Write them down. It may be that the ideas spark another idea.

Do I need a walking stick for days when it’s really bad?

You could do this exercise with someone, in a group, or on your own. If you want, have someone read over your work as they may have ideas to contribute and thought of something you haven’t.

You can also share this with someone who has been in the same place as you but a bit further down the road. They can share what worked for them and others.

If there is anything getting in the way of doing what is important to you in your life, consider what that is and how might you work with or around it so it becomes less of an #obstacle These could become #goals in your… Click To Tweet

4. Craft your goals

Remember, goals don’t have to be of the Big Hairy Audacious Goal type. But they can be if that motivates you. If your goals are big, break them down into smaller goals. These smaller goals are like milestones you can work towards. You are more likely to achieve these smaller goals and this feeds your motivation to continue. Important.

For example, maybe you’ve had a health issue like Transverse Myelitis, Multiple Sclerosis, Cauda Equina Syndrome or a stroke which has greatly impacted your mobility. You want to be able to walk again preferably without a mobility aid within a year. That is your Big Hairy Audacious Goal.

Let’s break that BHAG down into smaller goals.

  • Your first goal may be to go on a course to develop your skills of using a wheelchair so you can get out and about and maintain some independence.
  • You then practice your new wheelchair skills.
  • Your next few goals may focus on strengthening the muscles needed to walk through physiotherapy.
  • Once you have the strength, then you try standing.
  • Then take a few steps with a zimmer frame, then walk 25 meters, 50, 100, etc.
  • You progress to walking with a stick.
  • You then try walking without a stick.

5. Whatever the size of your goals, make sure they are specific

This is key. Because when a goal is specific, it’s more tangible in that a specific goal gives you direction on what you can be doing. Specific-ness ensures your goals are strong.

Whatever the size of your #goals make sure they are specific. That makes it more tangible giving you direction on what need to do. Specific-ness ensures your goals are strong. #rehabilitation #planning Read more here Click To Tweet

Here are some examples of unspecific, vague goals that don’t give much direction on next steps.

Get out more

  • Get out more where? Doing what? With whom? When? Where?

Be more independent

  • Independent from whom, from what? What activities do you want to be doing independently?

Feel calm

  • What do you want to feel calm about? When do you want to feel calm? What gets in the way of you feeling calm? Is it intrusive thoughts? What other people say and do (or don’t)? Something else?

Do more things that make me happy

  • What things specifically do you want to be doing? With whom? When? Where?

Return to work

  • To the same job? If yes, do you need adjustments to your job so you can actually do it? If no, what kind of job do you want? When ideally? How will you know your body is ready? Or are finances dictating your return?

Using me as an example, an unspecific goal would be

Walk more freely.

Unspecific goals can feel large and they don’t provide direction on next steps. Whereas with the walking goal provided above, there was a clear progression of steps the person had set themselves to take towards their goal of walking again. They also knew they would need to attend a course and get outside help in the form of physiotherapy to help them meet their goal.

Answer these questions to ensure your goals are specific

This picture contain the 10 questions to help you set strong goals for your rehabilitation plan. The questions are - 1) What specifically do I want to be doing, thinking or feeling? How will that be different from what I am doing, thinking or feeling now? 2) How often do I want or need to do, think or feel this? All the time? Or only in certain situations? What situations are those? Where and when do they happen? 3) When would I like to make this change by? 4) Who will I be doing this activity with? Or is it one I do on my own? Or both? 5) Do I need to learn how to do something? 6) Do I need specialist expertise to help me? If so, what kind and who can provide it? (coaching, physiotherapy, acupuncture for example) 7) Who can support me as I make this change? 8) How can I hold myself accountable for making this change? 9) What other questions do I have about making the change I want for myself?

I’ll continue using myself as an example.

What specifically do I want to be doing, thinking or feeling? How will this be different from what I am doing, thinking or feeling now?

I want to be able to get up from a chair with minimal pain and hobbling. Hopefully there will be less pain. I will feel more free in my body because it is moving more as it is meant to. That feeling of freedom will be me getting up from a chair and walking a little more quickly and ideally no hobbling which I do now.

Notice how goals can be something you see someone do or say. These are behavioural goals. Or goals can be about changing how you feel or think and these may not always be readily visible to others (which is fine).

How often do I need or want to do, think or feel this? Is it something I will be doing all the time? Like walking and/or using a wheelchair for example. Or is it only in certain situations. If in certain situations, what are they? Where and when do they happen?

I get up from chairs and walk daily.

I exercise and do my physiotherapy daily. If I can’t, at a minimum 5-6 times a week.


When would I like to make this change by?

ASAP ideally! But I need a scan. And the results of that scan may determine what happens after that. If I could be walking more freely in six months time, that would be good. It feels like a realistic timeframe. I’ll book an appointment with the GP on Monday.*

Who will I be doing this activity with? Or is it one I do on my own? Or both?

I walk every day with people like my husband, friends or colleagues.

Do I need specialist expertise to help me do what I want to be doing? If yes, what kind and who can provide it? Or do I need to learn how to do something?

I need the following specialist expertise: GP to get the referral for a scan; orthopaedic doctor regarding the scan and its results, physiotherapist for ongoing physiotherapy.

Who else can support me as I make this change?

Husband for moral support. He can also give me feedback on how I am walking.

Coach and therapist for support on how I am thinking and feeling about changes in my mobility.

Notice how these forms of support are non-medical.

How can I hold myself accountable for making this change?

This is SUPER IMPORTANT. I see a lot of people rely on others for accountability and when the other person/people don’t provide it, the person never achieves their goals. You want to strike a balance between support from others in helping you to achieve your goals and support from within yourself.

I have just entered the task of making the appointment into my calendar. If it’s in there, it gets done.*

Including this issue in a blog is a form of group accountability for me.

When I get up in the morning, put on my exercise clothes and do my physiotherapy first thing. I can lay my exercise clothes out the night before.

Every day after finishing my exercise and physio, I will continue posting in the online boot camp’s Facebook group that I’ve done it.

When it comes to #accountability for achieving your #goals, it’s important to have a balance between support from others and support from within yourself. You can’t rely on support from others 100% for achieving your #goal… Click To Tweet

What other questions do I have about making the change I want for myself?

How will I know when a using walking stick would be a good idea? Ask the physiotherapist. And can the physiotherapist do anything to improve how I am affected by the groin injury?

By answering these questions, you give yourself much more direction on what you do next. You have defined a route so you know where to go.

6. You need large doses of willingness to adapt, be flexible, be persistent and practice self-compassion

Picture of a woman sitting at a table on which there are four large bottles of medication. They are adaptability, flexibility, persistence and compassion. The woman is saying, "Time to take my heart and soul medication." Large doses of adaptability, flexibility, persistence and self-compassion will help you when implementing your rehabilitation goals.

Some of your goals are going to require a lot of work on your part. You’ll sweat – physically and mentally. You may feel frustrated at times. You’ve got to stay with. People can support you and contribute to you feeling motivated, but at the end of the day, you’ve got to do this. Because no one can do it for you.

You may find that your end goal of walking without a stick isn’t achievable in a year. It may take longer than you thought. Or it may not be possible at all. You may have realised you were over-ambitious. (Being ambitious is not a bad thing. Sometimes ambition can get you further than you or others expected even if you don’t meet your original goal.)

In these moments, it is ok to be upset. And as I always say, you don’t have to unpack and live forever and ever in the upset-ness. This is when you need those doses of adaptability and flexibility, the persistence and self-compassion to adapt or even change your goal and continue striving towards it.

I get frustrated on some days with my hip and groin. It gets so painful and the pain can be random. I’ll have a good day and then several bad days. I walk more slowly sometimes. It’s frustrating. It’s ok to yell. And cry. (I do!) It’s a good discharge for me. I can then move on.

Remember, sometimes you may not know what the end goal is or can be

Sometimes you just don’t know what the end result will be. Or you may prefer not to set an end goal. You just want to get started and figure out the next step as you go along. That is ok.

In either case, what Martin Luther King Jr. said is applicable.

“Take the first step in faith. You don’t have to see the whole staircase, just take the first step,” having to see the whole staircase, just take the first step.”

Martin Luther King Jr.

Taking that first step with faith in yourself and the people supporting you is key. That first step is a goal in itself.

This picture contains the quote, "Take the first step in faith. You don't have to see the whole staircase, just take the first step." by Martin Luther King Jr.

What’s it like for you?

Do you like to make a detailed plan of your goals or do you prefer to take one step at a time? What other approaches to goal setting have you tried which worked for you? Share your thoughts or questions in the comments below or alternatively email them to me (contact form in sidebar).  

If you are living with a serious health issue or are caring for someone who is, and would like support to set strong goals for your rehabilitation plan, have a look at how we can work together and get in touch for a free no obligation consultation.

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Know of someone who would benefit from reading this blog, or you just want to spread the ideas, click on the icons to share.

© Copyright Barbara Babcock 2019

*UPDATE on the scan – Went to the GP to make the appointment, was able to get an appointment that day due to a cancellation, ended up having an x-ray on my hip yesterday. And so just waiting for the results. That was quick!

Here is what you need to focus on when creating a rehabilitation plan

Here is what you need to focus on when creating a rehabilitation plan

Creating a rehabilitation plan to manage your recovery from a serious illness, injury, relapse or exacerbation of symptoms is doing what you can to take control and positively influence your outcomes.

Sometimes on this journey you can feel at a loss on what to do and where to get information. As I said last week and previously, you don’t know what you don’t know when you get ill or injured. And when you don’t get much information from medical and healthcare professionals, that makes it harder to know what to do. Feeling a bit lost in this respect is entirely normal.

So I am going to share what I and others have learned about creating a rehabilitation plan. This builds on last week’s blog in which I wrote about the ten principles which underpin a good rehabilitation plan.

A woman is sitting inside looking dejected. Her wheelchair is in the corner and her walking sticks are lying on the floor. Outside the window it looks like a nice sunny day. Above the window is the caption, 'Life happening out here!' The woman is saying, 'I need to make my life happen again! Both in here and out there. I need a plan but where do I start?' Creating a rehabilitation plan can help you rebuild and renew your life.

But…

In writing this blog, I realised that to share my knowledge with you adequately, this needs to be several blogs. I had written over 6,000 words, the equivalent of a major assignment for a masters degree! That was too much for one blog.

Therefore, this week I am giving you an overview of what creating a rehabilitation plan entails. Successive blogs will focus on setting goals and then what you need to consider for each section of a rehabilitation plan.

These blogs may not be published one after another but when they are, I will refer back to previous blogs in this rehabilitation planning series. This blog is your starting point.

It doesn’t matter what stage you are at in your recovery/rehabilitation

Maybe you just received a diagnosis, are in the early stages of your recovery, or have been through treatment and no longer under the regular care of a medical or healthcare professional.

Maybe it has been more than a year since the acute phase of your illness or injury and you are still adjusting. Or even some years since the original event and you are dealing with the ongoing impact and whatever else life has thrown your way.

There is something in here for everyone. Even those of you in a caring/supporting role. You too are impacted by your loved one’s health issue and you have had to make changes as a result. Many of the ideas here will help you to create a plan for you to look after yourself and your needs.

A #rehabilitation plan is for you no matter where you are at on your journey – just diagnosed, during treatment, after treatment, several or many years after the acute phase #chronicillness #wellness Click To Tweet

Things to keep in mind whilst creating a rehabilitation plan

I’ve taken a holistic approach to creating a rehabilitation plan focusing on the medical, non-medical and various parts of your life.

Given your rehabilitation plan will be very specific to your needs and you are all on different journeys, some of what I mention may not be relevant to you. That’s ok. Use what is. Discard what isn’t.

Each section represents a transition in an aspect of your life you are going through due to the health issue you or a loved one is experiencing. They are meant as a starting point. And it doesn’t matter where you start. Start with those that feel a higher priority to you.

Get help from family, friends and suitably qualified professionals as and when you need to.

When thinking about a rehabilitation plan for yourself, keep in mind the ten principles I wrote about last week.

This picture shows the 10 principles to include when creating a rehabilitation plan. It's holistic. It focuses on what matters to you. It involves those close to you. It specifies any specialist expertise you need and who can provide that. It's goal oriented. It can be adapted. It contains info on what to do when you experience a setback, a relapse or fluctuation or progression of symptoms. It contains info on what to do in a medical emergency. It contains info on what to do when you are doing really well too. And it is for life. There is a little boy in the corner of the pic who is saying, "My mummy's plan is helping her play with me again.'

What to consider when creating a rehabilitation plan to progress your recovery

Set specific goals on what is important to you in the various aspects of your life. The goals can be large or small. Break down any large goals into smaller ones as that can make it easier to achieve.

The various aspects of your life, all which can feed into your rehabilitation plan, are listed here. Some of them overlap one another.

1. Managing your health issue

This is more about the medical side of things and your physical health: the medications you take, routines you have, learning how you are affected, managing symptoms, what you do in a medical emergency, when you are not doing great (but it’s not an emergency), when you are physically in a good place, and your healthcare team.

If you are in a caring/supporting role, this is is about managing your health.

2. Your physical environment and getting around

How you may need to adapt your home or move home, adapt your car and equipment you need so you can do daily activities or do them more easily.

3. Nutrition and making any needed changes to your diet

Sometimes your health issue may require you to make changes to your diet. Sometimes it doesn’t. But sometimes making changes can lessen symptoms and so may be advisable.

Regardless, what we eat and drink (and don’t) is fuel for our bodies and when you are recovering from a serious illness or injury or living with a chronic illness, you want to give your body what it needs and nourish it.

4. Prioritise your emotional health

This goes without saying. I tweeted the other week that experiencing a life-changing health issue (yourself or someone else’s) is that jarring wake-up call to life, that you’re mortal and not invincible. It also gives you that permission to make yourself a priority and look after yourself. This is so important. You cannot afford to not look after your mental health.

5. Nurture your relationships

You need good people around you. So this is about taking stock of who is around you, what relationships you need/want to let go of, what kind of relationships you want going forwards, and who isn’t a part of your journey but you want them to be.

Nurturing your relationships are part of creating a rehabilitation plan. A woman is sitting down with her walking sticks nearby and she is thoughtfully considering the following questions about her relationships. Who do I have around me whom I love? Which friends are part of my inner circle? Who isn't any longer? Who might be willing and able to help me? How can I help those close to me help me? What kind of relationships do I want going forwards? What relationships do I need or want to let go of? What isn't part of my life but I would like them to be?

6. Financials

This can be impacted when a health issue enters your life so this is about knowing what changes you need to make and where you can get support.

7. Return to work, volunteering and/or education

You may wish to return to your existing job, change jobs, even change careers. Or you may wish to volunteer instead or return to education. You may wish to retire and find ways to still contribute in some way.

8. Your leisure activities

Your leisure activities are really good for your mental health so this is about returning to previous activities, adapting how you approach them if you need to, and/or finding new activities.

9. Cultural factors to consider

Sometimes the culture we are raised in has specific attitudes towards health, illness and disability and this can have an impact on how we deal with our own or a loved one’s health issue, our relationships and how we get on in and with society.

Sometimes the culture we were raised in has specific attitudes towards #health #illness and #disability and this can have an impact on how we deal with our own or a loved one’s health issue and our relationships. I reckon this… Click To Tweet

10. Spirituality/ Faith

This applies if spirituality and/or a faith are important to you. A serious health issue can test your faith and you may argue with it, and/or even turn away from it for a while or forever. It can also lead you to incorporate spirituality and/or faith into your life more consciously.

11. Your life purpose

This is about who you are, want to be, what you consider important to you now and into the future, the kind of life you want to live and what kind of person you want to be known for.

Set goals on what is important to you when creating a rehabilitation plan. Your goals can be in the area of managing your health issue; your physical environment and getting around; your diet and nutrition; nurturing your relationships; prioritising your emotional health; finances; leisure activities; returning to work, volunteering or education; your life purpose; spirituality and/or faith; and any cultural factors you may need to consider.

There is actually a lot to consider when creating a rehabilitation plan

And only one part of it is medical. There is rather a lot that is non-medical but has a significant impact on you and your life.

It may feel like a lot to address. Don’t take it on all at once. Just focus on those areas that feel the highest priority to you and you think could make the most difference to you and how you are feeling.

And it’s ok if it takes a few years or more to get through all the sections. What is in a section may also change over time too. That is entirely normal.

Stay tuned for future blogs in this series on creating a rehabilitation plan.

When creating your #rehabilitation plan, you don’t need to do everything all at once. Just focus on those areas that you feel are the highest priority for you, they can make the most difference to you and how you are feeling.… Click To Tweet

What’s it like for you?

Which aspects mentioned above about creating a rehabilitation plan are most relevant to you right now? What if anything, do you feel is missing? Share your thoughts or questions in the comments below or alternatively email them to me (contact form in sidebar).

If you are living with a serious health issue or are caring for someone who is, and would like support to create your own rehabilitation plan, have a look at how we can work together and get in touch for a free no obligation consultation.

Pass it forward

Know of someone who would benefit from reading this blog, or you just want to spread the ideas, click on the icons to share.

© Copyright Barbara Babcock 2019

Here are the 10 principles of a good rehabilitation plan

Here are the 10 principles of a good rehabilitation plan

Having a rehabilitation plan for recovery and managing the illness or injury sometimes feels like an afterthought in the treatment and care of people with serious health issues.

Unfortunately, I often hear of people being discharged without any information other than medical information on managing their recovery and ongoing rehabilitation.

These people were lucky if the nurses gave them information from a charity or signposted them to a charity that could give them information and support.

You can feel lost at sea wondering what you can do, how you can help yourself. If you learn that someone in a similar position to you did get more info, advice and a plan, it can feel very unfair.

A woman is in a boat and there is a smallish sail that has 'medical sail' written on it. The woman is noticing that the wind is picking up but she is saying, "I wish I had a bigger sail. It will take forever to get home.' Two fish in the sea are talking to one another. One is saying, 'She needs a Return To Wellness sail.' This picture demonstrates that a rehabilitation plan needs to contain more than just medical information to help you in your recovery and rehabilitation.

As I’ve said many times before, as a patient you don’t know what you don’t know when you are diagnosed with a serious health issue or become seriously injured. It’s not like you have read up on the health issue beforehand. So in the early stages, you are very reliant on the medical and healthcare professionals. Learning they have the information but didn’t give it to you can feel like a betrayal of sorts.

I operate on the basis that ‘knowledge is power’ and we can certainly take control and influence our rehabilitation. If you wait for someone else to tell you what to do, you could be waiting for a very long time. Or if someone like a peer who also has your health issue tells you what you can or ‘should’ be doing, it may not be right for you.

So I want to share what I’ve learned about creating a rehabilitation plan as someone who has had a serious illness and having been in the caring role. As a precursor to this though, this blog focuses on the 10 principles which underpin a good rehabilitation plan. I’ll focus on the how to’s of creating your rehab plan next week.

Here are 10 principles of a good #rehabilitation plan. Read more here. #recovery #seriousillness #seriousinjury Click To Tweet

A rehabilitation plan is holistic

It focuses on the medical aspects of your issue and the non-medical too. In fact, the non-medical part of it can be pretty extensive. It may also include any social care needs you have such as benefits, obtaining necessary equipment and/or adaptations to your home.

It focuses on what matters to you

What is important to you, the daily activities which are the highest priority for you to return to, and what you want to be doing because it makes you happy.  

A good rehabilitation plan involves those close to you

The people close to you are your support network. AND YOUR SUPPORT NETWORK IS INCREDIBLY IMPORTANT. It can make a positive difference in your rehabilitation (Reblin & Uchino, 2008).

These people may be family members, relatives, friends, colleagues, others who have a similar illness or injury, and/or your pets. These people are your cheerleaders, they give you comfort when you feel down or are having a bad time of it, they help you with your physiotherapy, shopping, cooking dinner, cleaning your house, looking after your children, helping you if you have a health emergency or something else.

You can of course involve close family members in helping you create those aspects of your plan that may involve them, for example returning to favourite family activities. This gives them a role in supporting you, which can be great for them as they know how they can help you. And good for you to have that active support. A key thing is letting them support you. A rehabilitation plan does not have to be a solo effort.

A mother who now uses a stick to walk, her young son and husband are sitting at the dining table helping the mother create her rehabilitation plan. Her son says, "Mummy, running is exercise. We can play tag in the park!' His mummy responds, "Oh honey! I cannot run anymore. But maybe we can create a new tag game." The father is smiling and saying, 'Make sure to slot me in under me-time!' He is also thinking about how proud he is of his wife. This picture demonstrates that creating and implementing your or a loved one's rehabilitation plan does not need to be a solo effort.

It specifies what kind of specialist expertise you need and who can provide that

You may not know how to do some things in your plan so you may enlist the help of someone who does. You may need support with an issue that feels too big to handle on your own. A problem shared is a problem halved as they say. There may be an activity you need to do that requires a specific expertise you don’t have, like physiotherapy, osteopathy, or a coach for example.

A rehabilitation plan can specify what specialist expertise you need or want and who can provide that. But some people don't like needing help. This pic says, 'We have the saying in our society that 'a problem shared is a problem halved'. So why do we stigmatise getting help?

It is goal oriented

You may have a big goal broken down into smaller goals. Or it may be a series of smaller goals. Some of these goals may be key milestones, like being able to walk with good balance and not falling down for 500 meters.

Your rehabilitation plan can be adapted

As you implement your rehabilitation plan you may find that you need to adapt it as your recovery progresses (however slow or fast that is), stalls or you experience a setback.

As you are not a static person never changing, neither is your rehabilitation plan. Flexibility to adapt as you learn what works and as things change is key.

You are not a static person never changing, so neither is your #rehabilitation plan. Flexibility to adapt as you learn what works and as things change is key. #recovery #seriousillness #seriousinjury Click To Tweet

It contains a section on what you need to do when you experience a bad patch

This may be a setback in your recovery or you experience a fluctuation in symptoms or a relapse. This is kind of like a sub-plan of your main rehabilitation plan which you implement as and when you need to.

Your rehabilitation plan contains a section on what to do in an emergency

For example, if you have a spinal cord injury at T6 (T = thoracic level), you may be at risk for autonomic dysreflexia, which can be life threatening if not treated. Another example is hypoglycaemia if you have diabetes. So if you are at risk of having a health emergency and you may need the support of others to stabilise tings, you need to have in your plan what has to be done, medications to take, who to call, etc.

It contains a section on how you look after yourself when you are doing really well too

Just like you have a plan for when you are not doing well, you have a plan for when you are doing well. These might include favourite activities that you really enjoy doing and can do when symptoms are quiet or well controlled, or you are feeling physically and/or mentally well. For example, going to a concert or play, spending a day, afternoon or evening with friends, going on a walking weekend, entertaining, bubble bath, etc.

A good #rehabilitation plan will cover all the bases – when you are going through a bad period, what you need in an emergency and what you do when times are good #recovery #seriousillness #chronicillness Tell a friend

Your rehabilitation plan is for life

You may be thinking, ‘What the…???’

But yes, rehabilitation is an ongoing process. When you’ve experienced a life-changing illness or injury, often times your body has changed forever. It, and you, need tender loving care. And you need to provide that and make that a priority.

Sometimes you may not make noticeable gains in your recovery and you may have even experienced a plateau and wonder if there is any point in continuing. But keeping to your rehabilitation plan often means you don’t regress, i.e. you don’t lose functionality.

I have heard people say that they notice a change for the worse when they stop their physiotherapy, exercise or stretching for example. Or they stop an activity that has contributed to keeping their mental health in a good place.

In short, a rehabilitation plan is about developing new life habits that are about looking after all aspects of yourself.

Finally, share your plan with the medical and healthcare professionals responsible for your care. Particularly for those items which are medically related (medication dosages, etc.).

This picture shows the 10 principles of a rehabilitation plan. It's holistic. It focuses on what matters to you. It involves those close to you. It specifies any specialist expertise you need and who can provide that. It's goal oriented. It can be adapted. It contains info on what to do when you experience a setback, a relapse or fluctuation or progression of symptoms. It contains info on what to do in a medical emergency. It contains info on what to do when you are doing really well too. And it is for life. There is a little boy in the corner of the pic who is saying, "My mummy's plan is helping her play with me again.'

Come back next week when I focus on how you can create a rehabilitation plan.

What’s it like for you?

What principles above do you think are particularly important? And is there anything you would add to the list above what makes a good rehabilitation plan? Share your thoughts or questions in the comments below or alternatively email them to me (contact form in sidebar).  

If you are living with a serious health issue or are caring for someone who is, and would like support to design a personalised non-medical rehabilitation plan for you or a loved one, have a look at how we can work together and get in touch for a free no obligation consultation.

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© Copyright Barbara Babcock 2019

When is being defined by your disability a good thing?

When is being defined by your disability a good thing?

When is being defined by your disability a good thing? Is it a good thing to be defined by your disability? Or not? You may have a disability and think, ’Yes, I have a disability.’ But you may not consider yourself disabled.

I’ve been discussing these questions recently with people and have also come across them in the press.

They are not questions for which a straightforward answer is easy. Identity and disability are complex topics. You can write a book on it. So I will only scratch the surface in this blog.

What I do is share real life examples of how people view their disability. And from that the three things which can influence your thinking about being defined by your disability (or not).

When is being defined by your #disability a good thing? Is it ever a good thing? Tell a friend

‘I have a disability, but I don’t consider myself disabled.’

I heard this a month ago at a bladder and bowel support group I attend. The person who said it has a colostomy bag. (I have this person’s permission to mention what they said in this blog.) A colostomy bag collects a person’s poo because they are unable to pass it through the rest of their intestines and then out their rectum (for any number of reasons).

Looking at this person you would not know they have a colostomy bag. They go to work, see their friends, enjoy their hobbies, etc, etc. They are living their life. They just empty their waste through a bag, that’s all.

My other half also says he doesn’t consider himself to have a disability – he has diabetes and is insulin dependent. Looking at my husband, you wouldn’t know he has diabetes. He works full-time, enjoys his hobbies, etc. However, I know the changes he has had to make and they have not always been easy for him.

I often hear from people whose disabilities are not readily visible

Like having a colostomy bag or diabetes. Some of these people are able to continue their lives from an outsider’s perspective nearly the same as before the disability’s onset.

But also, if someone has depression or bi-polar disorder, they go to work, have a family, go out with their friends, smile and laugh, have hobbies. For people who experience depression, they may not experience it all of the time. Bi-polar can also fluctuate and at times the person may be going through a period where they don’t experience the depressive or manic phases.

In the above examples, the disability can be invisible or just not visually prominent at times and the person may not think of themselves as disabled. They are getting on with their lives and dealing ably with the impact of their disability.

I have a disability but I don’t consider myself disabled.’ – I’ve heard this a fair number of times from people with a #disability and write about it here. Tell a friend

But what about disabilities that are visible?

Society’s view of disability has traditionally been that a disability is visible, i.e. a person using a wheelchair or other aids for example. The disability has to be visible for a person to be considered disabled. (But that is an older view of disability which is changing.) So you would think a person can’t help being defined by their disability, right?

A picture of four people representing society point at a man using sticks to walk. The four people are saying, "You have a disability, you are disabled." The man is saying, "Uhm, I have a disability but I don't think of myself as disabled." The pic also contains the questions: When is being defined by your disability a good thing? And who is doing the defining?

You may become known as the person ‘in the wheelchair’ or who ‘has a blade’, or ‘uses a stick’ and/or a scooter. You yourself know that you are different from many of the people around you. That difference stands out and it is often the first thing people see and often react to.

Ellen Blunsdon, a student in Edinburgh, noticed people were looking at her more and she got more comments from the public when she started to use her walking stick routinely.

Maybe you don’t mind being defined by your disability in this way

I have heard people say, ‘My wheelchair is a part of me, it’s an extension of my body.’ In Ellen’s case, she loves her six walking sticks because she sees them as an extension of her body and something she can express her identity with.

I have also heard people say that their disability has played in a role in shaping the person they are today and has provided the opportunities to do things they enjoy in their life.

I remember meeting a guy who described the day he sustained a spinal cord injury (due to a car crash) as his birthday. He also said that he would not go back to his previous life.

Or the disability is seen as a bad and unfortunate thing to have happened but not the end of the world. For example, Kristina Vogel, the cyclist who sustained a spinal cord injury in 2018 in a cycling accident and is now wheelchair dependent said in this BBC article, “I still love my life. So nothing changed, really. Just how I move. I’m going to do a lot of things in my wheelchair. It’s different, but it’s still my life…”

Kristina Vogel’s gives a matter-of-fact description of her situation. I have heard many people who use wheelchairs say that all that has changed is how they get around and do some activities. Like Kristina, they now use wheels rather than their legs. For them, the rest of their life is similar to as it was before: they go to work, love, laugh, cook, have hobbies, etc.

They’ve adapted to regain their abilities to do the things they want in life. And they’ve found new ways to be able. So saying they are ‘disabled’ feels a misnomer. I feel they have ‘re-enabled’ themselves. They too are getting on with their lives and dealing ably with the impact of the changes to their body.

The pic shows three people with various disabilities and it's about them regaining abilities and regaining new ones after the onset of a disability. The man in the wheelchair is saying, "I've taken up painting as a hobby and I have my first exhibition." The woman who uses sticks is saying, "I still work as an engineer." A younger woman is saying, "I've managed to go to university even though I have chronic fatigue syndrome. I won't finish uni with my friends but I will finish."

Or you may mind being defined by your disability

You may wish people would see past your wheelchair, prosthetic, blindness, deafness, diabetes and see you for who you are as a person, your sense of humour, your skills, your achievements, likes and dislikes.

Or you worry about ‘coming out’ with your disability, concerned that people you have known for a very long time may treat you differently, as in the case of the student Ellen mentioned previously.

Or you mind being defined by your disability but you’re aware of the benefits and opportunities it has brought you

Billy Monger’s story demonstrates this point. He was rising up the ranks in the motor racing world when he lost his legs in an accident on the track in 2017. The racing world rallied around him to help and he ‘found himself transformed from just another driver on the rise, to a symbol of triumph over adversity’.

But ‘Billy wants to be known as a racing driver and “not the guy who drives with no legs”’.

‘“Before the accident, I was desperate to get my name out there. Now, everyone knows who I am, but in my head, it’s not for the right reasons,” he says.’

‘He’s conflicted because, in some ways, Billy knows he needs the spotlight now more than ever’ to move ahead in motor racing. His accident and consequent disability has given him the spotlight he needed.

Not only can you have the conflict of recognising the good things that happened and opportunities that have come your way due to your disability, but you also want to be recognised for yourself and your abilities regardless of the disability.

You can also have another conflict like Billy said in the article, and I’ve heard from others – In some circumstances they would go back to their old life if they could. You may feel the same.

This is what could be influencing your thinking about being defined by your disability

Writing the above, three things occurred to me which could potentially influence your thinking around being defined by your disability. And this is by no means an exhaustive list.

  1. What we as a society have associated with the meaning of ‘disability’ and ‘disabled’.
  2. There’s a theme in everything I have written of what other people think and how they respond to disability.
  3. Feeling that one is ‘disabled’ is a very subjective experience. And so it will differ from individual to individual.

I could go into what the law considers to be a disability as per the Equality Act but to keep this blog from getting even longer, I have chosen not to address that. Suffice it to say that if your impairment is considered a disability under the Equality Act, you have an extra layer of protection in the workplace. This is when it may be open about your disability. For guidance on the Equality Act, this is also a useful document.

A man who uses sticks to walk is sitting on an ottoman holding a book titled 'About Disability' and thinking the following: I'm ok with the term disability. I do have a disability, but I still have many capabilities. So I'm not sure I'm disabled. But other people think I'm disabled. It's frustrating when they think I've lost all my abilities. What do we mean by being disabled?" The caption has the question: How do you think about being defined by your disability?

What we as a society have associated with the meaning of ‘disability’ and ‘disabled’

When you look at the word ‘disabled’, there are two parts ‘dis-abled’. And it’s the meaning of the prefix ‘dis’ which sets the tone for the meaning of the word ‘disabled’.

According to the Oxford dictionary, the prefix ‘dis’ can give a word

  • the opposite meaning, e.g. like and dislike
  • express negation, e.g. disadvantage
  • denote reversal or absence of an action or state, e.g. disaffirm
  • denote removal of something, e.g. disbar
  • express completeness or intensification of an unpleasant or unattractive action, e.g. disgruntled

Dictionary.com also defines ‘dis’ as having a ‘privative, negative or reversing force’.

I had to look up ‘privative’ and according to the Oxford Dictionary, it means ‘marked by the absence or loss of some quality or attribute that is normally present’. Dictionary.com refers to privative as ‘causing, or tending to cause, deprivation; consisting in or characterised by the taking away, loss, or lack of something; indicating negation or absence’.

A disability in the context of our bodies means that we don’t have (from birth) or lost some functionality whether that is physical and/or mental.

There are two parts to the word ‘disabled’ – 'dis' and 'abled'. The prefix ‘dis’ means loss, deprivation, negation, absence. No wonder people say, ‘I have a #disability but don’t consider myself #disabled.’ Who wants such… Tell a friend

But given the meaning of ‘dis’ has negative connotations, a sense of negativity has been associated with disability

That it’s negative to lose functionality. It may very well be, don’t get me wrong. In general, we don’t like losing stuff. But also, when we lose functionality, we are then different from the majority of people around us. And society doesn’t always deal well with difference.

This negativity is often inherent in the everyday language people use to describe disability. For examples of this, read the article about Ellen where there are assumptions that disability is associated with not looking pretty or older age. There is also the issue that if you have a physical disability, people will assume you can’t speak for yourself or are also impacted mentally.

Most people don’t want something negative associated with themselves and their abilities. So it’s understandable that someone who has a disability may not consider themselves disabled.

People often don’t want negativity associated with their disability. Take Billy Monger mentioned above. He wants to be known for his skills first, not his disability. First and foremost, he is a human being with a career path, hopes, dreams, likes, dislikes, etc. He just happens to move around differently.

So I come back to the point I made earlier about ‘disabled’ not being quite right when people have adapted how they approach every-day activities and found new ways of being able.

What other people think and how they respond to disability

As in Ellen’s story, sometimes Joe and Jane Public can do an excellent job of sometimes inadvertently, but also overtly, disabling the person with the disability. This often happens by what they do and say, and the assumptions which underpin what they say.

For example, being told you’re inspirational for doing something normal like going shopping in your wheelchair can be frustrating. You may have worked hard to return to the every-day normal activity of shopping so you could live an independent life like everyone else around you.

What is different about you is pointed out to you and you are fully aware of this difference. But the underlying assumptions of what people say can be patronising and disabling. Take the common saying:

“I think you’re inspirational for doing your food shopping!”

The possible assumptions could be:

  • “Poor you! It must be awful to have to use a wheelchair/stick!” – This comes across as patronising. It can also be a subtle way of the speaker saying, ‘You are worse off than me.’ One person is greater, one person is less than.
  • “Wouldn’t it be easier for you to have it delivered?” – This could be a subtle discount of the person’s abilities to do their own shopping in a wheelchair.
  • “I could never do that. That must be so hard. I find it amazing you can.” – If you ever become injured or ill which causes a disability, you may need to find a way yourself.

But you can have the opposite experience as in Billy’s story where people rally around you and support you to return to as full and active life. And people treat you the same as any other person.

Feeling that one is ‘disabled’ is a very subjective experience

Every person is different. You may mind being defined by your disability, or you may not.

You may define another person by their disability, but they may not do that for themselves.

You may not mind being defined by your disability, but you may very much mind the impact of having a disability means for getting out and about and contributing in our society as Hannah Cockroft points out so well in this video. Our built environment is certainly not accessible to everyone no matter the disability they have.

You may not want to be defined by your disability but appreciate what you’ve learned or gained as a result of your life post illness or injury which now defines you.

You may or may not mind being defined by your disability but you wouldn’t hesitate to return to your life pre-disability if you could.

So when is being defined by your disability a good thing?

It depends. There can be so many responses to this. It’s not an either-or issue. There is no right or wrong way to be. Whether or not you feel defined by your disability and whether that is a good thing or not is a very individual experience.

The picture contains a box on the left which has Good in it and a box on the right which has Not Good in it. There are nine boxes in between and they are various shades of grey. Among the boxes is written: All the shades of grey and contradictions. And the caption says, 'Being defined by your disability can be all of this.' There is a man sitting on the Not Good box saying, "See me for me." There's a woman with mobility sticks standing under the Good box saying, "It helps when a shop or venue is accessible."

What’s it like for you?

What do you consider to be a disability or when someone is disabled? If you have a disability, how do you feel about being defined by your disability? Or a loved one being defined by their disability? Share your thoughts or questions in the comments below or alternatively email them to me (contact form in sidebar).  

If you are living with a serious health issue or are caring for someone who is, and would like support to return to a sense of wellness, have a look at how we can work together and get in touch for a free no obligation consultation.

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Know of someone who would benefit from reading this blog, or you just want to spread the ideas, click on the icons to share.

© Copyright Barbara Babcock 2019

How to cope with a setback in recovery

How to cope with a setback in recovery

The realisation that you have to cope with a setback in recovery can be very disappointing. Especially if you have been doing what you need to be doing to recover well. It’s another piece of bad news.

Someone recently asked me for resources on how you cope with a setback in recovery and although I had written about this topic some time ago, that blog was from the carer perspective. Hence this blog. (and next week’s blog too)

So how do you cope with a setback in recovery?

When we’re recovering from an illness or injury, we often have an expectation that our recovery will be a smooth upward trajectory back to good health. (The meaning of ‘good health’ is subjective. Every person’s version of ‘good health’ will be unique to them, their body and their circumstances.)

Pic of a person thinking their recovery from a serious illness or injury will be an upward trajectory back to normality, i.e. their pre-illness or pre-injury self. The person is standing in a graph where the Y axis is Recovery and the X axis is Time.

It may not have occurred to you that you would have to cope with a setback in recovery because you didn’t think it would even happen. Or the medical and healthcare professionals said your recovery should be straightforward.

But actually, it is very common for the recovery process to be more like this.

Pic of a person thinking their recovery from a serious illness straightforward. Their future self is looking on saying, 'Sometimes it is. But not always.'  The two people are standing in a graph where the Y axis is Recovery and the X axis is Time. The line between the two people, which symbolises the recovery process, is going all over the place to show that recovery from a serious illness is not always straightforward and there can be setbacks. So it is important to learn how to cope with a setback in recovery.

Being able to cope with a setback in recovery is therefore something many of us end up having to do. So I share ten things I think can help you cope with a setback in recovery – five this week and five next week.

How do you cope with a setback in #recovery? Read five tips here #seriousillness Tell a Friend

See your doctor to find out what’s going on

This is stating the obvious but it’s important. The doctor can (hopefully) tell you what is happening, why and what they and/or you need to do medically to address the situation.

Keep a diary of your symptoms and bring it to your appointments. But make sure to look for trends and patterns in the info you keep before your appointment. Giving it all to the doctor and expecting him/her to analyse it for you during the appointment is not the best use of appointment time. Also come prepared to the appointment with the questions you have. This is all about helping the medical and healthcare professionals to help you.

Acknowledge that there will be uncertainty

Picture of a quote: "One thing is certain. There will always be uncertainty." This is true when you have to cope with a setback in recovery.

And potentially a lot of it. Sometimes the medical and healthcare professionals cannot tell you why there is a setback in your recovery. When they don’t know why, then there is potentially less they and you can do. Or they try something but there are no guarantees it will work. This can be a scary place.

You and the medical and healthcare professionals have all this energy to do something but without knowing what to do, that energy kind of has nowhere to go. So you all end up in a scary place with a lot of frustration and feeling powerless to make things better. It’s a difficult place to be.

When the cause of a setback in #recovery is unknown, the uncertainty can be scary. You and the doctors have the energy to sort things, but without knowing what to sort, that energy has no place to go. Feelings of frustration and… Tell a Friend

Although this is stating the obvious, what you can do to help manage the uncertainty is…

Take it one day at a time

Slow down. Be gentle with yourself. Shower yourself in self-compassion. Self-criticism has no place here and won’t help you or your situation.

It’s totally understandable if you are upset because of the setback. And it’s ok to be upset. Acknowledging your upset-ness is healthy. Just remember not to unpack and live there. If you lived in the upset-ness, that would be less healthy. As you come out of it, channel the energy of the upset-ness into your recovery.

A man is trying to cope with a setback in recovery. But he is so upset he is unpacking his suitcase of upsetness. In it are anger, sad, loss and frustration. He is saying, 'I'm so upset I'm just gonna unpack and live here.' His other half, a woman, is saying, 'Honey, I can see how tough this is for you. I can help you sort your suitcase. And I have another suitcase which might be better for this journey.' The other suitcase is near her and written on it is Return to Wellness. The point this picture is making is it is ok to be upset, and that you can acknowledge how upset you are without unpacking and living there.

Focus on what you can control and influence

Focus on what you can directly control and influence. This is how much rest you get, what you eat, taking medication, and doing any exercise or physiotherapy you can for example.

What you don’t want to do is attempt to control things which are not in your control. This could end up with you wasting a lot of energy which you need for your recovery.

There are a lot happening in our bodies that we cannot control. Processes happen on their own that don’t require active intervention from us. We can influence our body in how we take care of it, but otherwise that’s it. We can however control our minds, our muscles and our breath. (Provided the illness/injury we have doesn’t affect any of these.) And this leads me to my next point.

Picture of three circles inside one another. The inner one is Direct Control. The next circle is Influence. The outer circle is Concern. To cope with a setback in recovery, you want to focus on what is in your Direct Control and Influence to do. What you cannot control or influence, and that is in the circle of concern, you need to let go of that. This model is by Stephen Covey and is from his book The Seven Habits of Highly Effective People which was first published in 1989.

Look after your mental and emotional health too

Your mental/emotional health is equally important. And it could take a knock when you have to cope with a setback in recovery. Mindfulness, meditation, breathing exercises, speaking to a counsellor or a coach, reading books on maintaining your mental fitness, and more can all help you to care for your mental health.

If your physical health isn’t in a place where you want it to be, but your mental health is, that can help stay in the driving seat of coping with your physical health issue.

Picture of a man driving a car and the license plate says, 'My Health.' This is about looking after your mental health so you can cope with a setback in recovery. Your mental health can also be impacted by a setback. But if you look after your mental health well, you can remain in the driving seat of your health.

What’s it like for you?

What has helped you to cope with a setback in recovery? Is there anything which did which is not listed here? Share your thoughts or questions in the comments below or alternatively email them to me (contact form in sidebar).  

If you are living with a serious health issue or are caring for someone who is, and would like support to cope with a setback in recovery or another aspect of the health issue you are dealing with, have a look at how we can work together and get in touch for a free no obligation consultation.

Pass it forward

Know of someone who would benefit from reading this blog, or you just want to spread the ideas, click on the icons to share.

© Copyright Barbara Babcock 2019

What is the impact of family on health and illness?

What is the impact of family on health and illness?

The impact of family on health and illness and vice versa has long been an interest of mine.  I was reminded of the depth of this impact when working with a client last year. He has kindly given me permission to use one of our sessions as a case study to share what the impact can be like and what can help.

You are aware of the impact of family on health and illness given you have most likely lived through or are living with a serious health issue, whether yours or a loved one. There’s a practical, emotional, social, and financial impact, and the impact on family relationships. And all this can have a physical impact on you.

The impact of family on health and illness or injury can be wide and varied and I can write a lot about it. But in this blog I am focusing on how what we learn in our family of origin and how the family functions can impact our health.

Picture of a family having dinner together around a table, a mother, father, two daughters and son. The father is saying the eldest daughter is ready to return to university as they don't want her to get too far behind. The mother is saying it is too early as Lisa's chronic fatigue has only just started to improve a little. The younger daughter is thinking, "Uh oh. Mum is frustrated with Dad." The son is thinking how he wishes for sausages for dinner rather than all the vegetables they are eating. Lisa is thinking that she wishes her Dad would listen to her Mum. This demonstrates the impact of family on health and illness.

Anthony’s dilemma

The client, Anthony (not his real name), talked about his health issues. He had a badly broken leg which was still healing, back issues, and was ‘living on borrowed energy’. He also had a variety of projects in his professional life on the go and was wondering if he should put some on hold or even stop focusing on them so he could look after himself more.

Anthony spoke of his back pain and feeling something in his back pushing him forward, but also something pulling him back. He said he felt these sensations his whole life. He wanted to do something about it.

Anthony said, ‘I can be better, and get more work, but I can’t fulfil my existing commitments. I run around and do things. What is it in me that does this? But I do manage to take care of myself.’

I noticed Anthony described the pushing and pulling as not being done by him and that he had been experiencing it his whole life. To identify if Anthony felt that he had any role in this pushing and pulling, an ownership of sorts for it, I asked him, ‘Who or what is doing the pushing and pulling?’

The impact of family on health and illness

Anthony started to talk about his father and uncle. They were the authority figures in his family. He felt he needed to live up to their expectations throughout his life. Anthony described himself as a ‘people pleaser’. He described their expectations as the pushing forward feeling in his back. He said it felt like a burden. Anthony felt the pushing forward sensation where the pain was in his back.

How might the dynamics in your #family relationships be affecting your #health and #wellness? Click To Tweet

Anthony described the opposite feeling of being pulled/pushed back – the feeling of a cool breeze which balanced his energy, feeling more content and that he could let go. But he also said, ‘If I go too far, you (meaning himself) feel guilty and bad.’ (He leaned back as he said this.) He paraphrased what he told himself at these times, ‘Too weak. Don’t have a spine. Have to show up and be present.”

He talked of himself being in the middle of the pushing forward and pushing/pulling back sensations, not being able to please himself at a deeper level and not letting go.

A picture of a young man feeling caught between his father's expectations of him and his dreams and desired future. He feels the family expectations hitting his back and he is actually experiencing back pain. This demonstrates the impact of family on health and illness.

The implications of this impact of family on health and illness

As in Anthony’s case, sometimes family dynamics can have a negative impact on our health. He was being caught between family expectations and wanting to do something different, between pleasing his family and pleasing himself.

Sometimes the issues and conflicts in our #family can impact us so much our #health suffers. Read more about that here. Click To Tweet

This is a classic conflict – On the one hand, we want to belong to our family and be loyal to it even if the strategies we are using to do that are outdated. In Anthony’s case, he used the strategy of people pleasing to do this and continued to even though his father and uncle have died. On the other hand, we also want to be free of our family and be our own person.

Sometimes we end up seeing this belonging vs autonomy dynamic as an either-or choice – we can either remain loyal to the typical family dynamic or risk alienation. That pull to belonging can be very strong. But there can be a negative impact on our health in doing that which is also very strong. And after a time, you can no longer ignore the impact on your health. So what do you do?

Acknowledge how your parents’ history contributes to your history

We talked a little about the history of his family that would have contributed to his father’s behaviour towards his wife and children. The father had lived through some very traumatic experiences in his own life. His first wife died in childbirth leaving a premature son (who lived).

The father followed family expectations to serve in the military, and during World War II fought through an intense battle where most of his comrades, who were also friends, died. He survived and lay with his dead comrades for 24-48 hours until he was rescued. As a consequence he suffered from PTSD and turned to alcohol to cope. He remarried and had several more children. He also fought with his second wife a lot.

All of the father’s experiences including the traumatic ones would have impacted how he related to himself, his wife and others, including how he parented his children. The impact of the traumas the parents experienced then filter down to the next generation.

#trauma can impact our #health physically and mentally. But the traumatic experiences of your parents can also impact your generation. Read how here. Tell a Friend

Anthony was the youngest in his family and talked about the role he played in being the messenger between his mother and father. He also talked about how people pleasing was one way to deal with his father’s behaviour and to try and make things ok within the family. Trying to make things ok within a family is a lot for a child to try and do.

Not only was Anthony caught between meeting family expectations and his own expectations, between pleasing his family and pleasing himself, he was also caught in the middle of his parent’s relationship.

Transforming the negative impact of family on health and illness

With Anthony I had him set up a visual map of his family. He used pieces of paper to represent his father, his mother, his father’s first wife who died in childbirth, his uncle and himself. We looked at the relationships between these family members.

I then had Anthony step into the shoes (so to speak) of these family members to gain greater insight into what their lives must have been like, and how they may have felt about that plus their relationships to the other family members.

During the exercise we also said a few sentences to the various family members to acknowledge everyone’s situation and the role they played in the family issue we were discussing.

A picture of small wooden dolls representing various family members. The family constellation methodology can help you look at the impact of family on health and illness and gain new perspectives.
Setting up a visual map or constellation of family members to gain new perspectives on an issue.

A key thing when saying these sentences is not blaming or judging anyone for what they did. Even if their actions were wrong. The sentences acknowledge what happened and what you will do going forwards. This brings ease to your feelings and restores a sense of movement to your situation. But if blame and judgement remain in the content of the sentences you say or how you say them, then the conflict remains. That doesn’t help you to move beyond the issue.

To support the client to generate these sentences, a common question I ask is, ‘If that family member(s) were standing before you now, what would you want to say to them with no blame or judgement?’

Picture of the Return to Wellness lily with the following words superimposed on it: If your family were standing before you now, what would you want to say to them with no blame or judgement? Just to acknowledge how things were, are now and how you want them to be? This is a key aspect of the family constellation methodology which can help you evaluate the impact of family on health and illness or injury.

Reframing and changing the impact of family dynamics on your health

For Anthony, the exercise brought a sense of calmness. He mentioned the pain had lessened in his back. His said his spine was straighter, he felt relaxed and quiet within himself. He was questioning whether he needed to continue with certain professional projects. He talked of ‘being welcoming and content with whatever we learn and how I am living.’

This work is called family constellations. It highlights the hidden dynamics within a family which can impact our emotional, mental and/or physical health. Revealing these dynamics and acknowledging everyone’s role, issues and needs, gives you greater understanding into what happened. (And not all family members need to be present or even alive.)

This wider perspective and awareness in turn gives you greater choice of strategies to deal with your family and manage your health going forwards. It also restores a sense of balance within you. Your internal foundations of your sense of self and where you belong in this world feel more aligned and strengthened. You have a new kind of energy which restores a sense of movement.

An image of seven generations of a family. It resembles a peacock. You are in the bottom middle. Connected to you and situated above you are your mother and father. Branching out from them are their mother and father and so on back seven generations. This picture is courtesy of The Centre for Systemic Constellations.
This picture is courtesy of The Centre for Systemic Constellations. B Babcock added the annotations.

What’s it like for you?

Which dynamics in your family have or are negatively impacting your health? What contributes to those dynamics happening? What would you like to do about them? Share your thoughts or questions in the comments below or alternatively email them to me (contact form in sidebar).  

If you are affected by a serious health issue and would like support to explore family relationships to improve communication and connection, have a look at how we can work together and get in touch for a free no obligation consultation.

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© Copyright Barbara Babcock 2019

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