When you want yourself and your circumstances to be different, you need to figure out how to challenge yourself to change yourself. To do something different so you get what you’re seeking. As the saying goes:
If you keep doing what you’ve always done, you’ll keep on getting what you’ve always got.
Doing what you’ve always done needs to change. But sometimes it isn’t easy to figure out what to do differently. Particularly if you have no experience regarding the issue, like figuring out how to live well with the impact of a challenging health issue.
So I want to share an example of how a coaching client dealt with an issue which is common among people I work with, and how we came up with some ways she could challenge herself to change. I also share what it is about coaching that helps.
How to challenge yourself as a way to change yourself
Let’s call the client Trudy. It’s not her real name. I have her permission to share this with you.
Trudy’s wanted to
make sense of her willingness to take responsibility whether it is hers to take
or not so she could make different choices going forwards. She described taking
responsibility as a habitual knee jerk reaction.
There are pros
and cons to this. When you take responsibility for what is yours to manage,
it’s a way of you meeting your needs.
BUT, if you take responsibility for something that isn’t yours to do, then you can end up expending lots of energy and you may not get the results you’re seeking. It can end up being wasted energy. And if you are living with an energy limiting health issue, you don’t have lots of energy to waste like that.
Also, if other people don’t appreciate you for taking responsibility when it was theirs to take, that can further compound things for you in an unhealthy way. You can end up feeling very under-appreciated.
Trudy also identified that when she did not feel heard, she would ‘just shut up’. She described this as also being a habitual behaviour and linked to taking responsibility.
How coaching helps: As the coach, I give you space to think through and talk about your issue. I’ll help you find the words to explain your situation and how you feel if that’s needed. Also, I ask thought provoking questions which help you realise the subtleties around your issue, both the good and the no-so-good.
Get curious about when, how, with whom and why the behaviour occurs
Once you know the behaviour you want to change, dissect when it happens, who else is involved (if anyone), what you do, and why.
Trudy gave some examples when, how and why her willingness to take responsibility behaviour occurs. She also identified what was helpful about what she did and what was not.
Trudy’s kind and considerate nature is a good thing to have. I offered that sometimes when we care so much we end up willingly taking responsibility for what isn’t ours can be excessive caring. There’s a shadow side to our good qualities. Too much of a good thing can end up becoming a not-so-good thing.
How coaching helps: The other thing I do as a coach is point out (gently) how you get in your own way, but also your strengths and how you are helping yourself. In my experience, clients often find this new awareness very empowering as this ah-ha realisation opens up new choices.
Getting curious can help you pinpoint your triggers
Your trigger is what gets you to engage in this habitual behaviour you want to change.
Trudy identified that she has a real caring nature and a desire to help others. She also said she feels a sense of responsibility not to hurt others. In fact, she has to ‘avoid hurting others at all costs’.
She said this was
driving the willingness to take responsibility even in situations where the responsibility
isn’t hers to take.
I reflected back
to Trudy that avoiding hurting others at all costs sounded very strong and I
could see how that could drive a willingness to take responsibility even if the
responsibility is not yours to take.
How coaching helps: If something comes across as rather strong or otherwise, I reflect that back to the client. This is a form of feedback where the aim is to raise the client’s awareness. I pick this up through listening to what the client says, how s/he says it, what they don’t say and even listening to the non-verbal aspects of the conversation. Coaches are trained to listen at a deeper level than the level people usually listen at in everyday conversation.
Discover the beliefs which may no longer be serving you
Underpinning your triggers are often beliefs and assumptions about how life works and your role in it.
The beliefs underpinning Trudy’s willingness to take on responsibility were:
“If I don’t take
responsibility, I will end up hurting people and THAT must be avoided at all
“It’s ok if it’s
a cost to me if I take responsibility, even if the responsibility isn’t mine to
How coaching helps: Sometimes we hold beliefs that no longer serve us. And these beliefs can be driving your behaviours. When you explain what you do that isn’t working, a coach may ask you the following questions to help you uncover beliefs that no longer serve you:
What do you have to believe about yourself?
What do you believe about others involved? (If there are other people involved.)
What do you have to believe in general about the situation?
So how do you challenge yourself as a way to change yourself?
This is one way how you can challenge yourself to change yourself. There are many others.
First, look at what pisses you off in relation to your beliefs
It’s usually the opposite of what you would do in a given situation. What pisses you off goes against what you consider important or good to do.
Trudy has this
very caring and considerate nature, so I wasn’t surprised to hear her say that
she gets upset when people litter, put their feet up on the seat opposite on
the train or drive inconsiderately. In her eyes, these people weren’t
considering others around them. They were doing the opposite of what Trudy
How coaching helps: The coach will continue to ask questions, listen deeply and reflect back what their noticing. For example, with Trudy, I reflected back how the behaviour of these people did not seem to align to her caring and considerate nature.
Second, do what pisses you off
Do the opposite of what you normally do. Engage in the behaviours others do that you disapprove of.
The thought of
that is challenging!
For Trudy, I gave
her an experiment to do. I asked her to put her feet up on the seat opposite
the next time she was on a train. But she could take her shoes off and opt to
do it at a time when it wasn’t rush hour.
This purpose of
the experiment as I explained to Trudy was to challenge her to consider herself
and her needs and be less focused on others. I asked her to notice how she felt
as she did what she didn’t approve of. And to notice what it was like to take
up space. Remember above she said when she didn’t feel heard, she would tend to
stop talking. When you don’t make yourself heard, you take up less space so to
How coaching helps: The coach may give you experiments and homework to do in between sessions. This is actually where a lot of the power of coaching lies. What you do with what you’ve learned from the sessions. You and the coach may also formulate your experiments and homework together or you may come up with them on your own during the session.
You can be choice-ful in how you choose to challenge yourself
Notice the parameters of the experiment. Trudy could take off her shoes before putting her feet on the chair opposite. And she didn’t have to do this experiment in rush hour.
I was asking her to go outside her comfort zone. But not to the extent that someone else couldn’t sit down because of her actions. Thinking back to Trudy’s belief, no one was going to ‘get hurt’. That could have been too much too soon. She was still able to exercise consideration and care.
Your purpose is
to challenge yourself to change yourself. Not to overwhelm yourself with so
much change you end up not being able to make any change.
How coaching helps: Challenge is part of coaching. You come to coaching to seek support in changing something about yourself and your life and challenge can help that along. A coach will challenge you in a healthy and safe way and be there to support you through that process of change so you don’t have to do it alone.
The aim is to increase your flexibility and range in what you choose to do and why
Sometimes you may work to a value or belief you consider important to such a degree it doesn’t actually help you. But by doing something different, you increase your range so to speak. You’re no longer confined to one way of being but have more flexibility in how you deal with people and situations.
This is a way to safely challenge yourself as a way to change yourself.
What’s it like for you?
Think of something you wish to change about yourself. What small experiment can you give yourself to help you change yourself? When you have successfully changed something, what was it you did? 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 challenging health issue or are caring for someone who is, and would like support on any of the issues discussed here, have a look at how we can work together and get in touch for a free no obligation consultation.
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It sucks when a health issue strikes at the most
inconvenient time. You’re busy, you got a life, work to do, people to see,
family to take care, fun to have. And a health issue can stop everything. Or
maybe not stop everything, but it can take up time and energy you would much
rather be doing something else with.
Back in June I wrote about getting a diagnosis of arthritis in my hip, how that felt like a loss to me and moving on from feeling sad and bleh about it.
More has happened since then
In relation to my hip. And my breast.
All whilst trying to sort out our temporary accommodation, moving
house, starting a full house refurbishment, organising and running a family
weekend for children affected by rare neurological inflammatory conditions and
their families, coaching, facilitating, trying to keep up the exercise (did not
succeed at that), friend’s 50th birthday celebration in Majorca
(that was nice), etc., etc.
Basically, during my busiest period of the year. Most inconvenient.
But health issues wait for no one and nothing
When a health issue strikes, it just strikes. That’s it. It won’t wait for you to finish that really interesting project, or have that party, or go on that holiday, or even have your baby. Health issues are genuinely non-discriminatory like that.
So what do you do when a health issue strikes?
I came up with ten things you can do which will help. And I was using them myself last month.
Lesson One – You get on with it
This one we learn pretty quickly. We can’t do much about the fact that the health issue has happened. So we have to get on with it. And for many of us, that feels like the best and often times the only option.
Sometimes the other option of doing nothing can lead to death, ongoing disability or a feeling of powerlessness. So doing nothing doesn’t feel like an option. We want to live and live as well as we can.
Lesson two – It’s ok to get upset
I did about my hip. When I got back from Majorca, I had an appointment with the consultant. That was needed as the diagnosis was severe progressive osteoarthritis in my right hip.
Admission here: I did not mention the severe and progressive
bits in June’s blog. Just felt too dramatic to me at the time in the context of
how my hip affects my life. But I’m mentioning it now because I think I was
downplaying things at the time.
The consultant’s verdict – It’s not a question of ‘if’, it’s
a question of ‘when’ a hip replacement needs to happen.
I’m not even 50. I feel too young to have a hip replacement.
But health issues don’t discriminate based on age either. Or
gender. I shed some tears.
And it’s important that if you are upset, to express your upset-ness in a way that works for you. I wrote about this not long ago.
When a health issue strikes, it’s just gonna strike
Two days after hearing that verdict, I went to the GP regarding a pain I had been having in my right armpit for the past three months.
I know, I know. I should have gone sooner. But between
everything happening and focusing on my hip, I didn’t have the capacity to deal
with that too.
But whilst in Majorca, I was having discharge from my right
breast. (Sorry if this is too much info.) My body was speaking to me. When I
called to make the appointment with the GP, one just happened to be available
that afternoon. I felt lucky.
The GP did a breast examination and referred me to the local
The breast clinic called me four days later on the Monday
morning saying they had scheduled me for the coming Friday, but someone had
cancelled and an appointment was available in two hours. Was I free to come? I
felt lucky again. The universe was sending me a message.
I made myself free. And off to the hospital I went. Packing a soft easy-to-wear bra just in case.
This is how the breast clinic works
Regarding preliminary scanning that is. I was in this clinic last year being scanned and biopsied so I got to know the routine.
I saw the nurse practitioner who took my history, details of
my issue and did a breast examination. A sample was taken of the discharge.
Then I had the mammogram. It’s like having your boob squashed in a machine. Am Ample of Bosom so there’s a lot to squash. But it is necessary squashing because it helps to tell you if something is amiss.
Lesson Three – Humour can help you get on with it
It helps me.
If they see something amiss in your mammogram results, you
get called back for an ultrasound.
I was called back for an ultrasound.
‘You’ll be ok Barbara, you’ll be ok. You can do this.’ I kept telling myself, to reassure myself.
Lesson Four – Find 101 ways to reassure yourself
At least 101. Maybe more. Because you’re going to need it to get through scans, biopsies, treatment, rehabilitation, and life itself.
The consultant radiologist scanned me as they found an ‘indeterminant area’. You got to love the language they use. As I enjoy language, am pretty good with it, and good at asking questions too, I launched into curiosity question-mode.
‘So, tell me, what exactly is an indeterminant area?’
And using my best probing question approach to get info.
But those consultants are pretty good at remaining evasive.
And they need to be. They have to get samples of what is going on and get those
tested before they can definitively determine what that ‘indeterminant area’
actually is. They don’t want to worry patients unnecessarily or tell them the
wrong thing either.
But she did use the word ‘lesion’ and of course I pounced with a probing question to try and find out a little more about this lesion.
Lesson Five – A breast biopsy is MUCH better than a lumbar puncture
So I had a biopsy. My sense that I had better bring my soft bra just in case was a good one.
I chose not to watch because it was just all a bit close.
And I was grateful I knew what to expect this time around. This was my second
biopsy on my right breast in two years. The universe is trying to tell me
something I think.
I chatted to the consultant and nurse a bit and the consultant remarked on how well I was doing. I responded, ‘This biopsy is MUCH better than a lumbar puncture, trust me.’ But this is just my opinion based on my experience and there are people who may feel a breast biopsy is the worst procedure.
Lumbar punctures are awful procedures. When I had one done when in the acute phase of Transverse Myelitis, it took three attempts to get a sample of my cerebral spinal fluid that didn’t have blood in it and they had to get a bigger needle. It was weirdly painful, and I had a hangover headache for a week afterwards.
That finished, I was bandaged up, put the soft bra on and
went to see the nurse practitioner. She explained that they would hope to know
by the following week at the latest what was going on and they would either
call me with the results or make an appointment.
That is code for, ‘If it’s good news, we will call you. If
not so good news, we’ll make an appointment to see you.’
Scans and procedures done, it’s a case of waiting for the results.
It’s like living in a no-man’s land. You don’t know what
will be or happen so you don’t know what to do now and how to prepare. Living
with the not knowing in that interim time is not easy.
It’s not uncommon to feel you are not in control, but
actually you can focus on what you can control in the here and now. I reminded
myself of that. I couldn’t control that I was having pain in my armpit and
breast nor that I was having breast discharge. I couldn’t control what the
diagnosis was going to be. But I could do something about the here and now.
And I reminded myself of that. It’s one of the ways I reassure myself. (Lesson 4) So I consciously focused my energies on my work and the many other day to day stuff that was happening.
Despite being matter of fact about it all, I did shed tears. (Lesson 2) And speak to my therapist about it. I have a weekly therapy appointment so I used that to get and receive help. I received cuddles from my husband.
This is really important. Our society unfortunately prizes
doing everything yourself. When a health issue strikes, sometimes being able to
do everything yourself is not possible. You may need help with the kids, making
meals, keeping yourself relatively sane. Receiving help doesn’t mean you are
‘less than’. It actually helps you to get things done and continue living your
A side benefit of all this is if you have the right people helping you, i.e. they want to help you and have the capability to help you, it benefits them as much as it benefits you. Win-win.
Lesson Eight – Prioritise what you’ve got on
Sometimes when a health issue strikes, you may be too unwell to do much or you can do most things but not some things. And you may have more appointments than usual. (Had three in one week for three different things.)
So prioritise what you can and need to do. If you can’t do it because physically you are unable to, get help if you need to. Otherwise, it will have to wait.
If it’s something you need to do, like look after your
children or do a piece of work because it puts food on the table (to feed
yourself and said children), do what you can. It doesn’t have to be to your
Make sure not to overdo things. Doing less does not make you less than as a person.
Lesson 9 – Do nice things for you
Take a warm relaxing bath. Or chat with a friend. Read a book you’ve been wanting to. Light a candle. Make yourself a posh coffee or tea. Give yourself time and do nothing.
These are the little things that can be 5 minutes or 60 minutes. It doesn’t matter how long they are. The key thing is you are doing something you want for you.
Lesson 10 – Figure out what the universe is trying to
tell you and do something about it.
One thing that repeatedly comes to me is taking time out for me by doing a body meditation. When I’ve done this, I have felt amazing benefits. I need to do more of it.
The other thing that comes up is inflammation. I notice I tend to get health issues that end in -itis, which means inflammation. Transverse Myelitis. Arthritis. What is it about inflammation and my body?
Those two things have occurred to me so far. It may take a bit of time to figure this out and that is ok.
What is it like for you when a health issue strikes?
How did you handle it? What worked for you? Or if you are in the midst of it, what kind of support would help you?
If you are living with a challenging 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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The impact of anxiety – What is this like for you? Are you aware of when and how anxiety shows up in your life? How it slides into the driving seat in charge of your choices and actions? Do you know when it all started?
Many people have talked to me about the increase in anxiety after experiencing a serious health issue. A health issue tends to shatter our perception that we are totally in control – we realise we don’t have as much control as we thought. That and the resulting impact of not knowing what to do in this new place of not being well nor how long we will have to dwell there, anxiety can happen. In many cases, anxiety may have also predated the health issue but wasn’t as noticeable before the health issue’s onset.
I was reminded of the impact of anxiety the other week
Most mornings I do my exercise and physiotherapy first. That way it gets done. But I noticed myself thinking in a loop-like fashion, ‘I have so much to do! I don’t have time to exercise! I need to get to work!’ It was a very familiar feeling.
Anxiety and its impact has been a part of my life but became much more noticeable after having Transverse Myelitis 10+ years ago. The kind of anxiety I am talking about here is the anxiety that is in the driving seat in some areas of your life but not in every aspect of your life. It’s not pleasant and it can be frustrating.
But it’s also not severely debilitating, it’s not a clinical diagnosis of anxiety nor does it cause you to disassociate or lose yourself. If the anxiety you feel does cause you to do that, then please obtain the support of a person who is qualified to work with that such as a clinical or counselling psychologist or psychotherapist.
The anxiety I was feeling is the kind that slides into the
driving seat in some parts of my life particularly when I want to do something
for myself. The impact of anxiety is that my self-care plummets.
So this is what I did when I noticed my loop-like thinking. I took apart my approach and share it with you here to help you manage the impact of anxiety.
What the impact of anxiety
Back to that morning. I was sitting there just about to start my workout and the thoughts were going around and around in my head about not having enough time to work out and wanting to get to work at my computer.
A very busy period is starting for me where I will have two big
projects happening and other smaller ones going on in the background. Four of
them will be happening at the same time. (Trust me, this wasn’t planned.) This
will last through mid-June, quiet down for a week, and then things will get
busy again through mid-July.
The next thing I noticed was giving myself the suggestion to
start work, I could do my exercise and physiotherapy in the early afternoon as
I realised that I would probably end up not working out if I
did that. Because that is what has often happened in the past.
Then I made myself do what I have my clients do.
I made myself notice what
the anxiety was like
I sat still and just felt what the impact of the anxiety was like in my body. I felt the sensations in my body. From the waist up I was shaking a bit. I noticed I turned my head around to the right looking behind me. As if I was looking out for someone. I felt a little scared.
I was curious about me wanting to turn to the right and look
behind me so I did that again. I noticed I still felt scared. And kind of
young. Suddenly a childhood memory came up of my father telling me to get to
My internal response to this all was, ‘I must get the work
done. I don’t want to get in trouble.’
Rocket science doesn’t need to tell me when and where my anxiety started. And it’s interesting how it is still present to some degree 40 years on and how it can drive my actions if I let it.
What I learned about the
impact of anxiety on me
Two things were going on for me. The first trigger was the busy period and wondering how I would fit everything in. The next trigger was the loop-like thinking.
In this context I felt the anxiety as an internal shaking in me. (How you experience anxiety may be different.)
It was the movement of turning to look over my right shoulder and noticing I felt scared and young which really struck me. That and the childhood memory of my father telling me to get to work. He was an authoritarian father. He had a rota of chores for us to do and kept us busy doing them. As a young child, he more often barked commands and demands than words of warmth and gentleness. (He was dealing with his own anxiety but that is a story for another day. But interesting to note how anxiety can be passed on in families.)
This historical context turned out to be important
I’ll explain more about that in a bit.
My response to ‘get the work done’ felt familiar. It’s a
common response when I feel I have a lot going on, conflicting demands and desires,
and not a lot of time to do everything I want to do. I may want to workout and
do other things to look after myself and my wellness but historically work
would win out. That would calm the anxiety.
That nearly happened the other morning. Anxiety was sliding into the driving seat pushing me to work rather than self-care. Notice the black and white choice I was giving myself: work or self-care. I wasn’t allowing myself to have both or another option. That can happen when we feel stress due to anxiety, we give ourselves either-or choices.
I told myself I would be fine, work will be there and it was ok to do my exercise and physiotherapy first. Which I proceeded to do.
I went over this in a coaching session and learned that the
purpose of the anxiety wasn’t necessarily all bad. It enabled me to have inner
motivation to work and get a job done and strong focus on the task at hand.
However, the focus is so strong it means I get absorbed in
the task or project and hours can go by without me drinking water, eating, going
to the loo or taking a break. Self-care slides right off the agenda.
But I also said to my coach the anxiety no longer has a
purpose. The context has changed. My father is no longer with us. My mother
lives in the USA. I have no parents telling me what to do. I am my own parent
now. I don’t have any parents to please. I only have to please myself. The historical
context is no longer relevant. But I had been responding as if it was.
Much of the stress we experience can be due to blindly following outdated strategies. My strategy of ‘getting the work done’ had a purpose at one stage of my life, it served its role. But now it’s time to update the strategy. Here is how to do that when anxiety is trying to be in the driving seat of parts of your life.
How to manage the impact of
If the anxiety feels scary for you to deal with, please only do this with someone you trust, preferably a trained professional.
As you do this exercise, hold on to something that reminds you of the here and now. This helps to keep you anchored in the present.
There may be more than one. They may follow each other in a sequence or not. You will need to slow yourself down to do this. Sit for a time and take yourself step-by-step through what happened when you last noticed your anxiety. If you can do this as the anxiety appears, that’s a good time to do it too.
2. Really notice how anxiety affects you physically.
How does anxiety appear in your body? Spend time with it. And as you spend time feeling the sensations, gently remind yourself you do not have to unpack and live in the anxiety. You’re just visiting with it for a short while. Set a timer for 2-3 minutes if this helps you.
3. Notice what thoughts you have.
Write them down even. Doing that helps you keep one step removed from them so you don’t unpack and live in them.
4. Notice if you feel a compulsion to move.
And notice what that movement is like. Are you wanting to move away from something, reach or move towards something, turn and look for someone? It could be anything. Repeat the movement if it helps you to get a sense of what that movement is about.
5. Notice any feelings associated with the movement.
Are you feeling surprised, scared, numb, excited, young, weaker, something else?
6. Notice if any historical memories come up for you.
Make sure you are holding on to your here-and-now item.
Remind yourself you are in the present.
The historical memories I am referring to here are often not pleasant but they do not cause you to disassociate from yourself or to lose yourself in them. As you think of these memories, you realise you are still in the present and you can move on from thinking about them to focusing on something else.
But if you have a sense that something big is going to come up for you, that the historical memory was very traumatic for you and you do not feel ready to look at it yet, that’s ok. Stop and don’t continue with this exercise.
When it comes to dealing with anxiety due to very traumatic episodes in your life, I highly recommend you work with a psychotherapist or psychologist who is experienced in working with such traumas.
The historical memories can be from any period in your life. If other people are involved, notice what they are saying and doing if anything. And what you are saying and doing in return. Also notice how you are feeling about it all. This is about noticing the historical context of what may have kick started the anxiety.
7. Evaluate what is different about your current life as compared to your history.
How is your life currently different from the historical context? Who is no longer present in your life? Or they may be present but you don’t see them as often. What have you learned about yourself in the intervening years that contradicts whatever it was you thought about yourself in that historical context? What are your skills and strengths? Who else is in your life now who supports you to make the choices you want to be making?
This is key. Knowing the differences between your life then and now allows you to explain and reassure yourself that doing something different will turn out ok. This can help to quiet the anxiety a bit so you can get on with making different choices.
8. Develop a way to reassure yourself to calm the anxiety
Now that you know what is so different about your present life as compared to your history, develop a way to reassure yourself in those moments when anxiety wants to take over.
For me I have a conversation with myself. That morning I explained to myself that my father was no longer here to bark orders at me and it was more than ok to do things differently. I might not get as much work done but that wasn’t the point. The world was not going to end and my self-care is super important. I proceeded to do my exercise and physiotherapy. I still felt some anxiety but it eventually went away.
How you reassure yourself is unique to you. You may wish to journal your thoughts, draw, do another activity, whatever.
9. Keep practicing
You have to keep practicing making the choices you want for yourself rather than let anxiety dictate them for you. Don’t worry about perfection. Good enough is fine. You will respond as per the old strategy at times. That happens. It still happens with me from time to time. I even still feel the anxiety a little when I make the choices I want for myself. But the impact of anxiety does lessen.
10. Shower yourself in self-compassion
The reason you go back to old ways and still feel some of the anxiety when you make different choices is because you’re changing something that has probably been around for a few decades. So be gentle with yourself. Shower yourself in self-compassion.
What’s the impact of anxiety like for you?
When and how do you experience anxiety? And what has helped you to manage it? 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 manage an even transform the impact of anxiety, have a look at how we can work together and get in touch for a free no obligation consultation.
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When your recovery is uncertain, it can be a difficult time.
Scary even because you don’t know how much functionality you’ll get back and
how long that will take. That might make for uncomfortable reading.
I am mentioning this up front to acknowledge your or your
loved one’s reality and that it’s normal to feel uncomfortable about it, even
scared. I know, I’ve been there myself. It can be an anxiety-ridden place. But
there is hope.
It may feel like you have no control, but you do have some. It’s important to recognise that. And then exercise the control you do have, however much that is. I’ve come up with ten things you can do when your recovery is uncertain.
This blog is actually
for a friend who is in this position right now
I’ll call him Michael. And I have his permission to use him as a case study. Michael sustained a serious spinal cord injury a few months ago. High up the spinal cord as well so his whole body is affected. Initially he was paralysed but regained functioning and can walk. The doctor said he is very lucky.
Michael had an operation so the disk doesn’t impinge on the
spinal cord. It is to prevent becoming Michael becoming paralysed from the neck
down again due to the damaged disc if he were to ever have another accident.
As Michael can walk the impact of his spinal cord injury is invisible. The most difficult symptoms he has are fatigue and chronic neuropathic pain. When we talked about me using his situation as a case study for a blog, I asked him what is the one question he would like me to answer. He asked,
‘How long do I have
to wait until I recover and go back to the way I was?’
That’s a big question. The doctor’s prognosis figures into this. What did the doctor say to Michael regarding his recovery?
Recovery after a spinal cord injury, many neurological
illnesses, and other illnesses such as cancer, are not straightforward. Also,
you and your body hardly go back to way you were before the illness or injury.
You can be anywhere on this continuum of recovery.
No recovery and you live with the impact whatever that is. This may include permanent disability where a lot of functionality is affected.
Some recovery with residual symptoms that impact how you live your life to a moderate degree. It may include a moderate degree of permanent disability.
Good recovery with minor residual symptoms that do not have a great impact on how you live your life
And the recovery process can take time. For example, with the neurological illness Transverse Myelitis, the neurologists speak of a 2 year window of recovery. With some conditions like Multiple Sclerosis, you will have a periods of recovery after a flare-ups or relapses (depending on the variant of MS you have).
Michael is very aware of this and had this discussion with his doctor, so this blog isn’t the first time he is hearing this. So I move onto the first thing to do when your recovery is uncertain. These 10 things you can do are applicable to anyone in this situation. Some of them may not be easy to do, but they are important. And they aren’t an exhaustive list.
1. Learn to live with the uncertainty
Learning to live with the uncertainty of not knowing how long recovery will take and the degree to which your symptoms and issues will improve is important. When you can learn to live well enough with the uncertainty, you then free up your energy to focus on your rehabilitation and things that will give you meaning and joy. This can help the recovery process.
Linked to this is the relationship you have with your illness or injury. If it’s a fraught relationship full of fighting and anger, it can be harder to live with the uncertainty. I’ve seen people end up fighting it and as a consequence they end up not looking after themselves physically or emotionally very well. This is stress inducing which can exacerbate symptoms.
2. Take control of what you can
This is your physiotherapy (or exercise if you are not having physiotherapy), your medication and appointments, your diet, your mental health, your relationships, your return to work if you are working or volunteering, your hobbies and leisure time, finances, life purpose and values, and your physical environment.
This is all in your remit to control and influence, making any adaptations and changes to help you live well with the impact of your illness or injury. The next point suggests how you can take control.
3. Develop a rehabilitation plan when your recovery is uncertain
These days I don’t often hear of people leaving hospital with a care or rehabilitation plan. But there is nothing stopping you from creating your own plan.
Developing your own plan could be a blog in itself so I’m
going to quickly describe how to do this. For each category listed in point 2
ask yourself these questions for a start:
What do I need to do to do my physiotherapy for
example, or manage my medication and appointments, diet, etc.? What changes do
I need to make?
What are my goals for my physiotherapy,
returning to work, etc. Ensure these goals are concrete, i.e. based on
behaviours and have timescales attached to them.
What questions do I have? Is there a person I
know who has been through this or a charity who can help?
What specifically will I need support with? For
example, you may need someone to help you with your physiotherapy.
As part of this, it can be useful to keep a diary of your symptoms (particularly if they fluctuate), progress you are making, when you plateau or have an exacerbation of symptoms, etc. This can help you identify:
Patterns and themes in your recovery such as what may trigger an exacerbation of symptoms. This can help you manage the impact of the illness or injury.
Questions you have for your doctor and to prepare for your appointments.
Any improvements you have made over the longer term which can be motivating to look at from time to time.
Given recovery from serious health issues are rarely
straightforward, things won’t go to plan. Adopting a learning mindset will make
navigating this unknown terrain a lot easier and lessen the negative energy
spent when things are not going well.
Michael said it best, ‘Live and learn.’ He overdid it in the
garden the other day and realised it the next day. He now knows his current
limits for gardening activity.
So when you do something for the first time, or you are
increasing your activity levels, or something doesn’t go well, ask yourself:
What did I learn from this?
What do I need to do, think or feel differently
next time (if anything)?
Make a note of it if you need to.
5. Develop your willingness muscle to adapt
Develop your willingness to adapt and ask for help. Change
can sometimes be hard. Particularly in the context of an illness or injury
where things may be harder to do, take longer to do, and/or you’ve lost valued
levels of functioning and activities. This can include letting go of
pre-illness or injury expectations of yourself and developing new ones.
I am not saying you squash down any sadness associated with
this, not at all. Do acknowledge that because that is a psychologically healthy
thing to do. You can do this without unpacking and living there.
Developing your willingness muscle to adapt and change, gives you more options. When you have options, you have choice and more control. This can also help reduce black and white thinking where you only have either this option or that option (and neither may be what you want).
6. Ask for and say yes to help
Asking for help is important as you may want help but people may not be able to spot that, or they worry about imposing.
Also, asking for and accepting help does not mean you are
weak or a burden. Many times, the person has offered their help and is only too
happy to help you. You get to where you want to be faster and helping you makes
them feel good too. Win-win.
Sometimes though, as I mentioned at the end of this blog, you want to say no to help because you want to check what you can do now, if there has been some recovery. That is fine. If someone has offered to help you and you say no, let them know why.
7. It’s especially important to talk to your family when your recovery is uncertain
This is REALLY IMPORTANT. Don’t assume that they don’t want
to be bothered. Don’t assume they know what it is like for you. Ask them what
they want to know and the questions they have.
If you keep things bottled up out of fear of upsetting them
or making things more difficult for them, you inadvertently create the
conditions for people to come up with their own stories of what is going on
with you. And they may not be correct.
Those in a caring or supporting role are also affected by
what has happened to you. They are affected differently, but the impact can be
just as great.
Acknowledge what they have had to do. Chances are they have had to take on some of the stuff you did. Listen to them about how they are affected. Put feelings of guilt to one side and worries about not being able to ‘repay’ your spouse/partner/children/parents. Recognition in the form of a genuine thank you, a hug, a kiss, your time and attention is the most valuable ‘payment’.
Getting your children involved
Children often want to help so if there is some way they can
get involved in helping you with your physiotherapy for example, doing household
chores, or even in helping you set your rehabilitation goals, that can go very
far in helping the children know they matter. It can also help build their
confidence levels if they take on new chores and are recognised for making a
Regarding your children helping to set your rehabilitation
goals, ask them what they would like to be able to do with you and make a plan
as to what you need to do together to do that activity. Realising you may need
to make adaptations to how you do the activity and even the type of activities
you do together.
It is usually in these stressful times where pre-existing and sometimes unhelpful family dynamics can get in the way and cause issues. When the pre-existing dynamics come into play, you are both doing something that contributes to this dynamic so this isn’t about blaming one or the other person for what they’ve done or not done. Hence why I am emphasising the importance of talking with your family when your recovery is uncertain.
8. Limit comparison to others and your pre-illness/injured self
Comparison to others and your pre-illness/injured self can be a recipe for keeping yourself stuck. It is a natural thing to do. Just be mindful of it, how often you do it and how any comparison is making you feel.
I recommend you compare yourself to yesterday. That way your comparison is more fair and realistic.
9. Hold your wants lightly
When your recovery is uncertain and you’ve been dealing with a lot of unwanted changed, of course you may want to recover 100%. You want to be your pre-illness/injured self again. You want less pain, fatigue or whatever symptoms you are experiencing.
That is all a given.
Just be mindful to hold those wants lightly. If you fiercely cling to them, you can inadvertently limit your ability to adapt. You can end up continuing to fight your situation and remain stuck. Chances are that is not what you want for yourself.
10. Maintain a well-tuned sense of humour when your recovery is uncertain
There are times we laugh at our situation, but it is more of a gallows laugh, laughing at our misfortune. We do that from time to time but that is not what I am recommending here. Because gallows humour can be a subtle discount of ourselves and our situation.
I am talking about a well-tuned sense of humour. Sometimes
with people you know well you or they may find the humorous side to an an
aspect of your condition where it is truly funny to all those involved
Also, seek to laugh just for a laugh. It may be banter with
family, friends or colleagues. It may reading a book or watching a movie. It
may be following a comedian or funny social media account. (I recommend
@TheMERL and the libraries and museums on Twitter for that.)
I recommend a belly laugh a day because it brings joy into
your life. Put that in your rehabilitation plan.
When you look at all of the above, there is actually quite a bit you can do when your recovery is uncertain.
What’s it like for you?
What on the list above most resonates with you? What isn’t on this list that you think could be there? 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 in dealing with any of the issues mentioned in this blog, then have a look at how we can work together and get in touch for a free no obligation consultation.
Know of someone who would benefit from reading this blog, or you just want to spread the ideas, click on the icons to share.
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.
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.
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.
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.
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.
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.
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 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?’
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.
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.
Know of someone who would benefit from reading this blog, or you just want to pass on the ideas, click on the icons to share.
A former client, Wendy H., has graciously shared her health coaching journey to give you a taster of what it is like and how it can support someone to live well with the impact of the health issue they have. Wendy starts her story before we started working together, sharing with you the serious health issue she lives with and everything she tried to help herself before trying health coaching. She then shares what health coaching was like for her.
I made very little changes to what Wendy wrote. I added in a word here and there and the titles, and moved some sentences. I also drew the pictures. At the end of this article I provide a link to the questions referred to by Wendy. They will help you think about your own situation and what you want to be different. There is also the opportunity to try coaching for yourself for free.
Return to wellness: My health coaching journey
When my life changed forever
It was 7 years ago – in another life – since I was diagnosed with Transverse Myelitis (TM), resulting in a weakened left leg with inevitable muscle wasting, dropped foot and a multitude of other symptoms associated with the condition such as bladder and bowel issues and fatigue.
I had always been sporty and active so over the past few years my rehabilitative journey took on a multitude of self-help strategies, importantly, finding out as much as I could about the condition. I read books on neuroplasticity, brain training and mindfulness. I joined exercise programmes, the gym, saw a sports physiotherapist, neuro physiotherapist, trained how to do Nordic walking, which led to me taking up hippotherapy (horse therapy, or simply put, horse riding).
I have been measured for orthotic insoles and used a Functional Electrical Stimulation device (FES). I even went to acupuncture for weeks. I was on the verge of sinking into depression so was referred to a clinical psychologist, resulting in a short course of anti-depressants.
Even after all this determination and sheer will power to get back to my previous life, it wasn’t really working. I did a reasonable job at maintaining my physical strength. However, it seemed I was fighting a losing battle and began to feel ‘exercised out’. I would put pressure on myself to exercise and scold myself if I didn’t.
I’d watch people running and walking in the street or on TV. I found myself analysing their gait. How do they do this simple activity…. automatically?
I obsessed about how TM had affected me, was consumed with frustration, anger, loss, depression.
Finally, a few months ago I realized I had become STUCK.
After all this effort.
Everything became a mammoth task or a hassle. I’d stopped exercising. I became anxious and tearful. I lost motivation, interest and confidence in almost everything. I couldn’t move on or come to terms with or adjust to how my world was now.
I still fretted about my past life. I was still angry and frustrated. This mountain was in front of me and I didn’t have the energy to climb it again.
Then it occurred to me – I had been focussing mostly on my physical state and been neglecting my mental health state. I really hadn’t learned how to adjust, accept or come to terms with this long-term medical condition Transverse Myelitis.
Wishing for your old life but starting a new one feels like a large mountain to climb
At this time, an article in a newsletter from the Transverse Myelitis Society reminded members about a bursary to provide health coaching, guided by Barbara Babcock. I did have some apprehension and wondered whether this would be another fruitless journey.
However, having plucked up the courage to contact Barbara, she reassured me about the process and that we would have telephone contact at times to suit us both. She also provided lots of preparatory articles and questions to think about prior to our first communication, so I felt somewhat relieved and prepared.
Health coaching journey – One of enlightenment, empowerment and self-awareness
Over the weeks that followed, my health coaching journey became one of enlightenment, empowerment and self-awareness. I was amazed with how comfortable it was talking to Barbara on the phone and I soon realized that she didn’t put pressure on me to fulfil her agenda.
This was totally me guiding the script and pouring out my anxieties, stresses, frustration and anger. And importantly, we tackled the obstacles in my way, with a much more energetic and positive attitude.
I learned how to recognise my feelings within my body, not just the negatives, but the positives too. It was frightening that I rarely felt these ‘positives’ because I had focussed on the negatives for so long. It took practice, but I now consciously recognise when something feels ‘good’ and that this is the ‘anchor’ I needed.
I became more attuned to acknowledging anger and anxiety and importantly, how to manage, process and take control. With Barbara’s guidance and simple strategies, I learned how to ‘feel’ where in my body the emotion was and what thoughts arose.
By simply giving the emotion a name and spending time with it, enabled me to process these thoughts and feelings. This may sound daunting, but the nature of talking about your underlying feelings, in this safe environment, or writing them down was incredibly powerful.
Health coaching empowered me to focus on what I can do
My health coaching journey has now ended, but my journey to wellness and normality continues. This is my new philosophy.
If you feel you have a mountain to climb or feel ‘stuck’ and have determination and the willpower to want to take your first steps, I would strongly recommend health coaching.
Be prepared to be open and honest and be aware that emotions may become overwhelming and distressful. And be prepared to work at it.
Barbara will pose unexpected questions and prompt when you are off your guard. If you expect Barbara to tell you what to do and how to do it, you will realise that this is not how it works and you will not reap the benefits.
I am learning to focus on what I can do now, and although I still have a mountain to climb, I can tackle it in smaller chunks. I am more positive and less fatalistic. I am able to recognise anger. I am now able to move on. I am managing fatigue. I have resumed physical activities and registered for a one-mile open water swim. I no longer feel ‘stuck’.
Wendy H, York
Finding your own path towards wellness and your new normality
What’s it like for you?
In what ways did Wendy’s story mirror your own or someone you know? How do you think health coaching could help you? Share your thoughts in the comments below.
If you are living with a serious health issue, which may be a serious illness or injury or chronic illness, 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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