Attitude Determines Destiny

The picture is a friend of mine...

 

What can we do when we feel under the waves?

How can we find the
strength to climb back on top, and the patience to know that we
will? Here are ten cognitive exercises I use to maintain the most positive attitude I can:

1. Expect bumps! It is important to acknowledge that we will
sometimes feel down. Who wouldn't in our condition? But by expecting
rather than dreading down time, such periods become more tolerable.
In addition, recognizing that we will have blue periods helps keep
them in perspective. We will be able to say to ourselves, "I was
depressed before, and got out of it; this time, too, it will pass."
It is easy to forget that before our illness, there were times we
felt down. Now these periods are wrapped up in our medical problems;
but everyone gets depressed some of the time. After accepting that
we will sometimes feel sad, and even experience self pity, we can
concentrate on ways to shorten these periods and make them fewer and
farther between.

2. Track the changes. Keeping track of moods helps put ups and downs
into perspective. During your best times, make a conscious attempt
to capture the feeling. Leave notes on your wall attesting to the
way you feel. Living with chronic illness easily creates a Jekyll-
and-Hyde persona, where your optimistic self and your flare-up self
are not sufficiently acquainted. When we feel bad, it becomes quite
difficult to imagine that things can be otherwise. Similarly, during
times of improvement, it's amazing how quickly we may forget how bad
a previous period was, making subsequent flare-ups not only
intolerable but shocking. Counting and measuring the duration of the
bad times -- as well as the good ones -- can put them into
perspective. It may be that over time, our worst occurs about once a
month, although it feels much more frequent. This knowledge is
empowering, because we can remind ourselves that a bad flare is, for
example, our monthly temporary setback, and find ways to ride it out
until our baseline returns.

3. Stockpile fun distractions. We all need to keep lists handy of
the things that make us happy. One of the cruelties of our condition
is that when we need distractions most, we are least equipped to
seek them out. For this reason it is important to compile a list of
our favorite activities when we are feeling optimistic to be used
when we most need them. People with fibromyalgia often describe how
even their worst pain can be put on a back burner, so to speak, when
they become engrossed in an activity. This is not only a
psychological but a physiological response: our brains can only
process so much input at once. When we are engrossed in a beautiful
movie, talking to a good friend on the phone, or listening to our
favorite music while lying on a heating pad or in the bathtub, we
can trick our pain receptors into leaving us alone! Meanwhile
improvements in spirit have an added impact on our entire well-
being. Laughter is good medicine; while dwelling on our troubles
tends to compound them.

4. Shape your perspective. Is the glass half empty or half full?
Perspective determines, quite literally, how we view the world.
Having a chronic illness creates an ambiguous construction of
reality for us. Am I, for example, a successful cripple or an
unsuccessful professional? In American culture, much emphasis is
placed on independence, individualism, and achievement. Through this
lens, developing a condition that makes us feel more dependent and
less productive is likely to be a huge disappointment. Yet as we get
older, it becomes more likely that we, or somebody close to us, will
experience debilitating problems. People are often forced to adapt
to sudden, new conditions by adopting a perspective that
accommodates change. Our perspectives are shaped by the comparisons
we make and the expectations they create. Consider, for example, the
immigrant who had been practicing medicine in his home country, but
flees to the US to escape a repressive political regime. Here he
works as a janitor; after years of medical study, he has lost a
prestigious and rewarding occupation. Yet he is thankful for the
opportunity to work and wakes each day driven by hope, perhaps, of a
better future for his children. Yet his difficulties are also quite
apparent. What keeps his spirits up and makes him thankful rather
than bitter? His perspective.

5. Create a new self. If we hang on tightly to the "old self" we
were, finding the value of our "new self" becomes increasingly
difficult. (We may even exaggerate how fit that person was: "I
didn't need any sleep, I never felt bad, I could do anything!").
This does not mean we should totally discard our previous conception
of self; rather, we need to find a way to integrate the two. In
other words, we should seek to find in our new bodies new ways to
enjoy and experience the things that we had done before. Consider
all the aspects of yourself that you like, and the things that you
most want to do; then step by step, find ways to achieve as many of
these as you can. At the same time, recognize that our expectations
must shift so that we can once again meet them.

6. Don't forget the good stuff. While the physical symptoms of
fibromyalgia can feel all-encompassing, there are other parts of our
life--our social relationships, passions, family -- that also exist.
By focusing on the positive aspects of our life, we become more
aware of how many there are: the friends that stuck by us, the
things we still enjoy, and the accomplishments we have been able to
make, however small, under very different conditions. Because each
task now represents a challenge, we should celebrate whatever we
manage to accomplish. As we have been told many times, if we shorten
the list and pace ourselves whatever we do eventually adds up to
something to be very proud of.

7. "Oy, it could be worse." (The Jewish mantra). As comparisons
shape our view, it is helpful to find comparisons that will provide
a fuller appreciation for what has befallen us. OK, the "eat because
children are starving in (fill in the developing country)" did not
work for you as a child. But try to think of it this way: Many bad
things happen in the world. The odds are that some of them will
happen to us. Not because of anything that we have done, but
because, as the saying goes, shit happens. It takes only a short
view of the evening news to remind ourselves of the horrors
occurring every day. So, this is what has happened to us. We too
were caught. Let us examine what we have: (a) We know our condition
is not terminal, so we need not begin contemplating our pending
mortality. (b) As bad as we sometimes feel, our underlying condition
is not going to get worse. We have already experienced the worst,
and, to our credit, have gotten through it. (c) Although few people
achieve permanent remission, many improve significantly. As we
understand how our actions and emotions influence our general well-
being, we can find ways to partake in more and more activities.

8. Keep the hope alive! There is so much room for hope. It has only
been since the 1990s that our condition has acquired any legitimacy
from the medical community. We are in a far better position than the
generations before us who suffered without ever receiving
validation. We know much more about the important roles of exercise,
medication, stretching, pacing and meditation to bring relief and a
sense of control. Furthermore, as medical research increases, it is
only a matter of time before better therapies (and perhaps even a
cure!) are introduced.

9. Lean on me! A single most important predictor of how we do is the
support network we create. We certainly appreciate what it means
when someone helps us when we feel especially lousy. Make sure that,
within your means, you continue to be a good friend to those you
care about. We still have lots to give. During a good moment, write
to a friend that you are thinking about her. Help your family and
friends find ways to maintain their relationship with you. Invite
them to your place to eliminate traveling (and do not worry what
your place looks like! They came to see you, not your housecleaning
abilities). Try to be open with family members, while at the same
time supportive of their needs. Put yourself in their shoes as often
as possible -- it can be scary to have someone you love be sick!
Also make sure to seek help outside of your immediate circle so as
not to drain your closest friends and family. There are now all
sorts of support groups, both live and in virtual computer space.

10. Indulge whenever you can. We have lots of time to focus on our
thoughts. Most people do not have the luxury of taking time to relax
and think. OK, we did not ask for these "time outs." They are
demanded by the needs of our bodies. Nevertheless, we have control
over how we use this extra time. Instead of dwelling on what our
bodies are not doing, give your fantasy full liberty. Turn these
rest periods around to be indulgent time. In our mental playground,
we can practice dance steps we used to know (for there will be some
times we can dance!). We can use the time to think through problems
we face and how we want to spend time when we are feeling ready, or
we can analyze a movie we recently saw, say prayers, or mentally
write a letter to a friend. The article you are now reading is a
product of a spell in the middle of the night, when I lay in bed,
unable to sleep. After taking steps to make myself more comfortable,
I decided to think about what I would write next. I figured that if
I fell asleep, great!