Therapy Talks

Discovering Resilience: Opening The Window of Tolerance to Ease Chronic Illness with Destiny Winters

May 30, 2023 Switch Research
Therapy Talks
Discovering Resilience: Opening The Window of Tolerance to Ease Chronic Illness with Destiny Winters
Show Notes Transcript

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Destiny Winters, joins us on Therapy Talks, this week to deliver actionable advice on how to manage chronic illness and provide insight into the importance of cultivating a support system  that brings joy, and can help improve one's physical and mental outlook. 

Here’s what you’ll learn in this week’s episode of Therapy Talks with Destiny Winters:

  • Gain greater insight into chronic illnesses and how to manage one's tolerance window to reduce stress and pain.
  • Strategies and techniques that help validate adversity and difficult emotions.
  • Helpful tips to relieve struggles that come along with chronic illnesses.
  • Compassionate and trust-building approaches that allow individuals to rediscover their self-assurance and reconnect with their surroundings.

Destiny is a highly skilled and compassionate Licensed Professional Counselor, specializing in the transformative approach of Somatic Experiencing to facilitate healing and personal growth for her clients. With a deep commitment to building trust and fostering a safe therapeutic environment, Destiny guides individuals in rediscovering self-assurance and restoring faith in their surroundings.

Find Out More About Destiny:
Website: https://www.thechronicillnesstherapist.com/
Instagram: @the.chronicillnesstherapist

Learn More About Switch Research:
Website: https://switchresearch.org/
Instagram: @switchresearch

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Hello everyone. Welcome back for another episode of Therapy Talks. It's Hailey here. Before we get to the episode, I want to take a moment to tell you about an incredible gift from Switch research. Click the link in the description of this episode. To gain free lifetime access to the Self-Love Masterclass, you get access to introspective journaling prompts that encompass the daily lessons, and over 20 hours of guided journaling sessions by a licensed therapist.

Plus you get a digital version of self-love journal to using conjunction with the video series. So don't forget to claim your free gifts today On the episode today, we have Destiny Winters joining us to talk about her clinical practice assisting those with chronic illness and chronic pain she utilizes somatic experiencing as well as acceptance commitment therapy to help those suffering with their illnesses.

Hope you enjoy today's episode.

Welcome Destiny. I would love for you to take a moment to introduce yourself. Sure, yeah. Thanks for having me. I am a therapist in Atlanta, Georgia. I'm in private practice and I also host a podcast, the Chronic Illness Therapist podcast. And my modality is, Acceptance and commitment therapy as well as somatic experiencing.

So I practice from a mind body perspective and we work a lot through not only past traumas like childhood trauma. A lot of people know about the ACEs study adverse childhood experiences study. And we know that adverse experiences in childhood trauma does increase the likelihood of someone developing a chronic illness.

But aside from that piece, just living with a chronic illness in and of itself is inherently traumatic for lots of different reasons, especially in the US where our healthcare can get quite expensive. And so those are just some of the things that we're grappling with. And that's, yeah, that's my entire caseload is.

Folks with a chronic illness who either are looking to figure out how to not feel like a burden in their relationship or process some of the trauma they've been through. And so what led you to being a counselor and then working in this population? Yeah. I think I knew I wanted to be a therapist when I was young, and then I put that dream aside and went into nutrition and realized I actually don't wanna tell people how to eat or what to eat.

I more so want to understand why people are the way they are. And so I went back into the counseling field and I, myself have a chronic illness. I was diagnosed with Lyme disease quite a few years ago. And I've just had a lot of complications along the way with that. And yeah, that just, so my entire kind of everything I do is geared around Mental health and helping people who have chronic illnesses navigate especially invisible illnesses that don't have a lot of research behind it, or a lot of concrete treatment options.

So a lot of times they're leaving their doctor's offices kind of feeling like, okay, what do I do next? No one has any answers for me, and that could be really hard to live with. And I know what that's like firsthand and that's, yeah, that's where my interest comes from. So it's your own personal experiences really inspired you and just really trying to wanna understand like why people are the way they are and just, it sounds because of your own experiences, you're really able to give that true, empathetic understanding to your clients.

Yeah, absolutely. And then, yeah, I've had additional training on top of it so that it's, there's a good mix of lived experience as well as textbook knowledge. And I know this is maybe a very at the beginning type of question, but could you maybe define a little bit like what constitutes a chronic illness?

Yeah, no, that's a great question. So technically it's anything that is longer. Lasts longer than three months. Some sources will say six months, but, a around three months you start to know whether this is something that, doctors have answers for and you're about to maybe stop being in pain or get better.

But yeah, anything longer than three months is considered chronic. And some chronic illnesses are reversible, curable but most aren't most of these illnesses you're gonna live with in some way, shape, or form for the rest of your life. And so at that three month mark, is that because the body has just not been able to overcome that and just the pathology of the different illnesses are just like gonna be deep set into the person?

Yeah, I think it's. If I'm understanding your que your question correctly, I don't think it's so much that you didn't do something right in the beginning stages to get rid of it and now it's past three months and you're doomed. I think it's more like the chronic illness is starting to develop and at that three month mark we now start to know there was nothing you probably could have done to.

To prevent that, it's just this is how the chronic illness develops and if it hasn't gone away by three months, and that's a good marker to know that this is gonna be a long-lasting persistent problem. Yeah, for sure. And so when you meet someone, like a new client, like what is your treatment plan, and of course that would vary person to person, but do you find there's a bit of that journey of helping the client to like maybe grieve some of the loss that comes with having a chronic illness plus the acceptance piece of having to manage that chronic illness and then learning how to live with it as best as possible?

Yeah, of course it does differ from person to person, but the grief is usually filled with, no one really comes to therapy. Even I think even when people have experienced the death of a loved one, no one comes to therapy saying, I want grief work. They more so say things like I can't sleep anymore like I am.

I can't sleep. I don't know why I'm angry all the time. I, I'm really. It feels like no one understands me and I just dunno what to do with that anymore. It'll sound like I, I need my job, but I can barely get out of bed in the morning. And so we start working on some of that and the way that it looks with my clients.

We're also doing a lot of coordination of care with doctors. Sometimes it's finding new doctors, new types of doctors. Other times it is finding. Like who a lot of times it's finding who's in their support network, whether that's a spouse or family members or friends. I find that a lot of times it's, we feel so alone in what we're dealing with.

So it's the loneliness factor that really starts to, it. It can literally make some of your physical symptoms worse than they would be if you had a proper support system. So that's some of the things that we work on too. And I'm just hearing just because like here I am in Canada and you in the states, like our public systems or health systems, I guess we're public and you're private, but it works a lot differently because my understanding with clients in Canada, it's, we don't necessarily have that freedom to choose another doctor.

We just get assigned a doctor. And so that can be really challenging. And I've done a lot of work in the past with individuals who have suffered TBIs, ABIs, concussions, things like that. And. A lot of the times, some of those things become a chronic illness because of the injury to their brain and things like that.

But then they get stuck a lot of times with certain doctors that maybe not be really empathetic or caring and kind. But it sounds like with you, what you try and really do with clients is. Help direct 'em a little bit more, provide that support and advocation for them and their health. Yes. Yes. We're really big here.

Like for the, there's a lot of therapists that specialize in chronic illness now, and I've got a, I talk with them all the time, and one of the things we're really big on is you are allowed to fire your doctor. I don't know what that's like in Canada, it's pros and cons, right?

We fire our doctors and then we start all over with a new doctor and sometimes they're out of network, meaning they're not gonna be covered at all by your insurance. So that's a decision. Sometimes you, a lot of times you do feel really stuck with the doctors that you have because again, they may not, the other one right across the hall might not take your insurance in the same hospital.

There's even a, there's a new law that was passed last year called the No Surprises Act, and it's because people would go in and get surgeries and the hospital would say, yes, I take your insurance, and then the operating doctor was not in network. And then the patient gets sent a bill for. Every single penny of that operation.

It's interesting the pros and cons of it. So yes, you can get stuck with your doctors here as well, but I do think you probably have a little bit more freedom or choice than if you're maybe with what Canada system is like. Yeah. And like here, even in our city that where I'm located, there's a lot of people that can't even find like their own family doctor, their own gp.

There just isn't any available and there's like giant wait lists and things like that. And it feels like a Easter egg hunt to find someone. And so I can only imagine the distress and discomfort and a loneliness that a person with a chronic illness must be facing when they're coming up against a lot of these barriers within the healthcare system.

Yeah. Yeah. And it's not just on the doctor side too, it's, we also live in this really kind of society that is really uncomfortable with grief and difficult emotions. And so if you start to talk about some things that are going wrong for you, you'll often hear things like, oh I hope that gets better soon.

And that's the end of the conversation and it's it's actually a chronic illness. Like it's not gonna just get better soon. And I would love to talk about it more or have support in this. So that's another thing my clients really struggle with and that we work through.

When it comes to finding a support network, it's who is strong at what, who can give you the needs that you're looking for? And sometimes that might be five different people can give you five different things. Yeah, so we work on that a lot cuz there's so much that comes up with that as far as communication style and resentment and anger and frustration.

So it's hard enough when your doctors are already a piece of the puzzle that's causing some isolation and more anger and grief than on top of it. You've got the family work that, that sometimes that often needs to happen. And you're making such a good point that I often say to clients, regardless if a chronic illness or not, is that no one person can meet all of your needs.

And it's okay to diversify your relationships and have many people supporting you. And so it sounds like a lot of discussions that you're having is, are these relationships helpful for you? In what ways? If they are only helpful in specific ways, that's okay. Rely on that strength in that one area. And then also, Look for other ways to get your needs met, especially since, like you're saying the devastation that like a chronic illness has on a person's body, mind, soul, long term.

Yeah. There's a lot of things that happen as a result of the chronic illness. And then, going back to what we were talking about earlier, there's a lot of things that can contribute to extra symptoms as well. So we're always trying to go back and forth between those two.

What, and it comes back down to what can you control versus what can you not, which is a common, whether you have a chronic illness or not. That's something we as therapists tend to work on with clients. But I think the difference with chronic illness and that kind of phrase control what you can and know what you can't control is that think there's a lot of things that we think we can control sometimes.

And this is a bit controversial, but like sometimes people will tout like a certain diet to cure an autoimmune condition. And don't get me wrong, like some people see great success with things like keto and low fat FODMAP diets and the gaps diet and these things can be healing in a lot of ways, but Sometimes they're just not, and that it was nothing you did wrong.

It's just your body and your genetics and maybe the support system that you have or don't have around you. All of that kind of contributes to how your symptoms are going to show up. So it's just important when you're looking at the what you can control and what you can't control. You're not putting all of the eggs in one basket and saying I can control my diet and I'm doing that.

And then you, when it's not working, you feel like it's your fault and you still must be doing something wrong because you think it's something that you can control. But it's really not. I think you're making a really good point there, because so often we get. Very fixated and hopeful on an action that we're doing.

And this could even just relate to general, to anyone who's having a hard time in their emotions and thinking I'm exercising, so that must mean like I'm for sure gonna have a better mood. And so you're saying that with the chronic illness, someone might feel like, oh, I can control what I eat right.

And how much I eat and when I eat. So if I put all of my eggs in that basket, like you're saying, then I should be able to have this change in outcome that might not always be the case because. As we all know, we are all so unique. Even though two people may have the same chronic illness, it just may affect everyone differently within that.

Yeah, exactly. No two chronic illnesses look alike. It's, I think, the easiest example to share. Everybody understands this, but they have a harder time understanding some of the more obscure ones. But with cancer, two people can go through a chemo treatment for the exact same type of cancer and one might.

Go into re remission and one might not. So why is that? Is it because one person did something right and one person did something wrong? No, it's genetics. It's your support system. There's been a lot of research around people who have cancer and have a positive outlook, fare better. But I would challenge that research and saying like, why did they have a positive outlook?

Did they have a better support system around them? Did they. Just have, were they a, I work a lot with the Enneagram. It's a personality typing system, but were they like an Enneagram seven versus an Enneagram four or something like that. So there are just so many factors that go into your mindset.

It's not just about choosing your beliefs. And I think that's a really common misconception and I think it's important when it comes to chronic illness. You mentioned getting hopeful about something and we have to feel hopeful about things. That's a part of what gets us through, but it's about learning to have hope for something, but without being so attached to the outcome.

So when we're talking about engaging in meaningful activities or doing things that bring you joy, these kind of things. It can't be because someone told you to do it, because that was going to, make your cancer outcome better because then you'd have a positive outcome. It's like you have to do things that genuinely you enjoy the process of doing.

If you enjoy cooking, and cooking is a fatiguing issue for you, and it causes a lot of fatigue, but you enjoy it, then you might figure out ways to prioritize cooking because it genuinely brings you joy. But if you hate cooking, By all means, do what you can to figure out how to just get a weekly meal kit and get meals delivered to your door.

There's no morality in like doing things a certain way that, people think you should cook all your own meals and you should clean your own home and you should this kind of individualism that we have, especially here in America. It's not, it's morally neutral.

Like you don't have to do anything that doesn't bring you. I'll take that back a little bit. We wanna, there are things you have to do that don't necessarily bring you joy, but not just because you think you should. It's more like you have to feed yourself, right? And so within your own financial means and your support system, you do what you can to get yourself fed.

That's your basic need component. But then on top of that, the things you enjoy. Sometimes, again, might be fatiguing, might be painful, but if it brings you a level of joy and comfort, then we wanna figure out ways to make sure that happens so that it's not just like you've lost everything in your life.

That's good. And you only have this kind of painful experience to think about now. I really hear what you're saying in terms of not necessarily just the outcome, but the journey, which is very much like what life is about. If we're so focused on. The outcome, we're not experiencing the day-to-day, the moment by moment, which makes up life.

Life isn't the beginning and the end. It's everything in between. And so you're really highlighting that if a person's suffering from a chronic illness and there's something that they really enjoy to do, maybe they should do it, even if it is creating some discomfort them for them because the joy and the is outweighing that discomfort for them.

I would be curious on your thoughts around like why is there such a prioritization or a focus on doing things like the right way or very much outcome focused? That's a good question and I think it depends on your orientation, how you think about things. But I don't know if, I don't know if this is too controversial to go here, but Our, so our country was founded on a lot of like religious kind of Protestant beliefs, and that belief system holds a lot of pull yourself up by your bootstraps get it done.

Because again, too, like people came to this country and it was all survival based. Every single thing that you did had to be based in e everything. Everything that you did was you had to build your own home. You had to grow your own food, you had to, and if you didn't, your family would die. That kind of, and that's just a very watered down way of looking at my whole philosophy around that.

But over time, it has just come down to like that, that mixed with this hyper individualism and a priority for individualism. It means like we don't look at people and say, how can I help you? It's like, how can you help yourself so that you don't bother me as to exactly why that has come to be? I don't fully know.

But it does have a lot to do with our ancestral histories. And we really, today, especially social media, the way that our culture is that we really applaud and celebrate success and like success in very much the stereotypical way that we look at success. Look at this achievement, or look at me here and let's, et cetera, et cetera.

So I think that, Someone suffering from a chronic illness right. May not be able to always have that freedom to have some of those outcomes and those traditional successes and, but we need to look at it, go, that doesn't need to be that way. Like this person still can be celebrated. Yeah. And I think too, people, when people are successful, a lot of times people only see that individual and maybe what they put into it, A lot of times we're missing all the other aspects that helped them get there.

And so we we forget about that. So then when we look at somebody with a chronic illness and we say, oh, you can't do X, Y, and Z. You don't have enough energy to hold a 40 hour work week. Or you don't have enough strength to, climb this mountain like, Then it again, it starts to isolate people cuz then they think you can't do for them, so then they don't wanna do for you.

And it's just this like positive feedback loop that really leads into isolation. And as far as, the concept of not celebrating people who, like if you can't accomplish a whole lot of things, right? If you have fatigue and pain and there aren't these kind of successful outcomes that you're able to share with the world, that also comes down to.

I think just the way we look at our survival and what we need. A lot of times it comes down to what we can produce. We don't look at the fact that every single human being has strengths and weaknesses. So if I, as a person with a chronic illness and physically unable to do certain things, I might be the emotional support in the household.

I might be the person who's able to. Lift other people up emotionally and talk and be that person. There's other strengths that we have too, like just our ability to maybe see things because we're not in the thick of it, like in the labor of something. We can see the outside perspective and give some wisdom and some counsel around that.

But the person with the chronic illness has to have also their own support system so that they can. They can then exhibit their own strengths. So it's really reciprocal. I give to you, you give to me, and if we continue to do that, The question doesn't even have to be about like what the person can produce or not, because we just know inherently that each person is a part of the team and that the person who's showing success cannot do it without me as well.

I like that. Cuz then that's shifting more towards everyone together. Everyone is being valued, everyone is being honored, and not just focusing on an individual's limitations. Yeah, exactly. That's a big part of the work too, is I use a strengths-based approach and that's not just about just look at the positive and try to spin things into a positive.

It's no, you, there's actually a thing that you have to offer to your family, your community, your friends. And when we find that thing and we illuminate it, then everything else falls into place. You don't even have to try that hard to figure out. How to love yourself or how to feel confident. It just automatically starts to happen.

Very much I do wanna offer some space here around talking about the pain and physical pain that comes with a lot of chronic illnesses. So in your practice, how do you support individuals who are experiencing a lot of that physical pain? And do you mean emotionally or like accommodations or kind of accommodation of both.

Like I think when you said earlier, a lot of times clients may not say oh, I want to have grief work. If I've suffered a loss, they may come and say I can't sleep at night. So I'm under the assumption that a lot of clients would come and go, I have a lot of physical pain. But then you probably would then link it into the emotional pain.

Yeah, absolutely. So a lot of my clients are also working with physical therapists. Some are working with, traditional kind of MD doc medical doctors or others are working with functional medicine doctors. So I'm always, I always wanna know what they're doing with their doctors one to make sure like they're getting the proper care, but two, so that it's about continuity of care.

I'm not a doctor, right? So I can't address your physical pain and talk about treatments in that way. I wanna make sure that you have someone else on your team who is addressing that. But in session with my clients, we do focus on the fear of pain. So if you have this irritable bowel pain or joint pain or headaches or migraines, there's inherently fear and sometimes panic that comes along with that.

If you have joint pain and you say, today is a good day and you don't really have, it's not really a high level of pain but all of a sudden you feel like a twinge in your knee. It might be a normal twinge that any of us would feel, but because you have chronic pain, all of your pain receptors in your body go, here's a sensation in that area.

Typically sensation means something's wrong and this is painful. So let's put all of our resources towards this knee sensation that we just felt. When your body does that, it's physical. This is a chemical response that happens in your body. It sends pain receptors to that area and then it tells your brain, Hey, this is really painful.

So I help clients start to discern when something is a smaller pain. It's not really a, this kind of serious injury that, that their body is tending to think that it is. And it's not about trying to trick your brain or tell your brain that you're hurting less than you are by bringing awareness and mindfulness to that area and sitting with it, allowing the fear, allowing the pain.

And having someone like a therapist who can sit there with you and not say, have you tried to think differently about this? Or okay, that's painful. Let's move away from this. It's no I'm gonna hold your hand through this. This is a painful experience and if you allow the pain wave to rise as it naturally will, and then it falls.

Then we can actually assess if this was a small pain or a big pain, but we have to stay with it and observe what's happening. But most clients are way too scared to do that because they haven't had the proper support system in place. With a proper support system, you can stick with just about anything that's painful people go through things every single day that are really hard and really painful, and you get through it, through the support that you have around you.

I agree with, you mean like I think we've all been there where we have a weird body sensation and then we're like, oh no. Oh no. And a little bit of that health anxiety comes up, but I could only imagine what it must be like if it's a symptom that's related to your chronic illness and then that fear and panic of the pain, or unsure when it would, if it's what's gonna happen next or how long it's going to last.

And I think you really offer a great idea of that. We just need to have acceptance for it and just sit with it and be present with it, right? Instead of jumping far into the future with fear and panic, or jumping into the past and feeling sadness and mourning over the longevity or how long it has been happening.

Yeah. Yeah. And I just wanna really hone in on the fact that it's really not about just changing your beliefs, because that in and of itself can feel really invalidating, especially when it's no, like I actually have arthritis. There's actual joint pain like happening here. So it's not about trying to pretend that it's different, it's just about sitting with it.

And when you sit with it, those extra pain receptors that happen when you're feeling fearful, that's what dissipates. So you might not ever get rid of the actual pain, but you can get rid of the secondary pain that comes in as a result of fear and loneliness and things like that. Like it ki would it be fair to say almost like pain and reducing some of the suffering?

Yes. Yeah. Yeah, because my understanding is pain is more of that experience and then suffering is that lingering and magnifying experience. Yeah, exactly. Just like with emotional pain that all of us therapists work with every day, it really, there's a lot of similarities and a lot of overlap. I think what's different about working with a therapist who specializes in chronic pain, chronic illness is we just have a lot more of the medical language and knowledge.

So you don't have to sit here and explain to me what lupus means. I already know that. And there are other kind of micro experiences that you just don't have to explain cuz I've been there or I have a extensive education around it, or I worked in a hospital or something like that. And so I'd love to hear about your utilization of somatic experiencing and somatic forms of therapy with individuals with chronic illness and chronic pain.

Yeah, so in somatic experiencing the whole kind of goal is to what we call titrate. So we wanna get really close to the edge of a painful experience, and then we wanna bring you back into your window of tolerance. It's a, you have to be skillful at it or else it can feel, it can also feel a bit invalidating for clients if they're starting to go into.

Monologue about their pain or about what's happening, and you wanna reel them back down from that so that they can be in a window of tolerance. That, and again, that in and of itself can be a little bit invalidating, so you have to one, have a really good relationship with your client.

But the goal is to again, bring them close to that edge, bring them back down, and do that several times. And there's I can, I, if you wanna go through an exercise I'm happy to do that with you. Yeah, sure. Just to exemplify this. Yeah. But that's the goal is bring you in and out.

And when you do that, you, your nervous system is able to handle more and more Distress without feeling distressed. So it's that suffering piece. Like you can talk about the thing that's really hard. You can feel the pain that's really painful without it feeling like your anxiety is sky rocket skyrocketing, or you're going into a depressive episode.

Yeah. But I would be totally interested in hearing more about this exercise. I totally don't mind being an example. Sure. Okay. Yeah. And if any point you want to stop, that is always welcome. And for anyone who's listening, if you're trying this and you start to feel, I dunno, anxious or it's too much, then you just, you slowly stop and do something that brings you joy.

So I would invite you to close your eyes if that feels comfortable to you. And I wanna encourage you to find just one spot in your body that feels maybe a little bit. Open or neutral or positive even.

And when you have it, just let me know. Okay. We'll call. Can you think of a word to call this spot? It could be the name of the body part, or it could be a calming word. Doesn't matter. Meadow. Meadow. Okay. And. As you sit with that word and that area in your body, I want you to just describe some of the sensations that you're feeling.

Some words to use could be soft or open, or warm, or expansive or bubbly. This feels like the safe area, like a open metal within the trees. I see a lot of green grass in my mind, so it feels like fresh and feels hopeful and optimistic. Great. And as you hold that image in your mind, I wanna invite you to bring your attention now to maybe something that's slightly more uncomfortable.

Yep. Great. So again, I want you to label this experience. What is a word we can call it? Height tight. Okay. So we've got Meadow, which is a calm, warming, happy experience, and then we've got tight, which is a little bit more uncomfortable. I want you to just start to label some of these sensations as well.

Some examples could be, like you said, tight cold or hot. It can be rough or jagged. There can be tingles. Yeah, so like tight, like some pain discomforts along and narrow radiating in an uncomfortable way. Yeah. Good descriptive words. So notice that, and then I want you to just gently bring your attention back to the meadow.

And breathe there for a little bit, just direct your breath to that area. And sit with that comfort knowing that this is a part of your body.

Notice if anything starts to shift or change, and that's not the intention, but sometimes it naturally happens. I'm feeling it like Like the metal area is more in my abdomen and then the pain is more in my my left side of my head. And I'm noticing that that pain feels loosening or widening in a comfortable way.

Okay, good. So now if you'll bring your attention back into the tightness and notice even more concretely what has shifted or changed. You mentioned longer arrow earlier, it's probably decreased a little bit in pain or intensity, like it's still present, but it's shifted a bit. Like at the beginning when you first asked me to close my eyes, I first noticed that pain just cuz it's a bit of headache that I've had for a while.

And so it was hard to ignore, but now it just feels like lighter and easier to focus my awareness. Yeah. Yeah. And so we can, I wanna invite you to maybe come out of this now and just take a look around your room, remember where you are. Coming back to the present. Yeah.

That was a really lovely experience because we're like joining these two different contrasts of comfortable and uncomfortable. And it did start to shift, which was interesting and helpful. Yeah. Yeah, good. Yeah, and it doesn't always happen that quickly, but I do notice when somebody has like more of a mindfulness practice or they already have been doing a lot of acceptance work, this can be really quick and really easy.

And when someone is brand new to this work, the ability to allow something to shift and change. It almost for someone to even ask you to try to do that, it might even make you more tight in your body. And so if that happens if that happens with a client, we actually go there, we allow that to happen and then we so we titrate in with them and then we try to come back out.

So notice how that just got tighter. Notice how that feels a little bit worse. And that's okay. I'm right here with you. And now if we can kinda come back into a different area. We it depends on the client and what they're experiencing, but we navigate it in that way. And I'll even share we can laugh a little, but I think it's very normal to have exaggerated thoughts, but I know I just have a sinus headache from allergies in the spring, and so that's just what's been lingering for the last few days.

But in some of my anxious tendencies of myself, I was like, oh my God, like my brain is exploding. Or something really bad is happening here. But even though logically I knew, and so even through that exercise, it felt really a lot more justified and calm to believe that logical perspective that this is a normal science headache that unfortunately I usually get as the onset of pollen starts to come out every year.

Yeah. And it's really just our brain's way of keeping us safe. We talked a lot about survival earlier, and if you had a, if you had a, if you had something as small as a cut on your foot before antibiotics were created, that could turn into an infection and it could kill you, like there are so many things that we have had in our, in the evolution of our bodies that were in really dangerous, that aren't so dangerous these days. But our nervous system hasn't really caught up to that knowledge yet. So that's why, the other modality I use is acceptance and commitment therapy.

And a big part of that work is notice that thought. We're not trying to challenge it or change it. Just notice it. And when you sit with it and you notice it, You then have the skill to notice when it naturally starts to decrease. Because all thoughts, all feelings, all emotions and all physical sensations do go up and down.

But when you don't have a skill around mindfulness, then you're not able to notice when it usually, when it goes down, we're really good at noticing pain and when it goes up, but when it starts to go down, it's like you don't really notice until the pain starts to come back up again. So a big part of our work, Yeah.

The, yeah, and that's a big misconception with mindfulness is that it's supposed to get rid of something when really it's actually just supposed to help you notice when things go up and down on their own naturally. I even would give this example of like just a common cold, cuz I think we've all been there with a cold where we'd like, I.

Notice, all of a sudden our throat's getting sore. We're starting to have congestion and we're really aware of the discomfort increasing. But then a few days later, as common colds do, they start to dissipate and it's until someone goes, Hey, how are you feeling? You really start to realize, oh wait, like my cold actually has dissipated and a lot of my symptoms have dramatically improved.

Exactly, yeah. Now when you live with a chronic illness, there's so much fear around like that. Pain coming back or having another flare up, with a cold, it's like you have it, it goes away. It, what you said was a really good example cuz it still applies. And then there's just this added complexity with a chronic illness of oh, I know this pain is gonna come back again.

And so we stay in this kind of fight or flight bracing, like muscular bracing and that is inherently really bad for your body in so many ways. So we work a lot on figuring out how to. Prepare yourself for when things are gonna go south again. But in the meantime, how do we open up and relax your body, but still while staying alert to potential threat?

Definitely. And I, I know exactly what you mean because so often we're trying to help clients to not be so anticipatory towards everything. We're trying to get them to be more present. So I agree with you. It's that act of mindfulness being present, calming the body, and just really slowing things down like no matter what it is, just really slowing down that experience.

So I would love to hear more about like some of the strategies and like act and acceptance of commitment therapy and how you use that with chronic illness. Yeah a big part of it is honestly just a lot of validating. Most of my clients have, they're coming to me with years and years of invalidation from family and friends.

Cl clients will come in and they will just repeat the same things. That I've been told to them their whole lives here's how I'm feeling and I know I shouldn't feel that way because, and they'll always tell me why they shouldn't feel that way. And then my job is to actually validate why you should be feeling that way.

So that feeling is valid. We're not even gonna try to change it. It's totally okay that you feel sad and depressed and angry and all these really what we call negative emotions that are not negative. They're just protective. We accept that those are there. And. Once we accept them, they no longer feel so big, and they don't overtake your beha your mind so that your beha, you don't really know how to behave differently.

So once you accept it and that takes a lot of, in the beginning, a lot of modeling from me, the therapist. It's not really about the techniques or the specific kind of, again, the, yeah, the techniques, it's not really about that because if they don't trust me, I'm just gonna be one more person who's trying to change them.

And again, like people come into therapy and they want change of course. And eventually the goal is that there will be change. But in the beginning, as Carl Rogers said, the curious paradox is that once I accept myself as I am, then I can change. And that's just, it's so true. So that's really what it looks like a lot in the beginning.

There are some kind of, there's a lot of act techniques. One of the most popular ones would be like leaves on a stream where you visualize this word or this thought or this judgment that you have and you kinda just in your mind's eye, picture it on a leaf. Put the leaf on the stream in your mind's eye and allow it to float away, and then that thought might pop back up.

And that's okay. We acknowledge the thought, we put the words or the image or the thought on a leaf, and we allow it to float away. And we do this over and over again until, again, your body naturally the ruminating thought that you have. For example, I'm in so much pain, this is never gonna end.

How am I ever gonna get through this? We would just say, I. How am I ever gonna get through this? Can you picture that? Put that on a leaf and watch it float away. And at first it can feel so silly and like clients are like, what is this? I don't ever do that exercise with me again. And then we just work through that.

We work through that. That kind of fear of the exercise, cuz it feels again, you might be minimizing or invalidating what they're going through. But that's where, that's why it takes so much validating upfront from the therapist because they need to know that you are not trying to just tell them they're wrong for feeling the way they are thinking the way they are, and you're just trying to help them reduce some of the suffering around the pain that they're experiencing. For sure. I think that's so wise and I think that's a skill that we can all use to incorporate or increase our mindfulness or acceptance of ourselves. And I love that quote that you shared by Carl Rogers and got some really wise knowledge there for sure.

I would like to talk maybe more about, we briefly touched on it, the relationship between like trauma and chronic pain. So for myself, yeah. Like I am in more of an e MDR practitioner, I really try and practice more from an e MDR or like a trauma informed lens. And so maybe you could share a bit more about the knowledge you have around the link between the two.

Yeah. And I'm curious, have you worked with chronic pain patients with MD r? I have. And I wouldn't say that I'm like an expert as you would say that you are in your area. I really love E M D R and applying it in multi different ways. I do some, sometimes some trauma work. It's really actually interesting, like I've had individuals, clients who have a pain in a certain area that's just ongoing.

And there hasn't maybe necessarily been an official diagnosis for it, but they just have an ache or a pain and sometimes they get hit with like fibromyalgia or something as like their diagnosis. But it's really interesting that when we. Process some of their trauma from the past that pain dissipates.

And so it's really interesting in that way. And sometimes I do some like pain protocols within e MDR to help reduce, like you were saying, the association of the emotional pain with the physical pain and separate that and reduce the emotional pain distress level. But I would like to hear your understanding and your insights.

Yeah, no, that's all perfect as well. And you can think about pain like a bucket. There's several things that fill up this bucket that then give you a pain experience and some of the things that go into the bucket. Basically, once the bucket is full, then you feel pain. So some of the things that go into the bucket are environmental stress, everything from pollution to noise, pollution to like if you're sensitive to like light and sound, stuff like that.

Certain foods, if you have sensitivities to foods and you're constantly eating them, that kind of fill fills up your bucket, which is why some people do benefit from some of the diets I mentioned earlier. Childhood stress and trauma. We know that trauma is held in the body, so if that is something that you've experienced, then that is now in your bucket.

There's so many things that can go into this bucket that then cause the experience of pain and when you start to work on some of those things, for example, the. Job stress or the childhood trauma and the tension around that trauma reduces, then your pain experience can reduce as well. So I think that's too why somebody some people will really feel like, somatic experiencing or E M D R just cured them and it's yes, because that targeted what was filling up most of your bucket.

But if somebody else's bucket is filled with an environmental stressor and they have no childhood trauma, And ER might not do that much for them. It just depends on what's in your bucket. For sure. It depends again, like what we're targeting or what we're working on, but I love that analogy and hopefully everyone that's listening can think about that.

Like what is. Filling up your bucket in an unhelpful way. And what can we do to let some of that out? So poke a hole in it, drain some of that excessive possible so that you're feeling a lot less discomfort. And I like how you mentioned like the window of tolerance earlier. Again, such a great concept that If you have some free time, everyone to maybe listen to and read about, because the more that we can do to increase our tolerance and the things that we can do to take off our plate so we have less stress, right?

So I always give the example to someone like, Say you have a really bad sleep and you had burn your breakfast, and then you get a parking ticket, like that parking ticket relatively isn't really a big deal. But because you're already in lacking in your biological needs, your things didn't go that well.

There was a stressor, that parking ticket. Now maybe that thing that really pushes you into hyper arousal pushes you into a lot of distress, right? And even then, I'm assuming if you have a chronic illness, that distress and lack of biological needs getting met might really push your pain tolerance. Lower and you experience more intense pain.

Exactly. Exactly. That's right. And you guys have a really beautiful graph of the window of tolerance in your journals for people to look at. But as far as, you mentioned like poking a hole in the bucket so that we can relieve some of that pressure. And for people, just so people know, it's not always about what you can remove, because again, sometimes you can't control certain things like, There's a lot of things that you cannot change, right?

You're stuck in a certain environment or whatnot. But by bringing in more joyful experiences or with E M D R, somatic experiencing these kind of healing modalities, it just allows it, it basically makes your bucket bigger. So you haven't taken anything out of the bucket, but now your bucket is bigger and you can handle more because of the joyful experiences that you've brought into your life.

And say, if we go back to this example, say you still had a bad sleep, you still burnt your breakfast, but then you won the lottery. I'm just kidding. But maybe that barking ticket won't be so bad anymore. Yeah, that's exactly right. And obviously that's a funny example, but even as something like I. Yeah, say your day went terribly, but on the way to your car, a friend you haven't seen in a long time shows that like you're walking, they're walking on the sidewalk and you see them.

You're like, oh my God, I haven't seen you in forever. Like, how are you? And you catch up for a few minutes, and especially if you're an extrovert like you are, your bucket is like just completely I wanna say full, but that's the opposite meaning of what I'm saying in this example, it's, you feel full, you feel good, and that actually reduces the pressure in your bucket.

I do wanna ask you a different type of question. So say you, it's kinda like the miracle question buffer counselor. Say you go to sleep at night and the miracle happens and you wake up and you become an expert in any psychological modality, what would it be? It would be somatic experiencing.

Yeah. It would be exactly what I'm doing. And that comes from a lifetime of one, living a life by my values and knowing what's important to me and not, and knowing what's not important to me. Saying yes to the things that I love and saying no to everything that I don't keeping in mind survival needs, being taken care of.

Yeah, it would be somatic experiencing. It sounds like the way that you speak with so much passion and engagement and empathy and understanding that all of your work is really validating for you and all of your clients. So I appreciate all the hard work you're doing. And so could you share with everyone where they could hear more from you and about you and how they can reach out to you?

Sure. Yeah. I'm licensed in the state of Georgia, so I can only see clients in the state of Georgia. But I do have an Instagram, the chronic illness therapist. On Instagram and then I have my website, the chronic illness therapist.com and the podcast, the chronic illness therapist, so people can find my content there.

And then if people live in the state of Georgia, then I do have group and individual counseling available. Wonderful. We appreciate so much for you coming to join us today. I learned so much. I love all of the passion that you offer and so much knowledge, and it's so great to get to know you in your practice today.

Yeah. Thanks Haley. I appreciate it.