Accepting Life’s Limitations

When people are living with persistent chronic pain, they very naturally become focused on reducing that pain. In my work with people in chronic pain, I generally encourage people to change this focus. Specifically, I suggest that people focus on being able to do more (which, in pain management jargon, is referred to as increasing function) and improving their quality of life.

If you are interested in learning more about the rationale behind this suggestion, you may enjoy listening to this webinar on Functional Measures for Assessing and Managing People with Chronic Pain with Dr. Jane Ballantyne (1hr).

I invite people to consider that chronic pain is largely a function issue. Every human body has a maximum amount of activity that they can engage in before they end up in an incredible amount of pain. For some human bodies, that amount of activity can be as much as doing a marathon or an Ironman triathlon. For other human bodies, that amount of activity might be simply washing the breakfast dishes or taking a shower.

For people who end up in incredible amounts of pain after something like washing dishes, we want to coach them to slowly increase the amount of activity they are able to perform before their pain flares up.

This podcast with world-renowned pain researcher, Lorimer Moseley, offers insight into this process of slowly changing what the body can tolerate (45min).

For many people, an important part of the healing process is reducing expectations around how much they will be able to do. To clarify what I mean, I ask the people in my programs: what are the things you give up in an effort to get more done?

Here is a list of the most popular answers:

Sleep
Eating well
Self-care
Spending time with family and friends

It’s a short list, but I would argue that everything on that list is essential to being a healthy human being.

The research supporting links between sleep and our overall well-being continues to get stronger, and there are incredible links between a lack of sleep and pain. We are only ever going to feel as well as we eat, and caring for ourselves is an essential foundation of being able to meet the demands of life, long-term. We are social creatures. We need human connection, but many of us forgo opportunities to spend time with others in exchange for getting more done.

While many of us are already doing more than is sustainable, we also feel like we like we still have way too much to do, like we are just constantly trying to keep up. We want to take care of ourselves, eat well, rest well, and see our loved ones, but we also want to get sh*t done. How do we do both? How do we find balance?

I have gotten a lot better at finding balance over the years, and for me, the answers have largely come in the form of practicing yoga, mindfulness, and meditation. (Though a husband who has a very low tolerance for “all business Sarah”, as he calls it, has also played a role.) If I were to summarize the way that my yoga practice has helped me to decrease my expectations around function, I’d say:

Practicing yoga has chipped away at an ingrained belief that we are what we do, that my productivity is my worth. Yoga has a way of teaching us that we are who we are; we are kind, compassionate, wise, and generous beings who are inherently worthy of love and belonging.
The tools of yoga have deepened my body awareness and allowed me to become much more aware of how I am being impacted by the choices I make. I notice that crappy food makes me feel crappy. I notice that upsetting movies really upset me. I notice the moments where I can choose to feel more ease. I notice that I am happier when life is slower.

I continue to work on being at peace with my sense that there is too much to do. Quite likely, I will feel this way for the rest of my life. I can choose to respond with urgency and try to get more and more done, or I can choose to respond with playful laughter and focus on enjoying whatever thing I am actually doing right now.

Whenever I die, there will be things left undone. I can resist that or I can accept it. The challenge of my practice is to continue to choose the path of acceptance because it brings me infinitely more joy.

A Swimming Fail

by Sarah Parenthood

Today I set out on a big adventure: taking my one-and-a-half-year-old to the pool by myself.

In the late summer and early fall, I had a habit of taking her to the pool every week, but the routine I had (designed by my inspiringly intrepid friend) involved avoiding the change room by wearing a loose-fitting dress and not getting changed out of my bathing suit until I got home. When the weather got colder, my system failed me.

My daughter is more physically independent now, so I decided that we were ready to try out swimming and getting changed afterward. I’ve been wanting to go again for a while now, and today was the first morning we had the chance to head out to go swimming at Hillcrest Pool.

When we arrived, I was so excited to see so many available parking spots! Parking can be quite a production at this pool. But, as I am looping around to get a great spot, I notice that there is no one in the pool. That doesn’t happen at Hillcrest. Turns out, the pool is closed for the whole month of April.

What to do? I pull out my phone and search for “indoor pools Vancouver”, and the Vancouver Aquatic Centre comes up. It’s 20 minutes away, so off we head.

We get to the second pool of our day, and because it is downtown, it is pay parking. We pay $3.50 for one hour of parking, and head into the pool. Long story short, it turns out that the pool for little kids isn’t open in the morning! We can’t swim again!

Since we’ve paid for parking, we spend a bit of time watching people swim in the big pool. We check out the kids’ pool and decide that it would be fun to come back to go swimming. My daughter works on her walking-up-and-down-stairs skills in the bleachers. And then we head home for lunch.

There is a story that our morning was a bit of a failure. We didn’t go swimming. We mostly drove around. And I paid for parking unnecessarily.

But my daughter’s story goes something like this:

“Big pool!”
“Little pool!”
“Little pool fun!”

She went on like this during the drive home and through lunch. If you had no idea what happened this morning, you would have thought she had the most amazing swimming adventure of her life!

Listening to her was such a powerful reminder of how much more joy there is in life when we have less attachment to how it is unfolding.

Ritualizing Loss, A.K.A. Burning Things at the Beach

by Sarah Awareness

A confession: I used to watch The Vampire Diaries. It’s mildly embarrassing to admit, but it was such an addicting show. Some of my co-workers were trying to get me hooked, so they left the first season on my shelf at work. I watched six episodes in the first night.

When a teenage girl in the show becomes a vampire, she feels a lot of loss about the human life that she won’t get to live. She won’t grow up, go to college, or have kids. A group of her friends hold a wake for her to process the loss of her human self.

Around the time that I was (binge) watching this show, I also read this piece by Julie Peters called The Relationship Funeral: Rituals for a Breakup. In it, she writes: “Our culture is devoid of rituals.” She was specifically addressing the lack of ritual to process the loss of a relationship.

I agreed. I felt the general absence of space to process loss, and I was inspired, by Julie and The Vampire Dairies, to create it.

I have been a part of two late-night, burn-things-at-the-beach rituals since this time. They were both transformative experiences and have helped me become more aware of moments of loss in my life.

Why do I want to be more aware of loss?

Because I think we get stuck in fear when we don’t process loss.

I see it a lot in my work with people living with chronic pain. Developing chronic pain can be a little bit like becoming a vampire: the life that you thought you were going to live is suddenly not the life you are living. A fear of feeling the pain of that loss can make it very hard to move forward. Acknowledging and grieving loss in the face of chronic pain can be a very important part of the healing process.

The book This Thing Called Grief: New Understandings of Loss by Thomas M. Ellis influenced my current way of thinking about loss and grief. He puts it simply: “Grief is not about stages you go through and ultimately graduate from. Rather it is a dynamic process of ups and downs, fluctuating with painful and peaceful moments, hours, days, and weeks.” He also quotes C. S. Lewis: “No one ever told me that grief felt so like fear.”

It was interesting for me to relate my sense that we get stuck in fear when we don’t process loss to Lewis’ assertion that grief feels like fear. The relationship between grief and fear is complex. I have found that carving out the space to ritualize loss is a powerful way to soften the intensity of the fear associated with it. It doesn’t take away the sadness. It doesn’t somehow tie the loss into a little package that I can put aside. But it does seem to alleviate a sense of being frozen in the depth of the loss.

A student in one of my classes once asked, “So, how do we do it? How do we ritualize loss?”

It stumped me a bit at first because my own rituals have been very, very random. I certainly don’t have a formula, just a sense that I should burn something. Upon reflection, I think a loss ritual, at least in the way that I have approached them, can be captured in two simple steps:

Schedule a time where your intention is to spend that time acknowledging something or someone that you have lost.
During that time, perform some action (writing, burning, speaking, etc.) that for you is a symbolic honouring of the loss you have experienced.

Of course, a precursor to this process is simply recognizing that you are experiencing loss in the first place, which is harder than it sounds – especially in the context of chronic pain.

Ritualizing loss is the legacy of The Vampire Diaries in my life. Not every experience of loss requires burning things at the beach, but for me, late-night rituals with friends and fire have been a source of laughter in the midst of grief. A reminder that when we chose to be open to feeling the pain of our loss we also become more open to feeling joy.