Why My Dogs Make All the Difference!

The topic of this month's Migraine and Headache Blog Carnival is "Pets as Therapy: How our pets help us cope with migraine and headache disorders."  Ironically, I missed the yesterday's submission deadline because I was exhausted after spending the day at a continuing education seminar on "Animal Assisted Therapeutic Interventions."  I have long been a believer in the therapeutic properties of pets, and Marlie, my standard poodle, use to go to work to "help" me with my Play Therapy practice every day before I went on disability.  There were many days when I believe she provided much more therapeutic benefit to my clients than I did!  Hanging in my office was a sign that read:

Marlie and Milo are essential to my physical and psychological well-being.  They are my constant companions who are ever sensitive to how I feel.  They are content to lie with me when I feel badly and to entertain me when I am bored.  They cause me to laugh, to feel loved unconditionally, to feel less lonely and also meet my need for physical touch.  They are often the reason I get up in the morning because I know I need to feed and care for them.  When I am at my worst, they cuddle with me, providing me with warmth and love. 

But why take my word for it when there is a plethora of research which supports the fact that pets are not only great companions but are also psychologically and physiologically beneficial whether you suffer from a chronic disease or not.  My friend Rise Van Fleet has a website entitled the Playful Pooch which focuses on the benefits of animal assisted play therapy.  Press the word DOG to go to her site.  Some of the results of Dr. Van Fleet's research has indicated the following conclusions about using dogs in therapy with children; however, her conclusions and those of other researchers show that this information can also be extrapolated to adults. (To read her complete article, please go HERE.)  

1. "Animals help (people) overcome their fears and reduce their defenses."

2. "They help (people) feel accepted. The animals show affection, interest and attention that (people) need.... They provide comfort."

3. "They give (people) experiences of joy, playfulness and fun.  They invite laughter and release."

4. "They empower people and build their confidence."

5. They provide sensory benefits, including touch/tactile experiences and physical affection that are not (always available or possible).

6. "They help (people) relax and calm down, reducing some of the anxieties.  They provide comfort."

Other ways in which pets benefit our health include:

1. Pets are natural mood enhancers and can actually help with the production of Serotonin and Oxytocin.  Serotonin is a neurotransmitter and hormone which plays a significant role in mood regulation and is also associated with sleep, learning, Migraine and anxiety.  Oxytocin, also a hormone, is strongly tied to trust.  Medical research shows that Oxytocin is instrumental in human bonding and that Oxytocin levels go up when one is hugged or kissed (or pets their pet).

2. Petting an animal lowers blood pressure.

3. Pet owners have a lower risk of dying from heart disease.

4. Pets aid in increased mobility and activity because of our responsibility and desire to feed them, care for them and walk them.

5. Pets decrease the sense of isolation or being alone.

6. Petting an animal or lying next to it increases endorphins.  Endorphins are hormones which can increase a sense of calm, satisfaction and joy and can actually reduce the sensation of pain.  Additionally, cuddling up with a pet provides warmth which can be of benefit for aching body parts.

7. Pets increase our perceived ability to cope. (Siegel, 1999, Carmack, 1999)

8. Pets aid in lowering triglyceride and cholesterol levels. (Anderson, 1992)

9. Pets fulfill many of the same support functions as humans. (Melson, 1998)

After reading this, how can you NOT afford to have a warm, fuzzy friend!?!

Removing the Mask

Removing the Mask

This may be the most difficult blog post I have ever written due to the degree of honesty and vulnerability about which I am writing.  Even I am not sure if I will actually press the "publish" button to allow all to see my innermost thoughts.

I am a person who believes in hope and holds on to it with great tenacity.  I believe that there is a plan for my life and that it is a good plan (Jeremiah 29:11).  To the best of my ability, I focus on the positive because I believe that the way I think shapes how I feel.

However, this is not an easy task.  I am writing this for two reasons.  The first of which is that there is some catharsis in writing what I am feeling.  Secondly, it is my hope that if anyone else feels this way that they will read it and know that they are not alone.

The holidays are difficult for me.  They seem to accentuate my deepest longings and my sense of loss due to chronic pain.  They stir up a war within me and cause me to feel like I am playing emotional tug of war.  The holidays put a magnifying glass upon my feelings and make it difficult for me to not address my deepest, most hidden feelings.

I cried myself to sleep Thanksgiving night.  On the surface, I had a wonderful day of spending time with my family.  So what caused the tears?  It was the chronic struggle to survive in the midst of the fun.  I have a loud, fun and exuberant family who loves to laugh and play jokes, and I have always treasured being a part of that.  However, since I have been dealing with chronic pain from Migraines, Fibromyalgia, Spinal Radiculopathy and Chronic Fatigue Syndrome, it's all I can do just to be there.  

I struggle to keep people from knowing how badly I feel as I am being assaulted by noise, activity, lights and odors.  I feel old before my time, and I feel very alone.  Rather than sitting in the midst of the fun and participating, I sit at the table with the elderly members of the family.  I try to listen as they speak to me but am fighting the pain and the nausea to the degree that I only hear part of what they are saying and can only hope that they don't know that I am not really there.  I watch the ones in the other room who I long to spend time with and see them bonding with each other and feel invisible and unimportant.  

I struggle with my sense of identity.  None of the things that use to give me my definition of self are the same anymore.  I have few meaningful contributions to make.  I can no longer work at the job that gave me such overwhelming joy - can I even say I am a play therapist any more when there is no play in my life?  Can I say I am a mental health therapist when I sit alone in my home?  I try to keep up with my continuing education so I will not lose my licenses and certifications, but it is so difficult to attend the required in-class workshops and even harder to a pay for them.  I have no professional identity.

I'm not suppose to drive so I am dependent on people to take me places. When I do drive because I cannot get a driver, it is with fear of what might happen.  I am grateful to have some people who are willing to take me to the doctor, the grocery or the pharmacy, but my world is shrinking because I never go anywhere else and when I do, I pay for it dearly.  

My relationship with friends and family have changed to that of caregivers at best.  I feel like a burden.  With some, the relationship is but a memory.  I who use to have such a huge and vibrant world now have such a little world.  I attend church by watching webcasts because when I go into the sanctuary I cannot find a "safe" place to sit because of the perfume and the lights and because any ride I might have would be for the entire three hours of Sunday School and church which my body cannot endure.  So I have lost the fellowship of believers which filled my soul in a way I cannot describe.  

Friends sometimes still ask me to go to events.  I am afraid to say yes because I so frequently have to change my mind at the last minute because of how I am feeling.  A friend has asked me to attend a paint party which I have always wanted to do, but I cannot commit because I no longer have the finances and even if I did how could my Migraines survive the smell of paint.  And if I went and got sick who would I have to drag away from the party to take me home?  

I am utterly undependable.  I am not there for fun, but neither am I there when people need me.  There have been friends and family who are ill, lost loved ones or are hurting, and I am not there for them.  I have a friends whose babies or grandbabies are growing,  and I cannot spend time with them.  I offer to  babysit for a couple of hours and then have to cancel because of the pain.  So I who use to be in the middle of everything am in the middle of nothing!

I can't go anywhere other than medical appointments, but neither do I want people coming here.  I, who have always had such pride in keeping a clean and straight home, live in chaos because I frequently don't feel like picking up after the dogs, washing the dishes, dusting, vacuuming or going through the paperwork.  I am ashamed for people to see my home.  So the person who use to host all the get-togethers no longer does so.

Christmas is coming and frankly I am dreading it.  I try to focus on the reason for Christmas and remind myself that everything else is just fluff, but I loved the fluff.  I don't decorate for Christmas - there is no one here to see it and it's just too hard to do the work involved.  I can't go shopping because of the onslaught of stimuli, because I can't drive, and, frankly, because I can't afford it.  I actually bounced a check for the first time in 35 years.  I don't go to all the music performances and parties once again because of the stimuli and because I cannot make a steadfast commitment that I will feel well enough to go.

The things I saw as hallmarks of "me", that represented what was important in my life, were commitment, dependability, giving, friendship, serving, playing and laughter.  Where are these things now?  They are buried by pain.  How do I explain this to someone who doesn't understand?  I feel people pulling away from me and I feel myself pulling away from them.  I see the skeptical faces and hear the frustration of being asked for help once again.  I sense the skepticism about the medications I am on and why I travel six hours to see my migraine doctor.

Most of my friends and family know about my Migraines, but how do you explain something like fibromyalgia and chronic fatigue when they have difficulty understanding the impact of Migraines?  How do you not feel lazy when you sleep 14-18 hours a day?  How do you not feel slothful when you see things in your home not getting done?  How do you not feel alone and unimportant when you are so isolated by pain?  All the things for which I use to get positive affirmations are gone.

Taking away the mask is not pretty.  The sense of what is important to you and what identifies you is slipping away.  It hurts and is frightening. 

I am grateful that I am one for whom SSRI's work and that I have an outstanding and encouraging therapist.  It is not depression that I deal with - it is grief.  I experienced true grief with the heart wrenching loss of my mother, so I know that it changes things irrevocably, but also know that God can and will walk through this with me.  I am not giving up and I am not despairing - I'm just being honest.  

I am being vulnerable and transparent because I know that I have fellow sufferers who live this same existence.  Misery really doesn't love company, but knowing someone else has been where you are helps you to normalize what you are feeling. It helps you to feel not quite so alone.  It helps you to feel not quite so different.

My prayer for myself and for anyone who reads this is that we will continue to look for glimpses of hope and that somehow we will have a new and good sense of self - a new, but good, normal.  The one thing I can do is be here for those who hurt.  I may not be able to come to your side but I can pray for you and I will encourage you to the best of my ability.  We are not alone even when it feels that way.  

 "May the God of hope fill you with all joy and peace as you trust in Him, so that you may overflow with hope by the power of the Holy Spirit." Romans 15:13  

Please Hear What I am Not Saying

Charles C. Flinn

               Don't be fooled by me.

               Don't be fooled by the face I wear

               for I wear a mask, a thousand masks,

               masks that I'm afraid to take off,

               and none of them is me.

               Pretending is an art that's second nature with me,

               but don't be fooled,

               for God's sake don't be fooled.

               I give you the impression that I'm secure,

               that all is sunny and unruffled with me, within as well

                    as without,

               that confidence is my name and coolness my game,

               that the water's calm and I'm in command

               and that I need no one,

               but don't believe me.

               My surface may seem smooth but my surface is my mask,

               ever-varying and ever-concealing.

               Beneath lies no complacence.

               Beneath lies confusion, and fear, and aloneness.

               But I hide this.  I don't want anybody to know it.

               I panic at the thought of my weakness exposed.

               That's why I frantically create a mask to hide behind,

               a nonchalant sophisticated facade,

               to help me pretend,

               to shield me from the glance that knows.

               But such a glance is precisely my salvation, my only hope,

               and I know it.

               That is, if it's followed by acceptance,

               if it's followed by love.

               It's the only thing that can liberate me from myself,

               from my own self-built prison walls,

               from the barriers I so painstakingly erect.

               It's the only thing that will assure me

               of what I can't assure myself,

               that I'm really worth something.

               But I don't tell you this.  I don't dare to, I'm afraid to.

               I'm afraid your glance will not be followed by acceptance,

               will not be followed by love.

               I'm afraid you'll think less of me,

               that you'll laugh, and your laugh would kill me.

               I'm afraid that deep-down I'm nothing

               and that you will see this and reject me.

               So I play my game, my desperate pretending game,

               with a facade of assurance without

               and a trembling child within.

               So begins the glittering but empty parade of masks,

               and my life becomes a front.

       I idly chatter to you in the suave tones of surface talk.

               I tell you everything that's really nothing,

               and nothing of what's everything,

               of what's crying within me.

               So when I'm going through my routine

               do not be fooled by what I'm saying.

               Please listen carefully and try to hear what I'm not saying,

               what I'd like to be able to say,

               what for survival I need to say,

               but what I can't say.

               I don't like hiding.

               I don't like playing superficial phony games.

               I want to stop playing them.

               I want to be genuine and spontaneous and me

               but you've got to help me.

               You've got to hold out your hand

               even when that's the last thing I seem to want.

               Only you can wipe away from my eyes

               the blank stare of the breathing dead.

               Only you can call me into aliveness.

               Each time you're kind, and gentle, and encouraging,

               each time you try to understand because you really care,

               my heart begins to grow wings--

               very small wings,

               very feeble wings,

               but wings!

               With your power to touch me into feeling

               you can breathe life into me.

               I want you to know that.

               I want you to know how important you are to me,

               how you can be a creator--an honest-to-God creator--

               of the person that is me

               if you choose to.

               You alone can break down the wall behind which I tremble,

               you alone can remove my mask,

               you alone can release me from my shadow-world of panic,

               from my lonely prison,

               if you choose to.

               Please choose to.

               Do not pass me by.

               It will not be easy for you.

               A long conviction of worthlessness builds strong walls.

               The nearer you approach to me

               the blinder I may strike back.

               It's irrational, but despite what the books say about man

               often I am irrational.

               I fight against the very thing I cry out for.

               But I am told that love is stronger than strong walls

               and in this lies my hope.

               Please try to beat down those walls

               with firm hands but with gentle hands

               for a child is very sensitive.

               Who am I, you may wonder?

               I am someone you know very well.

               For I am every man you meet

               and I am every woman you meet.

Thanksgiving

Thanksgiving

Even in the midst of pain, chaos, conflict and the personal

storms of life, there are always

reasons for true thanksgiving!

It is more than a day -

It is a way of life -

A choice!

Where I put my mind, my heart follows.

Where my heart is, I find the source of my state of being.

If my heart focuses on that which is good and true,

I find that joy and contentment are close by

even in the midst of a storm!

We all encounter storms,

but we have a choice as to whether we are

storm chasers or rainbow seekers!

To all my family and friends, and to my Lord and Savior, I 
give thanks on this day set apart to celebrate Thanksgiving!

May you all have a Blessed and Happy Day!

The Power of Positive Thinking

The Power of Positive Thinking

Cheer Up!  

          You can if you think you can!  

Just look on the bright side!

          Smile - the world smiles with you if you smile! 

A frown turned upside down is a smile!    

        Things couldn't possibly be that bad! 

Fake it until you make it.  

Just put mind over matter!

One of the best greeting cards I ever received contained a number of platitudes of this sort on the cover and on the inside it said "The preceding lies were brought to you by the National Federation of People you run into when you're having a rotten day."  The card caused me to laugh not so much because it was so funny but because it was so true!  

For those of us with chronic illness and pain, there are always going to be people who try to help us with "cheer up" messages.  I don't know about you, but the response I frequently want to say with deep sarcasm is "Oh, thank you so much for your words of wisdom.  I would have never thought of that.  Just imagine how much money I could have saved from all of my doctor visits if you had just come along and said that a little bit earlier."   Of course, I don't say this to them because I know that most people are speaking out of a genuine desire to help or express caring or out of an astounding lack of knowledge, tact and empathy.  I also know that regardless of why they say it that there are few whose minds I can change by a single sarcastic remark.  

On the other hand, I have found that practicing positivity does help me in my day to day struggles with pain, worry and depression.  A study published in Health Psychology (2012) by Gillam (et al.) found that people who publicly state that they are coping successfully with their chronic pain actually tend to cope much better than those who do not.  In this study, 89 individuals with a history of chronic pain were divided into two groups.  One group was provided with scripts which contained positive affirmations regarding the individuals' ability to cope.  A part of their task was to present themselves as "good copers" to those around them.  The other group, on the other hand, portrayed themselves as "poor copers."  

Even though both groups of people had significant levels of chronic pain, it was found that those who practiced positive affirmations and saying that they were "good copers" had statistically improved levels of self efficacy (the belief that one is competent and able to meet their goals), depression, and positive coping.  In essence, there was a self-fufilling prophecy whereby individuals who focused on a belief in their own ability to handle pain actually experienced positive change in their ability to cope.  

The take-away from this study is not that one must deny his/her pain, but that by using positive affirmations and self-talk, we can actually increase our own belief in our ability to manage pain.  As our belief increases, it is only natural that hope emerges.  In my opinion, it is this experience of hope that allows us to be resilient in the face of chronic pain, anxiety and depression.  When we focus on our inability to cope, we find ourselves with the belief that we have limited options and are thereby "stuck" with little hope. On the other hand, when we develop the belief that there is hope, we are then able to think outside of the box when it comes to problem solving and coping skills. 

Based on this study, hope, resilience and self-efficacy are not a state of mind or a personality characteristic, but a trait that can be learned through positive affirmations.  I have long had a list of positive affirmations and Scriptures to which I turn when I am having a particularly difficult day.  When I take the time to read these things, they are powerful reminders to me of what can be.  I don't believe that one can necessarily use another person's positive affirmations; however, if it would help any of my readers, I'd be glad to share mine with you.  My list is one that has been compiled over a number of years during (what I like to call) my "sane" moments.  Those "sane" moments are the times when pain is not so oppressive that I can see no way out.  These were not written during pain free moments as I don't have those.  However, they were written during times when pain was at a lower level or when circumstances were such that I could see beyond the fog of pain.

In my life, I have truly seen the truth of the principles of this study.  When I focus on what I don't have or how I am feeling, I inevitably feel worse and begin to despair.  When I focus on hope, I inevitably feel better.  This does not mean that I don't share my struggles, my pain or my fears with others.  In fact, the ability to share these issues with others in the same situation who help me practice positive and proactive strategies is a huge part of my coping mechanisms. At other times, I reach out to friends (who know better than to utter trivial and trite cheer-up messages) and ask them to hang on to hope for me.  There is something very powerful in knowing that others believe in my ability to cope and to get better.  The key for me is to not get bogged down in the belief that chronic pain defines my life and means that I have no hope and no control.

"For I know the plans I have for you, says the Lord.  Plans for good and not for evil, to give you a future and a hope."  Jeremiah 29:11

Positive Psychology

As many of you are aware, I am a mental health therapist. I can't tell you how many times, I have said "doctor, heal yourself!" as I walk through my current storm of chronic pain.  You know as well as I do that it's just not that easy, and many of us have a choir of people who are ready to tell us what we need to do in order to feel better.  

However, as I was reflecting on this, I thought of one of my favorite models of psychology.  It is called Positive Psychology.  Positive Psychology, as a branch of psychology, wasn't formalized until 1988 so it is fairly recent.  It is based on the scientific study of individual traits that allow people to thrive and carry on in the midst of life's storms.  It is based on the belief that people want "to lead meaningful and fulfilling lives, to cultivate what is best within themselves and to enhance their experiences of love, work, and play." (University of Pennsylvania)  I would like to also add that it can enhance our experience with pain management.

Positive Psychology focuses on happiness and contentment in the present and hope for the future.  It specifically addresses good ways to handle disappointment, stress and those inevitable storms in life.

To a large degree, Positive Psychology is based on the premise that how we think shapes how we feel.  This is not to suggest that if we engage in some denial of our pain that it will cease to exist.  Rather, it offers coping mechanisms that are intrinsic to most individuals.  For example, have you ever noticed that if you focus on your blessings, things that make you happy, and things that are humorous, that your experience of pain is not as all-consuming?  This doesn't mean that your pain is any less.  It is just a shift of focus. 

I know that when I watch my silly puppy throwing his toys in the air, spend time with someone I love, watch a funny movie, have a belly laugh with someone over something ridiculous that I've done (you know who you are and you better not be talking), and spend time in prayer praising God rather than asking Him for things that something shifts inside of me.  The pain is still very real, but I am able to move my attention from looking at it so intensely that it cripples me to allowing myself to enjoy life in spite of the pain.  It doesn't make me any less physically disabled but it does help me to become less emotionally disabled.

If I focus on my pain, it drives me mad.  I become anxious; I become frightened; I become hopeless.  And I will confess that I do this plenty of times and that I then go into the "oh my goodness, what can I do" panic mode!  Having gone back to think about what I know about Positive Psychology has reminded me that while I might not have a choice over what my body does, I do have a choice over where my mind dwells.  It's not an easy or simplistic thing to do, but for me, it makes a huge difference.
   
I'm going to be focusing on Positive Psychology for the next few blog entries and how one can incorporate it into their life.  Before I do, however, let me stress that it is not meant to diminish the reality of both physical and emotional suffering.  These are both physiological functions, and thought alone is not going to "cure" anything.  Positive Psychology, in my opinion, is just another tool in my Migraine toolkit.  It is not a substitution for medical treatment, for medication or for honesty about what is going on in one's life.  I hope you will join me in exploring Positive Psychology.

Having the Blahs

Each time I turn on my computer, I see the link to my blog - just sitting there to remind me that I need to write something.  While I feel the tug to update my blog, I'm equally compelled to just ignore it.  I guess you could say that I have a major case of the blahs.  The goal of my blog was to be encouraging and a beacon of hope, so having to write about the blahs is the last thing I want to do.

It's not that anything is wrong.  I guess it's just because everything is the same.  You who deal with chronic issues in your life (whether it be pain or not) will probably understand this.  I am generally a person of great hope and expectancy.  I have always firmly felt that things won't be like this forever, but I have to admit that sometimes the "what-if's" sneak into my mind.  At those times, the majority of my energy seems to go to just keeping the status-quo emotionally.  Frankly, I'm tired of things always being the same.

I started with a new doctor about five months ago.  Although I know that working with any doctor is a process and that finding the right medicine or treatment takes time, I have to also admit that it is easy to become discouraged.  It's just that I've seen so many doctors - each time hopeful that he/she would be the one to help me begin to resume a "normal" life or would at least be the one who holds high a beacon of hope for me, helping me to believe that things have the potential for becoming better.

Don't get me wrong - I love my new doctor.  I even found that my first round of Botox gave me about two weeks of lesser intensity in my Migraines.  However, the second round of Botox has not had the same result.  In fact, the last month has been more difficult than usual. I know it sounds twisted, but there is a sense of being like a child before Christmas when I'm going to an expert in Migraines.  I can't wait to open up the unknown that he might have for me.  The anticipation and joy are great, but they dim quickly when you find that it may be more of the same old thing - certainly a lot more waiting and trying to find a reason to hope.  

So, I honestly feel stuck.  I have friends and family who I want to be there for during their difficult times; I have friends and family I want to be with during their fun times; I have obligations I want to complete; I have a house I moved into nine months ago that is still just a big white box and has not been decorated or organized to the degree that I feel at home.  I have a car sitting in the garage that I've been told not to drive, but places that I want to go.  I have people that I want to talk with but just don't have the emotional or physical energy to do so.  

I had a good talking to myself last night about what I need to do to get out of the blahs.  I know that one of the major things that I need to do is to re-set my expectations and once again remind myself to look for the reasons to be content and happy in the here and now.  I also need to remind myself that I have a reason to trust and hope for the future rather than resigning myself to just the here and now.  Hope surrounds me, but honestly sometimes when I focus too much on how I am feeling physically, I lose sight of the hope.  

So, I have to ask myself again.  Will I still choose to focus on hope and glorify my Lord in the midst of the apathy I feel right now?  The answering is a resounding yes.  It's not because I necessarily feel that way, but because I choose to remember that I am called to look at "whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable, whatever is excellent or praiseworthy." (Philippians 4:8)

Yes, I do have a major case of the blahs, but I am trying hard to hold on to the hope I know that I have - even when it doesn't take on the shape and appearance that I would like.