Carers Need Self-Care

Much of the focus in the resources on mindfulness is on ways to help people who are suffering from conditions that are debilitating such as mental illness or chronic pain.  Very little of the resources focus on ways to help carers in their role – ways to manage the physical and psychological toll of caring for someone else on a constant and extended basis.  Carers are the overlooked group – forgotten by others and themselves.

Carers: people who care and support others

Carers come in all shapes and sizes  – adults looking after ageing parents who may be suffering from Alzheimer’s disease; siblings caring for a family member who has a mental health condition such as schizophrenia, anxiety or depression; or anyone caring for someone suffering from a physical condition such as paraplegia, chronic pain or cancer.  According to Carers Australia, carers are people who provide unpaid care and support to family members and friends who have a disability, mental illness, chronic condition, terminal illness, an alcohol or other drug issue or who are frail aged.

The toll of caring

The “burden of care” can be felt both physically and psychologically.  The physical toll for carers can be excessive – they can become exhausted and/or accident-prone, suffer from sleep disorders or experience bodily symptoms of stress such as irritable bowel syndrome, chronic fatigue or related conditions like fibromyalgia. The physical toll of caring can be experienced as cumulative stress and lead to chronic conditions that adversely affect the carer’s long-term health.

The psychological toll of caring can also be cumulative in nature and extremely variable in its impact.  Carers can experience negative emotions such as resentment or anger, despite their compassion towards the person who is being cared for.  They can become extremely frustrated over the paucity of time available for themselves, the opportunity cost in terms of inability to travel or to be away for any length of time, the lack of freedom (feeling tied down), the lack of improvement in the condition of the person being cared for or the financial impost of caring (preventing desired savings/purchases or home improvements). 

Carers do not have inexhaustible personal resources – physical, psychological and financial.  They can suffer from compassion fatigue which can be hastened by emotional contagion resulting from close observation of, and identification with, the pain of a loved one.  Hence, carers can experience depression, anxiety or grief – reflecting the emotional state of their loved ones who are suffering.

The toll on carers has been the subject of extensive research.  For example, Emma Stein studied the psychological impact on older female carers engaged in informal aged care.  Sally Savage and Susan Bailey reviewed the literature on the mental health impact on the carer of their caregiving role and found that the impact was highly variable and moderated by factors such as the relationship between caregiver and receiver and the level of social support for the carer.

Being mindful of your needs as a carer

The fundamental problem is that carers become so other-focused that they overlook their own needs – their need for rest, time away, relaxation and enjoyment.  Normal needs can become intensified by the burden of care and the associated physical and psychological stressors.  Carers tend to neglect their own needs in the service of others.  However, in the process, they endanger their own mental and physical health and, potentially, inhibit their capacity to sustain quality care.

Carers can inform themselves of the inherent physical and psychological consequences of being a caregiver, particularly if this involves intensive, long-term caring of a close loved one (where feelings are heightened, and the personal costs intensified).  Mental Health Carers Australia highlights the fact that people who care for someone with a mental health illness are increasingly at risk of “developing a mental illness themselves”.

Self-care for the carer

One of the more effective ways that carers can look after themselves is to draw on support networks – whether they involve family, colleagues or friends; broad social networks; or specific networks designed for carers.  Arafmi, for example, provides carer support for caregivers of people with a mental illness and their services include a 24-hour carer helpline, carers forum, blog, educational resources, workshops and carer support groups. Carers Queensland provides broader-based carer resources and support groups.

Carers tend to go it alone, not wanting to burden others with “their” problem(s).  They are inclined to refuse help from others when it is offered because of embarrassment, fear of dependency, concern for the other person offering help, inability to “let go” or any other inhibiting emotion or thought pattern – in the process, they may stop themselves from sharing the load.

Carers could seek professional help from qualified professionals such as medical doctors or psychologists if they notice that they are experiencing physical or psychological symptoms resulting from carer stress.

Mindfulness for carers

Carers can use mindfulness practices, reflection and meditation to help them cope with the physical and emotional stresses of caregiving.  Specific meditations can address negative feelings, especially those of resentment and the associated guilt.  Mindfulness practices can introduce processes that enable the carer to wind down and relax – such as mindful breathing, mindful walking, mindful eating or using awareness as the default when caught up with “waiting” (a constant companion of the carer role).

Carers can employ techniques such as body scan to relax their bodies and release physical tension.  Deep, conscious breathing can also help in times of intense stress such as when experiencing panic. For people who are religious, prayer can help to provide calm and hope.

Dr. Chris Walsh (mindfulness.org.au), offers a simple mindfulness exercise for self-care by carers in his website article, Caring for CarersThe exercise involves focusing, re-centering, imagining and noticing (thoughts, feelings and bodily sensations).

As carers grow in mindfulness, they can become more aware of the stress they are under and the physical and psychological toll involved. This growing awareness can lead to effective self-care through social and professional support and meditation and/or mindfulness practices. Mindfulness can help carers develop resilience and calmness in the face of their stressful caregiver role.

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Image by Sabine van Erp from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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Mindfulness and the Mind-Body Connection

Dr. Cheryl Rezek, Consultant Clinical Psychologist, in her video presentation, What is mindfulness, stresses the connection between mind and body.  She highlights the fact that stress is not only experienced in the mind through perception of threat but also in the body in the form of stomach aches, headaches, pain in the shoulder or other parts of the body and many forms of physical illnesses.  Cheryl draws on neuroscience research to demonstrate the positive impact of mindfulness on the body and the brain.

What is mindfulness?

Cheryl discusses mindfulness in terms of “focus with intention” – designed to become more aware of what is happening inside of us as well as around us. She stresses the role of context in shaping who and what we are.  In her own practice and research, she seeks to integrate insights from biology, sociology and psychology – a holistic perspective on the forces shaping our makeup and the way we experience the world.  For example, like Johann Hari, she sees negative childhood experiences as contributing to the likelihood of experiencing depression in adulthood.  Our social environment – whether family, work or community, in isolation or conjointly – shape our perceptions.  Cheryl’s holistic approach is reflected in her training in the interrelated disciplines of clinical psychology, psychotherapy, play therapy, family therapy and mindfulness.

She reminds us that children are naturally mindful as they negotiate their world – they are curious and open, asking questions, exploring nature and wondering about their own bodily sensations.  I recall recently playing tennis with my grandson in a clearing in a wooded area while my granddaughter sat on the grass and explored everything in her immediate environment- the grass, wildflowers, leaves and anything that wriggled or moved.  Her attention was totally focused for an hour on whatever she could see, touch or smell.

Applications of mindfulness

In her presentation, Cheryl discusses the numerous applications of mindfulness – from dealing with chronic pain to managing mental illness.  Her own writings reflect this diversity of mindfulness applications.  For instance, she talks about how mindfulness can help people manage contracting cancer and undergoing treatment – her ideas are explained in her book, Managing Cancer Symptoms: the Mindful WayShe also discusses the application of mindfulness to dealing with Anxiety and Depression.

Cheryl stresses the importance of seeing mindfulness in its broadest context – not confined to the act of meditation but extending to being mindful in our everyday activities such as walking, listening, eating, attending meetings, waiting and washing the dishes.  She offers an app, iMindfulness on the go, to encourage people to be mindful when in transit or engaging in any of their daily activities.

As we grow in mindfulness, we become aware of the opportunities to be mindful in our everyday activities.  Practice of simple mindfulness activities builds our inner and outer awareness and helps us to better navigate the stresses of life.

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Image – Painting by a Chinese-born artist who experiences the mental health condition of Schizophrenia

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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Mindfulness and Dealing with Pain

Diana Winston in her meditation podcast, Working with Pain, offers some suggestions on how meditation can be used to alleviate and/or manage pain better.  She highlights the fact that along with pain are the stories that we tell ourselves about the pain we are experiencing, e.g. “This pain will never go way.”, This is ruining my life.”, “I cannot cope with this pain.”  Diana suggests that the stories aggravate the suffering we experience with pain and only serve to amplify the pain through their negativity.

Pain and suffering are part of being human as we are reminded by the Buddhist tradition.  Diana quotes the often repeated saying, “Pain is inevitable, suffering is optional”, to remind us that we have choices in how we deal with pain.  So, we are left with the challenge of managing the pain that occurs at different points of our life, whether the pain of loss or physical pain in some part or all of our body.   Dealing with chronic pain through mindfulness has been the focus of a lot of the pioneering work of Jon Kabat-Zinn.

Meditation for working with pain

Diana provides a meditation exercise for working with pain in her podcast mentioned above.  The meditation practice involves several discrete steps and is about 20 minutes in length:

1. Grounding – feet on the ground, arms relaxed on your lap or beside you (h0wever is comfortable), eyes closed or looking downwards, a few deep breaths to relax your body.

2. Focus on your breathing – focus your attention on wherever you can feel your breathing in your body (nose, mouth, chest, stomach). Don’t try to control you breathing but just notice it, e.g. the undulations of your stomach.  Get in touch with your in-breath and out-breath and the space between.  You can rest in the space.

3. Body scan – explore your body with your attention, noting as you progress from your head to your toes any points of tightness, tingling or other sensation.  Just notice as your attention moves over your body and let go as you experience the sensation. (The art of noticing is integral to mindfulness practice.)

4. Refocus on your breathing – now return to mindful breathing (3 above).  Spend a reasonable amount of time resting in this focus – about 10 minutes say.

5. Focus on a relaxed part of your body – the aim is to locate in your body a part (e.g. arm, leg, chest) that feels secure, relaxed, at peace and pain-free.  Rest for a time in this relaxed part of your body to enable the sensation of peace and calm to spread through your body.

6. Focus on your pain – now focus on that part of your body where you are experiencing the ongoing pain.  Feel the sensation of the pain and describe the sensation to yourself.  Now focus on the stories you have developed around the pain and let them go – they are fabrications created by your fight/flight response.  If you can, bring your focus to a point outside the area of pain as a prelude to completing the next step.

7. Re-focus on the relaxed part of your body – experience the restfulness here.

8. Re-focus on your breathing – gradually bring your attention back to your breathing.  After a time of mindful breathing, resume your daily activity.

As we grow in mindfulness though meditation, we can learn ways to reduce pain or better manage pain so that we can function normally.  It is important to master our stories that aggravate our suffering from pain.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of dimitrisvetsikas1969 on Pixabay

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Tai Chi and the Mind-Body Connection

In a previous post when discussing mindfulness and neuroplasticity, I mentioned that Tai Chi actually develops the mind physically by increasing the size of the insula in the brain.

Tai Chi is one of the mind-body techniques that form part of Traditional Chinese Medicine and is based on Chinese philosophy incorporating Taoism and Confucianism.  Tai Chi involves a combination of slow movements, body postures and mindful breathing.  In Chinese philosophy terms, it facilitates the flow of Qi, “life energy”.

Tai Chi has been shown to improve muscle strength, balance and flexibility and, when used in conjunction with Western Medicine, helps patients suffering from Parkinson’s Disease, Arthritis and low bone density as well as helping people to recover from the effects of a stroke.

The real benefits of Tai Chi flow from its capacity to simultaneously develop the mind and body of the practitioner and thus enhance their mind-body connection.  Alzheimer’s disease is a clear example of the mind-body connection because as the mind deteriorates so does the body.  Tai Chi has been shown to combat Alzheimer’s.

The power of Tai Chi to develop the mind derives from the state of “relaxed concentration” achieved by focusing on the coordination of mind and body in a series of slow, balanced and rhythmic movements, while focusing on a single thought.  The focused attention develops mindfulness, improves memory and strengthens concentration.  Dr. Shin Lin, in a talk at the UCLA Center for East-West Medicine, provided research results to show that Tai Chi produces new neurons during regular practice which suppress stress and build memory.

Dr. Lin indicated that Tai Chi, besides producing stress release, also improves immunity and eases chronic pain and fatigue.  Professor Michael R. Irwin, Medical Doctor and Director of the Cousins Center for Psychoneuroimmunology at UCLA, has demonstrated in his research that Tai Chi “promotes improvements in health functioning, viral specific immunity, and inflammation”.  His area of research and practice is focused on the mind-body connection – “Psychoneuroimmunology” involves the “study of the interaction between the psychological processes and the nervous and immunity systems of the human body”.

I have found from personal experience that Taoist Tai Chi helps both my mind (concentration, focus and creativity) and my body (energy, balance and fitness). I use the evidence of the mind-body benefits of Tai Chi to motivate my daily practice.

Karl Romain, in discussing how Tai Chi trains the brain, suggests that if you cannot find time for meditation and Tai Chi, practise your Tai Chi because it has a meditation element, as well as provides benefits for your mind-body connection.  I think the two practices, meditation and Tai Chi, are highly complementary and my personal goal is to achieve daily mindfulness practices that include both traditions.

As we grow in mindfulness through meditation and/or Tai Chi, we develop improved health and wellness, develop our minds and deepen our mind-body connection.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of johnhain on Pixabay

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Persistence with Mindfulness Creates its Own Reward

In previous posts, I discussed how mindfulness meditation can provide pain relief in situations of chronic pain and alleviate the symptoms of psoriasis.

From my personal experience, I can confirm that being mindful in the midst of pain or the relentless itch from psoriasis is not easy.  However, I have found in both situations that mindful meditation has been extremely helpful.

In 1997, my back collapsed and I could not stand for more than two minutes or walk more than 10 metres without experiencing excruciating sciatic pain that travelled down to my ankles.  On top of this, I had pneumonia which aggravated the pain whenever I coughed.

I spent 18 months having all kinds of treatment – chiropractic, hydrotherapy, physiotherapy and osteopathy.  There were times when I had to lie on my back on the floor, alternating one hour on and one hour off.  When you are lying on the floor, there is not much you can do except meditate – which is what I did to achieve some degree of pain management.

More recently, I have found that mindful breathing focused on the part of my body that is itchy, has provided some relief.  This is difficult to do because the temptation is to seek distraction rather than focus on the source of discomfort.  However, as I mentioned in my previous post on psoriasis, research has demonstrated that mindful meditation can actually enhance the healing benefit of whatever form of treatment for psoriasis you are undertaking.

We know from experience that conscious breathing can help us manage pain when, for instance, we are undertaking painful physiotherapy or remedial massage.  Research shows that conscious breathing, combined with focused attention, actually speeds up the healing process.

While the pain or itching discomfort can remind you, and motivate you, to undertake mindfulness meditation, this practice in turn helps you to grow in mindfulness – with all its attendant benefits. So, there is a two-way dynamic operating – pain and discomfort precipitate mindful practice and the latter reinforces other forms of mindfulness that you have developed through different techniques.  Also, as you grow in mindfulness, it gets easier to be mindful when experiencing chronic pain or discomfort from psoriasis.

What I found helpful too is to visualise a future state where you are healed – in my case, visualising returning to playing tennis again on a weekly basis, a state which I eventually achieved after mindfulness meditation in concert with multiple treatments for my back problems.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: Courtesy of illustrade on Pixabay

Mindful Meditation to Reduce the Symptoms of Psoriasis

In an earlier post, I discussed how mindfulness meditation can help the management of chronic pain.  In this post, I will focus on the beneficial effects of mindful meditation for the management of psoriasis.

Psoriasis is a chronic skin condition that can last for weeks, months and even years and can recur at anytime.  This skin condition is thought to be an autoimmune disease that typically manifests as a rash or skin lesion that can be exceptionally itchy and results in dry, cracking skin that can be painful.  The skin problem is exacerbated because people with psoriasis, consciously or unconsciously, scratch the itching skin which intensifies the itch and increases inflammation of the skin.

This vicious cycle can contribute to emotional and psychological problems.  People who suffer from this skin condition may feel embarrassed to be seen out in public and may withdraw emotionally leading to depression. The negative emotional effects are aggravated by the difficulty experienced in attempting to heal this persistent skin condition – a debilitating disease experienced by 450,000 Australians and over 125 million people world-wide according to the Skin & Cancer Foundation.

There are numerous triggers to cause psoriasis in an individual – stress and infection being two of the major triggers.  The inability to isolate the primary trigger for an individual adds to the anxiety experienced by the psoriasis sufferer.

Jon Kabat-Zinn, a renowned mindfulness expert, undertook research in support of an approach to curing psoriasis using meditation as a means to heighten the effect of the treatment.  His research involved two groups of people receiving treatment for psoriasis, one group practising meditation during the treatment and the other group, the non-meditators, taking the treatment as normal.  He found that “the meditators skin cleared at four times the rate of the non-meditators”.

In discussing these results (which have been confirmed by other researchers), Kabat-Zinn suggested that the positive effect of meditation on the rate of healing of psoriasis is related to the connection between the body and the mind:

And it is a beautiful example of the mind/body connection because you’re doing something with your mind and something is happening in the skin.  So it just doesn’t get any better than that.

The Psoriasis & Skin Clinic offers a number of meditation methods to reduce the stress associated with psoriasis and to build emotional resilience while suffering from this skin condition.  They suggest a form of body scan meditation which involves concentrating on a specific part of the body where itching or pain is experienced., breathing deeply and focusing your mind on that itching or pain to reduce or alleviate the discomfort.

They also suggest another meditation/relaxation technique which involves experiencing, or thinking about, a peaceful or inspiring location and using this focus to release any troubles or worries that may be causing you stress.  Their instruction for this exercise is reminiscent of Kabat-Zinn’s book, Coming to Our Senses: Healing Ourselves and the World Through Mindfulness:

If you are sitting on the sand on the beach, feel the setting sun warm your face, feel the breeze on your skin, smell the ocean air, taste the salty tang on the breeze, hear the waves washing right up to you and as you hear each and every wave, release all of your stress and throw it onto the waves to wash out into the ocean.

As you grow in mindfulness through mindful practices such as these meditations, you will be better able to manage the discomfort of psoriasis and assist your healing process, whatever treatment method you adopt.  The experience of itching or pain can even become a catalyst to mindful meditation to relieve the discomfort.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

 

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Mindfulness Meditation for Pain Relief

As we grow in mindfulness we start to learn the many ways that mindfulness can improve the quality of our lives.

The quality of life of many chronic pain sufferers has been improved through mindfulness meditation for pain relief, pioneered by Jon Kabat-Zinn.

This resource which is available in CD format or audio download, provides an insight into how mindfulness can help you manage chronic pain as well as mindfulness meditations that can be used for pain relief.

Jon Kabat-Zinn, the founder of mindfulness-based stress reduction (MBSR), maintains that current neuroscience research supports the idea that the more we become aware of the pain in our body and mind, the better we are able to manage pain and improve the quality of our life.  The research shows that awareness of the body-in-pain compared to distraction from pain, has a greater benefit and provides a more sustainable release from the physical and emotional impact of chronic pain.

We all experience the unwanted parts of life, pain and suffering, at some time in our lives – some people for longer than others through the experience of chronic pain.  Mindfulness meditation can help us relieve not only the physical aspects of pain but also the emotional impacts which can take the form of frustration, depression, annoyance, anger and the inability to concentrate.  We can expend so much of our energy and focus just managing the pain that we are quickly exhausted and unable to concentrate.

Jon Kabat-Zinn provides an introduction to his mindfulness meditation for pain relief and this free resource, which includes meditation practice, can help you realise the potential benefits of this approach for improving the quality of your life:

Jon Kabat-Zinn assures us that through mindfulness meditation we can come to realise:

  1. we are not alone in experiencing pain; and
  2. learning to live with pain is possible.

He makes the salient point that managing pain is part of the work of mindfulness itself and that by participating in mindfulness meditation for pain relief, we are immersing ourselves in the global mindfulness movement that is raising global consciousness – people all around the world are becoming more mindful and we are contributing to this movement that promotes peace, harmony, loving kindness and awareness of others and nature.   Our self-compassion through pain management is contributing to compassion for others.

We can grow in mindfulness in many ways.  The drivers for our motivation to practice mindfulness can also be many and varied.  If you are a chronic pain sufferer, this experience could provide the motivation to develop mindfulness for pain relief.

 

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: Courtesy of Sae Kawaii on Pixabay