Chronic Pain and Mind-Body Strategies

Those of us who are lucky enough to be Survivors of Life past the age of 50 are probably way too familiar with the kind of daily aches and pains that our doctors tell us are part and parcel of the privilege of aging.  In talking to my peers I realize that many of us cannot get out of bed in the morning without experiencing some kind of stiffness or pain. Some of you cannot stand up from a chair or even go for a walk without grimacing from the pain in your knees or lower back.  The current chapter I am working on for my book“Aging Happy: How to Knock Out The Nonsense and Make These the Best Years of Your Life”(to be released at the beginning of next year), looks at body image in older adults. This topic is particularly dear to my heart, as it completes the circle of the research I conducted as a (much) younger doctoral candidate many moons ago.  It comes as no surprise that an adversarial relationship with our body in our older adult years is just as poisonous to our happiness as it was in our youth. Body Image Dissatisfaction can still make us older adults vulnerable to eating disorders, low self-esteem, social isolation, and depression.

The bulk of body-image research on adolescents and young adults examines the influence of advertising, the cosmetic and fashion industries, and even the comparisons we make between ourselves and those we think look better than us (i.e. Leon Festinger’s Social Comparison Theory, circa 1954)—but what about the influence of chronic pain on our self image as we age?

Non-malignant chronic pain, the kind that many of us experience every day, can keep us from feeling good about about the very body that houses our heart and soul and keeps us functioning right up to our last breath.

Pain can make us feel (and look) older, and feebler, and often we perceive ourselves to look older as well when we look in the mirror.  Pain can strip us of our motivation to do the things we normally love to do. Thoughts of pain, and ways to adjust our lifestyle to avoid pain can consume our thoughts and eventually our entire existence; causing us become less social and less engaged in life—a disastrous outcome for older adults who need more than ever to be involved with meaningful social interactions.

I recently came across an article that reviewed a number of studies examining various mind-body strategies for relieving chronic NON-malignant pain in older adults. These strategies included tai chi, yoga, hypnosis, progressive muscle relaxation, biofeedback, guided imagery, meditation, and qi gong. The benefits of these methods are undisputed when it comes to relieving stress and its related maladies.  When dealing with chronic pain researchers are cautiously positive, but are calling for larger clinical trials to be conducted before the scientific jury can definitively weigh in. My hunch is that anything we can do to help ourselves when it comes to chronic pain will also up the happiness factor.

Let me explain.

Chronic pain commonly triggers feelings of learned helplessness especially when people have been to their doctors, tried a number of medications, modified their lifestyles to the nth degree—and still they suffer, despite reassurance from the medical professionals that there is nothing seriously wrong other than a touch of osteoarthritis in the joints that “everyone gets” sooner or later. Of particular note, however, when it comes to using mind-body strategies such as Yoga to relieve pain, is the change in attituderequired to perform these self-therapies.  It takes us from feeling helpless and defeated to actively taking control of our “rehabilitation”. Often this position of emotional strength starts a domino effect of better self-care and a more positive relationship with our body. For example: “That gentle yoga video made my joints feel better so I wonder if I will feel even better if I avoid all flour and sugar today and instead prepare a large vegetable salad for lunch (like mine, in the photo above).”  Then that leads to going out for a 15 minute walk at lunch time, then to setting your timer to get up from your couch or office chair every 20 minutes to march in place or do a few sit ups. And so on.

It’s been established that mind-body strategies are really good at relieving stress. That alone will reduce the perception of pain. But because they also require an “active” component, our sense of self-efficacy (belief in our ability to affect our situation) will also be bolstered and before you know it you may experiences longer and longer stretches of time in which the thought or fear of your chronic non-malignant pain will not even enter your mind. You can start to once again pursue the things you used to love doing, instead of avoiding them.

If you are in chronic pain have it checked out by your doctor and ask about either starting with, or using mind-body strategies as an adjunct to their recommendation. You may be pleasantly surprised at the results.

 

Reference:

Morone, Natalia E. & Greco, Carol M (2007). Mind-Body interventions for chronic pain in older adults: A structured review. Pain Medicinevol 8(4) pp 359-375.

© Raeleen Mautner, LLC 2018

Can You Ever Be TOO Happy? The Answer Might Surprise You.

 

On more than one occasion I have been mildly chided for being “too happy”. While I don’t consider myself sickeningly exuberant, I am, in general, an optimist; which is not to say I am immune to life’s heartaches. Never-the-less I guess that irritates some people. But it did make me think. I know that in general, too much of a good thing can actually be—well, no good at all. For example, once a year I enjoy a magnificent zeppola di San Giuseppe; a fried Italian pastry , filled with custard, lightly dusted with confectioner’s sugar and finished with a maraschino cherry on top. Fortunately, they are only on display at pastry shops around the time of St. Joseph’s Day (Father’s Day in Italy), the 19th of March. Heaven knows if they were available every day of the year, I would be a regular at my favorite Italian bakery and gradually either morph into a cannon ball, or get physically sick from eating a half-dozen in one sitting. So yes, moderation in most things, is key. But come on; happiness?? Can we ever be just too darned happy?

As it turns out, the answer is YES…and NO.

Let me be clear, I ran across no studies that indicate happiness is a bad thing; in fact, happiness is an agreed upon good thing, and has a number of benefits in every age category. Moreover, happy people seem to be more successful in all areas of life—from work, to love, to health—than are unhappy people. What researchers found, however, when taking a closer look, was that there are certain situations where ultra-happiness is productive and other situations where it may be counterproductive.

There are many definitions of happiness, and those definitions vary among individuals, but for the most part, we are referring to subjective well-being—a feeling of positive emotion and life satisfaction. Some experts define happiness as the presence of positive affect and absence of negative affect. But here’s the rub: there are situations where being 100% satisfied with things as they are will kill your motivation to take action in ways that might improve your circumstances. Sometimes negative emotions can be productive. Fear, for example, keeps me from walking down a dark alley in a strange neighborhood at night alone. I can whistle zip-a-dee-do-dah (yeah, okay, I still love that song) all I want, but that won’t help me avoid danger. Similarly, anxiety about my knee pain motivates me to see a physical therapist so I can get out of pain. A certain amount of stress keeps me on target in meeting my writing deadlines, and memorizing my theater scripts. A strong superego (i.e., guilt) keeps me from violating my own moral code.

Thus, when a person’s situation is less than ideal, being happy but not 100 -percent happy, leaves room for the kind of uneasiness that can lead to positive changes. If an uber-happy person is in a low paying job with no chance of advancement, (s)he may not put in the effort to get a better paying job that would cover the monthly bills; or fail to pursue a more challenging career because there is no motivation to seek more education or training.

Thus when overly happy people are in bad circumstances, they may become complacent and not seek to improve their situation. Too much happiness becomes an obstacle to making positive changes in such cases.

On the other hand, there are other situations where maximum happiness is a good thing. For instance in relationships, where being totally positive can help you overlook some of the more irritating flaws of our partners, family, and friends. Being totally content with your circumstances may have a positive impact on the stability of a marriage, for example, where you do want avoid making such changes, as searching for another partner.

Researchers examined how respondents rated their overall life satisfaction on a 10-point scale on The World Values Survey Data. They also examined other variables such as relationship satisfaction, highest level of education completed, volunteer status, and political participation. They found that the highest possible life satisfaction score was correlated to satisfying volunteer work and relationship status; whereas moderately high levels of satisfaction (i.e., less than maximum) were more useful when it came to income, education, and political participation –all variables that can improve our life circumstances if we are motivated to take action to make changes.

So have no fear about pursuing what Aristotle considered to be the ultimate goal in lifeàHAPPINESS. Just make sure you can gauge when complacency is keeping you from improving your situation when change is called for.

 

Reference

Shigehiro, O., Diener, E., & Lucas, R.E. (2007). The optimum level of well-being: Can people be too happy? Perspectives on Psychological Science. Vol 2(4) pp 346-360.

© Raeleen Mautner, LLC

Self-Help Books: Can They Really Make You Happier?

Don’t let anyone make you feel embarrassed about reading self-help books. I for one, devour them. I also write them. Why? Because I am convinced in their potential for helping readers get through tough times or get to better times. For some reason, just as with psychotherapy, self-help books come with an undeserved stigma attached to them. Critics say they can be “dangerous”, they can give us “false hope”, or the motivational boost they might give readers initially is fleeting—and then what? Well then you re-read, and re-assess. The truth of the matter is that up to 85% of psychotherapists recommend self-help books to their own patients, and a growing number of studies show that self-help books can make a big difference in readers’ lives. Self-help is as uniquely American as Stars and Stripes and the right to the pursuit of happiness as laid out for us in the Constitution.

If I didn’t believe there was a valid place in the world for good self-help books, I wouldn’t have dedicated many long hours, months, and years of my life writing them. Researchers use the word “bibliotherapy” (biblio=books) to refer to people who seek to feel better through the reading of certain books, and there is growing evidence that for many people, such books do make a difference. Let’s face it, most people don’t have access (or the time or interest) to go to the research journals and muddle through pages of academic writing. They shouldn’t have to have a degree in statistical analysis to interpret what research findings. A good self-help book, in my opinion, brings this information out the obscure journals and laboratories, and into the light of day; making it available and understandable for all who might benefit. I happen to trust that readers can make their own decisions as to whether one book or another makes sense to them; whether they want to try some of the suggestions contained in it; or whether they need more help than a book can give. If self-help books have become cliché or stigmatized part of the reason is that some authors have taken advantage of their platform by using their book as a little more than an empty advertisement for the author’s more expensive programs or products, without giving the reader any real information in the book itself. There are some charlatans in the field that just outright lie, by giving you “miracle” cures for just about every malady under the sun that “they don’t want’ you to know about.” Well ok, such con artists exist in every sector, but if you do a little research, read book excerpts, and examine real (non-solicited) reviews, rest assured that you can find very valuable self-help books with solid information, suggestions, and exercises that will help you to improve your mood, revamp your lifestyle, improve your finances, help you lose weight, learn how to dress more professionally, build better relationships, and get through loss.

Self-help books are neither a panacea, nor a substitute for psychotherapy when you need it; but my point is that you don’t always need it, anymore than you need medical therapy for minor injuries. If I fall and scrape my knee I wash the wound, slather it with some ointment and throw a Band-Aid over it. If I shatter my kneecap, you better believe I am off to a medical professional. Self-help can give you a clear roadmap for navigating the everyday challenges of life. Centuries ago people looked to philosophers or spiritual leaders for wisdom; today, self-help books in America have gained unprecedented popularity.

So the long answer to the question is YES, self-help books really can make a positive difference in your life. One study I came across even found self-help reading to be a viable remedy for sadness or depression in older adults.

Research has shown that both cognitive and cognitive behavioral therapy have typically had high success rates in reversing depression or depressive symptoms—and in many cases are at least as effective as anti-depressant medication perhaps even more effective. But there will always be individuals who, for whatever the reason, cannot afford to go to a mental health professional, do not have access to one, or who just don’t feel comfortable with one-to-one therapy. A good self-help book can be an effective alternative.

Adults between the ages and 60 and 80 were divided into three groups: Individual psychotherapy sessions (12-20 sessions); Cognitive bibiliotherapy (participants were asked to read a book called Feeling Good (David Burns, 1980) and complete all of the exercises in the book; and a third group, the control group, was the delayed treatment group. In general, both of the “treatment” conditions improved geriatric depression more than the control group, and both psychotherapy and bibliotherapy were found to be viable options for depression in older adults.

So the next time you are in a books store, library, or browsing online, check out the self-help books that address whatever it is you want to work on. And don’t let anyone tell you that you’re wasting your time. You and I know otherwise.

Let’s start a discussion! What are YOUR favorite self-help books? I would love to know how a good self-help book made a difference in your life. I welcome your comments below.

 

References:

Bergsma, Ad (2008) Do Self Help Books Help? Journal of Happiness Studies 9 pp. 341-360

Floyd et. al (2004) Cognitive Therapy for Depression: A Comparison of Individual Psychotherapy and Bibliotherapy for Depressed Older Adults. Behavior Modification 28(2) pp. 297-318

© Raeleen Mautner, LLC 2018