On Thursday’s group it was our final group for the year. We had decided to have a Christmas party.
However, as the group is called a life worth living we do acknowledge how Christmas can be a really difficult time for people.. We discussed how the run up to Christmas can seem to go on much longer and some people can find it very stressful. Some people find it a particularly lonely time, or a very painful time for a variety of reasons. Examples of this were, missing people no longer in our lives or dealing with our own/loved ones mental health issues.
For some people Christmas is a joyous time, often when children are around,and just enjoying the festive season and holiday.
Whatever Peoples’ experience is in our group we all feel valued and equal, we can all share our experiences but mainly have the best laughs with each other and Paul and Liz the facilitators.Every week there is a different topic and this week it was about celebrating Christmas.!
As always we had a quick ‘check-in’ for people to say how their week had been and then the party started!
We played a game called ‘The present game’ which was fast paced and great fun! Everyone had bought in a cheap present for this and everyone went home with at least two wee fun presents!
We then watched a compilation of funny Christmas clips from you tube, listened and chatted to Christmas music before playing the game Truth or lie. The rules of the game are that everyone had to say a truth or lie about themselves with everyone else having to decide which story is true and which is not. This proved to be harder than we thought!
We then had a buffet lunch before saying our goodbyes and looking forward to seeing each other in 2020, feeling blessed to belong to such a wonderful group!
The group met to discuss how books and reading have been a useful resource for recreation and learning throughout our lives. Aspects of this broadly broke down upon experiences of reading and being read to as children, books that have inspired or moved us, and any fiction character or real life person that we could relate to.
A common theme around reading as children was of escape. Partly to get respite from challenging home environment issues, but equally just to be explore other identities and be transported to new worlds and let our imaginations soar. Texts such as the Hobbit, the Famous Five, Black Beauty and works by Roald Dahl were amongst those early reading adventures enjoyed.
Reading can be a gender related issue, as whilst boys and girls equally enjoy and progress at reading, by adolescence it can be seen as a feminine pastime and this puts off some boys continuing to read as adults.
There were fond memories in childhood of libraries and read along storytelling cassettes.
As adults affected by Mental illness, it is important to read other lives that validate our shared experiences, even if this is dark and challenging. At other times we just want to spend time away from our own troubles and get lost in Agatha Christie or enriching literature, poetry and plays.
There can be barriers to reading throughout our lives. People with dyslexia were until fairly recently poorly as stupid or lazy. Fortunately this is not the case and appropriate help and use of alternative reading formats offered to people with dyslexia or other sight conditions. The ability to continue to enjoy reading when suffering depression can be restricted due to diminished concentration levels. This can be frustrating, although sometimes switching to either short stories or audiobooks can help.
One group member accounted how they had not been encouraged to read as a child and only by having a period in hospital discovered that they could enjoy it and pass the time.
In terms of biographical works, many in the group appreciated reading of extraordinary lives also affected by mental illness, substance abuse and recovery; eg Patrick Swayze , Elton John, Liam Gallagher.
Finally it was noted of the death of Clive James yesterday, a multi talented biographer, poet, TV presenter and journalist. He wrote Japanese Maple tree poem when diagnosed with a terminal illness. It beautifully accounts his increased appreciation of life and nature, and fortunately he enjoyed almost 10 years of life, albeit affected by physical health restrictions.
Have you ever noticed that you seem to say sorry for every little thing? Such as brushing past someone to get off a train, or coughing, or expressing an important opinion. Some people may notice that they never say sorry at all. We thought we would explore a little more the meaning of this word.
We had a think about the last time we said ‘sorry’. For a few people that was within the last hour or few and was a mixture of things we didn’t need to say sorry for and some where we had a concern that we had potentially hurt someone, so the apology was almost an explanation so our meaning was not misunderstood. Someone had also said sorry to a cat.
We then thought about the last time we intentionally apologised, and was this different? We agreed that an intentional apology was when we realised that we had caused offence or hurt or made a mistake. Apologies here were born from feelings of guilt, worry, not wishing to be seen as bad, and a desire to repair what had gone wrong. People said they felt relief when they apologised in this way, and generally people did not find this hard to do as it was like a burden lifted.
So what about all these unnecessary ‘sorry’ words we say? We dug a little deeper and realised that sometimes we had hold onto messages from childhood about being to blame for significantly tragic family events, or being bad, or not being wanted, or being in the way. The ‘sorry’ that becomes so frequently whispered is almost an apology for existing and causing so much trouble.
We began to connect ‘sorry’ to our sense of responsibility. Healthy self-responsibility is able to see which part (if any!) does belong to us, and we own that part, and also see what is not ours to carry. This is healthy for relationships where in communication responsibility is owned rather than blame being thrown. People also began to link ‘sorry’ to low self-esteem, being a ‘people-pleaser’ and low self-worth and self-confidence. Growing self-worth and confidence is a big part of this group; learning to value ourselves and not take all the blame to maintain peace.
We talked a little about what it feels like when people say sorry to us, and maybe what is it about when people feel unable to say sorry; sometimes it can be too painful to admit what has gone wrong, especially if we feel we are wrong!
So having been to some deep places today, we made sure that people were feeling ok after the conversation, and ended with our good notice board about things to be thankful for this week.
At this time of year now when we are noticing a lot less light in the morning and evening, it can be quite typical for people to notice a drop in energy and mood and experience sleep disruption. There did seem to be a sense of this in the group this week so we did something a little different to create a little energy as we investigated some troublesome little thoughts. Our room became a brain and each of us a thought. The difficult thoughts would present themselves whilst the other thoughts sought to neutralise them. This allowed some physical movement and some cognitive acrobatics.
The first thought to present itself was a belief: ‘I can’t do this’ in response to trying something new. This belief had the potential to quit or miss out on things. But the other thoughts reasoned with this belief ‘you don’t know that until you try’. ‘You can practise’, ‘no-one can do the things they haven’t learned to yet’. This quietened down ‘I can’t do this’ and allowed some patience with self and an acceptance that it is ok to not be able to do some things when we start out; but it’s important that we try.
The next thought said ‘I’m so tired I don’t think I’ll manage my day’. Balance was quite quickly on the scene here with a reminder that we could prioritise some things and that we could manage what we needed to. Practicality came in with a few suggestions too that if we we able to have a more gentle day we could do some relaxing things like have a bath and feel better rested for tomorrow. If our day was a bit more demanding we could have a shower to revive us and we would manage. what is required.
Worry showed up on the scene this morning too with beliefs that if we have always been this way we won’t change. Evidence came into the conversation here and asked if worry ever changes the outcome or ever made a situation different? Worry conceded that actually sometimes it got worse and didn’t change anything at all! Worry sometimes caused people to avoid and miss out on things. Bad things still happened whether they worried about it or not. In fact worry seemed to reproduce itself into bigger and bigger worries, and the worry about worry could cause another whole set of problems intruding into not being able to focus on other things or speak to people and causing distressing feelings. Identity spoke up too and said just because worry is something you have always done, it doesn’t mean that is who you are and need always to be that way. You will still be you if you worried less. Everyone has worries, that is quite normal but we made an agreement to spend a bit of time over the next week analysing the evidence for seeing if worry makes us feel better or changes anything. It was also suggested that a specific time could be given for worrying rather than it dominating the diary everyday.
A more stubborn relative then intruded into the conversation. Obsessively believing that ‘I am responsible for everything and everyone and if I think about a possible danger somewhere for someone and don’t do all I can to protect people from this danger and someone gets hurt then it’s all my fault, I’m the only one to blame. OCD then compulsively convinced us that unless we take the time and energy to do all sorts of precautionary and checking activities and carefully going through all sorts of mental check lists then disaster may occur which we could have prevented. Admittedly OCD was harder to quieten down. We concluded that it would be very frightening to tackle as we would just have to try really hard to not do the stuff it was convincing us that we needed to do. We will take it slowly at first and check a little less to start with.
A big thanks to the group who were willing to get involved in this exercise today in a slightly different way. We learned some new things from each other about how we think affects us, some new understanding and some new ways to start trying to change our troublesome thinking.
It had been requested by the group to look at ways of managing pain. Chronic pain, often with an undiagnosed cause, and for which medication is not effective affects about 7.8 million people in the U.K, 25% of whom have lost their job and 16% of whom experience such bad pain that at times they feel as if they want to end their life. (These statistics are from 2009 and cited by Corrie, Townend and Cockx , 2016). We considered a CBT coping model of coping with chronic illness, also presented by the above authors.
Because human beings are not easily compartmentalised into separate parts that function independently of each other, this model considers a number of factors; physical, environment, the impact of medical professionals, our thoughts and beliefs about illness, the social relationships that we have and support, the culture we live in, the level of activity we engage in, our emotional state and resilience. All of these areas affect our experience of pain. For pain “is simultaneously a sensory and emotional experience” (Dima, 2013).
Our medical journey can sometimes be very discouraging and disheartening when no diagnosis is forthcoming and we get passed from department to department with no resolution for the pain. When our emotions are affected by a sense of hopelessness or stress this can increase our sensitivity to pain. The things we tell ourselves about pain can contribute to our emotional state and maintain pain e.g. I will never be well, I will get worse, or we may hold images that are upsetting and unhelpful. We are also affected what other people or our culture tell us about pain. Group members talked about messages they had heard such as ‘well-you’re not getting any younger’. The level of activity people engage in is important-overdoing it leads to more pain, more injury, more recovery time and less wellness. Inactivity due to fear or beliefs about the pain maintains it and contributes to a reduced sense of overall wellbeing due to isolation and not engaging with pleasurable activities. Group members spoke about the importance of balance and how they continued normal activity although sometimes needed to moderate this at certain times but didn’t stop doing things altogether.
Group members spoke about how important it is to have support and how significant this is to them. Research shows that such support how ‘pain is perceived, expressed and experienced’ (Corrie, Townend and Cockx, 2016). Medical professionals and other social contacts can help or hinder what we tell ourselves about our pain and acceptance of illness and what we can manage.
Group members shared what helped them to deal with pain. Some said that a ‘mind over matter’ approach had been very important in helping them to push through very painful physio exercises to recover as they knew they felt better afterwards and eventually recovered completely. Using the mind differently, some people definitely recommended mindfulness as a way of coping with pain. Mindfulness involves observing what is happening in the body in a non-judgemental way. Clinical trials showed that mindfulness can reduce pain by 57% and for some up to 90%, brain imaging showed how the brain is soothed by mindfulness.
We talked about the importance of noticing our bodies. When we are in pain, or worried we become tense, we hold our bodies rigid and inflexible, this can both cause pain and exacerbate existing pain, so relaxation is important. As a group we have often used breathing techniques together as a form of relaxation and noticing where we are holding tension. One group member talked about a technique of full body stretching, as in if we think about how a cat stretches fully:
It was said that when animals stretch, they don’t do specific targeted stretching but just go for it….you don’t see bears doing shoulder stretches, however I did find this fun yoga bear workout!
People spoke about other activities which create the natural pain killers, endorphins, like exercise, and singing.
We spoke also about external and internal locus of control, and how much we believe we have power over elements of our circumstances or how much we believe we are helpless. As we looked at the model of managing chronic pain we could see areas where we could feel like we have more control:
Biological and physiological factors-if we are stressed this can increase the experience of pain, so finding ways to relax and calm down the threat system can help, such as breathing, nice walks and things we enjoy.
Psychological factors-the things we believe about our pain can sometimes increase our experience of it, so being aware of beliefs and reality testing them can be helpful, for example the group member who told us about believing that the physio exercises were helpful for healing helped her to push through and heal rather than giving up.
Social context and support-many group members today realised how important it is to have supportive relationships and places of support, isolation or lack of support can increase stress and upset emotions which can exaggerate the sensation of pain. For example many group members often leave the group feeling better than when they came in, this is an example of feeling soothed which can help pain.
Behavioural responses and level of activity-here we spoke about balance. It is important to do the right level of activity that we can manage. Pushing ourselves too hard can result in worsening pain, leading to the necessity of inactivity, which can in the long term worsen pain. Not enough activity can increase our sensation of pain but is also likely to lead to more isolation and missing out on things we enjoy. This can be to do with our thoughts and fears as well that activity may be bad for us, so growing confidence may be important. People spoke about for example taking a walk each day, and that sometimes they may need to walk for 5 minutes rather than the usual 50 minutes, but they are still managing to go for a walk.
The group had suggested that we could do a session on letter writing to process difficult emotions.
We had an outline for a process to follow if this would be helpful:
We recognised that each persons situation was very different, some issues are maybe in a current relationship, some may be with people from whom we are now estranged or may be deceased. Actual contact with the other person may or may not be possible or appropriate depending on the circumstances.
Some letters had dealt with anger or being controlled and realised some new things through writing it out. Other letters addressed betrayal and forgiveness. Some had written a letter to self, recognising that they were deserving of self-care and were worthy of value. Some people had written to a person in their life that had previously bullied them and realised that they now felt sorry for this person.
Through this process we acknowledged that there could be conflicting feelings, for example feeling angry yet loyal, or hurt yet had hope for reconciliation. People noticed that there was something helpful in the act of writing things down, that in the flow of that there could be more clarity. Some people saw that their process was still very active and that there were further layers of processing to do.
During the letter writing exercise we enjoyed having Neil Young’s song on about writing a letter!
It had been requested by the group to look at dealing with shame as a group topic. We began by watching the video clip of Brene Brown talking to Oprah about her research about shame.
Group members responded to this idea that talking about shame is helpful as some of them had experienced that this process for them, of talking about things they were ashamed of was very healing. People also responded to the idea that shame grows with silence and secrecy but cannot survive empathy and understanding. We talked about what is the difference between guilt and shame concluding that shame is about our identity; how we see ourselves and also how it extends externally in how we worry about how we are seen by others. We talked about what it is like to grow up with shaming messages or the message that our worth is dependent on us achieving or doing well-it is conditional.
Shame can come as a result of being abused, sexual or otherwise in childhood. Thoughts about this can create a very visceral reaction and people can physically feel sick, disgusted and a sense of revulsion.
People also talked about things that they had done or said when younger that we now feel shame over, what can we do about this now? Sometimes we just have to acknowledge that we did some things we wished we had not, but recognise that this is common to every human being. In some situations there is maybe a possibility to say sorry if it is appropriate and may help the other person. However, a sense of shame does not serve anyone, so maybe this same message applies that if we talk about the things we feel ashamed of, this can dissipate the shame. We can accept the error, accept ourselves and move on with the learning and growth from the experience.
It is important to have self-compassion and understand common humanity, (rather than thinking ‘I am such a bad person, no-one else is like me or would do such a terrible thing’) and bring some understanding for maybe why we did things at the time.
Shame is sometimes connected to responsibility we carry that isn’t ours to carry, other people make us feel bad for things we are not actually responsible for.
Deborah Lee in her book ‘The compassionate mind approach to recovering from trauma’ explains how shame can lead to feelings of anxiety; internal shame because when we are self-critical and self-hating this activates the threat system, causing us to feel anxious. With external shame we are afraid of how we exist in the minds of others. This links back to a basic survival need to belong in a group for protection. When we fear this social loss this activates the threat system again resulting in feelings of anxiety. Lee lists some of the common fears and beliefs we can have when feeling ashamed such as ‘I do not deserve love, kindness and care, or for good things to happen.’ Or feeling weak and pathetic for not being able to ‘get over things and move on with life’. Participants could identify with some of these thoughts.
After the group it was interesting to find an article in ‘Therapy Today’ about shame, saying:
“The way out of shame is to talk about the very issue you are ashamed of with people you trust”.
I guess this helpfully consolidates the conclusions we had come to as a group, when we do find the courage to speak, it is very important that those we speak to are trustworthy.