Chronic pain is physically and psychologically stressful and its constant discomfort can lead to feelings of anger and frustration. While the medical community may be able to provide treatment for the physical aspects of chronic pain, psychologists are uniquely trained to help manage the mental and emotional aspects of this often debilitating condition and can offer many avenues for pain relief and management. Counselors can help to re-frame negative thinking patterns about pain that may be interfering with normal daily functions such as work, and relationships.
Creative activities like art-making are mindful practices, allowing patients and caregivers to stay in the moment, which by definition can free them from the stress that cancer brings. Caregivers experience stress, which can affect their own health and the patient’s outcome. A recent study showed coloring and open-studio art therapy benefits stressed caregivers of cancer patients.
Living with a chronic or life-threatening illness or injury takes a cumulative toll on a person’s emotional and mental health, whether it is lifelong asthma, diabetes, a cancer diagnosis, a disability, or organ failure. Similarly, a sudden injury can leave in its wake life-altering changes and daily struggles that permanently challenges a person’s sense of well-being. Emotional adjustment to life altering changes such as these can cause coping problems due to the chronic stress and uncertainty presented by facing the unknown or having to live with a chronic illness.
Dr. Jenny Holland PsyD was once diagnosed with Neuroendocrine cancer and is now a cancer survivor. She has lived with chronic pain her whole life due to Cerebral Palsy. These experiences give Dr. Holland a unique perspective and a deep understanding of what it is like to live with chronic illness and a life-threatening diagnosis. “As a cancer survivor, I enjoy working with others with cancer to improve quality-of-life while going through treatment, by addressing symptoms that may arise practically and imaginatively,”
Facing a serious diagnosis
When someone undergoes a life-altering health challenge, the immediate reaction can include tears, emotional outbursts, reaching out to loved ones for comfort, or perhaps denial as the newly diagnosed patient chooses to pretend that nothing has changed. Some people may feel emotionally numbed or feel ‘stuck’ as they are unable to process that life has suddenly changed beyond recognition. Some people take the opposite route and leap into action to tackle the health problem head on.
No matter what the reaction, it is important to remember there are no rules for how to respond, nor is there an expectation to what one might feel. Every person’s experience is unique so it is important to allow the process to unfold, and allow yourself to adjust to the situation. A serious health complication is disruptive by nature, and all aspects of what we may consider to be a ‘normal life’ may become challenged. Feelings associated with chronic or life-threatening illness such as cancer, or a major health event such as a stroke, heart attack, long-haul COVID symptoms, or a debilitating injury present challenges, and every individual’s reaction is unique.
You are not alone
There are steps that can be taken to support emotional health during times of crisis and therapies that are designed to help patients cope, and eventually thrive. These therapies can help to ease the stress and anxiety that often accompany serious illness. Working with a trained therapist can help you discover ways to navigate a challenging life situation.
“Living with uncertainty, pain, and compromised physical ability takes a cumulative toll. My practice is process and solution-focused with outcomes aimed at symptom reduction and increased joy,” explains Dr. Holland. “I use a combination of therapeutic approaches and techniques to help patients successfully make the changes they most want to see in themselves. I am here to help.”
Dr. Holland is a psychotherapist providing cutting edge, integrative and evidence-based mental health care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss, and caring for a parent or loved one during a health crisis or decline. She is available for Teletherapy – Online Video Counseling Services — Short-term sessions, single sessions or ongoing support as well as in-person appointment for fully vaccinated clients. Contact Dr. Holland to schedule an appointment at 707-479-2946.
Blogging with Dr. Jenny Holland, PsyD
The Dubious Connection between Physical Pain and Depression
As a psychologist I understand that pain and depression are closely related. Pain can be a two-edged sword, and studies have shown that depression can cause pain just as pain can cause depression. Sometimes this kind of cycle of pain and depression or feeling low, can wear us down, create added stress and interfere with our lives and disturb sleeping patterns. To get symptoms of pain and depression under control, it’s important to take proactive steps to keep yourself on an even keel.
My Own Experience
Though I don’t often talk about it, I live with physical pain every day. When the weather is cold and damp, life becomes even more challenging. This past month has been particularly intense in this way. As such, I notice my own thoughts automatically drifting toward the negative. The mental list of things that are difficult or ‘wrong’ tabulate in my mind without effort. And I understand that the weather will probably be getting worse for the next couple of weeks, at least. As a way to tackle my own discomfort and to lift myself out of the cycle of pain and depression I thought I would blog about gratitude and how this practice has helped me.
The Study of Gratitude
In recent years, the study of how a simple action such as practicing gratitude can boost happiness and alleviate depression has gained attention and momentum among psychologists and mental health professionals all over the world. Scientists say that these techniques shift our thinking from negative ruminations to positive outcomes. Gratitude practice has been shown to produce a surge of feel-good hormones like dopamine, serotonin and oxytocin, and helps to build enduring personal connections.
Count Your Blessings
Many people find putting pen to paper to compile a gratitude list, or to start a gratitude journal provides a sort of ritual experience that lets us focus on the positive events of the day. As we journal, we can write more detail about the events that make us feel appreciative. When I put some energy into focusing on my own situation and turning my thoughts toward what is right about my life, I can begin to build a list of items that I appreciate such as:
- I am grateful for my children and my husband. Adam and I have been together almost 25 years! That’s almost half of my life now.
- I am grateful I am healthy and that those that I love are healthy.
- I am grateful to have a few lifelong friends that support me, always.
- I am grateful for my Jewish Communities.
- I am grateful to have a job that allows me to be with people in meaningful and hopefully, in helpful ways
Expanding Gratitude into Work
Showing up and doing what I can do to help make a difference has a strong impact on my experience of pain and helps me to maintain an active, rather than a passive focus. About a year ago, I took a big leap and launched a private pay practice. Today it is thriving, and I am re-invigorated. In addition to seeing individuals, I have started a professional consultation group that is going well. I also currently run a grief group, and I am starting groups for people with disabilities and their families. I will be traveling a bit in the next few months to spread the word about a book that is coming out in March in which I am a contributor. Fury: Women’s Lived Experiences of the Trump Era. I also started a book club this year that is feisty and fun. And on my favorite weeks, I get to do a little singing with my friends at Ner Shalom.
Gratitude is an Effort Worth Making
To count our blessings or to focus on the positive when dealing with pain, depression and/or anxiety is challenging for everyone and it takes a conscious effort. However, when we adopt the practice of gratitude as a daily habit it can become an important routine and step towards self-empowerment.
Get Started with Your Own Gratitude Practice
Journaling is probably the easiest gratitude enhancing practice we can undertake. Creating a gratitude journal can be as simple as buying a blank notebook and writing down a few things you’re grateful for each night before going to bed. You can enhance your journaling experience by turning it into a ritual such as first lighting a candle, making yourself a cup of tea, sitting quietly for five minutes before you begin, etc. Whatever you choose as a ritual, do it consistently. It strengthens the ability to turn what you’re doing into a positive habit. Anything fun and relaxing, will give you motivation to form a new habit.
New study reveals that relationships between children and their siblings with intellectual disabilities can be incredibly positive
The sibling relationship is the longest most people will enjoy in their lifetimes and is central to the everyday lives of children. A new Tel Aviv University and University of Haifa study finds that relationships between children and their siblings with intellectual disabilities are more positive than those between typically developing siblings. The research examines the relationships of typically developing children with siblings with and without intellectual disabilities through artwork and questionnaires. It was conducted by Prof. Anat Zaidman-Zait of the Department of School Counseling and Special Education at TAU's Constantiner School of Education and Dr. Dafna Regev and Miri Yechezkiely of the University of Haifa's Graduate School of Creative Art Therapies. The study was recently published in Research in Developmental Disabilities.
"Having a child with a disability in a family places unique demands on all family members, including typically developing siblings," Prof. Zaidman-Zait explains. "Although challenges exist, they are often accompanied by both short- and long-term positive contributions. Through our research, we found that relationships among children with siblings with intellectual disabilities were even more supportive than those among typically developed siblings. Specifically, we found that children with siblings with intellectual disabilities scored higher on empathy, teaching and closeness and scored lower on conflict and rivalry than those with typically developing siblings."
Until now, research on how having a sibling with a developmental disability affects children's social-emotional and behavioral outcomes generated mixed findings. At times, the findings suggested that having a sibling with developmental disabilities led to greater variability in typically developing children's behavior and adjustment.
"But these studies did little to tap into the inner worlds of children, which really can only be accessed through self-expression in the form of art or self-reporting, independent of parental intervention, which is the route we took in our study," Prof. Zaidman-Zait says. The scientists assessed some 60 children aged 8-11, half with typically developing siblings, half with intellectually disabled siblings, through drawings and a questionnaire about their relationships with their siblings. Mothers of both sets of siblings were also asked to answer a questionnaire about their children's sibling relationship quality.
"We drew on the basic assumption that artistic creation allows internal content to be expressed visually and that children's self-reports have special added value in studies measuring sibling relationship qualities, especially in areas where parents might have less insight," Prof. Zaidman-Zait says.
Both sets of typically developing children, with and without siblings with intellectual disabilities, were asked to draw themselves and their siblings. Licensed art therapists then used several set criteria to "score" the illustrations: the physical distance between the figures; the presence or absence of a parent in the illustration; the amount of detail invested in either the self-portrait or the sibling representation; and the amount of support given to a sibling in the picture. The children were then asked to complete the Sibling Relationship Questionnaire, which assessed the feelings of closeness, dominance, conflict and rivalry they felt for their siblings.
Reviewing the children's illustrations and questionnaires, as well as the questionnaires completed by the children's mothers, the researchers found that the children with siblings with intellectual disabilities scored significantly higher on empathy, teaching and closeness in their sibling relationship and scored lower on conflict and rivalry in the relationships than those with typically developing siblings.
"Our study makes a valuable contribution to the literature by using an art-based data gathering task to shed new light on the unique aspects of the relationships of children with siblings with intellectual disabilities that are not revealed in verbal reports," Prof. Zaidman-Zait concludes. "We can argue that having a family member with a disability makes the rest of the family, including typically developing children, more attentive to the needs of others." The researchers hope their study, supported by The Shalem Foundation in Israel, will serve as a basis for further research into art-based tools that elicit and document the subjective experience of children.
Story Source: ScienceDaily, 14 January 2020. www.sciencedaily.com/releases/2020/01/200114123525.htm.
"As a physically disabled person and a parent of a disabled child, I have a unique perspective on parenting children with disabilities. I am offering two new support groups beginning in January that are geared toward helping both parents of children with disabilities and teens & young adults with disabilities to gain a sense of empowerment and control. We will offer coping and practical skills as well. The goal of the groups is to give participants a chance to talk openly and honestly about feelings, share stories and gain support through the process."
More about upcoming support groups:
Dr. Holland also offers counseling services for people with disabilities on a on-going basis. To learn more visit Living with Disabilities or call 707-479-2946.
Study participants had levels of depression symptoms serious enough to suggest a need for treatment
When they said their wedding vows, many of them promised to stand by one another in sickness and in health. But a new study suggests that as married couples age and develop chronic conditions, the daily demands of coping with their own health demands and those of their spouse may take a mental toll.
Depression symptoms increased over time among married men and women who themselves had two or more chronic conditions that need different types of self-care -- such as a special diet and medications for heart disease or diabetes along with pain-reducing therapy for arthritis. When husbands and wives both had chronic health conditions, and needed different kinds of self-care from their partners, husbands fared worse. Their depression symptoms were significantly higher, but this effect was not found for wives.
The new findings, made by a team from the University of Michigan using data from a long-term study of more than 1,110 older opposite-sex married couples from 2006 to 2014, are published in Journals of Gerontology Series B: Psychological Sciences and Social Sciences. While less than 10% of the women and less than 7% of the men in the study had levels of depression symptoms serious enough to suggest a need for treatment, lower-level depression is important for older people, clinicians, caregivers and adult children to understand, says Courtney Polenick, Ph.D., who led the study.
In both husbands and wives, the rise of depressive symptoms didn't begin until a few years after the first assessment of their health and well-being. "Our results suggest that there's a window where, if one or both of you are managing complex conditions that don't have similar self-management goals, it may be possible to intervene and prevent the development or worsening of depression," says Polenick, who is part of the U-M Department of Psychiatry and Institute for Social Research. "This might be the time for couples, and those who care for them, to emphasize broadly beneficial lifestyle behaviors that help to maintain both mental and physical health."
For instance, a woman coping with both high blood pressure and arthritis needs to make changes to her exercise routine, but her husband without such conditions could commit to making those changes along with her. Or a wife with diabetes who does most of the cooking and has a husband with prostate cancer could adopt a healthier menu for both of them. Polenick and her colleagues from U-M's Institute for Healthcare Policy and Innovation looked at data from the Health and Retirement Study, which repeatedly interviews and surveys thousands of American adults in their 50s and beyond over time.
They focused on conditions that have similar treatment goals focused on reducing cardiovascular risk -- diabetes, heart disease, hypertension and stoke -- and those with treatment goals and needs that are different from each of the other conditions- cancer, arthritis and lung disease.
When one person in the couple had at least one condition with different treatment goals and needs, they're considered to have "discordant" conditions. When one member of a couple had at least one condition that has different treatment goals and needs from the other partner, the couple is considered to have discordant conditions. "Research has focused on how individuals with multiple conditions, also called multimorbidity, manage their chronic health needs," says Polenick. "But most people in later life are partnered, with similar health-related habits, and we need to understand how changing health affects the couple dynamic." The fact that both wives and husbands experienced significant increases in depressive symptoms as the years passed, when they were coping with discordant conditions in themselves, is by itself important to understand, Polenick notes. But the fact that wives whose husbands' health needs differed from their own didn't experience an even greater rise in depression is a bit surprising, she adds.
Meanwhile, husbands whose conditions had self-care needs that were different from their wives' conditions did experience an additional rise in depression symptoms. Among individuals who are baby boomers or older, wives may be more used to taking the lead in caring for the health and emotional well-being of both themselves and their husbands, she says. But when husbands have wives who are coping with different health demands than their own, the husbands may experience less of this support than usual, worsening their stress and mental health.
Polenick and her colleagues continue to explore these intra-couple dynamics, and their consequences for mental and physical health. They also hope to expand the range of chronic health conditions they examine, and to look at shorter time frames in conditions that can be managed with lifestyle changes. But in the meantime, she notes that middle-aged and older couples may want to do more now to understand the factors that they can control as they age, and those they cannot, and talk about how they feel as a result.
"This is a reminder to step back and look at what your partner is coping with, to learn about their health conditions, to be conscious of it on a daily basis, and for grown children and clinicians to do the same," she says. "Having that awareness, and helping one another manage health problems while watching for signs of depression, may help both members of a couple over time."
Story Source: Content provided by Science Daily and Michigan Medicine - University of Michigan. "In sickness and in health: Study looks at how married couples face chronic conditions." ScienceDaily. ScienceDaily, 3 December 2019. www.sciencedaily.com/releases/2019/12/191203104756.htm.
Caregivers often report feelings of exhaustion and overwhelm. While caring for a loved one can be very rewarding, it also comes with distinct elements of stress. When dealing with a long-term challenge it's extremely important to also provide for your own emotional and physical well-being. When the challenges associated with care giving are not taken into consideration the caregiver's physical health, relationships and mental health can deteriorate over time — eventually leading to burnout and exhaustion. And when it reaches that point, both the caregiver and the person being cared for suffer. Caring for yourself is equally if not more important as making sure your family member gets to their doctor’s appointment or takes their medication on time.
Focused Therapy for Caregivers
If you are having trouble with accepting or adjusting to life's challenges, Dr. Holland can help you find healthy ways of coping. The simple act of expressing what you’re going through can be very cathartic. Dr. Holland will tailor treatment to meet your specific needs. Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.