Gary McClain, PhD, is a therapist who specializes in helping clients deal with the emotional impact of chronic and life-threatening illnesses.
Taking good care of yourself. That's something I often talk about with my clients, and something I often emphasize in the articles I write. I can't emphasize enough the importance of taking responsibility for managing your chronic condition. Self-care means exactly how it sounds. It's all up to you.
Now, having said that … I also have discussions with clients who are concerned they might be leaning toward going a little-or a lot-overboard in how they approach their self-care. Here's an example:
To stay home or not to stay home
A client I'll call Mia talked with me about her concerns that she is being too self-protective. "I had some plans with friends for last Friday night. When I woke up that day, I was feeling okay but not super high energy. So all morning, I thought about whether I should cancel or not. I told myself that if I exerted myself too much, I might feel worse tomorrow. But to be honest, part of my inner dialogue was wondering if I might feel energized by getting out and getting support.
"I backed out. Halfway through the evening, I decided that I had kind of worried myself into thinking I felt worse than I really did. I'm disappointed with myself. And my friends were disappointed, too."
Matt, another client, expressed a similar concern. "My doctor has cleared me to go to the gym, and to do the routine we agreed on. That's been going well. But over the past week, I haven't been going. I worked out really hard one morning before work. Looking back, my workout was still within the limits that my doctor had given me, though I probably pushed myself to the limit. My leg muscles were a little sore the next day, and I worried that I had pulled something, or injured myself somehow.
"I need to exercise to maintain my health, I know that, but an injury could sideline me. So I kept myself away from the gym. Just for a little muscle soreness? I know I need to be careful, but at this rate I could also be at risk for protecting myself into complete inactivity."
The key question
Both Mia and Matt ended their story with the same question: At what point does monitoring myself begin to cross the line between being cautious, on one hand, and, on the other hand, restricting myself from participating in activities that promote my physical and emotional health?
In other words, how self-protective do I need to be?
If you're living with a chronic condition like Mia and Mike, chances are you've been in similar situations and asked yourself this same question. If so, here's some help in answering it.
Ask yourself: what's the worst that can happen? Clients often talk to me about fears that can cause them to hold back on fully participating in life, including doing what they know is good for their health. So I challenge you to actually define what it is that causes you to avoid something to protect yourself. Be specific. You might find that, once you define the worst thing that can happen, you don't have a compelling reason to hold yourself back. If in doubt, don't hesitate to check in with a healthcare professional.
Get specific with your doctor. Speaking of healthcare professionals, one of the best ways to develop a comfort level around what you can do, what you can't do, and how hard you can push yourself is to have a talk with your doctor. I've found that clients who are relatively newly diagnosed often have a lot of concerns, some more realistic than others, regarding what might be pushing too hard. And of course, experiences with actually pushing yourself too hard can cause you to err on the side of being more self-protective than you need to be. So this might be a good topic for a discussion with your doctor. Later, as a more experienced patient, you will be in a better position to ask specific questions such as, "What about ___? Can I do that when I am feeling ___?"
Create some guidelines for yourself. Between you and your doctor, you should be able to come up with a realistic approach to your self-care that provides you with a better sense of when you're within the safety zone and when you're edging outside of it. Work toward being aware of specific examples of what's good for your health and what isn't. Learn to recognize symptoms that may not be important as well as those that may be. Know what to do and when to do it if you do push yourself too hard. This awareness will help you to be responsible in caring for yourself and avoid those moments of feeling you are being too self-protective. Keep in mind this is an ongoing process, with revisions along the way.
Back off when you know you need to. What I often hear from clients is that they feel like once they've committed to something, they have to stick it out for the duration. But that's not realistic. If you find yourself in a situation where you know you have hit your limit, give yourself permission to stop. This might mean saying no to certain foods. Or modifying your participation in an activity. Or politely excusing yourself and heading for the exit. With this in mind, you might feel free to go ahead and give something a try, knowing you don't have to do anything that places your health in jeopardy. You're in charge.
Watch out for rationalizing and avoidance. Living with a chronic condition isn't easy. And it can be scary. Because of that, it's only human nature to sometimes just want to hunker down, to not try very hard, to isolate yourself. That's a whole lot easier than risking unwanted symptoms that may hang on for a while, or a setback in your progress toward managing your condition, or feeling exposed if other people see you when you're not at your best. But also keep in mind that the downside of being self-protective is holding yourself back from participating as fully as possible in your life. That's another reason to question your own motives when you feel yourself putting up a protective wall.
Be aware of the fear factor. A little fear may help you keep yourself on the right path. But also keep in mind that self-monitoring can turn into being so aware of yourself that you begin to question everything. That's called analysis paralysis. Again, being informed, knowing how your condition affects you, and understanding what's a risk and what's not a risk for you will help you to counter the urge to be overly self-protective. To combat the fear factor, flood the fear with knowledge.
You, your chronic condition, and what you can do to take care of yourself. Know your limits. Know when you're pushing yourself too hard. But also remember that fear of what might happen can keep you stuck. As always, knowledge is power!
What helps you set healthy limits for yourself? Add a comment below to share your advice.