One Step at a Time

Whew. These last few weeks, months, or years have really been a lot, haven’t they?

You may or may not have noticed, but other than Monday it has almost been a year since writing my last blog post here, “Maybe there’s time to rest”. I guess a rest, break or pause was needed.

How about you? Have you been able to find some rest, take a break from it all?

And Monday was also the first time I’ve been out for a walk in almost a month. If you know me at all, this is usually a daily occurrence. Out in nature, looking at the trees, taking in the fresh air – all of that. With ice and snow still on the ground, I joined a gym where I will walk on a treadmill for the time being.

Why the change of scenery?

I had a bad fall. On the ice and snow in our driveway. I thought I may have broken or cracked some ribs, but x-rays ruled that out. Still, progress of any kind of movement has been slow. Any plans of walking, skating, or skiing tossed aside.

This also brought forward personally, what we can all expect to experience from time to time – that being, feeling, experiencing pain. Much of what I teach and talk about with others, now applied (once again) to my own situation.

Immediately, how I moved during the day changed. What I was able to do changed. My thoughts around going outside changed. My worries about healing, how long it would take – all of it changed.

Luckily, my beliefs and understanding about my body didn’t. First, landing firm and hard on my torso with a steel water bottle right where my sternum is, reaffirmed my belief that these bones of ours are generally pretty robust. Particularly, those protecting our precious heart and lungs.

My breath changed. I often held my breath, trying to create stability particularly when I had to bend over or get up. I physically ‘held my body’, when sneezing or coughing to try and decrease the pain.

How I moved changed. I found ways to do things in a way that was not natural or normal to me in order to work-around the pain. When outside, I took very small, slow and guarded steps.

Mostly, I didn’t move a lot which is not great for me or anyone, really. I couldn’t clean the house (that might be a positive….). Many of my daily routines were put on hold. But the worst part by was not being able to go outside for a walk.

I’ve given it some time, almost a month now, and though there is still some pain or discomfort I am determined to get moving again. I also wanted to start lifting weights … but it may still be too much to work on my upper body, so I’ll instead do some lifting, pressing or pulling with my lower body. Not sure how that will go as I do still feel tension in my ribcage when exerting too much. We shall see.

Generally though, I know getting back to doing what is most important to me is the first and most vital thing I can do.

Pain doesn’t just change your body. It changes so much about your life. It’s by exploring all of these things, these changes, and slowly over time re-calibrating, re-patterning them, will help to change it back again.

Will it take longer, if you’re habits and patterns have been different for a while now? Maybe it’s been years that you’ve experienced pain. It’s good to know, however, that sensors/detectors around neurons in your body change every 3-4 days so with consistent practice it’s likely you’ll notice a change in sensitivity or pain, often within 8 weeks.

If someone I’m working with is experiencing really bad pain I might suggest they visualize movement. Or maybe there’s a particular area that is painful, so we’ll often begin somewhere else that’s not painful. I might suggest they begin by just moving their hands. Opening, closing, opening, closing fingers to palms, alongside an easeful breath. By giving your body and your brain a new (pain-free) experience these ‘painful’ patterns can be disrupted. There’s a lot more science to all of it, but I won’t bore you with it. (I try now to only do that to family and friends who have to listen.)

With spring around the corner, I so want to be ready for it. It’s not always easy taking steps forward. But in my mind, so worth it!

How about you? What is it you REALLY want to do? And how might I help you with that?

Curious to know how we can work together?

Planting Seeds

As Spring is often a time of new beginnings, I’m wondering if you’d like to explore something with me.

At least I think Spring is on the way. If I keep focused on this thought, perhaps it will soon be true. As I look outside my window today we still have heaps and heaps of snow all around.

On Thursday March 10th at 1:00pm ET I’m offering a FREE webinar all about getting curious about this thing called pain.

The experience of pain. What it is. Why it seems so confusing, frustrating. Why it can be so hard to change.

It’s not going to be about giving you all the answers. Rather just to plant some seeds. Maybe sprinkle in a few questions, some of the ways it is different for each of us. What you might consider, in terms of your own unique experience of pain.

I’ve scheduled an hour for the zoom call, but it may not go that long depending on any discussion or questions you may have. If you can’t attend, you will still be able to access the recording the following day.

I hope you’ll join us.

Maybe there’s time to rest.

I just finished offering a two-night workshop series this week with a CHEO (Children’s Hospital of Eastern Ontario) program that provides peer support to parents of children with complex medical needs.

The topic – sleep.

How did the facilitator, one of the Moms, introduce the topic on the first night?

“Beautiful, delicious, sweet, wonderful, elusive, lovely, sometimes a jerk – sleep.”

Anyone who is a parent will know the trials and tribulations encountered when your child is sick. Yet, imagine how you might find sleep when your child depends on feeding tubes or respirators as they can’t breathe on their own at night.

I didn’t have the opportunity to learn as much as I might like about them. That they showed up for an hour on two separate late evenings to do so inspires me. Suggests there is a need.

It is always challenging in planning and preparation to balance experiential practices with information. Experience is helpful for people but my role as I see it, is to also teach people mechanisms as to why these practices might help.

To provide tools that might be able to influence the elusiveness of sleep, when life is often so full of uncertainty. To gain a sense of agency over their own personal experience.

Perhaps,

  • How they might give themselves permission to… rest. Seems so simple yet in our culture, not so much.
  • How they might take two minutes in the day, to notice what and how they feel and respond in some way with some helpful practices. With compassion.

As I’ve learned from mentors such as Shelly Prosko, Physiotherapist and Yoga Therapist (via research by Kristen Neff on self-compassion) a simple mantra or affirmation of kindness to oneself,

“It’s okay”, as you breathe in.

As you breathe out “This is enough.”

Can this be enough, just as it is?

I can at times feel anxious before doing this work. Is it enough? This week seemed more so, with all that’s going on and feeling not quite myself, rather fatigued.

In the end, I hope the sessions served to support them in some way.

As feedback from the facilitator, “The fact that these moms actually took an hour out of their time to join us is so wonderful. They do not take that time for themselves often enough. A lot of times they do not even have an hour to do anything other than care for their children. So, thank you for giving them that chance to restore and relax.”

I am most grateful for the opportunity. So much credit to these parents and really to anyone, all of us, caring for one another.

Might there also be time to care for ourselves, as well.

Permission to rest…

The chicken or the egg?

This question about what comes first. The onset of chronic pain (and/or other conditions) from sleep disturbance or the relevance of sleep disturbance due to chronic pain?

Here’s some of what we know about sleep …

Sleep complaints are present in 67-88% of chronic pain disorders and at least 50% of individuals with insomnia – the most commonly diagnosed disorder of sleep impairment – suffer from chronic pain. Further, both chronic pain and sleep disturbances share an array of physical and mental health comorbidities, such as obesity, type 2 diabetes and depression.” 1

One study found that “women who endorse frequent, “sleep problems,” defined as frequently difficult falling asleep or having a sleep disorder, were significantly more likely to develop fibromyalgia 10 years later.” 2

Also, in another how “sleep disturbance temporally preceded increases in pain, … in “temporomandibular disorder (TMD).” 3

Similar research is being conducted in terms of cancer pain, for depression, PTSD and ageing (including Alzheimer’s and dementia).

I knew poor sleep to be a contributing factor for people who live with chronic pain. What I didn’t know was how it affects not only physical health but mental health.

What’s piqued my interest is in new studies where a trend has emerged suggesting that sleep disturbance may be a stronger predictor for pain than pain of sleep disturbance.” 4

…several longitudinal studies convincingly demonstrate that insomnia symptoms significantly increase the risk of developing future chronic pain disorders in previously pain-free individuals, whereas existing pain is not a strong predictor of new incident cases of insomnia.” 5

Not just a stronger predictor for pain, but also in terms of mental health conditions.

This bidirectionality or said another way, “what came first, the chicken or the egg?”

Lots of studies to examine obviously, but here’s one on the positive side “Quality sleep has also been shown to predict chronic widespread pain symptom resolution over 15 months.” 6

Researchers will continue to find out more and doctors will refer out to specialists in many areas. Pretty much the gold standard for treating insomnia now is CBTi or Cognitive Behavioral Therapy for Insomnia.

Yet, there are things you can learn to do for yourself, that will help.

Curious about this? Exploring some practices, tools and gaining resources that can support you in getting a better night’s sleep. What stress and the nervous system have to do with sleep? Or how you might find rest during the day?

I’m offering a 4-week workshop starting Feb. 16th at 7:30pm ET.

You’ll have some time and space to explore, experience what might be helpful for you all in the comfort of your own home. Online. Change into some comfy clothes, grab a warm cup of herbal tea and join in. Anyone can follow along. We’ll be rolling on the floor a little, expending energy maybe by rocking and swaying, taking some breaths together. And learning “all the things your parents/doctors/friends/colleagues never told you… about sleep.” There’s a lot more to it than just laying your head down on a pillow, each night.

References:

  1. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  2. Mork PJ, Nilsen TI. Sleep problems and risk of fibromyalgia: longitudinal data on an adult female population in Norway. Arthritis Rheum. 2012 Jan;64(1):281-4. doi: 10.1002/art.33346. PMID: 22081440.
  3. Quartana PJ, Wickwire EM, Klick B, Grace E, Smith MT. Naturalistic changes in insomnia symptoms and pain in temporomandibular joint disorder: a cross-lagged panel analysis. Pain. 2010 May;149(2):325-331. doi: 10.1016/j.pain.2010.02.029. Epub 2010 Mar 31. PMID: 20359824.
  4. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  5. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  6. K. A. Davies, G. J. Macfarlane, B. I. Nicholl, C. Dickens, R. Morriss, D. Ray, J. McBeth Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study. Rheumatology (Oxford) 2008 Dec; 47(12): 1809–1813. doi: 10.1093/rheumatology/ken389

You’re not sleeping either?

woman in red long sleeve shirt sitting on chair while leaning on laptop
Photo by Andrea Piacquadio on Pexels.com

Did you know “chronic insomnia is highly prevalent and affects approximately 30% of the general population?” 1

Or, that “approximately 40% of adults with insomnia also have a diagnosable psychiatric disorder – most notably depression?” 2

That “sleep complaints are present in 67-88% of chronic pain disorders?” 3

I was aware of the third statistic, that sleep can be a contributing factor for people living with chronic pain. But why my interest in sleep, generally? I had (mostly) been a good sleeper yet started to experience disruptions to my sleep patterns over the past few years. Along came menopause and similar to many others I found myself in a cycle of wakefulness around 2, 3, 4 in the morning and went looking for solutions.

Last fall, however, something else happened. On a Facebook page I belong to, the subject of sleep was brought up. Well, the lack thereof.

I was curious if it was only menopausal women who were struggling with sleep, so I created a random poll. Within an hour or so, there were hundreds of responses.

  • 404 responses
  • 74 comments about issues with sleep.
  • 224 neither menopausal or perimenopausal
  • 95 perimenopausal
  • 51 menopausal
  • 34 ‘other reasons’

Clearly a problem for many but I was surprised to learn that it wasn’t only my age group challenged by this issue. The poll wasn’t scientific and could just reflect the ages of people in the Facebook group. Yet, wow!

Of course people will at times need specific diagnosis, treatment and care from healthcare professionals. Yet, digging into some of the research and after some of the behavioral or environmental factors are addressed with general sleep hygiene information, a lot of what affects sleep has to do with stress and the nervous system (and other systems… circadian, homeostasis, etc.). Which you can learn to influence and modulate.

Would you be interested in exploring this thing called sleep? Safely, gently, with compassion and care you’ll get to experience and learn what might be helpful for you. In your own home, cozy in your pajamas … having some time and space to do so.

A 4-week workshop Rest & Restore: Strategies for Sleep starts Feb 16th!

What are the many factors or contributors that affect sleep? What does the research tell us? What can you do during the day, that will affect your sleep at night? What can you do when waking up from sleep? How might you find some rest in the day, if your sleep wasn’t that great?

If you’d like to join in, registration is now open.

I’ve tried to make it affordable at just $20 each week. If finances are really tight, reach out to me at info@yogatoolsforlife.com. If finances are plentiful, please reach out as well and look to sponsor someone else.

I’d love for you to join in. Experience and learn what might can be helpful, for you.

References:

1. Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7-S10.

2. Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7-S10.

3. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007

Just, Calm Down

It was probably my first year as a yoga teacher, 10 years ago now, when I had a student in my class I so clearly recall would get up and leave as soon as it was time for Savasana. I’ve been trying to remember what I offered her in terms of advice but it escapes me now. Likely, I didn’t have much to offer. Yet I did empathize and understand why she left, unable to stay in this ‘corpse pose’ as it’s often called.

Ask the same of people when they are told to “just” sit still and meditate. Particularly if they’re experiencing anxiety, or high levels of stress and notice what happens.

Or telling a young child having a full-blown meltdown to “just” calm down.

The last thing anyone can do in these moments is calm down. There are likely to be many reasons for the state in which people find themselves and can’t calm themselves, but the ‘state’ is the important piece.

If someone is in a state of arousal, a natural nervous system response, telling them to do the opposite may not be helpful. It might add to the stress or leave them feeling ashamed about not being able to control their emotions or behavior. All this movement, powerful breathwork (sobbing), yelling, screaming, stomping of feet, tossing and turning the body in an attempt to express feelings and emotions going on inside (insert here: toddler meltdown).

There are some ways, practices or movements that enable calming down or a relaxation response. But it might be something just the opposite that’s needed to even begin this shift. Maybe what was needed, in this particular situation, is a mobilized response. We need both… to survive and engage in the wide variety of experience life is going to throw our way.

Recognizing the state is the first piece. Having some tools and options to choose from that might be helpful to you in the moment, could be a good thing to practice.

Today, I would have a few suggestions should this person turn up in my yoga class and find it a struggle being in corpse pose.

I’m kicking off a workshop in February all about SLEEP. Deep rest. How one might get to a place of settling in… for the night. Or for Savasana. Or if you’re having a hard time with routine, uncertainty, stress in these days you might find it helpful as well. I’d love for you to join in so stay tuned here, or you can sign up at yogatoolsforlife.com.

Showing Up

I’ve been rather absent for the past three weeks, at least in this space. COVID-19 showed up for a close family member so it has been all-hands-on deck for a few weeks now.

Yet, here we are. A new year, another moment in these particular days that we may not be liking so much.

What I don’t like so much now and maybe in the past as well, is there seems to be this one way to be. A particular way to show up in the world, in any given moment. Whether in times of crisis or just the regular days of work, being part of a family, in relationships, or on my yoga mat.

“This, … is the way it’s to be done. This, … is the way to show up.”

Fortunately, or unfortunately for me, I was never much good with the status quo. At times I can tune in to this quickly. On other occasions it takes a long while before I get the sense that what might be well and good for one, doesn’t feel quite right for me. I’m hoping that as I head into my 60th year on this planet the gap between the two is shortening.

There is always a message, a signal trying to capture my attention and act as a guide. The harder part is listening. Even harder is acting on it.

Why is that?

Well, there does seem to be a cultural or societal expectation to go along with the crowd. We look for cues outside ourself. What is the other person doing, saying? How are they responding? From a young age we’re often taught to fit in. Be nice. Say yes. Maybe don’t say anything at all. Grin and bear it. Smile through the pain or discomfort. Do what others do. Again, “this… is the way to show up”.

Yet times are changing. A slow but forward motion allowing for difference. Celebrating it, even. This might be in terms of looks or gender but also a general movement to change other beliefs. That it might be okay to express who we are. What we feel. What we believe. How we see the world, that what we feel in our own uniqueness, matters.

As I think about another year’s passing what is becoming clearer to me is, there is only … right now. Now is the time to show up.

Which doesn’t therefore mean, my way, is the way. It doesn’t mean anyone or anything else is wrong. It’s only that what will be right and well for one, is not the same for another. Funny enough last year I created an online program exploring just that. It’s interesting to notice that often what I teach, is what I most needed to learn for myself.

Here’s what I’m learning these days.

It can be useful to have a place where I can simply show up with whatever I feel, wherever I’m at. Happy smiley faces not required. That in this New Year I don’t have to be better, more enlightened, 10lbs lighter, happy, smiling, fit or always be in a good mood. Trying to sustain all that these days might be quite a challenge.

That I have permission to do, be, what feels most right.

Maybe the same is true for you.

Habits of ours. Helpful or not?

What else might you do to prepare for sleep?

You might want to get a little curious about current habits. Perhaps life-long ones.

For example, I have never showered or bathed at night as I prefer it in the morning to get set for the day. It also helps me to wake up. But I am finding lately that a warm shower at night, the warmth feels awfully good. Perhaps it feels, or symbolizes in some way, that I’m washing away the day and stepping into sleep renewed. Refreshed.

Sipping on a warm beverage might be appealing. A herbal tea, water, lemon & honey, warm milk on its own or with turmeric. These might feel soothing and satisfying for you in some way. A ritual that becomes a way to mark the end of day, the coming into rest and restoration.

Maybe a foot massage might feel good. I have no formal training in massage, yet I’ve been doing this for a while now. It only takes a couple of minutes, but there is something about the massaging of the feet that makes me go “ahhhhhhhh……..”. I have to say in our travels that anywhere and everywhere we see foot massage on offer, people are lined up and waiting!

You can incorporate using oil with the massage, maybe even warming the oil beforehand. I tend to use almond oil, but you might like coconut or another of your choice.  I don’t choose to warm the oil, but rather just pour a little on my hands and then massage my feet in any old way, for about 3-5 minutes on each foot. (You’ll want to put some loose socks on afterwards, so as not to get oil on your bedsheets.) Then just notice… Try doing this 3 times a week and see what it feels like for you. I have noticed that while others may hold tension in their jaw, their shoulders, back or hips the tension I feel, what keeps me awake at night, is the inability to relax my feet.

Other soft, turning-inwards things you might try?

Sit by candlelight. Our natural circadian rhythms are disrupted by all the artificial light surrounding and available to us. Then there are all these screens. Do you know there are night settings you can change on your phone or laptop so you’re not having to stare at such a bright screen?

You might read, color, knit, or some other quiet, introspective activity. We tend to spend a LOT of time on screens these days, so anything other than, might be a place to explore.

Tomorrow we’ll lean into some practices you can do when nothing else works. When you are frustrated, can’t get to sleep, can’t get back to sleep. It’s all about distraction. How might we get our brain to turn off, or at least shift the focus of attention to something else.

Turning off, turning in

If you’re feeling stressed or wound up at the end of your day it might be helpful to notice, perhaps try to shift it, BEFORE trying to head off to sleep.

Let me preface this by saying you may not be ready for slow, restful or focusing-in practices. It may be that you feel the need to move in ways that burn off energy. Maybe rocking or swaying from side-to-side, bouncing a little, shaking things out. Perhaps some dancing in the dark… might be what’s needed in the moment.

However, if you’d like to try some ways to calm the nervous system you might practice one of these restful poses. Or maybe do them after the movement mentioned above. Something like legs up the wall, providing support and perhaps release for the back muscles, or tension elsewhere in the body. Or maybe the beginnings of turning inward, so a forward fold on a chair, or over a bolster.

This doesn’t have to take a long time. You may want to stay in one of these poses for 5 to 10 minutes. See what happens.

Notice the length and the quality of your breath. Notice if it shifts at all, while in the pose.

Notice your thoughts. Feelings.

Maybe it’s helpful for you to listen to calming music, be in a place with lowered, soft lighting.

Taking a few minutes may help to make the transition into sleep a little more easeful. Try it. I’d love to know if anything changes at all for you.

Balancing Act

In preparation for sleep at the end of your day, it might be another time to check in with how you’re feeling.

You might feel fully exhausted, in which case you may have an easier time falling asleep. Yet, even if you’re physically exhausted there is also a possibility of being in a mobilized, or upregulated state in your nervous system.

  • You may have been going full speed ahead with what feels like a million things required of you on any given day. Trying to balance what seems like never-ending demands.
  • Maybe you’ve just had an emotional or stress-filled conversation with someone.
  • You might be feeling some of the long-term stress from these strange times of Covid-19.
  • Maybe you ate a big meal late in the evening as you didn’t had time to do so, earlier.

Your body, your physiology, automatically changes and/or responds to what is going on, what is required in a given moment of time. First of all it takes some awareness to even notice what the state of being, or the state of your nervous system, is. If you’re in fight, flight or freeze (a more sympathetic nervous system response) sleep might not come so easily. However, if you can learn to shift into a more parasympathetic type response (the rest and digest response) it might make the transition to sleep more easeful.

The first step is in the noticing.

Perhaps you can do a body scan to notice what you feel. Bringing your awareness slowly to each part of your body, noticing any sensation you feel or any thoughts or feelings that arise as you do this. Or you may come to know through noticing the quality of your breath. Or perhaps noticing your thoughts and emotions.

People often have difficult going to sleep. More so these days, I find. You might want to look at it, approach it, in a way that requires some preparation. We need both types of nervous systems responses. We have stresses in our life, we need to mobilize. Yet, how might we find some balance and what practices might be helpful in the evening to downregulate our system. To allow for rest and build capacity to meet the challenges of our days. What might make the transition, more easeful? We’ll dig into a few this week.