Tag: bipolar

It Begins With The Body

People who come into therapy have often (arguably always) been traumatised. This may be an overt traumatic incident or more subtle and complex traumas over a period of time. Often, the trauma is in childhood and possibly outside of our ability to recall or consciously work with. Sometimes, we repress traumatic memories, even in adulthood. Trauma blocks our connection with ourselves by disrupting the connection between our minds and bodies and disallowing connection between various parts of ourselves. This means fragmentation is always around the corner and estrangement from one’s own self may become a familiar experience.

The body is where we begin. The body holds an immense amount of knowledge and tries to communicate with us all the time. However, we are frequently so shut off to our body’s intelligence, that we live in a conceptual, intellectual, ego-consciousness state of being. As if everything that exists and is of import in our journey is upward of the neck. This is untrue.

Our bodies hold vast wisdom and memory, storing information from nourishing and meaningful events but also storing trauma, holding it for us until we can look at it. Until we are able to bring our mind and body together – to engage the trauma on a bodily level – trauma held in the body may manifest all kinds of symptoms such as diagnosable illness, inexplicable symptoms, depression, anxiety, rage, fear, tight muscles, postural difficulties, sexual problems, addictions, loss of confidence and more. So many people coming into body-based therapy cannot feel their bodies, and definitely cannot feel their feelings in their bodies.

This is a slow process of learning to reclaim the body, to become aware of it’s existence, what it actually is, and to form a relationship with it. To learn to listen to it and allow the inner dialogue between mind and body to continue unimpeded by blocks.

For individuals who have suffered trauma, the body can be a frightening place. A place to escape from – not to. The body may have let us down or even turned against us, and coming into relationship with it may be overwhelming. However, verbal dialogue without the complement of coming into one’s own body can stay simply conceptual. However, verbal psychotherapy with body-based, non-verbal therapies can also be of great assistance to those are are trying to come home to their bodies and take control – a way to conceptually and emotionally process the increasing awareness of the body.

Breathing, trauma-informed yoga, cold water therapy and similar practices, when facilitated professionally, are non-invasive yet powerful ways of coming into the body.

The body is where we begin. If you are interested in body-based therapy or body-based therapy complementing psychotherapy – a brilliant combination of processing styles – please click here.

Grinding Into The Pain

Embracing Pain

What happens when Pain visits a little too often, a little too long? Like an obnoxious guest who overstays her welcome, talking and talking without listening, eating and eating without offering. Well perhaps this is uncomfortable, but just bearable. After all, it is not all that uncommon. And then perhaps, what if Pain decides to visit a great deal too often and a great deal too long? What if the visitor decides not to leave? What if the talking and the eating just don’t stop – on and on and on. What are we to do then? What happens when we are held hostage?

Do we have any control over pain’s inevitable and suffocating visitations? According to the Stoic Epictetus,

Some things are in our control, while others are not. We control our opinion, choice, desire, aversion, and, in a word, everything of our own doing. We don’t control our body, property, reputation, position, and, in a word, everything not of our own doing. Even more, the things in our control are by nature free, unhindered and unobstructed, while those not in our control are weak, slavish, can be hindered, and are not our own.

Epictetus, Enchiridion, 1.1-2

The pain of loss, grief, depression, neurochemistry, external events such as motor car accidents and more – these are not in our control. This may be disheartening or even crushing when fully realised. Why am I forced to sit by while Pain visits the full reign of hell upon me? Why am I not allowed to eject Pain, to revoke visitation rights? How can I escape? Why am I not even permitted to escape my own home with what little I have left? This is a brutal invasion!

As the Stoic relates, the sense of control sought in our bitter fight against Pain is won in our thinking, our choices and our exposure to that which will help us reframe our attitude toward our relationship with pain. Ultimately, our gains are made in our own relationship with and to pain. To those experiencing true, unadulterated suffering, this idea may be received as trite or it may even be impossible to imagine. However, even where chronic mental, emotional or physical pain are involved, the ‘Enemy’ that is Pain can change into something new, something more approachable, something we can negotiate with and engage with in a more balanced relationship. Pain does not have to remain the Enemy, it can become the Teacher, the Healer, even the Beatific Vision. Never losing it’s identity as Pain, and never lessening or coming under our control, Pain’s visits – even those long, excruciating and seemingly never-ceasing visits, can be experienced differently, without fear and without loss of control. The transformation and growth, even healing, that Pain can bring – if we let it – is illustrated in the lines below.

What is pain but a reminder that we are

grinding into the ground

flung into the fight

grating against the wound

slicing into the light

walking the two worlds

lost in daylight, found in night

taking the clean medicine

gaining vision, losing sight.

There are practical steps to forging this new relationship with pain. These really depend on the individual, but in general it is not an overnight process. Meditative practices, including mindfulness techniques and yoga help many. Exercise and diet/nutrition – as insufficient as that seems in the face of enormous pain – can play a large role in re-negotiating your relationship with Pain. Broadly, relationships, spirituality, talking, creating, music, nature and stillness are all ways to explore this different way of relating to Pain.

I wish you well on your journey. For more information on renegotiating your relationship with Pain, contact me by clicking here.

Tips for a Happy Holiday: Bipolar Christmas Planning

bipolar christmas coping strategies

Christmas is a difficult time for many people. There are financial obligations, family obligation and often many end-of year events that lead up toward Christmas, increasing the feeling of time-pressure and burnout that may already be present.

One of the reasons Christmas time is particularly difficult for individuals with bipolar disorder or depression is the lack of structure that permeates holidays. For those with bipolar disorder, having a predictable structure, a routine, and goal-oriented tasks are known to be extremely helpful for stabilising moods and preventing relapses or spiralling out of control. When the usual work/school structure falls away and no preparations have been made for the holidays and how one will cope, symptoms such as depression, mania, high levels of anxiety and even suicidality can crop up.

Because structure is important for your mental-wellbeing, it is a good idea to begin planning your routine for the holidays now, before the open, lazy days are upon you. I suggest you make a calendar (or update your calendar) based on the following suggestions and the coping strategies you already use. Here are some questions to get you thinking about possible ways forward:

  1. Is there a project you have been putting off that you can dedicate some time to each day? Schedule time to work on it into your calendar. This may be 2 hours daily, 30 minutes daily, or even 60 minutes every second or third day. Decide what you want to commit to and ensure that you have a regular entry for this activity in your calendar.
  2. Are there Christmas gifts or cards that you can make instead of buy – saving you money and providing you with a meaningful activity at the same time?
  3. Is there a friend or relative (or more than one) who you can meet with regularly, perhaps weekly for coffee or a walk, and schedule that meeting into your calendar? Alternatively, can you set up some meeting dates for during the holidays with various individuals?
  4. Can you ensure that your exercise routine remains relatively structured despite the ambiguity of holiday days? (If you don’t have an exercise routine, now would be a good time to put one into practice. Begin with a walk every day – or as often as possible – if you are starting from scratch.) We know exercise has strong mood benefits and it is obviously also great for keeping in shape and general physical health. If you are taking a break from exercise for a while in the holidays, I encourage you to continue with a light form of exercise like walking in order to still gain the mood benefits.
  5. Can you use social media and TV watching in an intentional manner: for example, as a reward for engaging in structured and meaningful activities, instead of opting for TV or Facebook in long, unregulated sessions? Too much social media is linked to depression and screen time easily sucks real time away. Because of this, one’s daily structure is disrupted and feelings associated with depression may emerge. This is true for most people, but those with bipolar disorder should be extra-aware of their screen time.
  6. Are there decisions you need to make about Christmas itself – which events you will go to, which you won’t, which you’ll host, which you won’t? If you feel you need to avoid certain shops/malls (or even people!) on certain days (such as busy Christmas Eve), make note of that now and schedule accordingly.
  7. Are you able to ensure that you have an exit strategy (such as taking your own car) for events that you are anxious about or hesitant to attend?
  8. Can you plan some ‘me-time’ activities, scheduling in a few things that you really enjoy and that feed your soul? Ensure it is scheduled in your calendar because these are easily the first things to fall away when demands compete; if you have kids, can you find someone to help you by looking after them during the scheduled ‘me-time’? Fit your activity to your pocket: a walk on the beach is free!
  9. Can you try keep to a regular sleep schedule, as much as is possible? This regularity is extremely helpful for maintaining a stable mood and sleep itself is revitalising and regenerating during times of wellness and ill health.
  10. Can you avoid over-indulging with alcohol? Too much alcohol consumption will certainly affect the mood negatively and if coupled with lack of sleep and lack of structure, the outcome may be damaging.
  11. Can you keep a journal, with as much or little detail as you like, in order to help track your thoughts, feelings, sleeping habits (monitoring that you are not losing sleep significantly) and general mood? This is also very helpful in the long-run, as you can reflect on your writings in the future and realise coping strategies, helpful activities or even triggers that you were not initially aware of.

I encourage you to begin working on a schedule that takes these questions into consideration. The holidays can be a happy, relaxing time but may need some extra thought and planning for those with bipolar disorder.

For more bipolar support, book a session by clicking here.