By Dr Sally Shaw
Think prevention. Think building resilience. Think about having a moment to clarify a few things. Think about a bit of basic stress management 101. Think strategically. Don't fall for the old, out of date, 'you only go to see a psychologist if you're mentally ill', line. If you have a chronic illness, add a good psychologist to your list of healthcare team members, and you won't look back.
Don't get me wrong. While I support the idea that a psychologist should be an integral member of your healthcare team, I don't think you should approach your relationship with a psychologist in the same way you would your GP, or your Neurologist. You don't have to commit to seeing a psychologist on a regular basis. One or two sessions here, or three or four sessions there, have the potential to make such a difference to your outlook, stress levels, or ability to make positive and proactive changes. Tell a psychologist (one who has a good understanding of multiple sclerosis, or chronic illness, and who you feel you have a good rapport with) what you're looking for, tell them what you want to achieve together, and then use the time you allocate with them, wisely. Check in with your psychologist if you're going through a difficult time, or more importantly, if you anticipate a challenging time on the horizon. How often do you sit down for 50 minutes and concentrate solely on your psychological health? Imagine what you could achieve!
Psychologists can offer assistance on so many levels. Yes, they assess and treat depression, anxiety and a whole host of other mental illnesses, sure. But don't limit your view of them to that. Stop thinking 'psychologists are only for people who can't cope'. They also spend a lot of time working with people to reframe perspectives, to figure a few things out, and to develop healthy strategies. It is this work that makes them a real asset to have on your team at any time, to use as a consultant, to provide you with some expertise, to assist you to view things objectively and strategically, and to move forward well, while managing MS and other challenges.
Incorporating a diagnosis of MS info into your sense of self.
I frequently hear people newly diagnosed report that they 'never get sick'. Prior to an MS diagnosis, they have been fit and healthy, and not someone that would be expecting such a dramatic turn of events. It is extremely difficult to incorporate a label such as MS, a chronic disease with no cure, into your sense of self. It is far easier to incorporate new labels if we plan for them, expect them, and want them. Becoming a 'parent' is often a label people are waiting to embrace. Who signed up for MS? No one. Does that present psychological hurdles? Absolutely. Talking about this new reality is important, in order to strategically place MS within your sense of self, and move forward with it, rather than pushing against it. Often, the statement 'I don't need a walking stick' can be made when the reality is 'I don't accept that I am a person that would benefit from a walking stick'. Two very different statements. Assisting someone to adopt a strategic view in managing their MS, by developing a robust psychological approach to using mobility aids (for example) can present enormous benefits on several levels.
Don't scroll past just because it says 'stress management'!
Yes, it has been talked about at length, and while reading the first paragraph of a stress management handout makes most people yawn, here's the basics that could help take a lot of the pressure off. Dedicate some time to think about your stress, on purpose, and you are ahead of the game already. If it all stays swimming around in your head, it will contribute to the noise and the worry, and the sense of being overwhelmed. If you set aside a time to talk about it (a psychologist comes in handy here), write it down, and categorise it as either stress you have some control over, or stress you have no control over... Then, in many instances, you are part of the way to reducing your stress load. Remember, you will never get a medal for being the most stressed out multitasker around, but you will reap the rewards of effective stress management (especially if you are trying to manage MS).
Want another strategy for stress management? Try mindfulness. No, it's not some kind of yoga. Nor is it meditation. It is something you can practice, in many moments during your day, to potentially access a range of health benefits by slowing down and living in the present.
If you are anything like me, you mind is constantly reviewing and ticking off the items on your 'to-do list', while simultaneously writing new items for an agenda of future considerations. It gets noisy! And the thoughts that are running through my mind are often not on the task at hand. Rather, they are anxiously reviewing what was said in a meeting yesterday, or worrying about finding time to go to the shops, let alone figure out what's for dinner! Frequently, our thoughts are not about what we are engaged in at the time, but they should be, if we want to have the best possible experience of the present. So, the best way to introduce mindfulness into your daily activities? Start by recognising that your mind is powerful, and is used to being busy. It will take a lot of practice, and patience, to retrain it to slow down to concentrate only on the task at hand. You could start being mindful, as you approach your next daily task, by taking a big breath and observe how the air enters and leaves your lungs. Bring your attention to your task and monitor when your attention starts to wander to other thoughts. Bring it back to the task. Repeat. It is harder than it might first sound.
Another great place to start? The 'Smiling Mind' app for tablets and smartphones. Australian made and free to download, it is a brilliant place to start your commitment to mindfulness, as someone guides you through the basics of calming your mind.
Communication with the people you love (... and the people you don't!)
Psychologists can help you out with communication strategies for every circumstance - and now that you have MS, you might realise there are quite a few different scenarios to negotiate your way through. Effective communication is the key, and it is often a different style to that which you are comfortable with.
The people you love - how do you communicate your invisible symptoms to them without
- freaking them out
- risking that they will treat you differently (or not treat you differently...)
- worrying how their reaction will affect your relationship
The people you work with - how do you communicate your diagnosis to your colleagues without them
- asking too many personal questions
- comparing you to their great aunt with MS who is in a nursing home
- changing the way they view your ability to do your job?
The randoms - how do you tell your neighbour why you use a disability sticker on your car sometimes but not all the time, without being told that
- you should talk to her 'ex-boyfriend's sister because she has MS and, well, she's in a wheelchair now, but she was ok for 6 years, mostly'
- you should only eat (insert specific food group here) and only exercise while standing on your head because that's the cure for MS - she saw it on tv
- she knows you'll be fine because you look so good (do you tell her you can't feel your left leg?).
Talking these scenarios through with a psychologist can help you figure out the important messages you want to convey, and some words you could use to get your message across effectively. It can be hard to reveal so much about yourself to certain people. It can be equally as hard to hear the odd bizarre response that you will likely get (examples range from someone you're not very close to bursting into tears, or someone who says that they think MS is all mind over matter!). Talking through the responses that you imagine you could get from people, and how to respond calmly, can 'arm' you for any tricky situations. Ultimately, how people will respond to your diagnosis says a lot more about them, than it does about you.
The search for meaning
Life is short. Taking time to examine what you want to get out of it is simply strategic, and the only way to stay on track. This, surely, is good advice for anyone. Not surprisingly, people with MS often spend a little more time on this concept of 'what's it all about?' or perhaps think about such concepts a little earlier in their lives than others. And while, of course, we would never wish this on our greatest enemies, some people would go as far as to say that a diagnosis of MS has brought them to think about meaningful and important areas of their lived experience, that they may not have come to consider otherwise. Embrace it. Not the MS (don't be ridiculous!) but the opportunity to prioritise what's important to you. Part of any healthy search for meaning resides in an attempt to identify what brings us happiness. Taking some time to examine what makes you really happy, and then working hard to increase the likelihood of engaging in that activity, is really important. And hard. Work at it. Carve opportunities into your life that bring you genuine happiness, because what is life, if it is not enjoyed?
Find a more strategic way to live, while managing your MS. Whatever your reason for seeing a psychologist, the benefit of allocating some time in your busy life to concentrate solely on you, can be enormous. I encourage you to think outside the box of the stereotyped reasons people see a psychologist, and be open to the benefit of a different perspective. Find a psychologist you have a good rapport with, and you could find an integral member of your healthcare team!