I know what to do, so why can't I follow through?

As long as I can remember, I've been highly sensitive to my environment.  I remember feeling like an emotional roller coaster and would experience times where I'd be overwhelmed by a specific sensory input, such as sound.  I also constantly struggled to pay attention in school and learn "inside the box."  In early college I read about ADD, and thought "Aha!  That must be me!"  I went to a counselor to pursue a diagnosis, gathered original copies of my school files to give him and never followed up on an appointment to get "officially diagnosed."  I was never able to track those papers down since by the time I thought to look into it again, I could no longer find the practitioner.  I remember later taking a psychology class and learning about dendrites, which are your neuron's branchlike extensions that carry nerve input to the cells, and deciding that my problem was "overactive dendrites." Somewhere in there, I began experiencing the beginning of Fibromyalgia with Chronic Pain and Fatigue.  I always believed that these were all intertwined, but only recently has there been the beginnings of research to support it, such as this article, which connects them both as Autonomic Nervous System Dysfunction.

Executive Functioning and Chronic Pain

People with ADHD have difficulty with Executive Functioning, defined on Wikipedia as, "cognitive processes that regulate, control and manage other cognitive processes, such as planning, working memory, attention, problem solving, verbal reasoning, inhibition, mental flexibility, task switching, and initiation and monitoring of actions." In the educational setting, we often compare Executive Functioning to an "Executive Assistant" who helps to plan, execute and manage projects.  In Executive Functions, Self-Regulation, and Chronic Pain: A Review, they note that, "Chronic pain conditions may be associated with impairment in executive functions, which is not surprising given that the same brain regions are implicated in both."  In addition to the negative impact that executive function and self-regulatory issues can have on physical pain, physical pain can also have a negative impact in the other direction.  It was found that "self-regulatory strength is a limited resource that can be depleted or fatigued."  This presentation further supports the idea that chronic pain has a negative impact on persistence of self-regulatory tasks.

So what exactly does this mean for me?

In short, poor self-regulation skills can contribute to chronic pain and chronic pain can exhaust your stores of self-regulatory ability.  Almost all of the things we know to help increase wellness and decrease pain involve creating consistent positive habits.  Creating new habits requires a significant degree of self-regulation.  Well crap!  No wonder I've cycled through any number of diets and physical therapy programs without sticking to them! 

Unblocking the roadblocks on your path to wellness

I've been working on this question for years, but things have really started clicking for me personally in the last year or so.  I am embarking on a journey to research what works to help people with self-regulatory issues actively change their habits and make it stick.  In the mean time, I will share what I've learned from a personal standpoint that has really helped.

Find something that works

Now this may seem like a no brainer, but over the years I've noticed something about my self.  If I haven't noticed a significant change in two weeks - I am highly unlikely to keep it up.  This is especially difficult with fibromyalgia, since it is very hard to find something that is so quickly effective.  I'm not saying not to do things that you know will have long term positive consequences, but if you can find even one thing that has an immediate impact, it can increase your motivation to make the changes that don't. For Patricia Stephens, author of Reversing Chronic Disease, it took a diagnosis and medication for AD/HD to spark the healing process, then she went on to find natural ways to treat her issues without conventional medication.  I shared the things that have worked for me personally in my last blog post.  These things were so powerful, that it was easy to maintain them.  When I found stretches that stopped my chronic headaches in their tracks, it became much easier to do them than not to.  When I can see how eating grains can make me feel like I was hit by a mac truck in the morning, it takes almost no willpower to avoid the muffins in the staff room.  

Routine, routine, routine!

As a school psychologist, this is one thing that I encourage in all students with Executive Functioning issues.  For me, if it's not in a routine, I'm unlikely to do it.  Since bedtime is the one consistent part of my day, it helps to tie things to my bedtime routine.  This means it often takes me an hour to wind down for the night, but that process also helps to slow down my brain and prepare for sleep.  You can also plan routines around wake up, getting home, after meal times or any other natural transition in your day.  

Ditch black & white thinking

This is big!  When you lack self-regulation skills, moderation can be hard work!  For years, I would dive into something 100%, then fall completely out of it after one break. Food has been one of those things until very recently.  I'd try something that felt intuitively right, but never made enough of a difference to stick with it.  Now I realize that low carb diets felt good for me for a while mostly because I wasn't eating grains.  Now I've come to learn that I can eat more carbs and still feel good, as long as I stay away from most grains except rice.  I am finally able to make decisions about what I eat on a case by case basis.  If I'm tempted to eat something that I "shouldn't," I weigh the pros and cons.  Sometimes "but it's delicious" is a completely valid argument.  I sometimes acknowledge that I overindulged, but I never feel guilty about it or "throw the baby out with the bath water."

Listen to what your body has to say

When a grain of sand in the bathtub is extremely irritating to you as a child, you begin to learn to block things out.  When your body is constantly sending messages of pain and discomfort, you try your best to stop listening.  I have always said that I have a very low pain threshold, but a very high pain tolerance.  Having been through natural childbirth, I now know this to be true.  The thing is though, if you are ignoring what your body has to say, you might miss when something is starting to work.  More importantly, if you aren't paying attention to the signals your body is sending, you will likely persist longer in activities that aggravate your pain.  This is where the mindful moments I discussed in my last post can be useful.  Basically, set a reminder for yourself every hour to check your pain and tension levels.  This can take you a long way in awareness of what is going on in your body and how things progress.

Take care of the ones you love by taking care of yourself

For some of us, it may be much easier to do something for the sake of others than for ourselves.  My best persistence with self-care activities was when I was trying to get and stay pregnant.  Fixing my pain for myself was never enough, but fixing my body for the sake of even a future child suddenly became more motivating.  Partly for this reason, my pregnancy was the healthiest time of my adult life.  What I've needed to remind myself is that taking care of myself is the best thing I can possibly do to take care of the ones I love.  First of all, there's the concept of putting your mask on first before you put it on your child.  If you don't take care of yourself, you won't be as effective at caring for those close to you.  Also, those who love you are often pained at seeing you suffer.  Finally, if you have a child and want them to thrive, the best way of doing this is to be a strong role model for good personal care.  

Take time to plan your time

When you are lacking internal organization in your brain, it becomes imperative to create external structures to support organization in your life.  Plan time in your week to do the things you need to do to feel good.  If you don't schedule it, it is unlikely to happen.  I recently took a webinar with Marydee Sklar on her program, Seeing My Time.  In this program she walks you through the process of making the abstract concept of time more tangible by making it visual.  Some strategies she uses include using analog clocks to see the passing of time and always having your daily schedule in view.

I am continuing along this journey toward wellness and finding my way as I go.  Even if I don't always feel great in the moment, I am learning that every step I take toward self-awareness is a step in the right direction!