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!

Things that have worked for me!

This isn't exactly about food outside the fact that changing my diet has been one of the single most powerful tools that has improved my well being.  Like many people with Fibromyalgia, Adrenal Fatigue and digestive issues, I have tried many things that haven't worked.  Add to that attention deficit/executive functioning issues which make it very difficult to start and stick to anything, and even things that might work in the long term are very difficult to maintain.  Turns out though, when something makes a serious and immediate impact, it is much easier to stick with!  I have had very few of these, but I thought it was worth sharing those things that have.  

Nutrition - I've tried all sorts of nutritional theories over the years and nothing really seemed to make a major difference until I tried eating Paleo/Primal.  I had gone gluten free before with no noticeable change, but cutting out all grains gave me more energy than I've had in my adult life for the first few weeks.  It went down a bit over the winter and with work stress, but as the sun has been out more, my energy has picked up more.  I've experimented with different foods, and discovered that the Perfect Health Diet has been the best fit for me so far, which includes white rice and is a little less restrictive.  When I had a ton of non-gluten grains and some legumes for my son's birthday, I felt like a mac truck hit me the next day.  I hadn't realized how much better my fatigue had gotten until I remembered having that feeling all the time!  If I have too much sugar I tend to get brain dead in the evening and just veg out.  I do plan on doing some experimentation with sprouted or fermented beans and non-gluten grains, but for now it's working for me pretty well. If I choose to eat something "forbidden," I don't stress about it.  I enjoy it with the awareness that it's worth it in the moment.  I'm not often tempted by most grains though, since it's rarely worth the way it makes me feel!

Acupuncture - I first started acupuncture about 13 years ago, and woke up for the first time pain free in years.  I got rear ended that day and it started to loose it's effectiveness.  I do believe that it was responsible for me getting healthy enough to have my son and a very healthy pregnancy.  In fact, it may have contributed to the fact that pregnancy was the healthiest time in my adult life.  I have had the occasional pain free moment following acupuncture, but not always.  It does, however, consistently reduce my tension and pain, especially when cupping or scraping is used.    

Myofascal Stretching - I was a chronic physical therapy dropout until I was trying to get pregnant and stuck to it until the physical therapist gave up on me.  At that point, I got referred to acupuncture.  However, there has been one stretching tool that made such a difference that I did them religiously for about 5 years.  These stretches targeted my chronic headaches that I had had about 50% of the time for at least a year.  The headaches stopped, and as long as I kept them up, they didn't come back.  After a while I got out of the habit, and it probably took another 5 years before the headaches came back.  Now I'm back to doing them every night.  I have searched online for something describing these stretches, but can't find anything that does.  I decided to share here what worked for me.

Fascia is the connective tissue surrounding your cells.  The way it was described to me, if you over stretch, the fascia can snap back like a rubber band.  Myofascal stretching uses micro stretches that you hold for a minute or so until you feel a release.  The ones I did focused on my neck tension.  It is important to note that the pictures below are exaggerated to show the difference in each move.  When I actually started doing them, you could barely see my head move.  The key is to stop the second you feel a slight stretch - not pain. Then hold for a minute.

Nightly headache prevention stretches:

1. Look down - hold

2. Tilt head to the side - hold

3.  Keep head tilted and look down - hold

4. Keep head tilted and look up - hold

5. Repeat steps 2-4 on other side

The above stretches worked most of the time and kept not only headaches at bay, but also improved my tendency to get car sick.  I have, on occasion though, experienced nauseous headaches or motion sickness.  The following stretches help with nausea so much that I stop and do them any time I feel it coming on, and they stop it in its tracks!

Anti-nausea stretches:

1. Lean head back with head support, either behind your head upright, or laying down (a towel behind your neck to support is helpful)

2. Look to one side - hold

3. Look to the other side - hold

This concept can be applied to other areas of tension by just passively stretching the area that is tense and holding for a minute or until released.  I have done this when my jaw is tight by simply holding my mouth open.  Just remember to stop and hold at a slight stretch sensation and before it feels like pain.  

Mindful Moments - When I learned the myofascial stretches, they also had me do another powerful exercise  which I like to call Mindful Moments.  I had a watch set to go off every hour on the hour.  When it went off, I just observed in the moment my level of pain and my level of tension.  This tool was very powerful in helping me observe my body as things progressed.  If I had a full blown headache, nothing outside of sleep could make it go away.  If, however, I could feel it creep up the back of my neck before it hit my head, I could stop and stretch and prevent the headache.  I'm actually thinking I need to do this again, so that I can observe how my body is reacting throughout the day to work tasks etc.

Movement - This has been something I get glimpses of every now and then, but with my past fatigue, it's been hard to get myself moving.  Now that I have more energy through diet, I'm getting into yoga.  I could see a difference doing hot yoga the last month, but as it's getting hotter outside, I haven't wanted to increase inflammation.  I'm working on finding good routines I can do at home, and hope I can maintain it since I'm starting to see the benefits.  I think the hot yoga was a good way to start for me, since it's a more immediate impact.  I do believe though that regular practice on my own will be a good thing.  Another thing that has helped when I do it is a daily 5-10 minute walk.  Recently, I've found a free app on my iPad called "Office Fitness" that gives a reminder at a set time of day to take a 5 minute guided movement break on an area of focus of your choosing.  I'm not using it every day, but when I do, I notice a difference!

In thinking about this post, I asked my friends "What healing approaches/techniques have had an immediate impact for you (difference within 2 weeks or so)?" Some of the answers I got included: Ancestralization/ Dagara Rituals, meditation, yoga, studying nonviolent communication, kickboxing, high dose vitamin D, crystals and stones, acupuncture mixed with cupping, compassion practice and mindfulness.

What strategies have had an immediate impact for you?  Comment below: