Making Mondays Bearable

As 2022 approaches and we face the prospect of having another twelve months speed by us again, I’ve found it useful to sit down and take stock of where I was last January, what changed over the past year, and with what attitude I will enter into the next 12 months.

One thing that has caused a great deal of anxiety for me has been work, even with having one of the greatest bosses in the world and a flexible work situation.

My work situation is quite positive, but anxiety has left me with emotional claustrophobia.

Why? Because my job has also been associated with some of the most wrenching anxiety that I have ever experienced, including being diagnosed with cancer.

What’s resulted is that even in a supportive and stimulating environment (although not my passion, admittedly), I’ve felt trapped, like an animal trying to scratch my way out of my cage.

This past year, I came up with a tactic to at least partially relieve this feeling.

Now, I actually look forward to Mondays, because I’ve set up a beautiful association for the first day of the workweek with something very indulgent.

First, I work from home on Monday. This softens the dread that I’ve historically felt on Sunday nights, knowing that the weekend is over. The transition to the office is gentler.

Second, with some changes in my kids’ school schedules (one in college living at home and the other in high school), I start my workday an hour later. This has given the entire family reprieve from the stress of waking very early and starting the week sleep-deprived.

It also gives me to time to enjoy a cup or two of decaf in the morning.

Third, when the rest of the family leaves for school and work, I have 45 minutes before my own workday starts. I set up my rower for a 30-minute row, facing the tv/computer monitor in the living room…

Great exercise + fun videos = an amazing start to Monday!

…and put on a half-hour YouTube video of something I really enjoy that I might not have time to watch otherwise. For me now? It’s an episode of “BuzzFeed Unsolved–Supernatural”. Pure 100% indulgent entertainment.

Because it’s a timed row, when the 30 minutes are over, I stop. No pressure to hit a certain speed or distance. No matter what, it ends up being a decent workout because I enjoy the exercise.

That leaves 15 minutes before I start work. Chemo left me with short hair that allows for a five-minute shower.

By the time my workday begins, I am completely refreshed and the day’s workout is done. I feel like I’ve been given a huge treat–almost like I’m cheating, but I know I’m not. That 30 minutes of physical activity tied with watching a fun video re-sets my attitude and I’m ready to take on the week.

I love Mondays!

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Can you create your own positive association with the toughest day of the week or anything else that causes you grief?

Losing My Voice and Finding Calm

About a week ago, I lost my voice. This doesn’t happen often (some in my family might say it doesn’t happen often enough) as I tend not to get demonstrably sick beyond a runny nose.

Oh yeah, and cancer, but that’s beside the point.

Quiet is contagious.

I was coordinating a lectureship that was to take place on a Monday and Tuesday (luckly, I was not the speaker, just the one making arrangements), and on the previous Friday evening my voice disappeared. I could only manage a whisper as the event approached.

And I noticed something funny. As my voice became quieter, so did the voices of my family members. When one of us is not speaking loudly, others don’t have to either. Everyone is heard. Like magic!

As we all lowered the volume, I found myself less anxious about work. As I became quieter, it felt as though the world slowed down a bit too. Things felt a bit calmer.

This made me wonder how much I was adding to needless noise clutter at home…and how much I was responsible for driving the hectic state.

Sometimes we need to be reminded that we have more control over our mental state than we may realize.

It also reminded me that even when things felt “out of control”, that was just an illusion. They were most definitely within my control. I could turn down the rush of anxiety. I just had to remain aware of what was happening and that I had a choice in the matter.

Now, none of this is a miraculous revelation. I’ve known this since before I started meditating. But knowing something is not the same as putting it into practice. And sometimes to put it into practice, you have to realize that even though you “knew” it, you didn’t truly believe that you could do it.

I need that reminder now and then. That’s the gift mindfulness has given me. And even then, I still might need a nudge.

And the lectureship? It came and went, a little hiccup here and there, but under the circumstances everything worked out well. No voice required. And more importantly, no anxiety required.

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I’m not going to pretend that it’s easy to switch off anxiety. If I knew how to do that I would be living a carefree and very wealthy life. But just being aware that we have a crumb more control than we thought we did…brings us one step closer to a little more peace in our lives.

Working Out to Avoid Freaking Out

It’s hard to imagine a cancer diagnosis that doesn’t provoke some level of anxiety.

When I was told that I had breast cancer, it didn’t take long before I got a prescription for Xanax because my anxiety was going through the roof — I clearly couldn’t handle everything I was feeling. It wasn’t until my radiation oncologist suggested that I try meditation that my view of the best way to handle my anxious feelings changed, and eventually I dropped the Xanax altogether.

But one thing that I kept on doing was exercising, at least as much as I could manage on a given day. So after reading a recent study about exercise, I had to wonder how much worse my experience might have been if I hadn’t kept to my workouts.

Henriksson et al. (2022, Journal of Affective Disorders; see link below) found that engaging in moderate or strenuous exercise was very effective in relieving the symptoms of anxiety. What I found so interesting was that half of the study participants had actually lived with anxiety for at least a decade, and they still got relief!

The subjects in the exercise groups did a combination of both strength and cardio training.

The subjects in the experimental groups were assigned to one of two groups: low-to-moderate intensity group exercise or high intensity group exercise. The exercise was timed circuit training that combined both cardiovascular and strength moves and subjects maintained heartrates at levels appropriate for their assigned intensity levels. At the end of the 12-week program, everyone’s anxiety had significantly decreased, as compared to a control group that was not participating in group exercise.

What is striking is that there was a tendency for the improvement to follow the level of intensity; the harder the subjects exercised, the more anxiety relief they experienced. Talk about motivation!

My own experience echoes this, but in a subtractive sense. At times of intense stress, my anxiety skyrockets when I’m prevented from engaging in my regular workouts. This may happen, for example, when I’m dealing with an unreasonable workload that ties me to my desk and preempts my exercise sessions.

I used to wonder why I felt so much worse when I was getting more work done. This study answers that question for me.

Couple these results with what we’ve learned about the beneficial effects of exercise in decreasing the risk of recurrence of breast cancer and it is incredible why physicians don’t write exercise prescriptions for their patients, and why personal trainer sessions are not covered by health insurance.

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There are several things that I feel are important to underscore here if you’re interested in trying this out yourself.

The social aspect of the exercise sessions may have also played a role in alleviating the anxiety that the study participants had initially complained of, and there was the added benefit of a pre-planned, supervised program.

First, this was a group session. That means that there was also social support involved as no one was exercising alone. The subjects were supervised by a physiotherapist; they didn’t have to come up with their own program, as it had been created for them.

Also, the exercise included both cardio and strength exercises and included warm-up, cool-down and stretching, so it covered all the bases, so to speak. And the subjects got fitter as the study progressed, so there was also a sense of self-efficacy at work here.

Does this mean that the exercise didn’t matter? Not at all! The emotional benefits of exercise have been documented in previous studies. If you consider the mind-body as a single system, as your physical fitness improves, your mental health will generally follow.

If you’d like to see the original article, it is available free online:
Malin Henriksson, Alexander Wall, Jenny Nyberg, Martin Adiels, Karin Lundin, Ylva Bergh, Robert Eggertsen, Louise Danielsson, H. Georg Kuhn, Maria Westerlund, N. David Åberg, Margda Waern, Maria Åberg. Effects of exercise on symptoms of anxiety in primary care patients: A randomized controlled trialJournal of Affective Disorders, 2022; 297: 26 DOI: 10.1016/j.jad.2021.10.006

For a reader-friendly version, see the write-up in Science Daily:
University of Gothenburg. “Anxiety effectively treated with exercise.” ScienceDaily. ScienceDaily, 9 November 2021. www.sciencedaily.com/releases/2021/11/211109095348.htm

The Voice of Reason: Why I Love Guided Meditations

If you’ve read my posts, you’re aware that I really like guided meditations. There are a number of mindfulness apps that I use everyday, and if it’s not a meditation, it may just be ambient noise that I have in the background that helps keep me grounded.

The fact is that guided meditations have been a game-changer for me. During those times when I am trying to fall back to sleep and shake off anxiousness, having someone else’s voice in my head makes a huge difference.

When I’m groggy, I’m vulnerable. My thoughts can run away with me and take me to places that will keep me awake.

What do I mean by that? I’ve found that I’m a very visual person and for better or worse, I have a vivid imagination (this seems to be the case for many anxious people). During the day, it’s much easier for me to ground myself with the techniques that I often write about here — and it’s even better if I can find a quiet corner to do so. But nighttime is different. Sometimes I wake up stressed and clearing my head of all the noise feels like a Sisyphean task.

When I am groggy, I am vulnerable. But I certainly don’t want to do anything to make me more alert since my goal is to fall back to sleep, not to practice improving my concentration. That is the perfect time allow someone else to guide me in meditation.

The guidance does this: it allows me to focus on someone else’s voice. That’s enough. I do not want to have to exert effort beyond that required to listen.

The exact topic of the meditation is far less important than the delivery. A gentle voice at a low volume draws my attention just enough that it keeps my anxious “Monkey Mind” occupied and quiet.

The Monkey Mind running loose is a good way to visualize what your thoughts might be doing inside your head, swinging from branch to branch, chattering, jumping and constantly changing directions. It can be a jumbled mess in there. The meditation helps sort it out.

I have tried this on a number of occasions and have been very impressed with how effective a guided meditation is in dulling the clarity of what my mind has cooked up and clings to. It provides space between my worries and my self. And then I drift off to sleep.

As I mentioned, the meditation doesn’t have to be anything specific. While body scans work particularly well, any calming meditation will do as long as its purpose is to relax the listener. Breathing cues can also be highly effective, as can novel ambient noise that pulls you away from your worries.

No need to overthink it. Just indulge in a lulling guided practice and get some rest.

Breathing into Limbs: A Grounding Visualization

I’m perpetually on the lookout for different ways to ground myself.

When things get tough and I feel my anxiety rising, I’ve gotten better at pausing and pulling a grounding technique out of my “mental tool bag” before the feelings become too intense.

One that I came up with recently works quiet well, especially if you can take a quick break and find a quiet corner.

As I breathe, I visualize my breath inflating my limbs, filling them with relaxation.

The idea behind this one is that you take a few deep breaths to help slow your breathing down, and then start imagining that your breath is going down into one arm, inflating it.

I’ve visualized it in two ways. The first being breathing into the arm as if it were a balloon that inflates in all directions, all the way down to the fingertips, until it’s completely full. I imagine it glowing from within.

The second entails imagining the breath filling the arm in the way that a fern leaf unfolds. The expansion starts at the shoulder, then upper arm, elbow, lower arm, wrist, hand and finally fingers. As the arm fills with the inhalation, it brightens. This visualization is best when your breathing has already slowed considerably, as it may take a longer breath for your entire limb to sense the serial expansion down to your fingertips.

If my breathing has slowed enough, I imagine the breath entering my limb gradually, just like a fern leaf gently unfurls, part by part.

Either way, I wiggle my fingers at the end of the in-breath, and then as I exhale, the fingers fall still again and the breath exits my arm as it arrived.

Then I do the same with my other arm, followed by one leg and then the other.

On days that I’m really rushed, I might only have time for one limb, particularly if I’m sitting at my desk at work. But that’s okay. Even that short bit is better than letting stress run away with me. That little pause may be exactly what I need.

If this “extremity inflation” sounds too complicated in the heat of the moment, I urge you to try it when you’re lying in bed with your eyes closed. Then you can focus on the sensation of expansion and get familiar with it, so that when you need to call upon it in a stressful situation, you’ll have an easier time bringing up that imagery.

My limbs glow as the breath brings brightness into them.

What I particularly like about this visualization is that it’s a touch more complex, and therefore requires more attention from you. The inhalation all the way to the wiggling fingers makes it more difficult to be thinking about other things. So while it may demand more, I feel that it also delivers more, since everything else decreases to a dull roar in the background as you visualize the air rush in and inflate your body.

And of course, there are different variations of this that you can play with, such as expanding your entire body.

If you are able to practice with this, or even duck out to the bathroom for a few moments of eyes-closed peace, I think you’ll find it a lovely way to give your nervous system a needed break.

Perspective: The Broom that Sweeps the Mind

Last week, I had a good reminder about the importance of maintaining perspective.

It had been a stressful few days at work. At the height of it I found myself in a problematic situation, trying to “fix” an issue that wasn’t my responsibility by sending a quick email. I would have done better to pause, but I was in “go-go-go” mode, driven by anxiety that the situation was causing.

Afterwards, I found myself obsessing about what had happened and how I had reacted. So even though I had initially felt that my email response was the best course of action, by evening I was convinced that it was the worst. This opened the door to allow in unrelated doubts about myself. That frustration carried into my nightly meditation, and ultimately, into fitful dreams.

In a few seconds, a perspective shift changes your entire view of things.

The next morning, I felt marginally better. But it wasn’t until I checked my text messages that my perspective shifted. I received photos of my father, leg in a cast, at the local hospital’s emergency room. Reason? Cracked tibia bone and deep vein thrombosis.

In an eyeblink, I forgot about what had happened with work. I needed to get more information about my father’s predicament.

As news of exactly what had happened filtered down to me (it was a much more controlled situation than I had initially understood it to be), I went into the office with a different mindset. The work stress that had been top-of-mind and in-my-face was now way over there in the back of the room.

FYI, my father is fine and the trip to the ER was actually a follow up from the previous day’s visit to his doctor where they discovered the fracture and the blood clot. The doc had encouraged the ER trip to get quicker access to an orthopedist. My dad is in good spirits and my mother (a former nurse) has been tasked with administering the clot-dissolving injections.

But the shift in perspective that morning reminded me so much of a similar shift several years ago: prior to my cancer diagnosis I had been experiencing a lot of anxiety at work…but once I learned that the lump in my breast was cancer, everything else fell away. It was as if the roar of work stress suddenly became muffled and all I heard was my beating heart, my health, the important stuff.

When I had cancer, the things that used to bother me, stopped. I knew then what was really important.

I distinctly remember that as I was going through my cancer treatments, in all the concern about what was happening in my body, I experienced the least amount of anxiety about anything going on at work that I’d ever had at that job. It felt like I could handle anything that they threw at me.

Perspective. That’s what I had as I sat in the infusion room. And that’s what I regained last week.

How curious that the shift in perspective was so simple to achieve. All I needed was to remember what was really and truly important and everything changed within a few seconds.

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“Simple” is not necessarily “easy”. We have so many things coming at us in the course of the day and we try to triage them as quickly as we can. It’s expected that we will make “little mistakes” and give more weight to the problem right in front of us–those things that are immediate. But with practice, we can realize that most of those are transient and the important stuff is what deserves our deepest attention and appreciation.

And even the “important stuff” needs to be swept out once in a while.

Surviving Another Ride in the Tube

During my last oncologist appointment, I was told it was time for a chest MRI.

The last time I had one of those, I was barely holding it together–it had been a couple of weeks since my breast cancer diagnosis an dI was in an emotionally fragile state.

But that was four and a half years ago. This time, I was fine. I thought.

In case you’re never experienced one, the bilateral chest MRI is not particularly comfy. You lie face-down, your breasts hang between two open slots beneath you and your arms are outstretched in a “superman” pose.

I was a bit taller than they expected…things didn’t completely fit.

And you hold that for a specified length of time. I seem to recall almost an hour last time in 2017, but this time it was only a half hour. Which is good, since I had a hard time getting comfortable–based on how the MRI bed was set up, they hadn’t expected me to be quite so tall.

And since I needed “contrast” in my MRI, I was hooked up to an IV for infusing gadolinium. But the veins on my right arm (which is the only one I’m supposed to use) have seen a lot of wear and tear. Yes, they bulge and look nice and juicy. But it’s a lie. Only after some false starts–the first vein the nurse tried was a bust–did we get the IV going.

The MRI machine looked shiny and competently high-tech. I got to listen to spa music through headphones, which is kind of funny, since it’s like being at a spa where they also bang pots and jackhammer while you’re getting your treatment. In case you’re not aware: MRIs are LOUD.

Ironically, there’s something quite positive about that: the percussive nature of the noise has an almost lulling effect–if you let it. This worked quite well with my strategy of meditating throughout the procedure. Breathing was not particularly comfortable because of pressure on my ribcage (again, due to my height and positioning on the bed), so I chose not to focus on it.

The dressing room was cute, but I couldn’t help feeling so alone in it.

Instead, there were many other bodily sensations that I could pay attention to. At times, I could “feel” the MRI in my hips and spine. I focused on the weight of my body on that bed and on releasing tension whereever I sensed it. Compared to the previous chest MRI, I felt a sense of grounding.

But there were little cracks in my composure. I took a picture of the cute little dressing room where I changed and left my clothing. It was lightly decorated with homey touches. At the same time, it looked so empty: my gown on one chair, my belongings on another. Briefly, I felt small and alone.

After unsuccessful attempts, the IV was connected, and I remembered the feeling of expecting that things were just gonna hurt.

After I got home I removed my bandages from the IV arm and looked at the crook of my elbow, and it reminded me of all the pokes that I’ve endured. All the discomfort that I learned to expect and not question if it was necessary, because it always was. And I fought back feelings of helplessness.

It’s not all bad. This time, I had a better grip on things. I wasn’t even thinking about the MRI the next morning when I went grocery shopping, until…

…I saw a call come through from my oncologist’s office. And suddenly my heart started racing. It was a pure knee-jerk reaction. The voice on the other end told me that the MRI looked normal and my oncologist would see me at my next scheduled appointment next year.

It took a bit for my heart to calm down. I hadn’t been worrying about the results, certainly hadn’t expected anything bad, but wow, when that phone rang, it was as if my brain yelled at me, “Time to PANIC!”

This ride in the tube had a happy ending. But there’s no mistaking all the anxiety bubbling under the surface. Try as I might, I am always going to associate these procedures with fear and possible death. Memories of what happened a few years ago are not going anywhere.

And that’s okay. Because even though my reactions to those memories may still be stressful, I can accept that this will be the case and not expect them to be otherwise. And that acceptance is one of the most valuable skills that I’ve learned.

Grounding Through Mental Tracing

I’ve written before many times about different “grounding” techniques. Grounding is what helps move us out of the chatter in our heads and brings us into the present moment, where we can pause and realize that we are safe. It helps put space between our ourselves and both fears about the future and regrets about the past that may unnecessarily cloud our minds.

On days like those, I need to fine-tune my focus. This calls for a grounding technique that won’t be as easy to derail.

Body scans are some of my favorite grounding and calming go-tos. But recently, I was introduced to tracing the outline of the hand with your mind, a focus on just one part of the body. I tried this and found that it worked brilliantly!

As kids, we traced our hands to help us draw; now, it can help us stay present.

Just like when, as a child, you started a drawing using the outline of your hand by placing it on a piece of paper and tracing the around your fingers with a pencil, you can do the same thing mentally. Imagine the sensation of a point of pressure (say, an invisible crayon) moving up your wrist to the outside of your pinkie, around the fingertip, and down the other side into the hollow between the fingers…and doing the same as it moves up and down each finger until it ends up on the outside of the thumb and travels back down the wrist.

What makes this so effective for me is that it is a simple visualization that requires a bit more concentration, and yet it is still uncomplicated. That means that it gives my monkey mind a little extra to focus on, but not so much that it becomes a struggle.

Try it next time you need grounding and want to trying something different.

Kindness to Cancer Patients

REMINDER: Be nice to other cancer patients and survivors.

It feels weird to write that, because why wouldn’t you? So many of us who have had the cancer experience feel like we want to support and encourage those who come after us. We are driven to help. But that’s not always what happens.

Let me provide an analogy of sorts:

When I was pregnant with my first child, a daughter, I got an enthusiastic positive response from so many other moms. Everyone was ready with helpful tips and good wishes. At the same time, many also started in with stories of their own experiences, often times telling vividly about their struggles and pain and even, “Oh, girls are the absolute worst!”

Some experiences may leave us feeling “unfinished”, needing a kindred spirit to tell our story to. But we need to be aware of whose ear we’re bending.

Why would some women do this? I can only hazard a guess: perhaps because no one wants to listen to difficult stories. Childbirth is a momentous life event brimming with intense emotions that friends and family forget, but the mother in question holds on to because they are tied into so much of her. Her lingering feelings are brushed aside. No one else cares to revisit the labor pains or complications. As a result, tales of the experience are often not expressed until she sees another woman, a kindred spirit, embarking on the same journey.

So, too, with cancer. And it can be a difficult and awkward subject for many, cancer patients or not. Those of us who are breast cancer survivors may want to “talk about it”, and thankfully there are support groups for that. But friends and family may not understand the scope of the emotional fallout. We get comments like, “well, at least you got a nice set of boobs out of it,” and are expected to move on. Conversation over.

And then we see another woman going through this, and it’s difficult to resist inundating her with your own experiences and emotions, all in the name of letting her know that she can get through this, just like you did.

Does it help? Maaaaybe? But as we all know, everyone’s experience is different. What happens is that you’re not “preparing” her for what might come. You’re inducing anxiety in an already stressed-out situation.

I experienced this myself after my diagnosis, when, a week before my surgery, I ran into an aquaintance who had gone through breast cancer treatment several years before. And I know she was trying to offer support and make me feel better, but it didn’t. She made me anxious about my upcoming therapies, including ones that she not gone through herself. While my intent as a newbie was to share about my diagnosis because I felt that she would understand, I ended up being a sounding board for her concerns. Concerns that were valid, definitely, but not appropriate in the context of a very fearful cancer patient.

Offer support without taking over the conversation.

For the record, this was a lovely woman with whom I’ve had numerous subsequent exchanges. There was no ill-will intended. But it’s likely that she didn’t have many opportunities to speak to relate her story to other women, and given the chance, just needed to talk.

And I know that in my exhuberance to show support for other cancer patients, I’ve probably tripped over myself in an attempt to reassure too much. Offer too many hugs. While also trying to be noncommital about outcome. That’s a really messy combination.

So please, let us remember (and by “us” I mean myself!) that sometimes the best form of support for a newly diagnosed cancer patient is simply being there with them and holding space for what they may be going through. They will make their way through the experience, day by day, just like we did. There will be time to talk about the ups and downs of treatments.

But maybe not right now.

Grounding though Contact Points

Lately I’ve been speaking with people who are having a hard time dealing with anxiety, so I thought it would be worthwhile to dive deeper into grounding methods.

For me, hands down, strong neutral physical sensations (with “neutral” being the operative term here) are by far the best ways to pull my head out of swirling thoughts and get back to where I am now on the Earth.

Buttocks and feet are great focal points for drawing attention away from rapid breathing or heartrate.

Currently, I’m focusing on touch points: those places on your body where you are making contact with any surface. This is highly effective because it is well-suited for any situation. You don’t necessarily need to be in a particular position, nor do you need a quiet space. So if you’re in the middle of an exam, sitting in your boss’ office, standing at a podium or walking down the hallway of a hospital, this grounding method can shift you back to the present moment.

The idea is to focus on the sensation of pressure. My suggestion would be to bring your attention to whereever on your body you can sense that contact with a surface, giving preference to places further from areas that might be reinforcing anxiety, such as the chest region and a rapidly beating heart. So, hands, feet and buttocks would be good candidates. If you’re walking, then pay attention to the change in pressure of your steps as you put your foot down and lift it again.

Feel into these body parts, sensing how the pressure feels against them. You can also bring in sensations such as tingling and temperature. Like an investigator, experiencing these sensations as if for the first time, get curious about their quality. If needed, squeeze the muscles, but then make sure to relax them too, so that you’re not clenching. Then see if you notice a difference in sensation.

Try it right now. Go ahead, I’ll wait…

You don’t need a special place to practice grounding yourself. Where you are right now is perfect.

Did you try it? And did you feel anything? The type of sensation doesn’t matter here. The main goal is to get out of your head, which may be in overdrive. Paying attention to what your body is doing RIGHT NOW helps move you away from thoughts of dread and gives you a handle on your reactions.

Important: as with all calming techniques, this takes practice. It is not a one-time thing that you try, nor is it a pill that you pop and everything settles down. The more you practice this, especially when you’re in a peaceful surroundings, the better you will get at shifting your focus during times of anxiety. Just as with a formal meditation practice, it is consistency that will improve your focus and thereby your abilities.

The added benefit to practice is that you will realize you *can* do it, that it *does* work, and you will build confidence in yourself that you can handle it. So in an anxious moment, you’ll be able to say, “I got this” and bring yourself to a more manageable place.