My writings


Take some time today, and another day, and another.

Take some time today to find yourself.  Sit quietly. Do nothing. Turn your attention to yourself, inward. Just be. Feel what you feel. Think what you think. Receive the sensations of your body. Drift away, and come back to yourself. Feel into your worries and preoccupations. Feel into your body into those places that get tight with excitement or dread. Feel into your body where sadness condenses like November rain clouds. Hear the voices of your fears and judgments. Feel the release and the peace if that comes. Be with it all. Your fullness and emptiness. Your wisdom or confusion.

Don’t try too hard. Being with yourself has no specific goal. Don’t worry about trying to do something right.  For now, no need to figure it out. Just be.

Take some time today to be quiet and to discover who you are beneath the plans you have woven and the busyness you have committed to.  Beneath the person you want yourself to be. Or that others want you to be. Be yourself for a little while.

Take some time today with yourself. To be.

Brian Grady 25 Mar 09

When do you stop going to therapy?  An x-ray can tell you that a broken bone is mended and that you can walk on it. But you aren’t a bone.  Here are some ideas to help you decide when you are done with therapy.

All of this assumes that you are working with a therapist who is a good fit for you. You feel you can trust them, you are in agreement on how to address your issues, and on what you are basically doing there. If you are there to understand your marriage and your therapist thinks you are there to feel less anxious, you have a mismatch and need to sort this out right away.  If you want to learn better coping skills and your therapist thinks you are there to understand your dreams… get on the same page.  If you can’t, find someone else.

Ideally you will leave therapy when you’ve accomplished the goals you’ve set for yourself.  When you started, you should have had some sense how you wanted things (you)  to be different when therapy is complete.   You can and should check in from time to time with your therapist about how you are doing and where therapy is going.  I like it when my clients do this.  I like looking for signs of progress, and sharing our insights. You should see signs of progress within one to three months. It might take longer to resolve, but you should not be waiting years to see something happen.

Some issues resolve pretty quickly, others can take a long time. Part of this depends on what level of work you are doing.  If  you are trying to find strategies to deal with  a specific life problem or make a decision, you probably won’t need to go for long.  Changing a specific behaviour might not take that long either,  depending on what it is. If  you are trying to change a part of your personality, this can take quite a while – minimum six months, and it could be years.  Trauma work generally takes a while, and the earlier it began and the longer it lasted, the more time it will usually take. Generally, short-term issues lead to short-term therapy. Long term issues, especially those that began in childhood, generally mean longer therapy to be resolved.

Other clues that you might be done are:

  • When you have made or resolved the life transition that brought you to therapy and you are getting on with life.
  • When you feel that you know how to deal with your feelings and relationships, and the problems life throws at you.
  • When you feel confident in who you are, what you feel, and what you want and you can stand up for these.
  • When you are able to make free, smart, and responsible choices for  yourself out of love and not fear.
  • When you are able to love as freely as you would like, and let others love you.
  • When you have good boundaries with others. You can let them in… or not. You can go along with them… or not.
  • When you are able to feel your feelings and you don’t take your feelings out on others.
  • When you are not in the power of an addiction.
  • When you are not haunted by past events any more.
  • When you have some sense what you want from life and are able to go for your dreams.
  • When you are able to work effectively, but also to have fun, play and relax.
  • When you feel that you now thoroughly know yourself.  You understand the sources of your happiness and unhappiness and know what to do about these.
  • When the problem that brought you to therapy is solved and you have worked through the other issues that came up along the way.

It’s usually not a good idea to stop just because you start to touch uncomfortably strong feelings or issues. Or you get scared of your feelings or impulses that are coming up.   It can be tempting at this point to think that therapy is not working or just making you worse. Strong feelings, including those about the therapy, are actually a great reason to continue. You are now getting ready to do some of the real work, discovery and healing.  The deeper problems are now within reach and are available to be explored.

However, if you are not learning any more, this is a clue that you  could either end therapy or else increase the heat. If you are just chatting session after session, there is something missing. Maybe you are not going deep enough, or maybe you are done and don’t realize it.  Discuss this with therapist. It’s not criticism. Even if it were, the therapist should be able to take it.

I appreciate it when I know we are near the end, and the client doesn’t just stop coming without telling me.  When I know we have just a session or two to go, I have a different focus, and use the sessions accordingly.  There might be a specific piece of work I want to suggest or a skill I’d still like to teach, and if I don’t have warning, this gets lost. An end date might be next week, it might be in 5 months. Some of my long-term clients like to taper off – checking in less often and spreading out the appointments.

If you feel that you’ve accomplished what you wanted to, but your therapist hasn’t said anything, it’s up to you to tell him or her that you are ready to leave therapy.  Then you can discuss it. The therapist may agree and be really pleased for you.  Remember that the therapist’s job is to make him or herself unncessary. Or he or she might be able to point out a possible next step that you overlooked. Then you discuss whether you want to do that piece of work or not.

If you are a bit scared about leaving therapy, remember that you can always go back if you need to.  And it can be nice and affirming to check in some time later, even if it is no longer a necessity.  Because you now know it is not a necessity!

Brian Grady, Ph.D. Registered Psychologist

23 Marchh 2009

A recent dream:

I am with a homeless man. I take pity on him, and I buy a lottery ticket for him, thinking that if it wins, I’ll give him the winnings. It turns out that the ticket wins $1 million. I give it all to him, but it comes in the form of water. I pour this into a mixing bowl of his. He lets it all slowly run away out of the bowl until there is nothing left. I can’t believe that he’s just let $1 million of water go away.

He tells me, “But it is flowing freely from the sky at all times, in all places, on all people.”  And I am shown an image of rain.

He has no need for me to give this water to him.

Brian Grady, Ph.D.

I was recently asked for input by someone trying to make a difficult relationship decision.  My oracle being on holiday at the moment, I could only reply by referring the person back to their values.  Some of these questions are useful for other kinds of decisions also.

———–

Ask yourself where you are coming from in making your decision.  Is it about pride, or your reputation, or a sense of possessiveness, or about your values, or about difference in values between the two of you, or trust, or fear, or what?

What is at stake for you personally?  What do you really want?  What are you willing to give up to have it?

Given that we don’t know the future and can’t control other people, what risks are  you willing and unwilling to take?

This means also: what is most important to you?  When you look back on your life, what would you like people to have said about you and the kinds of choices you made?  What kind of person do you most want to be?  What kinds of choices would THAT person make?

When you think about the possible consequences of your choices, think about – what do I go through in the short term, and what do I gain in the long term by doing this?  Would it be worth it?

Brian Grady

The ability to be mindful in a close relationship, is like the difference between two lumbering freight trains on rusty old tracks, and the free-flowing flight of hummingbirds dancing from one flower to the next.

When we are being mindful, we are noticing and making sense of our own experience and that of the other person in ‘real time’; that is, now. We are aware of what we are thinking, how we are looking at things, what we are feeling, (this means emotions, but also information the body is giving us through sensations like tension, energy or heaviness), what we want, and why. And we have some sense of these in the other person as well. We have a sense, a guess, (or at least some interest!) in what the other person is thinking, how he or she is looking at things, what is important to him or her, what he or she is feeling, what he or she wants, and possibly why.

Doing this changes how we show up in the relationship. First of all, if we are being mindful of ourselves, we are not going to be just reacting. When we know what we are thinking, feeling etc., we have choices in how to respond. So our reaction is not just a knee-jerk response. We hear what the other person says to us or does, and we can consider how this affects us, what it means to us, and then we can choose a response. Maybe a better one than the first impulse to comply, retaliate, withdraw, defend, or whatever our automatic pattern is.

Second of all, if we are being somewhat mindfully aware of the other person, we are much more likely to have empathy for him or her. Empathy prevents us from hurting the other person. When we feel attuned to another person, we don’t want them to hurt. This prevents downward spirals of conflict where the other person hurts us because of being hurt first. In addition, empathy connects us to the other person. This brings us closer, and helps us to work together, towards shared goals or solutions. It brings us into a sense of “We” rather than “you and me”, or worse, “you versus me”.

Third, if we are able to be mindfully aware of and tuned to the other person’s world, feelings, experience, and views, we are going to be more able to act in ways that help them with their distress, and make them feel more satisfied. We will more easily know what they want or need, and what will help. This will make us feel less frustrated and helpless, and we feel more effective. We generally like people better when we can understand them, and can affect them in positive ways. We will also be less confused by the other person, and so not so disconnected. We will also be less inclined to take things personally, when we are taking in the other person’s point of view. We’ll usually find out that it not all about “me”.

Fourth, when we have a good sense of our own experience and some idea about the other person’s beliefs, feelings, and their reasons, this transforms how we can interact. We can have conversations about what is going on, rather than just struggles. We can notice the patterns of interaction, and we can talk about them. We have the ability to say “When you get quiet, I start thinking that you are mad at me, and I want to withdraw”. This is the other person a chance to provide a reality check. He or she can say “well actually, when I get quiet, I am just not sure how to react, because I don’t want conflict.” What a difference to just going off in your different directions, neither person feeling understood or satisfied with what happened!

When we become mindful of ourselves, and of the other person, when we bring curiosity and good-will to our struggles, we get off the rusty tracks that go to the same old places. Instead, we have the chance to become closer, working together on solutions that bring us what we both need. This brings us hope and new energy for the relationship, as the nectar in flowers brings energy to the hummingbirds flying in the garden.

Brian Grady, Ph.D.
25 June 2008

Background
There are two basic kinds of meditation: those that have a theme or focus (like breathing or a visualization), and those that do not (theme-less). This describes the basics of theme-less meditation.

Environment
Where possible, the environment should be physically comfortable and not distracting. A clean, quiet place without too much visual distraction is good. Try to arrange not to be interrupted.

Timing
10 to 30 minutes once or twice a day, done regularly, can be enough. Regular practice is what helps, more than rare marathon sessions.

Body
Sit in a chair, with the back relaxed but upright, and the head balanced on the neck. If you can, don’t use the backrest, but sit upright on your own. Keep the eyes gently open. You can face a wall or look at the floor. The important thing is not to be too distracted by what you see. Breath naturally, without effort.

Mind
You are going to just hang out with your experience as it happens. You don’t have to DO anything. Feel what you actually feel. Think what you happen to think. Have the body experiences that you seem to be having. Notice and be aware of yourself as you are, in the present. Just sit. Just BE. Now.

Don’t try to achieve anything. Don’t try to be relaxed or calm. Don’t try to get to any particular mental, spiritual, or physical state. Don’t set yourself a goal of what your meditation experience should be like.

Also, don’t attempt to push away any experience. Don’t try to avoid any feelings. If you start to feel something, feel it. Don’t block out physical sensations. Don’t try to keep your thoughts off any particular subject.

Your mind will wander. When you get distracted – you go off on some train of thought or inner conversation, or you get into planning, or reviewing some past experience, notice that this has happened, and come back to the present experience, right now. Added commentary on what happened is not necessary. Telling yourself what experience you are having is not necessary.

None of this sounds all that exciting or glamourous. It generally isn’t. But there are benefits of this. You learn to be awake to your own life. You learn how to be present. You gradually find out how you can ’show up’ with others in your life and create genuine intimacy. You gradually find out what you feel and how you think more and more clearly and honestly. You notice your preoccupations and mental habits. As you become more aware of your conscience, your driving forces and your automatic reactions, you start to have more choices.

And when you meditate, you are consistently, quietly knocking at the door of your spiritual self. You don’t get to choose when, but if you practice, one day you will get an answer and your gratitude will be overflowing.

Brian Grady, Ph.D.

I have two beautiful dogs; a retriever, and a big German Shepherd cross. Along with food and companionship, they care a lot about territory. Whenever a cat comes into the yard, for instance, there is a lot of excited barking and chasing, and within seconds their territory is a cat-free zone again. I am pretty sure they enjoy the chase, but I’m pretty sure also that they don’t know what they are doing. If a neighbourhood dog barks, they bark, each and every time. I am pretty sure they could not stop themselves (even if they wanted to). They are acting out something automatic, and they are not being mindful.

Mindfulness means paying attention – sometimes exquisitely close attention – to our experience, as it happens, right now. This is the experiences of our thoughts (“I am thinking about my dad”). It is the experiences of our feelings (“I feel sad”). The experience of our body sensations (“My chest is a bit tight and I feel kind of heavy; my energy drains”). There can be images and memories (“I am remembering myself standing next to him in the living room when I was 12″).

If we bring this kind of awareness into a therapy session, it immediately catapults therapy into the present moment. And this is powerful because this is where therapy actually happens. We heal in present moments. This is why I use mindfulness as part of therapy so much.

Even if we are talking about some event in the past, the only reason it matters is because in some way it touches our lives now. So we pay attention to now and see how it shows up. Now is when we can make some change or make a new choice. The past has already flowed out of reach down the river. So how are we reacting or feeling now? To realize this means paying attention.

If we don’t pay attention to our thoughts, images, feelings, impulses, body sensations, and changes in energy as they happen, we will feel and will act automatically. As with my dogs, old programs or conditioning will play out the way they usually do, and we’ll have a very familiar experience.

The saying is that life is one damn thing after another…but if we are neurotic it’s the same damn thing over and over again.

This isn’t because life is out to get us. Life, and experience, are there to teach us. We are shown, daily, hourly, the consequences of our reactions, our choices, and our outlook. It’s in our face all the time actually. But none of this will make a bit of difference until we look for the teaching, and we look for the little moments where we can do something differently. Otherwise old, conditioned responses will lead us down the same path. No surprise we end up in the same place!

In a therapy session, paying mindful attention to our experience in ‘real time’ means that we can notice those automatic reactions, impulses, and beliefs as they arise. This gives us the amazing chance to do what my dogs, for example, don’t seem to be able to do – to observe our reaction and choose a response.

This seems obvious. But if you think about it, most of the time we are too busy, and probably don’t pay much attention. We are on autopilot. So we do what we usually do. We withdraw from intimacy when we get too close. Or we cling out of fear. Or we brush off a compliment. Or we go it alone. Or we take charge. Or we get dramatic and emotional. Or we go all rational. Or shut down. Or have a beer. Or work overtime. Or pick on someone. Or pick on ourselves. Whatever our conditioning is, we do it, and so we create the same kinds of experiences. My dogs always chase a cat if it comes into the yard, and always excitedly go eat when someone comes into the house. It’s automatic, and they don’t have a choice.

Most people come to therapy because they are tired of the same old experiences, like anxiety, inhibition, depression, isolation, or confusion. Or they are tired of the same old reaction or habit, like an addiction, or anger outbursts, or holding back, or retreating. In the end this is going to mean that they want more choices.

This might not always be so clear at first. Rather than thinking about ourselves, lots of times we just want the world to be a different place. Then we’ll feel more comfortable, then we’ll have more options. If my spouse would just be more reasonable; if the winter were not so long, if people would just leave me alone, if my boss were more understanding, if I had more money…

Sure, our circumstances affect us. But how do we respond? And how can we learn to respond out of our adequacy, not inadequacy; out of confidence rather than fear; more out of love and not so much from containment? How do we respond when we are disappointed, when someone is critical? When we are on our own? How can we learn to respond effectively and creatively when the going gets rough, not ineffectively or habitually?

Therapy, and mindfulness, help us to answer these questions. If we are paying mindful attention to our experience while it is happening in a session, we will see the old stuff playing out right in front of us, right here and now… and we can interrupt it and try something new. So this time, we accept a hug, or take a rest, or go into relationship, or whatever is called for. And then by mindfully trying out some new response , and moment-to-moment seeing what comes up (feelings, thoughts, beliefs, impulses and so on), we get to see where we stop ourselves from living, feeling, behaving as fully as we might.

And then, unlike my dogs, we get to consciously move beyond limiting feelings, beliefs, and habits. So the next time a cat comes into the yard, we can decide – is this the best time to chase it? And if it is, we get to really enjoy it, without having to hold back somehow!

Brian Grady, Ph.D.

Dr. Grady is a psychologist and Certified Hakomi Therapist. Hakomi is a psychotherapy method which relies on mindfuless as described in this article.

Can you relate to this?

I, together just about everyone I know, learned:

  • Be sensible

  • Be practical

  • Take risks if you must, but make sure they are not too big and are well researched.

  • Consider security. Pay up your RSP. Choose work has good chances for employment. Don’t leave a good paying job.

  • Pay your dues; then you can do what you want sometime later in your life.

  • Don’t raise eyebrows. Unconventional choices lead to suffering. Act responsibly.

  • You need to be able to justify with reason your choices. Intuition and feeling are a weak basis for important decisions.

  • The paths to personal and work success are well known. There are effective formulas for living. Follow them and succeed.

Clichés often become clichés because they are true, useful, and obvious. These lessons are not bad ones. Some truth sticks to them, like bread crumbs to a honeyed knife. They are hard to refute.

They are also incomplete. I recently talked with a man – a self-employed architect. He and his wife have 3 nice kids. He works incessantly, and in another cliché, smokes and drinks quite a bit. He’s got it all – a nice house (actually several nice houses) and lots of toys. He builds airplanes in his spare time with his brother. He’s a success, and all his family agrees. He also seems driven and inwardly miserable, for all that he’s a hilarious wise-cracker. Or so my intuition told me.

The heart’s longing is not always easy to define. In my case, almost never. Maybe yours speaks with a clearer voice. I know when my heart is longing, because what I’m doing does not satisfy it. But for what exactly? It’s like I get a glimpse out of the corner of my eye. Someone waved an arm northward. I’m supposed to go north. How far? Due north, or north-east? Silence. I see someone I admire, though, northward. I wonder what my life would be like if I lived like that…

The heart is also really not easy to hear. There is so much noise from other people’s opinions and examples. From past hurts and failures. From fear. Fear is the big deafener. Do I really want that, or am I just imagining something? Just dreaming. How much would I have to give up! I’ve invested years in safety, predicability. There’s no turning back now. My insurance is paid up.

I had to pay good money to have someone to teach me to dream again. To learn that my heart’s desire mattered. That it is possible to meet it. That it’s not clear cut how this happens, no matter what the books and conventions say. That hunches are wheels, and trust is an engine. And that daring is the fuel.

My dreams are not huge, but they, and my heart’s longing, are the source of my love and my life. I can’t turn totally away. I’m going …north-ish.

How about you? I dare you.

Brian Grady, Ph.D

LIVING WITH CHRONIC CONDITIONS: Beyond Survival.
by Brian Grady, Ph.D.

“There is nothing more we can do; you will just have to learn to live with it”. This is the message heard by many people suffering a chronic condition – chronic illness or pain. Medical treatment has not fully resolved the problem. The patient’s question remains: “But HOW do I live with this?”

The answers are not easy, but they exist. As people learn to adjust to a new life, priorities often change, and some old attitudes and habits will shift. Meanwhile, learning a set of well-understood coping strategies makes a chronic condition manageable. Life can be rewarding again.

Recognizing the various problems that come with a chronic diagnosis is a start for the patient and their caregivers. While some of this depends on the condition, there are common emotional, behavioural, social, physical issues facing people with chronic pain or illness. These are all interconnected.

Mood changes, such as depression, anxiety, or anger result from disappointed hopes for a cure, difficulties with medical systems or insurance, loss of ability to do valued activities in work, sports, hobbies, or family life. Some people go through a stage of grieving the person they were and the life they had. Behaviour and social changes that go with this might be withdrawing socially and becoming less active.

Some people become more dependent; others insist on trying to do things the way they used to, regardless. It can be tough on everyone, and families usually feel some stress. A spouse may have to take on much more of the family’s responsibilites and chores, while also providing practical and emotional support for an ill partner. Marital strain may result.

Physical changes result from the condition, and also from the changes in behaviour and mood. These often involve sleep problems, weight change (more or less), fatigue, loss of strength, flexibility and endurance. Medication side-effects also play a role in physical changes.

Clearly, learning to “live with it” involves much more than just managing symptoms. The condition is a rock dropped in a pool of water. Ripples wash across the pond, and nothing remains the same.
The person who is ready to learn to “live with it” will be helped by making positive decisions about themselves, their life, and their relationship with the condition. Here are some suggestions – ten resolutions – that can help people learning to cope with their changed lives. Those who make these resolutions their own stand a good chance of thriving, not just surviving.

10 Resolutions for people managing chronic pain or illness:

1. RECOGNITION: I realize that my condition has not been completely cured or resolved by medical treatment, or the force of my will, by waiting, other sources of help, or by deciding it’s not important. I am prepared to recognize this and move in a new direction.

2. POSITIVE APPROACH: I recognize that I need a positive relationship with my body and symptoms. I am learning positive ways to live with this condition.

3. LETTING GO: I let go of parts of my past life that are over. I may grieve what is lost, but I am committed to living well with what is.

4. SELF-ACCEPTANCE: I accept myself and forgive myself for having had difficulties. I recognize that I am human, and have human limitations like everyone.

5. BUILDING RELATIONSHIPS: I build or heal my relationships with others.

6. NO BLAME: I forgive anyone I have blamed for my condition or for mistreatment.

7. RECOGNIZING HABITS: I acknowledge any old habits that do not serve me or my condition, and am willing to develop new, healthier ones.

8. ACKNOWLEDGING RESISTANCE: I acknowledge ways I am held back – by myself, by others, by fear, or by reinforcement for staying where I am.

9. INDEPENDENCE: I understand how I can become dependent in unhealthy ways — on people, on medications, drugs, alcohol, on organizations, on objects, on ideas. I am willing to release these things and regain my power and control over my life

10. TAKING IT FORWARD: I am ready to make positive choices and to see them through. I am open to new ideas and ways of living. When I have made these changes part of my life, I can also help others.

Brian Grady, Ph.D. is a registered psychologist in Victoria, BC who has been working with people with chronic health problems since 1992.

last edit: 12 June 2008

Summary of Pain Management Techniques – Brian Grady, Ph.D

Technique What Purpose Effect on symptoms When How long
1 Diaphragmatic breathing Deep and slow breathing, using the belly. Physical Relaxation

Calming

Pain reduction

Pain tolerance

High pain

High stress

Can’t sleep

Tension

During activity

While stretching

5 to 25 minutes, daily

Duration of high pain episode

2 Activity pacing Alternate difficult and easy activities Prevents pain flare-ups while increasing productivity Preventive

Conserves energy

Any task Duration of task.
3 Persistence / non-avoidance Keep doing an activity Learn not to let pain control activity Neutral When continuing will create no long-term problems While symptoms are manageable
4 Thought stopping Noticing persistent negative thoughts, halting them, and changing focus Calming

Decrease worry

Neutral Can’t sleep

Worry, uncertainty

10 seconds, repeated as needed
5 Sensory transformation Feel “itching”, “pressure”,”heat” or “numbness” instead of pain Makes sensations more bearable Pain tolerance Moderate to high pain 10 to 25 minutes
6 Progressive muscle relaxation (active) In sequence, tense, hold, and then release muscles with an out-breath Physical relaxation

Calming

Pain reduction Any level of pain

Emotional distress

Can’t sleep

Tension

Too tired to concentrate on another relaxation method

5 to 25 minutes
7 Progressive muscle relaxation (passive) In sequence, be aware of muscle groups, and soften with an out-breath Physical relaxation

Calming

Pain reduction Any level of pain

Emotional distress

Can’t sleep

Tension

5 to 25 minutes
8 Peaceful imagery Use all the senses to experience or recall a peaceful experience Physical relaxation

Calming

Pain reduction Any level of pain

Emotional distress

Can’t sleep

Tension

When able to concentrate

5 to 25 minutes
9 Be with pain Non-resistance. Don’t fight it. Just let it be there. Makes sensations more bearable

Reduces distress

Pain tolerance Any level of pain Any length of time
10 Self-hypnosis (imagery, counting) Deeply relaxed, absorbed in what you experience, while open to what may happen as you use images and suggestions for healing Pain relief

Calming

Relaxation

Building confidence

Making behaviour changes

Pain reduction Any level of pain

When able to concentrate

10 to 25 minutes
11 Quick-cued relaxation / debracing Using a cue previously connected with the relaxation response to relax quickly Relaxation

Calming

Pain reduction

Pain tolerance

Any level of pain

Stress

2 to 5 minutes
12 Defusing negative emotions Notice negative emotions building, and short-circuit them early Calming

Makes sensations more bearable

Pain tolerance As soon as stress begins to build 1 to 10 minutes
13 Exercise Strengthening

Stretching

Fitness

Build fit, flexible, strong body Long term pain reduction Daily routine 30 to 60 minutes
14 Biofeedback Getting feedback about a body function helps you control it Gain control over tension, breathing Long-term Pain reduction In office with clinician

Thermal: on own, daily routine, as part of relaxation practice

10 to 20 minutes
15 Stretching Stretching muscles, joints Relieve tension

Improve flexibility

Pain reduction (immediate and long term) Daily routine

With increases in pain

When tension is noticed

Before activities

2 to 20 minutes
16 Distraction Put mind on something other than symptoms Reduce distress, pain awareness Pain tolerance Any pain level

Can’t sleep

As long as necessary
17 External focus Focusing on environment around, not body Reduce distress, pain awareness Pain tolerance Any pain level As long as necessary
18 Positive self-talk Coaching oneself through stressful experience Reduce distress, improving coping Pain tolerance Moderate to high pain

Stress

Can’t sleep

As long as necessary
19 Cognitive rehearsal Preparing oneself to cope before a situation Reduce distress, improving coping Pain tolerance Before possibly painful or stressful experience. 5 minutes
20 Posture correction Maintain balanced posture and gait (walking pattern) Relieve tension and fatigue Pain reduction long term Daily, frequently. Ongoing.
21 Pressure point release Press classical acupuncture points Release tension

Increase energy

Calming

Pain reduction Tension

Pain

Can’t sleep

15 minutes
22 Micro & mini breaks 3 second to 30 second breaks in activity Release tension

Conserve energy

Re-establish circulation

Preventive During activities. Micro breaks every minutes, mini breaks every 5 minutes. Duration of activity

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