Techniques to Help Us Make Changes

In 1995, I wrote an article called Changing Your Life By Conserving Energy. In it I listed three techniques from an article by Sybil Kohl. Her techniques help me to make healthy choices and prevent further pain and weakness. Since then I have discovered several more that work for me. Kohl [1] suggests three techniques that we could use to help ourselves make changes. These are push to avoid pain, blank pad, and plain talk.

The push to avoid pain system acknowledges the amount of energy that we must generate in order to reduce our activity level. It is a statement of action, not of failure or backing down. It means that we are dedicated to taking care of ourselves. Other people, obligations, and commitments will be prioritized according to pain thresholds and those actions that reduce pain. To delegate is action; to use nighttime oxygen or respiratory equipment is an action with enormous consequences; to retain authority in a seated position requires great assertiveness. Taking care of ourselves is not giving in but rather a restatement of control. The pain will not control us, we will control the pain.

The blank pad method of documenting accomplishments during the day reinforces a sense of purpose. Instead of making list after list of things to be done and then crossing off what has been completed, use a blank pad to record all you have done. It is a great training exercise for developing awareness of all the energy expenditure that does occur. It also saves us from devaluing ourselves for that which was not done. The goal is to avoid negative feedback at the end of the day and replace it with positive feedback.

Plain talk was developed in response to people asking how to keep themselves and others from feeling manipulated. If someone does not respect a simple "No" in response to a request, we may have to ask, "Why do you want me to be in pain, more tired, overextended, not able to enjoy our time together, etc.?" We need to practice simply worded responses that will increase the other person's awareness of the impact of their requests without creating defensiveness.

Three more techniques that I have found very useful are meditation, working to time and taking care of myself first.

Don’t just do something; sit (or lie) there. I need to rest regularly. For me, setting aside a couple of 15 or 20-minute times a day to rest seemed like giving in but setting aside a couple of 15 or 20-minute times a day to meditate felts like doing something positive for myself. I can meditate in any position. If I fall asleep while meditating lying down, I don’t feel I have failed, I realize I probably needed the rest. I started with concentration meditation and worked up to insight meditation. I take my breaks and I’ve added a new facet to my life.

Often I find myself worn out before a job is done but push ahead to finish it. Working to time helps me to feel a sense of completeness even if I don’t get the whole job done. If I start an activity with a plan to work for 20 minutes, I can feel I have accomplished what I set out to do when I have worked for 20 minutes. I need to set an alarm to keep track of the time while I are working. If I pay attention to my fatigue, I also learn just how long I should stay at an activity.

Take care of myself first. At first glance this seems selfish. Shouldn’t we take care of each other? We do need to take care of each other but if I care first for someone else, I am putting my attention on something over which I have no control. I experience worry, stress and anxiety. The only person I can control is myself. I am the most qualified to care for myself. On an airplane, when the oxygen masks drop down, we are told to secure our own masks before trying to help the child traveling with us. We are taking care of ourselves first. In a stressful situation, I try to stop, identify and manage my needs. When I am able to do this, my family appreciates not having to guess what I require. If I deal with my problems, they don’t have to.

Energy conservation helps us feel better and do more with less. As we continue to change physically our old coping strategies may not work. We are responsible for what we do. When we are clear about who is responsible for our activity we have the power to master it. Only we can make the decision to take control and take care of ourselves.

Kohl SJ. Emotional Responses to the late effects of Poliomyelitis. In Halstead LS, Weichers DO, eds. Research and Clinical Aspects of the Late Effects of Poliomyelitis. White Plains, NY: March of Dimes Birth Defects Foundation; 1987:135-143

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