Our free Telephone Emotional support service enables you to discuss any concerns you may have around transplant with a team of wellbeing specialists from Working To Wellbeing. It’s also available for family members, and you can also get advice on recovery, returning to work and physical activity.
In our latest blog Dr Julie Denning, a Chartered Health Psychologist and Managing Director of Working To Wellbeing, reflects on the importance of both physical and mental health, and how small actions can have a big impact.
It sounds easy doesn’t it? ‘Look after yourself’, ‘take care of yourself’, ‘don’t over do it will you?’ Before, during and after a stem cell transplant, you can be often told these statements. These are common statements that are made to ensure that our physical and mental health needs are met. But whilst they sound helpful and kind, they are remarkably broad in their reach. What does ‘looking after myself’ look like in practise? ‘What does ‘don’t overdo it?’ actually mean?
People make their own interpretations. For example, some of my patients report the cultural bias of a ‘stiff upper lip’ and the need to ‘just get on with it’ as ways of looking after themselves and coping. I have heard the’ Dunkirk spirit’ mentioned more than once. They also tell me they need to do 10,000 steps or do 150 minutes of exercise each week, also methods of ‘looking after themselves’.
However, a lot of the time they actually feel that their upper lip feels a bit more jelly like or that walking 10,000 steps feels like climbing Mount Everest. So perhaps they haven’t been looking after themselves?
It can get a bit confusing.
To start to iron out the confusion, it can help to know that our mental and physical health are intertwined. The first director of the WHO, Dr Brock Chisholm, stated that ‘without mental health there can be no true physical health”. If we know this, then we have a good starting point for looking after ourselves.
Taking the example of going for a walk, in getting ourselves ready, we will have moved our bodies to get our coat, hat and shoes on, thereby enabling physical health. We have had the courage to step outside of our homes enabling our mental health. Once walking we continue to feel the benefits from both perspectives. Our bodies start to relax into the movement of walking, our shoulders drop and our breathing regulates. Our minds start to switch their focus: onto passing cars, bird song and on other people out for a walk.
By the time we get back from our walk, however long it was, we feel better going back into our home than we did coming out of it. In this example, going for a walk equals ‘looking after yourself’ and so long as you walked a distance you were comfortable it also ticks the box of ‘not over doing it’
So far so good.
But let’s drill down a little further into the mental health side of things. In the example above, you will feel better about yourself getting out of the house if you say to yourself ‘it feels really hard getting out of the house today, but I know I’ll feel better when I’m out’. But if you say to yourself, ‘what’s wrong with you? We’re only going for a 5 minute walk, why even bother? You’re more likely to feel fed up and may not bother.
Compassion is the key here. Be kind to yourself. The thing is though, what does ‘being kind to myself’ actually look like? It feels a bit abstract too doesn’t it? But for a moment, reflect with me: How often do you say to yourself ‘don’t be stupid’, ‘you’re being ridiculous’, ‘I should have known better / done better / been better’.
How does it feel reading these words? If someone else said them, would you shout, ‘stop being hard on yourself!!’. Compassion and self-soothing start here. So next time, question yourself: Are you really stupid and ridiculous? At the time could you have known better? Could you have done better? Could you have been better? Probably not. You likely did the best you could in the circumstances. And… So what if you sometimes made a mistake? Aren’t we all human after all?
What if we focus beyond words though? What about kind actions? When was the last time you put some time aside for you? Made a decision that put your needs first? Said ‘no thanks’, because you know it’s not good for you to say yes? Doing these things is important. It is making sure you meet your needs too. These are not selfish actions. They are kind ones.
Let’s talk about your physical health too. So, if we’ve started to work on the mind, let’s look at the other half of the partnership, your body. We want to make sure that it is stretched but not pushed. Looking after our physical health needs just as much attention, exercise is medicine after all, but it also needs just as much kindness.
To put this more directly, if you’d struggle to run for the bus why would you put yourself under pressure to run 5k? It is important to keep your body moving, as much as you are able to, and to gradually build up your strength and stamina over time. Pacing is key to this process. You need to let your body gradually acclimatise to increasing amounts of activity and exercise. You will then start to reap the rewards of feeling less fatigued and having more energy.
It sounds a bizarre piece of advice, but make sure you stop before you get tired, don’t push yourself to squeeze every last drop from a good day. Instead, enjoy feeling good and the satisfaction of knowing you have done a little more today than you did last week.
Intertwined with mental and physical health is something that is not always addressed but in my experience has always been on people’s minds. Occupation or Work. Work provides us with structure, with normalcy and with a sense of self. It also involves the strength of our bodies and the efforts of our minds.
We find that people recovering from cancer don’t always have the opportunity to talk about work, but it is on their minds and they are concerned for their bodies in getting back. In the spirit of this blog, focussing on the health of your body and mind, I would urge you to talk about work: with your friends, your colleagues, your line manager and your clinicians.
Get the conversation going, if you want to get back or want some help staying at work support is there for you.
So, on reflection, mental health and physical health depend on each other, compassion is essential and pacing is a core activity. Putting all these ideas together will help you on your road to recovery after a life-changing event such as a stem cell transplant and you will be well on the way to ‘looking after yourself’.
If you would like further info on our Telephone Emotional Support Service, or any of the support we offer to patients and families, contact us at patientinfo@anthonynolan.org or call our helpline on 0303 303 0303.