Since the official day of lockdown on 23rd March, 2020 and the strict measures that were introduced into the UK there has been a huge shift in the way people behave. The measures have been referred to as draconian which would indicate ridiculously harsh but strictly speaking this is not accurate as it has been necessary to limit the Coronavirus temporarily. It’s been a rollercoaster of emotions for most people I have spoken with and with it being eased today Monday 4th July, 2020 I am reflecting on the past few months and how it has some parallels with managing a chronic pain condition which at times can also feel draconian and with no foreseeable respite.
As large parts of the economy re-open and people can see their family again life starts to resemble “normality” and this has come at a crucial time to people who have been feeling incredibly isolated. Loneliness and social isolation are closely related and the enforced social isolation during lockdown have meant that many people felt the effects of isolation. Chronic pain sufferers are not strangers to this when facing flares/injuries and being isolated at home for periods that have lasted longer than lockdown. Loneliness is associated with higher emotional distress and it is has been reported to be felt most with the younger people during the lockdown being forced out of school and university and away from their peers. This is all too common with school children with chronic conditions hunkering down at home on a reduced school timetable and missing many social events alongside many hours spent travelling to hospital appointments. While there have been of course positive social effects of distancing during lockdown those who are learning new skills online, reconnecting with friends and family not everyone is as fortunate. The negative impact of loneliness extends to mental health and is a predictor of social anxiety and depression.
With chronic illness it has its ebb and flow of loneliness and its normal to feel isolated when you miss an event or if fatigue makes it impossible to even stay in touch with others from inside. It’s easy at these times to blame yourself, feel depressed and worry that your condition is making your life different from everyone around you. It can make you feel very alone and hopeless which is an existential feeling of aloneness. These feelings can become very circular and it is at these times we have to dig deep into our emotional toolbox to find our way through the flares. It is interesting as they are the same tools that a lot of my friends and family have now introduced to help them through the lockdown period and feelings of isolation.
Using mindfulness, meditation and Acceptance Therapy improves our wellbeing and reduce feelings of anxiety and depression which can be increased with periods of isolation. For chronic pain sufferers this is used regularly to manage symptoms and often unhelpful social beliefs because of the complexities of the perpetuating symptoms. Using Acceptance and Commitment Therapy we can be in the present moment with mindfulness and find acceptance and commitment to value- based living helping to improve our wellbeing.
During lockdown society has been fostering real connections with movements like #InThisTogether that have sprung up on social media, promoting unity and shared progress in response to an unprecedented threat and we see communities regain a stronger appreciation of each other and our shared humanity . Of course we aren’t all in this together as ethnic minorities for instance are disproportionately affected and domestic violence has risen worldwide . But what is transparent is the collective feeling of bringing everyone together and raising awareness and support for those that are affected more. Organizations across the world have risen to this with the Church and national initiatives capitalizing on ways of meeting productively online and the tech and human initiatives are combining to make online relationship-building more intimate and effective than ever.
During my time in lockdown in some small way for the community I have jumped on the bandwagon and built my own website and opened it up with a hope to build a network of support so that we can find improved movement practices to build strength reduce injuries/ flares. I also used this time to research extensively other movement therapies and qualified with a CBT and Meditation Teaching Diploma to utilise in the management of complex syndromes.
As a Pilates teacher during lockdown like many others we are faced with so many questions and fears - what are we if we aren’t a teacher, what is going to happen next, the frustrations of inadequate information, not having what you expect and living with a chronic condition these questions are all too familiar particularly when you are unable to leave the house with an injury or a flare.
On a personal level I felt I already had the resilience to manage this period but there were of course a lot more fears on a global socio-economic level to consider. My fears were high for my family in the Emilia Romagna region of Italy and their warnings to me of what we were soon to face had us shielding a week earlier than the official lockdown on advice from our GP. Hospital appointments were scheduled to phone calls and physiotherapy ceased which initially we were concerned about but we soon discovered that increasing our Pilates practice and using skills such as Meditation were effective.
Emotional stress will slow us down and I decided to introduce routine into the day and a sense of “normality”. We set a regular schedule to wake up at a regular time and took some interesting classes online. This was surprisingly really exciting as I could connect with fantastic teachers all around the world and we kept in touch with friends and family most days to encourage each other to discuss our emotions helping to validate and process it all. It was very similar to CBT therapy to manage chronic pain by setting a weekly routine to pace and setting realistic goals to succeed for building self confidence and value based living which included cooking, gardening and walking.
Zooming was a constant of course for work, school and connecting with friends and it was interesting how fatigue set in as you don’t pick up the normal social cues … “Zoom Fatigue” emerged and we gradually cut down on daily calls to friends and family to let our brains reset and focused more on connecting with nature on our ritualistic daily walks finding feelings of gratitude which were incredibly supportive to emotional resilience.
Impaired sleep was something too we experienced early on and this was nothing new with managing pain so understanding how too little affects the immune system I was quick to introduce sleep hygiene practices during the week ensuring an hour before bedtime no electronics were being used and replaced with either some gentle movement therapy, a warm bath or listening to soothing music.
Body scanning and Mindfulness Meditation were useful tools to decrease anxiety and induce sleep and when friends complained of poor sleep I was able to share my tips for easing insomnia - alcohol and caffeine avoidance included.
Mindfulness, a Buddhist tradition originating 2,500 years ago, is the quality of being fully present and for chronic pain sufferers this can be incredibly helpful in flares to manage symptoms. When our mind takes flight particularly with increased pain we lose touch with our body and become involved with these circular thoughts of pain and worries of the future so by bringing our attention into the present we can reduce the feelings of being overwhelmed. This is something that we used during the lockdown often to keep present in the moment and manage any stress.
Other technique used for managing anxiety were finding my personal “safe place” and this technique can be used any time of the day. It can be anywhere, a beach, a colour, a walk in the rain - somewhere you can go for a short time and come back. Finding a “happy place” is another useful tool and this involves picturing times of being happy, successful performances, pain free days and recalling the images, sounds, smells and re-experiencing it again improving self- confidence and our ability to manage emotions.
Also useful for insomnia and managing anxiety is journaling which consists of writing down thoughts including three feelings of gratitude and any “to do’s” for the following day. Gratitude has played an integral part in acceptance of living with a complex syndrome as well as being present in the moment to limit worry of what the future holds.
Daily walks in nature, cuddling the dog and making healthy food became our focus being present in these moments feeling gratitude and blessed to be able to have these things available to us. Pure gratitude was really threaded through every part of the day and our daily walks involved connecting with the local community and this involved waving and saying hello to the elderly in the village as well as taking on the role as a NHS telephone responder. We prepared daily healthy meals for my brother each day who is a Nurse to fulfil the drive to support people I get from being a Pilates Teacher. There has been a real sense of camaraderie through our village and hopefully offering assurance to those home alone that “we were all in this together”.
As a Pilates Teacher passionate about this method of movement and my daughter whose passion is theatre/dance we resonate very much on physical activity / achievement. In lockdown setting short term goals for the next day was really helpful before bed to encourage us to move around in the house as we were so used to finding a sense of achievement in our Pilates / Drama practice , i.e. cleaning the fridge, tidying a cupboard and having a healthy lunch - our bodies craved regularity, routine and a sense of achievement.
These small goals were carried through without perfectionism and which we could share with family and friends. Perfectionsim interferes with our performance and self confidence and this interestingly translated into lockdown where we had to work hard to tidy the cupboards without perfection and feel happy that we were doing enough in this time.
Emotions run everywhere in uncertain times and “taking your emotional temperature” is key to bringing them to some balance and they can run high with symptoms of worry, increased heart rate, fatigue and low with slow decision making and low concentration. When you find yourself imbalanced there is now so much support and you can reach help by calling a helpline, BBC Actionline offering a multitude of support helplines.
So, as the country emerges back into more normal activities perhaps these tools learnt and used during isolation are forgotten by many but for those managing complex health conditions they are used daily and remain our treasure box.
I am pleased and excited from this enforced time at home to have had the opportunity to build my online platform to connect with the wider community and to share my knowledge so that I can support individuals to practice Pilates daily for pain free movement, increased happiness and a positive mind - thus my studio has been appropriately named “Daley Pilates” ! I look forward to getting back to the studio to share my passion of the Pilates Method to bring about that shared humanity of We are in this together.
