"I`m not okay, you`re not okay and that`s okay."

for caregivers
Judi Maguire, Parent Partner at Wayside Youth and Family, NAMI Basics
and Family to Family teacher, NAMI Connection and Family Support
Group facilitator.
Marla Lynch, Simmons College, Professor of Nursing, clinical specialist in
adult mental health nursing
Katie Hunsader, moderator, NAMI Mass, Criminal Justice Project Assistant
The 3 R’s
Watch for the warning signs of stress
Manage stress and seek support
Take care of your physical and emotional health
Recognize signs of stress
Recognize signs of stress
Stress is a normal response to things that make you feel upset or in
danger, whether real or imagined.
When you are confronted with a stressful situation, your body senses
danger, and kicks into the “fight-or-flight” reaction, or the stress
The stress response is the body’s way of protecting you.
But for those who are constantly stressed out, due to trying to balance
caregiving with work, children, money issues, fatigue and getting
services, stress stops being helpful and starts causing major damage to
your health, your mood, your productivity, your relationships, and your
quality of life.
Recognize signs of stress
Sleep Problems
Muscle Tension
Seeing only the negative
Eating too much
Recognize signs of stress
Stress can also cause physical symptoms
Muscle Tension
Stomach Problems
Aches and Pains
Chest Pain
Long-term stress can lead to high blood pressure, suppression of the
immune system, heart attacks and strokes and speed up the aging
Recognize signs of stress
70 – 90% of all illnesses are stress related
Reverse – manage stress and seek support
Reverse – manage stress and seek support
Learn about your situation – you’ll feel empowered
Go to the library
Attend a NAMI class: Family to Family or BASICS
Join a chat room
Contact illness specific non-profit organizations
Attend conferences and seminars
Build a support network
Reach out to family and friends
Attend support groups
Join in – Go to the YMCA, church groups, book clubs
ASK FOR HELP – Asking people for help is a gift from you to them
Reverse – manage stress and seek support
Set Boundaries
Learn to love the N word
Reverse – manage stress and seek support
Spirituality in the Recovery Process
Holistic Health Care:
mind – body - spirit
Spirituality is a key aspect to the recovery process for
individuals and their families and important in
cultivating resilience in coping.
My goals today are to:
1. Highlight the importance of spirituality
2. Summarize current research
3. Give you some practical tips to enhance the spiritual
aspects of your everyday life.
Questions in the journey of life…
• What is my life’s purpose?
• What is meaningful to me?
• How can I get beyond my
upsetting, and painful
• How can I find comfort,
sustenance, relief and recover?
• What offers me hope? A way
Spirituality definitions…
“Spirituality is the personal quest for understanding
answers to the ultimate questions about life, about
meaning, and about the relationship with the sacred or
transcendent, which may (or may not) lead to or arise
from the development of religious rituals and the
formation of a community.” (Harold Koenig, 2000)
“Spirituality is concerned with meaning and purpose,
love and harmonious relationships, forgiveness,
trust, sources of hope and strength, expressions of
personal beliefs and values, and the expression of
the concept of God through spiritual practices.”
(McSherry, 2006)
Spirituality matters!
Almost 90% of Americans describe themselves as religious or spiritual.
(Adler, 2012)*
92% of Americans believe in God or a higher power
50% of Americans state that religion/ spirituality is “very important” in
their lives.
(Gallup Poll, 2011)*
50% of patients receiving medical and psychological care wish to
discuss spiritual matters with their health care providers.
(Rose et al., 2000, 2001)*
49% of Americans report that they use prayer to address their own
health concerns.
(Wachholtz & Sambamthoori, 2011)*
*Lake, James, (2012).“Spirituality and Religion in Mental Health: A concise review of the evidence.”
Psychiatric Times,March 2012.
Religion/ Spirituality is a complex topic. (R/S).
Professional caregivers tend to avoid it.
Science based priorities have been on establishing the
biological roots and explanations of mental illness.
These scientific advances have helped ease the myths
and stigma of mental illness.
The latest research suggests that the “relaxation response”,
meditation, quiet time contemplation, prayer, and yoga
all offer similar neuro-physiological health
benefits! * (Lake, J., 2012)
Herbert Benson, MD
"The relaxation response is a physical state of deep
rest that changes the physical and emotional
responses to stress... and the opposite of the
fight or flight response.“
Promoting Health
One small health promoting practical step is to add a daily
“relaxation response” or meditation or a quiet,
contemplative time.
Let’s try this now…
There are multiple health
benefits . . .
o calmer physiology
o focused aware mind
o relaxed peaceful emotional state
o spiritual contemplation, renewal and hope
o allows you to bring an attentive, caring presence to
the relationship arena
These are the areas in our lives where stress may
o Physical
o Cognitive
o Emotional
o Spiritual
o Interpersonal
Your Body
Be aware of your sleep, diet, exercise & rest patterns.
When we pay attention to the messages our body sends us,
we can adjust our plans and priorities more readily.
Remember the more adjustments or changes in your life,
the greater the risk is for physical symptoms of stress.
Your Mind
Try to be ‘mindful.’ Stay in the present.
Consider establishing a meditation practice.
This may allow you to become more centered in yourself and
Be aware of your thought patterns.
Try creative visualizations…
Try reframing. Is there is some new learning amidst your
current dilemma or upset?
Your Emotions
How do you find solace?
How do you nourish and renew yourself?
Do you have some alone, quiet time each day?
What are your creative passions? Hobbies?
“Loneliness is poverty of self,
solitude is richness of self.”
~ May Sarton
You may want to consider keeping a journal.
Pray when you can, in whatever form you choose.
The deportment of prayer is one of receptivity and
Try to see the wonder and beauty in everyday & in ordinary
Cultivate ‘Flow’
You may not be able to attend to your planned agenda…
Allow yourself to relinquish control…
Allow yourself to be spontaneous…
Be in the present moment, where ever you are.
When we cultivate an attitude of gratitude we may
become appreciative for what we have, our talents, our
resources, moments of thankfulness, happiness and joy.
Interpersonal Realm
Stay connected to others…
Remember: everyone has vulnerabilities.
Try to be kind and compassionate.
Try to avoid judging yourself and /or others.
“What is the most loving thing I could do right now?”
Moving Forward with
Positive Intentions
If you have lingering regrets, hurts, anguish,
disappointments, or have suffered betrayals and losses…
Proactively consider your path forward to peace and
resolution by letting go, forgiving yourself and others.
If necessary, ask for forgiveness.
Your new and renewed self
Do you have a vision of yourself 1 year from now?
Do you have a vision of yourself 5 years from now?
Are you role modeling the person you want to be?
What adjustments would you like to make?
Favorite Quotes
“All life is suffering.”
[Buddhism concept ‘dukkha’: Also impermanence or change, and interconnectedness.]
“The purpose of our lives is to be happy.”
~ Dalai Lama
“Follow your bliss.”
~ Joseph Campbell, American expert in comparative mythology & comparative
Resilience – look after yourself
Develop emotional awareness
Recognize your moment-to-moment emotional experience
Handle all of your emotions without becoming overwhelmed
The Dalai Lama is really good at this.
That’s why he looks happier than you or me!
Resilience – look after yourself
We are motivated by our emotions
Emotional awareness allows us to, understand our behavior, manage
our emotions and accurately “read” the wants and needs of others
Make friends with all your emotions
By avoiding emotions we dislike, we distance ourselves from
emotions we do like.
We can overcome loss and great challenges, but only if we
retain our ability to experience joy.
Resilience – look after yourself
Create a “worry period.”
You can’t stop worrying but you can limit it!
Choose a set time and place for worrying. It should be the same every day During
your worry period, you’re allowed to worry about whatever’s on your mind. The
rest of the day, however, is a worry-free zone.
Postpone your worry. If an anxious thought comes into your head during the day,
note it down. Go over your “worry list” during the worry period. If the things on
your list are still bothering you, allow yourself to worry about them.
As you develop the ability to postpone your anxious thoughts, you’ll start to
realize that you have more control over your worrying than you think.
Resilience – look after yourself
Challenge Automatic Negative Thoughts
Resilience – look after yourself
Watch for Cognitive Distortions
All-or-nothing (polarized) thinking
I’ll never get this right
Mind reading
I know she thinks I’m fat
I’m late. I’m going to lose my job!
Control fallacies
Why aren’t you happy? Is it because of something I did?
Fallacy of fairness
It’s not fair. She can eat as much as she wants
Emotional reasoning
I hit you because you made me mad
I really screwed up. I’m so stupid!
Resilience – look after yourself
Laugh or else
“Your sense of humor is one of the most powerful tools you have to
make certain that your daily mood and emotional state support
good health.”
Resilience – look after yourself
Laugh at yourself. Share your embarrassing moments. The best way to take
yourself less seriously is to talk about times when you took yourself too seriously.
Look for the humor in a bad situation, and uncover the irony and absurdity of life.
Surround yourself with reminders to lighten up. Keep a toy on your desk or in
your car. Put up a funny poster in your office. Choose a computer screensaver
that makes you laugh.
As you go to sleep think of the good things that happened in
your day. You’ll find one and sleep better.
Resilience – look after yourself
Eat Breakfast - Drink fruit juice instead of coffee
Stop trying to multitask - Do mini relaxation exercises
Do little things to make your environment more relaxing
Celebrate your birthday - Find the funny
Ignore the news – filter your calls
Allow extra time for appointments - Relax while driving – no need for ‘road rage’
Resist the urge to judge or criticize – Be kind – Say hello with a smile
Special Thanks
Anne-Marie Barron PhD, RN, PMHCNS-BC
Associate Professor
Associate Dean for Undergraduate Curriculum and
Student Affairs
Simmons College School of Nursing and Health Sciences
Clinical Nurse Specialist and Faculty Nurse Scientist
Massachusetts General Hospital
Reverend Bonnie-Jean Casey
Simmons Chaplain
Simmons College
Baetz, M. & Toews, J. (2009). “Clinical implications of research on religion,
spirituality, and mental health”, The Canadian Journal of Psychiatry, May,
Bassett, H., Lloyd, C., Tse, S. (2008). “Approaching in the right spirit:
Spirituality and hope in recovery from mental health problems”,
International Journal of Therapy and Rehabilitation, June,15:6.
Clarke, J. (2010). “Body and soul in mental health care”, Mental Health,
Religion & Culture, Sept. 13:6.
Cooke, C. (2012). “Pathway to accommodate patients’ spiritual needs”,
Nursing Management, May, 19:2.
Grafton, Gillespie, & Henderson, (2010), “Resilience: The power within”,
Oncology Nursing Forum, Nov, 2010, 37:6.
Hadzic, M., (2011). “Spirituality and mental health: Current research and
future directions”, Journal of Spirituality in Mental Health, 13:223-235.
*Lake, James, (2012).“Spirituality and Religion in Mental Health: A concise
review of the evidence.” Psychiatric Times, March 2012.
Ledger, P. & Bowler, B. (2013). “Meeting spiritual needs in mental health
care”, Nursing Times, Feb 28. www.nursingtimes.net.
References continued . . .
Lindridge, A. (2007). “Spirituality matters”, Mental Health Today, Dec 2007.
Lloyd, C., & O’Connor, C. (2007). “Integrating spirituality into mental health
rehabilitation”, International Journal of Therapy and Rehabilitation, April, 14:4.
Melvill, G, Chang, D, Colagiuri, Marchall, P., & Cheema, B. (2012). “Fifteen minutes
of chair-based yoga postures or guided meditation performed in the office can
elicit a relaxation response”, Evidence-Based Complementary and Alternative
Medicine, Vol. 2012, Article ID 501986.
Rosmarin, D., Wachholtz, A. & Ai, A. (2011). “Beyond descriptive research:
advancing the study of spirituality and health”, Journal of Behavioral Medicine,
34: 409-413.
Sternthal, M, Williams, D., Musick, M., & Buck, A. (2012). “Religious practices,
beliefs, and mental health: variations across ethnicity”, Ethnicity & Health,
Feb/April, 17:1-2.
Walsh, J. (2012). “Spiritual interventions with consumers in recovery from mental
illness”, Journal of Spirituality in Mental Health, 14: 229-241.
Wilding, C., Muir-Cochrane, & May, E., (2006). “Treading lightly: spirituality issues
in mental health nursing”, International Journal of Mental Health Nursing, 15,

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