Chronic Illness and Mental Health (Part 2)

This is the second in a series of blogs contributed by our PM clinician Andrea Rawson,  who will introduce you to mental health issues associated with chronic illness.  She will explain how psychotherapy can help families maintain resiliency and thrive while supporting their loved ones during their journey.  Andrea has two practice locations in the GTA and provides access to collaborative care with PM psychiatrists via the Psychotherapy Matters Virtual Clinic (PMVC) for her clients.

When pain becomes chronic it also becomes a complex physical, emotional, psychological, and relational experience. People often deal with this in one of two ways.

On the one hand, they completely give up hope that there is any help. This is often a valiant attempt to save themselves from any further disappointments. And is especially true when there is a history of consulting with a variety of health practitioners and attempting a number of therapies with no significant success.

On the other hand, there can be a determined commitment to finding the one magic treatment that will cure the pain forever. Here people are deeply committed to finding help and hope. They pour significant energy and resources into consulting one specialist after another never really getting the relief they long for. Their days become organized by treatment protocols and researching the next or newest treatment modality as a way to keep despair away.

Somewhere in the middle, there is a “sweet spot” where there is some room for practices that reduce the pain, and also acknowledgement that pain may never completely go away. Finding a place in the middle of these extremes allows people to focus on improving their quality of life, returning to activities they once enjoyed, and becoming participants in their life again.

Finding things that work for you will be as individual as the person you are. Here are four ideas taken from a thoughtful, comprehensive, and compassionate book by Peter Levine and Maggie Phillips (see information about this resource below).

These four practices are just a sampling and are offered to open up possibilities rather than a prescription or quick fix. I’d invite you to consider them with curiosity and experimentation to see if they may be a helpful addition to your self-care.

4 Psychotherapy Practices for Dealing With Chronic Illness

1) Keep a Pain Journal

Rate your pain from 0 (no pain) to 10 (worst pain) daily for a good chunk of time (maybe a month or two). This will help you get an objective sense of what is going on with your pain, how it ebbs and flows and what might trigger it. Objectivity is very difficult to obtain when dealing with chronic pain and this practice can be a tremendous gift to yourself.

2) Re-inhabit your body

 One common side effect of living with chronic pain is to ignore, numb out or dissociate from the sensations of your body. This makes perfect sense as a way to cope with pain; however, this strategy makes you lose connection to good feelings and sensations. Paradoxically, all you are left with is the pain. Re-inhabiting your body means that you intentionally start noticing those parts of your body that are not in pain.

3) Circle breathing

This exercise uses breathing and imagination to help you connect to parts of your body that are not in pain. Start by getting relaxed and taking a few deep breaths. Next, notice the most comfortable parts of your body (for example, maybe the right side of your body is in less pain than your left). Now using your imagination, imagine that as you breathe in, your breath is actually coming into your body from those comfortable parts. And as you breathe out, imagine the breath has moved through your body and is being exhaled from the painful parts of your body (I know this is not possible physiologically, but just use your imagination). Continue to do this for a few breaths and notice if there is any shift in your body sensations. Finally pretend that your breath is a magnet picking up the most comfortable sensations as you breathe in and releasing those comfortable sensations into the parts of discomfort as you breathe out.

4) Move just a little bit 

Another side effect of chronic pain is a reduction of movement. When we are not able to move with ease, anxiety can result. The anticipation of pain when we move or the worry of not being able to do our daily tasks are both very anxiety provoking. Under the influence of anxiety we either “freeze” (stop moving) or “fight” (by pushing through the pain in order to finish the task). Freezing leads to less movement and fighting leads to further injury and burn out. Instead, try to find another “sweet spot” between these two extremes by moving “just a little bit” with gentleness and awareness taking breaks when needed. This approach will help with regulating your nervous system’s “freeze” or “fight” response that gets you stuck in the vicious cycle of pain and anxiety.


Freedom from Pain: Discover your body’s power to overcome physical pain by Peter A. Levine and Maggie Philips.

The views expressed in these blogs are the author’s own and not necessarily reflective of those of Psychotherapy Matters.  Information provided here and anywhere else on is for learning purposes only and should not be used to guide treatment of clients/patients. Copyright © 2017

Andrea Rawson
Andrea Rawson, Registered Social Worker

Andrea has over 10 years experience in working with individuals, couples and families in the greater Toronto area. She is a registered social worker with the Ontario College of Social Workers and affiliate member of the Ontario Association of Marriage and Family Therapy. She has practiced therapy in a variety of places including private practice, children 's mental health agencies, and internationally in a diverse cultural setting. She has a particular interest working with families touched by medical concerns, disabilities, special needs, emotional issues, and the everyday stresses of family life. What she appreciates about her work is that it allows her to walk with people through difficult times and help them find the hope that things do get better. Visit her website for more information.

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