Living with Mild Cognitive Impairment (MCI)

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May 11 11:37am

Day 6: Creating your Resiliency Roadmap

By Dr. Dona Locke, HABIT AZ Director, @DrDonaLocke

Road to Resilience

Healthy and helpful thinking vs. unhelpful thinking

Today is one of my favorite topics in our resiliency roadmap series! Thank you so much for joining me again. If today is the first day you are finding this series, I'd encourage you to go back and take a look at our Introduction to the series and then work you way through the other pieces of the roadmap (recognizing your personal signs of stress, recognizing situational factors that cause stress, identifying positive coping techniques you already use, learning diaphragmatic breathing, and learning other formal relaxation techniques) before coming back to this topic.

Heading into today's topic, I want you to keep in mind two difficult, but true facts of life: 1) there just is so much about the world that we CANNOT CHANGE and 2) WE ALL MAKE MISTAKES. Yes, you can use some relaxation strategies in these situations, but if you are diagnosed with a chronic illness or feel the depth of shame of something you wish you hadn't done, practicing relaxation will only go so far if you keep thinking how "awful, terrible, horrible" the situation is.

This is is why this is one of my favorite pieces of this whole series: Paying attention to the thoughts we tell ourselves is very helpful. Sometimes, we get stuck in the idea that something shouldn't be what it is.  For me, I tell myself that if I can just plan or problem solve enough, I'll fix it. Thinking we have more control than we do can lead to some unhealthy thinking patterns ("I'm a failure"), unhelpful behaviors (keep trying to plan/control the situation when it is not possible), and negative emotions (demoralization, guilt, anger, worry). Whew!

Our thinking affects our emotions and behaviors

"Our greatest weapon against stress is our ability to choose one thought over another." - William James

We all have a constant self-talk narration happening about the events around us. The narrative we tell ourselves affects how we feel and how we act. A simple, but easy to recognize example is traffic. How do you feel when you are stuck in traffic?  Nobody likes traffic, but there usually isn't anything you can do when it happens.  So, how can our thoughts impact our emotions when we are stuck in traffic? Here are two possible narratives we may say to ourselves:

  1. "All these people are idiots. Nobody can drive right in this town. I'm an idiot for not going another route or leaving earlier. I'm going to be late for dinner, and my friend will all think I'm a jerk and not want to be friends with me." Ok, that may be an exaggeration, but you can imagine even just one or two pieces of this thought chain would drive feelings of anger, anxiety, worry, fear, etc. OR
  2. "Oh man. Look at this traffic!  I'm going to be late for dinner, but I'll be sure to give my friends a big apology and explain what happened. I'd certainly understand if the shoe were on the other foot. Now, is there a song on the radio I really like?" Again, that may be an exaggeration, but I hope you can imagine that just one or two pieces of this thought chain would be more calming on the emotional state.

As another example, one of my coping techniques is planning ahead. Let's say I plan for a given situation, but there is something about a situation that I didn't anticipate and something doesn't go quite like I'd hoped. I can give myself two thought messages about that:

  1. "You are an idiot. You should have seen that could happen and be ready for it. You failed in your job as a parent/partner/psychologist". What emotions might I have after that thought chain?  Sadness? Guilt? Anxiety?  Defeat? And then, how might I act in the next situation?  I might tell myself I have to plan more, plan more in detail, think ahead to all the details and spend so much time planning and anticipating all possible outcomes that I'm just consumed and stressed and anxious.
  2. "Ah man, I would have liked that to go better. I didn't think of that possibility, but I know I did all I could with the information I had at the time. Nobody is perfect, but I know I'm doing my best to be a good parent/partner/psychologist. I'll do the best I can to move forward in the situation from here." What emotions might I have after that thought chain? Disappointment but with self-reassurance? Self-compassion?

shutterstock_1105605224

 

This visual helps to lay out these inter-relationships between events-->our thoughts about those events-->our emotions-->actions or behaviors we take in response to that event.

With some practice, we can learn to recognize and change our thought patterns.

 

Watch out for and challenge distorted thinking

It can be difficult to get used to paying attention to your internal self-talk. You maybe never paid attention to it before. Right now, it just happens automatically. It feels like the event happens, so we have emotions. It can take some time and practice becoming aware of the thoughts that occur between the two events. In general, look out for messages (either in your head, or when you share with a friend) that include words such as "should", "shouldn't", "never", and "always". Two common helpful thinking patterns that often include these words are overgeneralizing and catastrophizing.

Overgeneralizing:

Overgeneralizing is exactly what it sounds like--taking one example of a negative outcome and generalizing that to a never-ending pattern of defeat.  Maybe you or your family member makes a mistake, and you think, "I never get things right." or "Things never work out for us." or "He/she never listens to me." or "He/she can't/won't do anything."  Something went wrong, but does that really mean you or your loved one can't do anything or get anything right?

Catastrophizing:

Catastrophizing is a thought pattern where we believe something is far worse than it really is and/or believing that you cannot cope with something. "Everything is falling apart." or "I can't live this way." or "My life will never be normal again." How likely is it that everything in your life is falling a part? Maybe your health has changed, but do you have family that loves you?  are you financially OK?  still have a roof over your head and something to eat? You can interchange those items, as some may be good and others bad for you, but is EVERYTHING so awful that you will cease to survive?

I also think of catastrophizing as being unable to turn off or reign in "what if" thinking. Being prepared is good, but sometimes the "what if" train of thought can lead to some pretty unlikely scenarios that would be hard to prepare for anyway. Or we have unnecessary worry because the thought message we're unwittingly giving ourselves is "I'll never be able to handle it if [fill in the blank] happens."  or "This will never work out."

Maybe It's true, but:

So maybe what you are thinking is accurate; it's not an over-generalization or catastrophizing. "I feel sad that I can't move about like I used to because of my illness." or "I have lost a lot of money, and it will be difficult to pay the bills." or "My husband would know what to say to cheer me up if he was still here." But, ask yourself, what good does it do keep telling yourself this?

I said in the beginning that bad things happen that are often out of our control, and we make mistakes (sometimes big ones). Having negative emotions about that is perfectly reasonable and normal. I definitely do not want you to practice saying "oh well, that doesn't matter" and pretending like everything is fine. That also isn't healthy. What I'd like to you aim for is some balance, focus on the situation at hand, self-compassion, and reminding yourself of your resiliency.  When something is awful, how kind is it to yourself to keep repeating the narrative or story in your head?

Ways to challenge those thought patterns:

Just recognizing that our brains have taken an unhealthy thinking turn is really half the battle, so just that may be a great start to your resilience practice for now. When you have a strong negative emotion see if you can put up a stop sign for a moment and reflect internally on what thought pattern might be related to that situation and driving some emotion. Then, ask yourself:

  • How accurate is xxxx? (could it be an exaggeration?  over-generalization?)
  • Do I know for certain that xxxx will happen? (could it be catastrophizing?)
  • Is my thinking helpful to me right now? (would it be better to let that fact go for now, and think about something else?)

Once you've gotten this far, see if you can turn the pattern of your thoughts to something more useful (and kind) to yourself:

  • If xxxx does happen, how can I handle it?
  • What can I actually control in this situation?
  • What would I say to a friend that messed up, or was experiencing this situation?

Homework.

For homework, I'd like you to practice putting up that stop sign when you get upset, and consider what you are thinking/telling yourself. Then, try some of the challenge questions. For me, I typically fall back on "what can I actually control in this situation" as I'm prone to worry about things that are outside of my control. This simple challenge question often helps me back into a healthy thinking pattern, rather than worry and negative emotion about what I wish was different. I also like "Is my thinking helpful to me right now?"

Please feel free to add your own challenge questions to the list if you have others that you like.

COVID-19 Resiliency Training 4

Then, practice turning those thoughts around.

healthy

I look forward to hearing about your homework and whether you are able to detect those unhelpful thinking patterns and actively counter them. When I'm able to do this myself, it makes me feel really great! I feel less stressed, more confident, and more centered in the moment. I wish that for all of you. Please join me on Wednesday where I wish to focus more on ways to give attention to positive emotions on a daily basis even in the midst of such dramatic stressors (like all the changes we are experiencing due to COVID-19). I look forward to talking again on Wednesday!

 

 

 

 

 

If I ruled the world, Connect would have a WOW button in addition to the heart – and I would use it now! This is the first time since this series started that I have actually printed out the words and stuck them on my bulletin board. Right now, the challenge questions are in front of my desk pad – ready when needed. (I can pretty much assure you that it won't be long before I need to reference them!)

I also really appreciate you including the part about "Maybe it's true, but…" For me – and I'm sure many others – my husband's diagnosis with MCI was just about devastating. That's not an over-generalization. And the journey has not been an easy one. In many diseases or conditions, one expects improvement. My knee was hurt. I had surgery. A year later, I'm fine. Even cancer most often gets cured. But in the case of my husband's MCI, when I think about the future, I'm pretty sure its realistic to believe I will see a continuing decline – that's not catastrophizing. Your advice here is excellent. If thinking about that future helps me plan for, great. If not, just dwelling on it inevitably makes me miserable. Best to give it up and enjoy the day I have here and now – and most of the days are still pretty good.

Thanks for taking the time and energy to bring us this series.

COMMENT
@debbraw

If I ruled the world, Connect would have a WOW button in addition to the heart – and I would use it now! This is the first time since this series started that I have actually printed out the words and stuck them on my bulletin board. Right now, the challenge questions are in front of my desk pad – ready when needed. (I can pretty much assure you that it won't be long before I need to reference them!)

I also really appreciate you including the part about "Maybe it's true, but…" For me – and I'm sure many others – my husband's diagnosis with MCI was just about devastating. That's not an over-generalization. And the journey has not been an easy one. In many diseases or conditions, one expects improvement. My knee was hurt. I had surgery. A year later, I'm fine. Even cancer most often gets cured. But in the case of my husband's MCI, when I think about the future, I'm pretty sure its realistic to believe I will see a continuing decline – that's not catastrophizing. Your advice here is excellent. If thinking about that future helps me plan for, great. If not, just dwelling on it inevitably makes me miserable. Best to give it up and enjoy the day I have here and now – and most of the days are still pretty good.

Thanks for taking the time and energy to bring us this series.

Jump to this post

@debbraw Hi Debra,

I so agree with the "Wow" button! After reading this post I'd like to say the same thing. These ideas are certainly noteworthy for people with or without MCI. I think I will post it in the mental health group as well. I especially like, "What would I say to a friend that messed up, or was experiencing this situation?"

If only each of us could treat ourselves like we were our best friend and say the things we would want a good friend to say to us, how much better would we feel?

Thanks @DrDonaLocke

COMMENT
@hopeful33250

@debbraw Hi Debra,

I so agree with the "Wow" button! After reading this post I'd like to say the same thing. These ideas are certainly noteworthy for people with or without MCI. I think I will post it in the mental health group as well. I especially like, "What would I say to a friend that messed up, or was experiencing this situation?"

If only each of us could treat ourselves like we were our best friend and say the things we would want a good friend to say to us, how much better would we feel?

Thanks @DrDonaLocke

Jump to this post

What a great idea to post to the other group! We'd love to hear what insights they have on the topic!

COMMENT
@debbraw

If I ruled the world, Connect would have a WOW button in addition to the heart – and I would use it now! This is the first time since this series started that I have actually printed out the words and stuck them on my bulletin board. Right now, the challenge questions are in front of my desk pad – ready when needed. (I can pretty much assure you that it won't be long before I need to reference them!)

I also really appreciate you including the part about "Maybe it's true, but…" For me – and I'm sure many others – my husband's diagnosis with MCI was just about devastating. That's not an over-generalization. And the journey has not been an easy one. In many diseases or conditions, one expects improvement. My knee was hurt. I had surgery. A year later, I'm fine. Even cancer most often gets cured. But in the case of my husband's MCI, when I think about the future, I'm pretty sure its realistic to believe I will see a continuing decline – that's not catastrophizing. Your advice here is excellent. If thinking about that future helps me plan for, great. If not, just dwelling on it inevitably makes me miserable. Best to give it up and enjoy the day I have here and now – and most of the days are still pretty good.

Thanks for taking the time and energy to bring us this series.

Jump to this post

@debbraw I'm so glad to hear this! It sounds like you see why this topic is my favorite! I have to be sure can give shared credit to @drmelaniechandler as she helped me tweak the content of this one. I think the "Maybe its true, but…." language came from her and it is SOOO needed. So many things that happen are true and awful, but it I think you've seen that even when that is the case there are some helpful thinking patterns you can lean on for making it through it.

COMMENT
@hopeful33250

@debbraw Hi Debra,

I so agree with the "Wow" button! After reading this post I'd like to say the same thing. These ideas are certainly noteworthy for people with or without MCI. I think I will post it in the mental health group as well. I especially like, "What would I say to a friend that messed up, or was experiencing this situation?"

If only each of us could treat ourselves like we were our best friend and say the things we would want a good friend to say to us, how much better would we feel?

Thanks @DrDonaLocke

Jump to this post

@hopeful33250 Thank you so much. I'm glad this topic has been helpful. It has definitely been an honor and a pleasure to write this series. It has been wonderful hearing everyone's positive comments, but I also got my own refresher! I hope those in the mental health group would also find this helpful. If there are any other topics you or they have for suggestions, I'm all ears!

COMMENT
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