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I did a post around what approach you might want to consider , however now I feel it's time to address the actual person sitting with you as the therapist. The process of finding the 'right' therapist for you is detailed below and mostly relates to searching for a therapist in private practice. Generally, going through the NHS or charities may mean you don't have as much choice with who you're lined up with - though you always have the right to ask for someone else if you're uncomfortable in any way! I've had this talk often with people from different areas of my life, around how to choose your therapist, and I don't think there's an easy answer, however there are a few things that you can take into consideration when looking for a therapist/counsellor/psychotherapist. The searching process Searching for a therapist is difficult within itself when you're feeling in a vulnerable or overwhelmed state especially when there are so many places you could look and when it isn't a regulated profession. Counsellors Together UK have put together this useful document explaining how best to find a therapist who is qualified, trained, and being held to standards according to the Professional Standards Authority to keep yourself as safe as possible. The main thing to look for is that your counsellor is qualified and has done training. It is not a requirement to be part of a professional body, however if a therapist is a member of one this means they have had to complete a certain amount of training and gain experience to be part of the body. From here most research has found that the relationship with your therapist is the most important thing for a positive outcome in therapy, so finding someone who you feel comfortable with, able to disclose your vulnerabilities, and someone you trust is important, but this does mean that the search for a therapist can be tricky! It can be worth having a few people you want to contact as you may not always get in with your 'first choice' due to availability, finances, their preferences/experiences for working, and other reasons. If you don't manage to start working with your initial choice please don't take this as a personal knock - there will be someone out there that you can find to work with you and fit; it is difficult and it can feel overwhelming, but you are not alone in this and many therapists will offer details of colleagues they think might be suitable or have availability (don't be afraid to ask on this either!). My advice would be to think about what you want from a therapist before your search to make it a little easier i.e., are you looking for a friendly face? does age matter? does gender matter to you? is the language someone uses/ the way someone talks important? Then ask yourself why these things matter to you and are you willing to push out of your comfort zones or are they a need? From here you can get a sense of what some keywords you want to filter your search out with might be whether this is how the therapist works or what you're looking to work on e.g. anxiety, depression, PTSD, LGBTQ, ENM etc. The assessment/consultation/initial talk: As I explain in my FAQ's - "The consultation gives us chance to talk through what it is you would want from counselling and look at our expectations. We will go through our contract with each other and look at if we feel comfortable to work with each other going forward. The relationship within counselling is important for effective counselling to take place. The consultation is an opportunity to get a sense of if I am someone you feel you will be able to trust and work alongside you in your journey." When someone contacts myself, I will book in a consultation (described below) and outline what's involved in that. I also send over my contract in advance so that prospective clients get a better understanding of what my expectations are going forward. I also go through this contract in the consultation to make sure any questions or concerns are addressed. However, this is how I do my consultations and other therapists might have a different approach; the main thing to be aware of is that we are wanting to gain an understanding of what it is you're looking for from us as well as what you're wanting to explore. Saying all of this - consultations/assessments/initial contact is also for you, you are the one looking for a therapist that you want to connect to and so this is your time to check out things you have in mind such as: What's their experience? - Maybe you're wanting to look at a complex disorder that you feel needs experience behind it, maybe you're happy with someone newly qualified for general support in life, maybe it's somewhere in the middle. This question is useful to gauge how comfortable you might feel down the line with your counsellor. How do they work? what's their process and approach? - I outline my approach here , but you may not have this information readily available so it is always a good idea to ask how your therapist might work with you in general terms and even how they might work with you in relation to what you're bringing. It can also be useful to then look at how sessions might work i.e., how long are they, are they the same time each week or is there flexibility, how much do they charge and is there any negotiating around that, is there a certain structure to the sessions, what would ending sessions look like etc. Anything in the contracting you're unsure of? - do you have any questions about what is expected of you or your therapist. Have they covered what they'd do in a safeguarding situation? Have they talked about confidentiality and cancellations? Any concerns you may have about therapy in general or that's come up in the session? - If you've had therapy before maybe you have an idea of what you don't want from the therapist now this is a chance to talk about this and check this out. Maybe you've not had therapy before and so you have concerns around what it might be like in terms of emotions, feelings, talking things through... this is also a good chance to voice this and look at how your therapist might support you through the difficult emotions. Their experience of personal therapy - this is often a course requirement when training but not always, so it may be important to you that your therapist understands what it's like to be sat in the client’s chair and experience the vulnerability that comes with it. and whatever else may come to mind for you.... These posts also outline things to think about when talking to your therapist initially: https://lgbtcouplecounselling.co.uk/faq/how-to-choose-your-counsellor/ https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/what-happens-in-therapy/ So how do you know who's 'right' for you? Back to the question at hand, how do you know who's right for you?.... well, unfortunately that's only really something that you'll be able to notice for yourself, but I will leave you with some closing points that might be helpful in your search. Some people might look for someone who has the same experiences as themselves as they feel this will be more relatable and comfortable, whilst this can be true, therapist try not to assume what your lived experience is i.e. you've been through bullying and so want a counsellor who has also been through bullying to feel comfortable, although you've been through the same situation your experience of the situation may be completely different. Maybe you didn't have any other support around you, you were depressed, maybe you harmed yourself, amongst other things leading to an overwhelmingly negative experience. But then your counsellor was able to find support in the situation and work through the trauma at the time resolving a lot of the negative experience allowing them to cope in a more manageable way. Relatability is amazing, it can help with empathy and understanding, but too much similarity can bring on assumed experience that may be harmful down the line as it's not your lived experience. Take some time after your initial meeting to reflect on the situation and assess how you're left feeling. Try noting it down by freewriting your thoughts and feelings, come back to this in a few hours/the next day, and see if those thoughts and feelings still sit the same. This can be a great indicator into how you might feel after your sessions. Listen to your body! Knowing about how sessions would end is a good thing to know. Personally, I ask for 2 weeks’ notice (2 sessions) to round off the work and experience a managed ending in a way that might not have always been possible in life before which is great for mid-long-term work. Alternatively, if someone isn't too sure on therapy being for them, I do suggest that 6 sessions be the minimum to allow for some of the process to take place. My point? if you don't feel comfortable in the first few sessions listen to what is going on for you, what is it that feels uncomfortable? If possible, it's good to talk to the therapist about this in the next session as sometimes working through that can be an amazing piece of work too. If you're still feeling uncomfortable and nothing is resolved, then it is worth reassessing if this therapist is 'right for you'. Finally, if you're comfortable with your therapist but still unsure if they're 'right for you' after everything, could it be that someone is right 'for now'? Maybe they have the experience, qualifications, general demeanour you're looking for and you feel you can get on with them for what you're bringing to therapy - it could be that they're the right person for that specific thing, but then you can move onto someone else further down the line. I have had clients who I've worked with for a few months where I have held them where they are, looking at day to day management which they found helpful, however they then wanted to investigate a diagnosis and ongoing specific treatment that they felt would be better found elsewhere or through a service - this is absolutely your right to do! I hope you've found this article useful and do get in touch if you have questions or want to look into sessions. Directories that may be useful in your search: Free/low cost therapists - https://freepsychotherapynetwork.com/find-an-therapist/ GSRD Therapists - http://www.pinktherapy.com/en-gb/findatherapist.aspx Gendered Intelligence directory - https://genderedintelligence.co.uk/professionals/therapists-and-counsellors/directory.html Therapy for Black Girls - https://providers.therapyforblackgirls.com/ Liberatory Wellness Network - https://liberatorywellnessnetwork.com/explore/ National Counselling Society - https://nationalcounsellingsociety.org/counselling-directory BACP - https://www.bacp.co.uk/search/Therapists Counselling Directory - https://www.counselling-directory.org.uk/ Psychology Today - https://www.psychologytoday.com/gb/counselling

We will have all experienced stress at some point in our lives, sometimes on a daily basis. Stress is a completely natural response to situations, however it can have really harmful impacts if it's not managed and becomes chronic. The biology of stress: I will explain this in really brief terms as it's been a while since I learned it all in depth, but there are some links at the end of this section if you'd like to delve deeper into the ins and outs of our bodies response to stress.... Our body notices whether there is a stressor* by taking in the sensory information around us, but also relating the situation to any past events/previous knowledge we may have. Our body then responds to the stressor by releasing hormones to help us react. *(a stressor is a situation, or anything, that provokes a release of stress hormones). Evolutionary scientists would talk about the 'fight or flight' response which was an in the moment response to an immediate threat. This is generally related to a short-term stress response where the threat is dealt with quickly and the body doesn't have any long-term impacts from the response. Nowadays, stress can seem to be part of our everyday lives with modern life being full of stressors and threats. If we get stuck in 'stress mode' our body continues to release these hormones which can cause mental health and physical health implications. Links: https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response https://www.simplypsychology.org/stress-biology.html https://www.verywellmind.com/what-is-a-stress-response-3145148 @copyright to Kenkou.de Different 'types' of stress: One important thing to remember is stress isn't always bad! Stress can help us out when it is in manageable and small amounts. We can experience good stress, it's a natural response to a challenging, threatening, difficult or even exciting situation. Acute Stress - 'Good' stress is called acute stress, this is an appropriate reaction to a stressor. This stress is short term, infrequent, and can help us manage the stressor. Causes for acute stress might be: Needing to hit a deadline Getting in a fight Giving a speech Acute stress can boost our performance in the moment and motivate us. Once the stress response has done it's magic and got us through the immediate 'danger', 'threat', or situation, the body switches off the response so that we can once again relax and continue on as before. Eustress - Another type of good stress can be called "eustress" which is in response to a more positive stressor. Such as: Challenging sports/exercise Going on a roller coaster Promotion applications Getting married etc. Our body would react in the same way as it does when explained in 'acute stress', but this is in response to a more positive or thrilling situation. Chronic (bad) Stress - Stress becomes bad when it is chronic, long-term or turns into a disproportionate response. Acute stress can become harmful when our body is having this reaction frequently. Some believe our stress response hasn't yet evolved to fit modern day life. Back in prehistoric times our body would respond to physical threats caused by life threatening events. Now, we have so many sensory inputs that can be processed as a stressor from emotional stressors, physical stressors, psycho-social, and even spiritual leading to the response being more of a frequent occurrence. Causes of chronic stress can be in relation to events such as: Divorce Difficult relationships and abusive relationships stressful jobs Moving house Death of a loved one Long term stress can put significant strain on our bodies which can then impact our physical and mental health. Links: https://www.verywellmind.com/stress-and-health-3145086 https://www.bps.org.uk/blogs/dr-funke-baffour/stress-good-bad-and-ugly https://www.mentalhelp.net/blogs/types-of-stress-and-their-symptoms/ Image found here: https://cellsciencesystems.com/education/news/infographic-how-does-stress-affect-you/ Symptoms of Stress: The first step to managing stress is actually knowing and recognising when you're stressed. @mindcharity have a great outline of different emotional, behavioural, and physical symptoms of chronic stress. Emotional: Racing thoughts Feeling nervous or anxious Feeling irritable A sense of dread Losing interest in things Behavioural: Worrying about many things Not able to make decisions Picking at skin/biting nails more Snapping at people Being tearful Physical: Muscle tension Panic Attacks Headaches, light headedness, dizziness. Being tired all the time Clenched jaw Image found here - https://www.youthcan.hk/en/theme/conflictmgmt/infograph_3.html So, how do I cope with stress? There are many ways to manage stress. Some will work for you and others will not, so it's important to try a few things to see what works. DIET - Addressing diet may be one way to help with stress. Comfort eating can definitely boost mood in the short term but can cause longer term problems and so finding a healthy diet that suits you can help regulate your mood in the long run. EXERCISE - yes, I know this is another 'treatment' like diet that gets thrown around a lot, but having an exercise routine can be beneficial. Even going for a 10 minute walk has been shown to improve health and mindset too. MINDFULNESS - practicing mindfulness can help keep your mind in the present and to disengage with some worries. There are many mindfulness techniques, so if one doesn't work for you try having a look at a different technique. YOGA/MEDITATION - these practices focus on breathing and control of the body and mind. It can help build up a resilience to stress and block out stressors around you. THERAPY/TALKING - speaking to someone about what's going on and having your own safe space to explore this can be useful. There are many types of therapy around so you don't have to settle for something that doesn't suit you. SLEEP HYGIENE - try to get a routine in place for sleep. Find ways to switch off before bed and unplug from the wider world. ALTERNATIVE THERAPIES - why not try acupuncture or a massage to ease away the physical tension. SELF CARE - make time for yourself! Whether this is through any, all, or some of the above, or things like a hot bath, a long walk, talking to a friend, playing with a pet, watching your favourite TV show, having a sing-a-long to some music etc. As mentioned, it may be that only a few of these work for you, but it's good to try and mix in different ways of managing stress to they can complement each other and keep your well-being in check! If you feel you're doing all you can and you're still suffering from stress or you can't even think how to start putting this in to place try speaking to your GP to look into options. *remember these posts are purely for guidance! Links: https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/ https://www.mind.org.uk/information-support/types-of-mental-health-problems/stress/what-is-stress/ Extra Resources: Check out the 'Stress Management Societies' website. This site is full of resources looking at ways of managing stress and what to look out for. They even have a stress test that can be used as a gauge of the stresses going on in your life right now along with recommendations - https://www.stress.org.uk/individual-stress-test/ The 'Stress Busting' website is also full of great ideas to manage your stress. It's loaded with unique and wonderful techniques to try out - http://www.stressbusting.co.uk/treatments/ The 'International Stress Management Association' have a great page which lists loads of different organisations that may be able to offer you more information around stress or for seeking help with stress - https://isma.org.uk/isma-useful-organisations The Guardian have a great article on knowing what your rights are as a worker in the UK when it comes to stress. It covers what you can do to help yourself as well as what you can talk to your employer about - https://www.theguardian.com/careers/careers-blog/dealing-with-workplace-stress-your-legal-rights 'Helpguide' has a really in depth page around stress management and what you can do yourself. It includes some reflective questions, ways to identify the areas of stress in your life, and how to move forward with them -https://www.helpguide.org/articles/stress/stress-management.htm How do you manage your stress? Is there anything else you'd add to this?

How to cope with chronic illness is quite a big topic and one I'm still learning because chronic illnesses can be unpredictable and progressive and so our ways of coping also need to adapt and change with our health. This post is going to explore: Fighting for Your Diagnosis Medical Appointment Fatigue The Grief Process Focusing on the "Can dos" Anger Separation of Body and "Self" Pacing Self-Care & Managing Symptoms What Therapy Might Look Like with chronic illness * I will be using personal experience in writing this post as examples of what I'm talking about. I am not sharing this for sympathy, but rather to build on the content and raise awareness.* Fighting for Your Diagnosis Part of having chronic illnesses can be the medical experience of being dismissed or even gaslighted by doctors even though you know something isn't okay - remember you know yourself best and it's okay to ask for a second opinion or referrals to specialists. Personally I've had a pretty negative experience with getting support and treatment with the NHS and have had to go private on a couple of occasions in order to get a diagnosis or proper support in place, but I realise this is a privilege not everyone has. It can feel like there is a barrier in getting support from doctors at times, so lets look at what you can do and getting the most out of appointments. make a list of all your symptoms, it can be useful to note the frequency of them, the intensity of them, how long they've been going on for, and any other relevant information, e.g. night sweats on lower half of body that only happen in the lead up to menstruation. The impact of the symptoms e.g. night sweats disrupt sleep and make it difficult to stay awake in the day time. Disrupts work and day to day life. What you've tried so far including medical history, medicines taken, herbal treatment etc. What you are hoping to get out of the appointment - are you looking for a referral, treatment, management, support? It can be useful to colour code all of the above information with what feels most important to get out of the time you have and then what is useful to know. Often GPs will stick to the one symptom for the 10 minute appointment which is so difficult when with chronic illness you have a list of symptoms that all interact. So take some time to figure out which symptom you feel is most important to mention and then hopefully your GP will be open to hearing the domino effect this has with other symptoms. This can be really frustrating, especially if you're not sure because they're all so closely related, I have found it useful to state this in the appointment e.g. "I have a few symptoms which all feel like they have a big impact and interact with each other, how do you recommend me prioritise one?" If you feel you will need more than 10 minutes because of multiple symptoms and being unable to separate them out, try to book a double appointment. This isn't always possible as I know a lot of GP surgeries are inundated with patients, but it's worth a try! Where you can, it is useful to take someone with you who can add their perspective of how your condition impacts you and can prompt where necessary. Stay firm in what you're asking - it can be useful to do a little bit of reading around what you're hoping to get out of an appointment and knowing what you're entitled to with support. e,g. I know that extra pain relief can be offered for coil removal/insertion. When I asked for if this could be done the GP asked me to repeat what I was asking for 3 times and then laughed at the idea of needing it because the teaching is it shouldn't be painful (even though it very much is!). I know my body and know that any procedures like this cause pain for days afterwards and unbearable pain at the time so I stood firm in what I was asking and was eventually given options. Look at advocacy around support you can get in appointments and regards to ongoing support. I will list some advocacy services at the end. The NHS actually has guidance on questions to ask in an appointment - https://www.nhs.uk/nhs-services/gps/what-to-ask-your-doctor/ When getting test results it can be useful to ask what the next steps are regardless of the outcome. If your results are showing something then you will need to know what this means and what to do going forward, but this is also important for if test results don't show anything - even though this is often framed as a "good news your results are fine".... so then what's going on with me? If you face any stigma in appointments this can be especially challenging. The biggest one for me has been focusing on my weight as a way to manage symptoms. The biggest tip for this that I've learned is to ask, "what would you advise a skinny person in this situation?" to see if there's any options they're avoiding just because of weight. And this kind of question could be useful for multitudes of discrimination & stigma: "what would you advise a monogamous/white/male/cis/straight/skinny/young/older person?" It can also be useful to ask your GP to note down on your records if they are refusing to offer any referrals or treatments. Pros and Cons of a Diagnosis Pros Cons Access to specific treatment for that condition New symptoms automatically being put down to diagnosed condition rather than being investigated further Access to extra support due to diagnosis e.g. PIP Misdiagnosis may be made Sense of relief & validation in knowing what is going on Lengthy process for some conditions It is really up to you how much you push for a diagnosis from your appointments. My GP has an ethos of treating the symptoms rather than always focusing on a diagnosis - this was especially true for my fibromyalgia diagnosis as they "didn't want to put their name next to a fibro diagnosis, didn't want to diagnose me so young, wanted to focus on the symptoms" and so this is when I went private to a pain clinic as I felt like there were too many symptoms to look at individually amongst other reasons. Medical Appointment Fatigue Often with chronic illnesses we can get medical appointment fatigue, this is where our capacity is overloaded due to medical appointments, chasing treatments, chasing referrals, keeping track of everything etc. It can also be from the appointment itself. As you have seen in the above section preparing for an appointment can be time consuming, then the process of having the appointment can take its toll with waiting for the appointment, sitting in the waiting room, experiencing dismissal from doctors, or having positive results and processing what this means, to then going away and looking into what your next steps mean for you. It is a lot. it has both physical and emotional impact. All of this can be so exhausting an debilitating, especially on top of our day to day lives. This may be where we have to ask for help from those around us or services in order to manage our medical wellbeing. Other than asking for help from others, the best way to cope (anecdotally from my own experience and the experience of those around me) with medical fatigue is to give yourself space around the appointments. This might mean 10 minutes to go back into the waiting room to decompress before leaving or it might mean taking the week off around the appointment in order to prepare and recover - this will really be dependant on your responsibilities and dependants in life but it is essential to put in some time for caring for your wellbeing around your appointments. The Grief Process Having chronic illness brings an element of grief with it. The grief can be around the person you "used" to be and how that's now changed or feels limited, it can be grief for the life you imagined for yourself, it can be grief for the loss of independence you had, it can be the loss of relationships along the way due to impact of chronic health. For me, it has been all of the above. I have multiple chronic illnesses and it has meant my life has completely changed to what it was and what I wanted it to be. I can no longer do exercise how I used to and that was a big joy and way of coping for me so I really notice its absence. The grief process has been ongoing and adapting with time as I learn more about my own limits and what is possible for me. This process can become more complex when you have multiple conditions as you may be coming to terms with one condition and then be investigating another which means re-analysing everything again. I talk about how to cope with grief here and the biggest way of coping for this is to offer yourself compassion and grace with what you're going through. I think the dual grief model is really good at showing how messy and unpredictable grief can be (even though this is based on bereavement I believe it is transferable to most losses as a process) - It is so difficult and it can be that those around you don't always understand unless they have experienced a chronic illness themselves (first hand or second hand) - though it is important to note that loved ones may also go through their own grief process in relation to your illness too as it does have an impact on them as well. Finding someone or people to talk to can also be important so that you don't feel so isolated in it all. This could be a friend group, trusted loved one, support groups, therapist, a therapy group etc. There are always people out there ready to listen and be there with you. Focusing on the "Can dos" It can be easy to fall into despair and focus on all the negatives that come along with chronic illness; whilst it is valid, understandable, and definitely needs space to be acknowledged, there are still things within our control and that we can do for ourselves as well as there being good in the wider world - you still have a life to live as much as you can. I am not saying ignore the bad and only focus on the good, but rather to allow space for both of these to exist. Part of this for me was acknowledging that I couldn't do a lot of what I enjoyed, but I still can do a lot it just needs to be in a different way. I might not be able to go for a run anymore, but I can still go for a gentle walk. I can still do gardening, I can still spend time with my dogs, I can still eat delicious food; they just need to be adapted. I remember getting diagnosed with fibromyalgia and the consultant said to me (roughly), "we can not cure fibromyalgia we can only treat it to the best we have understanding of, but the aim is that you are able to live a life with fibromyalgia rather than fibro being your life". Now, I realise that this will be different for everyone and the intensity of what you can/can't do will vary as well, so I know it won't be as simple and can be much more challenging than "just" accepting how things are and focusing on what you can do, it takes practice and time to come to terms with and process. Anger I have found, and seen, that anger is a big emotion that comes up with chronic illness. Anger at yourself -it may be that you're angry at your body for letting you down and feeling limiting. Or maybe it's anger at your past decisions that could have led you to this point. Turning anger in on ourselves can be damaging in many different ways, but in relation to chronic illness it can actually add to our symptoms. It can increase heart rate, blood pressure, and impact other physical sensations. And so it becomes a cycle of self destruction. Anger at society - There can be a lot of anger directed towards society and it's limitations, inequity, and inequality. Accessibility in society can often feel like a token gesture where it isn't thought through enough and clearly doesn't have someone with access needs designing or helping. Just take a look at most wheelchair users on Instagram sharing their experiences of being out in the world and you'll quickly see how inaccessible accessibility is! On top of that there is also still a lot of stigma around being chronically ill or disabled where people are infantilised, shamed, or harassed. This can be apparent when focusing on what we can do, it is still then within the limits of our own body, mind, and society. There's also a lot of anger at the systemic issues especially within healthcare. We need the NHS and we are so reliant on it, but because of it's funding cuts, understaffing, programmes being cut, wait times etc. we are being sorely let down with getting the needed support. An example, I got diagnosed with Fibro 4 years ago and I am still waiting to see a Pain Management Service due to 5 incorrect referrals to out of are clinics or just wrong clinicians and now my appointment has been cancelled with no resolution. It becomes laughable with just how ridiculous it all is but underneath is a lot of anger as I am left to figure it out and make do by myself in the meantime! Then bear in mind that for many of us with multiple chronic illnesses this is just one task of many we are having to process, follow up, chase, fight for - there is a lot of anger, frustration, disappointment, and outrage. Anger in general - There can be anger in a wider sense of just being angry at the universe for how things are. What to do? - Anger is a difficult emotion to process and express, especially in society where anger for AMAB people can be misconstrued as aggression and where anger for AFAB people can be seen as hysterical and overreacting. BUT anger is normal and human, and there are many ways of expressing anger in a healthy way: physical exertion - this might be exercise (run, jog, fast walk), it could be punching in a safe environment (boxing practice, punch bag, pillow), it could movement (shaking your body, pushing against the wall, dancing, pole dancing). Vocalising - this might be talking to friends or a therapist or it could be screaming in a safe environment or into water/pillow/hands. Writing - maybe it helps to write down what's making you angry, or just writing random words that are on your mind, I used to find writing all the words out in bold across a page and then going over all of them until they rip the page a good release. Music - listening to music and feeling the emotion this way or singing/shouting along to music. It may be a mixture of all of the above! Separation of Body and "Self" I have found that when talking about chronic illness or illness is general we tend to separate out our body and our self e.g. "I really want to write this blog post but my body is in a lot of pain and my fatigue feels too heavy" or "I feel like a prisoner trapped in my own body". Often this is a protection to the sensations or feelings that are coming up for us. It is easier to talk about it with a little bit of distance between your "self" and the problem (your body). This makes sense, and it isn't necessarily a problem until it becomes a cycle we feel stuck in where we are constantly blaming and degrading our own bodies which are a part of ourself. Compassion is the best way of combating this, in my experience. Being able to hold all parts of ourself with grace and compassion can make a huge difference. This can mean trying to take note of when we are talking about ourselves negatively - whether out loud or internally - and then practicing reframing what we've said with compassion. Ways of doing this can be: imagining what you'd say to a child, a pet, a loved one, or a friend. More on this - https://www.bezzybc.com/discover/living-well-bc/health-8-tips-to-practice-self-compassion-when-you-live-with-chronic-illness/ Pacing Pacing is a huge topic with chronic illness, mental health, and disability. It is a real challenge to practice so please be kind to yourself when looking to implement ways of pacing in your life. I go into pacing in detail in my post here , but essentially it is finding a way to space out your day to day activities so that they can be more manageable on a long term basis rather than getting into a cycle of 'doing too much on a good day and then having a flare up for a few days'. It can be hard not to get caught up in doing things when you're having a good day because you want to get them done and it feels great to have more capacity to tick off items on the to do list however overdoing it then means we are in a flare up for longer and we get behind again. My tips for pacing: Start small - pick a few essential things to schedule. At the moment I'm trying to get back on top of housework and having the house how I want it. My perfectionist over worker part tells me to just go for it, do all the tasks, it'll look and feel great. But I know this isn't going to work for me, and so I've decided to start small by allocating an hour a day to doing something in one room in the house, so this may be washing clothes and being done with that. This involves realigning our expectations with our reality - it would be amazing and the ideal to get everything done in one weekend but it's just not possible anymore for me if I want to function the rest of the week, and so I have to look at working back in the steps to what then feels manageable. Reassess - Pacing means taking things slow and when we're not used to this slow can feel like we're not doing anything. And so it may be that we start small like above but we need to reassess because we didn't start small enough and it's still a struggle. As we then go on we might find that we can add bits in slowly over time. Be patient and kind to yourself. You are not lazy, useless, worthless or any of the other things your internalised ableism is telling you. Your capacity it limited because you're dealing with a barrage of symptoms and still expected to function in society. It's a lot! Do what you can - pacing is a wonderful concept for chronic illness when you are just dealing with chronic illness, however when we add work, families, houses, pets, other responsibilities on top it becomes much more complex and takes a lot more compromise. This will need those who your around to help with pacing, such as an occupational health and reasonable adjustment assessment at work. Self-Care & Managing Symptoms Self care is a combination of the mental self talk mentioned so far as well as the physical things you can do for yourself. I describe self care as short-term self care and long-term self care: As mentioned self care is not a fix for anything but can help in managing what's going on for us. The title of this blog post is "how to cope with chronic illness" and if someone were to ask me right now if I am coping with my chronic illness the answer would be no, but I am managing it as best as I can around living me life. Types of self care: Distraction & Mindfulness - Gaming, quizzes, puzzles, problem solving - these are great for taking my mind off the pain I'm in or feeling more present when fatigued. Music - singing or humming along to music can be grounding and can allow some distraction as it forces you to be with yourself in the moment. Crafts - colouring, painting, knitting, sowing, felt, crochet.... Writing/journaling Practical - Pill sorting and alarm setting - this allows me to know if I've taken my meds and reminds me to take them too. Pacing my client sessions to have breaks for mental rest - I am very privileged to be able to do this for myself as otherwise I wouldn't be able to work, but having space to rest and recover between sessions is important for me to be able to work. Being open about having chronic illnesses with clients to allow myself the grace for self management where needed Having an idea of finances so that I can look into tools to help with my pain, fatigue, other symptoms. Applying for disability support - this is a tedious and gruelling experience for many so I would highly suggest having advocates to help you in the process. Sleep routines - reducing blue light around going to sleep, relaxation before sleep (I find sleep tracks help me). Mobility aids - walking sticks, wheel chairs, stools to ease standing, push walkers, rails for bathroom use etc. You can get occupational health assessment for housing - https://www.scope.org.uk/advice-and-support/home-adaptations-occupational-therapist-assessments Physical - Baths or hot showers to ease pain or It could be a cold shower to reduce fatigue. Naps when needed for fatigue, overstimulation, decompressing. Pain killers when needed - speak to your GP about pain management Comfy shoes/slippers for around the house. Using heat packs, electric blankets. Using weighted blankets to reduce anxiety and reduce some pain. Trying to make healthy eating habits Mental - Forcing myself through fatigue - like with this blog post I sat with it open and started typing any words that made sense or didn't and the rest of it started to flow to make sense of it all (I hope!). It may be setting a timer to try and do something and if not coming back to it later. Recognising capacity levels and resting where needed - this might be a more practical thing of noting down symptoms and activities (I've found Visible App really helpful with this), or it may be doing mental body scan check ins every so often throughout the day to assess if you need to slow down or stop. Gratitude & Joy in the little things - sometimes taking a step back and recognising the smaller things in life that bring you peace can be important and helpful for your mental health. I love looking up and really looking at the stars & moon at night. Spiritual/Connection - Creating community and connections - this might be through religion, it may be creating community online, or it may be finding community in your local area. For me online has been so instrumental in coping with the bad days and celebrating the good days. Asking for help Therapy Connecting with nature - being out near water, in the woods, bare feet on grass, or just in a local park can bring some relaxation. Body Scans, meditation, or yoga. Spending time with pets What Therapy Might Look Like with a Chronic Illness Therapy with chronic illness is a process that follows similar topics discussed in this post. I have found that having a safe space to share frustrations, express anger, explore the grief and what it means to them, look at what is in their control, look at how they can see their life being with adaptations, look at ways of managing and coping, and focusing on compassion with self talk tend to be the main themes. It doesn't necessarily have a particular order of things either as they all tend to run along side each other and intersect. What might happen in therapy: Validation of your feelings and experience Learn how to recognise emotions/feelings in your body Learn how to express your emotions/feelings Explore trauma that may have impacted your chronic illness Experience a safe & supportive connection to then have an idea of what this might look like in your "real" world. Look at how you talk to yourself, where this narrative comes from, and how it can be more compassionate. Celebrate your achievements, good days, gratitude. Learn ways to regulate your feelings and symptoms. and more... This can vary depending on your therapists approach, their personality, how engaged you are, how long you have to work together etc. Check out my other blog posts for further info around this: https://www.emilyduffytherapy.co.uk/post/what-to-expect-from-therapy https://www.emilyduffytherapy.co.uk/post/the-counselling-process-and-you https://www.emilyduffytherapy.co.uk/post/finding-the-right-therapist-for-you https://www.emilyduffytherapy.co.uk/post/do-the-approaches-to-therapy-matter Further Resources: https://www.cisfauk.org/ https://chronicillnessinclusion.org.uk/ https://www.nhs.uk/nhs-services/hospitals/what-is-pals-patient-advice-and-liaison-service/ https://www.independentage.org/get-advice/health-and-care/living-long-term-health-conditions/get-support-long-term-condition https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/benefits-for-people-who-are-sick-or-disabled/ Access to Work - https://www.gov.uk/access-to-work Turn 2 Us for financial and general support -   https://www.turn2us.org.uk/get-support/ The Advocacy Project - https://www.advocacyproject.org.uk POhWER - https://www.pohwer.net/ Voice Ability - https://www.voiceability.org/ The Disability Rights Org UK has further signposting and guidance that might be more specific - https://www.disabilityrightsuk.org/resources/advocacy-get-your-voice-heard Mind info on Advocacy - https://www.mind.org.uk/information-support/guides-to-support-and-services/advocacy/types-of-advocacy/

What is Compassion Fatigue? Compassion fatigue can happen for most of us, but those in activism, support work, health work, or pastoral work can be at a heightened risk. Compassion fatigue is where we become physically, mentally, and emotionally exhausted from the demands of holding space for others. There are so many causes we can get involved in, and if you're anything like me, many of them are close to my heart. Compassion fatigue is sometimes call vicarious trauma or secondary stress reaction as it is a response to taking on other peoples emotions, not having enough support in place for ourselves, and thus experiencing a type of emotional burnout. Imagine a phone battery - this is our capacity for compassion for others - if we leave it with different apps open draining that battery we will eventually run out and become exhausted. We need to be able to recharge this battery - gaining compassion resilience - in order to keep going and offering support. From: https://calmerry.com/blog/burnout/the-cost-of-caring-coping-with-compassion-fatigue/ How can I notice if I'm suffering from Compassion Fatigue? Compassion fatigue can have a big impact on personal life & professional life, and if not addressed over time it can become debilitating. It can come out in many different ways, it isn't just psychological, it can be physiological too. You might start to feel helpless, powerless, and stuck when faced with others suffering . You may notice your ability to hold others with compassion and empathy to be dwindling and no longer able to access it. Sometimes this can be thoughts and feelings of lacking care. You may experience feelings of detachment and withdrawal from those around you and yourself - You might find yourself withdrawing from socialising with others; feeling like being social is "too much". You may feel numb to others needs and neglect your relationships. You may experience mood swings with increased frustration, anger, irritability, and anxiety. This may come out in feeling like your constantly "under threat" with an activated "fight or flight mode" even when sitting by yourself. It can be a feeling of impending doom and having no control. You may also feel listless and not have any interest or joy in things you used to. Work demands and personal demands from those you care about may become overwhelming to you. You may freeze and feel paralysed with not knowing what to do. Your ability to concentrate and focus can become affected with brain fog. This can impact both work and personal life by making it hard to make decisions. Neglecting your own self care is a symptom of compassion fatigue as it not only affects our ability to hold other with empathy but ourselves too. There are also then the physiological symptoms of compassion fatigue: Fatigue and exhaustion. Sleep can become impacted with disturbed sleep (not being able to get to sleep, not being able to "switch our brains off", waking up throughout the night) and also with nightmares. Headaches and migraines Tension in your body causing aches and pains Changes in appetite - it could be a lack of appetite or it could be increasing our intake. Increase in stress can lead to changes in weight Immune system can be compromised and so you might find yourself getting ill more often e.g. colds. Nausea and digestive issues Dizziness Muscle twitching - when I get run down my eye twitching tends to be my biggest give away sign From: https://macmh.org/resource/understanding-compassion-fatigue/ What can I do to look after myself? We are unfortunately in a position where we can't always change our environment and so self-care can only go so far. Many of us struggle in the worlds landscape of systemic oppression, bigotry, capitalism, and a patriarchal society. I get so angry, frustrated, and heartbroken at all that's going on in the world and want to do all I can to help others, but with chronic illnesses and being a therapist, there is only so much I can do before I would burn myself out completely. I am not saying don't get involved in any causes yourself, but to look after your wellbeing when you do, as you are important too and your capacity for how much you can offer will be unique to you. Below I have made some suggestions of what could be useful and ease the weight of the compassion fatigue enough to recover. Ways to manage professional work: 💚 Speak to your Supervisor/Support - As therapists we often have a supervisor who is there for us to talk to about our caseload and anything we might be struggling with. Hopefully most caring roles have something similar and someone who you can talk to about your caseload and how you might be able to change it or ease up a little whilst you can recover. 💚 Look at your works EAP (if you don't have one, check out helplines below) - An EAP is an Employee Assistance Programme which is there for all employees who might need some support from a third party. Sometimes this is a helpline, sometimes this is counselling, sometimes it's just other wellbeing services (I've seen coupons for spa days and things). 💚 Take some time off - You could look at getting signed off sick if you feel that work isn't supportive and you need some time and space away from that environment. The downside is, if nothing is going to change at work this is a short-term solution, still may be a necessary one though! 💚 Look at putting professional boundaries in place - You are allowed to say no at work. A no could look like, "I can't today but ask again tomorrow", "is there anyone else you could ask for this", "I am unable to make this a priority right now", "no, I don't have time for that", "no, I am unable to manage that". 💚 Speak to your GP or HR about occupational health review and reasonable adjustments - https://www.acas.org.uk/using-occupational-health-at-work 💚 Training for managers - https://www.wtwco.com/en-gb/insights/2022/09/awake-to-exhaustion-how-employers-can-help-staff-suffering-from-compassion-fatigue 💚Maybe a switch in role or career? - This is likely the last resort but if you're unable to change your environment and you aren't receiving support there's not too much that is going to let you recover, and so sometimes it can be moving jobs that can help with this process. Ways you can look after your well-being: From Unsplash via Wix 💚 Build a routine - start with the basics and build from there. Taking things one step at a time 💚 Put boundaries in place - look at what your needs and capacity are and start to look at boundaries to help you meet these. Remember boundaries are things we put in place for ourselves, not rules we put on others, though we do still have to communicate them. 💚 Self care - check out my post on different types of self care. 💚 Limit news and social media usage outside of work - take some time to switch off from the wider world and try to refocus on your immediate world or self. 💚 Hobbies - reconnect with some joy and do something that brings you peace. 💚 Be kind to yourself - practice some self-compassion . The analogy of putting your own oxygen mask on before helping others is a cliché for a reason! 💚 Support Network - re-connect with those you trust and care for you. 💚 Exercise and movement - reconnect with your body and be present with yourself 💚 Mindful Eating - I know I lean on food when I become overwhelmed and overloaded and go to quick easy options which may not be the best for me, so resetting and actually being present with what I'm eating is helpful. 💚 Sleep hygiene - try to get a bed-time routine in place. Look at similar times to sleep and wake up, look at white noise playlists/machines, eye masks, sleep sprays, blue lights etc. 💚 Therapy - I have many posts on why you might have therapy , what the approaches are like, what the process is like, and how to find a therapist to get you started. 💚 Ask for help - I have linked my posts around free & low cost support as well as helplines that can be helpful, too. Different ways you can get involved in activism: From Unsplash via Wix 💚 Petitioning - There are so many petitions to sign online for good causes and it is something that you can actively do to put your name to something. 💚 Educating yourself (and others) - This is a difficult one, it reminds me of the meme around "walking a line between staying informed and losing my sanity". Definitely only do this if you have the capacity but educating yourself and others can be a way to put the anger and frustration into action. 💚 Raise Awareness - Once you have the understanding behind you, you can raise awareness of the topics that matter to you by: 💚 Fundraising 💚 Volunteering 💚 Use Social Media 💚 Write letters to your MP 💚 Challenge behaviours of, & have conversations with, those around you 💚 Protest (within the law, which is becoming more difficult!) - Whilst we still have the right to do so, you can go to peaceful protests to share in the frustration of others and feel connected. 💚 Go to Town Hall events - You don't have to participate but you can be around like minded people who are looking to make change. 💚 Make small, lasting changes to your lifestyle Why not take the Self Test for compassion fatigue to see where you're at? - https://www.aafp.org/pubs/fpm/issues/2000/0400/p39.html From Unsplash via Wix Further Reading: https://www.cma.ca/physician-wellness-hub/content/compassion-fatigue-signs-symptoms-and-how-cope https://pmc.ncbi.nlm.nih.gov/articles/PMC7560777/ https://www.psychologytoday.com/gb/basics/compassion-fatigue https://www.webmd.com/mental-health/signs-compassion-fatigue https://pmc.ncbi.nlm.nih.gov/articles/PMC11980338/ https://baycrest.echoontario.ca/wp-content/uploads/2018/11/A-systematic-review-of-the-literature-on-recommended-interventions-Preventing-managing-and-treating-compassion-fatigue.pdf Want to start working with me? Check out my Bookings page to see my availability.

Self care is a buzzword that has been used for a lot of things in recent years, but essentially it is "doing things to care for your own wellbeing and mental health". Selfcare is a multifaceted term that covers all elements of our wellbeing - emotional, mental, physical, social, moral.... Alongside this, for me, self care is split into 2 categories - Short term self care & long term self care - which accounts for the care which addresses any current/ongoing issues we're facing, looks into maintaining our wellbeing, and adds in preventative forms of care too. Short-term self care I describe short-term self care as, "the little things we do for ourselves on a day-to-day basis which have an immediate positive short-term impact on our wellbeing". Short term examples: 💚 Going for a walk, a run, doing yoga, meditation, or mindfulness - exercise, especially exercise which allows time to process thoughts and emotions, can be so useful in maintaining wellbeing on multiple fronts. Even fitting in a 10minute brisk walk a day has been shown to have benefits. 💚 Having a bath or spending longer in the shower in order to relax and refresh. These can be a good way of metaphorically cleaning of the negative emotion from the previous/current day, i.e. to leave that behind, ground yourself, and focus on the current moment. 💚 Playing games, watching TV/Film, reading a book, or listening to music - i.e. spending time on your hobbies that bring you some emotional relief. 💚 Writing or journaling - Journaling/Writing are documented ways of helping to process thoughts and emotions so people often find these particularly useful when anxiety is heightened or to help collect their thoughts when stressed . 💚 Eating your favourite meal, baking, cooking, takeaway etc. - food/nutrition is also something that can have a massive health impact and emotional benefits. Of course, if you're favourite foods are heavy in sugar/fat/carbs then this form of self-care is best to be used in moderation to avoid it becoming a maladaptive way of coping causing harm. Long-term self care: Long-term self care for me is described as, "bigger more impactful forms of care which have a longer lasting impact on your wellbeing, however these can be more complex due to the nature of life". Long term examples: 💚 Reassessing your job & career as to whether it is fulfilling your needs - It can be useful to ask yourself the questions around what it is you get value out of within your life and if your job is a priority in fulfilling these needs - if so is this something you need to address and look into other forms of work (where possible) or are you able to get value & fulfilment out of other areas of life instead. 💚 Managing your physical health & nutrition by setting up long term routines or goals - it's a known fact that our physical health can have a big impact on our mental health, so it can be worth looking into nutritional changes to help alleviate any unhelpful dietary habits. 💚 Reflecting on your inner narrative to challenge how you talk to yourself (therapy is useful for this 😜) - This can be really hard work when our inner voice has been influenced and moulded by so many harmful/traumatic situations, but they way we talk to ourselves really does matter and so challenging these critical and negative voices can be so useful in the long-term. 💚 Saying 'no' to opportunities or events when you're starting to feel overwhelmed with activity - looking at your boundaries and what you're able to manage with the energy we have is vital. It can be difficult to start finding our voice when setting health boundaries but there are many ways to say no to situations. Again therapy can be helpful when looking at how to challenge this within yourself and then implementing the boundaries within your life. 💚 Taking stock of your finances - maybe you want to spend more in yourself to feel more comfortable in your environment and if affordable or maybe you want to save more to have a financial buffer. These are only a few ideas for what self-care can look like. Self care is different for everyone, it is about assessing your own needs and refilling your own wellbeing 'cup'. Further reading: https://www.verywellmind.com/self-care-strategies-overall-stress-reduction-3144729 https://www.everydayhealth.com/self-care/ https://psychcentral.com/blog/what-self-care-is-and-what-it-isnt https://www.mind.org.uk/information-support/types-of-mental-health-problems/mental-health-problems-introduction/self-care/

Following my Instagram posts over the last 2 Pride Months I wanted somewhere to put all of the ABC's of LGBTQ+ and Relationship Diversity in one place. ✨✨Reminder that these labels aren't always clear cut and may change over time. You do not have to use labels if you don't want to but some people find them useful in feeling themselves and understanding themselves better within the world as well as getting a better understanding of others. You know yourself better than anyone else so use the labels that feel right for you - no one else is able to tell you how to identify or gatekeep (even though some might try).✨✨ LGBTQ+ and relationship diversity Terminology A B C D E F G H I J K L M N O P Q R S T U V W X Attraction - there are many types of attraction - romantic, physical, sexual, intellectual, and emotional. You can experience one, some, or all types of attractions to any or specifically certain types of attraction towards certain genders. e.g. you could identify as sexually and physically attracted to all genders but only romantically attracted to women. Asexual (Ace) - those who don't experience sexual attraction to any gender - though they may still enjoy having sex. This is also an umbrella term for the Asexual spectrum. Aromantic (Aro) - those who experience little or no romantic attraction towards any gender. This is also an umbrella term for the Aromantic spectrum. Allosexual - is to describe someone who experiences sexual attraction of any kind. It is an umbrella term to define anyone who isn't on the asexual spectrum. Allosexism - defines the stereotypes and 'social norms' that sexual attraction is a normal thing to experience. Androgynous - Showing both masculine and feminine presentation; either in features, behaviour, and/or societal roles. Androgyny - A gender identity; it generally means identifying somewhere between masculine and feminine or it can mean having both a male and female gender. Agender - can meant to not identify with a gender or to be gender neutral. It can also be used as an umbrella term for those who don't identify with a gender but fall under other labels. Abrosexual - someone who's sexuality may change frequently. AFAB - "assigned Female at Birth" i.e. being identified as female due to the genitalia presented at birth. Where gender is given based on assumed sex. AMAB - "Assigned Male at Birth" - i.e. being identified as male due to the genitalia presented at birth. Where gender is given based on assumed sex. AXAB - "Assigned X at Birth". For those born with intersex traits and most often used in cultures where non binary gender is recognised. Ambiamorous - defined as having the ability to enjoy both monogamous or non-monogamous relationships. Ally - an ally of the LGBTQ+ community is considered someone who is allosexual, cisgender, and heterosexual, therefore not included in the acronym. An ally, whilst not LGBTQ+ themselves, is someone who advocates and fights for LGBTQ+ rights as well as challenging: hate speech, harassment, erasure & societal stereotypes. B Bisexual (Bi) - an attraction to 2 or more genders - this is not limited to binary genders (i.e. men or women). Bipolyam - someone who is bisexual and polyamorous Bi erasure - where someone's bisexuality is ignored, questioned or denied, i.e. a bisexual man in a relationship with another man may be called gay even after stating they are bi. Biphobia - similar to bi erasure; when someone discriminates towards someone who is bisexual through behaviour or speech relating to the negative stereotypes i.e. "it's just a phase", "so you're gay?", "you're 50% straight & 50% gay", "you're more likely to cheat", you're greedy" etc. Butch - used to describe someone who is of masculine presentation. This is often related to Sapphic women, but can relate to any gender or sexuality. C Cisgender (Cis) - identifying wholly to the gender you were assigned at birth Cisgenderless - identifying to the gender you were assigned at birth due to being perceived as that gender, however there is no strong leaning to the gender itself as an identity. If someone who is cisgenderless were to wake up as another gender they would most likely then identify as that current gender. Coming Out - this is used to describe when someone reveals their gender or sexuality to other people in their lives. Chosen Family - A chosen family is often used within the LGBTQ+ community and non-monogamy community to describe the friends and partners that they surround themselves with rather than necessarily their blood relatives. Casual Relationship - this is a relationship that doesn't necessarily have 'traditional' boundaries. It might be known as 'friends with benefits (FWB)' or 'no strings attached'. Compersion - this term is often used in non-monogamous relationships. It can be seen as the opposite of jealousy i.e. where you will feel happy, excited, joyous etc. for your partner and their other relationships. D Demisexual - this is a sexual orientation amongst the asexual spectrum. It often means that a sexual attraction isn't felt until there is an emotional connection with someone. Demisexual can go along with other sexualities e.g. being demibisexual Demiromantic - Similarly to demisexual, this often means someone who doesn't feel a romantic attraction with someone until an emotional connection has been made. Demigender - quoted from the LGBT.wiki "can be described those who feel the barest connections to a gender, but not enough to fully identify as that gender.....Demigender can also be an identity in itself, for people who feel a partial connection to the concept of gender in general". People may identify as another gender in combination with demigender e.g. Demiboy - partially a man or partially masculine Demifluid - partially fluid, with the other part being static Demigirl - partially a woman or partially feminine Demineutois - partially neutrois Deminon-binary - partially non-binary Demixenine - partially xenine or xenogender Dysphoria - this can be in relation to gender when feeling a disconnect between who you are and the body you are in. Deadnaming - using someone's birth name rather than their chosen name Drag - This is generally a performance by adopting gendered behaviours and presentation. Drag isn't an indication of sexuality, gender, or sex identity. Drag Queen - This is taking on a feminine persona for performance or expression Drag King - This is taking on a masculine persona for performance or expression DADT - Don't Ask Don't Tell, is a 'policy' used within some non-monogamous relationships in relation to not wanting to know information about other partners, i.e. if I don't ask about them, don't tell me. E Enboric - this is and umbrella term to describe attraction towards non-binary individuals. LGBT.wiki quote, "Enboric people can be exclusively attracted to non-binary people or they may be attracted to non-binary people along with other genders." Expression Fluid - an expression of gender that may change rapidly or over time regardless of our gender. i.e. a cis man expressing femininity. Ethical Non-monogamy (ENM) - an umbrella term to describe non-monogamous relationships that have been consented to by all involved. These relationships don't follow the structure of monogamy and can include, open relationships, polyamory, monogamish relationships, casual relationships etc. F Free Love - a way of having relationships which don't fit in to the social norms of relationships. The idea is that love is unrestricted by marriage, labels or commitment. FTM - "Female to Male" is used when someone who was assigned female gender at birth has gender affirming surgery or has transitioned to Male. This is now seen as an outdated term as Trans man is preferred. Femme - expression in a feminine way e.g. dressing in stereotypical female clothing, make-up, acting feminine etc. Fluidity - where gender or sexuality aren't set in one identity and isn't binary. Having sexuality or gender that can shift within the spectrum. G Gay - means to be attracted to members of the same gender as yourself. However, this is also used as an all encompassing term for people who aren't straight. H Homosexual - not often used any more sue to the stigma that has been attached to it, but is a term to mean you're attracted to members of the same gender. Homophobia - language or behaviour that is offensive, oppressive, or harmful towards someone who is gay/queer. Heterosexual - or 'straight', to mean being attracted to members of the opposite gender. Heteroflexible - someone who is predominantly attracted to the opposite gender but not exclusively. Hierarchy (in non-monogamy) - where relationships have labels such as being a primary partner or secondary partner. This shows distinction between the relationships and can be seen as oppressive within polyamory communities where equality between relationships is promoted. However, it is a viable form of relationships where everyone involved is consenting and aware of the dynamics. I Intersex - Someone who is born where their sex characteristics are not, solely, traditionally male or female. LGBT.wiki - "variations may appear in a person's chromosomes, natural hormones, genitalia, gonads, secondary sex characteristics, or some combination of these things." J Joyfriend - a gender neutral term for referring to a partner. K Kitchen Table Polyamory - a style of polyamory where all partners can get along and share resources/have a 'family style' way of being together. This includes those in the polycule that aren't dating each other. L Lesbian - Women or non-binary people who are attracted to other women. Lesbophobia - discrimination or aggression towards lesbians. M MTF - Now, mostly, considered an outdated term for someone who has transitioned from being Male to Female. If someone uses this to define themselves then this is still completely valid and relevant. Misgender - This is when someone is labelled as a gender which is different to the one they are. e.g. this can be done by using incorrect pronouns or calling someone a man when they might be a trans woman. Multigender - An umbrella term for those who might experience more than one gender i.e. someone who is genderfluid or bigender. Monosexual - An umbrella term for sexualities which are attraction to one gender i.e. straight, lesbian, gay. Multisexual - An umbrella term for sexualities which are attraction to more than one gender. Mono - abbreviation for someone who is monogamous. Monogamous - A romantic relationship which consists of two people exclusive to each other. Metamour - Used as a term for your partners partner and is often shortened to meta. N Non-Monogamy - umbrella term for relationships that aren't monogamous. Non-hierarchical Polyamory - A type of polyamory that sees partners on an equal footing. New Relationship Energy (NRE) - describes the excitement in the early stages of a relationship Non-Binary - Where someone's gender is not exclusively male or female, but somewhere else along the spectrum O Omnisexual - used to describe someone who can be attracted to all genders but may also have a preference. Outed - used when someone else reveals our sexuality or gender to others. P Pansexual - attracted to people regardless of where they fall on the gender spectrum. Panromantic - romantically attracted to people regardless of where they fall on the gender spectrum. Pangender - someone who experiences many or all genders; the number of genders experienced may be unknown or may fluctuate. Polysexual - attracted to many but not necessarily all genders. Polyromantic - romantically attracted to many but not necessarily all genders. Polygender - A person who has multiple gender identities. Polyamorous/polyamory - having consensual in multiple intimate relationships. Polyfidelity - someone who is in multiple relationships but closed off to any more. Polygamy - Often seen as a term rooted patriarchal philosophy as it often refers to many marriages for men not women. Polysaturated - when you have hit the maximum level of partners you can manage. Pronouns - words used to refer to someone's gender identity i.e. her/him/them/xe. Passing - can be used in the sense of gender or sexuality: * a queer person might be in a 'straight passing' relationship with someone of the opposite gender. * a trans person might want to 'pass' as the gender they have physically transitioned into Platonic Partnership - can be used to describe an intimate relationship with individuals who are on the ace sexuality spectrum so not necessarily sexual relationship. Primary partner - used to describe a main partner when in multiple relationships Q Queer - Is a term that covers all non-heterosexual labels of orientation or gender. It was used as a slur but was taken back and embraced by members of the community in the 80's - though some still see the term as a slur. QPOC - stands for Queer People of Colour QTIPOC - stands for Queer, Trans, & Intersex People of Colour Queerplatonic Relationship - "a close non-sexual, non-romantic relationship that is beyond what most would consider to be a friendship." - LGBT wiki Queerbaiting - A manipulative marketing practice used to imply queerness is involved for publicity. Questioning - A term used for when someone is unsure on or exploring their sexuality or gender. R Romantic Orientation - describes someone's romantic attraction towards other gender rather than their sexual attraction. Relationship orientation - describes someone's preferred way of having a relationship i.e. polyamorous, open, monogamous, ambiamorous etc. Relationship Anarchy (RA) - Is an approach to relationships. "Its values include autonomy, anti-hierarchical practices, lack of state control, anti-normativity, and community interdependence" - LGBT.WIKI. S Sex - Medical term for biological assignment which may be different to gender. This is often based on genitalia even though sex characteristics are a lot more complex than this. Scoliosexuality - an attraction to trans & non-binary individuals. Sapphic - relates to women who are attracted to other women, often referred to as women loving women (WLW) Sexual Orientation - relates to our general attraction towards other genders. Secondary partner - often used in hierarchical polyamorous relationships in conjunction with primary partners. The secondary partner might have their relationship as a lower 'status' to the primary relationship though this doesn't necessarily mean it is viewed as lesser and is still consensual with all involved. T Trans - is an umbrella term for someone who isn't the gender assigned to them at birth. Trans Woman - is a woman who has transitioned from being assigned male at birth. Trans Man - Is a man who has transitioned from being assigned female at birth Transfemme - is an umbrella term for someone who's trans and where their gender identity leans more towards feminine expression. Transmasc - is an umbrella term for someone who's trans and where their gender identity leans more towards masculine expression. Transition - is the process that someone goes through in order to express their gender when it is different from the assigned gender at birth. This may be via medical interventions, hormonal and/or clothing/external expression. Transition can also refer to 'coming out' to those in the individuals life. Transphobia - the discrimination or dislike towards trans people or someone who may be perceived as trans. This can include purposefully mis-gendering someone, using their deadname, refusing to accept their gender etc. Two-Spirit - This is strictly a Native American identity which refers to having both a masculine and feminine spirit. Triad - Often a closed polyamorous relationship involving three people. The combination of which could consist of multiple genders or all of the same gender. Trisexual - has multiple uses 1) to describe someone who has a preference for a relationship involving three people. 2) having an attraction to three genders 3) willing to try 'anything' sexually U Undetectable - used when HIV medication reduces the levels of HIV to a low level and it's unable to be passed on. Unlabelled - Used when someone doesn't want to label their gender or sexuality in more specific terms. This could be for many reasons. V Vee - a term to describe a relationship involving three people; where one individual is intimately involved with the other two, but the two aren't intimately involved with each other. The relationship looks like a V where the central person is the 'hinge'. Veto - used in non-monogamy relationships where one partner has the 'power' to end or 'veto' external relationships or boundaries of an external relationship of their partner. This is often seen as a 'red flag' in most non-monogamy relationships as it gives an unbalanced power dynamic. W Wibble (polywobble) - used when a partner has an 'emotional wobble' of insecurity or jealousy when seeing a partner with someone else. This is a human response and often means doing some internal reflection to understand what this means. Women Loving Women (WLW) - is an umbrella term used when talking about bisexual, lesbian, pansexual, polysexual.... women and their attraction to other women. X Xenogender - A term for those who don't identify with any gender identities currently out there due to the current language not being able to encapsulate their identity. This is a non-binary gender identity outside of the binary of masculine and feminine. Am I missing any? Let me know in the comments below :) Are you a Therapist, Counsellor, Psychotherapist, or Mental Health Professional and want to know more about working with Non-Monogamous Clients? Check out my online course - here

Our bodies are so important to take note of as they hold our emotions, feelings, and trauma for us even when we haven't necessarily processed them cognitively. We can find that all these things can manifest in different physical symptoms such as headaches, nausea, stomach pain, global pain, tense muscles etc. It can be difficult to know whether the symptom is a physiological one itself or coming from a build-up of psychological overwhelm. A big example of this is stress; Often, the trigger for stress is situational, leading to a psychological reaction, however within our body, hormones are being released to help us react to the stressor. Over time if the body is still under stress, releasing these hormones can lead to overwhelm, psychologically and behaviourally, as well as physically causing symptoms such as headaches, fatigue, muscle tension, and irritability [ See post on Stress ]. Another example can be for those of us with chronic illnesses. Our bodies will tell us when we are doing too much or neglecting certain things with physical signals. With my fibromyalgia I have learnt that when I start to get more intense headaches or dizzy spells that I am starting to get run down mentally and need to take some time to rest and regroup by switching off with some mindless TV or a bath. If I am pushing my body too hard physically, I will notice that my global pain is more intense and will kick in quicker when doing activities and so I need to slow down and take a step back from what I'm doing. It is beneficial to treat our bodies well consistently; eating a varied and nutritious diet, trying to exercise where we can, having a sleep routine to allow for rest - though this isn't always easy when we are in a state of exhaustion, stress, or despair. Therefor, in the day to day, it can be useful to take a step back and reconnect our psychological and physiological to notice how we're doing overall and give us chance to assess if there's a way to take the day a bit easier or make it more manageable. Try it yourself: A body-scan technique Below I'm going to talk you through a body-scan technique that allows you to relax and get a sense of where the emotions, feelings and trauma are being held. Start by finding a quiet and safe space that you can feel comfortable in. Settle into a relaxed position either seated or lying down and close your eyes. Allow your mind to quiet as much as possible and steady your breathing to a slow rate. To do this, it can be useful to count your breathing to slow both your mind and breath (breathing in for 4, hold for 4, breathe out for 4 and repeat a few times). Now you're ready, take your time to focus your mind on your toes. While you're focusing on your toes notice any tension, pain, or sensations; at the same time, let yourself notice any emotions that come up with the physical sensations you may have noted. Now slowly tense and relax your toes to release your focus and move to the soles of your feet to repeat the process. Move your focus upwards to each section of your body doing the same as above by taking your time to notice how each part is feeling and the emotions that may correspond. Once you have made your way up your entire body, give yourself some extra time to reflect and note all of what you noticed and allow your mind to wander. When you feel ready, start bringing movement to your fingers and toes, your feet and hands and then the rest of your body to continue on with the rest of your day. This process can be really powerful and will take some time to do when you first start. If you start to lose focus partway through the exercise, try not to beat yourself up, but instead take some more slow, deep breaths and bring yourself back to your body. From this exercise, you will be able to connect with parts of your body that could be holding certain emotions, and you might be surprised at how you feel while you're going from limb to limb. As a result, you can then look at ways of processing and managing these symptoms and emotions with therapy or different ways of coping in your toolbox! Originally posted here - https://www.counselling-directory.org.uk/memberarticles/chronic-illness-our-bodies-and-us

What is anxiety? Anxiety is a natural human emotion in response to a stressor or situation. A small amount of anxiety every now and then is normal, it is part of our stress response, and a way in which our body functions, however when anxiety becomes a feeling you experience constantly and/or severely, it can be part of a mental health condition like General Anxiety Disorder (GAD), Post Traumatic Stress Disorder (PTSD), Social Anxiety Disorder, etc. Bearing in mind that, just because you feel anxiety doesn't mean you have a disorder. So do speak to a medical professional if you are concerned about how often and the intensity of the feelings you're experiencing. What does anxiety feel like? Anxiety tends to have an impact on our physical, cognitive, emotional, and behavioural responses e.g. Physical - palpitations, feeling hot, sweating, shaking, tremors, dizziness, nausea, headaches... Cognitive - worrying about small things, ruminating, getting stuck on an intrusive thought, worrying about the anxiety itself, your mind racing with 'what ifs'... Emotional - feeling scared or fear, feeling irritable, feeling overwhelmed.... Behavioural - avoiding people, withdrawing, asking for reassurance, picking fights/arguments with others.... Anxiety will feel different to each person, you may find you have all of these corresponding symptoms or only a few. For me, anxiety feels like a raw emotion; when it's intense it feels like it's a buzzing feeling coursing through all of my body, I feel like I'm shaking even though I may not be visibly shaking, I can get a chest pain which feels like a tightening heavy feeling, I get palpitations, and I can have an on set of dizziness. I tend to feel overwhelmed with my thoughts and unable to concentrate on anything. It's like my body and mind are running on overdrive and I am not in control. When it's general anxiety on a proportionate level to the situation I'm in, I may feel my heart racing and I may shake but I tend to be able to slow my thoughts and body down to feel in control. What causes anxiety? Noticing your triggers can be helpful in managing your anxiety as you can have a plan for how to cope with it. There are many things which can set off anxiety, and again this will be individual to you. Our past tends to have an influence on our ability to cope with anxiety - if you have had a challenging, traumatic, and difficult upbringing without any support in place then you will be more likely to experience anxiety on a intense level or faster than someone who had support in place. I look at it in terms of our capacity. If we have been modelled and taught how to regulate and process our emotions growing up, our capacity & tolerance for stress and life events will likely be larger than someone who wasn't allowed/taught to regulate or express emotion. Therefore, not only does our past have an influence on our ability to cope with anxiety, but so do our current life events. Someone who has a larger capacity will be able to withstand a larger proportion of stressful events than someone struggling with capacity. Things like, our health, our cognitive functioning, our home environments, our working life, our finances, our family support, our friendships and relationships, and any addictions, all have an impact one way or another on our anxiety levels. Holmes and Rahe, created the stress scale when looking at peoples health. They gave stressful life events differing scores on their general 'stress levels' and how this impacts us - https://www.verywellmind.com/what-is-the-holmes-and-rahe-stress-scale-6455916 When I think of capacity, this is what comes to mind. Humans tend to have a reaction to change, even when it is inevitable. This reaction can be one of excitement and embracing or it can be one of anxiety and avoiding. If we then have multiple of these live events coinciding with each other, it will have a bigger impact on us, even if we don't notice or acknowledge it initially. Our tolerance and capacity for stressful life events will be different to the next persons, but as the saying goes, "there's only SO much someone can take before it breaks them". On top of all of this, there can be the smaller day to day things that set off anxiety in us. For me things like having "too much" mess in the house makes me feel restless and anxious, having a list of chores but not having energy to do them, knowing I have to make an appointment - particularly medical ones, being out in public in busy spaces etc. When I think about these day to day type triggers they all have some link to past narratives I've internalised or linked to past traumas. So, take a moment to think about how you noticed anxiety when you were younger - was it something you noticed? Was it something that was feared and avoided or was it something you were supported with and had soothed? And now think to your current life, do you express your anxiety? Do you notice it? What does it feel like? Do you notice anything going on in life which is setting it off? When we learn to notice the triggers, we can learn how to soothe ourselves in stressful and anxiety provoking situations. Until then, we can look at how to manage the anxiety when it occurs. How to cope? As with all coping methods, it is not a one size fits all and so you might find everything recommend works for you, you might struggle to find something that works, or somethings might work one day and not the next. The main thing is to keep trying - some methods take time and practice, so don't write something off after one try. Beathing - Yes, yes, I know, breathing techniques are pushed a lot, but they can be really effective in grounding you and slowing your body and mind down. There is the "box breathing technique" which is to: Breathe in through your nose deeply for X amount of seconds, filling your stomach. Hold this breath for X amount of seconds Breathe our your mouth in a controlled flow for X amount of seconds Hold your empty stomach and lungs for X amount of seconds And repeat for as long as is needed. The reason I have written "X amount of seconds" is because this will be different for your own capacity. I don't have the best lungs and so for me I tend to do 4, 4, 4, 2 and I find this works well for me, but this might be too short a time for others. So play around with it to find something which is comfortable and works for you. I would also suggest doing breathing in a controlled and mindful way to help slow the mind down. Bring your attention to your breath rather than your thoughts. Focus on the counting and the feeling of breathing. Ideally you would be in a quiet and comfortable space too, however this is also useful to do in the moment and so can be done wherever you need to. Grounding - Similarly, to breathing techniques, grounding is a way to bring your focus back to the here and now within yourself. The most popular grounding technique for anxiety is the 5,4,3,2,1 method. Name 5 things you can see Name 4 things your can touch Name 3 things you can hear Name 2 things you can smell Name 1 thing you can taste This brings the focus onto your current immediate environment as well as distracting your mind by getting it to focus on a task. It also engages your body to ground it by engaging each of your senses. Movement - For me breathing and movement are my most effective ways of coping with anxiety in the moment and I tend to combine them. That buzzing feeling is lessened by doing some gentle stretching or standing up and shaking all of my body. Yoga can be a gentle way of doing this, especially if like me you aren't able to do exertive exercises due to chronic illness - https://psychcentral.com/anxiety/yoga-for-anxiety Alternatively, any type of exercise can be useful in helping ease off some of the symptoms of anxiety - running, walking, boxing, rowing, dancing, martial arts, pole dancing etc. Writing - journaling, free writing, letter writing, mood boards, bullet journals etc. all of these ways of writing and expressing yourself can help ease the feeling of anxiety. There is something in the process of getting it out of your head and into written words which is cathartic. I prefer to do this the old fashioned way with pen and paper, but I do also find that typing out notes to myself on my phone is just as effective and accessible when on the move. Talking - talking to someone helps. This can be your support network of friends, family, colleagues, managers, unions, HR etc. or it can be a professional like a therapist or your GP. Check out my availability here - www.emilyduffytherapy.co.uk/book-online Relaxing - meditation, yoga, bubble baths, naps, etc. Being able to calm your mind can help ease anxiety. If you find your mind racing too much try a transition exercise to try and train your mind into shifting states: What my colleague called the "Power Animal" technique: Imagine your anxious state - describe it. Now think of an animal that resonates with this state of being Imagine your relaxed, calm state - describe it. Now think of an animal which resonates with this state of being. When your feeling anxious picture your anxious animal, now slowly breathe into the belly of your calming/power animal. e.g. for me, my worked up anxious state is a crocodile, it feels rigid and hard to move, I feel stuck in myself but going too fast at the same time. It feels vicious and on the attack. But my chilled out relaxed animal is a sloth. It's slow, peaceful, resting, sleepy, doing its own thing. So when I get stressed out I imagine myself as that crocodile, rigid and stuck, but then I do some deep breathing, allowing the air to fill my belly and picturing it changing into the big sloth belly, I loosen up and inhabit that animal "form". All of these ways of coping are all well and good for the short term anxiety, but longer term and intense anxiety will need a mix of coping techniques as well as some practical support too - which can be done in therapy or by yourself with support from others. Break things down into small manageable chunks - try to reduce the overwhelm and take things one step at a time, starting with the smallest of steps. If you're too anxious to leave your house and see other people, the first step might just be thinking about what you would wear. And slowly over time you would build these steps up. Set aside time to worry - If you are ruminating all the time over everything, challenge yourself to only have 30 minutes a day to focus on these worries. Plan that time and set it aside. If you start to notice you are ruminating outside of this time, try to acknowledge the thought and tell yourself to focus on it later and bring your focus back to whatever you are doing in the 'here and now'. Try to think about your situation with compassion and a different perspective -Take a step back from yourself and ask yourself what would you tell a friend if they came to you with this worry? Would you like more suggestions? Download my Coping Plan here . Essentially you have a few steps in how to cope with your anxiety on a whole: Understand your anxiety - speak to your GP and/or mental health professional for support in doing this. Learn how to cope with it - find healthy ways in which you can ease your anxiety symptoms Learn how to manage it - find ways to reduce the stressors and situations setting off your anxiety Some final notes... Crying is a natural regulation response, you're allowed to cry! You can't do everything, all the time, at 100% at least not for long. Remember it's good to rest. You are human, you are not perfect. Try to give yourself some grace and compassion 💚 Anything else you would add, let me know in the comments :) Further Reading: https://www.emilyduffytherapy.co.uk/resources https://www.nhs.uk/every-mind-matters/mental-health-issues/anxiety/ https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/about-anxiety/ https://stem4.org.uk/anxiety/

I've been wanting to write this for a while now as having a chronic illness in relationships and balancing those dynamics can be a lot of work for all involved. I also find it difficult to find support out there when I've been going through this as my chronic illnesses affect me in certain ways and articles can't always cover every aspect or fit to your unique situation and dynamics; I am going to do my best to bring in points of reflection to this article to try and allow for this as you are the expert of you in your own life! This post will be focusing mostly on typically romantic and sexual relationships, however there will be a lot of relatable content for other - familial & platonic - relationships too. Content: Sex Life Feeling a Burden Responsibilities Imbalance Support Break Downs Dating Relationship with Self Further Resources on Chronic Illness Sex Life - From Unsplash Many with chronic illnesses can struggle with their sex life once symptoms start. There can be many factors that come into this: Pain levels can be at a point where being touched doesn't feel comfortable or pleasurable. This can also mean that positions and penetration can be really uncomfortable too. It can be that our bodies feel medical. I often find I think of my body in relation to my pain and symptoms not how I actually am as a person and not as a sexual being either! Having our body discussed, investigated, and "judged" in a medical setting can leave us with trauma and difficulties in self-image. Scheduling time for sexual activity can be difficult and takes out the spontaneity, but sometimes this can be necessary as waiting for a "good" symptom day can be unpredictable. This is not to say force yourself through your comfort levels in order to participate, but rather scheduling time can allow for the opportunity to be intimate with your partner(s). If you already have a mis-match in libido, chronic illnesses on top can be really frustrating for all involved as it adds an additional "challenge" in connecting so both/all of you involved feel comfortable and satisfied. How to navigate this as the individual with chronic illness: Self compassion - Are you in touch with your compassionate voice? If not this is something to work on as it can help give you some space to allow all of the discomfort whilst trying to bring space for the pleasure. This might be getting back in touch with that feeling of whenever you last felt comfortable in your body. If you can't remember a time (I feel this!) then imagine what that might be. From this you can try to harness the mindset you had about yourself then. Try to view yourself without judgement and without focusing purely on the chronic illness, but as who you are as a whole being. What do you see? It can sometimes help to think about what your partner(s) see when they look at you. What do you think they'd say? What have they said? Make intimacy a priority Take it into consideration when you are putting your routine together, where can you fit it in to give you enough space to prepare, participate, and recover? This doesn't mean for intimacy to be THE priority (unless that's how you want it), but to try and have it in mind when making plans. If you're like me spoons are pretty limited and so I do have to plan days of rest and recovery into my schedule, so make intimacy part of this. How to navigate as the partner(s): A change in sex life from our partner(s) can sometimes feel like it is about us, as the partner. Often, this isn't the case and your partner really wants to be intimate but there can be all sorts of feelings and thoughts that they are battling in order to do so. Find ways to be intimate with yourself whilst your partner is coming to terms with their illness and what this means for them. Try to be patient with your partner - it may be that sex is a different pace to what it was before. Navigating it together: Reframe what intimacy looks like Does sex need to be penetrative or can it be more about the connection and sensuality of togetherness? Maybe oral or more sensual acts could be more satisfying when symptoms are causing discomfort. Orgasms don't have to be the aim - quite often orgasms are seen as an "aim" in intimacy rather than it being acts to be intimate and together. Maybe mutual masturbation could be a more comfortable option? Or being present whilst your partner satisfies themself? Could more lower level and less demanding intimacy help offset the change in dynamic and sexual activity. Things like long hugs, holding hands, kissing, cuddling etc. Communicate about what positions feel comfortable or now feel like they're off limit. Keep checking in with each other: A check in is having a conversation about your experiences, what works, what doesn't, what you'd like to try, what's off limits, i.e. exploring your boundaries It can be useful to check in before sex, during, and after. Before may be, "do you feel able to do X?", "I would like to X is that okay with you" etc. During may be, "does this feel okay?", "that's good", "can we try something else" etc. After may be, "how was that for you?", "I noticed X was uncomfortable maybe we try Y next time" etc. If you're in non-monogamous relationships, it may be worth looking at how the dynamic has changed and how this impacts the polycule and keeping these conversations ongoing. It might be that group play might feel like too much now and so this would need to be communicated with all involved. It might be that talking about intimacy with other partners, who don't have chronic illnesses, could bring up a lot for the partner that does, and so space for this will be needed. Jealousy and comparison may surface, even if this was never an "issue" before. This will often be coming from a place of insecurity and so a talk about needs and boundaries could be useful to reaffirm your relationship. Maybe a Don't Ask Don't Tell might be needed for the time being whilst the diagnoses are processed and understood more. Remember to get consent from all partners about disclosing intimacy details before you share the details with others. Just because they're not in the conversation doesn't mean they don't have a say in what they consent to. From Unsplash Burden There is a stigma in society around being disabled and/or chronically ill. This stigma can be internalised and so coming to terms with a chronic illness or disability can be a battle with the internalised stigma and ableism. It can leave us feeling like a burden in our relationships - like we're not "enough" or we're bringing our partner down, even when this often isn't the case! I have conversations with people about how we, the person, are not the burden, but a chronic illness is a burden as it is heavy and disruptive in so many ways. That burden is a part of us, but it is not the whole being. And whilst we feel that burden so deeply our partner(s) can be willing to help lift and share in it with us - and I'm sure you'd do the same on the other spin. How to manage this as a dyad or group: Allow space for ALL of the feelings in the relationship that come up from the chronic illness. You're allowed to feel shitty from the impact the illness has on you, it's understandable. Your partner(s) allowed to feel frustrated because of the impact of the chronic illness too. You will both have feelings about the impact of the chronic illness on your dynamic, and whilst it may change this dynamic in ways which feel difficult and challenging, it can also highlight the love, care, support, and respect you have for each other. Accept the help that is being offered to you. Your partner wouldn't offer it if they didn't mean it, and even if they did that's still their choice and you are allowed to accept the help. Accepting help doesn't confirm that you're a burden, but it does accept that you may be struggling with some very real difficulties that you're facing, and a relationship is about facing those difficulties together. In arguments it can be hard when things are said in anger. If the shame and stigma has been perpetuated in your relationship then it is important to talk about how this has made you feel and work out how you can communicate going forward. Maybe you have a word to give yourself space when disagreements are becoming heated and you feel you'll say things you'll regret or don't mean. Try to avoid name calling in arguments, remember that a way through arguments is to look at the problem rather than battling each other, i.e. you and me Vs. the problem, not you Vs. me. If the person with chronic illness is perpetuating the stigma and putting themselves down vocally, you can challenge them on this with how this makes you feel to see them do this. Again, communicating in a way which tries to remove judgement and holding each other with compassion can be healing. Imbalance of Responsibilities From Unsplash The weight of responsibilities within the relationship and household can be a difficulty in any relationship, and when chronic illness is then added in, it can cause some challenges. There is no "right" way to divide responsibilities within a relationship. When I talk about responsibilities I am including household chores, time spent with each other, children, pets, work & finances, hobbies, social events etc. This can be responsibilities spread across all households of the individuals involved in the relationship too. There can be shame and guilt felt by the person with chronic illness as it may mean having to ask for more support from partner(s) in order to keep up with responsibilities, this will look different in every relationship, but it could look like: Partner A, with chronic illness, still working full time to keep finances stable but then needs Partner B or children to help with the keep up of the household. Partner A going part-time in work and not doing as much planning or social events, in order to keep up with the household responsibilities Partner A giving up work so that they can do household responsibilities, still do hobbies, and have social life. The shift in dynamic can cause a ripple affect onto everyone else in the household (family, children, parents) and in the relationship/polycule. I have struggled with this personally, in how to juggle everything and give each part of my life the time I want to, but the want isn't always possible and this can lead to thoughts and feelings of "not pulling my weight" or "not doing enough" even though I do all I can. Pacing has been a big challenge but I have been lucky and privileged enough to be supported whilst figuring it out, but I know this isn't the case for a lot of people. What you can do as the individual with chronic illness: Take some time to explore and understand your capacity. This can take a while and may need to be done "on the go" as we aren't able to stop life. My post around Pacing may be useful here. Understanding capacity will then allow you to know what areas you need to prioritise or where you may need help from others. When communicating what you feel able to do and not to do, allow space in the conversation for their feelings which may come up in response to this. Change can be jarring for all involved, but communicating it where boundaries can be clear is useful. Allow yourself to grieve - there is a big grieving process involved when getting a diagnosis of a chronic illness. It may not be as impactful for everyone, but it can take a while to process that the person you once were might not be possible anymore, certain hobbies, foods, ways of life might not be possible anymore, and the life you once envisioned for yourself can all be a felt loss following a diagnosis. Remember to communicate this with your partner(s) when you feel able to so they understand what's going on as it can cause a disconnect when it is all bottled up - you don't have to go through it all alone. What you can do as the partner(s): Again, be patient. Figuring out the limitations of our unpredictable symptoms can take some time to figure out. And when doctors aren't always the most supportive or helpful it can take longer. Allow space for communication around what is possible and what isn't. Keep in mind that what is possible at this point in time can change for anyone involved and so regular check-ins on both sides is important. Look after yourself too - if you take on more responsibility in your relationships, this can take a toll and so it's important to still look after your own wellbeing. You might also experience a grief process as the person you're spending your life with is going through a big shift in identity which will also impact your relationship. So you may also grieve what you once thought your relationship and life might have looked like and to then process what this now might look like with the chronic illness involved. What you can all do: If the responsibilities are feeling too much for both of your capacities, it could be that you look to outsource some of the help needed - other partners, family, friends, hired help. I am aware this will be a big decision to lean on your support networks or to lean on your finances to bring in more support, in which case remember that there are charities and organisations that may be able to help. Reduce the expectations that you put on yourselves. It may be that you need to allow for the laundry to build up a little more than you'd prefer, or you no longer iron every piece of clothing, or you vacuum once a fortnight rather than weekly etc. This can be challenging, and it may be that this is something you've already done and so reducing the expectation further pushes past your comfort level or wellbeing level. It may mean living under your means or cutting down on spending. Again, I realise this isn't possible for everyone where this is already where you're at, in which case it may be leaning on support from organisations and charities even further. Keep checking in with each other on where you're both at, how you're both coping, if anything can be done differently, etc. From Unsplash Support & Lack of There can be times where relationships hit a real rocky patch (with or without chronic illnesses) and so this can be especially difficult when chronic illness is involved. It may be that the partner without chronic illnesses feels like they are being leaned on too hard and can't offer the type of support the person with chronic illness is needing. Or it might be that the person with chronic illness is asking the minimum needs to be met by their partner, but the partner isn't willing. Or it might also be if you're in a polyamorous relationship, and that your meta (your partners partner) is the one with the chronic illness and your partner is giving more time and support to your meta than to you and so you're feeling unsupported and cared for. What to do if you're feeling unsupported: Assess what your needs are which aren't being met and look at if they can be met in other ways. Is there anyone else you could talk to? Are there other ways of getting things done e.g. ordering food deliveries rather than going out to the shops. Communicate your needs to your partner and how it feels with them not being met - try not to blame but focus on what you can both do to help the situation. What to do if you're not willing to support: Think about what your capacity is and what you feel able to support your partner with. Have a conversation explaining your boundaries and how you're feeling. As above try not to blame but instead both focus on helping the situation. Relationship Breakdowns - Unfortunately it may be that you can't come to a decision on how your needs can be met, or how support can be improved, or how you can both work together, etc. and this can lead to a break down in the relationship. With break ups and chronic illness it can be difficult to manage as the emotional stress can impact the intensity of the symptoms and lead to a flare up, so it is important to look after yourself as best you can with the resources you have. What to do with a break up: Try to put in more self-care so that you can manage any unpredictability of your illnesses as possible. This isn't always doable but having the space to care for yourself however that looks is important. A break up will mean reassessing your capacity, needs, and wants with your life and how this might look now without your partner in the picture. It may be that you have both decided to deescalate your relationship in which case it will be important to have a conversation around your boundaries and how your dynamic will look going forward. Lean on your support network, organisations, charities, helplines etc. where you can. Even with chronic illness, sometimes keeping a routine can be helpful when dealing with a break up as it brings a feeling of normalcy to life where it can feel like it's falling apart otherwise - this is especially so where your partner was your main support structure. Dating - From Unsplash Dating can be an exciting part of relationships but it can also be emotionally draining and bring the priority of safety too especially for femme presenting chronically ill individuals. Some general points: Potential partners may not be willing to meet your needs and expectations in a relationship and use your chronic illness as the reason. An example, "you can't be serious about meeting me if you're cancelling from migraines all the time..." This can be really unfair when a chronic illness is unpredictable and something you didn't ask for. If you're in a non-monogamous relationship it's important to know what your agreed relationship boundaries are before dating - again emotional stress can cause more intense symptoms and so being on the same page as everyone from the off can be helpful in these situations. Be mindful of the dopamine loop when dating in how this can be something you do for short bursts of connection and feeling good. Remember (mostly) they are other humans on the other side and so their emotions need to be considered in how serious you are about making a connection and moving forward. What to do as an individual with chronic illness: Try not to compare yourself to other people on the dating apps or to metas. Remember to check in with yourself on your capacity levels. Do you have the energy and time for a/another partner and what does this look like if you do? Whilst it can be vulnerable to do so, it can be useful to be open and honest about your chronic illnesses from the start so you are both on the same page. N.B. Don't feel pressured to do this! What you share with others is absolutely your decision and you do not have to share anything if you're not ready. Look after yourself - societal timelines don't fit everyone, in fact they don't fit most people, get in touch with you, what you want, and go from there. Try not to put pressure on yourself, but instead be kind to yourself. What to do as a potential partner: Be open and curious as to what the other persons boundaries are. Don't push for details, someone will tell you about their chronic illness when they're ready Do your own research around what it means and if it's something you're wanting to be supportive with. As above, you also need to look after yourself too. Whilst dating can be fun it can take it's toll on you. Relationship with Self - I am planning on doing a post about coping with chronic illness which will go into this in more detail, so keep an eye out for that . You are in a relationship with yourself, just as much as you are with other people. And so it is important to keep checking in with yourself about how you're doing and what's going on for you. I find that this changed often, I get a routine in place and then another symptom comes up or a flare up happens and I have to start again with finding what works for me. Try to be patient with yourself. It can be difficult to go from being able to do whatever you want to having to try to pace and take things slow. Turn up the compassionate voice & turn down the critical - it won't help you to put yourself down on top of the difficulties you're dealing with. Yes, we can learn from any mistakes we make, take accountability, and reassess our behaviours, but we don't have to hold it against ourselves. Learn different types of self care - physical, mental, emotional, social, spiritual etc. If you find yourself struggling and not ready to talk to anyone, try writing/typing it out. Set a timer for 30minutes and just let it flow out without judgement. Alternatively you could write it as a letter directed to someone or yourself. Look at individual therapy and also relationship therapy to have a space to process all that's going on and navigate you through the difficulties. Further Resources on Chronic Illness https://www.cisfauk.org/ https://chronicillnessinclusion.org.uk/ https://www.independentage.org/get-advice/health-and-care/living-long-term-health-conditions/get-support-long-term-condition https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/benefits-for-people-who-are-sick-or-disabled/ Access to Work - https://www.gov.uk/access-to-work Turn 2 Us for financial and general support - https://www.turn2us.org.uk/get-support/ The Advocacy Project - https://www.advocacyproject.org.uk POhWER - https://www.pohwer.net/ Voice Ability - https://www.voiceability.org/ The Disability Rights Org UK has further signposting and guidance that might be more specific - https://www.disabilityrightsuk.org/resources/advocacy-get-your-voice-heard Mind info on Advocacy - https://www.mind.org.uk/information-support/guides-to-support-and-services/advocacy/types-of-advocacy/ Therapy: https://www.emilyduffytherapy.co.uk/post/finding-the-right-therapist-for-you Want to know more about me check out - https://www.emilyduffytherapy.co.uk/post/what-i-ve-learnt-from-my-fibromyalgia Want to know more about non-monogamous relationships check out my guide here.

The Science Different types of antidepressants & how they work: There are a few different types of antidepressants used and some of them have different functionalities for what they can treat. The most commonly prescribed type is SSRI which is thought to help increase the amount of serotonin absorbed in the brain by blocking some reuptake nerves cells allowing the serotonin to travel to other cells. A newer medication is SNRIs which work in a similar way to SSRIs but include blocking reuptake of norepinephrine alongside serotonin. Additionally there is an uncommon drug under NDRIs, which is another reuptake inhibitor blocking the reuptake of norepinephrine and dopamine in the brain. There are then less commonly prescribed medications due to their side effects such as triyclics and MAOIs. Overview of antidepressants: In short antidepressants look to work by boosting or prolonging the levels of certain chemicals in the brain that are believed to help with regulating moods. Below there is a table taken from Mind which shows a comparison of all of the different drugs used: Pros of taking antidepressants: Helps to manage low moods and often anxiety as well might help increase the sense of control over a diagnosis or 'label' Can help with balancing out appetite and also sleeping routines if these were a struggle beforehand You are able to stop taking these - with GP consultation - so are considered 'worth a try' by many GPs. Cons of taking antidepressants: Side effects - these can range from slight side effects to some quite serious side effects. Taboo - even in 2020 there is still a stigma for taking antidepressants. Some people may find that antidepressants have adverse effects on other medication they are taking. Symptoms can get worse before better in the first 4-6 weeks whilst the medication settles into effect - with suicidal ideation being common report for young users. It can be a case of trial and error with finding the medications that work for you which can take time and energy. Alternatives to medication: St Johns Wort - this is a herbal remedy that some people use to help manage their moods. Again there are things to weigh up with taking this alternative as this can still cause side effects and impact on medications already being taken, so it is recommended to still consult your GP before considering this alternative. Talking therapy - CBT is generally offered by the NHS and IAPT services in short term work. CBT looks to re-frame your thought processes and in turn impact positively on your actions and behaviours. There are many other types of talking therapy available which you can find through many different types of mediums. The aim of all talking therapies is to equip the client with strategies and skills to cope with life transitions or situations. Exercise - as clich é as this alternative is, there is substantial proof that exercise releases chemicals that can boost your mood. Aerobic exercise for around 20 minutes 3 times a week is generally advised but as with anything this can differ from person to person. The downside to this is when you are experiencing low moods you may experience lack of energy and motivation to even get out of bed let alone exercise and so this can be a difficult alternative. Support Groups or networks - finding people you can talk to who are in your lives is a great way to boost your mood and feel valued. This can be support groups offered by charities allowing you to talk to multiple people about your experience or friends and family who you feel able to open up to. So antidepressants yes or no? Well, that really is down to you and how you are feeling. I was once told that there shouldn't be any shame in taking medication that helps you to live your life and cope with things that are going on. The main points would be that if you were to take antidepressants that is your choice, but they do tend to only treat the symptoms therefore it is recommended to take them in combination with therapy or some form of emotional support to also 'treat' the cause. Sources: https://www.nhs.uk/conditions/stress-anxiety-depression/improve-mental-wellbeing/ https://www.mind.org.uk/information-support/drugs-and-treatments/antidepressants/alternatives-to-antidepressants/ https://www.nhs.uk/conditions/antidepressants/alternatives/