Resilience

Realistic optimism is maintaining hope while moving forward and dealing with one's current reality. It requires flexibility and perseverance and comprises both courage and hope.

Realistic optimism is not determined by the number of adverse events in your life but rather by how you view and respond to the adversity.

• If adversity is perceived as a threat, this is an indicator of less resilience
• If adversity is perceived as a challenge, this is an indicator of more resilience

Confidence is not a guarantee of success, but a pattern of thinking that will improve your likelihood of success, a tenacious search for ways to make things work

— John Eliot

• A growth mindset is simply the belief that improvement is possible.
• Someone with a growth mindset believes that they can change things for themselves through effort, strategies, and help from others.

After developing chronic pancreatitis, you might not be able to do everything you could do before, and this might make you feel frustrated and exhausted.

• Even though it may take time, you can gradually learn to thrive while you deal with your health issues through effort, planning, and support from others.
• The opposite of a growth mindset is a fixed mindset, or the belief that you cannot improve your skills or situation.
• A fixed mindset would lead you to overlook the good things in your life and ruminate about what you cannot change.

Having a growth mindset involves appreciating the happy moments, no matter how small they may be.

I can be changed by what happens to me. But I refuse to be reduced by it.

— Maya Angelou

The joy you experience from doing things you love can do more than just boost your mood (although that is important!). Joy can also restore your mind, help you de-stress, improve your sleep, improve your physical and mental well-being, and even reduce pain.

Next time you feel overwhelmed, exhausted, or frustrated, try some of these simple self-care activities to ease your mind:

• Listen to music
• Make a list of things you are grateful for
• Play with a pet
• Take a warm bath
• Spend time in nature
• Exercise
• Watch a movie
• Make art or do a craft
• Journal
• Read a book
• Meditate
• Pray
• Try yoga
• Take a nap
• Call a friend
• Socialize

You might feel that self-care is a luxury for people with lots of free time, or who aren't dealing with illness, pain, childcare, and work demands.

• The truth is that the more stressed you are, the more important self-care is for your mental and physical health.
• When we are stressed, self-care is often the first thing to go.
• But even if you're busy, try to take at least five or ten minutes every day to do one of these activities.
• Note how you feel afterwards, and which activities make you feel best.

I am not what happened to me. I am what I choose to become.

— Carl Jung

When you have a chronic and unpredictable condition such as chronic pancreatitis, you might feel a lack of control over your life.

• Your illness may leave you feeling angry, sad, nervous, or helpless.
• While you might not be able to make your symptoms go away, you can control how you respond to them and how you think about them.

By regaining control over how you think about your symptoms.

• You can reduce your stress
• Make healthy choices that align with your goals
• Cope with changes in your health status over time.

Self-talk is the inner chatter that runs in your mind

• The little voice in your head that helps you make sense of the world around you.
• If the voice is critical and negative, it may stress you out without you realizing it.
• You may be unaware of how negative your inner voice can be.
• The first step to change your inner voice is to acknowledge its patterns.

You might recognize thought patterns by:

• Writing down a summary of your negative thoughts in a journal and then rereading them.
• When you notice yourself slipping into a negative thought pattern, consciously say "stop" to yourself.
• Saying it aloud may be more powerful and allow you to track how often you slip into negative thinking.
• Some negative thoughts might be self-limiting statements, or ones like "I can't deal with this!" or "I'll never feel better!".
• Next time you have one of these thoughts, try turning it into a question. "How can I deal with this?" and "How can I feel better?" are statements that enable you to problem-solve and will guide you back to self-care.

The use of positive affirmations, or statements that rewire your brain toward positivity and empowerment, is a scientifically backed way to improve your self-talk and ease your symptoms.

• You might choose to write affirmations down and hang them on your mirror or bedroom door.
• You might also write them down in your journal or simply repeat them when you wake up, before you go to bed, or during the day when you feel overwhelmed.

Research has shown that positive emotions play a vital role in our physical and emotional health.

• As you know from your own life, positive emotions such as joy can and do occur even when managing the challenges of living with pain.
• Positive emotions are not just about feeling good.

Research has also shown that they can:

• Foster creativity
• Increase flexibility of attitude and thinking
• Help with problem-solving
• Serve as a break or respite from stress and negative emotions (can replenish us)
• Sustain our efforts to manage challenges
• Build social connections (people who show positive emotions a lot tend to attract other people and build helpful support)
• Decrease distress
• Prevent depression, chronic stress and anxiety
• Improve our physical health

You may not realize it, but you do things every day that make you feel good, even if for just a few minutes.

• What are some things you are already doing that make you feel good?
• Or that you have done lately that made you feel good? For example, listening to music, or watching movies.
• What are some things you can do in the future to deliberately experience more positive emotions?

Your beliefs about the control you have may influence how you manage your emotions.

• One core belief people have is about how much control they have over being able to manage their lives, including their health.
• The unpredictability and chronic nature of pain can leave people feeling like they don't have control of their lives.
• This (feeling not in control) can, in turn, lead to a number of other emotions, such as anxiety, fear, anger, sadness, or hopelessness.

Control is generally thought of in one of two ways:

• People who have an internal locus of control feel they are in charge of making change happen in their lives. Control comes from within.
• People who have an external locus of control believe things happen to them as a result of external forces such as powerful other people, or by chance/luck.

Research has shown that people who have an internal locus of control are better able to handle change in their lives and make the necessary adjustments to cope with those changes than people who believe that there is nothing they can do about their health.

Benefits of feeling "in control" include:

• Increased self-confidence
• Increased positive mood
• Reduced anxiety and fear
• Reduced stress and tension
• Reduced feelings of being overwhelmed
• Increased ability to make decisions/take action on one's own timeline
• Increased ability to cope better with unexpected changes
• Increased overall health

Fortunately, there are several things you can do to increase your sense of control while living with pain.

• The first one is to recognize what you do and do not control.

• It's true that you cannot control everything and pain certainly can cause feelings of uncertainty and unpredictability.

• However, you do have control over the choices you make and how you react to your circumstances.

• Taking a few minutes to list several things that you feel you can control about your life is a helpful start.

  • Save this list.

  • Sometime in the future, it may come in handy to remind you that you have the ability, skills, and intelligence to make things happen.

  • When you finish making this list, you may be surprised and realize that you have more control over the events in your life than you previously thought you had.

The approach of Self-Care is all about putting you in the driver's seat to have more control over how you manage your pain. This allows you to spend more time and energy on things that are meaningful for you. Thus, you can use your self-care skills to be and feel more in control.

Feeling in control of your life can help you to live more fully in the present and not be held back by things from the past.

Some examples are:

• Letting go of feeling guilty about things done or not done
• Forgiveness of others/letting go of old grudges
• Forgiveness of self for past actions
• Not dwelling on decisions or actions from the past
• Not getting caught up in "what if's"

Another aspect of living in the present involves reducing energy spent worrying about things that are out of one's control. Living in the present involves:

• Awareness of the current moment and what you are thinking or feeling without judgment of those thoughts/feelings
• Experiencing what you are doing with all your senses: sight, sound, taste, smell, touch
• Savoring positive emotions/experiences as they occur
• Fully engaging with others/in your activities
• Practicing self-care as you need it (not after you've pushed too far)
• Appreciating things that are currently going well
• Avoiding thinking and worry about the future

Here is one activity you might try to help you focus on living in the present:

Sit quietly. Look around you and notice:

• 5 things you can see.
• 4 things you can touch.
• 3 things you can hear.
• 2 things you can smell.
• 1 thing you can taste.

Savoring is the mindful act of noticing a pleasant moment and trying to make it last. To most effectively savor something, it is helpful to use all of your senses.

For example:

• If you savor a cup of coffee.
• Notice the sound it makes when poured.
• Become aware of the deep brown color, rich aroma, and the warmth of the mug in your hands.
• Allow a feeling of gratitude to wash over you for having a cup of hot coffee and a new day to explore.

Step 1: Savor life's best moments.

• Consider a typical weekday.
• Review your morning routine, your daily activities, and your evening rituals, and consider how much time you spend noticing and enjoying the pleasures of the day, both small and large.
• Every day for the next week, be sure to savor at least two experiences (for example, your morning coffee, or the sun on your face as you walk to your car).
• Spend at least 2–3 minutes savoring each experience. Be sure to use all your senses.

Step 2: Enhance your savoring experience (optional).

• Snap a picture with your cell phone or even collect a physical souvenir of the event and reminisce about it later with others.
• You could even start a scrapbook of memorable moments you want to savor forever.

Watch the following video to learn what is savoring and how to practice it

Sometimes our lives are so busy, or chronic pain is so dominating, that we forget to note and remember the good people, moments, and things in life.

This little daily activity can help you become more aware of the good things in your life.

Step 1: Find a box or container with a lid or a piggy bank.

• Place it someplace where you will see it every day.
• Your pleasant memories will be placed in this container.
• You will also need some small slips of paper and a pen or pencil.

Step 2: Take note of a pleasant memory.

• Every evening, think about the people, things or events for which you are grateful.
• You may make a list if you like.
• Pick one of these and spend a moment savoring it.
• What made it so special to you?
• Now, write this moment down on a small piece of paper. Use enough detail that later you will be able to immediately recall what happened.
• Next, add the date, fold up your grateful memory "currency," and drop it in the piggy bank or container.
• You will make these gratitude memory "deposits" in the same way every evening.
• You may choose for how long you would like to do this. It could be for one week, 30 days, or even longer.

Step 3: Review your grateful memories.

• At the end of a week, 30 days, or however long you choose to keep a positive piggy bank, you will "close your account."
• This means that you will withdraw all of the "currency" from your piggy bank and read each and every one of the deposited grateful memories.
• As you read them, try to recall details of the event and what made it so special to you at the time.
• Reading your piggy bank account can serve as a "pleasant activity."

This video teaches that practicing gratitude through daily reflections or activities like a "positive piggy bank" can boost happiness and well-being:

Acts of kindness can have a ripple effect – one simple act of kindness can inspire others to act more kindly too.

Acts of kindness can make both the person conducting the act and the recipient feel happier, so why not try a few?

Step 1: Pick a day and plan your 5 acts of kindness.

• Pick one day in the next week where you will do five kinds of things, all on that same day.
• These acts can be for people who are complete strangers, friends, or family members or for society or the planet.
• These can be small acts of kindness, such as sharing a genuine compliment or giving somebody a hug.
• Or you can do larger acts of kindness, such as volunteering for an event, making a donation to a favorite charity or giving a homeless person a meal.
• You can even do anonymous things or start a project that will take some time to finish.
• Here is a link to a website that offers some fun ideas to get you started: https://www.randomactsofkindness.org/kindness-ideas

Step 2: Do your 5 random acts of kindness all in the same day.

• When you do your kind acts, do not expect anything in return.
• You might even get some strange looks or reactions, as sometimes kind acts are unexpected.
• Smile as you do them, knowing that you are putting positivity out in the world.

Step 3: Conduct one more act of kindness.

• After you have done your 5 kind acts, do an additional kind thing for yourself.
• People with chronic pain tend to put others first and forget to be kind to themselves.
• It's important to take care of yourself too.
• If you are rested and happy, you will be in a much better position to do things for others.
• Perhaps you could take a long bubble bath, go for a walk in the park, or see a movie with a friend.

Watch the following video to learn more about the importance of performing acts of kindness:

The goal of this activity is to help you learn what your strengths are and how to use them to make your life more engaging and successful.

Studies have shown that using your strengths on a regular basis can result in feeling happier, more engaged with life and even more hopeful.

If you'd like to learn more about character strengths and the science underlying their power, you might enjoy this video.

Step 1: Determine Your Character Strengths.

You can do this by taking a test like the one offered by the VIA Institute.

Step 2: Write your top five strengths and post them somewhere that you can see them.

• Do they seem right to you?
• Pick one of your top 5 strengths and think of a way you regularly use this strength.
• For example, if your top strength is kindness, in what ways do you use that strength on a daily basis?

Step 3: Put your strengths to work.

• Each day, find at least one way to use one or more of your strengths in a way that you haven't before.
• You can do this by modifying something you already do on a regular basis or by creating a new activity altogether.
• What's important is that you use one of your strengths in a new way.
• For example, if you usually use your strength of creativity for artwork, try using creativity to solve a difficult problem or perhaps settle a disagreement with a friend.

Dose: Try using one of your strengths in a new way every day for a week. It can be helpful to note what you did and how things turned out.

Watch this video that will help you to practice your character strengths:

Myths about positive activities, positive emotions and resilience MYTH: "My emotions have nothing to do with my pain."

FACT:

• Pain and emotions are processed in many of the same areas of the brain.
• This helps explain why depressed people are more sensitive to pain and why happy people report lower levels of pain, have better functioning despite pain, and have better quality of life.
• Positive emotions buffer the effects of negative emotions, so even if you are sad, doing a gratitude activity or act of kindness can help you feel better.

MYTH: "I don't have time for myself."

FACT:

• Just as a car needs gas to run, you need to recharge and refuel your mind and body.
• Pleasant activities can be that fuel!
• Just taking five minutes to read a funny cartoon or a note from a friend may give you a little boost and help take your mind off your symptoms.
• But if you don't take time to renew yourself, you may exhaust yourself and run out of gas.

MYTH: "As soon as my pain goes away, I'll be happy."

FACT:

• You likely have already discovered this, but waiting for your pain to go away before you can enjoy your life is not a good strategy for success.
• Studies show that people who have more positive emotions, feelings of gratitude, and a sense of purpose in life and who feel socially connected have less pain and a better quality of life.

MYTH: "Some days the pain is so bad that you simply have to write them off."

FACT:

• Of course, there will be days that you feel terrible and like you don't want to do anything at all.
• As part of this program, try to do something you enjoy anyway – something pleasant.
• If you at least do that one fun thing, you will look back on the day knowing something positive happened that day.
• Many of the activities you will do in this module will help you learn such resilience skills.

MYTH: "I'll feel instantly better once I try one of these positive activities"

FACT:

• Actually, you might feel a bit happier right away.
• But for others it may take up to several weeks to notice improvements in your mood and outlook.
• Know that your efforts are not wasted because improving your mood and general well-being can help ease your pain and other symptoms.

MYTH: "My pain is more serious than these activities – they can't possibly help."

FACT:

• Engaging in pleasant activities is not meant to cure pain.
• These activities are designed to bring balance to your mind which is likely to be focused on pain.
• If pain gets processed in the brain against a background of pleasantness rather than negative emotions (e.g., despair, anger, anxiety, frustration) it can be experienced as less intense.
• This can lead to less pain and a more enjoyable day.

There are many additional resources available to help you practice resilience that works well for you. Consider the following options: There are many books that provide more information on resilience and tips for success. Some examples:

• The Power of Now: A Guide to Spiritual Enlightenment by Eckhart Tolle
• The VIA Institute on Character: Get to Know Your Character Strengths
• Greater Good Science Center: The Science of Gratitude
• Happify module: Love Your Life Despite Chronic Pain
• Return to Wellness: How to Have a Growth Mindset
• A Video on the science behind character strengths and their impact on happiness and wellbeing
• Random Acts of Kindness Foundation: Ideas for Acts of Kindness
• 100 Affirmations for Chronic Illness (That Actually Work…)
• Savoring Activities: 35 of Life’s Simple Pleasures to Cherish Everyday

You can visit the following websites:

• Character Strengths: https://www.viacharacter.org/
• The Science of Gratitude: https://ggsc.berkeley.edu/images/uploads/GGSC-JTF_White_Paper-Gratitude-FINAL.pdf
• Happify module: Love Your Life Despite Chronic Pain: https://my.happify.com/tracks/68/

Social Support is good "medicine"

• People with chronic pain often do better when they have other people in their lives who love, support and understand them.
• Being there to try some of these positive activities with your loved one with pain or encouraging him/her to do these positive and enjoyable activities can go a long way to ensure their success.

Here are a few ways you can support them:

• Encourage participation in positive activities.
• Acknowledge progress and strengths.
• Be patient and listen without judgment.
• Celebrate the good moments.

By showing consistent, compassionate support, you are helping to build a foundation of resilience. You don't need to have all the answers. Just by walking alongside your loved one with openness and kindness, you are already helping more than you know.