Transcription
I'm David Calendars. I'm a clinical psychologist working at the university of Edinburgh, where I'm developing a program of research investigating how to do people live well with long-term medical problems.
The developers of Arthur's Place have asked if I'd make these short films describing how the work that I do might be relevant to people who are experiencing rheumatoid arthritis. In these films, the approach that I'm going to use is called Acceptance and Commitment Therapy. It's a modern form of cognitive behavioral therapy that helps people to respond as flexibly as possible to whatever they're experiencing in terms of their physical health and to try and stay on track and on target with doing things that they care about, even when their medical condition is exacerbated.
When we think about having a long-term health problem like rheumatoid arthritis, it's not just the symptoms of pain that can be problematic. Along with the problematic symptoms comes thoughts, feelings, and behavioral responses to those things. So some of the things that you'll probably be familiar with would be thoughts about your rheumatoid arthritis, for example, thinking, "This is going to get worse," thinking, "I can't live with the pain," thinking, "What does the future hold for me?"
And with those kinds of thoughts, that can come feelings: feeling fearful, feeling sad, sometimes feeling guilty if you haven't managed to maintain treatment goals, for example. Sometimes people become fearful of needles, for example, and it makes it hard for them to get blood, take blood tests taken, and that can make it difficult for them to establish whether their treatment is going in the right direction, and so on. So when we have a long-term health problem, it's not just the symptoms of the problem that can be hard to live with, but also everything that comes with it: the thoughts, feelings, and so forth.
We can think about the symptoms, thoughts, and feelings as basically the problem. And often when the problem shows up, we fairly automatically go to certain behavioral responses to the problem. If you think about the question of what do you do when your problems show up, so for example, symptoms, thoughts, and feelings about that, what do you typically do when when these things are present for you?
If you're like most human beings, the tendency will be to want to try to either get rid of these things in some way, to try and control them in some way, to try and not have them be part of your life in some way, or to try and figure them out, to try and kind of make sense of them, understand them, and by doing so, somehow you'll get some kind of sense of control or get rid of these kinds of problems.
It's not that those control-type strategies are necessarily bad or a poor choice. They are the natural, logical thing to do. And if you find strategies that do help to control aspects of the situation, aspects of your problem, and that they do seem to work well, then we would invite you to continue to use those kinds of strategies and to try and and to live well using those strategies.
However, our research and our clinical work shows that across a really broad range of different kinds of health problems, the strategy of controlling and getting rid of a problem first, and then I'll get on with living my life, generally doesn't work that well. If you think about, for example, some of the things that you're doing in response to your problem, does it feel that sometimes the things that you do to try to control and get rid of your problem actually lead to life being on hold or a feeling of being more stuck?
The idea being that you've kind of said to yourself, "I'll make plans once this gets better," or "once I'm able to get some control over this." If that's the case for you, I'd invite you to ask, "For how long have you been waiting for that to happen?" "How much effort have you been putting in to trying to get rid of your problem?"
Well, maybe there's an alternative. If you weren't spending your time trying to get rid of, trying to control, trying to figure out this problem, and you have a sense that those strategies of trying to get rid haven't really been very effective for you, well, maybe the alternative would be to begin to recognize that that those strategies themselves are part of the problem. It's not that you haven't been doing it right. It's not that you haven't put in effort or time. In most of the times when we see people who are engaged in this kind of normal, natural strategy of control and get rid of the problem first, they find that they put a lot of effort into it, but in fact, in that effort, the problem grows and grows, and the person feels more and more stuck.
We are generally quite explicit that it is the strategy that it's a fault. And so we want to try and introduce people to a different kind of strategy. And we can call this strategy a willingness, greater willingness to have the problem as it is.