ColumnsSmart Health

The Mind-Body Connection

Maintaining your mental health in the face of physical illness.

Passing the halfway mark in 2022 provides an opportunity for reflection—and the stark realization that it has already been quite a year. 

With COVID deaths coming down as vaccinations and boosters proved to be highly effective, there seemed to be a collective sigh of relief this year. Unfortunately, with the recent increase in hospitalizations due to BA.5, the newest and most contagious COVID variant to date, awareness of our continued vulnerability to COVID has returned in full force.

To complicate matters, we’re now in the midst of a monkeypox virus outbreak tha disproportionately impacts members of the LGBTQ community. Access to vaccinations and medication is currently limited, so caution is certainly warranted. And it doesn’t help that our collective COVID fatigue makes it difficult to muster up additional concern for a new health threat. 

The focus on our bodies has also been heightened in the aftermath of the overturning of Roe v. Wade. That Supreme Court decision also lays the legal groundwork to challenge Obergefell v. Hodges, which established the right to same-sex marriage. Substantially limiting abortion access will disproportionately impact people of color and those living with challenges related to poverty, access to insurance, or limited social resources.

These acute medical issues are superimposed on a longstanding history of health disparities impacting LGBTQ people. Studies have shown that LGBTQ folks are more likely to delay or not receive medical care due to cost, lack of insurance, or difficulty with finding affirming healthcare providers. As a result, the health of many members of our community is negatively impacted, with increased rates of chronic conditions. Taken together, the collective physical health of LGBTQ people is an area of particular concern that warrants deeper consideration, especially because of its impact on mental health.

Generally, the concept of “the mind-body connection” refers to the way mental-health conditions can manifest as physical symptoms. For example, we probably all know someone who experiences a “nervous” or “upset” stomach in response to feeling anxiety. In this case, their mind is actually manifesting bodily sensations to let them know they are under stress.

As it turns out, the mind-body connection also works in the opposite direction where a physical illness can create mental-health problems. In truth, no one is immune to this possibility. We all get sick. And for many of us, the illnesses we develop will become chronic. Thus, the illnesses we experience carry the potential of negatively impacting our mood, increasing our anxiety, and diminishing our overall quality of life—at a minimum. 

To further complicate matters, some illnesses directly impact our cognitive function and memory, while others dampen our energy levels and make it more difficult to get motivated for tasks big and small. 

Even though it’s hard to look at, what do we do with the possibility that our physical health can, and likely will, deteriorate over time?

The First Step Is Acceptance

Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that focuses on breaking the connection between pain and suffering. ACT can help us acknowledge that pain is an unavoidable part of life, and that avoiding or trying to control painful experiences is the ultimate cause of suffering. Many problems related to our quality of life stem from this harmful mindset.  

From this perspective, if we work to accept painful experiences and feel them completely, we can become open to the possibility of freedom—where our life choices are no longer based on our pain, but on decisions that are consistent with our values.

Try this thought experiment: think of a negative event where you blame yourself or someone else for an outcome you’ve experienced. Perhaps there’s a job that you lost, or a relationship that ended. As you think of the person or persons you blame, ask yourself: How does that blaming motivate and empower me to live in a more vital, fulfilling, and liberated way? 

As it turns out, blaming ourselves or others isn’t actually very useful, and it can often keep us stuck.

This type of self-blame can easily extend to decisions we make regarding our health. Perhaps you blame yourself for having long-haul COVID because you didn’t always wear a mask or get vaccinated. Or you regret a decision to have unsafe sex that resulted in an HIV, hepatitis, or monkeypox infection. Perhaps your behaviors around diet, exercise, or alcohol and drug use have negatively impacted your weight, blood pressure, cholesterol, or liver function. Maybe you delayed seeking medical care out of fear, only to find that your chronic medical condition has worsened significantly.

A Path Forward

An alternative approach to blaming yourself for your health-related problems is to incorporate and extend grace to yourself. Even if you are struggling with illness, you can still decide how you might respond to the pain of a particular diagnosis. As you work through this journey to acceptance, you are better able to consider your values and determine how best to live up to them. 

If this seems particularly challenging, perhaps one avenue for relief is to seek a mental-health clinician who specializes in ACT. They can guide you through this process and assist with you stepping into the possibility of a life that isn’t necessarily free of pain, but is free of suffering.

The reality is that our health status will eventually change, and we will have relationships that change or no longer serve us. Finances and work may also present serious challenges. Despite these painful situations, how can you reduce suffering? 

The answer may begin with identifying your values, and discovering how you can best live up to them.

This article appears in the August 2022 edition of OutSmart magazine.

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Daryl Shorter, MD

Daryl Shorter, MD, is a Diplomate of the American Board of Psychiatry and Neurology and is board certified in both general and addiction psychiatry. His clinical practice focuses on veteran care, and he lectures widely on LGBTQ mental health. Dr. Shorter can be reached at [email protected]
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