The Pushing & Crashing Cycle

Episode 38 - The Pushing & Crashing Cycle
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Do you often feel that you are stuck in the pushing & crashing loop? Do you find yourself caught in a frustrating cycle, swinging between overactivity, and forced rest. When your symptoms are low, you push to get as much done as possible because you know you will crash soon enough; the overexertion triggers an increase in symptoms, leading to forced rest or a crash. Resting is usually successful in reducing symptoms and providing needed relief, but then, the pause in activities during this rest leads to feeling frustrated at all you didn't accomplish while resting; you plunge into another round of overactivity to catch up, leading to another crash. 
Listen to this podcast episode to learn more about pushing & crashing cycle, why you may be doing it and how to get out of it. 

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Transcript

Pushing and Crashing

Welcome back to the Mind your Fibro podcast. 

I had such busy weeks I got behind on podcasting; sorry if you have been waiting for a new episode. 

Recently, I spoke at the Support Fibromyalgia Conference. It was a phenomenal conference, and I heard so many positive reviews from my patients, family, and attendees. I hope you attended live or listened to the replays. Such important work and support were provided to patients with fibro during the conference. 

So today, I want to talk about pushing and crashing. 

So over the last several weeks, I have been swamped. In October, I launched my new membership, RheumCoach. And although it has been such exciting work, it added to my already heavy workload; it felt more in the amount of additional mental energy I had to put into creating content in a way I have never done before. 

I also had hectic weeks in my clinic and had the stress of closing left behind open charts. Then my kids had a Halloween party, their first sleepover in the new house we moved into this summer, so we were busy getting ready for that and, of course, late-night stay supervising teenagers, feeding them, and worrying - the typical mom stuff. Then work week, coaching, kids, and on Friday, last-minute changes to the presentation, reworking slides, practicing, and finally delivering the talk. Now, I am a relatively resilient person, but like everyone, I have my limits. Several nights of poor or not enough sleep, stress, and worry, coupled with my fear of public speaking… pushed me over. I used to have migraines before or during any public speaking events. Over the years, I got them under control. But last week, my threshold of stress was blown, and after the presentation, I sure did have a migraine, followed by extreme fatigue. For the next 2 days, I felt like I had just finished a marathon – I felt exhausted, unmotivated, wanting to stress-eat and do absolutely nothing. By Sunday, I had to pull myself out of the unmotivated slump and attempt to finish tasks I put on hold on Friday/Saturday –that did not decrease the stress but actually increased it. 

As I contemplated about the next podcast episode, I realized that what I experienced was a rather typical pushing and crashing episode; with some exceptions, I did not criticize myself but used coaching tools to get me through it. 

So pushing and crashing are not isolated to fibromyalgia patients. The majority of people experienced it at least sometime before. We crammed for the exam in high school or college, stayed up too late decorating the x-mas tree or wrapping presents, pushed through the airports to catch a redeye or worked on a project to make sure it was done to get that bonus or cleaned the entire house in one day before the in-laws arrived. We push to get the thing done, get stressed out, sleep deprived, or physically exhausted, and need a pause to recover. 

However, I feel that most patients who have fibromyalgia have a different dynamic with pushing and crashing. They often feel that they are stuck in the loop. It's not one incident of pushing with a purpose to accomplish something concrete; instead, you find yourself caught in a frustrating cycle, swinging between overactivity, and forced rest.

When their symptoms are low, you push to get as much done as possible because you know you will crash soon enough; the overexertion triggers an increase in symptoms, leading to forced rest or a crash. Resting is usually successful in reducing symptoms and providing needed relief, but then, the pause in activities during this rest leads to feeling frustrated at all you didn't accomplish while resting; you plunge into another round of overactivity to catch up, leading to another crash.

Instead of pushing due to the need to accomplish a particular task, like studying for the final exam, your push is due to your anticipation of the crash due to worsening symptoms. Living in response to symptoms, often anticipated, they are caught in a vicious cycle in which intense symptoms alternate with periods of extended rest. This leads to feeling out of control and having a highly unpredictable life that is difficult to plan. Often the only plan is knowing that the push will end with the flare, but not when and for how long. 

When I work with fibro patients, the concept of pushing and crashing is not often apparent to them or their families. This is just the way they live and adapt to fibro.

They plan for the crash. It is anticipated. There is a component of vigilance, paying more careful attention, especially to notice possible symptoms; the mind is on the lookout. It's like sleeping with one eye open – you are doing your tasks, and part of you is on the lookout, anticipating the end, the escalation of symptoms. Any symptom is recorded by your mind – like an increase in fatigue, pain, irritability, or sensitivity; the more symptoms start to accumulate, the more your nervous system or your mind anticipates the flare. It's like watching the pot of water beginning to boil- every new symptom is like the initial bubbles; you and your brain know that if you see a few bubbles, soon enough, the pot will be fully boiling. If the pot is at full boil, nothing else can be done but to turn off the heat – or force yourself to rest.  

So the flare or significant increase in your symptoms forces you to crash. The crash is forced rest or a period of inactivity or lower activity. Some cannot afford to stop everything: they have a job or kids. So they start eliminating activities deemed by their brain as unnecessary – for some, it maybe the ordering takeout instead of cooking, not taking the daily walk or shower, spending more time on a couch, and procrastinating. For some, it is maybe going to bed and staying there. I have patients who tell me that they can stay in bed for days at a time – they do everything there – sleep, eat, watch TV, surf Facebook, talk on a phone, etc..- whatever their brain associates with rest and inactivity. All of them feel utterly unproductive and often still unrested and fatigued. 

After the inactivity, full stop, or reduced activity, the crippling nagging starts as frustration, guilt, shame, and inner criticism boil over. As I coached clients, they tell me they may often think of themselves as worthless, hopeless, inadequate, or just plain awful about themselves, their need to rest, and accumulating things that are not getting done. 

The motivation to get out of bed or the rest phase of the pushing and crashing cycle often comes from negativity. Most people don't start by telling themselves – well, I feel great now, I rested, I have more energy, and ready to go back to do things. No, most of the time, that motivation comes from feeling guilty and frustrated at yourself. That feeling drives you to pull yourself together and get going. 

You see, the thoughts you have about yourself create feelings you have about yourself that drive your actions and results. So the negative thoughts and feelings you have about yourself, your rest, and your symptoms can not produce positive, beneficial actions and good results. The result of getting out of the crash is the beginning of the push. 

Push and crash lead to a lack of control, unpredictability, and discouragement. There is an alternative to push and crash, and that is pacing. Pacing suggests that your symptoms are not random but primarily due to variations in your activity level. If we do more than our bodies can tolerate, the result is an intensification of symptoms.

If we stay within our energy limit - both mental and physical energy limits, we can gain some control over our symptoms.

Pacing offers the possibility of a more stable and predictable life. Using pacing, you can live your life according to a plan rather than in response to symptoms, giving you a sense that you are managing fibromyalgia rather than fibro controlling you. 

So, how do we break the cycle of pushing and crashing? 

In my RheumMate membership, we have been talking about emotional awareness and how our thoughts create our feelings or emotions, actions, and results. 

So part of our work here is learning new skills to handle these difaficult thoughts and feelings more effectively, so they have less impact and influence over you and your energy. 

If you practice the thoughts and feelings for many months to years during the pushing and crashing cycle, it will take time to learn new skills. So giving yourself grace that it will take time to learn a different pattern is a must. 

The 1st step of any change starts with awareness or noticing symptoms. Notice what you think when you push yourself. Are you doing that particular task or job with a goal in mind? Have you conditioned yourself to only clean the house by pushing, getting everything done in one big swoop, and then letting go of maintaining it until the next push? If that's the case, what thoughts do you have about getting everything done during cleaning? 

What I can tell you, many of you will find that you have All-or-nothing thinking. Also known as black-or-white thinking.

All-or-nothing thinking is one of many negative thought processes, known as cognitive distortions, that is common in people with chronic pain, fibro, depression, or anxiety. All-or-nothing thinking is especially common in perfectionists. I will have a separate episode on perfectionism, but for now, I want you to realize that perfectionism is a coping mechanism and often arises from a fear of judgment or disapproval from others; it's not a good thing. All-or-nothing thinking - it's either perfect or a disaster. You treat yourself like a failure if you're not feeling physically or mentally well enough to perform a task you'd planned to do. With all-or-nothing thinking, as soon as you fall below 100 percent in your estimation, that 100 percent turns to zero.  

Examples of black-and-white thinking could be getting a B on a test in school and feeling like you failed it because it was not an A. During cleaning your house, you did not finish cleaning one room, and now you think the whole place is a disaster. During a job interview, you choked on one question, and even though you got positive feedback and all the other questions were answered great, now you don't think you will not, should not, or even don't deserve that new job. You did not send a birthday card to a friend and now think you are a terrible friend and she will never forgive you. If you eat one cookie, the whole diet is now ruined. 

Here is what you may catch yourself doing: 

You often use words like "always," "never," "should," and "shouldn't."

You won't try something unless you're confident you can do it perfectly

Small mistakes can make you feel like a total failure

You have a hard time receiving feedback, positive or constructive

You won't try something unless you're confident you can do it perfectly

Here are some ways all-or-nothing or black-and-white thinking affects us. It causes decreased confidence and self-esteem, feeling like a failure, fear of asking for help, lack of self-compassion and unwillingness or inability to forgive yourself, and having difficulty thinking of solutions to find a middle ground.

So letting go of the black-and-white or all-or-nothing thinking or just noticing it is a good start as you learn how to avoid the push. 

As you catch "shouding" yourself, be on the lookout for this type of thinking. Once again, just notice— don't use it as an excuse to beat yourself up. This is a game of noticing, and if you notice what you do even once, you're doing great.

So pushing yourself to get everything done, or keep doing it until you are totally exhausted. We are trying to notice it and catch ourselves in the act. Because if you are not totally exhausted, collapsed, and incapacitated, it is easier to be more rational and follow through. It's like shopping when you are hungry. If you are starving, all rational thoughts are out, and you will buy whatever you see because of hunger.

So we are trying to prevent a crash by noticing thoughts and feelings that lead you into actions, hoping that you will not end up in a crash mode. 

Another part of pushing and crashing is the anticipation of a crash. I had a client who would plan every event, every outing, anything strenuous or active, with a day of a crash after, regardless of how she felt. Saturday is busy with shopping, cooking, cleaning, and date with a husband, and Sunday is nothing – a day in bed with Netflix to recharge, rest and improve symptoms that she may or may not have because of the fear that if she does not do that, she will certainly end up in a fibro flare. This is anticipatory anxiety. If you have anticipatory anxiety, you are fearful for an extended period about an imagined future situation you perceive as an unpredictable threat. Anticipatory anxiety causes people to feel nervous, concerned, or afraid about the future that may or may not happen. You may spend time dwelling on the worst-case scenarios regarding future fibro flare that may or may not happen.

You see, your brain can only predict things based on your prior experiences and has a negative bias – we tend to think more negatively and predict negative outcomes with much more ease than a successful ones. 

If you had an excellent busy Saturday and woke up in a fibro flare on Sunday, you may start thinking that, of course, I had too much fun, too good to be true to feel well after all that action, no wander I am in a flare. Your brain will take notice and connect the experiences into one continuum. Now it will be vigilant after any event to look for symptoms or worry ahead of time, trying to prevent harm. If you worried and anticipated a flare and got it, your mind got the evidence that it was right. 

So, it may be an interesting dynamic – part of your pushing, the black-and-white thinking, do all of the tasks, or you are a failure thinking, and the other part of your mind is anxious with anticipation that all that work will make you crash. That is a lot of mental energy being spent. And with increased anxiety, you are easily distracted, feel apprehensive, and have more unfounded irrational thoughts. You may start feeling overwhelmed and spinning. Your mind may start fortune telling – trying to predict the future, what will happen if you don't finish your tasks, catastrophizing by assuming the worst will happen or magnifying the situation by thinking that one little thing you don't complete will ruin everything.

A lot of mental energy is being spent ahead of time, contributing to fatigue and mental and physical exhaustion. That mental energy that was increasing in the temperature of your negative thinking, spinning, and spinning, got your pot to boil, you are starting to boil over, and the only solution you see is to turn off the heat, to stop whatever you are doing because it's exhausting and mentally painful. And you are already tired and physically exhausted from the fibro or other conditions and have brain fog and pain. You beat yourself to do things, beat yourself down for feeling your symptoms or anticipating them, and you are spent. 

No wonder you see that the only way of it is to crash and do nothing. 

So, now you crashed, and your body and mind got to pause. If your brain beat you into a pulp to the point of a crash, and now got a nice warm bed with a long nap or a cup of tea and Netflix as a reward, what do you think the pattern will start to form if you keep doing it? Like a toddler that got away with a cookie even if you told him no, your brain will try to get that reward of the crash, the pause, something pleasant, the mental and physical rest. And if you don't reward yourself with rest unless you pushed and crashed, if the only rest you get is with crashing, your mind will find a way to get you there again and again. What you practice makes it stronger. You have created a pattern. Black-and-white thinking tells you that the only way to get things done is to do 110%, anticipate the crash, then crash, and get rewarded with much-needed rest. 

Now that you are resting, your brain will initially try to get the rest it needs. Very often, in patients with fibro, the rest period will help with pain and other symptoms, but soon enough, the nagging voice in the head will start up again. The longer you rest, the louder the voice will be. The voice may tell you mean and nasty things about you, your need for rest, how your family, loved ones, friends, and co-workers see you, and all the things that pile on and not getting done. You may have a lot of judgment, hate, and self-loathing come up. Frustration with yourself starts to increase and finally creates the motivational force you need to get out of the rest, or your crash and start being active again, but unfortunately, you end up at the beginning of the push cycle. 

Push, rest, frustration, push, rest, frustration, etc. 

Again, noticing your thoughts, feelings, and what you do and do not do when you are in the crash will give you the data you need to recognize and analyze your patterns. 

Inside the RheumMate membership, we talk a lot about how our thoughts create feelings that lead us into action or inaction. The results in our life ultimately come from the thoughts we have. 

So, here are the steps of the change you need – 1st is to notice your patterns, thoughts, feelings, and actions. Name what you notice. I am starting to crash, or I am starting to shoulding myself into finishing this task, or I am pushing myself to do 110%; I am noticing my perfectionism; I crashed and starting to nag myself. Actually, verbalize what you are doing or not doing. Neutralize –put your thoughts into a new context that 'neutralizes' their influence ('disarms' them). If you let this thought or action guide you, where does it take you? If you act on this thought/ let it guide you … will it take you towards or away from the life you want or your goal? For example, the thought "I need to finish cleaning the entire house" – how does the clean house help you not be in a fibro flare? Does the entire house have to be 100% done for you to feel well, or will your cleaning over the threshold of your ability will prevent you from doing other things you need to do? Is this the life you want? Can you notice the power of the "I must clean everything" being diluted by other thoughts and being neutralized and disarmed? Now work on creating new thoughts and new patterns. How can I pace my activities to accomplish things and not crash? When do I stop so I do not end up in bed? How can I get out of rest without hating myself? Can I create a self-compassion practice to motivate myself with love and kindness? 

Learning how to shift your thoughts and then learning how to pace instead of push and crash. 

You can accomplish it by writing your before and after in the journal. You can journal about your notice, name, neutralize, and new patterns. You can write your negative thoughts and look at them with curiosity and kindness; why do you think these thoughts? You can work with a therapist and or a coach or join our community of RheumMates who would love to have you, and we can work on it together. Knowing that you are not broken, that you are not alone in this struggle, is so so powerful. 

This episode concludes the Season 1 of the Mind your Fibro podcast. It’s hard to believe that it has been almost a year since I started this podcast. 

I just created a guide of the 1st season of the Mind Your Fibro podcast. 

Mind Your Fibro podcast season 1 covers the basics: what is fibro, and how is it diagnosed and treated.  Other episodes cover pain science, the pain-stress connection, self-care, diet, exercise, and sleep. This season also includes important topics on grief, relationship, and pushing & crashing. So the Season 1 guide includes the list of all episodes, as well as the fill in the blank guide for episodes, so you can follow along, pay more attention to the material and have some fun. Link to download is in the show notes. 

If you listened to this podcast and it resonated with you, please write a review! I would love to hear what you think of this podcast and help others find it.  

Thank you so  much for listening.  I will talk to you soon!