Working with as many patients as I do, I hear themes among their concerns that the individuals involved may not be aware of.  For example, situations they are experiencing in their work lives may share similarities.  Another example of commonality would include experiences related to the recent economic downturn.

The most common theme (in fact, a constant throughout life) is that of CHANGE.  The range of change falls mainly in exchange… that was my attempt at levity for the moment, but in a sense it’s also accurate.  Whether the “exchange” in question is that of trading household tasks because a family member has become disabled, or the currency “exchange” that has been lost through job layoff, it seems like we are all quite sensitive to the occasional re-arrangements of our life circumstances. For the most part we want stability and continuity in our lives, with some variety. Therefore, it only makes sense that our strongest reactions to these changes would come when the re-arrangements are outside our individual control.

Coping with changes that we have little control over is tough—maybe one of the toughest things we do in life—so it makes considerable sense to learn skills and strategies for doing it well.  Experts in resilience and change management suggest these as key coping strategies:

If you see the change coming:

• Whether you like what’s coming or dread it, the best strategy is to plan for it.  For example, two very different situations would be the addition of a new baby to the family, and the loss of income occasioned by one partner leaving the workplace to care for a new infant.  Two parts of one big transition where the baby is a welcome and the lost paycheck is not!  Pretending that the changes won’t make a major difference is short-sighted, and potentially disastrous.  When you see a change coming get busy with planning.  You’ll feel more in control when you have a plan to work from.
• Along with generalized planning, create step-by-step plans for parts of the circumstance that you think might cause the greatest challenge for you.  Even if these steps need to be altered as new situations arise, you’ll have something on paper that helps you set a course for coping.
• Learn strategies to “think” your way through adversity, rather than let your emotions drive your daily life. These can be simple steps such as: 1) not relying on mental shortcuts that lead to negative thinking; and 2) putting things into perspective (most likely scenario, worst case scenario, best case scenario). Or you may choose to do the more difficult work of vigorously challenging deeper beliefs and assumptions that have become ineffective over years, if not decades.
• Strengthen your social support system.  No matter what changes you see coming down the road, having a network of friendships and even expert support, is a good idea.  Maybe you have gotten so busy with work in the last few years that you haven’t been in frequent contact with friends or neighbors you used to enjoy.  Now is the time to reach out and simply check in with them.  Some may have moved on, but others will more than welcome your renewed interest.  Caring about others, and knowing they care about you, is a buffer against tough times.
• Think about the core values that you have individually, and if appropriate with members of your family.  For example, if money is going to be tight for the foreseeable future, concentrate on what your needs are, and discuss what “wants” can be postponed or let go.  By putting these thoughts into words, and even committing them to a paper plan, you reduce the likelihood of mind-reading and second-guessing with those you care about.

If a sudden change is dumped in your lap:

Unexpected changes are sometimes dealt with better than the expected ones, because we are quicker to recognize that “everything has changed” and are less likely to try to keep things going just as before.  For example, when a family member dies very suddenly, it’s not something that can usually be ignored or pushed off to deal with later.

In times of sudden change we usually recognize all the small ways that we have not been taking care of ourselves in the long term—another reason to make a commitment to better self care as a buffering strategy in advance.  Still there are things we can do to reduce the impact of unexpected changes.

• Stick to a routine as much as possible.  The first thing that generally happens in times of unexpected change is an interruption in daily routine.  Getting at least some of your routine back is one way of re-establishing clear thinking.
• Among the routines that need to be established (or re-established) is nutrition.  Experts conclude that simply starting your day with a balanced breakfast will increase your ability to cope with stressors all day long.
• Drinking water seems such a simple thing, and yet most Americans do not (despite all the plastic water bottles being plowed into landfills) consume enough water.  Good hydration is important for lots of reasons, but here are two: water helps remove the stress chemicals that are a response to unexpected change, and there is evidence that consuming adequate water is related to prevention of brain cell loss as we age.
• Make time for relaxation.  Often the first thing to be sacrificed in crunch times is the thing that is most useful in coping.  Sometimes that will be sleep, for others it will be the exercise time, and for others it might be quiet moments of conversation with a friend.  By recognizing that sudden change is an assault against your mental and emotional status-quo, it will be easier to see the importance of relaxation.

Even eagerly anticipated changes can throw us for a loop if we do not recognize personal responsibility for self care.  In coming blogs, I’ll get down to more specifics about the changes I have been hearing about in my practice, and some of the suggestions I make to those experiencing them.