Discover essential insights on managing migraine through effective communication and support strategies in this insightful webinar from Migraine Canada. Whether you’re a migraine patient navigating relationships with loved ones and healthcare providers or a caregiver seeking to provide meaningful support while maintaining personal boundaries, this session offers invaluable guidance. Explore the dynamics of collaborative relationships, learn practical tips for clear and respectful communication, and understand the impact of connected versus disconnected interactions. Join us to enhance your understanding and advocacy for migraine management. Sign up for future webinars, engage in live discussions on our Facebook page, and contribute your voice to advancing migraine awareness and support initiatives. Visit Migraine Canada’s advocacy page to learn more and participate in making a difference.
Click Here for Video Transcript
0:00 everybody Welcome
0:02 um welcome tonight
0:06 um so we’re going to do things a little
0:07 bit differently I think than some of the
0:10 webinars in the past I actually asked my
0:12 green candidate if we could do this is a
0:14 little bit more interactively
0:17 um more of a meeting style because
0:20 I really want to field some questions
0:22 with you and kind of see where you’re at
0:24 and you know hopefully work through some
0:26 issues that you might be having
0:29 um in your life
0:40 foreign
0:45 for a second there but it came back up I
0:47 think it was my fault I apologize okay
0:50 so anyway
0:52 um so we’re
0:53 interactive today so again I’m gonna
0:55 take a few pauses throughout the
0:57 presentation and I have some questions
0:58 that I might post for you but if any
1:00 time you have any questions as well
1:02 write them in the chat
1:04 um and they’re going to be moderated
1:07 um throughout the presentation and
1:08 hopefully I can address all of your
1:10 questions as we go along
1:13 um
1:17 oh there we go it wasn’t working for a
1:19 minute so just a little introduction
1:21 about me my name’s Susan Kate I’m a PhD
1:24 candidate at McMaster University I just
1:26 started my fourth year this year and
1:29 hopefully uh I’m getting close another
1:32 year and a half and I’ll be finishing I
1:35 did my masters at McMaster as well in
1:38 gender studies and feminist research and
1:41 a Bachelor of Arts at Athabasca
1:43 University
1:44 um but I’m also a social social service
1:46 worker
1:47 so I run my own practice in the Hamilton
1:49 area but I’ve spent many many years in
1:52 the non-profit field working with
1:54 addiction
1:57 um you know women who were escaping
1:58 abused relationships and shelters
2:02 um in hospitals so I’ve done all kinds
2:04 of work in the social service sector
2:07 um so now I run my own practice and I
2:10 work with lots of different people who
2:12 are experiencing lots of different
2:14 challenges in their life I just put down
2:16 some of my information and my website
2:18 there for anyone who’s interested in my
2:20 research or my practice some of the
2:22 stuff that I’m doing right now
2:25 so my research interests and my practice
2:27 Focus just to give you an idea of what
2:30 I’m doing is migraine disease chronic
2:33 migraine disease
2:34 um I’m really interested in women’s
2:36 experiences of care and I’m interested
2:39 in understanding kind of the culture of
2:42 migraine care and what that looks like
2:44 especially around women’s experiences of
2:48 dismissal and women’s experiences of
2:50 medical gaslighting it’s rooted in my
2:53 own experiences as a woman trying to get
2:56 care and diagnosis for chronic migraine
2:59 which I’ve had for about 18 years now I
3:03 have vestibular migraine
3:05 and I work from a very feminist lens
3:09 feminist care ethics and logic of care
3:13 and in terms of my practice I support
3:15 clients as they learn to accept and
3:17 manage their chronic illness that’s kind
3:19 of my focus but like I said I work with
3:22 clients who are experiencing a range of
3:25 issues from anxiety depression and
3:28 Trauma
3:29 um to you know how to cope with
3:32 relationships how to develop better
3:34 communication which is what we’re going
3:35 to talk about today
3:38 so just to brief agenda
3:41 um
3:42 I’m going to give a brief overview today
3:44 of the impact of migraine on individuals
3:46 in their daily life
3:48 and obviously this is not for those of
3:52 you who have migraine but this is more
3:55 for those of you who are tuning in who
3:57 might be partners who might be allies
3:59 friends family of someone who has
4:01 migraine I’m going to talk about how
4:03 this might affect communication and
4:05 we’re going to talk about how to
4:07 communicate better with our partners
4:09 family members friends colleagues what
4:11 this actually means what does good
4:13 communication actually look like and how
4:16 can allies and partners communicate and
4:19 collaborate better with us and then
4:21 towards the end of the presentation I
4:23 know Wendy wanted me to talk a little
4:25 bit about how we can communicate towards
4:27 getting our needs met in healthcare
4:28 environments and self-advocacy and why
4:31 that’s important
4:32 so we’re going to touch on that as well
4:36 so to start off
4:39 um just that review of the impact of
4:41 chronic migraine and actually chronic
4:44 illness in general
4:46 um so we all know chronic migraine is a
4:49 genetic neurological condition
4:52 um you know there’s 15 or more migraine
4:55 attacks per month for at least three
4:57 months so people who have chronic
4:59 migraine have migraine symptoms on a
5:01 regular basis and those symptoms range
5:03 from excruciating headache
5:06 to having light and Sound Sensitivity
5:09 nausea vomiting vertigo they might get
5:13 Paralysis on one side of their body they
5:15 might get visual changes in the form of
5:17 Aura attacks are subjective and affects
5:20 people in various different ways
5:22 and patients don’t just cope with their
5:25 symptoms but they cope with a lot of
5:27 other pieces that are really really
5:29 difficult to manage so for example
5:31 there’s that stress of having the
5:34 condition but also the stress of dealing
5:37 with side effects from treatment which
5:40 is often a trade-off for some people a
5:43 lot of people who struggle with chronic
5:45 migraine have feelings of anxiety or
5:47 vulnerability they might have depression
5:49 or grief they might feel a loss of
5:52 control
5:54 um and migraine really impacts one’s
5:56 productivity and feelings of worth and
5:58 self-esteem so depending on the severity
6:02 of symptoms people who have chronic
6:04 migraine might not be able to work or
6:08 they might have to lessen the amount of
6:10 time that they spend at work or they
6:13 might have to rearrange some other goals
6:15 that they had in their life maybe they
6:16 need to parent differently and that can
6:19 really impact someone’s sense of purpose
6:22 and sense of self
6:26 coping with migraine is really
6:29 intersectional and subjective as well
6:31 and it depends on a lot of different
6:33 interrelated variables social support is
6:37 one that we’re going to be talking about
6:38 today specifically
6:41 um Financial standing someone’s access
6:43 to medication and resources treatments
6:46 whether or not someone has access to
6:49 Allied health professionals whether or
6:51 not they have private insurance or the
6:53 money to pay for private care
6:56 whether they have access to food that
6:59 doesn’t aggravate their symptoms and
7:00 nutritional supplements
7:03 um foundational knowledge so whether or
7:05 not someone has learned how to cope
7:08 effectively with change or with crises
7:12 not all of us have those skills we
7:14 weren’t all raised and and
7:17 um socialized to have those skills so
7:20 we’re all dealing with really different
7:24 um
7:25 I guess a baseline of what we have in
7:29 terms of our toolbox to deal with
7:31 migraine and so some people might be
7:33 really resilient and they might deal
7:35 with their migraine quite well and some
7:37 people might not and it might be because
7:39 they don’t have access to some of these
7:41 things
7:42 um that might help with resilience
7:46 so I just wanted to highlight crisis
7:49 Theory
7:50 um again specifically for people who are
7:53 supporting someone who has migraine
7:55 disease
7:57 um so crisis theory is really a theory
8:00 that talks about how when someone is in
8:03 a state of Crisis they become anxious
8:06 fearful stressed right so their arousal
8:09 State goes up in a very acute way and it
8:13 affects them in lots of different ways
8:16 um but it leads them to find ways to
8:19 restore balance so we want to bring
8:21 homeostasis back to the mind and the
8:24 body so as human beings we’re always
8:26 problem solving and we’re trying to
8:28 figure out okay how do I fix this
8:30 problem
8:32 um so that’s when people start going to
8:34 the doctor they start going to their GP
8:36 they go to the hospital they might do
8:39 some of their own research they might
8:41 self-medicate in some way they do things
8:44 to try to figure out how do I resolve
8:46 these symptoms for these migraines that
8:48 I’m having or this migraine attack that
8:50 I’m having so I can get back to normal
8:53 but sometimes what happens is there’s a
8:55 failure to restore balance maybe
8:58 treatment doesn’t work maybe they are
9:01 having a really hard time navigating the
9:03 Health Care System maybe every time they
9:05 go to the doctor the doctor dismisses
9:08 what they’re telling the doctor and the
9:10 doctor attributes their symptoms to
9:12 something else
9:13 maybe they don’t have a good social
9:16 support network so failure to restore
9:18 balance results in increased negative
9:21 feelings about themselves
9:23 and others and sometimes this is where
9:26 maladaptive coping strategies start to
9:28 set in
9:29 [Music]
9:30 um
9:30 you know so they might have a trauma
9:32 response in regards to
9:35 um what’s happening with them and that
9:36 might mean developing agoraphobia maybe
9:40 they start to avoid going to places that
9:43 trigger their symptoms they start to
9:45 withdraw from Life
9:47 um they might start self-medicating in
9:49 ways that might have repercussions for
9:52 them maybe they’ll develop OCD type
9:54 behaviors to try to regain control so it
9:58 affects people in various different ways
10:03 so a lack of social support in addition
10:06 to these other things
10:09 can result in a failure to restore
10:11 balance in homeostasis and again we’re
10:14 highlighting social support today
10:15 because social support is so so
10:18 important
10:19 um I know for myself when I first
10:21 started having migraine symptoms I
10:23 didn’t know what was going on with me I
10:26 was having these weird attacks every day
10:28 where it felt like I was having a stroke
10:31 and I had just moved to Toronto I had
10:35 just gotten married I didn’t have any
10:37 friends in Toronto
10:39 um and I was I was drowning I I really
10:43 needed a community around me to help me
10:46 and I didn’t know who to reach out to
10:49 um and it was really really hard for me
10:51 to adjust in those early years and that
10:54 had an impact
10:57 so when we talk about resilience we’re
11:00 really talking about that ability to
11:03 recover from Misfortune or change or
11:06 crisis
11:08 um so that resilience really comes from
11:10 the quality of relationships which can
11:13 heavily influence how emotionally
11:14 resilient we might be in a crisis
11:17 okay sounds good
11:20 so chronic illness and relationships
11:24 um chronic illness changes our
11:25 relationships as I’m sure many of you
11:27 have experienced yourself right so
11:29 individuals with migraine might not be
11:31 able to engage in Life or activities the
11:34 same way they did prior to their
11:36 condition I know for myself I was a very
11:38 extroverted person I used to go out all
11:41 the time I was very social and then
11:44 after I started to get chronic migraine
11:46 attacks I became a lot more withdrawn a
11:50 lot more introverted
11:52 um and and that piece of me just kind of
11:55 you know it just wasn’t part of my life
11:58 anymore
11:59 um and it’s something that I had to
12:00 grieve
12:01 they might require accommodations people
12:04 with chronic migraine or chronic illness
12:06 in general again because life changes
12:09 and they can’t do things the same way
12:10 anymore so we need to find ways of
12:13 equalizing life for them
12:15 um but sometimes that’s hard to accept
12:17 for the patient as well
12:19 partners and children might engage in
12:22 caretaking activities or experience
12:25 caregiver burnout so those who are
12:28 really close to someone who has chronic
12:30 migraine might start trying to do things
12:32 to pick up the slack which is normal in
12:34 relationships we want to help but that
12:37 can become too much for you know
12:39 especially Partners or the people
12:42 closest to us and so without proper
12:45 boundaries that can be really
12:48 problematic and individuals with
12:50 migraine might experience feelings of
12:52 guilt and shame due to how their illness
12:54 impacts their loved ones and because
12:55 they might not be able to live life in
12:58 their ideal way so there’s a lot of
13:00 guilt and shame that goes on for
13:01 patients
13:09 I don’t know why my slide isn’t going
13:14 that’s odd oh there we go so how is
13:17 migraine disease impacted your
13:19 relationships
13:21 um just kind of wanted to take a pause
13:22 here and just hear from you how migraine
13:25 has been impacting you in your daily
13:28 life and the people that you interact
13:30 with yeah and I a lot of women in
13:33 particular
13:34 um and and probably some men but it is
13:37 something that a lot of women in
13:38 particular do experience that feeling of
13:41 dismissal that feeling that people don’t
13:43 really believe you or there’s also this
13:46 kind of idea that migraine is just a
13:48 headache right it’s no big deal take
13:50 some Advil take some Tylenol you’ll be
13:52 okay
13:54 um and so I think that that
13:55 misconception of what migraine is people
13:58 think that you know we’re exaggerating
14:00 or you know we’re this dramatic person
14:03 who’s just embellishing which is very
14:07 far from the truth obviously
14:10 foreign
14:12 if you’re having an attack you know it’s
14:14 it’s something I really relate to it
14:16 because even when I do these talks or I
14:18 do a guest lecture or whatnot I always
14:20 have it this fear in the back of my mind
14:21 that I’m going to have a migraine attack
14:24 um and then today like I just remind
14:25 myself I’m among white people so it’s
14:27 okay but
14:29 um you know I feel that you know
14:32 um and a lot of people do end up losing
14:34 a career or losing
14:37 um you know a profession or that part of
14:39 them I certainly can’t go back to
14:41 non-profit work
14:43 um that ship is kind of sailed
14:45 um for me
14:46 um and that’s something that I had to
14:47 grieve as well
14:49 chronic illness and chronic migraine in
14:51 particular is very isolating for a lot
14:54 of people
14:55 um and I hope that you know by being
14:57 part of this talk tonight but also you
15:00 know being part of you know what’s going
15:02 on with migraine Canada
15:05 um you know and again there’s there’s
15:06 some different groups out there on
15:08 social media and what not being part of
15:10 those hopefully will give you a sense of
15:12 community so that you don’t feel so
15:14 alone but it is very isolating
15:16 um granted I I get that
15:19 I wanted to
15:21 I want to comment on the person who said
15:24 um they can’t get anything done I find
15:27 that um the migraine medicine
15:30 um makes it seem like I have ADD you
15:33 can’t get anything done for in my case I
15:35 can’t handle paper I just can’t handle
15:37 it I can’t keep it moving and you know
15:41 that’s
15:42 part of my work is to do that so it’s
15:45 frustrating but I’ve noticed it uh
15:48 derives from the medicine and maybe not
15:52 the headache
15:54 yeah and we’re going to talk a little
15:56 bit about that but like I said sometimes
15:58 that um the side effects are a trade-off
16:01 for a lot of people
16:02 um and that’s some other source of
16:04 stress that a lot of people are focused
16:05 or or experiencing
16:08 um with chronic migraine and migraine
16:10 I think we’re gonna
16:12 um I think I should move forward with
16:13 the slides a little bit so that we have
16:15 some time to cover the other stuff
16:17 um because I think I only have an hour
16:19 today but I’m hoping to get to more of
16:21 your stories um and shares as we kind of
16:24 go along
16:26 so just so we’re going to kind of
16:29 transition more into the communication
16:31 piece
16:33 um but how does all of this relate to
16:35 communication so again positive
16:37 supportive relationships are essential
16:39 to emotional well-being and as we’ve
16:41 heard you know migraines really can
16:44 contribute to isolation to loneliness to
16:47 not feeling like people understand what
16:50 you’re going through
16:52 um there’s a lot of dismissal out there
16:54 and that can impact our relationships in
16:56 different ways so we want to focus today
16:59 on how we can build supportive
17:01 relationships within people at least who
17:03 are close to us and who are trying to
17:06 understand and work with us and how do
17:08 we do that we do that through effective
17:10 communication we do that through
17:14 um building trust and building
17:15 connecting behaviors
17:17 so this is really geared at people who
17:20 are willing to work with us
17:22 um
17:23 so in terms of communication
17:25 relationships really suffer when
17:27 difficult topics are not discussed right
17:29 or avoided
17:31 um and I know you know for my own
17:33 relationships sometimes this is what
17:35 happens right when you’re in a couple in
17:37 particular
17:39 um and I know tonight I’m going to be
17:40 talking about a lot of things in
17:42 relation to Partnerships or couples
17:45 um but a lot of these skills and whatnot
17:47 that I’m going to be talking about can
17:49 be applied to all types of relationships
17:51 whether they be family parent child
17:53 friend what not
17:56 but in Partnerships when there’s a
17:58 crisis situation it is not uncommon for
18:01 one or both Partners to start shutting
18:03 down to have more secrecy to start
18:06 disconnecting from one another
18:08 um and to avoid the stressful topic if
18:11 that’s something we don’t want to do we
18:13 want to get it out in the open and
18:14 address that kind of pink elephant right
18:17 without effective communication we might
18:20 suppress our own needs in our
18:21 relationships we probably will ignore
18:24 the needs of others and that leads to
18:26 poor boundaries and conflict so I find
18:29 in my practice
18:31 um but also in my own life and
18:33 experience
18:35 if you don’t have good boundaries with
18:37 your partner if you don’t have good
18:38 boundaries with other people in your
18:40 life or at work
18:42 and that’s when things start to fall
18:43 apart we do need to honor our own needs
18:46 we need to honor the fact that life is
18:49 very different for us
18:51 um we’re going to have partners and
18:53 friends and people in our lives that
18:55 need to also honor their own needs and
18:57 we have to find ways of working together
18:59 setting boundaries with one another and
19:02 adhering to each other’s boundaries
19:04 so constructive communication really
19:06 helps us to feel secure and safe and
19:09 authentic in our relationships and
19:11 destructive communication leaves us
19:13 feeling resentful anxious and
19:14 inauthentic in our relationships so we
19:17 want to build those constructive habits
19:21 so in terms of what communication is I
19:24 thought I would break it down to just
19:27 you know what it is as a thing
19:30 um so some of you might have seen this
19:31 Nifty diagram before it’s really common
19:35 um but it just highlights that
19:36 communication isn’t just an exchange of
19:39 information right so it’s this process
19:42 where you have someone sending out a
19:44 message and someone receiving a message
19:47 and the message is taken up in different
19:51 ways
19:52 by the receiver
19:54 depending on how that message is
19:58 expressed you know is it expressed
20:00 verbally non-verbally is it expressed
20:03 through text or email which is something
20:06 that’s very common nowadays and causes
20:08 lots of problems
20:10 um
20:11 and then underneath that there is noise
20:14 which is something else that affects
20:16 Communication in terms of how messages
20:18 are taken up and we’re going to talk
20:20 about that in a bit more detail in a
20:22 minute
20:23 so communication is necessary for
20:26 survival in our relationships without it
20:28 our relationships aren’t going to do
20:30 very well
20:32 um it includes language and tone and
20:35 pitch and volume it is description or
20:38 its inference a lot of our communication
20:40 85 of it is non-verbal
20:43 um and are kind of more reactive lizard
20:46 brain picks up on non-verbal cues things
20:49 like posture and body positioning eye
20:52 contact facial expressions physical
20:54 proximity and it does that because we on
20:59 a biological survival level want to
21:01 assess for safety so a lot of our
21:04 communication is not wrapped up in words
21:06 anyway
21:08 so when I spoke about noise does anybody
21:11 have an idea of what I’m referring to
21:15 um and how noise might affect
21:16 communication okay
21:18 so when I’m talking about noise
21:21 I’m talking about
21:25 um
21:26 our values and experiences and
21:30 subjectivities that information passes
21:33 through
21:34 so when someone says something to us
21:37 when they tell us a story we hear that
21:40 story subject to all of those values and
21:43 experiences and opinions and things that
21:45 have made up our own life it’s filtered
21:48 through all of that before we can make
21:50 sense of it that’s how we make sense of
21:52 it right so we all have this very
21:56 subjective experience when we’re taking
21:58 in information
21:59 and that’s why
22:02 um or usually the source of a lot of
22:04 misunderstandings it can be the source
22:07 of
22:08 um you know information being taken in
22:11 particular ways or heard in particular
22:12 ways
22:14 um that isn’t how necessarily the sender
22:17 wants it heard that makes sense
22:21 so there are ways to work to lessen
22:23 noise
22:24 practicing empathy is probably one of
22:27 the main things that I’m going to
22:29 highlight throughout this talk that I
22:31 want people to do in their relationships
22:34 and we’re going to get into more detail
22:35 about how you can actually do that
22:38 um recognizing that we all experience
22:40 life and circumstances differently so
22:42 like I said earlier we all have these
22:45 different experiences and values we’ve
22:47 all been socialized in different ways
22:48 our families have all raised us
22:51 differently we value different things
22:53 differently
22:55 um and that impacts how we live our life
22:57 and how we take up information and the
23:00 choices that we make and they’re all
23:02 very subjective and there’s no right or
23:03 wrong answer
23:05 active listening is really really
23:07 important
23:09 um when someone is telling us something
23:11 it’s really important that we listen to
23:13 them fully I don’t know if any of you
23:16 relate to this but I find most people
23:18 are guilty of this I’m guilty of this
23:20 but when someone’s telling me a story I
23:24 will latch on on to something in that
23:26 story and then become fixated on it and
23:29 think about how I want to respond to it
23:31 and when you do that you kind of close
23:33 yourself off from hearing the rest of
23:35 the story
23:36 um so when we’re doing that we’re not
23:38 listening fully and again I think we’re
23:40 all guilty of that at times and that’s
23:42 something we want to avoid doing we also
23:45 want to keep our biases and values in
23:46 check so just because we see something a
23:50 particular way it doesn’t mean someone
23:51 else is going to see it the same way
23:53 asking for clarification paraphrasing
23:56 and summarizing what we think we hear or
23:59 asking the other what they are saying or
24:01 what they are hearing us say is really
24:03 important as well
24:05 foreign ticity and vulnerability is
24:08 really important in relationships
24:10 um
24:11 and as I already mentioned you’re you’re
24:13 going to learn or probably already have
24:15 learned who you can be authentic with
24:18 and vulnerable with and who you can’t
24:20 and I think that that’s something that
24:22 everyone with a chronic illness goes
24:25 through but we need to allow space for
24:27 others to be authentic as well in our
24:29 relationships and we need to allow
24:31 ourselves to be vulnerable to others so
24:33 we can be our authentic selves
24:35 um and so again this is
24:38 I guess the point of this talk is about
24:40 figuring out if you’ve already figured
24:42 out who you can do that with safely how
24:45 we can strengthen that relationship
24:47 because there still might be tension in
24:49 it from time to time
24:52 also when relationship serves this issue
24:54 of control that you might have already
24:56 experienced as well
24:58 um so I’m going to talk about control in
25:00 terms of something called Choice Theory
25:02 which is a psychological theory by Dr
25:05 William Glasser
25:07 and he talks about how many long-term
25:11 problems
25:13 um are relational problems there they
25:15 often develop from relationship problems
25:17 and that human beings behave in various
25:20 ways in order to meet needs so we all
25:24 have needs that fall under these five
25:26 areas of importance power Freedom fun
25:29 survival
25:31 um and love
25:34 and we all rank the importance of these
25:36 different areas differently and they
25:39 differ from person to person and so in
25:41 practice what I actually see usually
25:44 when people bring relationship problems
25:46 to me is that
25:48 um you know one person in a couple might
25:51 be ranking Freedom as their number one
25:53 value or priority and then the other
25:55 person in the couple ranks it you know
25:58 further down the list and then that
26:00 creates tension
26:02 um so understanding again that it’s okay
26:04 for us to be different in terms of what
26:06 we value or how we value things is
26:08 really important
26:09 and dysfunction in relationships occurs
26:11 when we try to control others rather
26:13 than focus on what is actually in our
26:15 control ourselves and our own behavior
26:18 this is all going to come together and
26:19 make more sense hopefully
26:22 um so the issue of control sometimes
26:24 that desire
26:26 um to control others manifest through
26:28 various communication Styles very very
26:30 specific things that we do when we’re
26:32 communicating with others in our life
26:34 that can be helpful in building our
26:37 relationship and making each other feel
26:39 safe and that are really unhelpful and
26:43 so I have this fun infographic
26:46 that I give to a lot of clients who are
26:49 having relationship issues and it’s
26:51 something I’ve used myself and I often
26:54 ask them to put it in a common area of
26:56 their household maybe on the fridge in
26:59 the kitchen somewhere where they’re
27:00 going to notice it and whenever conflict
27:02 comes up between them and their partner
27:04 or them and with their kids or someone
27:06 else in their life that they’re having
27:08 difficulty with or that they’re feeling
27:10 tension with I asked them to kind of
27:13 think about the types of language
27:16 um on communication that they’re using
27:19 in that moment during that conflict you
27:22 know are they criticizing or blaming or
27:24 complaining
27:26 um are they punishing in some way or
27:28 threatening these are behaviors that
27:31 again we’re all guilty of at times but
27:34 they damage our relationships they push
27:36 people away from us
27:39 um
27:40 and when we engage in them on a regular
27:42 basis it just ends up making things a
27:45 big old mess
27:46 what we want to do is we want to lean
27:49 more into connecting habits
27:51 um
27:52 so those more connecting behaviors such
27:55 as again demonstrating empathy
27:57 supporting each other encouraging
27:59 listening fully
28:01 um accepting other people for where
28:03 they’re at or what’s going on with them
28:05 being trustful and respectful these are
28:08 the things that actually help build
28:10 intimacy they help to build rapport with
28:13 one another and they make people feel
28:15 safe and comfortable
28:19 um I’m hoping I guess some of these
28:21 slides can be shared because I have a
28:24 couple of other infographics that I just
28:26 included in here so when I was talking
28:27 about those different needs the
28:30 different value areas where you can rank
28:33 I normally give this sheet to clients to
28:37 kind of introduce to their partner as
28:40 well if I’m not working with their
28:41 partner as well
28:43 um and I asked them both to kind of take
28:45 some time and rank these different areas
28:48 of importance and then check in with
28:49 each other around what their answers
28:51 were so that again they can kind of
28:54 think about where those areas of tension
28:56 might be where they’re not adding up and
28:59 sometimes that can open the door for
29:01 dialogue or communication to happen
29:04 and this is just another thing I threw
29:06 into in terms of this both of these are
29:08 from The glosser Institute
29:10 um but this questionnaire questions for
29:12 a better relationship
29:14 um is something else I often provide
29:16 couples at the beginning of couple
29:18 therapy
29:19 or if they have a client who has
29:20 relationship issues
29:22 and I asked them to fill this out and
29:26 hopefully have their partner fill it out
29:27 as well and sometimes
29:30 you know when people come together and
29:33 compare answers and discuss answers it
29:35 can be a good way kind of a good jumping
29:37 off point for discussing where the
29:39 actual tensions or issues are on the
29:41 relationship
29:44 so how do we steer clear of
29:47 disconnecting
29:49 um habits and disconnecting Behavior
29:52 we need to let go of control which I
29:55 think I there’s a theme right
29:58 um but letting go of control is
30:01 extremely difficult for a lot of people
30:03 again I I I’m a work in progress
30:07 um but it’s super super important in our
30:10 relationships that we do that
30:12 practicing radical acceptance is
30:14 something that can be really helpful
30:17 um when letting go of control some of
30:19 you might have heard that before it’s a
30:21 common
30:22 mindfulness technique used for lots of
30:25 different reasons that people are
30:26 struggling with anxiety you’re
30:28 struggling with acceptance around a lot
30:30 of different areas of life but it’s
30:32 simply the act of choosing to accept the
30:36 present moment for what it is
30:39 and it’s a commitment to that choice
30:43 um and it’s something that you do by
30:45 having an inner dialogue with yourself
30:47 where you remind yourself I need to
30:49 accept what’s happening right now
30:51 let go of any ruminations let go of you
30:56 know any thoughts around how I might
30:57 control this or manipulate this to be
31:00 different simply just letting it be
31:03 um being mindful of your feelings is
31:06 really important
31:07 so if you’re in a tense moment with
31:10 someone else if you’re having conflict
31:11 with someone else
31:13 I often remind my clients to think about
31:15 what’s happening in their body I ask
31:18 them you know do you feel your stomach
31:20 kind of churning do you feel your
31:23 shoulders around your ears do you have
31:25 other bodily Sensations that start to
31:27 happen when you start to feel angry or
31:30 anxious or upset
31:33 um and if that’s the case and you feel
31:35 like you need a breather take it you
31:38 know take a moment ground yourself you
31:41 don’t need to address it in that very
31:42 moment in most circumstances this is
31:46 where boundaries come in handy right you
31:48 can tell the other person you know what
31:49 I want to talk about this with you but I
31:53 need to have some space right now can we
31:55 talk about it tomorrow can I call you
31:57 later
31:58 um boundaries are really really
32:00 important so that you can meet your
32:02 needs of just kind of stabilizing and
32:04 getting yourself in a better head space
32:06 so that you can address the problem
32:09 becoming aware of your habits and
32:11 triggers are really important
32:13 um you know maybe you have someone in
32:15 your life who does something in
32:17 particular that sets off something
32:19 inside of you sets off anxiety being
32:22 aware of that trigger can be really
32:24 important so that way you can figure out
32:26 how to problem solve how to deal with it
32:28 when it comes up
32:30 remember it’s really important to honor
32:32 the other person’s right to autonomy and
32:35 authenticity you don’t have to agree
32:38 with what they are thinking or feeling
32:40 or whatever is going on with them you
32:42 just need to accept that that’s what’s
32:44 going on with them
32:46 um again going back to acceptance of the
32:48 present moment is really important and
32:51 using collaborative affirming language
32:53 is really important so going back to
32:55 again those connecting behaviors
32:58 and again we’re going to talk a little
33:00 bit in more detail on how you can do
33:02 that
33:04 so when I talk about working together I
33:07 know often people talk about compromise
33:10 and relationships I really like to use
33:13 the term collaboration
33:15 um over compromise just wondering if
33:18 anyone has any thoughts around that
33:21 um why I might choose collaboration over
33:23 compromise what what action do you think
33:26 is more effective or what do you think
33:27 the difference is
33:31 um so yeah so when you’re collaborating
33:33 with someone you’re building something
33:34 from the ground up
33:35 so you’re problem solving together uh
33:38 whereas compromised yeah we’re always
33:40 thinking about you know someone’s got to
33:42 lose something
33:43 um and it doesn’t always feel very good
33:45 and it doesn’t mean there aren’t times
33:47 for compromise because I’m sure there
33:49 are times where compromise might be
33:51 effective but if you can collaborate
33:53 instead
33:54 um that’s generally a better approach in
33:56 your relationships
33:59 so have you discovered ways to
34:01 collaborate with your partners or
34:03 friends or family members since you’re
34:05 chronic migraine diagnosis are there
34:08 things that have worked for you in terms
34:10 of problem solving
34:12 um or collaboration
34:15 I mean there’s lots of ways that we do
34:18 collaborate like I know for myself
34:21 um and I think this is pretty common
34:24 there are times when my symptoms are
34:27 really really bad for a stretch of time
34:31 um and funny my husband also has a
34:33 chronic illness but a very different
34:35 kind of chronic illness so I find that
34:37 we often trade off
34:40 um so in terms of household tasks
34:43 um in terms of we we have a bit of a zoo
34:46 we have two dogs and a couple of cats
34:48 and they obviously need to be taken care
34:50 of so you know if I’m having a stretch
34:54 usually in the fall in the spring where
34:56 my symptoms can get really bad because
34:57 the weather is really unpredictable he
35:00 will often take on the bulk of um you
35:04 know household chores and things like
35:05 that and errands
35:07 um because I just simply can’t
35:10 um and there are times when you know he
35:12 needs some extra consideration and I’ve
35:15 picked up the slack so that’s something
35:16 that we’ve done in terms of problem
35:18 solving to try to figure out how to make
35:20 things work
35:21 foreign
35:24 so
35:26 um the last bit I have I just wanted to
35:28 talk a little bit about something called
35:30 Imago therapy I don’t know if anyone has
35:32 heard of that before I’m sure you’ve
35:36 seen it parodied
35:38 um it’s something that’s been around for
35:39 a really really long time and it is a
35:42 specific type of couple’s therapy or
35:45 relationship therapy that helps to
35:46 improve communication between couples
35:50 um you know it’s evidence-based it’s
35:52 been around for a really long time it’s
35:54 often parodied on sitcoms where you’ll
35:57 see couples going to therapy
36:01 um and they learn how to talk
36:02 differently to one another so that’s
36:06 some of the stuff that I talk about it’s
36:08 going to click where it’s like oh I’ve
36:09 heard about that before
36:12 um there’s a lot of books that have been
36:14 written by the developers or founders of
36:17 Imago therapy I put in two that are most
36:20 common if you want to look up those
36:23 references but they are books that
36:26 people have found really really helpful
36:28 for a very very long time they’re a bit
36:31 out of date
36:32 um
36:33 but I would still recommend them as
36:35 being potentially helpful if you’re
36:37 having issues particularly with the
36:38 partner
36:39 so they build on attachment Theory and
36:42 they use dialogue techniques as a way to
36:45 communicate with others in a connecting
36:47 safe end in a way that equalizes power
36:49 between both parties
36:52 um so again taking from you know some of
36:54 the stuff I talked about in relation to
36:56 Choice Theory and we’re kind of tying it
36:58 together through this as well
37:01 so they talk about this kind of
37:04 three-stage approach to communicating
37:06 during tense conversations or conflict
37:11 um
37:12 in order again to break down that
37:15 tension
37:16 so mirroring and validation and empathy
37:19 are really the three main pieces that
37:23 are really really important to work
37:24 through
37:26 um during conflict and we’re going to
37:27 break them down
37:28 um and talk about how you can actually
37:30 do them
37:32 so when you’re mirroring in your
37:35 relationship when you’re doing mirroring
37:37 exercises
37:40 so I think Joanne you need to put your
37:42 mute on thank you
37:45 um it’s it’s about how to listen without
37:47 distorting another person’s message
37:49 which we talked a little bit about
37:50 earlier right how do we do active
37:52 listening
37:54 um how do we listen fully for the other
37:56 person so the exercises here are really
38:00 concrete things that you can do with
38:03 anyone I know I’ve kind of kind of
38:05 contextualized it as what you can do
38:06 with your partner but you can do this
38:09 with anybody in your life so you might
38:12 want to practice telling the other
38:14 person a message that you would like
38:15 them to hear and the message should
38:18 start with i it should describe your
38:20 feelings your thoughts your Sensations
38:23 what’s going on with you and what you
38:26 want the other person to do is then to
38:29 mirror or feedback to you what they
38:30 heard you say so this is a way that we
38:33 can ensure that a message is received
38:35 properly
38:36 and if you feel that the other person
38:38 doesn’t understand your message
38:41 um the idea is to explain it again and
38:43 have them mirror you until the message
38:46 is received in a way that you want it to
38:48 be received for partners or for the
38:51 person who is on the receiving end once
38:54 you hear their message accurately you
38:57 might invite them to elaborate further
39:00 um and you can check back in towards the
39:02 end of the conversation by summarizing
39:04 what you heard them say
39:07 the next step is validating so again we
39:11 want to validate in our conversations
39:13 with others and this is not something
39:15 that I think we do enough of
39:17 um it’s something that I do a lot of
39:19 because it’s part of interviewing
39:21 techniques it’s part of how you do
39:24 Psychotherapy with someone or at least
39:26 the way that I’ve trained in the way I
39:29 prefer to do therapy with people I like
39:32 to be very validating of my clients
39:35 um validation isn’t about agreeing with
39:38 the other person necessarily it’s about
39:40 understanding that they’re having an
39:42 experience they have thoughts and
39:45 feelings that are Salient to them and
39:47 their experience and that’s valid right
39:50 it doesn’t matter what I think
39:52 um I’m not them I’m not in their body
39:56 um and I’m not in their minds so we need
39:58 to be able to respect again where other
40:00 people are at so it’s about recognizing
40:03 that we’re all entitled to our own
40:04 perceptions and feelings and reactions
40:06 to events
40:08 um and you might validate someone by
40:10 offering a statement to them such as I
40:12 can see how that must have been
40:13 difficult for you or what you’re saying
40:16 might make sense
40:18 um you know feeding back to them what
40:20 you hear them say
40:23 and then empathy
40:25 again really important it’s really about
40:28 trying to walk a mile in someone else’s
40:30 shoes so we want to attune to what
40:32 someone else might be going through
40:34 rather than filter it through what we
40:35 might think or feel or do in a situation
40:39 which is something that’s really common
40:41 um you know it’s not uncommon for
40:43 someone to tell us a story or an
40:45 experience and then we respond by saying
40:47 you know I was in the same situation and
40:50 this is what I did and then go into like
40:52 advice giving or whatnot
40:55 um and there’s a time and a place for
40:57 that certainly if someone’s asking for
40:59 advice or information but I I find in a
41:02 lot of our conversations we jump to that
41:04 when it’s not necessarily needed and
41:06 what someone is really looking for is
41:09 empathy they’re looking for someone to
41:11 really listen to get it to really try to
41:15 understand what they might be
41:16 experiencing although we can’t fully
41:18 know what someone’s experiencing we can
41:20 try
41:21 um so you might try to reflect for
41:23 feeling you might try saying to them I
41:26 hear that you are feeling XYZ just
41:30 trying to demonstrate to them that we’re
41:32 really trying to get it
41:34 um and we do that by again feeding back
41:37 what we hear them seeing and how we’re
41:41 taking up that experience that they’re
41:43 speaking about
41:45 another piece to Imago therapy that I
41:48 didn’t really go into here when it’s
41:50 appropriate you might
41:52 offer a gift at the end of the
41:54 conversation so sometimes you might make
41:57 a request of the other person or the
42:00 other person might make a request of you
42:02 sometimes you might want to end things
42:06 if you’re in a couple if this is a
42:08 communication strategy you’re using in a
42:10 partnership you might want to end your
42:12 conversation with some types of physical
42:13 touch maybe a hug something that’s going
42:17 to break down the tension in your
42:19 defenses
42:20 so Studies have found this to be really
42:23 really effective
42:25 um and people who communicate in these
42:28 ways they tend to have better intimacy
42:29 with others their self-awareness
42:32 improves
42:34 um but developing that empathy and
42:37 learning to validate the other people in
42:39 their lives it really builds that
42:42 relationship in a really caring
42:44 supportive connecting way and that’s
42:46 what we want
42:48 um and again so I’m hoping there are
42:50 people who are watching this today who
42:51 are watching this with a partner are
42:53 watching this with someone else in their
42:54 family someone who’s close to them
42:57 um you know so that you can try out some
42:59 of these techniques
43:01 so I’m going to switch gears a little
43:04 bit and then this is kind of the last
43:07 bit of the talk and then I think I’ll
43:09 field questions at the end on everything
43:12 um if that makes sense
43:14 but I know Wendy talked to me about
43:16 wanting to also include pieces on
43:18 self-advocacy
43:20 because self-advocacy is a really huge
43:23 topic and I could probably do another
43:24 talk on this topic
43:27 um
43:28 but it is something that I don’t think
43:31 we talk about enough so I’m going to try
43:33 to just talk about I think a little bit
43:35 more about why it’s important
43:38 um and then we’ll go from there
43:41 so as a lot of you know and this is kind
43:44 of tied up with my research too the
43:46 healthcare system isn’t really designed
43:47 for patients with chronic illness
43:50 um it was created for acute care it’s
43:52 created for things like broken legs
43:54 acute infections things that you can fix
43:57 really quickly and get people out the
43:59 door
44:00 um care is really focused on symptom
44:02 relief and that might or might not be
44:05 what a patient needs in the moment when
44:08 they go and they seek care and a lot of
44:11 the drugs used to treat migraine carry
44:13 significant side effects like we’ve
44:14 already talked about tonight and some
44:16 people have shared about that tonight
44:19 um many Physicians have very little
44:20 training or knowledge about migraine
44:22 disease and realistically uh there’s no
44:26 Doctor Who’s going to know everything
44:27 because they’re not Androids they’re
44:29 human beings and we have limits somewhat
44:31 we can memorize and know
44:34 um you know and there’s an argument to
44:35 be made that migraine is such a common
44:37 Affliction that more doctors should know
44:39 about it but again
44:43 um the reality is a lot of doctors
44:44 aren’t necessarily interested and
44:47 they’re not necessarily going to know
44:48 what they need to know to treat us
44:51 um
44:53 misdiagnosis and under diagnosis as as a
44:56 result is high and humans are incapable
44:59 of objective thought so all diagnoses
45:02 and Care decisions are filtered through
45:03 a healthcare provider’s personal biases
45:06 and subjectivities and values like we
45:08 talked about before that noise right
45:10 that impacts
45:12 um how we take up knowledge you know and
45:15 I’ll give you an example you know when I
45:17 was first having symptoms the main
45:20 symptom that stood out for me was
45:22 Vertigo you know I I could work through
45:24 headaches all the other stuff that was
45:26 going on with me wasn’t really on my
45:29 radar what was on my radar was I was
45:31 getting these horrible horrible attacks
45:33 of vertigo and visual Aura and I just
45:36 could not function and so when I went to
45:39 my doctor I didn’t tell him about I had
45:41 blinding headaches I didn’t tell him
45:43 about all of the other neurological
45:45 stuff that was going on I was really
45:46 focused on I have vertigo make it stop
45:49 so he took up that information and
45:53 started to treat me for issues of the
45:55 inner ear migraine was Far Far Away
46:00 um you know he wasn’t even thinking
46:02 about migraine because what I was
46:04 telling him sounded like an inner ear
46:07 disorder right so you know we have to
46:10 think about things sometimes in terms of
46:14 um
46:15 you know the information that we provide
46:17 or again how a healthcare provider is
46:19 able to take it up is going to really
46:20 affect how they are treating us
46:24 um also ideally developing self-advocacy
46:27 skills like we’re talking about tonight
46:28 might lead you to feeling more empowered
46:32 um you might have more care options if
46:34 you self-advocate
46:36 um and it might give you a sense of
46:37 control
46:39 I also want to highlight tonight that
46:41 understandably this is written from a
46:43 really privileged position I had a
46:45 really hard time writing this part of
46:47 the talk
46:49 um as a white woman who’s educated and
46:52 has access to a lot of things
46:55 um because I acknowledge that
46:56 marginalization occurs in health care
46:58 and systemically the system is not made
47:01 for all people it is not made for people
47:04 who are differently positioned if you
47:06 are living in poverty if you were bypoc
47:08 if you’re an immigrant if you’re a woman
47:10 if you’re lgbtq
47:12 um 2s class
47:15 um you know all of these groups suffer
47:18 in different ways under these systemic
47:21 institutions such as our Healthcare
47:23 Institution
47:25 so these are all the things that make it
47:28 really important that we learn how to
47:30 self-advocate because they get in the
47:31 way of us getting
47:33 um really good care
47:36 so agency is really really important
47:39 it’s important that you change your
47:41 mindset we want to take control over
47:44 health and well-being so instead of
47:48 seeing your doctor as someone who has
47:50 all the answers we want you to see your
47:53 doctor as a service provider so there’s
47:55 someone who can provide information who
47:58 we should work alongside with
48:01 um as you work towards finding Solutions
48:03 towards resolving your migraine symptoms
48:04 but they’re not going to have all the
48:06 answers
48:08 um they’re going to have some answers
48:09 and they’re going to have limitations on
48:12 what they can provide as well
48:13 so don’t discount or allow your own
48:17 experiences or knowledge to be dismissed
48:19 we talked a little bit about dismissal
48:21 today in terms of relationships but
48:23 there’s a lot of dismissal that happens
48:25 in healthcare
48:27 um you know if you walk out of a medical
48:30 appointment and you’re like they weren’t
48:33 getting me or they weren’t hearing
48:35 something that was affecting me
48:37 or this isn’t a good solution for me
48:39 don’t be afraid to voice that
48:43 um and we’re going to talk about other
48:45 things that you can do but you should be
48:46 able to take that back to your health
48:48 care provider and say you know what I
48:50 really need you to hear that there’s
48:52 other pieces to this that I don’t think
48:53 you’re taking into account
48:55 ask questions take notes during your
48:58 appointments contact your doctor’s
49:00 office if things are not improving with
49:02 prescribed treatment it’s really
49:04 important for people to stay on top of
49:06 this stuff again your doctors have
49:09 really high case loads they have a lot
49:12 of stuff going on in their practice
49:15 um you know so they don’t always have
49:17 the time to attune to things in the way
49:19 that we would want them to unfortunately
49:21 and so if we don’t speak up about these
49:24 things we might not necessarily get our
49:26 needs met so again tying in setting
49:29 healthy boundaries knowing what your
49:31 needs are it’s really really important
49:33 that we’re able to push ourselves to do
49:35 that in these settings
49:38 get involved
49:40 um do your own research about your
49:42 illness and about treatments ask to see
49:44 a specialist Define what type who and
49:47 don’t take no for an answer which I know
49:49 can be super difficult I recently went
49:53 through that with my own doctor
49:55 um you know I I was having lots of
49:58 autoimmune symptoms recently and I said
50:02 I want to see a rheumatologist and he
50:04 was like no no no I’ll do my own tests
50:06 and we did that and I didn’t think he
50:09 did enough tests I didn’t agree with
50:11 this diagnosis and I had to go back and
50:14 say you know what I want to see this
50:16 rheumatologist I really want the
50:18 referral and I’m really not leaving this
50:20 office until you do it
50:22 um which was really difficult for me
50:24 because I’m a very anxious person but I
50:27 knew that if I didn’t do that then it
50:29 would have just been swept under the rug
50:30 unfortunately and fortunately I went to
50:33 that rheumatologist and it turns out I
50:35 actually do have an autoimmune disorder
50:37 that he misdiagnosed so I’m glad that I
50:39 did so know your body and if you need to
50:43 really push to see the people that you
50:46 need to see
50:47 if you hit a wall
50:49 don’t be afraid to change providers and
50:52 again
50:53 this is really tricky because I
50:55 understand that there aren’t a lot of
50:57 providers and if you live especially in
51:00 rural Canada or in places where there is
51:02 less care that’s going to be very very
51:05 tricky
51:06 and sometimes you just have to kind of
51:08 push through with what you have which
51:09 really sucks but if you can change
51:12 providers you should try if you’re not
51:15 getting your needs met
51:17 understand your insurance coverage
51:19 whether it be private or provincial if
51:21 you have insurance coverage know the ins
51:23 and outs know what’s being offered to
51:25 you
51:26 and connect with migraine Canada so
51:28 migraine Canada is an excellent source
51:31 of information
51:33 um they really do pay attention to
51:36 Patient voices
51:39 um you know so they have tons of
51:40 resources on their website that might be
51:42 really useful to you as many of you know
51:44 but even aside from that I you know I’m
51:48 sure if you reached out to my green
51:50 Canada and said I’m experiencing this
51:52 issue and you were looking for
51:54 um you know a new health care provider
51:56 someone who specializes in migraine I
51:58 know they’re putting together kind of a
52:00 database of practitioners that are more
52:02 migraine and headache focused but they
52:04 might be able to help with things like
52:06 that so they’re a really good resource
52:08 just giving them a plug they didn’t ask
52:10 me to do that but I think they’re
52:12 wonderful so use them
52:17 um create your own Healthcare team I
52:19 guess the last point I have so if you
52:22 can again this is a very privileged kind
52:25 of
52:25 option but
52:27 find Healthcare protection practitioners
52:29 who listen to you and provide acceptable
52:31 care if you can
52:34 reach out to Allied health professionals
52:36 as needed again if you can you might
52:39 round out your care I found more help
52:43 sometimes through chiropractors and
52:46 massage therapists
52:47 I see a really fantastic social worker
52:51 for therapy myself and for supervision
52:54 because I have my own practice who has
52:57 been amazing
52:58 um in helping me kind of just
53:00 figure out how do I work through these
53:02 symptoms because I still have symptoms
53:04 that I have to deal with how do I accept
53:06 them how do I work through them on a
53:08 day-to-day basis there are
53:09 physiotherapists out there they’re a
53:11 naturopaths or a whole bunch of
53:13 different Allied health professionals
53:15 who might be able to help you in
53:17 different ways
53:18 if you need to continue with a physician
53:21 or specialist who’s difficult or who
53:23 lacks empathy
53:26 you know again you might have to push
53:28 through
53:29 um use them for what you can
53:32 um but access support through your peers
53:36 or a counselor or friends or family when
53:38 needed to help you cope with some of the
53:41 issues that might come up with that
53:43 practitioner
53:45 um maybe there’s someone that you can
53:48 talk to who might help you problem solve
53:50 through a particular issue that you’re
53:51 having with that practitioner
53:54 um or might help encourage you if you’re
53:56 having difficulty working up the courage
53:58 to address some of the problems in that
54:01 working relationship
54:04 so I’m just gonna end this talk today
54:08 um just highlighting it’s okay for you
54:10 to meet your own needs and to set
54:12 boundaries with others and to build the
54:14 life that you want
54:16 um and I hope that this was really
54:17 helpful in terms of trying to figure out
54:20 you know what are some elements of
54:23 communication that might help me do that
54:25 with the people who are close to me
54:28 um you know as well I know we covered
54:30 kind of a
54:31 a vast array of of things tonight
54:35 um but hopefully it was helpful
