RHR: Finding Joy in the Midst of Illness, Pain, and Difficulty

In this episode, we discuss:

• Why health has a much larger definition than just the absence of symptoms or disease
• Understanding health as a process, rather than an outcome, and how that contributes to a moment-by-moment experience of health and well-being
• Stepping away from a myopic focus on root cause to take on more pleiotropic interventions that contribute multiple benefits to our health and wellness, even in the midst of whatever chronic condition symptoms are present
• The concept that we’re part of an ecosystem that influences our health, sometimes in ways that are out of our control
• Tools you can use to find joy in the midst of difficult circumstances, including meditation and awareness, zooming out, shrinking the change, elevating your mood, and radical self-care

Show notes:

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Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. The focus of this show and my work in general for the last 15 years has been on how to prevent and reverse chronic disease and pain. In particular, how to address the root cause of the problem so that you can fully recover and not end up just suppressing symptoms with drugs or putting Band-Aids on the issue. This is still a worthy and important goal, and it’s still a primary focus for me. But having said that, I have learned over many years of my own struggle with chronic illness, treating thousands of patients who’ve dealt with chronic illness, and training thousands of healthcare professionals around the world who are also helping to support people with chronic illness, that there’s a lot more to it than we might imagine on the surface. When you’re dealing with any kind of challenge like pain or illness, generally, the healing process takes time. We still need to figure out in those circumstances how to live our best life while we are continuing to deal with those problems. Also, the truth is that it’s not always possible to identify or address the root cause of a health problem and fully reverse that condition. Let me give you a few examples.

The most obvious level, let’s say somebody gets into a really horrible car accident and shatters their leg. In that case, the expectation would likely not be that they’re going to recover the full use of their leg to the extent that they had before that devastating accident. The expectation might be in that scenario that they’re going to do everything they can to restore as much function as possible, but because of how many places they broke their leg or how severe the damage from the accident was, there’s a recognition that they may never fully recover 100 percent of the function of their leg. In that case, the focus would be on regaining as much function as possible and living as happy and joyful a life as possible within those circumstances. It gets a bit murkier in the case of chronic illness because in many situations, there’s at least the possibility that we might be able to figure out the root cause or causes and address those and fully recover. But with many conditions, like autoimmune conditions, at least as we understand them right now, once the body starts producing antibodies to a particular tissue, it doesn’t ever fully stop. Certainly, there are many steps we can take, which we’ve talked about a lot on the show, that can reduce the immune system’s attack against soft tissue and can even lead to complete remission in some cases. But generally, if you stop doing those things, stop eating a healthy diet, stop taking care of yourself, stop getting enough sleep, [and] stop managing your stress, then the immune attack will resume and so will the symptoms and the impacts of that attack. So it’s not really a cure in the sense that we take some steps and then it goes away entirely [and] we never have to think about it or worry about it again. It’s more of a process of management or engagement, [where] we are continually taking steps moment-by-moment to improve our health and well-being, and we have learned to live in a symbiotic relationship with that condition over time.

There’s a spectrum from a relatively simple and straightforward condition that has a clear root cause, [which] can be clearly addressed, all the way to the other end of the spectrum with a very complex, significant condition that’s mysterious, with no clear identifiable root cause and/or a root cause that may be identifiable but can’t be addressed. All of us are on that spectrum somewhere if we’re dealing with a health issue, and I think it’s really important to have this conversation of, “How do we live with that? How do we approach ourselves and our healing process wherever we are on that spectrum?”

The other thing is that, as the COVID[-19] pandemic showed us, no matter how much attention we pay to our own health and well-being, things can happen that are totally outside of our control. We may not be dealing with a chronic illness or pain, but maybe we’re struggling with other difficult circumstances, perhaps related to the pandemic or not, like loss of employment, the effects of inflation, rising housing costs, grief over lost loved ones, feeling stuck in a challenging relationship, etc. The process that I’m going to talk about in this show for working with a difficult issue applies to those challenges, as well. It’s not limited to a health-related challenge or chronic pain. Some of the same perspectives and practices and tools that I’m going to discuss can be applied in any situation where we feel stuck or we’re dealing with some challenge in our life. In this show, particularly, I want to focus on how we find joy and live our best lives, even in the midst of difficult circumstances like chronic illness [and] chronic pain, but not limited to those issues. That doesn’t mean that we can’t continue to work to improve our circumstances and to heal chronic illness and to relieve chronic pain or to change the conditions that are leading to us feeling stuck. But it does mean that we don’t stop living or give up our right to thrive and flourish, even in the midst of those challenges. So that’s the topic of the show today. [I] hope you enjoy it. Let’s dive in.

The Definition of Health

The first concept that I want to speak about is that health is more than simply the absence of symptoms or disease. It’s always struck me that we don’t have a clear definition of what health is in our culture. Certainly, I never saw a clear definition of health when I was a student studying medicine. There were lots of definitions of diseases and disease states and syndromes and things like that, but never a clear definition of what health really is. And I’ve asked a lot of people in my life over the years, and the responses vary. [For] some people, it’s something like, “I don’t know how to explain it, but I know it when I feel it, or I know it when I see it.” Other people tend to define it as just feeling great all the time, and never having any symptoms, [or] not having a disease. And still others define it in a much broader context. Over the course of my career, I definitely now find myself in the camp of those who define it in a broader context. Because the problem with defining health as simply the absence of symptoms or disease is that it doesn’t really take our full human experience into account.

For example, let’s say you are a person who has an autoimmune condition, and you still struggle with symptoms from that condition occasionally. Maybe [you have] disrupted sleep or exercise intolerance or occasional digestive issues or occasional fatigue. Maybe you have to watch how much activity you do. If you overdo it, you get more tired than you’d like. You have a range of symptoms that you deal with. And through your diet and lifestyle changes, you’ve been largely able to manage that condition. And let’s say you have really rewarding and meaningful work, you have a great family life, you’re in a happy partnership, you have kids [who] you love, you’re active in your local community, [and] you have physical activities or hobbies that you enjoy or creative pursuits that you love. You just love your life. You’re really thriving and flourishing as a human being. It would be difficult, for me at least, in that situation to look at that person and say that they’re not healthy. Likewise, on the other end of that spectrum, you could have someone who is free of any symptoms and doesn’t have any diseases or syndromes or anything like that. But they’re a total wreck in many other areas of their life. They have terrible relationships or not many relationships at all, [and] they’re not happy with their work or their life in other ways. Maybe they’re dealing with substance abuse or addiction. There [are] so many other ways that a person can struggle and suffer that aren’t related to physical or mental health symptoms or diseases or conditions. And we may not think of that person as being healthy or well. Those are maybe extreme examples, but in my work with patients over the years, and in my own pursuit and thinking about this, I certainly have seen that most people fall somewhere on that spectrum. I’ve also, just in my research and writing, [learned] of so many remarkable people, famous historical figures, scientists, politicians, musicians, artists, inventors, people from all different walks of life and backgrounds, who have accomplished incredible things in their life. So much so that we’re still talking about them hundreds or even thousands of years later. And there are historical records that tell us that many of these people struggled with sometimes very significant health challenges and diseases and conditions, which were sometimes known and sometimes not understood or not defined very well. Yet, they went on to live a remarkable life and make a huge contribution to humanity, and they’re people [who] we know and love and recognize today. And that’s not just true of historical figures. That’s true of many contemporary figures. Entrepreneurs, artists, actors, musicians, etc. I’m sure many of you who are listening know of people you admire [who] also have [had] or still deal with some kind of chronic health challenge. And yet, they appear to be living a really fulfilling and rewarding life.

Over time, I have come to understand health as a much broader process [rather] than just a simple definition like the absence of symptoms or disease. And even after all this time, I still don’t have a really clear definition of what health is, despite thinking about it a lot more than the average person. But I will offer one definition that I like a lot. I don’t know if it’s the definition, but you may have heard me say it before. It’s from Moshe Feldenkrais, who was the founder of the Feldenkrais Method, [which is] a somatic education in neurological reprogramming. [It’s] a very sophisticated body of work that’s really hard to explain, especially for non-practitioners like myself. He said [that] true health is the ability to live your dreams. And I think that gets closer than just about any other definition that I’ve heard because it gets at what we’ve been talking about so far, which is [that] it doesn’t refer necessarily to a state of being in the body that is transitory, like if you’re free of symptoms or disease. Is that right now? Is it for today? Is it for the last two weeks? Is it for the next two weeks? It’s not referring to a transitory, temporary state that could change. It’s referring to our capacity to inhabit our full humanity and realize our potential. And I think for most of us, that, ultimately, is what we’re most interested in.

If we were able to live a life where we felt like we lived our dreams and fulfilled our full potential, I think we’d all agree that would be a very satisfying and rewarding life, even if we were dealing with some symptoms or even a disease during that lifetime. Conversely, if we live our full life without achieving that, and we’re in good health for most of our life, we may feel like something was missing. I don’t know. I’m going to leave it there to move on to the next topic. I am largely interested in the question more than the answer. What is health? What does it mean to you? It might mean something different to you than it means for me. And that’s totally appropriate and great. I would just invite you to think about what it means for you. Especially if you’re someone who is struggling with a chronic condition, pain, or illness. What does health mean to you? How can you find health and wellness, even in the context of that chronic health challenge?

Health as a Process, Not an Outcome

This leads me to the next concept that I want to discuss, which is that health is a process rather than an outcome. It’s easy to make the assumption that health or well-being is an outcome that we arrive at once some conditions or circumstances have been met. An example from my own life would be when I got really sick in my early 20s after traveling. Of course, naturally and appropriately, all my focus was to regain my health [and] eliminate those symptoms that I had, get rid of the disease condition that I was dealing with, and get back to my life as I experienced it before I got sick. But over time, I came to understand that [the] way of looking at health as an outcome that we arrive at some point after we do a bunch of different stuff, or various things happen, is at least incomplete if not just inaccurate. The reason is that when we look at health as a process, we begin to understand that the choices we make on a moment-to-moment basis, and where we put our attention on a moment-to-moment basis, is what primarily determines our health or our experience. Rather than some idea of where we might get to once we get rid of our symptoms [or] we’re able to deal with the disease or condition that we’re facing.

One of my teachers, Sherry Huber, said, “The quality of our experience is determined by the focus of our attention.” If our attention is constantly on what’s missing, what’s lacking, what’s broken, [and] what we need to do to fix those things, that creates an experience of not enough, not okay, not well, [and] not healthy. It’s easy to understand how that happens when we’re in a painful or difficult situation, whether that’s a chronic illness or some other circumstance in life. It’s quite natural to assume that we can’t be healthy or well until those circumstances change. But my own experience in my work with patients, as well as the experience of people who are a lot wiser than me, suggests that is not necessarily true. For example, Viktor Frankl, who was an Austrian psychiatrist put in a Nazi concentration camp during World War II, said that “our perspective on life’s events [and] what we make of them matters as much or more than what actually befalls us.” He also said [that] “when we are no longer able to change a situation, we are challenged to change ourselves.” What he’s pointing at is that the way that we relate to our circumstances, [whether that’s] chronic illness, pain, or something else, is as important if not more important than the circumstances themselves. That’s a major shift in awareness and in consciousness, and it leads to a really different relationship with ourselves and the world around us when we are dealing with challenging conditions.

I want to be clear here: I’m not glorifying suffering or pain. I’m not suggesting we don’t work hard to alleviate it, however and whenever we can. I still think that is very important. It should always be a part of the process to the extent that that’s possible. But I am suggesting that we do have a choice in how we relate to the circumstances of our life, and where we put our attention will have a huge impact in our experience, which is to say our health and well-being, from moment-to-moment. When we understand health and well-being as a process rather than an outcome, that actually does lead to different choices. We might choose to do things, for example, that aren’t clearly connected to changing or fixing our problem, at least on the surface, but that do contribute to the moment-to-moment process or experience of health. Let me give you an example that would often come up when I would talk to patients in my practice. I would often have patients with very complex chronic health conditions. That was basically my typical patient for many, many years. Understandably, those patients were really intent on figuring out the cause of their condition and what they could do to address it. What would often happen [is] they would report to me that they [spent] almost every waking moment trying to figure that out. That might [mean] researching on the internet to find articles or forums or other people dealing with a similar condition who might be able to offer some insight into what’s going on. It might mean working with many, many different practitioners, starting with one practitioner, and after a few appointments if they don’t make progress, going on to the next one. Almost their entire life would be consumed by this process of trying to figure it out and address the root cause. I know that process. I know that relationship because I was there myself in the earlier part of my chronic illness. And I know how all-consuming it can be.

The problem with that is [if I have] this belief that health is something I’ll arrive at, at some point, if I can just change the conditions, [then] all my energy goes into that process, rather than the things that would actually contribute to an experience of health and well-being moment-by-moment. Like doing things to elevate our mood or cultivating pleasure, seeking social connections, spending time outdoors in nature, etc. Those are the things that really make life feel like it’s worth living and contribute value and make us feel alive. But if we’re spending all of our time thinking about researching, exploring, [and] focusing on how we’re going to get better at some future point, then we miss those opportunities. That was a lesson that took me many years to learn because I’m stubborn and I was doggedly fixated on one perspective or one idea about what health means. I did learn that over time, and as I was able to help patients zoom out and broaden their perspective, I found that many people, including myself, experienced a lot more joy and pleasure and happiness, even in the midst of whatever they were dealing with, when they were able to understand health and well-being as a process rather than an outcome.

Root-Causism Versus a Pleiotropic Focus

The next concept here that I think is helpful is one that I’ve talked a little bit about before on the podcast. I’m still looking for a good term or good way to talk about it, but right now I’m using the term pleiotropy versus root cause. I alluded to this a few times in the last section, but one of the core principles of Functional Medicine is getting to the root cause of a health problem so we can address it rather than just suppressing symptoms. That’s just the basic Functional Medicine canon. An example of this would be if you’re having a lot of gut and skin symptoms and you get tested and find out you have celiac disease, that information will be invaluable in helping you figure out what’s going on and make a plan. So trying to identify the root cause of a condition and address it should always be a goal. But having said that, the reality is that it’s not always possible to identify or address the root cause of a disease. If we only focus our attention there, we can miss out on other possibilities that lead to better health and well-being. [This] is what the cognitive psychologist and linguist Steven Pinker calls “root-causism.” Pinker doesn’t write about health. He wasn’t thinking about health when he coined that term. He was actually referring to how we approach solving complex societal problems. I’m going to read you a quote from his book Enlightenment Now, where I came across this term. “This version of historical pessimism may be called root-causism: the pseudo-profound idea that every social ill is a symptom of some deep moral sickness, and can never be mitigated by simplistic treatments which fail to cure the gangrene at the core. The problem with root-causism is not that real world problems are simple, but the opposite: they are more complex than a typical root-cause theory allows.” Then he goes on, “So complex, in fact, that treating the symptoms may be the best way of dealing with a problem, because it does not require omniscience about the intricate tissue of actual causes. Indeed, by seeing what really does reduce the symptoms, one can test hypotheses about the causes, rather than just assuming them to be true.”

When I first came across this passage, as I’ve noted before, it was one of those lightbulb, “Aha!” moments. I remember distinctly where I was when I read that passage, and I put the book down and took a very long walk in the woods near my house where I was living at the time. Because as a Functional Medicine clinician, the idea of addressing root causes was and still is at the core of my belief system, for the most part, and certainly was at the core of my approach to treating patients. But those passages opened my eyes to the possibility that that is not always the best lens to see through, especially when we’re dealing with really complex problems. The societal issues that Pinker was talking about and chronic disease are not the same, of course. But they are both complex, multifactorial, and systemic phenomena. And while root causes always do exist, they aren’t always easily identifiable, or addressable if we can identify them, as I mentioned earlier. If that’s the case, [then] what is the alternative to an exclusive focus on root cause? As I mentioned, I’m still trying to find the best word, but the one that gets closest that I’m aware of now is pleiotropy. It doesn’t exactly roll off the tongue, but it’s accurate. It’s a term that is typically used in the context of medications and genetics. It’s usually defined as the production of diverse physiological or psychological effects by a single drug or gene. An example of this would be a drug like metformin, which is typically used to lower blood sugar but [has] also been shown to have anti-cancer effects and maybe even extends lifespan.

In this sense, I’m talking about pleiotropy more generally, as any intervention that has multiple and diverse effects on us. Examples would include diet, because when you eat a healthy diet, it doesn’t just improve one thing, it improves many things. Same for exercise, stress management, [and] adjunctive therapies like infrared sauna or cold thermogenesis or pulsed electromagnetic field therapy [(PEMF)]. These are all pleiotropic interventions because they have numerous effects across many different systems of the body and the mind. We could also include things like shifting from a fixed mindset to a growth mindset, cultivating more pleasure and joy in our life, building resilience, embracing positive psychology, improving our relationships, etc. All [these] interventions have pleiotropic effects—not just one single benefit, but many, many different benefits.

Now more than ever, we’re finding ourselves faced with trying to find joy in the face of chronic illness and difficult circumstances. Learn the practices and tools to use when you’re feeling stuck or dealing with some challenge in your life, in this episode of Revolution Health Radio. #chriskresser #joy #mindfulness

Imagine a scenario where someone is feeling tired. A hundred percent focus on root cause might be to do a full blood panel and run a bunch of other tests to find the source of that fatigue. Is it [a vitamin] B12 deficiency? Is it a hormone imbalance? Is it mercury toxicity? Maybe some of those, maybe none of those. I don’t know. On the other hand, an exclusively pleiotropic approach would be, “Okay, I’m tired. So I’m going to clean up my diet a little bit because I noticed it’s been slipping lately. I’m going to get to bed earlier because I’ve been getting a little bit less sleep. I’m going to do some PEMF or sauna sessions in the afternoon. I’m going to cut down on coffee, and maybe take some supplements that are designed to improve health and energy.” In that more pleiotropic approach, there is some investigation or some exploration of root causes, [like the] assumption that it might have something to do with diet and sleep. But that’s a light or secondary theme, and it’s really about engaging in interventions that we would assume will help with energy and a bunch of other things on top of that.

Here’s the crucial point. Both approaches could get to the same goal [of] improved energy, regardless of the underlying cause. If it’s a [vitamin] B12 deficiency, cleaning up the diet can help with that. If it’s a hormone imbalance, diet and stress management [and] PEMF and sauna and more sleep could help. Even with mercury toxicity, doing things like more exercise, PEMF, and sauna, a really healthy diet with detox-supportive nutrients, getting more sleep, all of that would help. It might not be enough on its own, especially for severe mercury toxicity, but it would certainly help. The crux of this is that, over time, I have come to see that the best approach is generally a mix of root cause and pleiotropy. But the reason I’m even talking about this at all is that I’ve seen a lot of people [who] I’ve worked with get unhealthily focused on root cause at the expense of pleiotropy. Going back to the example I used before, if you have someone who has a complex and mysterious chronic illness, they could literally spend all their time just trying to figure out what the root cause is and address those root causes. I have seen that in patients I’ve worked with.

For example, say someone has a couple [of] hours of free time after they’ve cleaned up [after dinner and put] the kids to bed or something like that. What are you going to do with those couple [of] hours of time? You could spend all that time on the internet researching, looking in forums and social media, figuring out what was working or not working for other people, [or] researching a new doctor you might want to see. There’s nothing wrong with that, and there’s certainly a time and a place for that, as well. But if that is always the choice, instead of maybe going for a walk with your partner and spending some time outside, playing with your pets, picking up a musical instrument, writing in your journal, reading a book that you really enjoy, [or] watching a funny movie, those are the pleiotropic interventions that are likely to contribute to that moment-by-moment experience of health and wellness, even in the midst of whatever chronic condition symptoms are present. I think the really interesting piece of this is that there’s a possibility you reach the same place that you wanted to reach by addressing the root cause by taking that pleiotropic route [instead]. That is to say, you might find your way back to health and well-being without ever figuring out what the root cause was. Or if you did figure out the root cause, not being able to fully address it, or figuring out one cause and not the others. There [are] lots of different paths to the top of the mountain, and I’ve seen with the people I’ve worked with that it’s really important not to get stuck in an exclusive root cause approach and to remember that big changes in our life are often the result of many small changes. We don’t always need to know the cause or be able to address it completely to be able to make progress. That’s where this distinction between pleiotropy and root cause comes into it for me.

Now, one thing that often comes up when I talk about this to patients and other people in my life is this objection of, “Okay, well, are you just telling us that we should give up? We shouldn’t even think about finding the root cause and trying to address it? And if we can’t address it, or it’s been hard to address it, should we just stop trying entirely?” No, that’s not what I’m saying. I think acceptance and submission are two very different responses that are easy to confuse. My understanding of acceptance is recognizing what is true in each moment, and that’s it. Just being honest with ourselves about what is in each moment, and it doesn’t mean anything about the past or the future. We could recognize something to be true in the present moment, and then in [the] next moment, we could work to make that thing different. That’s still acceptance. Submission is giving up. Submitting to something and essentially projecting into the future that it will always be that way and there’s nothing we can do. It really is a razor’s edge, but it’s an important one. Because I believe that acceptance really is a precondition to making change in our life. If we don’t recognize what is true, we cannot respond appropriately. The term responsibility is quite a literal term, when you think about it. It really just means our ability to respond. If we’re going to have an ability to respond, we have to be clear-eyed about what it is that is happening and what we’re responding to. So as we talk about root-causism versus pleiotropy and health as a process rather than an outcome and being more than just the absence of symptoms or disease, what I’m saying here is that we are being truthful with ourselves about what is. From there, we’re free to make whatever choice we want. We can move toward trying to find the root cause and addressing that, or we can move toward a more pleiotropic approach, or we can do what I think is the best approach for most people, [which] is a blend of the two. And one of the ways of doing that is zooming in and zooming out, which I’m going to talk about in a moment here.

Our Existence in an Ecosystem

I want to at least touch on a final concept here before I start sharing some of the tools that I’ve developed over the years for working with a difficult issue and finding joy in the midst of challenging circumstances, and that is that we’re part of an ecosystem. We have a tendency, especially in our culture in the West, to believe that pain and illness and suffering are purely individual. So many of my patients, and myself included earlier on, believed that it’s their fault that they’re sick. [That] there must be something wrong with us [or] we’re to blame in some way for what happened, and there’s often a tremendous amount of guilt and shame that accompany chronic illness or any kind of difficult circumstances that we might find ourselves in. There’s a tendency for us to blame ourselves or take credit for everything that goes wrong and not take credit for anything that goes right. I think that’s part of our negativity bias as human beings, and it’s something that’s hardwired into our brains. It helped us survive in a natural environment because we were always scanning for threats and challenges, and our ancestors who were more successful in doing that were the ones [who] passed their genes onto us. But it’s a limited view, and I don’t think it’s accurate in most cases.

We are part of an ecosystem that is extremely complex in most situations. What happens to us is often influenced by our context and environment and the ecosystem in which we find ourselves. Let me give you a couple of examples. Let’s say you have a mold-related illness. I’ve worked with many patients over the years who’ve struggled with this. I struggled with it myself. We had a pretty serious mold problem in a house we lived in many years ago, and it caused health issues for my entire family, so I know about this firsthand. It’s pretty obvious in that situation that there are factors that are outside of our own individual choices and life history that impact our health and well-being. In this case, living or working in a moldy building [and] being exposed to that mold. It goes beyond that, too, because there may be other people who lived in that house or were exposed to that same building who didn’t get sick. What explains that? Often, it’s the gut microbiome, or nutrient status, or the existence of other health challenges that pre-existed the mold exposure, and many of those things were not something that we had control over. For example, we might not have been breastfed as an infant or our parents might have given us a lot of antibiotics when we were young, which disrupted our gut flora. Maybe we were fed poor quality food when we were growing up, and that led to nutrient deficiencies and other problems. And/or maybe we traveled overseas and got an infection that had a big impact on our gut. There [are] so many possibilities. We have varying levels of control, ranging from none at all to total control, [over] many of these different influences in our life. But they all combine in aggregate to create the state of health and well-being that we have right now. That’s an example of this ecosystem that we’re a part of and how it influences us.

Another example that’s not illness-related, necessarily, would be the difficult circumstances that many of us find ourselves in post-COVID. I don’t mean post-COVID [as in] COVID[-19] is gone and we never have to think about it again, but we are in a different phase of this pandemic than we were two years ago. We’re starting to see a lot of other systemic effects from the response to the pandemic and how it affected all aspects of economic, social, political, [and] cultural life. Rising inflation, supply chain issues, rising fuel costs [and] food costs. Many people are feeling squeezed and challenged by those circumstances. I think we can safely say that nobody had any individual control, or even agency, in a lot of those circumstances. Those are conditions that we have to deal with on a day-to-day basis, but that we’re not in full control over. I think that’s very important to recognize and to acknowledge because it frees us from the guilt, blame-and-shame cycle that can make it very difficult for us to accept what is happening and to respond appropriately. If instead we get stuck in that, “It’s all my fault and I’m in full control” idea, then we can’t really respond in a way that’s going to help us move through that challenge.

Tools for Finding Joy in the Midst of Difficult Circumstances

I want to talk a little bit about some of the tools that I’ve developed over the years in my own life and in my work with patients for finding joy in the midst of difficult circumstances. One is mindfulness meditation practice and awareness practice. Awareness of what’s happening in our lives, both internally and around us, is a prerequisite to everything that we’re talking about here. Awareness is always the first step toward change, and if we can’t be aware of our own thoughts, feelings, sensations, [and] reactions, then we don’t have much hope of changing them. I’m not going to spend a lot of time here. I’ve talked about mindfulness and meditation a lot, including lots of different ways to start a mindfulness meditation practice. You can search on my website for that if you’re interested. But I think that is really at the foundation of everything I’m talking about here. Another helpful framework is this idea of zooming in and zooming out. What I mean by this is [that] there are times when it’s totally necessary and appropriate to get really into the weeds and details of whatever challenge that we’re dealing with and try to find the root cause, [and] try to address that root cause if we find it, and that can lead to huge changes [and] huge benefits, like the example I talked about earlier of someone who has all kinds of [gastrointestinal] issues and then found out they were gluten intolerant. Removing gluten from the diet will make an enormous difference. That’s just a life-changing benefit. There are times when that is really necessary and helpful, and absolutely the right thing that we need to be doing.

There are also times when we need to zoom out. What I mean by that is softening the focus on whatever the issue is that we’re dealing with and shifting it toward some of those pleiotropic interventions that we know will improve our health and well-being on a moment-to-moment basis, even if we don’t know what’s going on under the hood and we can’t identify that root cause. In my own experience over many, many years with chronic illness, I learned the hard way through trial and error that I had to zoom out, and that [staying zoomed in all the time] was a prescription for suffering and actually inhibited my progress. Everybody’s rhythm for zooming in and zooming out will be different depending on their circumstances. But I think that’s been a helpful frame for me, and I’ve introduced [it] with my patients and they’ve gotten value out of [it], so I wanted to share it with you.

Another concept [that] you may have heard me talk about is shrinking the change. This comes out of the behavior change and coaching framework literature, and it’s the idea that every big change that we want to make in our life is generally best [broken] down into a series of small steps, for lots of different reasons. One is that big changes are overwhelming and it can be difficult for us to get our head around them. We can feel a lot of resistance and friction when we think about making big changes. But if we’re able to break a really big change into the smallest possible increments, those smaller steps often feel attainable. They’re more concrete [and] they’re something that we can often do in a single chunk of time. And when we are successful with those small steps, we gain confidence and momentum that helps us carry through to the next step. Through that process, we find it much easier to arrive at the big change that we were looking for. When I reflect on my own life, I see the truth of this over and over. I see how many times in my life, not just in terms of health but in any other area of my life, these really big changes came about as a result of numerous small steps, sometimes steps that were so small that they barely even seem[ed] like steps at all. That’s another really important concept when we’re working with difficult circumstances.

Another one is the importance of elevating your mood. This might not seem intuitive at first and I think is one of the things that people struggle with the most, because if we’re feeling sick or in pain, it can feel almost impossible to elevate our mood. Or [at least] it certainly doesn’t come easily. But we know from so much research that when we are able to elevate our mood, endorphins are released. These endorphins, in addition to making us feel good, have a profound impact on the immune system. Most white blood cells, for example, in the body have a receptor for endorphins. If you’re familiar with the research on how music, laughter, or pleasure contributes to health and well-being, and immune health in particular, that’s the mechanism. These endorphins stimulate immune function and support our endocrine and nervous systems in ways that we are only scratching the surface of understanding. If you put this another way, feeling good turns out to be really good for you. And I think that’s a crucial concept here because it fits with this pleiotropic lens that we’ve been talking about, where doing things that make you feel better will improve your health, regardless of what the cause of the symptoms or condition that you’re dealing with is.

What you do specifically to elevate your mood will differ from person to person. I think some of the most well-researched and accessible ways would be gratitude journaling, listening to music that you love and elevates your mood, various forms of movement [like] taking a walk outside, or dancing, or sport activities, especially those that are really fun. For me, surfing and skiing are at the top of the list. [Also] mountain biking [and] laughter. This could be watching funny movies, [or] it could be more intentional practices like laughter yoga, which seems ridiculous at first, but you can really get into [it] if you give it a shot. Things that actively cultivate pleasure [like] getting a massage, taking a hot bath, etc. Spending time in nature, particularly with your shoes off and just connected to the earth, can make a really big difference.

Along the same lines, I’m a big believer in radical self-care. What is different about radical self-care than self-care? It’s radical because you’re really swimming upstream these days if you’re making time for self-care. You’re going against the grain, and sometimes you have to be a bit radical in your approach. That could involve giving yourself full permission for self-care. Micro self-care is similar to [the concept of] shrinking the change [that] we mentioned before. If you only have two minutes to meditate, [then] meditate for two minutes. You will still get some benefit from that. If you only have 10 minutes to do some movement or exercise, do that. You’ll still get [some] benefit. In our culture, we have this mentality of all-or-nothing, and I think that prevents a lot of people from doing self-care throughout the day that would really help them, because of a belief system around it [needing] to be big and long and thorough and complete to be worth doing. Lowering our expectations, which goes along with recognizing and accepting that it’s not going to be perfect sometimes and we’re just going to do the best we can. Doing something is better than nothing. There’s a lot more to say here, and I’m going to do another podcast on radical self-care at some point, but I just wanted to introduce that as one of the tools that I think can be really helpful.

I hope this was helpful. I know it might be a mindset shift for some of you, and for others, it might not even be relevant at all. If you’re firing on all cylinders and doing great and not feeling stuck or not dealing with any kind of illness or pain or challenging circumstances right now, you probably didn’t make it this far and aren’t listening anymore. And that’s awesome. That’s great. Perhaps someday in the future, if circumstances change and challenges arise, you might find this to be useful, as well.

Before I finish up, I wanted to briefly mention Adapt Live, which is my upcoming retreat at the Snowbird Resort [in Utah] over Labor Day weekend. If you’re interested in the topics that we talked about in this episode, you should definitely check out this retreat. We still have a few spots left. The theme is “Getting Unstuck,” [and] we will be exploring many of the topics, perspectives, tools, and practices that I briefly introduced in this podcast in much more depth. I’ll be joined by five incredible, experienced facilitators and guides. All people [who] I have been privileged to work with and know in my life and in my professional career, as well as yoga, meditation, and movement instructors. We’re going to do a balance of activities and practices designed to help us get unstuck, [including] guided meditation and movement, breakthrough sessions, integration sessions, nature immersion, as well as chances to relax, connect with fellow participants, enjoy the beautiful surroundings, and, importantly, I think, celebrate and have fun. That’s a really big, important part of getting unstuck. Space is limited to only 45 participants because I wanted to preserve a retreat-like atmosphere and create a more intimate experience. As of the time of this recording, we’re about 70 percent full, and I think by the time this podcast comes out a few weeks from now, I’d expect that to be closer to 80 to 90 percent.

If you would like to learn more and grab your spot, go to Kresser.co/adaptlive and you can learn more about the schedule, what we’re going to get up to, the guides, food, accommodation, costs, etc. It’s Kresser.co/adaptlive and it’ll be an amazing chance to come together as a community with this higher purpose. [I] really look forward to seeing those of you who’ve already signed up, and if you can join us and you’re drawn to this, we’d love to have you there. Okay, everybody, thanks for listening. Keep sending your questions in to ChrisKresser.com/PodcastQuestion, and we’ll see you next time.