How does RA Affect Identity? Reflections on Gender, Sexual Orientation, Mental Health and More with Psychotherapist Timothy Weymann

Summary:

In this episode, host Cheryl Crow and psychotherapist Timothy Weymann delve deep into the existential, philosophical questions that chronic illness poses. Is there hope without healing? Is it possible to “make peace with loss and change?”  How on earth can you “access a sense of peace in the midst of ambiguity,” particularly when that ambiguity has to do with your own health and wellbeing? 

Timothy reflects on gender, sexual orientation, disability, acceptance and more, sharing how he used “minority survival skills” he learned as a gay man to help him navigate his newfound identity as a person with rheumatoid arthritis. He and Cheryl also discuss how gratitude, forgiveness, self-acceptance, compassion, and social connection help them and others face health difficulties with meaning and purpose.

Video of Conversation

Episode at a glance:

• Diagnosis story: Timothy advocated for himself as his symptoms worsened despite experiencing medical gaslighting. Eventually he was tested for and diagnosed with Mixed Connective Tissue Disorder and Rheumatoid Arthritis – which came with feeling crushed and wondering: “Is this going to be my new life?”. 
• Impact of gender and chronic illness: Men are a minority in the rheumatoid arthritis community, and Timothy shared how his gender has affected his experiences of healthcare and belonging in the chronic illness community. He reflects on how our culture has often given the message that men should tough things out and not ask for help, which can be challenging for mental health.
• Sexual identity: Timothy shares lessons he learned while navigating being a minority as a gay man. Gaining protective skills through this experience helped prepare him for the considerations of sharing disability-related information.
• Mental health: Early on in Timothy’s diagnosis he felt like he was in a “crisis phase”, which led to self-blame, shame, and an urge to keep it hidden. Cheryl shares that many people aim to ‘conquer” the diagnosis in an effort to feel like they can control it, but in time inevitably reach limits. Tim reflects on the wisdom of turning away from control and learning ways to “access a sense of peace in the midst of ambiguity”.
• Coping Toolbox: Timothy explores existential psychology, which is rooted in existential philosophy and is a  non-religious examination of the human condition. The 4 ultimate concerns of this are captivity versus freedom, meaning versus meaninglessness (we get to define what is meaningful to us as individuals), connection versus isolation (we’re independent but also need support), and life versus death / ambiguous loss (experiencing limitations and losses). These 4 ultimate concerns can ground one in building a fulfilling life despite chronic illness.
• Best advice for newly diagnosed: Know that it’s ok to not be ok, and it’s ok to let everything unfold. Build a good team, be patient with yourself and others, get connected through support, and utilize collective wisdom.
• What it means to Timothy to thrive with rheumatic disease: Reframing life purpose to mean that a rich life includes both difficulties and happy moments.

Medical disclaimer: 

All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Episode Sponsors

Rheum to THRIVE, an online course and support program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. See all the details and join the program or waitlist now! 

Speaker Bios:

Timothy Weymann

I’m a 39 years old, white, gay American cisgender male; living in the Southwestern U.S. (i.e., Arizona). I was diagnosed with Mixed Connective Tissue Disease at 18/19 years old, and was warned that it could turn into rheumatoid arthritis or lupus. It did turn into a debilitating case of rheumatoid arthritis with co-morbid fibromyalgia when I turned 30 years old and I have spent my entire 30s trying to reclaim as much functional capacity as possible; while working as a psychotherapist,  helping people with mental health issues and various life losses, conflicts and challenges (including chronic illness).

Cheryl Crow

Cheryl is an occupational therapist who has lived with rheumatoid arthritis for nineteen years. Her life passion is helping others with rheumatoid arthritis figure out how to live a full life despite arthritis, by developing tools to navigate physical, emotional and social challenges. She formed the educational company Arthritis Life in 2019 after seeing a huge need for more engaging, accessible, and (dare I say) FUN patient education and self-management resources.

Episode links:

• Links to things mentioned in episode or additional listening
  • Man’s search for meaning – frankl
  • Existential psychology
  • Academy of psychologists – recommends ACT for chronic pain
• Tim’s links
  • Website: www.timothyweymann.com
  • Instagram: @timothyweymann  
    • https://www.instagram.com/timothyweymann/ 
• Cheryl’s Arthritis Life Pages:

• Arthritis Life website 
• Youtube channel
• Instagram @arthritis_life_cheryl 
• TikTok @arthritislife
• Arthritis Life Facebook Page
• Cheryl on Twitter: @realcc 
• Arthritis Life Podcast Facebook Group

Full Episode Transcript:

Cheryl:  

I’m so excited to have Timothy Weymann on The Arthritis Life podcast today. Welcome!

Timothy:  

Thank you.

Cheryl:  

Can you just start off by letting everyone know where you live, and what is your relationship to arthritis?

Timothy:  

Yeah, absolutely. So, I’m currently living in the American Southwest in Phoenix, Arizona. I actually moved down here because of my rheumatoid arthritis. In terms of my relationship to rheumatoid arthritis, I was diagnosed about 10 years ago. However, when I was about 19, I was diagnosed with mixed connective tissue disorder. So, it just hadn’t, it may or may not have been differentiated enough at that time. So, I’ve been dealing with autoimmunity now for 20 years. And it’s been quite a journey.

Cheryl:  

Yeah, that is a long time. So, you’re kind of like me, about half your life. Is that right?

Timothy:  

Yeah. Yes, half my life. And then, it became, about 10 years ago, when I got rheumatoid arthritis, it became very significant. And affecting — in my 20’s, I was well maintained with mixed connective tissue disorder with hydroxychloroquine, and occasional prednisone. And I was quite functional in terms of my capacity to do pretty much everything or anything I wanted. And then, 30 came along, and it advanced. And it, you know, blocked a lot of that stuff or has interfered on and off with all of the things.

Cheryl:  

Yeah, yeah. And we always start by talking about people’s, like, diagnosis journeys, or diagnosis sagas, as they often are. I would love to hear just a little more about what were your first symptoms and what was like the emotional response to getting that definitive diagnosis of rheumatoid arthritis?

Timothy:  

Yeah, sure. So, I mean, if I start back at 19, I had Reynaud’s syndrome. And it was pretty severe. I ended up in the ER at that time and they even thought I was a burn or frostbite victim at one point. And that was a really scary time, and, you know, at 19, not knowing what was going on and having those kinds of issues. I eventually was able to go on appropriate medication, and then I just have occasional flare up. I was told at the time by my rheumatologist that this could become lupus or rheumatoid arthritis. And I was, you know, young, 19, I didn’t really think much of that, or take stock in it. And I just kind of went on with my life. 

And then, when I hit 30, I noticed I just started to slowly have this different onset of pain issues in different areas of my body. It started more in my wrist. And I worked for like an hour — not an hour, a year, a year, about a year and a half, I was slowly collecting the symptoms until I got sort of acute, that I was unable to like perform the function in my job. I was on the computer a lot and then I ended up, you know, going through the whole process of doctor after doctor, test after test. And, you know, that was a really scary time, very ambiguous. I didn’t fully know what was going on. One day or one week or one month, I’d have another symptom or problem that I dealt with. And then, another one. And just ranging in different — severe fatigue, severe pain. 

And what happened is my primary care eventually ran the blood test for rheumatoid arthritis. And I can still remember the day that I got that call. She called me to let me know that it looks like RA and I just was crushed, totally crushed, because they’re in my family. And like, I have a family member who was, it was before the biologic, and they’re just completely having deformities in every joint that they have. And so, we’re just kind of projecting, like, is this now going to be my new life? 

And yeah, so it was a really upsetting time. It took years to really know what was going on. There was also some, a lot of like, medical gaslighting going on. And so, it was a very difficult time in life. And in just a general overview, it did take me a few years to kind of adjust, like to integrate it into my identity and, you know, get out of denial about some of it, and it still affects me today. And I mean, I think that probably would be on some level. So, yeah, that’s kind of a rough overview of my general trajectory.

Cheryl:  

Yeah, I think it’s very common when you have a family member or friend or someone in your life who was diagnosed before the modern medication era in the last two decades, it is really, it’s a really different prognosis. I could totally see how scary that that would be. What was the other thing I’ve already wrote — sorry, I interrupted my own train of thought. Oh, I was gonna say you mentioned medical gaslighting. 

I’m curious if that happened before or after your diagnosis. Because I experienced it in the lead up to the diagnosis with multiple doctors telling me I was not sick, just anxious. You’re a hypochondriac. Stop coming, like, don’t come back. You’re not — nothing’s wrong with you, like, or just go to therapy to cure yourself of your hypochondria ’cause you’re not sick, versus go to therapy to cope with this pain that you’re having and uncertainty.

 So, of course, I didn’t want to go to therapy, because I was like, no, that would be proving you right, that this is on my head. Even though actually now that I’ve been to therapy, I know that therapy would have been really helpful. So, it gave me the skills to cope with the situation. You know what I mean? The lack of diagnostic clarity. But what did it look like for you?

Timothy:  

So, when I first had it, like, I had a really difficult time. I was on the South East Coast in Florida. And I was going to a doctor and he walked in, didn’t examine me or anything, just looked at me, eyed me up and down and said, “Oh, you’re a young guy, you’re fine.” And I was just kind of — I was just like, wow, like, I can’t believe what just happened here. And he left the room. And I think that time I was just so disoriented. I didn’t say anything else to him. He did have a training physician. At least I told her like this is inappropriate, this isn’t how you handle support, and I hope you learn that. But it’s still a little drastic, and they kind of like seep into your head, or they can. 

And so, there was a little bit of influence, even though I knew that was wrong with how he handled it. Theres still kind of like that little part of me that was like, well, maybe I am fine. Or maybe — you know what I mean. And also, then at that time, I started to work with a physical therapist. And I was still in the process of getting diagnosed; I was awaiting tests. And I just was having a hard time moving. 

And I had less kind of like depressive affects, and just from complete lethargy, total fatigue, just so hard to even move with my arms and everything. And he told me, I needed to work on my attitude. And I walked away from that, and I was like, I was like, oh, yeah, like, I’m buying into it, and I’m believing it. And then, like a couple of weeks later, I get the blood test back and my rheumatoid markers are off the chart, just crazy off the chart. So, you know, it’s moments like that, where it’s like, wow, like, I really bought into this person’s line of thinking to my own detriment, and there really is something going on here. 

And there’s been other times of that as well. Later on after being diagnosed that I had a doctor, like, occasionally when I’m in a big flare up, sometimes they need like a handicap or disability parking designation. And I handed him like all my positive imaging, my blood results, a full official functional capacity assessment, and he just looks at me and he goes, “Do you really need this?” So, I just — for sure, with rheumatoid arthritis or even chronic illness, you do end up facing prejudice and discrimination and sometimes in the places you would least expect it, right? We would think like in a medical field or healthcare setting, it’d be an actual understanding and competency around that kind of stuff. But I can infer a lot of probably listeners, and certainly myself included, but you’ll probably find that that isn’t true. They, a lot of people, really don’t know about disability. 

And so, I’ve had some great doctors, too. Like, they have been very compassionate and understanding. But for sure, there’s been many times when that’s happened. I even had a time when I was getting my blood drawn in a lab and I, at that time, my ankles had been so bad they had been casted in and I wasn’t able to really stand or walk in these big casts and they wouldn’t give me a chair to sit on. 

Cheryl:

Oh, my gosh.

Timothy:

So, it was the time of COVID. And they were, they’re like really, like, you have to be this feet apart or whatever. And so, I was like, but I’m disabled right now. And I can’t, I can’t stand and like, even point into, like, there’s a chair back there, can I sit on it? Or can we take a chair outside and I can sit on it? And the front desk person was fighting with me about it. And so, you know, there’s these moments, I just think it’s like, unreal, you’re like, seriously? 

Cheryl:  

Yeah, I think I would say like, and now I know, you’re like a, you know, a provider, trained provider as well. But for me, it’s like my impression after my two-and-a-half-year master’s in occupational therapy is that the healthcare field is really good at preparing people to cope or to address acute health issues or health issues like a stroke that have a very like, that have a trajectory where you have a period of every day is steady recovery, right?

And then — you do eventually plateau with stroke recovery — but point being like, the healthcare education for occupational therapy was not as good at preparing people for dynamic disabilities, chronic illnesses that are going to flare up, where one day, yeah, you need the disability parking card, not because every single day you need it. But because one out of every three days you can’t function. And it’s very hard for people who haven’t coped with or had to live with that before or lived with someone who’ve gone through that to understand, like, well, if you could do it yesterday, why can’t you do it today? You know, that’s like my least favorite thing. I like want to go around the Universe with a sign being like, “If you could do it yesterday, does not mean you can do it today,” you know?

Timothy:  

Totally. Yeah, absolutely. And people really struggle with conceptualizing that. And we would hope the standard would be better in the medical field that you — I mean, 40% of Americans have a chronic health issue they’re managing, and 60% have multiple chronic health issues they’re managing. 

[Editorial note: Timothy emailed me after the episode to clarify that these numbers are switched, he meant to say 60% of Americans have at least one chronic health issue and 40% have multiple]

And so, we have that reality, and then the reality of how people are experiencing the healthcare system. And it’s quite a problem. It’s quite an issue. And whether I’ve been in rheumatoid or chronic illness support group, wherever I am, like, the number one complaint I hear is, “My doctors don’t understand me, my healthcare providers don’t get it.” And we have to pause and go, what’s going on here. This is like your main job, and you’re not understanding these aspects? Where are we failing in terms of training and education and those kinds of things? But absolutely, it’s hard for everybody to grasp dynamism in your health, and we suffer a lot because of that. 

Cheryl:  

Absolutely. Yeah, and this is a great time to kind of start discussing the different intersection of different identities, because we’re talking a little bit about experiencing maybe ableism or distrust within the healthcare system. And then, there’s also different kinds of discrimination people can face, too. You know, their ethnic identity or sexual identity, and I’m just curious if you want to share more about your — before we started this recording, you let me know that this is something that you really love talking about. So, I would love to hear your perspective on the intersection of all your different identities.

Timothy:  

Yeah. I mean, I think if we deal with a health issue, it really matters what age are we, what sex or gender identity, or ethnicity, race, and that really affects the experience of having a health issue and coping with it. 

And for myself, so, being a man with rheumatoid arthritis, I am in a minority there. And I had — the incident I related earlier was an indication of maybe some kind of discrimination of that, like when I’m looked at, you’re a young guy, you should be able to physically toughen up. And so, that definitely has been present before. Additionally, in trying to connect with people with rheumatoid arthritis, there rarely is another guy there for me to connect with in terms of how we experience it. And it differs in terms of what your identities are, you know. Certainly women face some sexism in terms of the dismissiveness and this kind of idea of hysteria or whether it meaning it’ll go straight to like, “Oh, it’s a mental health issue,” or, you know, amongst other issues that they face. But then men kind of have an equal or similar yet slightly different experience as well in that regard. Additionally, with like, with sex differences, women tend to be more relational oriented. And I think this is a protective thing for them when women face chronic illness because they’re more inclined to reach out and are inclined to have that reach out, whereas with men, we’re inappropriately taught to not be in touch with our vulnerability. I think that can get into more denial for men, too. And as well as not getting appropriate help seeking or not having help seeking behavior when we need the help. It’s like, I’m a psychotherapist. And it’s sad. In fact, in my field, it’s really difficult to get men into getting the care that they need. And so, there’s those kinds of intersections. 

And then, on top of it, I’m a gay man, I’m LGBT, and just having a provider that’s also accepting and understanding and just respectful of that identity as well, that matters, too. And so, that brings an extra layer to dealing with things. However, I will say, having been a gay man, I have already faced the process of being a minority. And I worked through issues around that early in my life. And I think it actually prepared me to become a minority as someone with a disability or chronic illness. And when I first became ill, a group I was involved with a lot of the time was still hiding their illness. And right out the gate, I actually was very open about it. And it wasn’t, because I didn’t maybe have some trepidation about it, I just had learned not to guide my life by that kind of fear. 

And so, it was kind of, it was a protective factor for me when I was first diagnosed. And I ended up seeing, you know, when we become ill, we kind of go through these stages. And I think at the beginning, there’s kind of a sense in the crisis phase, there’s a sense of where the disease has its onset, maybe you don’t have a diagnosis, really difficult things are going on, we can end up being kind of in like a victim mode and mentality. And I want to be clear that we’re, in a way, we actually are legitimately victimized by the disorder that’s going on. But when we adopt that psychologically, we end up having more issues. And so, in being a victim in that victim stage, what do we end up doing? We end up blaming ourselves. 

That’s a big thing in chronic illness, right? Is this is my fault, or did I do something wrong, or, you know, you get treatment like some of the examples I shared in the medical field, that I’m the problem, not the way I’m being treated, and the ableism. And we can also end up isolating ourselves in the victim mode. So, we pull away more because maybe we don’t trust to share or just basically kind of living in fear and letting that dictate what’s going on. We can also try to conform inappropriately, meaning like we hide our disability, and we pretend it’s not there, and then we suffer different, bigger consequences for that. And so, it’s a very, it’s a very isolated and small place many of us begin with. 

And that’s kind of the initial stages of being a minority. You’re kind of surrounded by a sense of isolation, and having prejudice and discrimination. Now, if we want to work our way through that, we want to move into other behaviors that evolve us, and where we get connected to our sense of power. And in doing this, what people tend to do, maybe start to explore more about people like you, and maybe connect to communities like you. Maybe you read information more about your disorder, or listen to more about it. So, maybe you don’t feel powerless, helpless, confused, and in the face of being with a doctor or anyone else so that you have knowledge to speak from what’s going on. A big part of this, too, is confronting shame. Like, we, like human beings are really fascinating. But we’re wired to have vulnerabilities. We’re wired to age. We’re wired to die. And yeah, sometimes we have shame about that process. We hide it or ignore it or deny it.

Cheryl:  

Yeah. Yeah, I think there’s — you touched earlier a little bit on this, but a lot of people, I think, are raised with this kind of moral idea around health, right, that if you just did the right things, you’re going to be healthy, you know? And just wanting to build up on top of what you’re saying and add that into that, because that can lead to that sense of well, if good health things happen to good people and bad health things happen to, quote-unquote, ‘bad people’ or someone who made a ‘mistake’, I must have made a mistake. Like you were saying that mindset of self-blame, you know, I must have done something wrong. And that can also come from a place that’s actually a place of seeking certainty and seeking control.

 So, I talk a lot about like, I am a recovering control freak. Control freak — I would never say recovered, because I’m still, my mind always wants to go to a place of control as like an anxiety reduction strategy, which is, as my therapist tells me, it’s fine if the problem is controllable. The problem is if you’re trying to control a problem, that’s not controllable, you’re just literally, you know, wasting your time. But if you’re like, well, okay, I’ll just, like, I kind of have this very simplistic mindset of like, well, I have RA, but it had this weird form of denial that was like, but I’m just going to conquer it. Like, I’m just going to fix it. Like, you know, so don’t worry, I got this like, yeah, just don’t, just yeah, I’ll tell everyone my hero’s journey, you know, how it ended in like, two months when I conquered it! And that’s it. Like, give me my gold star, move on. But it’s so much more complicated than that. Anyway, sorry. That’s my story.

Timothy:  

Yeah, definitely it is. There’s this kind of — exactly. I think of humans kind of leaning towards being control obsessed anyways, and it’s the human condition we’re in. Like, we’re wired to have power to act, but at the same time, there’s so many things that are uncontrollable. We saw that like, in terms of the macro perspective, with illness in the COVID pandemic, where people were just really doubling down on control. And whether it’s this kind of issue or any stressors, people tend to go first to this control. And I agree with you a hundred percent that, you know, the solution isn’t trying to control an uncontrollability, the solution is to learn to make peace with mystery, ambiguity and access a sense of peace amidst things that we cannot change.

Cheryl:  

I was literally — I was just typing. I’m sorry. I’m like literally typing down the phrase you just said. I loved that. Access a sense of peace in the midst of ambiguity. I think that’s what you said, right? My poor brain fog. It’s a good thing this is recorded. I’ll write it down. 

Timothy:

Yeah.

Cheryl:

Is that —? 

Timothy:

Yeah, yeah, sorry. Go ahead. 

Cheryl:

No, that’s, like, has become my life goal instead of before, my life goal was, annihilate all ambiguity, figure out all the answers. Feel happy. The end.

Timothy:  

And we can end up going to a deeper inquiry, meaning like, is safety arrived at me being able to control everything? Or is safety arrived at because I trust that whatever will happen, I’ll face it. I’ll sit up and face it and grow from it. So, it’s quite a mind shift for a lot of people. But when you shift into the latter, you actually do access quite a bit of peace. And that puts you in a better position to solve the complications and issues that arise.

Cheryl:  

Yeah, yeah, absolutely. Oh, my gosh. And I think that the survival skills you talked about, surviving the world initially as like a sexual minority, and then learning how to survive it as someone with a disability or disabled person, it’s, I never really thought of it as survival tips. But as you were talking, it reminded me about how I actually felt like March and April of 2020, I, in a way, I was saying, why am I feeling so okay with all of this? Like, I feel like I’m coping better than like — not to make it a competition, but, you know, I felt more of a sense of peace with what was happening. Even though the first COVID cases were literally 15 minutes away from where I live, the first couple of cases in the United States. 

So, it was scary, but it was also like, I realized afterwards, it was because I had done all this work before on accepting the randomness of life, accepting that you can go to bed one night, wake up the next day to a worldwide pandemic, and that’s just how it goes. Like, instead of saying, “No, no, no, this was — my plan didn’t involve this. I can’t cope with this,” you know, it was more just okay, like, this is life. Like, the condition of life is suffering and randomness and, you know, it’s not like that I am the master controller of the Universe. 

And you know, we’re kind of getting into philosophy a little bit here and that’s something that we had talked about before. Like, you mentioned you’re a psychotherapist. I would just love to know some of the psychological, you know, mental health tools and coping tools that have been most helpful for you personally and with the patient population that you support.

Timothy:  

Yeah, sure. I think you described and connected maybe what we were drawing on before. Like, in chronic illness, there’s this term ‘ambiguous loss.” And what that means is that when you’re facing, you know, with your rheumatoid arthritis and my rheumatoid arthritis, we’re facing these interjecting moments where we lose something for a while, we get it back, we lose something, we never get back, maybe like a capacity, or a promise that we had, a dream, you know, something along those lines. And so, it’s sort of a little bit different than a loss that maybe just somebody dies. And not to mitigate that, that’s a difficult process. But it’s a different one, because there’s almost a sense of resolution and knowing that, okay, they’re gone. This is how it is. And so, we do lean more into because of facing ambiguous loss, a lot of people find comfort and growth in what we could call like existential psychology. 

And basically, what chronic illness does, in my view, is it puts a magnifying glass on the human condition. So, as humans, we all face disappointment, suffering, and pain. We face losses. We face questions of our freedom, how free are we? We face issues related to connection, how isolated or connected we are. And rheumatoid arthritis comes into our life and it puts things like right in our face. 

And so, we’re really, we’re really invited to kind of work on our sense of self in the context of meaning, purpose, trying to navigate those issues with the illness that we have. And I think, in terms of back to your question of what helps people is if we can normalize that. And normalize it — really, everyone’s going through these questions. Now, they’re not going through in the way that we are totally. Nevertheless, those questions are there about freedom, limitation, making purpose, connection, so on and so forth. 

And so, I think addressing those things in terms of coping with your rheumatoid arthritis, it’s very helpful, especially in terms of, you know, our medications or treatments go only so far. And so, what fills in those gaps? But where do we go from there? And my view, I think a lot of it is an emotional maturation. Potentially, if you’re a spiritually oriented person, with spiritual maturation, and trying to process and understand what you’re going through. And I find those things to be helpful. And they’re more making peace with loss and change. 

And like, as humans, we’re constantly in change. We don’t even know that. You can see this as like if you do mindfulness exercises or meditation, and you hear every sensation and feel every sensation moving. And again, chronic illness magnifies that. Like, we’re like, whoa, it really is, like, I’m having all these changes going on. And so, it bites us on a bigger level. How do I relate to change? How do I relate to loss in my life? Maybe it’s resistance, control, grasping, denial, or trying to integrate it in as a normal part of being a human and maybe become curious with it or interested or make something out of it.

Cheryl:  

I love that. That curiosity for me was like a huge stepping stone between control and acceptance, you know, making peace with acceptance, making messy, maybe peace with acceptance at times, but saying, okay, you don’t have to like what’s going on in your body right now. But can you attend to it, pay attention to it, with a mindset of just curiosity and compassion, versus a mindset of problem detected, problem detected, must find solution, must find solution, right? 

Because that’s — I mean, our brain is wired to be protective and pain turns the signals on, right, that say, danger, danger, alert, you know? And that takes training to train your brain when it comes to chronic pain to say, maybe this isn’t as big of a threat as like a lion chasing me down the, you know, down to the — I was gonna say desert. I guess, do they live in the desert? But I want to make sure we defined — you mentioned existential philosophy, or existential psychology. I’m not sure everyone will be familiar with that. Do you have like a Cliff’s Notes definition?

Timothy:  

Yeah. So, just kind of reiterate, existential psychology is rooted in existential philosophy. And it’s basically, in defining existential psychology, it’s kind of like an areligious, sort of transcends any kind of religion, but just kind of people looking at what do humans go through, what is the human condition like throughout your life. And through philosophy, there’s been four, what are called ‘Ultimate concerns’, and I touched on some of those.

Concern number one is captivity versus freedom. You know, as humans, we have this longing for freedom. With our rheumatoid arthritis, we have a longing to be free from it or free and vital in the world. And at the same time, you can still be captive and be somewhat captive by your RA. 

The second concern, meaning versus meaninglessness. So, we have to face lives with our difficulties and have this question, is there meaning in this or is there not? And according to existential psychology, we’re the one that defines that. We don’t seek the meaning outwardly, we cultivate it in our lives, and we ascribe what it means to us and for other people in the world. 

The third ultimate concern is connection versus isolation. You know, as human beings are independent, but we’re also tribal, and we need our support groups to survive. And rheumatoid arthritis, this becomes a big question. If you’re isolated in your house, you’re isolated in your bed. And furthermore, if you’re out with people, and you’re experiencing symptoms that other people aren’t, there’s an isolating factor in that, you know, and many more. 

And then, the fourth ultimate concern is life versus death. In other words, facing limitations on losses, you know, that we’re constantly losing and gaining in life. And like, what do we do about that? What does that mean for us? And do we cultivate room for it within our hearts in our life and our psyches? And so, exploring all the themes in the face of your rheumatoid arthritis can kind of give organization maybe to what feels like a chaotic, you just feel like distress in your mind in your heart, but to recognize, “Oh, this is the ultimate concern I’m dealing with right now.” And coping with meaning versus meaningless, and it kind of guides us. And furthermore, it builds beyond just skills for coping with things. This is like a bigger framework for understanding what we’re going through. That can be grounding for people.

Cheryl:  

I love that, the word ‘grounding’ in that context because it can feel so destabilizing, like so many people tell me, you know, on the first meeting of the support groups that I run, it’s like, “I feel like a bomb just got dropped in my life,” you know? Or that like that shock, especially if the diagnosis is come on really fast. Or maybe they thought, “Oh, I just had carpal tunnel. And then, I’m like, huh, now I have carpal tunnel on both wrists and a finger.” This is where, you know, and then suddenly, it’s you get this diagnosis. 

And so, you can feel very much like everything I thought was true is no longer true. But then, these fundamental philosophical truths can ground you to say, okay, I still have, you know — or I guess maybe I’m trying to, I’m twisting this a little bit, but saying, you know, like, I have some freedom. I think I’m remembering Viktor Frankl in Man’s Search for Meaning. He was, you know, he had lived through being in the Holocaust in a concentration camp, and he said, you know, the ultimate freedom is — well, in his opinion, the ultimate freedom was to choose your attitude in any situation, which we can argue rather what degree we could actually totally choose our attitude. 

I’m like, not sure I would feel strong enough to choose my attitude if I was like, starving, and like in a concentration — oh, my gosh, you were amazing to be able to do that. But, you know, you can choose. You have some freedom. You can attempt to strive for some meaning. And in even the most difficult moments, so, I love that, personally….I went to a liberal arts college. So, I’m like, we could talk about this stuff all day. This is awesome.

Timothy:  

Yeah, I know, Viktor Frankl’s used existential philosophy from Nietzsche quite a bit. So, it’s like his book, Man’s Search for Meaning, can be a great resource for people who are facing their RA diagnosis and coming to terms with: how do I face these things I don’t have full control over? 

So, for sure, and I want to be clear to you that the like, attitude, or working on our attitude isn’t an invalidation or dismissiveness or a Pollyannish denial, because I think people can hear that and because of past experiences of people having inappropriate responses, you know, like, “Pull yourself up by your bootstraps,” kind of stuff that they can filter it that way, but it really isn’t that. We still honor all the feelings, all the losses. It’s just if we can’t control something, do we work on how we relate to it and how we conceptualize it? And actually, people can find quite a bit of relief from that. In fact, psychological research shows that when big events have happened in their lives, they tend to go back to their same happiness level. We call it the happiness level setpoint. And there is a study on people who had won the lottery and people who had nearly become paraplegic and found on average people returning to how they were before those events, in terms of their level of happiness. 

So, that doesn’t — what that does is it doesn’t paint a sense of hopelessness for us, but what it does is it shows us how we overestimate how the events affect us and influence our lives. And we’re not really always like great at even predicting what will make us happy.

Cheryl:  

Yeah. It reminds me a little also of the hedonic treadmill, this idea that we keep thinking, you know, okay, I’ll achieve the next thing and then I’ll be happy, you know? Or if I get a, like, before I was diagnosed, I was like, all I want is, all I care about in the whole world wide world right now is just someone to tell me what’s wrong with my body. And then once I got the diagnosis, I’m like, okay, now all I want is something to fix it. Okay, then now, oh, I’m in remission. Now, all I want is this remission to last forever. And that, you know, it’s like, we have to be so careful. 

Again, that’s like, having — actually, this is one of the best things about having social support, I think, and having access to like a friend group and family, you know, is that we can remember things like, yeah, when my son was six-weeks-old, all I wanted was for him to sleep more. Now he’s nine, and I’m not sitting here every day being like, “I’m so grateful my child sleeps through the night.” And then, like, I replace those worries with new ones. 

So, yeah, I just find all of this like, this overlaps with, in my mind, with the Acceptance and Commitment Therapy, too, a bit. And I guess I’m guessing it’s like drawn — Acceptance and Commitment Therapy I know is newer than existential philosophy. But, yeah, it’s, I guess, in your psychotherapy practice, would it be correct to say that you’re kind of like — a lot of times people say, “What kind of therapist should I look for? What kind of counselor should I look for?” And it’s hard because you don’t wanna be like, “Well, I want someone that only uses Acceptance and Commitment Therapy,” or only uses existential psychology, or only uses CBT because my impression from the ones I’ve worked with is that they kind of pull from whatever tools will help the client. Is that what you would say?

Timothy:  

Yeah. Yeah, I would say I’m an integrative psychotherapist. So, I integrate Acceptance and Commitment Therapy, cognitive behavioral therapy, and existential psychotherapy. And I’m also an affirmative therapist, meaning like I enlist some feminist psychology. What that means, too, is that I also integrate our understanding of structures and systems and how they marginalize us or contribute to our mental health issues, and that’s certainly relevant for having a disability or chronic illness. In terms of cognitive behavioral therapy, I think that can be great because you can end up having a lot of distortions in your thinking when you first have — or not just when you’re first diagnosed or first experience symptoms, but when you go back into a crisis phase, where your symptoms escalate, or change and intensify. And that can teach us to monitor our thinking. 

Acceptance and Commitment Therapy, it’s more of a newer package therapy, but it’s actually older than all of them because it’s based on Buddhist psychology. It’s derived from the Buddhist religion and philosophy. It’s not teaching you how to, you know, join a specific Buddhist religion, but it’s drawing on what we understand from science, really helped from Buddhist philosophy. And its actually, Acceptance and Commitment Therapy is the number one recommended therapy by the American Psychological Association for chronic pain and chronic illness. So, it’s a great thing to make sure that you if you can find it and use it, that you do. 

And then, existential psychology is almost more of a philosophical kind of conceptual way of understanding things. It’s less of like a skill teaching. It’s more about just, how do we create our own philosophy or our own meaning in life, our own sense of spirituality, if that’s how we define it? And so, I integrate all of those. 

And I just, too, before I move on from this, I just wanted to comment on when you’re talking about the hedonic treadmill and how we want things. I tend to think of it this way. I think humans, as humans, we all want the same thing — something else. So, you know, whether it’s RA, whether it’s not, we want something else. And so, Acceptance and Commitment Therapy actually kind of teaches us to move out of that kind of mindset as well and so it can be very beneficial in that regard.

Cheryl:  

Yeah, I think, and I know just from my very probably too much activity on social media, it’s a shame that the word ‘acceptance’ can be very — it’s unfortunate that the word acceptance is very loaded, because I know that there have been people who’ve said, “Well, you know, my, my doctors, my therapist said, I just have to accept it now.” And like, and there is a point where you do get to the end of the road and in terms of treatments that are going to resolve your pain or address the disease progression. And so, you do deserve to have some tools to try to still live the best life you can, but it can feel like, well, perception is reality, right? 

So, the reality to the patient, it can feel sometimes like, “Well, they’re just saying, they’re just dismissing me saying, you know, go away, there’s nothing more I can do for you.” It’s like, no, there’s nothing more I can do to you, to fix you, like to control, to potentially control those problems. Those are all controlled to the best that we can do. Now, there’s this technique, you know, Acceptance and Commitment Therapy, which can help you cope and feel a fulfilling, meaningful existence with all these uncontrollable things. But it can feel so much like they’re just giving up on me or they’re just saying, I have to accept it, like, my life sucks, you know. I’ve definitely come across that.

Timothy:  

Oh, totally. I mean, as human beings, we kind of a knee jerk reaction like, this idea of acceptance. I think it gets amplified by Western American culture, because we’re so into the idea of conquering and limitlessness and the ultimate freedom. But really, acceptance isn’t meaning that you’re just like, turning over and letting harmful things happen to you or that you like harmful things happening to you, is when people get hung up on it. It’s that we’re recognizing the limitation, the boundary of where we have power. And then, where we work to — in an area that we have power, we work on that, and we do what we can. But then, with the area beyond our power, we let go. And I think it reminds me of a really important quote that came from Bruce Kramer. He was a famous educator and he was dealing with ALS at the end of life. And he had stated, and he was talking about how we tend to think we’re going to fight things, right. I’m going to fight RA, I’m going to fight my arthritis, and say this kind of oppositional antagonisms, kind of this antagonistic energy we bring to things. And he posed this question. He said, he would say of his illness, “Rather than fighting it, how should we grow into the demands of what is beyond it?” And he said, which is a different question from ‘How shall we fight it’, how do we grow into facing rheumatoid arthritis? Because fighting isn’t gonna solve anything. What it will do is it’ll make us tense all the time. It’ll make us chronically disappointed and frustrated, and then that leads to helplessness, which then turns into despair.

Cheryl:  

Well, oh, and there’s — you’re really reminding me, and I hope this is helpful to people listening, but when I first started developing programs to support what they call them in, I think, you know, the OT and health world, is like ‘self-management’, you know, the skills with a chronic illness to manage the day-to-day demands, including your emotional, the emotional demands, coping demands, and the logistical demands, and just the knowledge of the basics of how to control your, you know, what the controllable things are like protecting your joints and the importance of exercise, all that stuff. But what I realized is that when I started trying to figure out how do I get this product out there, this program out there, Rheum to THRIVE, and it was like, it felt like that so many other programs were promising those fighting things. Promising to heal, promising that you’re going to, after 12-weeks, you know, in my program, after 12 weeks, you’re going to heal your gut, you’re going to heal this or that, you’re going to hack your vagus nerve so you’re never gonna feel stressed again. Or, you know, and I was like, how do I get people to buy into this when this, I’m ethically, I cannot tolerate obviously anything that’s like — and like, that’s not consistent with my own, you know, the values and my beliefs that I don’t think we can, you know, there isn’t a scientific cure for RA. There isn’t a lot of evidence for a lot of other programs people are peddling out there on social media. So, I’m like, how do I resolve — the thing that — ’cause it’s like, I’m between a rock and a hard place. It’s like when you’re, you know, you need job experience to get the job but you can’t get the job without experience? It’s like, people need the skills that I’m teaching about except — and that it’s you’re not going to conquer it in order to take the program that would teach you how to do that because you’re like, but I don’t want that like, do you know what I’m saying? It’s like when I tell people I got this advice like from a business thing, like webinar that I went to. It’s like, “Here, sell them what they want, give them what they need,” but I’m like, but I’m not willing to do that. What am I gonna say, like, actually, wait, that sounds like a bait and switch, which, you know. So, anyway, I figured it out because people are tired, like, they get tired, they cycle through programs. They try the autoimmune protocol, they try this, they try different, you know, and then it’s — do you know what I’m saying? It feels like I kind of have this phrase that just came into my brain one day, it was like, ‘Hope beyond healing’. You know, like, what if you don’t heal your condition? What if you have pain the rest of your life? Like, there’s still hope for you, you know. But it’s hard to say that, to be honest.

Timothy:  

And what came to my mind is you’re talking about that is I’m thinking that sometimes there’s a conflict between what we want and what we need. And they’re not always the same thing. And life teaches us that over and over again, if we open our eyes and we open our hearts to that. At the same time, there’s also a difference between healing and curing. If you do, if you have — at this time, rheumatoid arthritis is an incurable disorder. That doesn’t mean that there isn’t wiggle room in how you treat it, it doesn’t mean that there isn’t hope. But if we know you’re not going to have a cure right now, maybe there will be along the road, what does it mean to be healed and to be on a healing journey? And that becomes a really important question that I think reorients people actually to more power in facing their illness, because if we let go of agendas of things that we can’t control, I like the phrase, ‘Hope can be misleading if the task is unattainable’. So, we do need hope in our life. But if we hope for the wrong things, we set ourselves up for chronic disappointment, frustration, which then goes into helplessness, powerlessness, which then goes into despair, which even can go to suicidality. And so, before we follow that kind of whole causal chain, we want to interrupt that ahead of time. So, certainly, we hope, but we must ask ourselves, am I hoping for a productive thing? Hoping I’m gonna, you know, have a certain elixir and then my rheumatoid arthritis is going to be totally gone, that’s a misguided hope.

Cheryl:  

Right, right. Yeah, yes. And I appreciate — and I think the word healing is different in different contexts, but it does — I did talk to somebody on this podcast earlier who said, you know, she reminded me the root word of ‘healing’ is to make whole, you know. So, yeah, on definitely, on a philosophical level, or an emotional level, can you feel like a whole full person? And I have this like, very defensive, like, knee jerk reaction, like, “Yeah, I’m already whole. Like, I don’t need it,” do you know what I mean? Like, I’m like, I’m whole. Like, I this is fine. I’m fine. But that’s another one of my interesting psychological things. But I was gonna, because we do, I know we have to wrap up in a little, you know, shortly. But was there anything else you wanted to say? You used a phrase that when we were chatting before recording about areligious spirituality, I thought that was kind of interesting. We’ve touched on it, but I know if there’s anything more you want to say about that?

Timothy:  

Yeah, sure. We touched into — oh, just before we go into that, I just want to quickly comment on your comment about wholeness, which I love. Thank you for sharing that. In this framework, wholeness then isn’t that we are without what we don’t want, wholeness is that we include what we don’t want within our hearts, our life, and our mind. It’s a deeper sense of what wholeness really is. And then, to answer your other question, so we talked about existential psychology. Now, through psychological science and research, there are six different things that have been supported by science that are helpful in their psychological health when they’re facing distress, opposition in life. Now, these things are found in a number of religious practices. But it’s areligious, really, because of whether you’re atheist, Christian, Muslim, Hindu, anything and everything, you can do these things, and possibly find some benefit from it. 

The number one thing is gratitude. What am I grateful for? There’s research, there was a research study out of Stanford, people had to write five things they were grateful every day for three weeks. Depression significantly improved. So, what am I grateful for? And in my own rheumatoid arthritis, it could be like maybe I’m having a difficult day and I’m in my bed. Well, I’m thankful that my bed is comfortable. I’m thankful that I’ve structured my life that I can have these moments or, you know, things like that. The second thing is forgiveness. You know, an interesting thing about chronic illness is research shows that when people first end up having it, a common theme as they feel betrayed by their body. There is a sense of betrayal. Can we forgive the disorder? Can we forgive our bodies? I think, in my personal story, I was very angry, the first onset of it, and I was mad at my body. And I got to a point where I was like, wow, I’m thankful for my body. Like, it is trying so hard and this disorder, and there was such a shift for me in that kind of framework, adopting that framework. The forgiveness can be a big thing. And forgiveness is a sticky thing. Like acceptance, people have a knee jerk reaction that, well, if I forgive, that means it can lead to more harm, or it’s not what forgiveness is. In fact, one definition I like of forgiveness is giving up on ever having a different past. You let go of the idea, like, oh, if I just wasn’t diagnosed with rheumatoid arthritis, or if I hadn’t —

Cheryl:  

Yeah. Yeah, “This is a life I was supposed to have. Like, I was supposed to be running marathons in my 20’s. I wasn’t supposed to be going to doctor’s appointments, and I’m too young.” But it’s all from this ableist assumption that like, well, it can’t happen to me, you know, it can’t happen to me. I did all the right things, you know, I exercised and ate well and didn’t do drugs. It’s like, health is random. Anyway, sorry. You’re going through this list. This is very helpful. 

Timothy:  

Yeah, no, I went through that as well. And as I pull back from that, I’m like, wow, that’s really entitled of me, right. Like, I think I’m owed all this.

Cheryl:  

Who do you think you are, that’s totally true. Yeah, that’s, I think the same thing. Like, wow, how privileged are you to have been 21-years-old, and still be able to hold on to that. In most parts of history, people would have had to face that truth of all the things out of your control, when they were like, four-years-old and watching their mom die in childbirth, or whatever. I mean, like, that’s like the reality of most, you know, most humans in the last few million years. But anyway, sorry.

Timothy:  

Yeah. And then, for me, when it was I shouldn’t be this way or it shouldn’t be this way, I thought, I started to understand that I was expressing arrogance. Like, I was like, I started asking myself, who am I to know how it should be? The body’s gonna do what it wants to do. The Earth is going to be as it is, like things are gonna unfold. And so, it comes from a very vulnerable place where we’re trying to cope with our vulnerability by doubling down on entitlement and a sense of grandiosity or arrogance. And this doesn’t mean we’re those kinds of like, oh, I’m such an arrogant person. And we’re having natural reactions that are unhelpful to the situation. So, I think it’s really, if you do cognitive therapy, that will help you recognize more of that kind of stuff for everyone who’s listening. And then, the third scientifically supported spiritual practice is self-acceptance. How do we accept ourselves? Do we want to accept ourselves? What does that mean? In rejecting an illness identity, the research shows as there are two polar approaches to chronic illness that people face a couple of problems. Illness rejection, where they just want to denying keep pushing through and ignore it. And that would be a lack of acceptance. And the other is chronic illness engulfment, being like, everything is about our illness. And so, you want to stay in a balance in there. And self-acceptance becomes an important component in having that balance, because also when we accept ourselves as a chronically ill, so we are that, and we’re all these other things, too. 

Cheryl:

I love that. Yep. 

Timothy:

Number four is compassion. So, are we able to have compassion, with our capacity to be with what we’re feeling or what another is feeling without judgement or resistance. And we approach what’s going on with a sense of self-kindness, and really suspending the judgments that come up in our head. And so, it’s learning to sit and deal with what is. And that includes our pain. With rheumatoid arthritis, how do I deal with my pain? In the height of our pain, when it’s very acute, it’s probably not the best time to maybe be super mindful. You can do things that kind of distract you. But then, the lower levels of our pain, if we cultivate a mindfulness practice which is connected to compassion, it can be quite beneficial for us psychologically. And the fifth thing is connection. So, connection is really a large part of the chronic illness experience. We can feel severed from maybe family members who don’t have what we’re going through, maybe our partners or our friends. Furthermore, we can end up housebound, bedbound; we feel isolated. So, that connection becomes a very important thing to cultivate. And within the illness research, we find that people who maintain relationships that have what is called emotional constriction — these are relationships where people aren’t allowed to express who they are in a safe way and they are met with judgement or invalidation — those actually affect our chronic illness symptoms and make them worse. So, there was one study of people with rheumatoid arthritis. And if they got in a fight one day with someone they loved or connected to, the next day, their pain was worse. So.

Cheryl:  

That is not surprising. But it’s not something that people talk about, right. Everyone’s talking about diet and exercise. But what about these things, you know?

Timothy:  

Yeah, absolutely. So, connection is a real issue as are relationships, and we want to surround ourselves with people who aren’t invalidating, who aren’t dismissive, but wanting to know everything about our illness, that I would hope that everyone would have a standard that does that they’re close to are at least open to maybe knowing more or accepting us as we are. The sixth thing that is supported by science is for us to, again, we go back to the meaning making and purpose — what’s my purpose? For me, in my personal life, part of the purpose of my illness has been using it in incidents like these, like, can I combine what I’ve learned professionally and help people who are going through similar things that I’ve gone through? And that’s been a purpose for me.

Cheryl:  

Me too. Yeah. It’s really gratifying. And it, yeah, sorry, I just, I didn’t mean to jump in so fast. I was like, me too!

Timothy:  

I think it resonates with everybody.

Cheryl:  

Yeah. Yeah, I think it’s, I’m just thinking so many of these are reminding me of what newly diagnosed people have to contend with. It’s a lot, you know, when you have been living with it for a while, and you have like things, there’s kind of, you learn these things, like little sprinkles over time. And I’m always on this quest to support the newly diagnosed population, because it’s like, okay, I want to shepherd you in, take you under my wing. But also, I think sometimes — sorry, this is just me self-reflecting — but like, I kind of like shoot a firehose of information at them. Like, it’s okay, you’re gonna accept yourself, and it’s gonna be great, and you’re gonna connect with blah, blah, blah. And I’m like, well, that’s probably too much all at once. But yeah.

Timothy:  

Oh, I just wanted to comment on that. Some of the the spiritual practices, the sixth one that I just outlined, aren’t always appropriate at the onset of your illness. First, you maybe want to get a little more stabilized. And if you’re doing a therapy, maybe you’re doing cognitive therapy first and doing a lot of problem-solving, advocacy work, things along those lines. So, sometimes these approaches are more appropriate at different phases of where you’re at. But I will say that, the sooner you get to them, typically, the better your experience will be.

Cheryl:  

I was kind of — I spoke with a pain researcher earlier, Dr. Afton Hassett, who specializes in fibromyalgia and chronic pain conditions. And we talked a bit about Dr. Martin Seligman’s work and like, positive psychology, you know, and one of the things that I thought was so interesting is that he developed a program. He called it like ‘Depression inoculation’, which was like a cognitive behavioral therapy-based program that you would do with kids who didn’t show necessarily — who had life conditions that are associated with higher rates of like, depression and anxiety, but weren’t showing those yet, right. Like, elementary aged kids who were not in the clinical phase of any of those things. Yeah, but they’re like, let’s inoculate them against that by teaching them these skills. And they were things like, basic, you know, basic CBT, stuff of figuring out the distortions, and like, you know, thoughts are not facts, and all that stuff. And yeah, so I think it’s, you’re so right, though. It’s like, I feel so often, the new diagnosis, they just, they want someone to say, “It gets better.” And I think I’m just so stubborn sometimes with like, I’m like, I can’t — like, first of all, it depends what the meaning of it is. Like, it depends on what you mean ‘it’ is, right. And I’ll just say, your symptoms may not get better, and they will likely get better. But they may not. But I guarantee you that you can get better at coping with your symptoms. Like, that is a guarantee that is possible for every person, you know. But yeah, I tried — sorry, I just think about this stuff all the time. Because it’s like, it’s, yeah, but you said it very diplomatically. But it’s true that yeah, it is not the most appropriate time to, at the very beginning, for some people — they’re just not ready yet. It’s kind of like Glennon — I don’t know if you follow anything Glennon Doyle Melton says? She’s a writer.

Timothy:  

Yeah, I know of her but I haven’t read her book. What does she say?

Cheryl:  

Well, she says — this is a weird analogy — she says, “Write from your scars, not your wounds.” Like, which is actually kind of funny, because she’s kind of gone back on that. But what she was saying is like, she waits until like, she’s gotten some clarity on her issue before writing about it and putting it into words. So, it’s almost like, in some cases, it’s like the diagnosis is such a fresh open wound, it’s like you have to wait for that acute wound to kind of get out of the fight or flight phase emotionally to then say, “Okay, let’s look at these,” because the coping skills you and I talked about, with existential philosophy, or, you know, psychology and self-acceptance and compassion, these are long-term skills, right? These are not like, let’s do a two-hour workshop, and you’re gonna learn all this. Although I did take a course in ACT as a brief intervention, I don’t know if you’ve ever done that one. But, it was interesting, it was like about, can you actually teach people the skills of Acceptance of Commitment Therapy in literally, like, 20-minute, primary care length encounters. And it was, well, like, yeah, again, that is ambitious goal. But these are things we’re going to be working on the rest of your life. And in a weird way, I think that learning these things hasn’t just helped me as a patient, learning these self-acceptance and acceptance of my body and what it can and can’t do and feeling, you know, compassion and connection and gratitude has actually made me a better parent, it’s made me a better spouse. Like, it’s because it’s like — it’s hard to put into words, but I just use these skills all the time in navigating all kinds of difficulties. You know, whether it’s my son has someone on the playground that’s not being nice to him. Or, you know, you know what I’m saying, like, these are just life skills.

Timothy:  

Yeah, yeah, I love that. And I even think that’s part of like purpose making, getting better and better at this. Because, like, again, it’s not a Pollyannish denial. We still hold space for the reality that our rheumatoid arthritis does cause some losses and grief and pain, some alteration. It’s just that we’re also adding to that, and we’re rounding it out in a balanced way. So, I love everything you said. I think that’s great.

Cheryl:  

Well, echo right back at you, and I do recognize that we’ve gotten over time. So, I just want to wrap it up with the last question that I usually ask is, what is your best — well, I actually have two. I lied, I have two questions. Well, I mean, all of this is great advice for newly diagnosed patients. But do you have like, anything that comes to mind if I say like, what’s your best advice for newly diagnosed people with rheumatoid arthritis?

Timothy:  

I would say, it’s okay to not be okay, number one. That it’s okay to let everything unfold as you maybe cry, you get confused, you’re afraid, maybe you even blow up in anger, as long as it’s non-violent. Any moments that you have, let that be. Also, get connected to really good providers. Don’t hesitate to eliminate a provider if you immediately don’t feel comfortable or there’s an issue. Be patient with yourself right now. And double down on your relationship with people in your life, the relationships you have with people who’ve always been mostly supportive. Get connected as soon as you can to some kind of support group with people who have your diagnosis, like the group you offer. But that’s really important because, we’re built for connection as human beings, so the more connected you are to supports, the more smooth your nervous system will be. You’ll also then, when you join a support group, draw on the collective wisdom of the group, the resources everybody knows about, sometimes the patients know more than the doctors about some things. And I think that’s a really good thing. And then, also just trying to stay out of predicting the future because you don’t know what’s going to unfold for you. I know that there can be hard moments, but just focus on doing the next best thing for you as you are. Any bigger than that, have faith in yourself that you will grow to learn how to face whatever happens here with your disorder.

Cheryl:  

Oops, sorry, I muted myself. Sorry. My dog was snoring. What is — the last one, what does it mean for you to live a good life and/or to thrive with rheumatic disease? I mean, kind of everything you’ve just said it’s good advice for that, but.

Timothy:  

I would one thing in answer to that question would be when I was younger and certainly when I didn’t have rheumatoid arthritis, I oriented my idea what was life in an achievement-focused way. That my life was about I’m gonna do this, and then I’m gonna do that, and I’m gonna mark this off the list. And maybe this is just coming with natural age, but also maybe the disorder itself as well, but I reframed that my life is an experience. And that a rich life, the goal my life isn’t necessarily like a happy life. Do I want happiness? Yes, I do. But my goal is to have a rich life; rich in experiences. And rheumatoid arthritis provides this incredibly odd, challenging educational experience. And when I approach it that way, like, I see things I would never have seen without my disorder, and then there’s a lot of value in that to me.

Cheryl:  

I love that. Yeah, it really reminds me of — the point you made about happiness reminds me a lot of The Happiness Trap, which is my most recommended book, but I think Man’s Search for Meaning would be right behind that. They’re both really helpful.

Timothy:  

Well, let me add one thing to that. And it’s that research also shows us that the more we pursue happiness for happiness’s sake, the less happy we are. 

Cheryl:

So true.

Timothy:

And that happiness is really found in a meaningful connection. And doing what we really love, and losing ourselves in that.

Cheryl:  

A hundred percent. Yeah, I have totally flipped my expectations on happiness, yeah, based on all of that knowledge and research. And where can people find you online if they’d like to connect there?

Timothy:  

Timothyweymann.com. That’s T-I-M-O-T-H-Y-W-E-Y-M-A-N-N.com.

Cheryl:  

Nice. And then, you have —

Timothy:  

I do psychotherapeutic services; I do educational, confrontational, consultative work as well. And I do treat chronic pain and chronic illness.

Cheryl:  

And is that just in your home state? Or is that —?

Timothy:  

I’m licensed in Utah, Arizona and Iowa. However, if you’re outside of those, some states have a provision due to limited mental health care providers where I could potentially work with you, depending on your state law.

Cheryl:  

Oh, that’s really good to know. That’s really, really good to know. I know like with occupational therapy, for example, we’re working on like an interstate licensure compact that would allow all states that are in the compact to provide services to anyone else in those states, which I think should — I think it’s a lot of all the fields are looking at that. PT is looking at it, I would be shocked if psychologists weren’t looking at it.

Timothy:  

Yeah, I hope that will eventually be done.

Cheryl:  

Yeah, yeah. Oh, I just really, really appreciate your time and insights. This has been very, very edifying. And I can’t wait to re-listen, because I’m like, oh, I need to like, pause and just like take in, because you had so much, just so many great thoughts. So, thank you. Thank you so much.

Timothy:  

Yeah, you’re very welcome. And thank you so much. It’s been a pleasure to do this. And I really just appreciate all the good work that you’re doing. So, thank you.

Cheryl:  

Oh, thank you. Well, we — hopefully, I’m sure this won’t be the last time we chat. So, but this is just bye-bye for now. Have a good rest of your day. Bye!

Timothy:

Okay, you too. Bye.