When my mother was already showing early signs of her vascular dementia and had to move into an assisted-living apartment, she hated it. The staff reminded our family that “having something to look forward to” every day would help her feel more settled. They were so right. The move had been scary and overwhelming for Mom, but even knowing that after lunch she’d be playing cribbage or watching a favourite movie could bring a smile to her face.
We didn’t call it this at the time, but what Mom was doing, in the middle of all of her angst and fear, was planning joy. .
Being diagnosed with a scary and overwhelming chronic illness can also be compared to a forced move to a new place. As the late patient activist Dr. Jessie Gruman once described this move:
“I don’t know the language, the culture is unfamiliar, I have no idea what is expected of me, I have no map and I desperately want to find my way home.”
No wonder we feel so scared and overwhelmed! In the early post-hospital-discharge days, many of us can’t even imagine that we’ll feel joyful ever again.
In his 1848 book called “The Sphere and Duties of Woman: A Course of Lectures” , George Washington Burnap wrote:
“The grand essentials to happiness in this life are something to do, something to love, and something to hope for.”
(I can only imagine, by the way, the other lessons that women of the 1840s were learning from a book with this title while being “lectured” to by a 46-year old Unitarian clergyman).
But Burnap’s specific lesson on the “grand essentials” – especially “something to hope for” – remains a wise one.
Particularly for the freshly-diagnosed heart patient, the sense that life as we once knew it is somehow now over can feel as scary and as overwhelming as my own mother felt when she was told she’d have to move out of the home she loved.
As Calgary heart patient Cynthia Culhane said in her interview for the documentary film, “A Typical Heart“:
“After the initial shock of my heart attack, everybody’s life went back to normal again – except me.”
The good news: this “newness” does indeed tend to wear off over time. Slowly, gradually, heart patients learn to feel less fear and more confidence, less weakness and more strength, less grief and more ability to imagine a life in the future. But this can take time – and a plan.
The plan takes deliberation. We can’t lie around all day waiting for life to automatically snap back to “normal” one fine day all by itself.
And this, by the way, is yet another reason that registering for a cardiac rehabilitation program as soon as possible after a cardiac event is so valuable, especially for women. Cardiac rehab has been shown to improve both physical and psychological health for heart patients – even lowering our risks of another cardiac event in the future! – no matter what kind of heart condition we live with. It helps to “normalize” what‘s just happened. And there’s lots to look forward to each week in attending cardiac rehab classes!
I recall in my early post-heart attack days feeling so debilitated that simply walking to the corner and back was the highlight of my entire day. But I had to force myself out the door, often leaning heavily on my son Ben’s arm the whole way, while silently wailing, “What has HAPPENED to me?!”
When every fibre of your being wants to crawl back under the covers, deliberately planning how to build in some basic joy every day can be critically important.
But there’s another good reason that planning for joy can help heart patients. For Alaska cardiac psychologist Dr. Stephen Parker (and most importantly, a heart patient himself), a symptom of Post Traumatic Stress Disorder that rang true for him after his own cardiac event was “a sense of a foreshortened future“.
In other words, after a traumatic event – in this case, his serious heart attack – Dr. Steve subconsciously no longer expected to have a normal lifespan. And if he no longer expected to ever see a “normal” life again, it meant he had nothing to look forward to. For example, he once described a routine shopping trip to his local Home Depot store, where he quickly lost interest – because he knew he wouldn’t be alive much longer to finish doing any projects around the house.
So why bother even starting?
When I felt like that, too, my own plans – no matter how small – had to be written on my calendar so I could psyche myself up in advance:
“Go for a walk – 10 a.m.”
Lately, I’ve been reading and re-reading Toni Bernhard’s “Turning Straw Into Gold” columns in Psychology Today about her own experience living with chronic illness. Her recent essay is an example of the wisdom of learning to plan joy every day. Here’s her advice:
“Each evening, write down something enjoyable you intend to do the next day.
“This little exercise can be a challenge because many of us look after our own happiness last. Try it though.
“Each evening, write down something fun or fulfilling that you plan to do the next day. Putting it in writing makes it part of your agenda for the day to come, which increases the likelihood that you’ll follow-through on it.
“Of course, sometimes it’s wise to change your plans after you get up the next day. If this happens and you’re not able to get to the activity on the day you planned, let it go. No blame!
“But, that evening, don’t forget to write down something enjoyable you plan to do the next day.”
I’m not sure when it happened for me, but one day I too must have decided that I needed to start deliberately doing more of the things that I love doing and far less of the things I don’t.
My own joy plan for today includes a walk in the sunshine along the ocean. What about you?
Q: What kind of activities are on YOUR Joy Planning list for today?”
NOTE FROM CAROLYN: I wrote much more about adjusting to becoming a patient in my book, “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press (and use the code HTWN to save 20% off the list price when you order).