On April 1st, Parkinson & Movement Disorder Alliance presented a webinar called “Practicing Wellness to Build Resilience.”  The speaker, Julia Alleyne, MD, defines resilience as finding our own inner strength to deal with discomfort, distress, and uncertainty, when we are unsure what the outcome will be.  This webinar focuses on the connection between resilience and physical health.   Though almost none of the webinar was PD-specific, we at Stanford Parkinson’s Community Outreach attended the webinar as we thought the topic of resilience was worthwhile.  Here, we are sharing our notes from the webinar.

The webinar was recorded and can be accessed through PMD Alliance’s YouTube page.

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“Practicing Wellness to Build Resilience”

Webinar by Parkinson & Movement Disorder Alliance

April 1, 2020

Notes by Adrian Quintero, Stanford Parkinson’s Community Outreach

Julia Alleyne, MD became interested in wellness at the age of 13 when her father broke his leg while skiing. She was the oldest of 5 kids, and believes her resilience started with having to take on responsibility and use skills she didn’t know she had in a situation she didn’t quite understand.

Dr. Alleyne went on to become a physiotherapist. In her practice she had a focus on exercise, prevention and health maintenance. She believes the partnership between patient and provider is key. Early in her career she wanted to empower people to have better self care and feel they could have a say in their well-being.

Later on, Dr. Alleyne went into sports medicine, and worked with Canadian Olympic teams. A survey was given to the athletes that found 75% of them didn’t sleep well during the games, and as we know, sleep is so important. Also they found that athletes who did yoga at home didn’t do it during the games.

At some point a wellness center was established during the games. Another doctor on Dr. Alleyne’s team got a cancer diagnosis during the Olympic games. He went to the wellness center everyday to get peace of mind. The center was a peaceful and calm place made for rejuvenation. It helped the doctor cope better, and athletes benefited from the center as well.

Wellsense Website

Dr. Alleyne was not “into” social media when COVID hit. But with more people working at home, news stories building, she decided to put up a post. The post was about framing this current situation with inner strength, not letting worry erode what we already have. She made a commitment to do something everyday we are in this together. This lead to the creation of a website, Wellsense, which serves as an open, public website of wellness. Dr. Alleyne wishes to turn science into common sense so people can connect with it.

A post about resilience has been the most popular post on the site. How do we define resilience? She says it’s finding our own inner strength to deal with discomfort, distress, and uncertainty, when we are unsure what the outcome will be. Dr. Alleyne sees the definition to be about our own inner strength. How do we build resilience? It’s about our mindset, how we look at the world.

When we look to people who have overcome difficulty, we see they continued to have hope, and they didn’t get lost in the big picture. These people are not unrealistic optimists, but rather they see there has to be a way to do things, and that attitude becomes practiced.

Some Resilience Builders

• Having gratitude is a wonderful resilience builder
• Having empathy for others, we actually build our own empathy and strength to deal with ourselves
• Understanding happiness and the ability to experience human connection
• Having a sense of purpose, which contributes to a sense of value and worth

Wellness List

When Dr. Alleyne worked with the Olympic team, the athletes had a wellness list as a reference. This was based off of indigenous people’s medicine wheel with four quadrants to wellness — physical, emotional, intellectual and spiritual. When you nurture and balance each of the quadrants, you have health.

• How am I physically feeling today? (Sleep, eating, hydration)
• How am I doing emotionally? (if it’s the blah zone, where do I need to be? How can I get more energy going? Listen to music? Positive self talk?)
• How am I doing intellectually? (Starts with awareness of self, of relationships, and surroundings)
• How am I doing spiritually? (What’s my belief system? Is it “Do unto others as you would have them do unto you” Whatever it is, make it an action. Maybe you need to listen to music, read a reflection, pray, etc.)

The emotional zone you can shift; you can change your emotions. Examples are using music or self talk. Scientifically, self-talk is based in Cognitive Behavioral Therapy (CBT). You look at the three different realms of feelings, thoughts, and actions.

• What are my feelings? (Down, news not getting any better)
• What are my thoughts? (I don’t want to get out of bed. Is this really ever going to end? What’s the point?)
• What are my actions? (At that point, I say to myself, before I take action, can I change my feelings or thoughts? What’s my choice for today? The choice gives us control.)

Creating a Special or Sacred Space for Self-care

Dr. Alleyne says creating a wellness corner in your own space is very useful. It doesn’t have to be big or elaborate. Some advice:

• De-clutter it. Clutter represents a to-do list, which is interfering with ability to focus on the here and now. Try to create a space to refocus.
• Have something to focus on. This might be a painting, picture, fireplace, etc.
• Plants to nurture
• A place you feel relaxed and grounded
• Could be a windowsill, maybe with plants, statues, stone, picture, etc.

Possible Silver Linings from this Pandemic

• Having more time with our “home buddies” (pets- for her, bonding with a cat)
• She thinks when this is over we will have deepened connections to those most important to us
• Hoping we will understand much better how to care for elders as valued members of society who need help
• We have to emerge as a stronger society. The virus is most destructive with vulnerable people, and we have to learn how to care better for the vulnerable.
• Become barrier free. Right now there are lots of opportunities to learn technology and do things on-line. She thinks that’s good, it’s pushing us to modernize, and not be as dependent on physical experiences. In communities with disabilities there are so many barriers, taking down these barriers is good.

Social Connection

There is research in the Parkinson’s Disease world that social connection is a good prognostic. In ageing and wellness spaces, talk about socially connecting is helpful; whether it’s a walk, yoga class, dancing in a group, etc.

How do we continue to socially connect in this social distancing era? And how do we access people who are not connected to Internet?

In Europe, we saw the need to connect without technology. Opening windows and singing on balconies and hearing another voice is a connection.

That can go further with the telephone. You don’t need the Internet to feel connection. It can happen through a window, leaving something on a doorstep, ordering or receiving a delivery, etc.

The news is starting to show stories of connection. In Toronto people are opening their windows and singing the national anthem. Then they are honking their horns at evening as thanks to frontline workers.

We have to reach out and we have to be able to respond. If you’re feeling isolated, reach out. If someone is trying to reach out, respond. Reach and respond keeps us connected.

Sense of Purpose

What happens to people who feel they can’t give and help right now? What about people who are being told to stay inside when they volunteered before?

Dr. Alleyne has some tips on keeping a sense of purpose in this time frame. She says purpose is filling a need – it might be our own or another. The problem is we don’t know how it will all fit together until years later. We don’t know the full value of our actions. Does it fill a need? If so, go further with it. Don’t worry about evaluating the purpose. All purpose is good. How do we pivot or reshape our own expectations when what we have been doing as a purposeful activity has changed? This requires coping skills and creativity.

Having purpose to fulfill your own needs is not selfish it’s self-care. You are lessening the burden to others, and increasing your ability to care more for others. Change the idea of selfish to self-care, that you are helping others as well as yourself.

At this point, Dr. Alleyne asked attendees a survey question.

Survey Question: When faced with a difficult situation, how did you actually cope?

• 1-3: I did not cope, needed lots of help (if so, call for help early, don’t let it overwhelm you, the longer you aren’t coping well, the harder it gets)
• 4-6: I managed eventually but had difficulty figuring out my way (want a bit of number one, asking for help early)
• 7-9: I did better than I expected and learned new coping strategies
• 10: I coped much better than expected and I even helped others (that builds confidence, and confidence is a tremendous resilience builder)

The reality is we learn from every situation. We learn what we know, and we learn what we don’t know. That helps us shape how we will deal with the next situation.