Cognitive stimulation and mind-absorbing activities

Use the mind-absorbing activities worksheet

“To strengthen your mental flexibility, which will help with thoughtswitching and mental coping strategies, it might be useful to add cognitive stimulation to your programme.

“You can count backwards in sevens, spell backwards, recite poems, repeat foreign vocabulary, say tongue-twisters, sing songs, use mobile phone games or many other things.

“Some people have found brain-training exercises or apps to be useful. Caution must be undertaken if using screen-based activities for too long, as eye strain and poor neck postures can lead to headaches. Beneficial alternatives are those day-to-day tasks that you may find slightly challenging. For instance, setting your safety alarm at home, programming your mobile phone, working out the TV remote control, preparing a new dessert or assembling a flat-pack piece of furniture. Make a list of such tasks. Break them down into manageable parts. Use relaxation or deep breathing to remain calm, plan each step ahead and use the cognitively stimulating tasks in the same way as the pain distraction methods.”

Stress-inoculation revisited

“Stress-inoculation is an older psychological term meaning that one can learn to adjust to certain demands in a graded fashion. For instance, your mind and body can become de-skilled if you have avoided certain activities for a long time due to your headaches or residual brain trauma difficulties affecting mental and complex tasks or day-to-day responsibilities. This means that if your headaches and other symptoms were to cease right now, you might not be as skilled as in the past at a non-practised activity.

“Maybe your attempts to get back into the swing of your previous routines have been hampered by headaches or other problems and you have given up trying to get better. You may have discovered that this has not helped either, your mood got worse and you have lost your confidence almost completely. You might have tried to find out which situations trigger your headaches. You might have eliminated most scenarios and activities from your life, but still experience the headaches. Under such circumstances, your body and mind have simply forgotten how to deal with fairly normal activities.

“Stress-inoculation works a little like a flu jab. Provided you have achieved fundamental elements of well-being and relaxation, you can begin to ‘inject’ tiny doses of challenge into your routines. Challenges could be those activities you have avoided up to now out of fear that they might trigger or intensify your headaches. You could start engaging with small doses of planned activity, combined with relaxation practice beforehand and afterwards. This way, you build skills in dealing with the task. You learn to plan the activity into your day. You combine your activity with positive coping strategies. That way you know how to cope should this trigger a headache. If you don’t know which meaningful activity to choose for your stress-inoculation, perhaps begin with doing a short physical exercise.”

Positive self-talk

Use the positive self-talk worksheet

“It is very important to be kind to yourself. This is a matter of emotional hygiene. Positive self-talk links realistic aims with well-being and relaxation. Positive self-statements are characterised by:

Short, simple sentences

Positive phrases, such as, ‘I am calm,’ rather than, ‘Don’t panic!’

Being phrased in a way as if the goal has already been achieved, ‘act if now.’ Even if you have a headache and feel stressed, the statement would be ‘I am relaxed.’ That’s what you want your mind to focus on.

“Self-statements can be very effective if integrated into your relaxation practice. By this stage in the programme you have had plenty of relaxation practice. Next time when you practise at home, at the point when you feel

Figure 3.9 Therapeutic reinforcement.

the sense of deep muscle relaxation, formulate your positive self-statement and repeat it five to ten times as you are breathing out. For instance, you might say to yourself, ‘I am a person who can exercise daily for 20 minutes. I am able to relax my body.”’