Episode #19 Thriving with Chronic Illness as a Therapist
Hi, this is Welcome to Self ™ Caring for the Human in the Therapist Chair, and I’m your host, Dr. Hayley D Quinn, fellow human, clinical psychologist, supervisor and trainer. Welcome to Self ™ is a place where you can come and learn ways to elevate your own care and compassion. A place to rest, be soothed, and at times maybe gently challenged to think about yourself and your practice. A place to remember that you are human first, choose the helping profession is just one of the roles in your life. My aim is that this is a place of soothing, comfort, nourishment, growth and nurture. A place where you can also welcome your self.
Hayley:
Hi, and welcome to another episode. I’d like to take a moment of gratitude for Emma who sent me feedback on the podcast. She said,
“I just wanted to say that I finally managed to listen to the first two episodes of your new podcast. They were fantastic. I particularly found your bravery in sharing some of your own story hugely helpful and normalizing”.
Emma, thank you for taking the time to send feedback and I’m so pleased you’re finding it helpful.
Hayley:
I’m excited to introduce my next guest Dr. Angelo Contarino. Angelo is a clinical psychologist and supervisor based in Brisbane, Australia. He has over 28 years experience working with adults, children, couples and families and has worked in numerous public and private sector environments, including hospital facilities, adult mental health services, child and youth mental health services, Crisis Response Teams, school settings, the disability employment sector and in private practice. Angelo is the owner of a group private practice in Burpengary north of Brisbane. He was also the clinical college chair for the APS Queensland branch, and is the current secretary for the APS Queensland branch, as well as the current clinical college conference chair and the lead of the APS online peer supervision group. Angelo manages all these roles, whilst also navigating life with a long term chronic illness. And throughout all of this remains a kind, compassionate and thoughtful human being. I first met Angelo when he joined by Welcome to Self group back at the start in April 2020. And it is my pleasure to introduce my friend and colleague to the podcast.
Hayley:
So hi, Angelo and welcome to Welcome to Self. It’s an absolute pleasure to have you here with me. Thanks for joining me this morning.
Angelo:
Thanks, Hayley. I’ve been looking forward to this for quite a while. So I’m really looking forward to our chat today.
Hayley:
Fantastic. So could you start with telling us a little bit about yourself and what led you to a career in the helping professions?
Angelo:
Okay, well, I guess to let people know a little bit about myself, obviously with a name like Angelo, I come from an Italian to be more specific Sicilian background. I’m married with another Italian by the name of Rosie and we have two beautiful boys, Giovanni and Enrico well, I shouldn’t call them boys. They’re the men now, you know, one’s 24 and ones verging on 19. I guess in terms of myself, and my career, my mother used to work in mental health services. And in the psychiatric, if you like, parts of the Royal Brisbane hospital. So I used to hear a lot of stories over the years. And I guess, you know, the other thing that I would say is even going through your own personal issues, I guess, or life traumas or stressors, spiked my interest in becoming a psychologist. So I guess they are the things that led me there. And then I’ve had a bit of a wealth of experience. So I’ve worked in adult and child and youth mental health services, both in their case management teams and in their acute care teams for Crisis Response type services. I’ve worked in a school where I was employed as the school guidance counsellor and I’ve also worked in the employment sector, where I was a clinical support supervisor and Training Manager for an organisation called MAX Employment, so or, Max Solutions. So I used to actually supervise the psychologists for Queensland, Victoria and Tasmania. So I’ve had a bit of a breath of experience across a lot of areas. And over the years, I’ve really developed a keen interest in supervision, and provided supervision in all of those settings. Now, for the last three and a bit years, I’ve primarily focused on my private practice as well.
Hayley:
Yeah, you have had a wealth of experience. Lot’s of diversity, you have had and still have a lot of roles in your life, including many within the field of psychology. And like many practitioners, you also live with the diagnosed chronic illness. Can you tell us a little bit about how this impacts you in your work?
Angelo:
Okay, so, I guess I’m a real believer in sharing and hopefully raising awareness for the particular condition that I have. So I’ve been diagnosed with a condition back in, oh, it’s quite a number of years now probably 1997 or eight, with a condition called myasthenia gravis. And myasthenia gravis is an autoimmune condition that basically attacks your muscle receptors. So as a result of it, I ended up with weak muscles for T periods of double vision, a thing called ptosis, where your eyelids droop. And then I guess you also develop the, if you like, the emotional side of things that goes with that. So as well as the treatment with things like prednisone, which are immune suppressants, they produce emotional repercussions such as fear, anxiety, some sadness and irritability. So yeah, that’s the condition. It’s quite rare. I think it’s one in every three to 400,000 people. And as a result of having an autoimmune condition, you’re more likely and more at risk to develop other autoimmune conditions. So I’ve got a number of other comorbid conditions, including diabetes, so yeah, it has a real impact on you. I guess the thing, it also required major surgery a while ago, so I’ve had my thymus gland removed, which is like having open heart, right. So basically, all of these, I guess, conditions and the symptoms that go with it result in pain as well. So you do experience a lot of really the biggest issue for me these days, because I’ve had periods where I’ve been considered to be in remission. I am, I really these days experience, more so than not pain and fatigue. So basically, the things that I need to do to manage that is to make sure I make time for significant rest. Use the medications that I’m required to use. And I guess, I practice a lot of what I I’ve learned in psychology, not only do I impart those strategies to my clients, but I use them for myself. So things like mindfulness meditation, breathing, relaxation strategies are a part of my life. And like, I guess one of the things I have had to do over the years, and it has had an impact in other areas, is reduced my working hours. So I, you know, my private practice, I work at three days a week, rather than five days a week, because if I worked five days a week, I’d probably flare up the condition more. Given my other roles, it’s sometimes difficult because I am filling the other two days, but I fill them with something different.
Hayley:
Yeah, yeah. So being really mindful around what you’re doing and how you’re doing it. I think a lot of people who live with chronic illness, including myself, the pain and fatigue can be a big one. And also having to kind of manage your workload around your health. You talked about sort of sadness and irritability kind of showing up for and I think also, you know, the grief, of acknowledging that life is not as you might like it to be if you didn’t have that particular illness.
Angelo:
Yeah, absolutely.
Hayley:
Yeah, I think it’s an important one, isn’t it? So I mean, this can really impact can’t it? I mean, this can really have an impact on your work. If you have a flare up. It’s not easy as a therapist to go to work when you’ve got a flare up.
Angelo:
No, so the flare ups occur. So I live pretty much with a constant level of pain. But I’ve managed that most days, but when a flare up occurs, the pain can be so so bad, that it’s really difficult to get out of bed and I have to be, I guess kind and compassionate enough to myself to be able to say, I need a day off today. And you know, I might have to cancel bookings all sorts of things.
Hayley:
Yeah. Yeah. Which can be tricky. I know a lot of people I speak to sort of supervisors I’ll talk to, is when it’s, when it comes to doing things like that for ourselves. That’s when the tricky mind can can sometimes get a bit brutal even.
Angelo:
Absolutely, yeah.
Hayley:
So we’ve talked about a few things, mindfulness and rest and things like that. So what have been the things you’ve found most helpful when navigating how to live and work with chronic illness? Whether that’s cognitive, emotional, social, physical?
Angelo:
Yeah, that’s a really good question. Hayley. I guess, for me, it’s, it’s a combination of things that I try and do. And by no means would I suggest I’m perfect at this. We’re all human. And sometimes we do better than others.
Hayley:
You know, I’ve had many conversations around this, you know, we can know what to do. It doesn’t mean we always do it does it?
Angelo:
No, exactly right. And like you said, our tricky mind jumps in sometimes, and the self criticism goes right along with that. So it is difficult at times, but the things I try to implement are a balanced routine, you know, making sure that I’m having a combined day, it’s not just work, it’s not just one thing or the other. The self care and self compassion is really important. And a level of acceptance, cognitively, being able to just accept and say to myself, it’s okay, there’s really not much you can do about the fact that you’ve had a flare up, for example, today, this is what you need to to move forward. But I guess, there are a number of other things I try and do as well, I’d really try and maintain a positive attitude and hope for the future. I’m really finding that I don’t, you know, I don’t want to be reactive. So I make every effort to sort of remain calm and not allow my, if you like, threat system to be triggered. But again, we’re human, and that doesn’t always work. But I also then try and engage socially. Accepting help from others. And, you know, like we’ve already mentioned, adjusting my work hours. And in my balance, I guess, the biggest thing is also maintaining my hobbies, the things that bring me joy, you know, so I love living on our two acres. I know I can’t always do the jobs I want to do at any particular point in time, depending on heat, humidity, and pain. But at other times, I really love being out on the property and feeding animals and doing the things that we do here, loving the environment.
Hayley:
You live in such a beautiful spot, I had the privilege to come and you know, have a look at your place and the beautiful animals and birds that you’ve got there. I can imagine the joy that brings you but also the struggle that you face. Because it is a lot of work. And there’s times when you can’t manage all that.
Angelo:
We were talking about that earlier, weren’t we that I love what I do here, and I love the environment and the life we have. But there are times where the work, for example, maintaining weeds on a larger property can seem insurmountable. It’s like, where do I start?
Hayley:
And that’s outside of you your work, you know, your paid work that you’re doing as well. So how’s developing a compassionate mind helped you manage this?
Angelo:
Well, I guess what it does, it assists me with being patient with myself. Probably one of the biggest factors. And it really assists with picking myself up when the tricky mind or the threat system kicks in. So I don’t say I guess, in that wallowing moment, as long as I might have in the past. Yeah.
Hayley:
So where did you first kind of learn about that the benefits of developing a compassionate mind? Do you remember?
Angelo:
That’s a good question, too. I um, I guess I’ve been aware of it for a number of years. And I’ve heard from it or about it from a number of courses over the years. So part of your studies, I guess I plays a part. But I guess I’ve engaged in a number of activities. So I’ve had discussions and conversations with colleagues. So I know of a couple of colleagues at the University of Queensland that not only colleagues but friends of mine so engaged in conversation and they’re very well into the compassion focus therapy, being part of the weekly you know, Welcome to Self group that we were involved in, really has been helpful. But to pinpoint an exact time where I learned it, or I heard about it, it’s really difficult because I guess part of that also been part of my nature, I think, throughout my life, I’ve always had a compassionate streak, and particularly a compassion towards others. And that I think has been imparted to me, or, you know, from family. My grandmother was a very compassionate person, my mother’s a very compassionate person. So, knowing about compassion has been something that I’ve heard about and known about, and practice to, you know, apply throughout my entire life, what I’ve had to learn is how to apply that compassion to myself.
Hayley:
Yes, it’s been an ongoing process. Yeah, throughout your life. And then learning that actually, it’s not just about giving compassion to other people actually turning it inwards and giving it to ourselves as well, isn’t it? So I mean, we took the three flows of compassion, compassion to others, which is helping those we’re very good at compassion from others, and then compassion from self to ourself. What do you notice in relation to your health and well being, when you perhaps don’t allow yourself to receive compassion from others or act compassionately towards yourself?
Angelo:
I guess the biggest thing in those circumstances is the combination with my chronic illness, I guess, with the autoimmune condition. So if I’m not permitting myself to receive compassion from others, or from myself, I’m more likely to experience greater flare ups, greater pain. So when we’re in threat mode, we know that our muscles are really tense. So when my muscles are tense, if I’m already in pain, the pain is going to get worse. Then I guess, the other part is, you know, there’s the fatigue, and the weakness, and the level of emotional distress that goes with all of that. So, again, the key really, is trying to balance what I need to do. And I guess also realising that I’m not perfect. So and that no human is perfect. I know I bring back to that. But when I realised, and I acknowledge that I’m not perfect, it’s sort of the same as, I guess, engaging with my suffering. Yeah. And then when I’m engaging with my suffering, what do I need to do to actually help myself? So you know, trying to actually talk nicely to myself with with a nicer inner voice tone. Trying to validate what I’m experiencing. And offer encouragement to myself. And then do what I need to recover.
Hayley:
Yeah. Yeah.
Angelo:
So those not allowing those moments, I guess, where I am being critical of myself to last as long.
Hayley:
Yeah. You mentioned before, you know, about all these skills that you’ve learned, and we impart so much of this to our clients don’t we and I’ll often sort of say to people, so what is it about the stuff you do for your clients that will be helpful for yourself? Your clients are human, and you’re a human as well. So if we know this is all going to be helpful for our clients, how can we actually offer these gifts to ourselves as well? And what difference might that make, if we were to do that?
Angelo:
And that’s the struggle, isn’t it? Because we spend so much time focused on providing these skills or these gifts to others, and helping others. But then we get caught up in our tricky mind where we’re telling ourselves, I can’t have time off because my clients rely on me or, or because the practice is so busy, or whatever it might be. But the reality is, and I’ve been a true believer in this my entire career, is we need to practice what we preach. And I really liked a quote that I heard recently, and it really resonated for me. I believe it was the Dalai Lama who said it recent most recently, but the idea that if I practice compassion for others, without compassion for myself, my compassion is incomplete.
Hayley:
And so true, and if we don’t allow ourselves to take time when we need it, then there’s a chance that we won’t be there for our clients anyway. I know for myself when my health was at, its worse, I got to the point where I didn’t know if I was going to continue being a psychologist, and it was only through leaving the practice I was at and changing what I did, reducing my hours, taking care of myself more focusing on looking after my health, that I’ve been able to stay working as a psychologist and continue to have a thriving business. So it can be, you know, we can get caught in that short term, but I need to be there today. And it’s like, well, if you want to be there for the long term, maybe today is not the day to go.
Angelo:
Yeah. I can empathise and validate that as well Hayley, because that’s sort of a process that I’ve been through as well. It really resonates with me that idea that, you know, I needed to change how I was doing things. Otherwise, I couldn’t sustain this work, which is, again, you know, but in a sense, I don’t consider it work. It’s something I love doing. So I really didn’t want to give up what I was doing that I love. And I hope I do well. But I needed to find another way of doing it so that I could maintain doing it well.
Hayley:
Yeah. And you mentioned earlier, that you have different roles you do three days in private practice. And then you have different roles. How important do you think that diversity is, as a psychologist, particularly as we move further into our careers, and as we dare I say it get a little older.
Angelo:
I, for me, I think it’s very important. It’s invaluable. I think, I couldn’t sustain just work and not that I don’t love working with my clientele. But that’s not the only thing I love. Yes. So, you know, I love imparting knowledge. So I’m really quite pleased to be part of, for example, the APS supervision training team. So being able to train supervisors is something I love. I love supervising psychology students, and registrar’s those sorts of things. So I’m making sure that I diversify my work. And the other keen interest, obviously, is my involvement with the clinical College, which allows me to be part of developing our upcoming conference allows me to be part of the new programme, we’ve got running of online peer supervision groups for those that can’t meet face to face. So for those that are interested in a particular topic, so it gives me a breadth of things that I can be involved in, that provide interest and growth. And I guess the other thing is that the involvement in these things, allows my learning to continue, which means I’m then a better value to my clients as well.
Hayley:
Yeah, absolutely. And I think you might have already answered this, in what you’ve just said, but what what do you think it is that continues to motivate you to keep doing so much? Because you do you wear a lot of hats? You and I’ve had this conversation before, you wear a lot of hats Angelo. So what,
Angelo:
I remember you even saying, you know, what’s in it for you almost, you know, because you can be careful. I think you have to be careful that you’re not just doing it because of a sense of duty to do it. Yes, I want to give back to my profession. But it’s more than that. It’s something I love. So it’s, you know, there’s a passion for it. So I need to fit it in in a way that works for me. But how do I do that? I guess. For me, it’s doing what I love. It’s setting goals to achieve what I need to do. And it’s also knowing that I can still be useful to myself and to others.
Hayley:
Yeah, yeah. So despite your illness, that’s the sort of stuff that motivates you to keep doing so much.
Angelo:
Yeah. Despite the other side, I’m not prepared to let the illness win. And I guess the reality is that it’s not an illness that I guess everybody recovers from. So, you know, I see myself again, I’m not downplaying my suffering, but I see myself as one of the fortunate ones. There are people with myasthenia gravis in different ways that they experience it and different complexities that end up in wheelchairs. Or I’ve known of people who’ve died because of the condition because of what they call myasthenic crisis, where you stop breathing. So there are a number of things that can happen. I guess my attitude is one will, I’m going to live my life and I’m not going to let that happen
Hayley:
Live your life, and be aware of when you need to sort of take it a bit more slowly,
Angelo:
Absolutely.
Hayley:
And add in rest and sort of be a bit more gentle with yourself. Because I think there’s a risk you I think you walk this well, this kind of fine line should we call it? I think there’s a risk that people can get caught up in. I need to push through this. I need to live my life. I can’t let this illness stop me. And that’s almost being in like a fight with your illness of like, well, I’m gonna win this one. You’re not gonna win this one. And I think it is that fine line of how can we accept our chronic illness and live a full and meaningful life. And some of that means that you have to take time off, you need to slow down, you have to say no to some of the things you might like to do, because you’ve already got a lot on your plate. So I think, yeah, it’s important that we kind of acknowledge that, you know, I’ll always say, you know, management of chronic illness is not a cure.
Angelo:
That’s right. I’m glad you’ve qualified that, because it’s not that I’m fighting the illness. And as such, you know, where I’m saying, I’m gonna push through it. If I did that, I think I would actually exacerbate the condition, I’d make myself feel worse. But when I say I’m not gonna let the illness when it’s walking that fine line, it’s walking that tightrope, and knowing okay, today, I can do this. On other days, I can do more on other days, I can do less, but it’s making sure that I still do, and don’t just give up hope.
Hayley:
I think you walk that well,
Angelo:
And I walk it well, but again, I don’t think by all means, I don’t think I’m perfect. And there are times where I think I have pushed through in the past in particular. And it was to my own detriment. So I still have to be mindful of that.
Hayley:
Yeah, same. I can relate to that. I think, no, no, I’m good. And I think that’s getting that boom and bust cycle, which isn’t helpful at all, it’s better to kind of pace yourself, well, and then you can keep going. But we do. I mean, you know, we can be enthusiastic passionate humans who wants to do all the things and then we we go boom and bust. So like you say, acknowledging that we’re not perfect. We’re human beings that even though we might have all the knowledge and skills and know what would be helpful, we still do what we want to do at times.
Angelo:
Absolutely. And you know, you’re right, because I um, I still have, you know, maybe we again, we’ve got all the training in the world, but we are still human. If you start doing the thing of comparing yourself to others at times, you know, that can be a problem. And I know I’ve done it, I’ll be at home in pain and laying down and thinking, what I’d really like to do is go to the beach, and I see people with their photos at the beach or whatever and thinking, Ah, you know, so you can get caught up in that as well. But yeah, I guess I see it as okay, well, on that day, I might feel a little down. But that doesn’t mean I can’t go to the beach and another time.
Hayley:
Yeah. And how can we take care of ourselves on those days where that is difficult. And I think this is where bringing compassion certainly been a life changer for me. I’ve said this many times. And I don’t say that lightly. But it literally has been a life changer for me. I think we can bring compassion to all parts of ourselves. Those days when living with chronic illness is harder than other days. I think the compassion piece makes it that little bit easier.
Angelo:
Yeah, I agree. I’d add you know, imagine how powerful it would be. And that’s why I think we’ve got to keep striving to impart compassion. Because imagine if everyone on the planet was able to live that compassionately what a powerful movement that would be.
Hayley:
So and I know, this is always a hard, hard one to answer. But if you had a piece of advice for our listeners, what would that piece of advice be?
Angelo:
Okay. So, if we go to the old adage, you know, people talk about your employers likely to replace you in a second if you weren’t there. So my piece of advice would be make more time for self care and self compassion. Stresses might have been a trigger for things. So as a result, do what you love. So do what you love and make time for self care and self compassion. Because if you can’t do it for yourself, the likelihood is no one else is really going to do it for you. They may be compassionate towards you, but they can’t actually live your life for you.
Hayley:
Yeah. And I think I think acknowledging, you know, you and I both come from a privileged position. And we have had the opportunity to, I guess, design our lives the way that best serves our health. Not everybody is in that position. And I guess some people do have to keep turning up every day, so that they can, you know, have enough money to pay the bills, pay the rent, whatever it might be.
Angelo:
I think we do need to acknowledge that. I think that’s extremely important. And but I guess, you know, also remembering that all of us will go through different struggles along those lines along the way anyway, so reducing my hours has meant for example, I know we’ve had this conversation before making it harder to pay bills to pay off the mortgage, you know, which, in my earlier days, I might have thought I would have had paid off by now. Having said that, I also feel blessed that, you know, I did have choices I could make, whereas others have less choices they can make.
Hayley:
Yeah. So when we think about that, wherever we’re coming from, is thinking, what is the smallest thing I can do to take care of myself and be compassionate, and it might not be that people can, you know, completely rearrange life, I certainly feel very privileged and grateful that I could make the changes I made. And I’m really aware that not everybody can do that. But what is the smallest thing, always going back to what is the smallest thing that I could do to take better care of myself? Whether that is, you know, if you are at work, asking if you could have a chair that’s more comfortable for you, or, you know, making sure you get up and move your body. I know, for me with my illness, if I don’t move enough, I get very stiff and very sore. So little things like that, even if I’ve got to go and do these things that are hard for me to do. What can I do to help that? Would staying hydrated help that? Would making sure that I’m eating, you know, not sitting at my desk eating, but taking a bit of a break, slowing down my breath and actually soothing my nervous system, would that be helpful? But coming back to what is the smallest thing? If there was only one small thing I could do to take care of myself today what might that be?
Angelo:
Yeah, I think I’d agree with that, too. I think, you know, we don’t all have the capacity to change large things, but we do have the capacity to just change small things. And for me, you know, even that idea of slowing my pace slightly, so I’m not darting mindlessly from one thing to the next. And taking a deep breath every now and then. Yeah, is one thing I can do to maintain self care.
Hayley:
So this is a question I asked everybody that comes on the podcast. And I’m always curious as to what people’s answers are going to be. So if you could meet your 80 year old self, what do you think you’d say to you?
Angelo:
Okay, that’s another very good question, Hayley. I guess, my 80 year old self would say to me, always remember to take care of yourself along the way. And in that way, you’re going to prevent illnesses being triggered or flaring up. And I think I’d say to myself, good job, you did your best. And you didn’t expect perfection, you’re a work in progress. And you’ve still got more to learn. It’s like a fine piece of art, you know, we can we can keep building on a fine piece of art. And we’ve still got a lot to learn. And that’s okay. It’s okay to be who you are. And keep learning along that journey of life.
Hayley:
That’s beautiful. I often think to myself, not always successfully. But I think you know, what can I do today that my 80 year old self would appreciate me having done. And that might help me kind of, you know, drink more water or because these things I really struggle with is drinking enough water and getting out and walking enough. So I try and sort of think, you know, what would a two year old Hayley, appreciate me to do today, but like I say, it certainly doesn’t always work. That’s certainly something I continue to struggle with. Despite knowing that those things will be good. But I think that’s lovely. And also, you know, you’re doing your best, you’re not perfect, we’re never going to be perfect. But we can do our best.
Angelo:
And that’s okay, doesn’t matter if it’s not perfect.
Hayley:
Takes a lot of pressure off, doesn’t it when we can acknowledge that we’re human. All that that means and all that that comes with. Fantastic. So finally, if people want to find out more about you, or get in touch, where can they find you and engage with you and your work, and I’ll put links on the show notes for people to find you, but what’s the best way of kind of
Angelo:
The best way to contact me would probably be again, there’ll be phone contact numbers and emails, but if they were to go to my website, so it’s CCCpsychology.com.au. And the website has all of my contact details on it.
Hayley:
Fantastic. And I’ll put that in the show notes. It’s been an absolute pleasure chatting with you this morning. I hope you go on to have a lovely day and take care of yourself in the way that I know you do so beautifully. Thank you for coming on.
Angelo:
Thank you. Hayley it’s been a really great pleasure. I, like I said, I’ve been looking forward to it. And I’m really glad we did this. I’m grateful that we were able to do this together. So thank you so much, and have a wonderful day too.
Hayley:
My absolute pleasure. Thanks.
Angelo:
See you later.
Hayley:
Bye.
Hayley:
Thank you for sharing this time with me today. I hope your time here was helpful and supportive. If there has been something in this episode that you have found helpful, I invite you to share it with another person you think might benefit. I’d also love it if you’d like to leave a review wherever you tune in. Reviews really helped to increase awareness of podcasts, meaning I can spread helpful information more widely. All reviews are welcome and much appreciated. As I know they take time out of your day. If you’d like to be notified when the next episode airs, please use the link in the show notes to join my mailing list. Music and editing by Nyssa Ray. Thanks Nyssa. I wish you all well in your relationship with yourself. And may you go well and go gently.
Angelo’s Confidence Competence and Compassion Psychology website
https://cccpsychology.com.au/
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This transcript may not be an exact representation of the audio
