Implementing the ‘Pause Between’ in Parkinson’s Management

Armed with the tools of threshold management and mindful movements, I am ready to put the brakes on this accelerating Parkinson’s progression. Having tools and using them wisely are two different things. It’s the distinction between the design and delivery of my Parkinson’s self-management program. For me, the use of these self-management tools starts with intent.

My intent is to decrease the intensity and frequency of the very worst of times, those “ugly days.” My intent is to function better, and therefore, feel better. Making this my primary intent is important because some experiences are difficult to endure as part of improved self-management. Knowing that I have a chronic, progressive condition is discouraging. Knowing that I can work through the worst of the symptoms nestles my intent to function better in a safety blanket of possibility.

Recommended Reading

November 5, 2021 Columns by Dr. C

The Emotional Flicker Effect Has Its Triggers and Precursors

This disease often feels like wrestling with a bear, leaving wounds and extreme fatigue. I try to be gentle with my intent, framing it with genuine curiosity and kindness. It’s an exploration of how best to fit these self-management tools into my life with Parkinson’s.

Throughout this process of putting theory into practice, I am checking in on myself and with my partner. How am I doing? I write about these techniques, but are they truly helpful?

After several months of work on these processes, even with proper intent, I found it so hard to use these tools consistently. I would do mindful movements for a while, then forget. When I forgot, I would stumble. Or, I would aspirate during dinner, not concentrating on mindful mouth movements while chatting with friends and family and eating at the same time. Not being mindful continues to result in movement problems.

Even though I was putting in some effort every day, I didn’t see any positive outcomes. The ugly days were still happening, and both stumbling and aspiration were still problems. I needed something more.

I created what I call the “pause between,” which I wrote about earlier this year. To review, it’s a small, often only seconds-long pause before the start of any change in motor movement. When I move from sitting to standing, I take a pause and then start practicing mindful movement. Before I start to get out of a chair, I pause and then direct my attention fully to my body. I find my balance, feel my feet on the floor, and then start to move forward, focusing on being mindful.

Because of the pause between, my use of mindful movement is somewhere around 90% on a good day. That has reduced both stumbles and the occurrence of ugly days.

The pause between has also helped with threshold management, though I’m still learning how best to implement it. The difficulty lies in shifting attention from the Parkinson’s brain/body noise of pain and big emotions to the pause between for long enough to shift perception.

This pause between helps me avoid my automatic responses to system dysregulation (the flicker effect). It gives me time to implement a new Parkinson’s self-management reaction that can replace the auto-reaction. Overall, it has been helpful with managing emotion and pain, but I can clearly see room for improvement. I still lose control. I hope constant use of the pause between can decrease the negative impact of the disease.

The pause between helps me to take the brain path less traveled. There is always the urge to do the habitual response — the path well-traveled. The pause between provides me the opportunity to turn my back on the habit and make myself act and think in new ways.

Overall, my efforts to implement the pause between work because of its versatility. I simply pause before doing any sequence of motor actions. I don’t have to remember every different Parkinson’s malfunction for which I need to apply mindfulness. I just need to practice the pause between at every possible opportunity. I think of it as the “starter button.” I don’t start moving until after I press the button.

What I discovered is that over time, it became easier to use the starter button, to shift attention from habit to the pause between. The easier it was, the more likely I was to do it. The more I did it, the more I benefited.

Significantly for me, the pause between makes it possible for me to slow disease progression. That brightens my day, and my partnership with Mrs. Dr. C, considerably.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.