Living with the Enemy - a book review


Book review: 'Living with the Enemy – Coping with the stress of chronic illness using CBT, mindfulness and acceptance' by Ray Owen
Publisher: Routledge 

When first asked to review this book I have to admit that ‘self-help’ books are not really my ‘thing’. But I had heard of this one through a recommendation by a clinical psychologist, Dr Graeme Gillespie, who had spoken eloquently at a Cardiomyopathy Information Day and at the Cardiomyopathy UK National Conference – and so my curiosity had been piqued.

And I am pleased I’ve read it. By doing so, I have learnt a lot about myself and learnt a few ‘self-management’ tips too.  And I would recommend it to others with a long term condition such as cardiomyopathy. Why? Because it guides us into accepting and co-existing with our long term condition, rather than letting it take over, or using up our precious energy and resources waging war on it. Acceptance is not about ‘giving up’ but rather learning to ‘live with the enemy’ – and this frees us up to move forward and get on with our lives.

The book is based on an approach known as ACT – Acceptance and Commitment Therapy. The author, clinical psychologist Ray Owen, writes in an accessible, easy to read style. He avoids jargon, explaining things in a lay person’s terms.  He introduces us to four people, all with long term conditions (LTCs), and he uses these folk to explain the problems LTCs bring and how the techniques in the book can help.  We can see elements of ourselves in these people. Owen does not belittle the problems that a LTC can bring for both patient and their loved ones – the limitations, frustrations, loss, physical and emotional suffering and his approach is not a ‘quick fix’.

The book contains numerous exercises, some taking a few minutes, some revisited each day for perhaps a week or more. The exercises build on each other and are designed to help the reader understand and learn to ‘live with’ their LTC. I have to confess I didn’t do them all which you probably should to reap maximum benefit. And some of the exercises are not easy – taking 10 minutes out of your day to relax and focus on breathing sounds like a doddle – but it’s amazing where the mind wanders off to when it’s supposed to be focusing on something else! However, one of the things I liked about the book is that there is no ‘right or wrong’ in these exercises. Owen knows full well our mind will wander off, so when it does, he simply asks us to bring it back and refocus.

The early chapters and exercises help us to learn more about ourselves and how our cardiomyopathy (or other LTC) affects us. Through exercises, Owen encourages readers to think about whether they try to control or avoid their LTC and suggests neither approach is helpful. Rather, he proposes tackling those aspects that can be improved and accepting things that can’t, otherwise we may become caught up in a control/avoidance cycle. He recognises that we can become trapped in our thoughts (‘ruminating’) but reminds us that thoughts are just thoughts and to treat them as such. A helpful concrete suggestion was to try the ‘worry time’ technique – 15 minutes to focus on the worry and then move on and get on with your day. Not as easy as it sounds but certainly worth a go. 

The middle chapters introduce the idea of mindfulness – a buzz word these days. Mindfulness is described as ‘present moment awareness’. It’s about appreciating the here and now and enjoying the present. By worrying about missing out in the future, or dwelling on what has happened in the past, we can forget to enjoy the present. It was good to be reminded to take notice of the world around you and to savour the moment whatever you are doing - and I particularly enjoyed this chapter.

Owen recognises that we may sometimes hold on too strongly to who we used to be, even though things have changed, and this can cause us to be continuously disappointed by not being able to do what we used to do. He suggests ways of dealing with this. Working out who we are now and how to live with a purpose is explored through goal setting. Having goals and a purpose can give a sense of direction. An LTC can mean having to let go of old goals and establishing new ones can be difficult. In order to do this, Owen encourages reader to think about their values… what is really important to us and what we stand for (e.g. helping others, being caring, being creative etc.) and how we can live our life in a way that reflects our values. Taking small steps to connect to our values everyday can have a positive effect on how we feel about ourselves and how we live our lives.

In conclusion, as stated earlier, the book isn’t a quick fix, but it does offer sound practical ways of understanding yourself so that you can learn to live with your cardiomyopathy or other LTC. It is not always easy to learn things about yourself, but it is important before you can see if there’s a better way of doing things. Owen’s aim is to help us manage our LTC so we can live life well and to the full –a life well lived – and I can’t argue with that!

Cathy Stark, May 2017

Living with the enemy is available from Amazon (opens new window). If you order through Amazon, please remember that you can raise funds for us by signing up to Give as you Live.

Cathy is a long-term supporter and friend of Cardiomyopathy UK, and co-runs our North East England support group