What is distraction?

Distraction is another way to help you manage JIA pain and stiffness. Distraction can also help you manage your emotions and the stress that you may feel because of JIA.

You may remember from the section “Managing your symptoms” that your brain perceives pain and there are ways you can change the pain signals or messages. Distraction is a technique you can use to change these pain signals. Distraction can help you to put your attention onto other things and not focus on the pain.

When to use distraction

Distraction is a good technique to use when you are experiencing pain but want to be able to do an activity. Distraction can also be helpful when you are feeling stressed. Here are some examples of situations when it would be good to use distraction:

• Lisa is trying to finish her biology homework when her pain starts to get worse.  She cannot get an extension on the due date, so she really wants to finish it.

• John is sitting on a school bus with his friends coming back from a field trip. He wants to be sociable, but his hips are feeling pretty stiff from sitting so long.

Can you think of some times when distraction might help you?

Types of distraction

There are various methods of distraction. Some are very simple to do while others need more practice. Each of these distraction techniques can be used to help you carry on with activities and other things that are important to you.

There are four methods of distraction:

• Attention focusing
• Imagery
• Mental games
• Activities

Try to find at least one distraction strategy that is a good fit for you and that you are likely to continue to use.

Attention focusing

What it is and how it can help

As we go through the day, our attention is constantly shifting. Sometimes we pay attention to a lot of things at once, but other times we get so caught up in a single thought or activity that we become less aware of what is going on around us.

Have you ever become so involved in one activity that you didn’t notice what was going on around you? For example, maybe you were playing a game and you didn’t hear your mom call you for dinner. Or perhaps you were really focused on a book you were reading and you didn’t notice the colour of the chair you were sitting in.

By turning your attention to something else, you can block out unpleasant or stressful thoughts. In the case of JIA, focusing your attention on something else can help you to notice the pain less frequently. The trick is to become as focused and involved as possible in whatever it is that you choose to concentrate on.

You can use attention focusing to:

• take your mind off of stressful thoughts
• move your attention away from pain and stiffness
• help you get to sleep faster.

Learning how

Here is an experiment you can try to help focus your attention:

Focus your attention on your breathing. Notice how each breath moves your chest and stomach in and out. Notice how your breathing sounds, and how the air moves into your nose or mouth. Now begin to breathe more slowly. Take a deep breath in, and very slowly release.

Think of three pleasant things that you can focus on that are more interesting than JIA symptoms. They might be places such as a cottage or walking on the beach somewhere warm. They might involve special events such as going to a concert or watching your favourite sports team. Or they might involve doing fun activities with friends or family.


What it is and how it can help

Imagery is using your imagination. Think of the taste of a lemon, or the colours of the sunset, or the sound of a drum.

There are two main ways to use imagery to help with pain:

• To change your thoughts to something more enjoyable. Imagine being in a pleasant place, maybe on a beach or in a park with your family and friends. This is much more interesting to think about than pain.

• To change the sensation of pain. Picture your pain as having a certain shape, size, or colour, and then change it. For example, if your pain in your joint feels like the size of a baseball, change it in your mind to the size of a golf ball, or a marble, or even smaller. Or change it from hot red to pale pink, maybe even to blue.

Imagery can also help you with the stress and tension that builds in your body from worrying. By thinking about something pleasant, your body can become more relaxed.

Learning how

Imagery is like daydreaming except you are doing it on purpose. Some people find it easy to use their imagination to distract themselves. Others need more practice to develop the skills. When you practice imagery, you need to become involved in the scene as much as you can. The more involved you are, the less attention you will have to spend on other thoughts. This will help you become more relaxed.

To help with this, when thinking about your scene, involve as many of your five senses as you can. For example, if you are thinking about the beach, think about the sound of the water you would hear, all of the sights on the beach, the smell of the ocean or the lake, the feeling of the sand, and the taste of the ice cream you’re eating.

You can use any pleasant experience to help you relax. Try remembering a trip you have taken or remembering a favourite story. However, for imagery to work well, it should be easy to picture. It should be pleasant or calming for you.

What are some of the pleasant experiences you have had?

Practice exercise

Listen to this audio recording, called “Your comfort zone.” This imagery tape was made to help you reduce the pain and stiffness you feel from JIA.

Mental games

What they are and how they can help

Mental games are a way of controlling stress or pain by turning your attention away from stressful feelings. They involve using your mind and concentrating on the game. Your mind is kept busy with another activity so that it isn’t available to think about the pain or stress.

Learning how

You may have already played these games to help pass time during a long road trip. Here are some examples of mental games:

• Alphabet games. To play, think of any categories of interest, like sports, cars, teams, animals or countries. Let’s say your category is countries. Think of a country that starts with the letter A, then B, C, and go all the way through the alphabet to Z.

• Try to remember all of the words to your favourite song.

• Count the number of tiles on the floor or dots on an area of the ceiling.

• Count backwards from 100, by any number you choose. For example, count backwards from 100 by fives. 100, 95, 90, 85, etc. until you get to 0.

• Look for faces or animals in the clouds.

Can you think of any mental games that you could play?


What they are and how they can help?

Doing an enjoyable and distracting activity can help you take your mind off the pain. If you are in pain, try to keep yourself busy with another task. It will distract your mind from the pain for a little while.
Distracting activities can include:

• talking to a friend or a relative on the phone
• playing a video game
• reading a magazine or book
• watching a movie
• baking
• working on a project.

Can you think of any other activities that would be enjoyable and distracting for you?

A story of hope

“I had trouble accepting that I couldn’t play sports like I did before. Even though I didn’t play them anymore, I still really wanted to. To solve this problem, I developed an interest in something else—music. I spent hours and hours listening to music, which relaxed me and took my mind off things. It also introduced me to bands I had never heard of. Another way was to sign up as a referee for volleyball. That way, I didn’t have to move around, I just had to watch my friends play and earned a little pocket money to buy new music CDs.”

-Adrian, age 15

Welcome to the Taking Charge: Managing JIA Online Program! In this section you will learn what to expect in the program, how to get started and how to set goals to better manage JIA.

JIA stands for juvenile idiopathic arthritis. Find out what causes JIA, the different types of JIA and how it will affect you now and in the future.

Diagnosing JIA may be difficult as joint pain and swelling may be a part of many different illnesses. Diagnosis of JIA typically includes a physical exam, blood tests and imaging studies.

Pain, stiffness, and tiredness or fatigue, are common symptoms of JIA. These symptoms can lead to difficulties with participating in school and sports activities, and enjoying time with your friends. Learn about pain, fatigue, and stiffness, how to manage symptoms and how these symptoms can cause stress.

There are several strategies you can use to help you cope with pain, stress, and sleep problems. These include relaxation, distraction, and managing your thoughts. In this section, learn more about how each of these strategies work.

When you know about your medications, you can talk to your doctor about them and make good choices for yourself. Find out about the different types of JIA medications, how they work, common side effects, and the importance of talking to your doctor about your medication plan.

Did you know that there are many other therapies that you can use to manage JIA symptoms? They can help to prevent complications so that you can do all the things you want to do. In this section, learn more about physical, occupational, and psychological therapies; maintaining healthy nutrition; surgical options for JIA, and more.

Your role in making decisions about your treatment plan is very important. Your health-care team and other members of your support system are available to help you make these decisions. In turn, they can help you to manage your JIA.

Whether you have JIA or not, you need to maintain a healthy lifestyle. Find out how to stay healthy and active, learn about puberty and relationships, healthy body image, and making healthy lifestyle choices.

Sometime between the ages of 18 to 22, you most likely will transition from your pediatric rheumatologist to the adult health care setting. At that time, there are a number of things you, your family, and your health-care team can do to help make this change go smoothly.