Harm reduction, to me, is the art of making the best choices you can with due consideration for what you’re given to work with. It’s a framework for finding peace when your goals and aspirations fall outside of the realm of what is possible for you in that moment. If you can’t do things the way you dream of doing them, you can do them the best you can, accept what is, and keep moving forward.

Like many people with chronic illness or chronic pain, I spend a lot of mental effort every day carefully weighing choices that don’t even register for folks in good health. Can I go out to coffee with a friend, or will that leave me too exhausted to finish my laundry later? Should I try to weed the garden, or will it leave me in too much pain to cook dinner tonight? The exquisite calculus of managing energy resources or pain is a large part of what it means to be chronically ill.

There is a constant, implicit pressure to make the right choices. To be my best, healthiest self at all times. To muster the will and the wisdom to never do ‘something I’ll regret later,’ particularly if I have to lean on my support system to help pick up the pieces. Who can resist feeling guilty when that happens, when your choices make work for the ones you love, or prevent you from doing things with them, or for them? And there is always an element of unpredictability in my condition. What is no problem on one day might be a big problem on another. What I do now may have consequences in a day or two that I can’t always predict.

The pressure to do it right is part and parcel, too, of the societal pressure to be the perfect parent or the able worker. If I don’t manage to take care of myself in exactly the right ways, well, then it feels like my fault when I can’t get the job done or play with my daughter the way she wants me to or organize the awesome craft project that I had been hoping to do with her.

I am working hard, every day, to learn that doing my best doesn’t always mean doing it ‘right.’ There is no such thing as perfect in these murky waters, where the interface between my lofty goals and my biological realities crash together, struggling, surging, meeting like two air masses that spawn a thunderstorm. When you know you’re in it for the long haul, there has to be a way through this conflict. A path to peace. The concept of harm reduction is helping me, slowly, towards mine.