My 4 Key Principles For Tackling Complex Chronic Pain
Complex Chronic Pain, regardless of whether it is the symptom of a health condition, old injury or has no clear cause at all, is as the name says “complex”.
This means that there is no magic pill. Treatment is not simple and there is not one intervention that can resolve it fully alone. Complex chronic pain is also highly individual, which means that every person’s pain is different and it responds differently to different treatments.
I know how desperately people do everything they can to reduce their pain and I also know that the lack of success that so many experience is not due to them not trying hard enough. When it comes to complex pain the power lies more in the “how to I do it” than in the “what do I do”.
For example, you can have weekly massages and exercise regularly and maybe even have counselling if you are already aware of emotional pain that is connected to your physical pain, and yet there may be little change in your pain levels, because you are not actually working with your pain, you are just ticking boxes. The same therapies may really be helpful however, if they are part of a self-healing experience that the person is deeply invested in. It is hard to explain what is meant by being “deeply invested”. It means we are involved and emotionally connected with our pain and our healing.
Chronic Pain expert Maggie Phillips summoned it up in her book “Reversing Chronic Pain”: “When we muster enough courage to question, to really look at our pain, and stay present to our bodily experience of pain, we inevitably notice that our experience of pain shifts constantly, and that the body is amazingly resilient and filled with abandoned healing resources to tap. We need only believe in these possibilities.”
This may sound rather simplistic and idealistic to anyone who is being crippled by pain right now, however I know that there is power and wisdom in these words and that when people begin to feel the truth of these words, healing really begins.
The tricky thing seems to be to muster the courage that Maggie Phillips mentioned and with it the self-belief, determination and curiosity that is also needed. When we are overwhelmed with pain, when we have experienced many setbacks and our hopes for improvement have been disappointed many times it can be the hardest thing to muster any of those qualities.
And yet without them we are just wasting our time and money on yet the next intervention we already are not able to give our full commitment.
So I wanted to share with you a few key principles that, in my opinion, are essential in whatever interventions we use to improve pain.
Principle 1: Let go of hunting the magic pill!
Your body is not a machine, stop trying to fix it like one.
If you are still trying one new therapy after another and move on after a couple of sessions because they have not solved your problem quick enough, stop! We are complex beings and so is chronic pain. Creating a lasting and gradual reduction of your pain takes building a relationship with your practitioner. It takes time, thorough exploration and sometimes practice. It is not so much what they are doing to you, it is also about how you receive, what the state of your nervous system is and what your relationship with your pain is. Next time you want to start a new kind of therapy, pause a moment and really check if you are actually willing and able to engage in this process and give it the time it needs. Are you able to summon some curiosity, be prepared to face difficulties, small victories and setbacks? Because if your honest answer is “no” you may be wasting your money and time.
Principle 2: You are your most powerful healer!
Unfortunately other people can not heal your pain. Other people can help you, support you, guide you and advise you but unless you are fully taking on the mission to seek and find change, change simply won’t happen. This does not mean that you need to DO an awful lot. But what is needed from you is your full presence, your honesty, your feedback, your thoughts, your suggestions, your questions and your experience and your willingness to engage with the process. Research has shown that when we are actively involved in our healing, results tend to be much better than when we hand ourselves over to some professional who works his or her magic on us. I know that it can be a big ask for a person in pain to be present and curious about their process. Pain can make us literally check out from our body and the world. While that is a great survival strategy, we need to gently find a way back because we need to be the healer inside.
Principle 3: Be prepared to hear your Pain
This is perhaps the biggest hurdle. Whatever created the pain in the first place, the pain very likely itself is causing further tension in the body as we brace against it all day long. Added to that our resentment towards our body letting us down and our fixation on getting rid of the pain is causing a tense standoff inside of us that only makes the pain worse. It is as though the pain was a person inside that is giving us a hard time and we are resenting them for it. Since we can not walk away from ourselves and our body the only real option to resolve the conflict is for us to sit down and listen to each other with calmness and kindness. Again, this may feel very counterproductive. When someone is shouting at us in the street, our instinct is not to walk towards them and ask them what the matter is. On the other hand one can not blame a person for beginning to shout if they were ignored before. You may feel that that is not what happened but how can you be certain until you have honestly listened to your pain?
You could literally sit down and imagine your pain was a person and have a chat with them. Or you might just take some time and acknowledge your pain and try if you can stay connected with it while keeping breathing calmly and keeping your body relaxed. This is a start and remember it is not just about telling your pain what you think of it. The important bit is to accept that it is there first of all, and to listen to what it has to say to you and to communicate with the goal of finding new understanding between you both. (Btw, if you find connecting to your pain to be emotionally overwhelming, do not force it. You may need a little bit of professional help with this. Please feel free to contact me for a complimentary zoom call.)
Principle 4: Also do something else
Working with pain means finding a very fine balance between not ignoring, and in some ways embracing the pain, and also making your nerves aware of other sensations in your body and other stimuli in your life.
Pain can be so all consuming that we end up literally unable to feel or know anything else (except for other negative things to do with the pain, like the loss of what we can no longer do and the pressure from other people to get better). So a simple way to remind your body that there are other things than pain is to really enjoy a meal, or taking extra time in the shower and really feeling the hot water on your skin. Research has also shown that people who learned a new skill, such as juggling, recovered more successfully from chronic pain than those who did not. This is because when we engage our brain in having to create new neural pathways the whole nervous system rewires and old patterns of pain that have become automatic become disrupted in the process.
So besides having lovely showers, massages and good food, how about learning a new hobby (that is possible for you considering your current pain levels.)? Maybe you start indeed juggling, or knitting or going to yoga. Ideally it is something physical that involves coordination in order to really get the brain and body engaged with it.
These 4 principles, for me, are fundamental to whatever therapies or interventions you eventually choose to help you with your pain. And they are also the hardest to really master. They may sound terribly simplistic but of course writing about them is one thing and mastering them is another.