16Apr/15

Mindfulness is a great skill

Mindfulness is a great skill to learn at any age. To be mindful simply means to be aware of what is happening right now and without judgement–notice how you judge your thoughts and how that makes you feel.

Everything that we are aware of is our own, unique interpretation that emerges from our belief system. We appraise our thoughts, our actions, others, and the environment around us. This appraisal evokes an emotional and bodily response in many cases, even if it is just a shrug of the shoulders. It is important to clarify that emotions, body responses, thoughts and actions are all part of one and the same; i.e. the whole person. Sadly, much of the thinking, particularly in health, remains Cartesian and separates mind and body. This is despite reams of research papers and common sense telling us otherwise. What does your tummy do when you think about giving the presentation tomorrow? Your body reacts in response to the thought, and that reaction involves the nervous system, the motor system, the brain, the immune system etc etc….WHOLE PERSON.

So, if the appraisal or our perception guides how we respond, then we have a buffer between any give situation or thought and what happens next. We have a choice — ‘the greatest weapon against stress is our ability to choose one thought over another’ said the great philosopher William James. Shakespeare had insight: ‘there is nothing either good or bad, but thinking makes it so’.

Mindfulness is the skill that allows you to observe thoughts and interpretations rather than become embroiled, living out thinking that is felt in the body as emotions and tensions. You notice with quiet curiosity how your body is responding, lifting the veil of suffering.  We have that choice, but most don’t realise, operating on automatic overdrive leading to repeated stress physiology that affects every body system.

A stress response is designed to protect us from the dangers of wild animals. The same responses kick in to a threatening thought–the most dangerous things we face are our own thoughts and interpretations: a shadow after watching a horror film is threatening because of the way you think about it and create a story of a murderer lurking behind the tree. Actually, it’s a cat but that story does not feature. What stories do you tell yourself to create fear? How useful is fear? Not very.

Fear triggers further negative thinking, and that gets us nowhere. Respect and understanding create opportunities to learn and grow. Much better.

How are you mindful? If you look on the bookshelves, tome after tome sits there awaiting your mind. It seems that everyone has something to say on the matter. The reality is that mindful practice is simple. Practice is a habit that needs to be grooved. You must fail and fail and fail again. That is how we learn. And when you think you are good, fail again to get better. Learn to love failing because then you are getting better!

Start being mindful by noticing what is happening now. Where are you? What are you thinking? How are you feeling? Take a breath and observe it. The rise and fall of your chest and tummy. It’s a wonderful feeling to sit still. Especially in this crazy, high speed world with demands pouring in digitally and otherwise. Simply recall that whatever comes your way, it is your perception that counts. You are in charge of that perception. Make a choice. Create calm so that your body systems can do their job and slip out of protect mode and into health mode. On-going stress accounts for and contributes to most of the modern day ills–chronic pain, infertility, headaches, chronic inflammation, IBS etc etc. To think effectively about stress we need to look at it as a societal, cultural, physiological, personal phenomena.

So, I thought I would write a book about it as well. A very short one. Coming soon.

Mindfulness practice is part of the Pain Coach programme; a complete strategy to overcome chronic pain | t. 07518 445493

11Apr/15

50 strokes

Ajahn Brahm tells the story of a monk who thought he deserved punishment for breaking a monastic rule. He had knowingly done wrong and expected reprimand, yet this was not the way. The monk insisted, so Ajahn Brahm prescribed 50 strokes. The thought of this ancient punishment undoubtedly filled the monk with fear yet he knew this was his fate. However, no whip was produced but instead a cat, which the monk was ordered to stroke—50 times. After the 50 strokes of the cat there was peace and calm and the passing of a learning experience. Change was afoot.

In physiotherapy we use our hands to treat and create calm in a body that is protecting itself, perceiving a range of cues to be threatening. It has been thought that moving joints, muscles and nerves bring about the desired changes (or not if unwisely applied) because of a change in the structures. Science has since taught us otherwise, and that in fact what we are really doing is changing the processing in the body systems and then the recipient has a different and better experience—pain eased and movement more natural and thoughtless.

Touch is very human. Touch is a part of the way we develop in the early years, a lack of touch being detrimental to normal development. So potent when the meaning is aligned with a sense of creating wellbeing and soothing woes both physical and emotional, touch should be part of therapy for any pain condition. Interweaving hands-on treatments during sessions, teaching patients how to use touch themselves, teaching carers and partners how they can use touch, all create the conditions for healthy change.

Touch send signals from the nerves in the skin and muscles to the spinal cord and then onwards to the brain. In this way, the body is an extension of the brain and the brain an extension of the body, demonstrating  how we are  a whole person with no system or structure being in isolation to any other. Using touch is literally sculpting the representation of the body that exists in the brain, like moulding clay into a humanly shape. And of course, a shape has a function and the two are not distinct. The more precise the shape, the better the function. The manifestation of this being a normal sense of self in how we think and feel and a move. Normalising, desensitising, to me are one and the same.

— 50 strokes of the area of the body being protected, much like stroking the cat then, sculpts our ever changing brain and sense of physical body. The physical body exists and occupies space with the ever-potential of action, yet this does not exists without thought—it is my thought, the meaning that I give to my body that creates what it is in any given moment. When the strokes feel pleasant, or at least not painful, then this is your body and brain perceiving the action as being non-threatening and learning that the area is safe. The more of this the better. The same applies with movement: any action that is tolerable or feels good is the body (your whole self) saying ‘yes, that’s ok’. And that’s what we practice and practice.

To overcome and change pain is to normalise and to alter one’s relationship with pain and overall perception. We have much more say in this than most people realise but once they understand their pain, what pain really is and what they can do, change occurs in the desired direction.

Puuurrrrrrrrrrrrrrrrrrr.

05Apr/15
Pain Coach Programme

At a distance

With people coming far and wide for some years now, the Pain Coach programme has been designed to work at a distance when individuals are not able to regularly attend the clinics. The best case scenario is meeting face to face, but subsequently the use of technology allows sessions to be conducted with ease thereafter. I use all forms of communication: text, email, phone and Skype; which means that people can access the programme in the vast majority of cases.

Having used distance sessions for some time, I have seen how individuals benefit and move forward. Overcoming chronic pain is a learning process and distance learning has always been a successful mode of education. If done in the right way, the learning required to overcome pain is no different.

What do I mean by learning as opposed to treatment?

Treatment encompasses many forms of learning. Learning is the way we take new information and adapt for the better. Overcoming chronic pain is an active process and not a passive process. And whilst there is a role for hands-on therapy in persisting pain, to simply lie in a treatment room and have something done to you is absolutely not enough to move forward with the potential that everybody has within themselves.

To overcome chronic pain, the individual must learn about their pain (some biology and what influences this biology) so that they can make informed and clear decisions about how to be healthy and create the conditions to move forward. Nothing happens without thinking in the right way about a problem. From this foundation of understanding, specific training is needed to re-learn normal movement and body sense as well as developing the confidence to move and be active once more in different scenarios. This is all learning.

The Pain Coach Programme

The programme is designed for you to overcome your pain. Individualised for your life and your vision of where you want to go, the concept of coaching is a potent way of moving forward. A coach is always looking at different ways of achieving success and tackling problems, learning and getting up quickly if things go wrong. The coach uses a growth mindset, the mindset that knows that things change. We are not fixed, we are always changing. Which way do you want to go? If you are suffering with chronic pain, all the changes have been about on-going protection. Now it is time to go in a different direction. Change is one of the few certainties in life. Buddhists call it impermanence. Nothing is permanent, even the pain you are in right now. This pain will change and there is something you can do. There are still, despite the science of pain telling us differently for years, too many messages about chronic pain that are simply untrue, including the one that says you must just manage or cope.

In essence, with your new knowledge and development of skills, you become your own Pain Coach, making effective decisions about how to move forward at each step. This releases you from the cycle that you are currently within, including how you learn from a flare-up (a temporary increase in symptoms) and return to the business of living your life. The overarching aim is just this: attaining a meaningful life that involves all the important people who you wish to include. The programme is designed to embrace the role of partners and carers where possible and when desired–please ask us about carers and partners training days and sessions, as they too can become pain coaches to help you overcome your pain.

Pain Coach ProgrammeCall us now to book your Pain Coach Programme: 07518 445493


05Apr/15

The art of batting

With the cricket season about to begin, I thought it timely to use a batting metaphor to illustrate how thinking can obstruct free flowing movement. For the cricket lover, there is great joy watching a batsman lean into his front foot, head towards the ball, eyes focused through the grill, as the bat arcs guided by fast hands, the wood kissing the leather ball in the briefest of seconds before accelerating to the rope.

Seeing an expert perform in any field has the common denominator of ease. They make it look so natural and effortless, whether playing a musical instrument, dancing or stroke play. The movements have been rehearsed and honed thousands and thousands of times before, the motor patterns in the brain grooved with the synaptic efficiency that results from hours of practice.

Most people are ‘experts’ at walking. We don’t think about it in this way necessarily but the walk is a movement pattern that has been practiced since we started, well… walking. It is only when things go wrong does the motion change. A limp for example. Walking can also change when we start thinking about it rather than naturally, unobservedly going about our business of ambulation. Note how much activity is afoot from the simple stepping action, involving the whole body, the whole person and his or her mood and the environment in which the individual resides at that moment. Of course, the perception or even attention upon the environment is affected by one’s mood — ‘how did I get here? I didn’t even notice’.

With movement and posturing being an expression of who we are and what we are thinking and feeling, there are characteristic styles that identify us to others and to self — you will recognise a friend from afar by the way he walks; and you will know that you are moving well and normally by detecting self, or rather when the self feels different. When all is well, the act of walking is not noticed, yet as I have said, this changes at the point of being conscious of how the arms swing, the legs lift and the body sways, and if heavy or light thoughts crowd into the mind.

It is well known that the batsman must concentrate on the ball until the last: ‘watch the ball onto the bat’. This happens quickly and hence any unnecessary thought can affect the end result. ‘He looks quick’, or listening to the banter from behind the stumps, and oops, it could be the long march back to the pavilion. Some high quality players have in recent years been subject to depression, which has certainly affected their ability to hit the ball. Thoughts crowding in. The art of batting then, is a mindful task whereby the mind must be quiet to allow for the free flow of movement. There is no difference between this and movement on a day to day basis.

The person suffering chronic pain moves differently. The body is protecting itself, the individual consciously protects and hence simple movements, once take for granted, are now anticipated, planned and executed in a timid and fearful way. This pattern is encoded and passed back into the sensorimotor system to plan the next movement and other possible actions that the brain predicts may happen. Where this does not match the normal pattern, a threat value is created, evoking activity in the salient network that detects when something is physiologically amiss. Part of this network’s role is to trigger responses that motivate behaviours and attention to the relevant areas of the body. Once satisfied that all is well, protection is lifted and wellness ensues.

Movement is fundamental to health and feeling normal. We can tell when someone is not well in many cases by the way they move and hold themselves. To restore flow and ease of movement often requires that we target fears and anxieties that are caused by thoughts that can obscure. Much as the batsman needs clarity, so does the person overcoming pain. And whilst sometimes we need to think about the way we move, most times we just desire natural, unconscious and purposeful action that results in a reward.

In rehabilitation and in overcoming chronic pain, just like batting, we need a clear mind so that we can focus upon the job in hand. Thoughts come and go, but if we let them interfere with the action rather than letting them pass, there will not be the same result. Practicing mindful movements where you learn the skill of focused attention allows for the right kind of concentration and attention, eradicating the effects of fear and anxiety that can so commonly be associated with normal movements and activities. Understanding pain is another key element of reducing these fears and their potent effects.

To set up the right conditions for recovery, we must consider beliefs, thoughts and fears as well as the environment and the vision of where the person wants to be. From here we can create an individualised programme that addresses all dimensions of the pain experience: the physical, the cognitive and the emotional; and how theses dimensions interact. This is the complete and whole person approach to pain that is necessary and indicated by modern pain neuroscience.

For informationPain Coach Programme or to book onto the Pain Coach Programme, please call us on 07518 445493

 

 

03Apr/15
Pain Coach

Change and pain

Change is happening all the time. Every moment is new and unique as we pass along our own timeline, being moulded by each new experience. Where we are right now has been determined by every thought, action and exposure to date. It has taken me 41 years to write this blog!

Change and pain — learn to change and overcome your pain on the Pain Coach Programme

Change is something that we are expert at, and it is something that we cannot prevent. Apart from death, change is the only certainty in life. So if we are always changing, why does pain persist and seem to be the same for the many people suffering chronic symptoms? The answer to this question is that the symptoms are not the same, but we just don’t realise.

Our memories are notoriously unreliable, yet we think that they give us an accurate recall of events. What did you have for lunch three weeks ago last Tuesday? If it was a particularly important lunch date, you may remember. Otherwise, it is a guess or there is no memory at all. And why should you remember anyway? How useful would it be to remember it unless food was hard to come by, in which case you may recall the location so that you can go back there to search again (evolutionary biology at play).

We do not remember events as well as we think we do. The same is for pain. Pain is experiential. We experience pain now. Not in the past or the future because the past and future only exist in our heads whereas pain exists in our body (space) in the now. In fact, this is the same for any experience. It can only really happen now, otherwise it is being created by our mind. This is the case even if we think about something unpleasant or dangerous that triggers a pain response; that pain response is now (some readers will be aware that imaging movement or watching someone else move can evoke pain in someone who is sensitive to that particular movement).

So, although we can recall that last Wednesday we had pain, we cannot recall the pain itself with any accuracy, but we can remember that it was a difficult day. Thinking about the day and things that we did may evoke a pain response, but you are feeling that now, and not then. What you feel now cannot be said to be the same as what you felt then. We also have further history to add to our timeline between the time we are trying to recall and the time that we are doing the recalling. We are thereby not accounting for the changes that have occurred between times.

We are masters of change. How do you want to be? Who do you want to be? What is your vision for you next week, next month, next year? To create that person, you need to take action now. Because now is the only real moment. Sculpting who you will be has to start in the present moment. In terms of overcoming pain, you work at a realistic vision of who you want to be and what you want to be doing, and the begin training and rehabilitation. This always begins with a thought based upon a belief, which drives big action. All of our thinking emerges from our belief system that has been grooved by all our experiences to date. This is why understanding pain is so important for overcoming the problems.

We create many habits around persisting pain, many of which are protective in nature in both thought and action, and are not actually taking us in the direction of changing pain for the better. Rather they are taking us down a path of change towards further protection. This gets us into trouble because it can look like there is no way out. Often this line of thought has been influenced by what you have been told and now believe. In essence though, consider all the change that has brought you to where you are now, and that is you have changed to get there, you can create conditions for change to go in another direction. Pain has come (a change in state), so why can pain not go (a change in state)?

Change in the direction that you want takes time. Change in the direction that you want takes hard work and dedication. But there’s nothing wrong with hard work and dedication to a better life full of meaning and a sense of wellbeing.

Pain Coach

Call us now to book your first step to overcoming pain with the Pain Coach programme: 07518 445493

Clinics in Harley Street, Chelsea and New Malden.

02Apr/15

My tips for healthy revision

Easter holidays are here! Bunnies, chocolate eggs, Easter bonnets, spring and…..revision. Chatting to my younger patients, they all tell me that this holiday will be dominated by revision. So it is not so much a holiday but instead, 2-3 weeks of homework. Perhaps Easter Sunday will be a day off.

This appears to be the way of school life in the modern world. The demands increase, the pressures increase, the stress and anxiety increase, and the pains increase. Is this right? 1:5 children reporting chronic pain. Chronic pain is the number one global health burden and depression is at number two — and frequently they come as a pair.

Body systems are on alert. They are working hard for survival instead of orchestrating the biology of health. In adults we used to call the effects ‘burn out’. These systems that protect us can only function at that level for a finite period of time.

Of course there is nothing wrong with hard, conscientious work. But, we need to regularly put the heavy bags down and take a break.

If you or your kids are entering the revision season, here are some handy tips for them to reduce the risk of ill-health, persisting stress responses, and flare-ups of existing aches and pains. We not only need to be physically fit, we also need to be emotionally fit. The two are not exclusive but instead come together to form the whole person. The whole person is not in isolation to their environment, beliefs or what has been before. Dwelling on negative events in the past and anticipating an unpleasant future both create suffering, until you realise that both are in our minds. The problem is that we play these out in our body, e.g. tension, pain, anxiety. It is not the situation that is important, but rather how we respond.

There is nothing either good or bad, but thinking makes it so. Shakespeare (Hamlet)

My Tips for Healthy Revision

  1. Make a timetable that incorporates your best time of day for learning, chunks of 40 minutes, exercise, movement.
  2. Motion is lotion: change your posture every 15-20 minutes; stand up and move around every 40 minutes
  3. Take 3 breaths every 20-30 minutes (when you breathe out, muscle tension naturally relaxes, which you will notice if you pay attention). The breaths can be slightly deeper than normal. Of course you can do this for longer and more often if you wish. Focusing on breathing anchors you to the present moment which means that you are putting down the heavy bags of ‘past’ and ‘future’. The bonus is clarity of thought and hence performance, memory and learning can improve as you become more efficient.
  4. Exercise before you start working; e.g. a walk, a jog. And a little more later as well; 20-30 minutes is good.
  5. Test yourself on the material you are learning — many people tell me that they copy their notes out again and again. You will have a nice pile of notes, but how much do you know?

** BONUS tip 1: set up the right environment – your desk space, the lighting, odours (don’t under-estimate the effects of smell; e.g./ use an infuser for a fresh ambience).

** BONUS tip 2: dress for work and sit for work – this will put you in the right mindset. We respond to our body language as much as our body language communicates how we are feeling. Keep moving (motion is lotion) but concentrate and engage more by sitting up.

** BONUS tip 3: make sure you have enough sleep — minimum 8 hours, and if you are tired, have a power nap between 1pm and 3pm for 20-30 minutes. You need to refresh and renew and you need sleep to learn.

Pain CoachFor more information about Pain Coach programmes and wellbeing programmes for health and performance, call us today 07518 445493

23Mar/15

I used thirst to help someone understand pain

I used thirst to help someone understand pain. He had been given the structural explanation for recurring low back pain (trapped nerve that runs all the way to the toes), which naturally leads to a tissue based focus on ways to get better. Whilst this is a common way to describe pain, it is wrong. Pain is a protective response to a perceived threat.

Yes, if a nerve is sensitised by inflammation or injury, it will transmit danger signals to the spinal cord and then the brain. All the while, signals are being sent down from the brain to mingle with these ascending signals, the sum of which will be scrutinised by brain networks to determine whether a threat exists. If there is a threat deemed tangible, then the body will protect itself with pain, altered movement, altered thinking and altered behaviours:

  • it hurts in a location
  • you limp or limit how far you move the painful area
  • you consider how bad it is and whether you can go to the party, game, work etc
  • you don’t go to the party, the game, work etc

This is all very useful at the outset, but becomes less so as time goes on and the body is healing.

Often there is a kindling or priming effect. The first acute painful episode calms down but then recurring bouts of pain become more intense and with less and less time between–familiar? In the first instance, the systems that protect do so effectively, slowing you down and enforcing action to allow healing. This would usually be in response to inflammation, and is all entirely normal whilst being an unpleasant experience. Not nice, but nothing to worry about. Of course, you would be wise to take heed and do everything that you can to fully recover, which means that the tissues heal and the protective systems switch back to normal modus operandi. There is a chance that you will need some guidance.

It appears that there are some people who maybe vulnerable to developing on-going pain, which is on-going protection. There is likely to be a genetic aspect to this, and certainly a prior experience that may have primed the systems so that they kick in more vigorously, or simply do not turn off when they need to. An over-protect or sensitivity. The priming event(s) may happen much earlier in life so that when the body perceives a threat some years later, there is recognition of the need to protect based upon what has been learned before. Detecting this potential vulnerability is really important in the assessment so that the right action can be taken to counter on-going pain.

Back to thirst.

Where do you feel thirst? Think about it for a minute. Where in your body is thirst? It is not a dry mouth; so it is not your mouth (a dry mouth is a dry mouth and that is all). Is it in your stomach or chest? We have a sense of discomfort that can include a dry mouth, and when we note that sense we give it a meaning. That meaning is “I am thirsty’. The point of this is to motivate us to take action and seek water to quench the thirst.

The same happens in pain. We have a feeling or sensation in our body that grabs our attention. This sensation is given a meaning: this hurts, and then we look for a cause, why does this hurt? What have I done? What is going on? What are the implications, now and in the future? Naturally this happens very quickly, in a split second. The pain then motivates us to take action, like thirst. We rub, cry out, seek help.

In both thirst and pain it is the meaning that defines the experience, and whilst we feel things in certain places, it is how we think about them that gives the richness and implication. We therefore have these experiences with our whole body and self. We feel and experience thirst with our whole body, the sensation not distinct from how we then think and act. The same in pain. To se the whole creates marvellous opportunity for change, growth and moving forward. In most cases thirst is easily overcome, chronic pain being far more challenging.

Chronic pain is about on-going perception of threat as body systems adapt, we adapt and the world around us adapts. We are on a continuous timeline of development that we can influence by our knowledge, understanding and use of skills. Understanding your pain is the first step, creating a foundation for overcoming pain.

Pain Coach

Pain Coach courses for clinicians and therapists: a practical way to coach chronic pain sufferers how to overcome their pain; small group learning and 1:1 mentoring. Call us on 07518 445493

20Mar/15

Pain and trauma 

Pain and trauma — The smell of freshly mown grass would be enough to trigger feelings of panic and pain in Clive. He didn’t know that this normally innocuous odour was a cue for protection and re-ignition of memories of a car accident that occurred several years before. This is a classic example of the co-existence of pain and trauma.

Equally in others the cue could be a piece of music, a particular place, a person or a taste. We are multisensory and at the time of a trauma, the context creates a multisensory (molecular) memory that has high emotional valency due to the unpleasantness of the situation. At the time of an incident we may cope but afterwards there can be a trauma response that is when the coping fails and the person becomes ridden with anxiety. The physical dimension of anxiety commonly manifests as tension, discomfort, feelings of unease and pain that can gradually become increasingly widespread. Initially localised to where an injury may have been sustained, often it does not take long for the sensitivity to increase and the pain map widen.

Post-traumatic stress disorder (PTSD) is a relatively well known term and describes how a person continues to experience  the trauma despite that fact that it has passed. They continue to replay the tape and suffer the consequences: pain, tension, anxiety. The simple fact is that when we think about something, if we are embroiled with that thought, we live it out through our entire self: that is the physical feeling, the emotions and the thoughts all emerging as the one experience. The different dimensions are not in isolation to each other but rather integrated into the reality of that moment.

The problem appears to lie with the attempts to numb and avoid the trauma whilst repeatedly re-experiencing the event. This struggle causes great suffering whilst the body pain continues and often amplifies, vigilance to bodily sensations increase and other symptoms can begin to emerge: digestive problems, abdominal pain, headaches, disrupted sleep and concentration.

In essence the body is in protect and survive mode. All resources are being diverted to survival and hence the motor system is on alert ready to fight an opponent/wild animal or to run away (muscle tension, overactive muscles), the immune system is primed for healing initially but then drops off, digestion falters and vigilance is high for threat. With continuous feelings of anxiety, it seems like all life presents to you is dangerous.

Pain associated with PTSD is a good example of the need to think about the whole person and all the inter-related dimensions of pain: physical, emotional and cognitive. It is always about the individual as much as the condition, and the environment in which they reside. For pain to get better, the person must get better.  There are a number of newer approaches based on top-down mechanisms (brain focused), however my belief is that we have an embodied mind. In other words, our (physical) bodies are as much the experience as the thought itself and therefore we must consider this in any treatment programme. Promising techniques may exist in reprogramming memories or learning how to re-interpret thoughts, but where do we feel the sensations? In the body.

Example programme

Foundation:

  • understand pain and symptoms—the biology of pain and stress, what influences pain and stress, what triggers pain and stress, how thoughts and feelings are part of the pain experience, other influences such as tiredness, the environment, beliefs, gender and prior experiences. Setting the scene with modern pain science reduces fear and anxiety as the patient starts to see all the opportunities for change.
  • re-training body sense and normal movement that is commonly affected in pain and PTSD.
  • learn skills to ease muscles tension and over-activity, how to switch from sympathetic to parasympathetic to create the conditions for change, easing out of survival and into well-being in both thought and action.
  • create the vision of where the patient wants to be and plan how that will happen
  • check patient’s language (verbal, body and the ‘internal voice’) and change if necessary

From the foundation the above skills are developed alongside motivation and resilience training, focused attention training for clarity of thought. The patient must be able to problem solve moment to moment and use their skills and techniques independently whilst being fully supported and progressed along, always Molina at moving forward. There may be a need to plan a return to work, return to sports or increasing other limited activities gradually.

Clearly any programme must be individualised and monitored closely alongside treatment given for the purposes of pain relief. I commonly use my hands to desensitise and reduce pain, often teaching the patient how to do this themselves or how to involve their partner.  The notion that hands on therapy does not have a role in dealing with pain is wrong in my view. We need touch for normal healthy development and it plays an important social role. Judicious use of touch therapies can help to develop trust between care giver and recipient and change the processing of signals from the body, also having a top-down effect when explained.

We are complex, pain is complex, pain relief is complex; however this creates many opportunities for change. And our role is to facilitate change, to focus on our own natural ability to create health and wellbeing. We must acknowledge and validate pain, teach patients about their pain but then we must focus on moving on, so the less attention on pain the better. Let’s think about what we can do — the CAN mentality and start changing the largest global health burden. Because we can.

Pain CoachContact us for details about the treatment, training and coaching programmes for pain sufferers and for clinicians wanting to become a Pain Coach (small group training and 1:1 mentoring): call 07518 445493

 

14Mar/15
Pain Coach

Overcoming pain – key skills (1)

Pain CoachOvercoming pain requires us to understand it and have a range of skills that we use moment to moment to change the direction in which we are going. To be able to change gears once we are aware what is happening is vital. Cultivating awareness is the first step, followed by adopting a new behaviour and subsequent change for the better. ABC.

3 steps: 

  • A- Awareness
  • B – Behaviours
  • C – Change

I like ‘threes’, and the ABC above is one that I use to guide individuals from where they are when they arrive to where they want to be. Each encounter (session) that we have will be unique and designed with specific aims using ABC.

We are continuously adapting to our situation, internally and externally. Much of this happens without us really knowing about it in the form of habits. When we have suffered pain for some time, there are a number of protective habits that have been created and whilst these maybe useful with a new injury, they prohibit recovery in time. Identifying these habits and then working hard to create new healthy ones is a key skill.

The world is constantly changing, we are constantly changing and the people around us are constantly changing. We are not in isolation to others and the environment in which we are situated at any given moment, which is why both are so influential. Whilst we are subject to these influences, we can also use them to our advantage and in particular to change the social dimension of pain. One of the most significant features of the social dimension is isolation.

One becomes isolated through withdrawal and avoidance. Isolation is simply not good for health — the way you think and the behaviours that follow. And it worsens with time, so certainly a dimension of the pain problem that must be addressed. Gradual resumption of social activities, similar to gradual increase in physical activities, allows the individual to realise that they are safe to progress. We do not function in isolation to others and the world around us. I think that we define ourselves in relation to others and the environment, for who are we without another?

The moment to moment decision making has to be based upon clear thought. Clear thought emerges from awareness of self, others and the environment — the ‘econiche’ (Edelman) or the concept of emotional intelligence being utterly relevant. ABC it is. Learn these skills and see how you can move forward. The range of training methods and techniques used all base their effectiveness on the ABC.

***

The Pain Coach programme is available at all clinics, addressing all dimensions of pain (physical, emotional and thinking) for the complete way forward to overcome chronic pain. Call us for details: 07518 445493 — Pain Coach website coming soon

 

11Mar/15
Specialist Pain Physio Clinics, London

Toast of Surrey Business Awards

At SpeToast of Surrey Awardscialist Pain Physio Clinics, we are delighted to be shortlisted for Toast of Surrey Business Awards in the Mental Health & Wellbeing category. This is great news because it creates an opportunity to tell Surrey businesses about the problem of pain — the number one global health burden — and what we can do about it.

Many businesses suffer the financial and social consequences of employees being on sick leave for painful problems; back pain, neck pain, repetitive strain injury, injuries sustained at work etc. I believe that understanding pain and communicating about it in the right way leads to return to work for many, instead of the common scenario when the employee and employer reach loggerheads. I welcome the opportunity to show businesses how to deal with these problems effectively and efficiently, which is ultimately by looking after the employee’s welfare and wellbeing from the point that they report pain or injury.

Surrey Clinic at The New Malden Diagnostic Centre. Call 07518 445493

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