When we have suffered pain for some time, the habits we create can become part of the problem, and part of the reason why we are not moving forward. Whilst certain actions that become habitual are useful in the early stages, they only have a role for a finite period of time. Subsequently, other strategies need to be used to develop, learn and move on to overcome pain.
A simple example would be a limp that is useful after an ankle sprain, that is not helpful one year later. In different parts of the body we do different things according to the typical actions that body part would be actually used for as well as intended use. This latter point is relevant because we are continually predicting and planning actions mostly at a subconscious level. We are responding to ten environment we are in, the context of that environment and the tools within that environment that we may use, such as a cup or a pen that the brain plans to pick up on sight if relevant. We don’t always know about this, and interestingly, just the mere plan or intent of doing something can cause pain on the basis that we are in protect mode. The same is true for watching others actions that would be of a high threat value to us. Someone with pain in their back may experience a twinge on observing someone else bending. For clinicians, this offers clues as to the level of protection — bend in front of the patient to see how they feel.
As well as movement based habits that are actually based upon our beliefs about pain, injury, ourselves and the world, we have habits of thought. We automatically think about a situation, someone’s comments and about something we may need to do. These thoughts, if identified with, will impact upon what we choose to do. If I believe that when I move it hurts because I am further injuring myself, I will either not move or will move in a guarded way. In part I will do this on purpose, in part my protective systems (nervous, immune, autonomic) will inlfuence my movement upstream by contacting the sensorimotor areas of my brain. Of course we are not just brain but whole person, so I say this for convenience of the description. We learn quickly at the outset that a particular movement hurts and we may then anticipate this and decide not to move to to tense up and move abnormally. Whilst this is again useful in the early stages when the tissues really need protecting (whilst healing), as time goes on we need to move to get fitter and back to normal life.
These are just a few examples of what happens. In some cases there are cycles of inflammation that trigger an acute flare-up within a persisting problem. Initially it maybe useful to use some of these protective habits, but only in the short-term. Not allowing them to take hold and only using them wisely is key. I like the metaphor that describes a man who is walking through a forest and comes upon a fast moving river. To cross he builds a raft and successfully reaches the other side. Does he still have a need for the raft? Should he hoist the raft onto his shoulders and carry the cumbersome vessel thought the trees? I think not. At each moment we need to think clearly about what is the wisest action.
As I said earlier, and often say, we must address the whole person including their habits of thought and action and how the two entwine. We must explore why protective habits are being used and then develop this thinking into a range of skills that take the person onwards to where it is they envision being. This vision is vital and I work hard with people to create a strong image of what it is they want and how it is they want to be. This becomes their steer and all their thinking, focus and actions are upon attaining this vision. We become what we focus upon and hence we must use our strengths.
For further information about my Pain Coach Programme for overcoming persisting pain, please call 07518 445493