Tag Archives: anxiety

12Nov/17
Overcome stress and pain to live well

The worried world and what we can do

Overcome stress and pain to live well

A recent article by Oliver Burkeman entitled ‘Anxiety bites. How to keep calm when world events are freaking you out’ highlighted the impact of Brexit and Trump upon people’s life perspectives. He states that levels of anxiety and being troubled have gone up, quoting the American Psychological Association as finding 57% of those surveyed to feel stressed by the political climate. There has also been a rise on the UK. We are, it seems, as a society, worrying about life and the future. Are we in a worried world?

We can argue that anxiety, like all perceptions, are inferred states as we try to make sense of the possible and most likely causes of the sensory information. After all, we are a bag of chemicals, and depending upon where they are and what they are doing, our brain has to make a best guess as to what they could mean based upon what we already know (priors). It is interesting that the ‘feeling’, the ‘what it is like’ of anxiety is similar to excitement. The key is the interpretation and what you tell yourself: I am excited or I am anxious. Try it.

Burkeman raises some good points. He mentions the contagion of anxiety as we are tacitly capable of sharing our emotions with others whereby both you and I feel anxious together despite being distinct organisms. Consider how quickly the atmosphere changes in an office or the mood of a football crowd. We are supposed to do something about the problems we perceive, but what should that action be? A feeling of outrage, powerlessness, isolation, and despair can prevail when we become over-focused on problems. This is some protective biology at play that results in us drifting into that state and maintaining it by continuing to attend to certain thought patterns. Burkeman also picks up on the notion of fear, with one of the therapists he interviewed mentioning the deep rooted and basic fear in life that stems from childhood. Without the safety of reliable parents, a child is destined to fend for herself, making the world appear to be a very dangerous place. Of course this can be hugely amplified if suffering or having suffered abuse when the protect systems are deeply provoked and remain active.

This is a serious issue. We have progressed remarkably as a species and the momentum is building, yet we appear to be falling behind when it comes to the so-called mental health. Regular readers and followers will know that I have an issue with this term, which I feel implies a dualist approach to the human experience. Experience is embodied (Varela et al. 2017). Everything we think and do is embodied, meaning that suffering depression and anxiety, the common and increasing problems previously identified, emerge in the bodily self. Where do you feel anxious? Most people will say in their stomach or chest.

Consistently being in a state of protect has health consequences as our resources divert towards defence rather than nourishment. This in turn raises the chance that the person will suffer a plethora of conditions, including those of an inflammatory and auto-immune nature. In my view a serious consideration for society (and policy makers), this is likely one of the reasons for the uptick in chronic pain, remembering that pain is also a mode of defence inferred from the existing circumstances.

what can we do?

This all seems a bit grim as we quickly forget the possibilities in life and the beauty that we are surrounded by in nature and human beings. So what can we do? Certainly knowing what we can control and focusing upon this rather than what we cannot control is a good start point together with a picture of what we actually want. This is the basic model of success. In terms of chronic pain, this is the first step we take when addressing the problem(s) before coming up with the principles to follow in order to achieve wins and overcome pain.

Here are a few simple tips, beginning with the creation of inner calm. Why is this so important? Because it gives us a perspective, making contact with our reality, allowing us to see things for what they are instead of being caught up in emotions that are the fabric of thoughts past and future. We learn to sense that inner calm, a feeling in the body akin to a deep peace and knowing. I would argue that this is a natural state, and one we can learn to access routinely each day, through the day, as well as when we need to be calm, clear and to see things as they really are. Biologically speaking, when we know and live this calmness, we are in parasympathetic mode, the branch of the autonomic nervous system that nourishes us.

Two simple ways to create inner calm: (1) take 3 breaths and slowly breathe out, paying attention to the breathe all the way in and all the way out. (2) take 10 breaths, following your breathing from the entry into your nose or mouth into your body and then letting go naturally, not trying to control or change your breathing at all. Note how you feel.

Further practices that can be integrated and implelemented into daily living include the practice of gratitude (Mccullough et al. 2002) and acts of generosity or kindness (Layous et al. 2014). Both are now known to be distinctly healthy and easily practiced each day, much like learning a musical instrument. We are not only considering the healthy effects, but also buffering against life’s challenges and the approach that the person takes to life–how do you do life? Possibility our problem?

Two easy ways to practice gratitude and generosity: (1) each day write down 5 things that you are grateful for in your life. (2) choosing to do something for someone else, including people you do not know, such as giving up your seat or letting someone go first. There are many opportunities through the day, however we must be aware and take note of how we feel, noticing the positive emotions as they arise. The more we notice, the more we notice, establishing the build and broaden effect (Kok et al. 2013).

Despite the world events and those closer to us in our days to day lives, it is our perception that is key–my own unique interpretation. As Shakespeare wrote: ‘there is nothing either good or bad but thinking makes it so’. These words highlight the importance of how you choose to approach life and the situations within your life. The practice of daily skills such as those outlined above are simple habits we can create to develop our thinking and our style of ‘doing’ life. Like other habits they become part of what we do with greater and greater ease, building our wellness that does not simple happen without effort and persistence.


The skills of being well are an intrical part of The Pain Coach Programme that is not only about overcoming pain, but living well, the best you can.

 

05May/17

Exams, stress and pain tips

Exams, stress and pain tips
Exams, stress and pain tips

Exam exhaustion | Felix Neumann

Exams, stress and pain tips ~ It is that time of year again when kids are preparing for their exams. With the emphasis on high grades reflecting success, the pressure on youth has increased. There is the sense that if they do not achieve all those ‘A’ grades, then somehow they are a failure. What a terribly damaging way to go about it, and indeed one of the major influences upon kids health. Levels of pain, anxiety and depression are on the rise. Social media also has a part to play, not the channels themselves per se but the way in which it is used and relied upon as a source of temporary reward ~ ‘likes’ etc. We can and must change this as a society.

One of the most respected and successful sports coaches of all time, John Wooden, made the key point that each person should be focusing upon what they can control and to do their very best. If your attentions are on doing your very best, you will be successful, for you. If you thinking drifts towards the grade ‘you must’ achieve, then your focus is not on doing your best, it is on the grade. Re-focus on doing your very best: maximum effort. Besides, if you are focusing on and doing your best, there is no worry or anxiety because you are doing. Those feelings only appear when we are thinking about being somewhere else, whilst embodying the feelings and hence suffering. That somewhere else is the past or future, and neither exist.

We can realise that this is not necessary as we learn to make other choices. Ask yourself: How am I choosing to feel? Could you choose to think about the situation in another way and feel better or good? Yes you can. Try it and see!

Read hereJohn Wooden ~ Wooden: A Lifetime of Observations and Reflections On and Off the Court
Choice

You could choose to think about something in life you face as a problem, that it is difficult, perhaps impossible or that your efforts are doomed to failure. How are you likely to feel? Or, you could choose to view the situation as a challenge, an opportunity to learn something and seek to find and practice ways to overcome the challenge. How would this feel? Very different. We feel better when we have understanding and a plan that we action because we are actually doing, and this includes writing a new inner dialogue or script. How are you pre-empting or expecting things to go? How often do they actually turn out that way? Well if so, why not water the seeds of positivity rather than anticipate the worst outcome or a miserable outcome? Re-frame your thinking that is always embodied, i.e. we experience our thoughts with our whole self including our bodies — where do you feel the feelings that you label as anxiety? They are remarkably similar to the feelings of excitement but which label are you choosing? Choose another and see what happens.

Here are some exercises from Mike Pegg on Positive Scripting: click here
The inner dialogue

What are you telling yourself? Are you listening? The two are different. You cannot stop thoughts popping in but you can choose what you do with them. The practice of mindfulness is a way of achieving this as you are aware and open to the different thoughts, feelings and emotions as they pass through rather than become embroiled.

Self-confidence relies upon the inner dialogue. No matter what you have achieved before, what you are telling yourself and listening to now is what determines your confidence. Create a positive script about what you can do and what you can control: my own thoughts, my own actions, where I focus, doing my best.

Developing insight into your own mind creates the opportunity to choose your direction. We are always changing, but which way do you want to go?

Some great reading on how to communicate with yourself and others: Thich Nhat Hanh
Movement and posturing

Movement and exercise are healthy. During periods of revision we need to move to nourish the body but also our thinking — the two are NOT separate but parts of you. Changing position, using some exercises, walking, jogging and other activities punctuated through the day help to keep the focus. Some exercise in the morning before starting, changing posture and position every 30 minutes or so and having a good break every 45-60 minutes can help to keep a certain freshness and concentration.

This is about performance and to perform we need to focus in the present moment. Refresh and renew then, are key ingredients.

Recharging and sleep

You need good sleep patterns for healthy functioning. Make sure you have a routine that you stick to through the exam period. Many important healthy activities occur during sleep, including a kind of physiological cleaning in the brain. When this does not happen we can feel groggy and moody the next day.

If you are tired, focus on mantras such as ‘I need energy’ rather than ‘I am tired’. We notice what is on our agenda and therefore by telling yourself that you need energy, you’ll be orientated towards this as a goal: regular healthy snacks, fresh air, movement, mindful practice, periods of relaxation.

Through the day we need to plug in. Refreshing yourself allows you to focus well for bursts of time.

Pain and stress are body (whole person) states due to a perceived threat

People come to see me because thus far they have not been able to recover from their pain problem. This is inherently stressful, which adds to the biological and behavioural mix resulting in on-going states of protect.

~ pain and injury are poorly related and are definitely not the same

Pain is about protection and not a precise guide for tissue health or state. This is the common misunderstanding that leads to ineffective treatments. Pain and injury are not well related and they are definitely not the same. Pain is a unique perception emerging in the person and belonging to the person. This is one of many we experience but it is a dominant feeling, as it should be, to motivate action in line with getting better.

Persistent pain involves many adaptations that include those in the brain (emotional, reward and emotional centres in particular), the way we perceive the world and ourselves, the way we make decisions, behave and the way we act. The world appears to be far more dangerous than it really is and the rating of threat is applied in normal circumstances, just in case. For example, sitting is not dangerous yet it is often associated with back pain. The body systems in weighing up the evidence and based on prior experience, deem sitting in a chair to be actually or potentially dangerous. It is the result of the weight of this evidence that manifests as pain in the area of the body deemed to need protection and awareness.

Overcoming pain is about changing this weighting of evidence by taking new actions (habits) based upon new thinking (understand your pain), beliefs and expectations.

During exam times there is usually a change in routine. More sitting, less exercise, and potentially more stress depending upon how the individual views the situation. For optimising performance, this must be addressed whether there is pre-existing pain or not.

It is common for pain to increase during times of stress and pressure. This is not because the tissue state changes greatly but instead the perception of threat is raised and hence protection more likely. We can also tend to anticipate certain relationships. For example: ‘sitting will hurt’, which can become a predominant thought pattern unless we work to create a new way forward. We are always changing, it is a matter of which way you choose to go.

Simple practices during exam times can make a significant difference. Starting with understanding your pain, you can choose to use the strategies mentioned previously that include regular movement, appropriate exercise, practicing a positive script, refreshing & renewing, together with mindful practices (that actually enable many of the others), deep relaxation, imagery and visualisation. Making a plan of which to use and when through the revision and exam timetable can make all the difference.

Pain Coach and Wellness Coach ~ to overcome life’s challenges, live well and perform

For appointments or enquires about Pain Coach Mentoring and speaking events, call Jo on 07518 445493
15Mar/17

Values mismatch

Listening to peoples’ stories for over 20 years, one picks up on the important themes that consistently arise. These are the areas that need addressing as part of a full programme to overcome chronic pain. One such theme is the values mismatch.

Values mismatch

Put simply, a values mismatch is when our deepest held beliefs about ourselves and the world are at odds with the value system in which you find yourself. Arguably the most common context for a values mismatch is when the individual’s values do not fit with those of the workplace. A further example can be when a person’s values evolve so that a difference exists between the new values and those held by the family or close network.

As an illustration, trust is the value at odds. With trust being of inherent importance to the person, when the work environment is driven by high levels of competitiveness, the so-called dog eat dog culture, underhand methods can be rife and accepted by the company. This fear based approach causes great suffering. Continuously looking over one’s shoulder is unhealthy and unsustainable. For the person who holds the value of trust to be dear, this can drive a more consistent state of protect. Further to this is the impact upon health and the sense of well-being.

Values mismatch and suffering

The mismatch can affect us deeply as we either try to fit in or somehow rebel against the culture. Both require effort. Add this to the energy cost of being in a sustained state of survival, and one can begin to see how health can be affected. How many people who suffer burnout would tell you that they hated their work? Scratch beneath the surface and you usually discover that it started well. With time they became ground down by the demands, the attitudes and behaviours. We are not separate from the environment, nor the other people who we are surrounded by, and hence the ‘toxic’ place affects our health. Even just thinking about the place or certain people there cause a feeling of discomfort or anxiety.

When we are in survive mode for sustained periods of time it potentially affects many body systems. The systems that protect us are looking out for danger and the feel of our body and self is just that. We feel on edge, uncomfortable, tense, anxious and this tells us that threats are about. They may or may not be, yet this is what we feel. Our body is saying there is danger when in fact there is no actual threat. The systems work on a just in case basis. With protect state ‘on’ consistently, everything appears to be dangerous. Now, every little prompt or cue stokes the fire: watching the news, reading social media, the look someone gives you etc. How you consciously interpret these things and how your body systems alert you has changed.

“Our body is saying that there is danger when there is no actual threat. This is a habit that can change

The common manifestations in terms of health include chronic pain, fibromyalgia, fatigue, poor sleep, irritable bowel syndrome, headaches, migraines, struggling to recover from an illness or injury, jaw pain, anxiety, depression, poor concentration and memory, feelings of isolation and despair, and a great deal of suffering.

This does not need to continue. You can change course by understanding why this has happened, addressing the reasons and creating a new way forward. We are designed to learn and change, and with a new moments continuously unfolding, we have enormous potential to succeed with the right thinking and right actions. Writing down our values helps to clarify what is important to us. From there we can see how any mismatch maybe affecting us. Then we can seek to understand how we can best go about achieving alignment with our values. This would form part of a programme of training, coaching and treatment so that you can achieve your best by focusing on your strengths.

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Pain Coach Programme to achieve your best | t. 07518 445493

 

 

 

21Sep/15

Vulvodynia

VulvodyniaVulvodynia is a painful condition, often exquisitely so, located in the vulva, which is the skin surrounding the vagina. Usually unexplained, this troubling condition can arise seemingly from nowhere, interfere with intimate relations and hence attempts to conceive. Vulvodynia is also known as a functional pain syndrome–these are painful problems that lack a pathology of note that explains the extent of the pain and include irritable bowel syndrome, fibromyalgia, TMJ dysfunction, migraine and pelvic pain. Functional pain syndromes are often concurrent with hypermobility, anxiety and depression, a further common character trait being perfectionism and a tendency for the person to be hard on themselves thereby creating a cycle of chronic stress.

The pain of vulvodynia is often very localised and triggered by direct contact. Naturally this occurs during sex and touch, but sometimes sitting position can bring on the pain. As with any sensitisation, there is a primary location of pain but there can also be a secondary area surrounding that is due to central nervous system (and other systems) involvement. Suspected vulvodynia or other pains in the pelvis should be assessed and examined by a gynaecologist as a first step before beginning treatment, and by a consultant who knows and understands both the condition and the impact — Miss Deborah Boyle at 132 Harley Street.

With vulvodynia often being part of an overall picture of sensitivity, it means that there is a common biological adaptation that is upstream of the range of seemingly different conditions (the functional pain syndromes). As soon as the individual understands that pain is not an accurate indicator if tissue damage, but rather a reflection of the perceived threat and prioritisation by the body-person, there is a realisation that the pain can change. Pain can change because perceptions can change as we take on board new information and consequently think and act differently, creating new habits. The new habits set the conditions for on-going and sustained change that includes overcoming pain.

We have limited attention and hence can only be aware of certain amount of stimuli in any given moment. If pain is consuming much or all of your attention and consciousness, then this is all that is happening in that moment, with all other possible experiences being disregarded–it is a matter of prioritisation. When the perception of threat is reduced by a constructive thought or action, the pain moves out of our attention span and we become aware of other thoughts, feelings and experiences. How we respond to pain is unique and learned through our lifetime right up until that point; all those bumps and bruises as a child, how our parents reacted, more serious injuries or illnesses and the messages we received from doctors, teachers and other ‘big people’, then through adult life, moulding our beliefs about ourselves, the world, health and pain each time we feel it. The sum of all this activity, most of which we are unaware of, sets up how you respond to the next ache, pain or injury, blended of course with genetics. It seems that some people are genetically set up to be more inflammatory, meaning that responses to injury are potentially more vigorous and go on for longer. Understanding this means that the right messages and treatment can be given, thereby appropriately addressing the injury or pain. One of the big problems is that this does not happen, and the explanations are structural and based upon the body tissues. This ignores the fact that we have body systems that protect and these systems have sampling mechanisms in the tissues and organs but largely exist elsewhere–e.g./ nervous system, autonomic nervous system, endocrine system, sensorimotor system, immune system. We have to go upstream as well as improve the health and mobility of the local tissues.

Going upstream is vital in overcoming vulvodynia, and this is where the Pain Coach Programme works–this is my part of the treatment programme. You may also choose to work with a women’s health physiotherapist who will work more locally. So what is the Pain Coach Programme?

The Pain Coach Programme is a a blend of the latest neuroscience of pain with a strengths based coaching approach to success. Understanding your pain and that you have the biology and strengths to overcome your pain is a vital start point. You have been successful in the past using these strengths, and you can do so again by drawing on these characteristics and using them to develop your health in terms of how you think and act. Overcoming pain is all about resuming a meaningful life, engaging with activities and people as you want to, in a way that allows you to flourish. The Pain Coach Programme provides you with the knowledge and skills that you need to in effect become your own coach, moment to moment making clear decisions that take you towards your vision of how you want to live. This alongside treatment and specific training to develop normal movement and a healthy body-mind. The skills you learn also help you to fully engage in life, whether this be at home, at work or at play.

If you suffer vulvodynia or other painful problems, call us now to start your programme: 07518 445493

08Apr/14

The habitat — multisensory memories

Running in the woods today I was taken back to school days when we would go down to the habitat to learn about nature. Our enthusiastic science teacher, whose laboratory experiments would invariably go wrong, led us down the hill, across the playing fields and into a small wooded area that surrounded a murky pond. This was safer than a bunsen burner, and I do not recall anyone ever falling into the water.

In the habitat we would collect data on flowers, plants and insects. In particular I recall that we should note down the irritability of insects, in other words, how reactive they were to a stimulus — the stimulus being a group of excited kids. Generally they flew away; the insects.

My point here is that whilst running I was taken back by the context of where I was, especially the smell of wild mustard. It was this olfactory experience that evoked a clear memory of the habitat, most likely helped by the fact that I was in a wood.

Recently I was talking to a patient about an experience that he had when visiting a hospital where he had been in ITU. On entering the building and walking the corridors, he was hit with a storm of emotions and memories that triggered a need to escape. He did not understand why this happened.

We are unaware of the vast majority of the things going on around us. Our brain filters and draws our attention to what is important right now. We can only focus on a limited amount of data otherwise it would be impossible to function. You may now be thinking about your right butt cheek, but probably not before I mentioned it. And whatever you do, do not think about a white elephant…

The brain stores memories that can be retrieved when it thinks that a reminder is useful. In the case of re-entering the hospital, although the feelings of panic are unpleasant, it is a useful set of responses to a threatening environment as this is where the brain recorded the events in the first instance. Knowing that this is a normal response allows for control to be re-gained. Not understanding often kick starts further thinking that evokes further protection via the autonomic nervous system — increased heart rate, dilated pupils, sweating etc. This demonstrates the importance of understanding our biology.

In chronic pain the same mechanisms are on alert. As we are multisensory, any of the senses can evoke a protective response. Sounds, smells, touch, taste and sights can all evoke emotional and physical responses. Think of that song, the one that perks you up or brings you down. It is a song, yet it is the meaning that you give to the song that determines how you respond.

Pain being an output from the individual, from the brain, in response to a perceived threat is no different. The more protective the systems, the wider the range of cues that can trigger a pain and stress response. This is equally true in anxiety. Our individual interpretation of a situation or a thought effects the response. We notice butterflies in the stomach (a change in blood flow through the gut) and know that we are anxious before realising what is making us feel anxious; or we have a thought and this leads to feelings of anxiety. It is bi-directional.

From a survival perspective, the brain registering information from all the senses during an experience is useful. Learning is vital. The next time we are in that situation, or one that is similar, the brain will use prior experience to work out if a threat exists, or a potential threat. On concluding that there is something dangerous going on, or about to happen, the brain will initiate protective responses that drive protective behaviours. Whilst this is entirely appropriate in acute pain, on going protection is a problem in chronic pain. Pain is always a normal response to what the brain thinks is going on, but in persisting pain it is often the underlying processes in the nervous and immune systems that are problematic and need targeting for effective treatment.

Memories play a fundamental in how we live and learn. We can actively search our archive but often reminders seemingly just pop into the mind’s eye. There will always be a reason why your brain thinks this is useful but that may not be immediately obvious.

RS

Specialist Pain Physio Clinics, London — for chronic pain and complex pain — 07932 689081

08Mar/14

Want to feel happier, suffer less pain & anxiety, think more clearly?

Mindfulness for pain, health and performance

Mindfulness for pain, health and performance

Mindfulness programme

The brief practice of mindfulness for just 10 minutes each day has a positive affect upon physical and psychological health.

Mindful practice forms part of our treatment and proactive training programmes for chronic pain and health problems. However, learning the practice is beneficial for anyone who wishes to reduce feelings of tension, anxiety and stress; improve sleep, concentration and clarity of thought; and overall have a healthier and happier experience of life.

Mindfulness itself is very simple and practical. Much like we train our body in the gym to be fitter and stronger, mindfulness trains our ability to be aware of what is happening in the present moment, and without judgement.

How much time do you spend on autopilot? How much time do you spend noticing what is going on right now as opposed to dwelling on the past or constructing a future in your mind? Does the past or future make you feel bad or anxious? Do you relive scenarios that make you feel unhappy? The problem is that the brain does not distinguish between what is happening in reality and what is happening in our mind. The body still responds, often by protecting itself using different systems in the body such as the nervous system, the immune system and autonomic nervous system (‘fright or flight’). Gaining insight into the mechanisms and becoming skilled at being present not only creates time, but also disarms the effects of drifting into the past or the future.

Enhancing the potency of mindfulness

Alongside the practice of mindfulness, a simple exercise habit that includes strategies at work will create the conditions for the body systems to cultivate health. A rounded programme of physical and mental training that interlaces with normal living improves performance, sleep, clarity of thought, sense of self, social interactions and immune responses. These factors are related and positively affect each other once healthy habits are learned.

Call us now to book your first mindfulness session: 07932 689081

The Specialist Pain Physio Clinics in London – expert treatment and training to tackle the problem of chronic pain and injury.

30Jan/14

5 reasons why mindfulness is part of our treatment programmes

1. Mindfulness reduces suffering: pain, anxiety, tension.

2. Mindfulness promotes clarity of thought.

3. Mindfulness develops a sense of calm.

4. Mindfulness creates an ability to focus ones attention where you want to, and not in response to the wandering mind.

5. Mindfulness changes physiology, triggering restorative processes: e.g./ healing, digestion, sleep, anti-inflammatory action.

For pain, stress, anxiety, performance, concentration, call us to make an appointment: 07932 689081

14Jan/14

Are you turned on?

At the risk of sounding ambiguous, many people are turned on. In particular, city dwellers and workers who are being hit with innumerable stimuli, bombarding the senses, triggering on-going responses by the brain, the mind and the body. Whether it be the noise of the traffic, the lights at night, the phantom vibrations of the phone, pollution or close-quarter travel on the train, outputs are being generated by the nervous system, the immune system and the endocrine system that are experienced as thoughts, feelings and physical sensations, some being pleasant, others not so.

Once a chronic state of arousal has been reached, the on-going energy demands can eventually result in burn-out or a gradual state of declining physical and mental health — the two being inextricably linked.

How does this manifest?

The all-too common conditions that we see include general body-wide muscular aches and pains, headaches and migraines, irritable bowel syndrome (IBS), anxiety, indigestion, pelvic pain, fertility issues. The thread that ties these seemingly unrelated problems is stress. Stress however, is a physiological response to a situation that is perceived to be threatening. Two people can give entirely different meanings to a particular scenario, thereby having diverse experiences — it is all about an individual’s perception. Our perception is based upon beliefs about the world, sculpted over the years by exposure and influences.

The biological response to threat involves the autonomic nervous system and the motor system at least, preparing to either flee from the danger or confront the situation. An incredible set of responses, they evolved from the need to deal with wild animals. Fortunately this does not happen too often these days, but there are plenty of potential threats including the thoughts that pass through our mind. The brain does not differentiate between a thought and actually being present. The response is similar and usually thinking about something unpleasant that may happen will lead to feelings of anxiety — tingling in the tummy, tension, increased pain.

If these systems are persistently triggered by stress, there is less opportunity for smooth digestion, conception, healing and clarity. Being chronically turned on hence results in digestive issues, sensitivity of the bowel (bloating, pain etc), difficulty conceiving (thoughts of sex and conceiving are not going to be high on the brain’s agenda if there is a constant perception of danger) and pain that results from gradual changes in the tissues. In fact, every body system is impacted upon by the chemicals released during an on-going stress response. And not in a good way. Performance is affected, mood varies, sleep is disrupted, concentration is poor, catastrophising becomes rife and negative thinking about life predominates.

How do we turn off?

Relaxation or having the ability to switch off is often a skill that requires learning and practice. Going to the gym, having a cigarette or a coffee is not turning off. These are all stimulating a system that is already fraught. It is the calming, restorative, digestive and healing mechanisms that need to be fortified.

Promoting calm in a habitual way across the day is a potent way of re-programming the right responses for the right scenarios. Checking in on the body and thought processes, attending to the present moment rather than automatically drifting into the past or future, avoiding stimulation (e.g./ electronic screens, coffee, cigarettes, sugary foods and drink, certain reading material), mindful practice, breathing techniques and cultivating focused attention are all ways in which we can build our positive bank account in terms of energy and feeling good. Creating good habits. Exercise although stimulating, and certainly in a gym with bright lights and loud music, should form part of a routine for the overall healthy benefits. It is the best wonder drug that we know of and it is free.

Changing behaviours is difficult but it is achievable with the right programme that addresses both body and mind. Cultivating a routine around sleep, movement, diet, exercise, mindfulness, work and family will groove a healthy, resilient, positive and happy path forward. Turn off.

08Jan/14

Too many cases of “I can’t” — the effects of persisting pain

Frequently patients tell me at the first meeting that they cannot do x, y and z. Naturally, when something hurts we avoid that activity or action because pain is unpleasant. It hurts physically and mentally. In the acute stages of an injury or condition, it is wise to be protective as this is a key time for the tissues to heal, and although some movement is important for this process, too much can be disruptive. As time goes on, gradually re-engaging with normal and desirable activities restores day to day living. However, in some cases, in the early stages of pain and injury, the protection in terms of the thinking about the pain and subsequent behaviours becomes such that they persist beyond a useful time. The longer that this continues, the harder it becomes to break the habits.

Don’t feed the brain with “I can’t”, feed it with “I can” — cultivate the natural goal seeking and creative mechanisms of the brain

The vast majority of patients who come to the clinic have had their pain for months or years. I would like to have seen them earlier so as to break the habits of thought and action that are preventing forward movement. As a result of the longevity and severity of the pain, the impact factors, distress and suffering, a blend of experiences, expectations and thinking about the problem, it is common to slip gradually into a range of avoidances that are strongly linked with thoughts that “I can’t do …. or …..”. These thoughts may have been fuelled by messages from care providers.

As a general statement, most activities that someone avoids because they fear that it will be damaging or painful can be approached with specific strategies that address both the thinking about the activity and the actual task itself. Recalling that pain is a protective device, an emergent experience within the body in an area that is perceived to be under threat and requiring defence, by diminishing the threat we can change the pain. And there are many ways of doing this on an individual basis — as pain is an individual experience with unique features for that person.

One of the main aims of our contemporary approach is to ensure that the individual understands their pain and problem so that the fear and threat value dissolves away. This leaves a more confident person willing to engage in training that promotes normal activities and re-engagement with desired pass-times.

01Jan/14

Mindfulness programme

Mindfulness commonly forms part of a comprehensive treatment and training programme for pain, anxiety and stress. The origins of the practice stem from many years ago but in a modern sense, mindfulness is mind training that is akin to physical training used to improve fitness. A great deal of time is dedicated to physical activity for health, less so on the mental side, however the two are inextricably entwined. For one you simply need the other, and to combine the training is the most potent way of cultivating the conditions for healthy living or recovery from pain and injury.

The modern day use of mindfulness is to create health, foster clarity of thought, increase awareness of thoughts and actions for self-improvement and to reduce stress, anxiety and pain that occurs as a consequence of simple practices. Mindfulness is not steeped in religion, but is a philosophical framework to attain a more fulfilling existence.

See Vietnemese Buddhist monk Thich Nhat Hanh speaking here 

A programme of mindfulness activities, followed week by week over a period of 8-10 weeks is an excellent way to groove the habit. It is a learning process that increasingly develops awareness in order to make the necessary changes to promote health. Many activities and thought processes are automatic or habitual, but do not point us towards a positive, fulfilling existence. To change this situation requires practice, in essence to re-wire the way we are working via the characteristic neuroplasticity, a feature of the nervous system that underpins learning and adaptation.

Over the 8-10 weeks the practice of a variety of mindfulness activities creates a healthy habit. Several daily sessions of 12-20 minutes focused training is the goal. In addition, forming a routine of performing tasks in a mindful way is a powerful way of regularly enrich awareness; this is simply by paying attention to a normal activity such as cleaning, making a drink or walking. Attend to the sounds, the feel, the aroma and physical sensations thereby standing in the present moment rather than drifting automatically into the past or building a future.

Typically over the period of training, the practice of mindful breathing to cultivate awareness of the effects of thoughts upon the body and vice versa, the body scan to regain a sense of the physical body and how it constantly changes and responds, mindful movements that combines awareness with comfortable motions that nourish the body tissues, working with the pain and suffering and developing compassion towards oneself and others.

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