Tag Archives: chronic pain

14Oct/17
Pain is a very human experience

Pain is a very human experience

Pain is a very human experience

Pain is a very human experience

It is easy to take being human for granted. It is what and who we are but it is also why and how we ‘do’ life. We do it in a very human way, which is somewhat unique to each of us, yet there are patterns.

Part of being human is being conscious. Now, we don’t have to be conscious to be human, but we do have to be conscious to be having the experience of being human. We have many, many experiences, and one of the commonest is pain. There are a few exceptions, but on the whole most people will experience some pain each day. Many people will experience a lot of pain each day. This can be to the point that they feel it is continuous.

Despite pain being embodied, it is somewhat elusive. It is as complex as we are, because it is part of who we are and how we survive. To say that pain is embodied means that we experience it in our body, for where else could it happen? There has been a huge focus on the brain in recent years and this continues. However, pain is not ‘in my brain’ as some people believe and say, instead it is emergent in me, and I am a whole unique person (WUP).

What is the purpose of pain?

Despite the complexity of pain in terms of biology and experience that together are a lived experience known only to the individual, there are simple reasons why we feel it. There is also the way that we do pain. This is our style and it typically resembles the style with which I ‘do’ my life. My life-style is the approach I take to life. This incorporates the way I face challenges and address my needs.

We are aware of our needs implicitly by the way we feel and the sensations we experience. These are our need states and we must attend to them to maintain homeostasis. Failing to do so results in a shift into a protect state. Basic need states include hunger, thirst, the urge for toileting and pain. When our basic needs are taken care of we can focus on what we are doing.

Of course there is a prioritising system, so if I am thirsty but a pack of hounds are chasing me, it would not be wise to stop for a drink. Also, we don’t always get it right and so needs may not be apparent or we may feel a need but not actually require any more. An example of the latter would be food when you may have the feeling of hunger, yet you have actually eaten enough.

Similarly with pain as a human need state, when this becomes a more persistent state, we can argue that the emergent experience does not fully represent the need. I would suggest that when someone is suffering chronic pain, this is normal and what is an experience that compels thinking and action to address certain factors in one’s life. However, the frequency, intensity and intrusion is not representative of the threat. Instead, it is a summating nagging that can become extremely intense at times as the evidence continues to suggest that something dangerous could, or is happening. This is basic biology at play, maintaining our survival.

Continuously we appraise our circumstances, our brains predicting what could be the best explanation for the sensory signals. This is what we experience consciously as the world around us as well as ourselves in the midst of this most vivid film. We are the actor, the director and the pundit all together somehow. There can be a flitting from one to the next but never wholly one nor tother.

Perfection is what you are striving for, but perfection is an impossibility

As well, we can often be the most critical of each, seeking the perfect performance, which of course rarely of ever exists. As John Wooden said, arguably the most successful coach ever and a wholly decent and insightful man, “Perfection is what you are striving for, but perfection is an impossibility. However, striving for perfection is not an impossibility. Do the best you can under the conditions that exist. That is what counts”.

Pain and the way we experience it, what we do with it, how we acknowledge it as part of us like any other experience or anatomical part makes us the very human that we are. Love and how we ‘do’ it is another fine example of a conscious experience that is so very human. The repertoire of descriptions, responses, narratives, poems, paintings and expressions pays homage to something that we need not fear, only address. For that is the purpose of pain.

How we address pain, how we approach something that is not just a feeling but an action and cognition, is as part of the experience as the experience itself. There is no separation. When people try to distance themselves from ‘it’, or fight ‘it’ or resist ‘it’, they only try to do this to pain with themselves. We cannot successfully fight ourselves. Instead, accepting and understanding the need state before taking action that proves our own safety. We have to actively generate that prediction, or actively infer by new understanding and new actions within a world that we, as Anil Seth describes ‘predict into existence’.

Let us never forget that we have remarkable potential because we are human. We can choose our approach to life once we have become aware of our existing style. If it does not work, if it does not bring health and happiness, you can choose another. And like anything that is important, we have to practice and take steps and learn along the way. This is what we are doing each moment as it unfolds and we are re-sculpting ourselves to make sense of the world and ourselves, where the two are interconnected. So why not feel a sense of control and practice skills of being well, each day, every day. This you can choose to do.

07Oct/17
Royal Parks 1/2 Marathon

Why I run

Royal Parks 1/2 Marathon

Team shirts for Royal Parks 1/2 Marathon

Why I run

Recently I was chatting to a good friend who asked me why I run. I had to pause and think because naturally I don’t class myself as a runner. Instead, I am someone who goes running.

Whether I am a runner or not is not particularly important, however the purpose is. I used to go out regularly just to keep fit. 30-40 minutes would suffice, I would feel pretty good afterwards, but it was often a bind beforehand. Then the Royal Parks 1/2 Marathon 2016 was on the agenda so I had to get a bit more serious. Somehow it became more enjoyable. There was a goal and a reason. The reason was to raise awareness of the problem of chronic pain and to raise money for UP, understand pain.

Purpose and mine as an example

Having a purpose or a meaning is known to be a key ingredient for a healthy and happy life. You may or may not know what it is, so it’s a great idea to write it out. We all have a calling, or as Seth Godin says, a ‘caring’. We can have a number of these in relation to family, work and other activities in life.

My purpose, which you could also call my ‘why’ in Simon Sinek’s language, is to inspire as many people as I can, to live well and overcome pain. This is by directly working and coaching with people who suffer chronic pain to date, and delivering The Pain Coach Workshops to clinicians and therapists who choose to become inspirers, educators, enablers and encouragers.

Here is Richard Leider on purpose ~ TEDX talk

UP & CRPS UK London Marathon

Next came the opportunity to run the London Marathon 2017. I was selected to represent CRPS UK, joining together with UP, and realised the excitement of taking part in an incredible day. The experience of preparing for a marathon was something I can now look back upon with pride. Somehow you manage to fit in the regular and long runs. Undoubtedly this required the support of the people close by. The 20 mile plus efforts would consume a Saturday with the recovery on return usually consisting of walking like John Wayne accompanied by much grunting and groaning until the next day.

What has running done for me?

There have been a number of effects of long distance running beyond the obvious fitness. At a time when I was driving understand pain onwards, the regular and intense exercising helped me to focus. In part this was from organising my time, prioritising and concentrating on completing tasks. There was no choice, because I had to fit in the long runs, but now this has become a habit. We have finite time and so wise use is important to me.

The ability to focus comes into its own when you are some miles into the run and your thinking turns to stopping, the pain, and plenty of other reasons why continuing is a bad idea. To keep going and ‘just run’ as my good (running) friend advised me was gold. You can and do just keep going, suddenly inspired by something you choose to turn your attention to, fortifying the attitude I describe below, which we can take into other arenas of life.

The most significant opportunity was building upon the ‘you can’ approach to life. Building up the miles with an attitude of ‘I can do this’, keeping my attention on a picture of success that I clarified from the start and following principles that take me in that direction resulted in completing the marathon. Looking back now, this was a mindset that pervaded the UP ethos and how grown immeasurably since. The more you work that approach, the more the approach works.

you can

Undoubtedly, focusing on one’s strengths means that you get results together with the development of clarity and resilience to face challenges that crop up. This is no different with a pain challenge to overcome, which is why I encourage people to adopt the strengths approach. It works if you have a purpose, principles to follow and a picture of success to work towards based on living a healthy and happy life.

So this is why I run. Not to keep fit — that is a great side effect and not at all separate from the way we feel and think; we are whole unique individuals — but to nurture and build an approach to life that is about possibility and fulfilling potential.

approach to life: problems or possibilities?

Tomorrow I run the Royal Parks 1/2 Marathon in London. This was a great day last year and I am very excited to be doing it again. I am running to raise awareness of CRPS UK and understand pain and the work we are doing to address the No 1 global health burden ~ see below. Please support my work. Chronic pain affects each and everyone of us either because we suffer, know someone who suffers or pay towards the problem via taxes, insurance premiums and long NHS waits. This can change. This is our work at understand pain, this is my purpose.

11Sep/17
Specialist Pain Physio for chronic pain

You are supporting meaningful change in society

Understand pain for social change

Supporting meaningful change in society

Chronic pain costs us more than any other health issue

Think about all the things that hurt and can go on hurting: back pain, knee pain, stomach pain (e.g./ irritable bowel syndrome), pelvic pain (e.g./ period pain, endometriosis, vulvodynia), headaches, migraines, sports injuries, chest pain and so it goes on. Pain is a universal experience, except in a very small number of people (congenital insensitivity to pain), and so it is no surprise that it can be such a significant social problem. It is a vital part of the way that we learn and protect ourselves, or survive.

“100 million Europeans suffer chronic pain, costing up to €441bn per year

This is a massive public health issue affecting millions of people across the globe. Pain is having a huge impact on society and society has a huge impact on pain. It is in society that the experience of pain is embedded and therefore why we must think of pain as a social issue. In changing the way society understands pain, we will transform this suffering. This is the reason for UP | understand pain, a purpose-led enterprise, to reach out to as many people as possible and advance the knowledge and practices in society to transform pain and live well.

Specialist Pain Physio for chronic pain

Richmond Stace | Pain Coach & Specialist Pain Physiotherapist

How are you contributing to this work? 

When you work with me to overcome your pain, part of your fees go towards the work of UP | understand pain. Similarly, when I run a paid workshop, this is matched with a free workshop for people locally. UP is also supporting the next generation by providing 2 free places at each professional workshop for local undergraduates. This is how you are supporting meaningful change in society.

“Each of your sessions is helping society positively change. 

If you would like more information about workshops, you can click here

If you would like information about the Pain Coach Programme to live well, you can click here

If you would like any other information or to book a session, please email us ([email protected]) or use the contact form below:

24Jul/17

Improve staff fitness

Improve staff fitness

Call to improve staff fitness by the Chief Executive of Public Health England, Duncan Selbie

To improve staff fitness is a great idea all round. According to The Observer yesterday, the cost of staff sickness is £29 billion a year. Denis Campbell reports upon Duncan Selbie’s call for companies to encourage healthy practices. Imagine freeing up some of that cash for education, including educating the next generation to look after themselves. We may laud ‘great results’ in A*’s and A’s but at what cost? We continue to see the figures for mental health rising in kids? I would rather my kid had a D, had tried his best and was all-round healthy. What use is an A if you are suffering depression?

“To improve staff fitness is a great idea all round”

The main target for this message seems to be small and medium sized businesses. Naturally this draws responses about the costs and limited opportunities within such firms compared to bigger companies. However, this problem can easily be solved by creating guidelines and providing support ~ see below for some ideas. It would be well worth the investment.

We can look at the trend in big businesses of building gyms on-site, having physiotherapy and doctors available, bringing sandwiches to the desk and even a neck massage while your pour over your spreadsheets. However, you could also argue that this merely keeps people at their desk or in the workplace for longer, often in the very environment that is causing most of the problems!

“The skills of wellbeing easily weave into the day”

There are a vast number of different options for healthy practices and skills of wellbeing. Teaching people such practices each day, I am very familiar working with individuals who have decided to create new patterns (habits) to supersede existing patterns that cause pain and suffering. Most people I see have chronic pain together with varying degrees of anxiety, depression and other persisting ills (e.g. migraine, headache, IBS, pelvic pain, fibromyalgia, chronic fatigue). Usually this is accompanied by perfectionism (expectations are never met resulting in ‘I am not good enough’ and consequential stress) and self-criticism to a unhealthy degree.

Many people spend their lives in protect mode. Occasionally they experience care-giving mode, but not often. Biologically these people are likely to be ‘inflamed’ much of the time, which explains many of the common complaints in the modern world for which medicine has no answer. The endless search for a medical explanation leads down a slope of decreasing expectations and hope. In essence, like chronic pain, this is not actually a medical problem. Once any sinister pathology has been excluded, the biomedical model offers nothing here as the problem is embedded in society; i.e. it is a public health issue.

To address a public health issue, we need society’s thinking to change. For thinking to change, existing beliefs must be shaken as we update our understanding. Understand Pain is a purpose led enterprise that works to change society’s thinking about pain. In the same way we can build upon the strengths in society with regards to being active. The ‘already active’ can become champions, spreading the right messages about the healthy practices that they have adopted. These people are living examples of the benefit.

“Staff fitness benefits business and society”

Staff fitness

Turning this on its head as I like to do, let’s think about living well and meaningfully. In other words, what can we do and what can we focus on? What positive action can we take as individuals and society? This is not just about small and medium sized businesses creating opportunity for healthy practices. Businesses must collaborate with staff who they themselves need to be motivated to live well. We all have this responsibility to ourselves, our families and society.

There is too much knowledge to sit back now, we all have a role to play, not just the business owners. However, if owners and executives take the right steps and lead from the front, they will inspire action. Do we have good enough leaders to do this and recognise the benefits for the business itself and society as a whole? That’s another question!

What could we do at our place?

Consider how staff will engage with the business and colleagues when the right environment and ethos exists. What are the company values? This is a great opportunity for small and medium sized businesses to engage deeply with its people. Even if this means re-writing the values in an effort to keep growing.

  • Create a space for exercise
  • Create a space for meditation
  • Link with local teachers: yoga, Pilates etc. ~ also an opportunity for staff to bond by doing something together
  • Encourage meetings that are mobile ~ where can we go? Let’s walk and talk
  • Encourage conversation over email/text ~ walk to that person’s desk
  • Compulsory lunch break away from the desk
  • Education programme for the skills of wellbeing

Using your imagination, you will be able to come up with some great ideas for your place. Your people are your greatest resource. Looking after them means looking after your business.


If you would like to know more about healthy practices and skills of wellbeing, please contact us. See what we can do for you as an individual and a business

Individual coaching and workshops ~ t. 07518 445493
13Jun/17

Steps forward at SIP 2017

Positive work done at SIP 2017

There were some important steps forward at SIP 2017 last week when stakeholders got together to discuss the societal issue of pain and agree ways forward. Positive work was done by the collective, consisting of patient representative groups, policy makers, clinicians, scientists and others.

It is rare that all the stakeholders meet, making this a very special conference. Here is an initial summary.

Societal Impact of Pain

Steps forwards at SIP 2017

The problems

The title of the interest group itself, ‘Societal Impact of Pain’ or SIP, drew me to the 2017 conference. I firmly believe pain to be a societal issue that has enormous consequences for individuals and the world in which we live. Whilst there are many meetings dedicated to pain, most focus on a scientific programme. This is only part of a much bigger picture that includes socioeconomic factors, culture, beliefs, gender, access to healthcare, understanding of pain and lifestyle, to name but a few. SIP, as far as addressing pain as it needs to be addressed is ‘on the money’. And speaking of money….

Chronic pain is a huge economic burden. The cost of pain to the EU each year is up to €441 bn — today that is £387 bn.

Wake up policy makers, yes that is £387 billion.

Back pain alone costs €12 bn per year in Europe although the most staggering figure is the €441 bn think about all the other conditions that hurt) and the source of immeasurable suffering for millions. It is estimated that 100 million people suffer in Europe.

“Pain causes a problem for individuals as well as a challenge for healthcare systems, economies and society (SIP 2017)

Clearly, what we are doing at the moment does not work. There are reasons for this, including the fact that pain is misunderstood in society: healthcare professionals and people (patients). This results in the wrong messages being purported, low expectations and poor outcomes. This must change and the SIP 2017 meeting was a perfect breeding ground for positive work in the right direction. There were some significant steps forward, emerging from the synergy of different groups gathered together.

What was my purpose?

Representing UP | understand pain, I was attending SIP 2017 to gain insight into the current thinking about pain from a societal perspective. In particular I was interested in the language being used, the messages being given about pain, and the plans for positive work to drive change. Listening to the talks, being at the meetings and talking to different stakeholders, I was inspired. My passion has been strengthened by what I heard. I know that UP is absolutely on track and my aim now is to contribute to the on-going work, primarily by changing the way society thinks about pain — see workshops here.

The message that I deliver, and that of UP, is that pain can and does change when it is understood thereby empowering, enabling and inspiring the individual to realise his or her potential. The individual is part of society and hence with so many people suffering, this means society is suffering. Drawing together the necessary people to create the conditions for change was the purpose of SIP 2017. From the outcomes (see below), this is what has been achieved.

See the SIP 2017 Impressions here: videos and photos

Who was there?

One of the features of the meeting was the range of people in attendance. For fruitful discussion and action it is essential that stakeholders from the different sectors get together. This is exactly what SIP 2017 created. In no particular order, there were clinicians, academics, scientists, policy makers, MEPs, patient groups and organisations, patient representatives and others who have an interest in the advancement of how society thinks about and addresses pain.

Understand pain to change pain

The right language

The focus was upon the person and their individual experiences of pain within the context of modern society. We all need to understand pain for different reasons, although we are all potential patients!

  • People suffering need to understand pain so that they can realise their potential for change and live a purposeful life
  • Clinicians need to understand pain so that they can deliver the treatments and coaching to people in need
  • Policy makers need to understand pain so that they can create platforms that enable best care

I was pleased to hear and see recommendations for coaching, although the term was not defined. Having used a coaching model for some years, I have seen this bring results, as it is always a means to getting the very best out of the individual ~ see The Pain Coach Programme.

Within the biomedical model, which does not work for persistent pain, the person is reliant upon the clinician providing treatment. We know that this approach is ineffective and in turn, ineffective treatments result in greater costs as the loop of suffering continues. Giving the person the skills, knowledge and know-how enables and inspires people to make the decision to commit to the practices that free them from this loop. People do not need to be dependent upon healthcare to get better. With a clear vision of success and a way to go about it, people can get results and live a meaningful life. This is the philosophy of UP and I was delighted to hear these messages at the meeting.

An issue raised by many was the measurement of pain. The way that pain improvements are captured and the desired outcomes differed between people (patients) and policy makers. The Numerical Rating Score (NRS) is often used, but what does this tell us about the lived experience of the person? Pain is not a score and a person is not a number. If I rate my pain 6/10 right now, that is a mere snapshot. It could be different 10 minutes later and was probably different 10 minutes before. The chosen number tells the clinician nothing about the suffering or the impact. It is when the impact lessens, when suffering eases does the person acknowledge change. No-one would naturally be telling themselves that they have a score for pain unless they have been told to keep a tally. We need to understand what is meaningful for the person, for example, going to work, playing with the kids, going to the shop.

Understand pain to change pain

Valletta panorama, Malta

Steps forward

SIP have issued this press release following the symposium:

‘MARTIN SEYCHELL, DEPUTY DIRECTOR GENERAL DG SANTE, FORMALLY ANNOUNCES LAUNCH OF PAIN EXPERT AND STAKEHOLDER GROUP ON THE EU HEALTH POLICY PLATFORM AT THE SOCIETAL IMPACT OF PAIN SYMPOSIUM’

Mr Seychell gave an excellent talk, absolutely nailing down the key issues and a way forward. This has been followed by with positive action. The SIP statement reads:

‘The European Commission is following SIP’s lead and has launched the EU Health Policy Platform to build a bridge between health systems and policy makers. Among other health policy areas, the societal impact of pain is included as well and will have a dedicated expert group.’

From the workshops the following recommendations emerged:

  1. Establish an EU platform on the societal impact of pain
  2. Develop instruments to assess the societal impact of pain
  3. Initiate policies addressing the impact of pain on employment
  4. Prioritise pain within education for health care professionals, patients and the general public
  5. Increase investment in research on the Societal Impact of Pain

A further success has been the classification of pain

Building momentum

Following this inspiring meeting where so much positive work was done, we now need to take action individually and collectively to get results. I see no reason why we cannot achieve the aims by continuing to drive the right messages about pain. This is a very exciting time from the perspective of EU policy but also in terms of our understanding of pain. The pinnacle of that knowledge must filter down through society, which is the purpose of UP.

To do this we (UP) are very open to creating partnerships with stakeholders who share our desire for change. UP provides the knowledge and the know-how that is needed for results, because without understanding pain, there can be no success. Conversely, understanding pain means that we can create a vision of a healthier society that we enable with simple practices available for all. Society can work together to ease the enormous suffering that currently exists. We all have a stake in that and a responsibility to drive change in that direction.

~ A huge thanks to the organisers and Norbert van Rooij


Please do get in touch if you would like to organise a meeting or a workshop: +447518445493 or email [email protected]

 

04Jun/17

Headache

Headache is a leading cause of suffering

Headache and migraine are in the top 12 of the Global Health Burden of Disease Study (2011)

 

Headaches

If you watched Doctor in the House on BBC recently, you would have gained an insight into the terrible suffering caused by cluster headache. This is one of the many conditions characterised by chronic pain. In this case, there was significant improvement as the family made some important changes. More on this shortly.

Chronic pain is the number one global health burden, costing more that cancer, heart disease and diabetes put together. There are millions of people across the globe enduring chronic pain states. They have little or no understanding of why they continue to suffer and no knowledge of how to overcome their pain. This can and must change, and to do so means that society needs to understand pain ~ this is the reason for UP | understand pain. Pain is a public health problem of huge significance.

The programme hosted by Dr Rangan Chatterjee highlighted the impact not only upon the brave lady Gemma, but also upon the family. It was their shift in thinking that resulted in new habits, which create the right conditions to get better. That was a choice made based upon new understanding. Realising that we have a choice is a key first step. We can make the decision to commit to doing the things that will change our health, our relationships, our performance and our pain.

Pain always occurs in a context and involves life’s habits. On realising the range of influences upon pain, the person can instigate changes that make a huge difference. In the family setting, this involves all members, including children. There are huge numbers of children who suffer pain (1 in 5) and huge numbers who support a parent. This is a vast problem in itself.

A brief look at pain ~ what is it?

Pain is a whole person state of protect based on the existing and prior evidence that there is a threat or possible threat to the person. Much of the processing is subconscious, our biology in the dark (e.g./ you don’t know what your liver is doing right now), emerging as a lived experience or perception. Anything that poses a possible threat can result in pain. It is important to consider that something only becomes a threat when we think it so, and hence the meaning we choose to give a situation makes it what is it.

It is not only when we are thinking that something is a threat to us of course. Our biological systems interpret sensory information and predict that it indicates possible or actual danger. Working on a just in case basis means that we can get it wring. When we are sensitive,m this can happen more often than not, which is why pain can become so dominant. The range of contexts and situations widen and we notice the pain moments over and over. This does not have to continue. We can actively infer something else with new understanding, new actions, new habits and new patterns — that’s the programme.

Pain and injury are words often used synonymously, but they are simply not the same. Pain is part of a protect state, very similar to that of stress, and injury is something you can see. The former uniquely subjective and a perception constructed by the whole person

What can we do about pain?

The short answer: a lot!

The first step with any change is to make the decision to commit to practicing new habits that lead towards your desired outcome. This decision comes off the back of understanding pain because then you realise that there is plenty you can do to change and overcome your pain.

This always starts with developing a working knowledge of your pain so that you can coach yourself: the right thinking and the right actions to get the best outcome. Initially you are likely to need advice, treatment and coaching to ensure you remain on track.

When you understand pain, you do not fear it or try to avoid it, instead you face your pain, learn about your pain and overcome your pain. This is different to taking a pill or having an injection, which circumnavigate the issue. Only by facing the challenge can we transform the experience of pain. Many messages in modern society encourage us to avoid the difficult things in life but they are unavoidable. We are not typically taught skills to face the challenges that will come up, and so when we do have something to deal with, we suffer. This does not need to be the case, certainly when it comes to pain.

This is not to say that pain is not unpleasant. Of course it is, but we can learn how to minimise the impact and work to create a happy and meaningful life, by living and practicing the skills of well-being. By living I mean that you try to do the things that you want to as much as you can. More dated thinking about pain suggests that you have to get better in order to resume living, however I have turned this on its head and said that you get back to living by getting back to living. Getting back to living IS the way to get better.

In a sense there is a template of how your life and you should be, and there is no real separation between the two. When the template of what is actually happening is different to the expected one, this mismatch creates a drive to bring them together. Pain is one of those drivers. So, if we try to live as best we can, we are in fact bringing these two templates together. Of course there will be a certain tolerance, even perhaps a few moments in some cases, but this is the start point or the baseline. Working from your baseline, you can get ‘fitter’ and healthier with the practices you commit to, and thereby point yourself in a desired direction.

“what is your vision of success?

A treatment programme is therefore weaved into your life. You are in the driving seat. This is an important concept as healthcare often puts you in the passenger seat, or as one patient told me, ‘in the boot’. This is not right and will certainly not help the person to get better. The modern understanding of pain tells us a very different story, which is exciting, but must be told as far and as wide as is possible, which is the reason for UP | understand pain.

If you are suffering headaches, you should consult with your healthcare practitioner as a first port of call. You will want to know the possible reasons why you have headaches, but then you will want to know what you can do, what they will do to support you and roughly how long this will take. With an understanding and a direction, with a decision to commit to practices of well-being and determination, it can be transformative.

RS

 

 

 

 

05Apr/17

5 ways a partner can help you

Chronic pain can be the source of huge strain upon a relationship. Partners and other people close to the suffering individual can be at a loss as to what they can do to help. Sometimes their assistance is welcomed and other times not. It can be confusing and stressful. There are many ways that a partner can help and some will be individual to those involved. Here are 5 ways a partner can help you:

Be an extra pair of ears and eyes

During consultations with specialists or therapists, it can be useful for a partner to come along. Beforehand you can decide upon their role. The possibilities include:

  • listening and note taking
  • offering observations about what has been happening
  • watching and learning exercises so that they can provide feedback at home
  • just being there for moral support

Sometimes having someone else in the room, even a loved one, can be distracting depending upon what is being practiced. So do discuss this with your clinician for the best outcome.

Understand pain

When your partner understands pain they will be able to further empathise and act through compassion rather than fear and worry. We do respond and are influenced by the people we are close to, meaning that if they have a working knowledge of pain they will better provide support and encouragement.

Pain can and does vary as each pain experience is as unique as each unfolding moment. Knowing that pain is related to perception of threat rather than tissue damage or injury, along with some of the main influences (e.g. emotional state, context, tiredness) helps to navigate a way forward. To overcome pain the person learns to coach themselves, making best choices in line with their picture of success. Sometimes we need help or someone to listen to us whilst making these choices.



A hug

Touch is healthy, especially from a loved one. Someone recently told me about how a hug from her children relieved her pain. Why? The release of oxytocin for a starter. The feelings of compassion and love can cut through all other emotions and feelings, which is why the development of self-compassion is one of the key skills of well-being.

Sometimes a hug can be painful of course, depending on where you feel your pain. If this is the case, then simple touch somewhere else is enough. Seek to notice the good feelings that emerge in you: what do they feel like? Where do you feel them? Concentrate on them. And if you are not with that person, just imagine a hug or a loving touch. This triggers similar activity, just like when you think about that beautiful scene in nature, your body systems respond as if you are there ~ our thinking is embodied.

Practice the skills of well-being together

A good example is metta or loving kindness meditation that cultivates self-compassion. It is best to gain instruction 1:1 to start with and then use a recording as a prompt until you are familiar with the practice. Group practice is also good when the collective or community creates a soothing atmosphere in which to practice.

At home, practice metta with your partner. Doing it together, you form a bond as you spend meaningful time together. You can also practice the exercises together. These are nourishing and healthy movements with the purpose of restoring confidence as well as layering in good experiences of activity to overcome pain.

Spend time together doing something meaningful

We are designed to connect. The chemicals we release and experience as that feel-good factor, do so when we have meaningful interactions. Pain all too often appears to limit choice and our tolerance for activity. However, on thinking about what we CAN do rather than what we cannot, we begin to build and broaden the effects of choosing positive action.

Positive action is all about focusing on what we can do: e.g./ I can go for a coffee with a friend for half an hour to gain the benefits of connecting, moving, a change of scene etc. and I will concentrate on these benefits. Make some plans, working within your current tolerance level, knowing that you are safe to do so, and follow them through by keeping yourself pointed towards the picture of success*. You can then gradually build your tolerance by pushing a little with increasing confidence.

There are many other ways that a partner can be involved. The key is to communicate openly and make plans together ~ here is a great insight into communication by Thich Nhat Hanh.


* Clarifying your picture of success gives you a direction and the opportunity to check in and ask yourself: am I heading in that direction or am I being distracted?

Please note: Whilst the practices above can appear to be straightforward, you should always discuss your approaches with your healthcare professional

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

 

 

 

13Mar/17

3 ways to ease suffering

We all suffer. Suffering is part of living and so is unavoidable. There are many reasons for suffering and they are unique to that person and the way that they view life. The Oxford Dictionary defines suffering as “The state of undergoing pain, distress, or hardship”. We are all subject to these states regardless of age, gender, culture or class. In fact, we could say that humanity is connected by the universal experience of suffering. Bearing this in mind and essentially normalising suffering as part of life, it would be prudent to develop some skills that allow us to face suffering, transform, learn about, and ease it. Here are 3 ways to ease suffering.

These are simple practices for everyone that can be integrated into day to day life. Moment to moment awareness creates the opportunity to practice healthy habits resulting in living well.

Acceptance

Accepting what is happening right now dissolves any resistance. Resistance results in suffering because we are not happy with how we are or where we are or what we have. This is a common cause of discomfort and resistance can certainly drive tension and pain in the body. Accepting is NOT giving up. Instead it is actively being open to what exists now as a lived experience, allowing it to transform as it always does with each passing moment. Acceptance allows us to move forward in a chosen direction whereas resistance does not.

Mindful practice

There are simple mindful practices that give us insight into the way we think and feel, help us to be acceptant, allow us to let go of unhelpful thoughts and to be open to experiences as they unfold. By the very nature of these practices, a sense of well being emerges as we fully engage with the joys of life as well as think clearly about how to surmount the inevitable challenges we face. Here are a few examples:

  • take 4-5 slightly deeper breaths at regular intervals during the day, being fully aware of the ‘in’ and ‘out’
  • pay full attention to what you are doing, whatever that happens to be
  • formal practice of mindfulness meditation ~ this is best done with a coach or instructor to start, or in a group
Practicing gratitude

There are great benefits of practicing gratitude as a skill of well-being. Next time you are feeling glum, in pain, feeling anxious, try thinking about something you are grateful for. This does not need to be anything momentous, instead something more day to day such as the clothes on your back, the sun in the sky or a text from a friend. It needs to have some kind of meaning to you. Practicing gratitude can change the way we relate to an issue of concern. We release some important and healthy chemicals by actively generating the feeling (the feeling is underpinned by those chemicals as best we know), which creates the conditions for more clarity. Clarity of thought means we can focus on the thinking/actions that can result in face a challenge successfully.

The Pain Coach Programme to overcome pain and to live well | t. 07518 445493

08Mar/17

Find peace

In a sense I think that we are all trying to find peace. We week to find peace within ourselves and the world in which we find ourselves — the two are entwined.

We often hear the word peace nowadays. This is because peace is a state we strive for globally in the face of threats that are often purported in the media. There are fewer who seek the polar opposite; people who appear to welcome violence, war and other destructive states. This can only be because of wrong perceptions of the world resulting in wrong thinking and wrong actions.

In terms of chronic pain, perhaps we can say that we strive for a state of peace. This is an idea that came from a conversation with a learned friend some months ago. It was based upon thinking about the ‘opposite’ of pain, which cannot simply be pain free. When we are pain free, we are not thinking ‘I am pain free’, instead just acting, thinking and perceiving as a blended trio within each moment. To find peace seems to be a good place to start overcoming pain.

What is a state of peace?

By definition, peace means ‘quiet, tranquility, mental calm, serenity; a state of friendliness’ (Oxford Dictionary). Consider how we feel and think when in pain. We are suffering, fighting, surviving, emotionally turbulent, living the storm of physical sensations and the turmoil of the thoughts and feelings about these sensations. The former appears to be a good place to be in comparison. There is however, one issue, and that is the effect of resistance to what is happening right now.

Resistance itself causes great suffering. Not wanting to be here, instead wanting to be there. Not wanting to look like this, instead wanting to look like that, are two common examples. This is being non-acceptant and fighting the present moment. But it does not necessarily seem natural to do anything else other than resist. Why would you not want to feel better? Look better? etc etc.

This is an issue of desire and the grip that it can have upon us that causes suffering. The problem is that if you are strongly focusing upon how you want to be and resisting how you are or what you have, you are missing the opportunity that exists now. This is in the form of acceptance, which is simply acknowledging and being open to what is happening right now without resistance. Accepting what is happening right now relieves the suffering and allows us to take the right actions to find peace. These actions can only happen now because now is the only real moment. Thinking about what you might do or what you did only exist in your (embodied) thoughts. Concrete action can only be in this moment.

By being present we can find peace. This emerges from simple practices such as mindful breathing and mindful activities that mean you are present, aware, open, insightful and accepting in a compassionate way.

Where is peace?

There is only one place that we can find peace. That is within ourselves. I recall a pertinent moment a few years ago when a friend said to me ‘I hope you find peace’. It is something we appear to look for, yet we don’t need to look because it is right here. We simply need to create the conditions for peace to emerge and be felt. Does this mean no pain? No, not necessarily. Can you feel pain and be at peace? Yes, absolutely. And in this state, the pain transforms and our suffering eases. So, when we find peace that was already there, just overladen with our day to day fears and worries, the pain rents less and less space. Then we can concentrate our efforts on living well, which is the way to overcome pain.

How can I be present and find peace?

Everything that ‘happens’ does so now, in this moment. It is called being present and we can be fully aware, attending to this moment to gain all the rewards. To be present we can start with a few simple practices:

1. Take our attention to our breathing, even just 4-5 breaths, and do this regularly through the day ~ set a reminder

2. Fully attend to what we are doing, whatever that may be. ‘An unhappy mind is a wandering mind’ was a recent study title. We are happier when we are attending to what we are doing in this moment.

You may also choose to regularly practice mindfulness and other meditations such as metta, or loving kindness meditation. The formal practice each day develops our ability to accept, let go, be open, be tolerant, gain insight into our own and others’ thinking. In so doing, in the wake of the practice comes a sense of peace and calm that deepens in time. There are well described healthy benefits of regular mindfulness practices yet it is important that we practice for the sake of practice and not to ‘become’ something else. This is a challenge but you will recall that trying to be someone else or be somewhere else creates resistance. By far the best way to begin practice is with a teacher but there are some excellent apps and videos aplenty on you tube; for example Thich Nhat Hanh, The Dalai Lama, Matthieu Ricard, Ajahn Brahm, Jon Kabat Zinn.

Pain and peace

Pain is as complex as any other lived experience. It involves the whole person, their biology, their consciousness, their past experiences and their genetics to name but a few factors — it is complex! Equally as complex is pain relief that involves all the same factors. Where we feel pain is not where pain is ‘generated’, instead this is where there exists a perceived threat.

Regular readers of modern pain science literature will know that pain is related to being threatened or potentially threatened, acting in the name of survival. The location of the pain is really a projection of all the biology involved with protecting us, emerging in a specific place where we are compelled to attend. If there is actually an injury there it seems to make sense. Often in cases of chronic pain there is no obvious injury or pathology. This is because pain and injury are poorly related. Despite this, the pain felt is the pain felt. Pain cannot be seen so we must listen to the person as it is the individual who feels the pain.

“Pain and injury are poorly related

Existing under a state of threat results in a range of thoughts and behaviours that can be combatant in nature. Consider what we have said about peace. To find peace we must be acceptant, open and demonstrate compassion towards ourselves and others. If we ‘fight’ the pain, we are only fighting ourselves. Creating a sense of peace allows us to choose to focus on the actions (e.g./ exercises, re-framing our thinking to reduce fear, socialising, practicing mindfulness, gradually becoming more active, and many more) that create the conditions for living well.

Overcoming pain is an active task. The person needs guidance, motivation and support but the to begin with the basics to sustainably move in the desired direction. This includes a working knowledge about (your) pain with skills and practices to use day to day, moment to moment. The new knowledge about pain creates a sense of safety rather than threat, peace if you like. This clarity that emerges from understanding pain means that the person can truly focus on what they need to do to get better. This starts with thinking like the healthy person who is living well: ‘what would they think and do here?’ you can ask yourself, before doing exactly that, albeit with certain limitations at the start. These limitations can and will be worked upon: ‘can I?’ turns to ‘I can’ and ‘will I?’ turns to ‘I will.

From a place of peace and clarity come right perceptions about oneself and the world. To find peace is to find it in oneself. It is there and may need uncovering. When you do, the world looks to be a different place. One that is far less threatening and one in which to thrive and to live a meaningful life.

The Pain Coach Programme to address suffering by learning to live well | t. 07518 445493