For the patient, once we take inventory of what has happened to get them where they are at today (often, mapping a chronological timeline of all contributing events helps the patient connect the dots and make sense of their current state of health), we must then start the task of having them coming back to themselves. They must drop the labels and stop identifying with their Pain Body. As patients, they must make an effort to come back to a neutral place within themselves from which they can operate actively in the healing process. In this phase, it is common for pain to intensify before it gets better as they are coming back to themselves.
Once we have helped our patients to synchronize their physical bodies with their psychoemotional beings, healing can commence. In this case, the ol’ adage ‘You gotta feel to heal’ rings true.
It is an illusion that we are separate beings. It is an illusion that we can heal our body without dipping into our emotional and psychological bodies and vice versa.
We are whole, complete sandwiches with many slices of existence in between our meat suit ends. In this phase of treatment, we spend time digesting. Dysfunction is often rooted in unresolved trauma to varying degrees whether they be physical injuries or emotional trauma (Levine, 1997).
Physical and psychological treatment is helpful in conjunction with one another to work through the backlog of unresolved issues most of us carry in a heavy pack on our backs. In this process, it is important for the patient to allow themselves to be vulnerable. Walls are helpful in keeping out more trauma, but they’re also great at holding in past trauma. In this stage, we slowly and carefully help the patient deconstruct their walls in a controlled manner so that they can come home to themselves. Treatment is impossible if our patients do not invite us in.
It is important to respect the emotional and psychological changes that have occurred during the course of the patients chronic pain journey. There is still serious stigma around CPS because of the lack of science to back it up, and the insidious and seemingly invisible nature of the varying syndromes. Issues of worthiness and shame are common in complex cases of CPS. Enter our support system: Our patients will need support and love and encouragement as they climb out of the darkness and re enter into the light. They will have setbacks and moments where their Pain Body overtakes, but this is when their loved ones will pull them up again.
In the Babemba tribe of southern Africa, for example, it is normal to help troubled members of the tribe be accepted back into their community not by punishing them, but by surrounding them in a circle and taking turns expressing their affection for the person and recounting stories where they displayed integrity and goodness in their actions. The entire community takes turns in this ceremony that often lasts for days in order to remind the individual of the good within them, until the person finally breaks down, comes back to themselves, and is accepted back into the arms of their community (Zunin, 1972). In a similar way, we must all come back to ourselves in order to return to our inherent health.
The most efficient way to transmute our pain and transcend it is to use self love as our catalyst for change.
Chronic pain has many facets, so it stands to reason that we need a multi dimensional approach to helping our patients return to health. Along with therapy (physical, psychological, etc.), it is important that the patient keep in mind the benefits of healthy sleep routines (despite sleep challenges that come with most chronic pain syndromes), good nutrition, daily activity, and stress management. Without proper fuel for the body, fatigue is exacerbated and energy levels are affected. If the client is in a perpetual state of tissue inflammation, little progress can be made until an internal balance can be reached. Probiotics play an enormous role in serotonin production which help mediate stress hormones and support the immune system which is key for overall health (Pedre, 2015). We also need daily activity to release natural endorphins which have been found to be more powerful and effective than most available pharmaceuticals (McMurray et al., 1987). And the bonus is that there are nothing but positive side effects to natural endorphins! Walking, dancing, and pilates are great ways to get the heart rate up and the endorphins pumping.
Activity based in mindfulness practises such as yoga, Tai Chi, and Chi Gong are even more effective since they merge mindfulness practice and movement for a powerful effect on our nervous system. Modifying activities for mobility restricted patients is always an option, the point is to get the circulation moving. Finally, reducing stress is probably the most important thing a chronic pain patient can do to help themselves, whether it’s reducing the amount of time spent at work, making an effort to do things that bring them joy, or limiting time spent with toxic people and situations. Stress reduction plays a massive role in our overall wellness. The effects of stress reduction are not immediate; it’s important for the patient to remember that it took years to get sick, and it might take months or years to return to optimal wellness.
Cultivating healthy mental hygiene habits are key in overcoming chronic pain.
Cultivating a meditation practice is incredibly beneficial in treating chronic pain syndromes. The mind, like a muscle, benefits from regular exercise. Meditative practice helps to calm the autonomic nervous system, increase heart coherence, and rewire the central nervous system which greatly helps improve the root cause of CPS (Hanson and Mendius, 2009). The greatest obstacle in the path back to ourselves is often ourselves. Once we become comfortable in our vulnerability and remove the physical, emotional, and psychological stressors, healing is a natural occurrence. Health and vitality are inherent. They are ever-present.
Health is our natural state of being. We just have to remove the tensions that obstruct it from expressing itself.
We look to newborns to remind us of how to be. A baby doesn’t know how to be stressed or neurotic. Their natural state is joy. Only when they experience a disruption in their health processes do they complain. They are a beautiful example of pure consciousness. That state of joyful being is what we should aim for as much as possible.
In closing, as health care professionals, we can accompany our patients to the bridge, but we cannot cross it for them. At the end of the day, we are all responsible for our own level of health. Taking an active and motivated role in our treatment is key on the path to healing.
To summarize, the most effective approach to chronic pain treatment for health care practitioners seems to be a patient centred treatment model within the confines of a safe, non judgemental environment. A patient and compassionate approach bodes well for making progress. Setbacks will occur. Persist and remember to empower your patients.
For the patient: it is important to remember a time when you felt well and to set attainable goals with that in mind. It is important to feel empowered and supported in this process, and not to be hard on yourself during flare ups or times of setback. The path to wellness is not a linear one. It will take courage, determination and a lot of self love to get you back to you. But in the end, what could be more worth it?
Tips for Managing Chronic Pain:
- Build a support network of health care professionals, support groups, friends and family
- Space your appointments and keep them short, too much of a good thing is a bad thing when it comes to CPS
- Start a health journal in order to observe patterns in your health
- Talk to your pharmacist or Naturopathic Doctor regarding the benefits of probiotics and nutrition to support your microbiome
- Initiate a meditation practice: 20 minutes per day is a great goal
- Get outside for some fresh air and gentle activity 20 minutes a day
- Cultivate healthy sleep habits: Limit stimulating activities before bed, restrict screen time 60 minutes before bed, aim to go to bed and wake up at the same time daily to create routine
- Reduce physical and psychological stressors
- Do not identify with/as your pain