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Pain and The Brain

So many of us have unexplained pain or chronic pain that ends up increasingly dictating  the way we live. There seems to be a misconception that psychosomatic pain and illness, somehow means that it is imagined and not real. This is not the case at all, the pain is as real as any pain, but it is influenced by psychological stress and pain. Where in your body is your anger, sadness, the weight of responsibility you might carry held?

Lorimer Moseley’s video below about the link between pain and the brain is brilliant for anyone wanting to gain a deeper understanding into their pain.

He speaks of pain being all about protection. Anything suggesting we are in danger, including stress and emotional pain, increases pain. Pain is in the brain, it’s not the level of tissue damage. The level of risk is assessed and the brain sends pain signals as this protects us by making us stop whatever we are doing, as pain is as you know unpleasant. He gives an example of how if you pinch your own finger it hurts more when a friend does it, and even more when its a stranger. This is purely based on the brain’s assessment of risk.

So you can have excruciating back pain, where you are bent over or unable to move in pain, but no tissue damage. This can feel the same as someone who does have tissue damage. Those that have life threatening damage often are pain free – think about that. This is because you will only feel pain once you are in safety again, as pain is all about protection you would not survive if you had your arm blown off and you stopped in pain to attend to it. The brain has a very complex pain and risk system.

Another interesting piece of research is how if you see your medical report saying ‘degenerative spine’ you will be in more pain, than if it is explained to you that degenerative merely means age appropriate changes. This is because with the former the brain says ‘danger’.

The brain also attributes meaning and therefore the same stimulus will hurt more with a red light flashed at the same time than a blue light. This is because in many countries we place the meaning of danger with red and blue with calm.

As you can see the pain system learns almost too well and the pain system can become over-protective so that you can be doing very little and have a flare up. People then tend to avoid all pain-associated activities or try to beat it. Both these options make you more and more disabled by pain and the range of what sets its off becomes broader and less predictable and manageable. Soon you have given up much of what you loved and your life seems less and less yours. This is because it’s the same brain producing pain whatever option you take, you cannot avoid or beat pain. There is a third option however – teaching and training your over-protective brain to become less reactive. It is possible to bring the system into being appropriately protective once again.

  1. Rethink pain – pain in the body’s protector, so EVERYTHING matters and is relevant (things do, hear, see, what friends tell you, medical professionals tell you, what you feel)
  2. Pain can become part of who you are and your identity – i’ve got danger in me (DIM), rather than safety (SIMS)
  3. The challenge that anyone has with persistent pain (pain not following expected trajectory) needs to work out what your DIMS and SIMS are. They require hard work to find them. They live within the bio-social model. In this you have the bio which is the true make up and state of body, the psycho (moods, fears, thoughts, belief, knowledge) and socio (community, culture, relationships, access to care). Pain sits in the middle of all of these. All of these apply to everyone, pain sits in the intersection, if you are human! It is very easy to think ‘my pain is different, it’s all bio”. The SIMS and DIMS can be found it all of these. You can teach the pain system to be less protective and rethink pain, but understanding takes a lot of work. Understanding is the first way forward out of pain. Pain is clearly in your body, but 100% it is produced in your brain, so understanding matters greatly.
  4. Then need to plan how you go about new learning, then need patience and persistence as its a learnt and adaptive mechanism so will be quite a journey to shift it.
  5. Active aspects are essential and protects you against many other problems that are increased with persistent pain. Even when things are a bit painful with an over-protective system, that is still better than passive aspects and having things done to you. Do not simply avoid movement, the risk of inactivity is much greater than activity. Find and become super aware of your safe baseline, your flare up line and at some points this may be very easily triggered. Then from this apply the rule – Always do more today than yesterday, but not much more take it slowly. This does not have to be aerobic activity, walking is the best, but you can even get benefit from imagining movement. Even the brain sending movement commands has significant effects. It’s all about finding balance and experimenting and become really conscious and attuned to your baseline and body.
  6. Support – a good coach and support groups with pain experts by experience. Interactions with others are essential, especially with shared experiences.
  7. Life can be better, but not with out time and work. Understand your particular pain meter, the triggers, the meanings, the functions and that is the start.

I really recommend the video below:

Some other useful websites and links:

http://bodyinmind.org/

https://wholeperson.healthcare/clinicians/

http://www.msk.org

http://www.painrevolution.org

http://www.tamethebeast.org

Simple sugars can be inflammatory of pain, dairy can too for some people. There might be certain things that you notice are particularly bad for you.

 

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Schneider and Fitzgerald-Pool on Eating Problems

Though it’s hard, it is important to face the void/emptiness/loneliness/pain inside you, Don’t try to cover over it and flee from it using various addictions, ways to keep busy and distracted, or self-medicating. Plastering over the cracks is never a long-term solution. Like with any addictive behaviour or symptom, it is important to deconstruct it and first understand its personal meaning and function to you, as well as your unique and subjective way of experiencing it.

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“Emptiness. The attempt to overcome it by intoxication…intoxication by cruelty…intoxication by blind worship. The attempt to submerge oneself…in any kind of working routine, any silly fanaticism; a confusion of all means, illness as a result of a general lack of moderation” (Nietzsche in Will to Power).

“Addictive behaviour is not inside the person, but takes place between individual and the world, at the point of interaction. ‘The person cuts himself off from possibilities for authentic relatedness, and lives instead in a “wish world”‘ (Heidegger, 1962, 240) – an illusion of escape from insecurity. nothing will ever be enough to satisfy this insatiable need. There is a blind hankering after more and more, but this closes off real possibilities, so the individual loses himself/herself further into the addiction. Entering this closed, unrealistic world, the person seeks omnipotence. When high, the fantasy feels real, anything is possible, and everything is perfect” (61-61)

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The importance of SELF CARE

IMG_0051 (1) ©️ Anna Loake

It seems that so many people struggle to make time for self care and get caught up in living for others and putting others’ needs first, while forgetting their own and losing themselves to some extent as a result of this. Or getting caught up in an exhausting rat race, where it feels like there is never enough time for anything else. Self care is a fundamental part of emotional and physical wellbeing that too often is not prioritised. Without self care we feel depleted, stressed and as if we are running on empty. Often, we wait for our bodies to slow up down or stop us through illness and psychosomatic issues and are surprised that we feel depressed and anxious, despite living in this way. No one is superhuman, no matter how busy and active you are it is so important that you look after and protect your resources.

Some Tips:

Try not to put all your energy into pleasing others, this will leave you depleted and having to shut off from others to cope. It’s important to learn when to say ‘no’. One way of doing this is considering ‘who am I doing this for? Is it for me or for someone else?’ That way you are making a conscious choice and not operating on autopilot.

Create a ‘no’ list of things you do not want to do, such as not checking emails at night, saying no when feeling tired or unwell, rather than pushing on to not feel like you are letting down others.

Start to prioritise taking time for yourself on your list. But also separate things that are immediately important from more general tasks, so that you do not feel overwhelmed and dictated by your list and can live beyond daily tasks.

Identify what calms you down when distressed, what relieves stress and what also nourishes you to feel energised and ensure that this is incorporated into your life as much as possible. Reflect upon which friends nourish you and with whom you come away feeling better, and those that bring you down or result in you comparing yourself.

Avoid using perfection as your measure of success. There are so many other ways and this is a definite way to feel low.

Identify what is getting in the way of your practise of self-care and acknowledge how much this is because of you. This is such an essential aspect of your wellbeing and therapy that you have a choice within and responsibility for.

Here are some important aspects of self care, that which may seem very basic, but so many people forget them:

Sleeping at least seven hours

Keeping active – exercise is essential for your physical wellbeing, but also the endorphins are key for emotional wellbeing

Eating healthily and at set meal times

Doing hobbies, passions, things that make you happy and laugh

Incorporating mindfulness into your day or doing mindful activities that allow you to switch off from thoughts and be in the present. Some include gardening, drawing, puzzle or logic books, reading, dancing, knitting, pottery, pilates/yoga

Relax and take time for yourself – have a bath, walk and be around nature, swim, cycle to work – find what works for you and changes how you feel about your day

Final Note

You only have one body, one mind, one life, so start treating it well and try to accept and have compassion for you.

Self care is often misconstrued as being selfish. Considering your needs is not selfish we might just not be used to it.  In fact we need to take care of ourselves, in order to be able to take care of others as well. As a therapist if I don’t keep myself well, I would not be able to be there of others.

You can’t always control the circumstances or difficulties that life throws at you, but you can control your response to it and how well you take care of yourself. When you are too tired, eating unhealthily or generally run-down, you will likely be more reactive to the stress in your life and have less resilience. If you are ensuing self care you will find you have more resilience and can respond from a grounded, calm and considered place.

I hope I have given enough reasons for you to at least start reflecting on how you do and could incorporate self care.

The easiest way I find to start to do this, is to care for yourself like you would care for someone else that is important to you. 

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Ulysses by Alfred Lord Tennyson

 

The journey through life continues as one grows old, even though one gets weaker, you still have to carry on and keep striving:
“We are not now that strength which in old days
Moved earth and heaven, that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield”
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Healing the Shame that Binds You – John Bradshaw

“I used to drink,” writes John Bradshaw,”to solve the problems caused by drinking. The more I drank to relieve my shame-based loneliness and hurt, the more I felt ashamed.” So often it is shame that lies under our unhealthy ways of coping with emotions and behaviours and yet it is frequently neglected. It is shame that can motivate all kinds of addictions, codependency, and a drive to superachieve.. This book is a core text at many specialist addiction clinics and can help you to identify your personal shame, understand the underlying reasons for it, address these deeply rooted causes and wounds, eventually freeing you from some of the shame that binds you and keeps you stuck in past failures.A564E90E-BAD3-4AB1-A229-5FB0A45747BD.png