Understand Pain Talk & Workshop 22nd May

Richmond at The Understand Pain Workshop

The Understand Pain Talks and Workshops are our way of getting out into communities and listening to people: the voices of society. A suffering society. At UP, our purpose is to contribute to society by showing people practical ways of reducing their suffering by living their best lives.

Understand pain and move on to live a fulfilling life

On Wednesday 22nd May, Richmond will be talking and running an UP workshop in New Malden.

This event is free, although we always welcome donations to fund our going work.

Click here to get your place

 

Why keeping in touch with your body is important

Body painting

This is a short blog about why keeping touch with your body is important

The body, your body, is always there. It is always changing and updating, but in essence a constant feature of the present moment.

The mind however, goes off. It travels forward and back at a whim so it seems. But reality is only here and now, the rest is just in thought. However, each thought, each feeling, each sensation and each movement are all embodied. They are also embedded within a context, an environment and a society.  The mind simply cannot be considered in isolation.

This in mind so to speak, means that what we focus on governs how we feel. Our emotional state is a biological state, orientating us towards a particular experience, to meet a particular set of needs. What is interesting is that when we focus our attention on the feeling itself, if it is a state of pleasure or joy or any other positive feeling, it grows. When we focus on a negative feeling such as anxiety or anger, what happens? Well, you can either try it or wait until the end to discover the answer.

The whole person

Regular readers will be familiar with my writings on the whole person. In short, the premis is that it is always the person as a whole who has an experience. For example, I feel pain in my hand rather than my hand is in pain. The importance lies in the need to address the person to successfully address pain. As I tell people I see, the biology of pain (and there is nothing specific to pain) is largely not where you feel it.

To feel oneself then, requires a completeness. A wholeness that needs both body and mind to be in the same place at the same time. Only when the two are together as one are we truly present. In our world where we learn early to escape the body from horrible feelings, emotions and sensations, this can seem like the thing to do. We are encouraged to drink, smoke, take drugs, buy something new and distract. Except trying to avoid and escape results in on-going suffering instead of facing and transforming. We cannot escape suffering in life. It is part of life. But no-one teaches us how to suffer. To know how to suffer is to reduce the impact and overcome the cause(s) of one’s suffering.

A simple practice

One simple way to be whole, and to connect and re-engage with the body is with the body scan. This is where you pass your attention through your body from top to bottom. You notice without judgement, with acceptance of what is, and an openness to all experiences and sensations. In so doing, you are whole, which is the true person.

The awareness, or check-in as I sometimes call it, is a way to address our biological needs. Checking in, I am aware that I need to move, to stretch, to drink, to eat, to scratch, to go to the loo etc etc. Without this bodily awareness, I miss the cues and conscious feelings of need states. And to miss out on the basics can add up over time. Place stress on top and soon our bodily systems are in survive mode, increasingly interpreting sensory information as possibly dangerous. What do we feel then? Headaches, body wide pains, irritable bowel, fatigue, poor concentration, low mood, anxiety and more.

Make a commitment

So what can we do?

We can decide to commit to a route of wellness and practice certain skills each day to build. Without wellness life is even more of a challenge. Part of being well is being present and we can only do so with body and mind together. Each moment is made up of our perception, action and cognition. They are inseparable, yet each adding something distinct the the richness experience.

If you like, now, you can sit or lie and pass your attention through your body to see what is what. Remembering of course, impermanence. Things are always changing, otherwise life would not be possible. So notice the ever changing biology at work. You can spend a minute or a few minutes or an hour. That’s the beauty of checking in. It is easy, and you can do it anywhere, anytime.


This is one of many practices and tools from The Pain Coach Programme

Talking pain with Pete

Pain Coach + Pain Toolkit getting together to deliver the RIGHT messages about chronic pain

This is the first of a series of conversations about pain. Pete’s 5 question challenge:

  • how did you get into pain?
  • what about people looking for a quick fix?
  • what questions should patients ask me?
  • is social media useful?
  • what is the future for pain management?

A series of chats coming soon. Enjoy!

The final run ~ Ellen completes the 1/2 Marathon

IMG_0675
UP & CRPS UK Royal Parks 1/2 Marathon Team

The final run

This morning I woke up feeling like I was going to do an exam. Wondering if I had done enough practice in the last few weeks to enable me to perform on the day. I felt sick to my stomach, had hardly slept and just wanted to get to the start line so I could get it over and done with as soon as possible!

We left at 6am; I was layered up to the max not only with my running gear on but 2 jumpers and my thick jogging bottoms over the top, to keep my body warm and loose. Dad had made me swallow down some porridge with half a bottle of maple syrup in it to make it more bearable, before we left. That really did make me feel sick!

We jumped in the car and began the hour and a half journey. My nerves were getting worse so I started listening to my iPod music to try and settle myself down. Music has always been my go to thing to calm my nerves, even during flare-ups; singing to the music settles my breathing and brings me back to normality.  I was so tired and kept feeling my eyes drooping but I know sleeping before the run would be a bad idea as it would probably just make me more tired.

We arrived in London and I wish I could say my nerves had gone but they hadn’t. Not one bit. I took my 15 thousand layers off in the car and then we walked towards Hyde Park. We had no idea where we needed to be so the four of us probably looked like headless chickens! We got into the park and it was so much bigger than I thought! People were flooding in and I was feeling more and more intimidated by the minute. What had I got myself in for!!

Richmond and his wife arrived, so we got to see our t-shirts for the first time. It was so strange to see my name on a sponsored shirt! It was suddenly really real and I just needed to get to the start line. We said goodbye to mum, Tom and Cooper and headed off. We got ourselves into our start section, and then did the 30-minute wait till it was our turn to head over the line! Dad and I took some last minute selfies, looked at each other then started our gentle run over the big white start line! All I had to do was get back to this line, to finish!!

The route was even more beautiful than I imagined and having that many people shouting my name as I ran past made my legs just keep going without me even really thinking about it. About 20 minutes in a man was running next to Dad and noticed his shirt. He said “CRPS?” and Dad explained that we were raising money and that I had the condition myself and was still running it. He said he had a friend who was suffering with it in his back and he needed help, so Dad told him to speak to Richmond and then the man congratulated me for what I was doing! I did not think anyone there would actually know what we were running for as most people look at me blankly when I tell them about my CRPS so it was such a positive boost that not only did someone actually know and understand the condition but that they also realised that this was not an easy challenge I had set myself! The issue with a invisible disorder is that no one can ever tell, day to day, unless it is obvious on that day so to everyone on that run I was normal but that day I didn’t want to be normal. I wanted everyone to see my condition and how hard I had worked and was trying to get round this run!

RP

The first 6 miles seemed to fly by and it felt like as soon as we had come out of Hyde Park we seemed to be going back into it. The pathway through the beginning of Hyde Park was full of people; I couldn’t help but smile at the support and music blaring either side of us. There was so many people, I could not recognise the individual faces however suddenly I could just understand recognisable voices shouting both mine and dad’s names to which Dad then pointed to the left hand side and there was Mum, Ben (my brother), Tom and Cooper. I didn’t want to look directly at them as I knew I looked like a tomato and was panting like a dog! But just hearing them made me smile ear to ear and I could feel my legs pushing through more and more.

We got to the 8 mile mark and we were still running although it was starting to get hard now. Both Dad and I were starting to breathe differently although I could tell that neither of us wanted to be the one to ask to stop first as that person would then feel like they were letting the other person down! There were some slight hills but nothing as bad as what we have done at home so the hills weren’t too bad it was just the general ache in the whole body that was starting to slow us down. Dad suddenly stopped so I did too, and if I am honest I was relieved, I was in agony but I knew I would not stop if Dad kept running. The walk break allowed both of us to catch our breath but it also made the pain within my legs become more intense. This meant that when we started running again my legs hurt twice as much as before. But I just kept setting little goals for myself so I just had to get to that tree and then when I got there, I would set a new one.

This method worked for a while however then the CRPS started in my left hip and I was really struggling. In my head I was just thinking “I can’t do this, its too much” but no matter how much I thought this, my legs just did not stop running. We got to the 10 mile mark and Dad said we would just keep doing a mixture of both running and walking up to the 12 mile point. Dad was suffering with terrible cramp by this point and my hip felt like it was going to pop out of the socket any second. More and more people around us were walking too but everyone was so determined to keep going to the end! I have never had a 2 mile run feel that long before but today it felt like it was never going to end, like one of those impossible mazes you cannot get out of!

UP understand pain

We eventually made it to the 12 mile mark and at this point, the walking was more painful than the running for me however for dad it was the opposite because of his cramp! So it then worked out that while Dad was pace walking, I was jogging beside him at the same pace and that is how we got through the final mile. As we finished that final mile, we were on the straight path in Hyde Park and we could see the finish. It was so close but considering the pace we were going it was still a way away. But slowly we got past the 800m mark. Then the 600m mark. As we went over the 400m mark Dad began to run again, and I suddenly felt my legs kick into a new gear. Very suddenly the finish line was right in front of us and Dad grabbed my hand. I could feel the tears coming up into my eyes. As we came over the finish line, hand in hand, together as we had started I burst into tears and fell into Dad. We had actually done it.

6 months ago when I agreed to do this I never actually thought I would make it to the end. Until I felt that feeling of getting over the finish line, it had always completely felt like a dream! I was so proud and happy my dad agreed to do it with me as I knew I would never have got round it without him. He really is my hero.

We got our medals, banana’s and free water before trying to make our way out through the crowd to find everyone. We knew Richmond would probably have finished already but we were not sure about Jo. We eventually caught up with Mum and everyone and once again I cried as soon as I saw Mum (I am blaming the tiredness for this!!) and just felt like I wanted to collapse on the floor. We caught up about it then found out that Jo had just finished so we decided to wait till they got back before we left. I sat on the floor and stretched my legs out however I struggled to get back up so had to get Tom to lift me back up! Although my body felt tired, I didn’t feel physically tired, surprisingly I felt okay! Everyone finally was all back so once we had all caught up we headed back home, with our branded hoodies, wooden medals and pride beaming from us.

CRPS UK charity for complex regional pain syndrome

6 years ago I never would have even contemplated doing something like this let alone actually do it. I am a very different person to 6 years okay, some things for the worse and some things for the better. My determination to prove people and myself wrong about my condition is definitely something for the better. Today made me feel more normal than the average person as not many people are able to say they have completed a half marathon but now I can and if anything, it has made me want to do more. Maybe not another half marathon for a while but who knows what will happen in the future so why not enjoy life to the full now. Today I am proud of where I have come in the last 6 years, and hopefully in another 6 years time I will be even prouder.

The final thing I want to say is a huge thank you to everyone who sponsored me, to everyone that has supported me and wished me luck and of course to my amazing family, especially Dad. Everyone was hesitant at first about me doing it however I hope I have proved to them that I am a lot stronger than I look. The amount I have managed to raise is amazing and will do such amazing things to help others not as lucky as me. So a huge THANK YOU goes out to everyone and my last piece of advice will be that if there is anything you have ever thought of doing but think you cant, just do it because trust me you will not regret it!!!!!

Opioid painkiller prescriptions increase

A report from the Public Health Research Consortium (PHR) has shown the increase in use of opioid medication over the past 15 years. This is despite the fact that our understanding of pain and what we can do to overcome pain has advanced enormously in that time. There is a clear mismatch between the pinnacle of pain knowledge and what is known and practiced in society. The gap must close.

Screen Shot 2017-09-08 at 22.30.24
PHRC Final Report: Prescribing Patterns in Dependence Forming Medicines

Chronic pain is the number one global health burden, costing society enormously whilst millions are suffering. This is a public health crisis embedded in society. Whilst doctors are increasingly prescribing opioids, society is also demanding a quick fix in the form of a pill.

There is only one person that can overcome his or her pain

In many or most cases, when someone goes to their doctor they expect to come away with a prescription for a pain killer. They do not expect to receive advice on ‘self-management’ despite the fact that this is exactly what should come first. There can be a role for medicines, but within an overall programme of care that revolves around the person’s own understanding, thinking and actions.

To overcome pain takes understanding, the formation of new (healthy) habits, lifestyle changes, practice and effort

The problem of pain can only be solved with social change. This is the reason for UP, to drive that change by delivering knowledge, skills and know-how to society. To truly understand pain is to be free from the on-going loop of suffering by using our strengths to build wellness. This is the essence of the positive strengths-based Pain Coach Programme, with each person reaching their potential by clarifying their picture of success and learning the principles to follow in order to achieve results.

Screen Shot 2017-09-08 at 23.09.52
BBC News 

UP driving social change

As a purpose-led enterprise UP has the vision of a world where pain is understood to reduce unnecessary suffering. Our purpose is to drive social change with regards to beliefs about pain because we know that people can overcome pain, build on their wellness and live meaningful lives. Understanding pain provides that opportunity together with self-coaching that gets the best out of each individual so that they can reach their potential in whatever circumstances they find themselves.

The Understand Pain and Pain Coach workshops are tailored for the different groups: e.g./ patients, healthcare professionals, schools. The key information is the same, but the workshop structure and the practices are created with the participants in mind. They leave inherently knowing that there is a choice.

The actual experience is a vital part of the process. The sessions are designed to inspire individuals and healthcare teams to learn and grow, provide practical tools that can be used straight away and to integrate their learning in their own unique way that is appropriate for their life.

UP is bound to the principle of delivering positive work to people across the globe. If you would like to partner or connect because you are interested in driving social change for a better world for all, we would love to hear from you. We all have a responsibility to look after each other and the planet and we can choose to do this in our own way. The UP and Pain Coach Programme encourages, educates and enables individuals and groups to build on their innate capacity for wellness by learning and practicing the skills of being well.

In cultivating our ‘wellness’, we create the conditions for a healthy and happy life. Forming a strong foundation of being well that includes such components as self-compassion, purpose, resilience, attention and gratitude means that we become attuned to the existing goodness in us and the world. This does not mean that we do not face adversity, because everyone does at some point. However, practicing being well means that when we do come up against a problem, we can view it as a challenge and an opportunity to learn instead, using and bolstering our strengths. You could say that in fact we are choosing the positive approach as a way onwards.

To overcome pain is not to somehow fight it or to mask the true cause by taking medication. You can’t fight yourself after all. You are your pain as much as any other part or dimension of you. The pain is characteristic of the person as much as their humour or their posturing. Pain is not about tissues or pathology, it is about a perception or prediction of possible danger or threat. To overcome pain is to face the challenge, learn about pain, learn about yourself and how the pain emerges in you, and then transform the experience using practical tools that focus on what you want: your picture of success.

It is not unacceptable for the approach to pain to revolve around medicine. We know too much about what pain really is, what it is for and why we experience persistent or chronic pain. We know that people can get better, lead fulfilling lives and build on their wellness by understanding their pain and what they must do themselves to overcome pain. There is a choice to be had and society need to know that this choice exists. UP strives for the choice to ‘come alive’ across the globe, and we will work tirelessly so that each person can reach their potential for a healthy and happy life.

UP works on a 1 for 1 basis, which means that for each paid workshop delivered, one is provided to the local community within their environment. Please contact us with the form below if you would like to arrange a workshop in your area

Drugs and pain

Help

Drugs remain the predominant approach for chronic pain….

…which is one main reason why the problem of pain is escalating. We can never truly overcome chronic pain by thinking that drugs are going to do it for us. We have been brought up in a society in which medication is embedded in our thinking ~ we expect it, healthcare delivers it.

However the reality is very different, which is why the continued use of the biomedical model for chronic pain consistently lets people down. This is now an old fashioned approach that does not work.


Recent headlines

‘Unnecessary’ painkillers could leave thousands addicted, doctors warn’ in The Guardian, May 2017 ~ read here

‘Accidental addiction to painkillers ‘a public health crisis’, says charity’ on Sky News today ~ read here

Mr Shapiro said: “If you look back to say 2009 when the all-party parliamentary group on drugs produced a report on this very issue, including not just painkillers but tranquilisers and anti-depressants and the Government then took a very complacent view of the whole situation… that attitude hasn’t really changed.”

WHY? 

Why is there such little interest from the government, from policy makers, from research funders etc etc? I am sure that when some of these people experience their own chronic pain, they will regret that lack of interest. In the meantime we need social progress for this enormous social problem ~ understand pain a purpose-led enterprise driving social change


You may think that my opening statements suggest that I am anti-drugs. No, I am not. There is a place for medication in the treatment of pain but there must be parameters. For example:

  • What is the best drug for this person and how their pain problem emerges
    • e.g. based on latest evidence ~ ‘Existing evidence on the use of gabapentinoids in CLBP is limited and demonstrates significant risk of adverse effects without any demonstrated benefit’ August 2017 ~ read here
  • Does the person understand the drug: why am I using this one? What does it do?
  • How long will the person be on the drug?
  • When will it be reviewed?
  • How will the use of this drug fit into an overall treatment programme?

The fact that the old model continues to be used means that other serious problems have emerged, adding further suffering and cost: addiction. To use the Buddhist definition of the word ignorance is relevant. To be ignorant is to fail to see the reality. That is most definitely what has happened and this must change now.

Drugs do not teach us how to overcome pain. They merely mask the underlying issues for a short time before they bubble up again. Whilst this can be convenient and briefly satisfy the search for a ‘quick fix’, each time the pain re-emerges and each time the next dose is taken there is a learning.

We learn to gain a dependence on the relationship between taking something and the pleasure of relief ~ this is not addiction, which is another result from over-using drugs or an inappropriate use of medication. The short-termism is perhaps the way we are designed to work, seeking pleasure and avoiding pain as quickly as possibly. This us understandable, yet it still remains the wrong route to truly overcome pain.

Overcoming pain

So if drugs don’t do it, what does? There are simple steps yet it is challenging and hard work. However, hard work and focus are fundamental when we are seeking results and achievement.

“Success comes from knowing that you did your best to become the best that you are capable of becoming” ~ John Wooden

Firstly we must get our thinking straight. Understand pain: like any problem we must understand it to seek the solution.

Then we must take action, repeatedly, in the desired direction. Actions include our thoughts and how they make us feel and direct what we actually do. We must not make the error of thinking that the mind and our thoughts are somehow separate from the physical-ness of ourself. They are not. Our mind is embodied ~ where else can you experience your thinking but in your perceptions and actions? And where do you experience this from? Your body. Each moment is made of thoughts, perceptions and actions that define how we ‘live’ that moment.

Whilst this can sound a bit wordy and a bit philosophical, it creates a practical way onwards with a range of practices and skills that we can develop. What we practice we get better at and what we focus upon we get more of. What do you want?

“What do you want?”

Re-read the question if you need to. What do you want? What does that look like? How can you orientate yourself towards this vision in your thinking and actions each day, each moment? The answer to the first question is not, I do not want this pain. That is what you don’t want, this pain. It draws your attention, focus and resources to pain, pain, pain. Again, think about what you want. Let the image arise in your mind’s eye. Then make it brighter, more colourful and bigger. How do you feel?

To overcome pain we must learn to coach ourselves. We ask ourselves the right questions to start the day off well, committing to be the ‘best me’. Then we practice the skills we have learned that are all in line with your vision ~ movements, exercises, sensorimotor training, mindfulness, communication (with self and others), attention, gratitude, resilience, re-engaging with desired activities, people and situations to name but a few.

The content of each programme is sculpted according to the individual, who always does his or her best, learning all the way. Learning about the causes of on-going pain and how to transform their state over and over so that there is sustained change as the person reaches their potential. This is the essence of Pain Coach ~ the person getting results.

We are seeking social progress. The vehicle to drive this progress is UP or understand pain. UP is a purpose-led enterprise delivering the pinnacle of our knowledge of pain to those in need via workshops (recent CRPS Workshop success) and other means: including the pain sufferers, their families and friends, the policy makers, patient groups, charities and organisations.

Now is the time. Now we must move onwards and embrace the knowledge that we have gained and the new knowledge that will continue to emerge from research and experience. With this we can carve forward to reduce the enormous suffering and costs for a better society that thrives. Drugs are not the answer. The answers are within us.

“Be the change you want to see in the world” ~ Mahatma Gandhi

I would add, be the change you want to see in you. Because you can.

Please contact us if you would like to link, partner and arrange a workshop:

UP & Pain Coach Workshop in the community

Understand pain tackling the global chronic pain crisis

Delivering knowledge, skills and know how to people in need

On Monday 31st July I will be working with CRPS UK to deliver a workshop for people suffering complex regional pain syndrome (CRPS). This is the fundamental work of UP, to provide not only education but how to use the new knowledge effectively to get results.

CRPS UK charity for complex regional pain syndrome

Our focus is on change and moving onward by engaging in positive work. This is our work at UP as we seek to inspire, empower and enable individuals and society at large to live well and with meaning.

Human beings are incredible. We have such great potential. Our ability to learn, adapt, and transform ourselves means that we can decide to commit to the skills of well-being and reap the rewards. We are designed to change. We just need to decide upon the direction. What is your picture of success? What do you want your life to be like? These are the questions we pose in using a strengths based coaching approach to overcoming pain.

Pain Coach and Understand Pain Workshop

The workshop this month in Bath will be proactive, interactive and full of practices for the participants to take away and use with immediate effect.

To attend the FREE workshop, click here

What is Understand Pain all about?

The purpose of UP is to provide knowledge, skills and know-how to people who need to understand pain. With pain being the number one global health burden, this is a huge number of individuals in many different circumstances. We are not limiting ourselves at UP as we seek to grow quickly in order to reach across society and the globe to tackle this crisis. Our vision is a world where pain is understood and hence addressed effectively by individuals, society and healthcare.

We believe in the potential of this vast group of people across the world. They represent an incredible resource if only pain were understood, allowing for meaningful, fulfilling and useful living. Imagine the resources that would be available! The picture we see is society moving onwards, evolving and growing with a great sense of community.

UP delivers a range of workshops. To:

  • People suffering chronic and complex pain and their carers
  • Clinicians, therapists and allied heath professionals
  • Others who must understand pain as part of their professional role; e.g. medico-legal lawyers, policy makers, commissioners.
How does it work?

UP has different channels of provision. For each paid workshop we provide a workshop to a community or patient group. This means that those who are paying for their place or companies/organisations purchasing a workshop, are not only growing themselves but also society. This together with free places for the next generation of clinicians and therapists at each Pain Coach Workshop means we are building the knowledge and skills base together as a community.

Keep up to date by signing up to the Pain Physio Blog, the UP blog or sending me your email address to join the newsletter. The purpose of the blogs and newsletters is to advance our thinking as a society. As you will see if you sign up, overcoming pain is not by only focusing on treatment for pain, but by developing the skills of living and wellbeing. And the exciting thing about that, is that this is all about living well and performing our best. Do you want to be the best you? I know the answer to that! So join us and let’s understand pain and live life.

RS

Probably the best meeting in the World

More reflections on SIP 2017

IMG_4732

You know what it’s like. You realise at the time that you are involved with something important. Then you get home and start thinking ‘wow’, that really was probably the best and most important meeting in the World when it comes to the problem of pain: SIP 2017.

The problem of pain is undoubtedly one of the greatest challenges facing society, and most people don’t even realise. Up to 441 billion Euros is the cost of chronic pain each year. That is an enormous financial burden that does nothing to describe the suffering endured. This can and must change. Attitudes and beliefs in society need a drastic update in line with what we really know about our potential as human beings for fostering change. Out with the old messages, out with interventions and medicines as the way to solely ‘manage’ pain, out with the notion that pain equates to tissue damage. Out, out, out!

“out with the old messages and in with the real understanding of pain. Then society knows that this suffering can ease

It was fascinating and enlightening to hear so many European clinicians and stakeholders talking about people (patients), the importance of healthcare professional education, and even the word coaching was used. In the room were people looking at pain from all angles, a unique blend in the first place. This set the scene for deep discussion, learning and results.

The openness to ideas and modern thinking about pain was refreshing. The people at SIP 2017 want to understand, want to learn and above all want to make a difference. And we can make a difference by persevering and looking at every possible way to change the way society thinks about pain ~ understand pain to change pain.

No single group dominated the meeting. Instead the forum was truly free for each person to contribute and put forward their thinking and experiences. We heard people talk about their pain, and they were able to discuss this with scientists, clinicians and policy makers in an environment created purposefully. It seems that clinicians ‘worry’ about conferences or meeting where people with pain and suffering can speak about their lives. Instead, this should be encouraged and embraced as we get to the bottom of the problem and take real steps forward. How useful is a conference where academics or clinicians speak about cases and research without ant real stories in the room?

“the openness to ideas and modern thinking about pain was refreshing

My intention is to build and cement relationships with other stakeholders across Europe, be involved with the new EU platform, contribute with UP and Pain Coach workshops and take action in line with the vision of UP: a society that understands pain.

SIP statement

‘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.’

In the UK we must take this example of how we can move forward. Pain is a societal issue and hence we need to hear from all stakeholders, in particular patient representative groups. The lived experience of the person is the basis of what we are working with to overcome pain. We are seeking to change the story so that the person can say: I feel like myself. Change is what people want, defined in their own terms by things that they want to do in their life. We can and must work on a number of levels to achieve this and we can and must be optimistic. Why? Because we are changing every moment, we are designed to change and need to know how.

Our quality of life is determined by how we feel. How we feel is determined by what we are thinking (consciously and subconsciously). What we are thinking is based on our beliefs about the world, and these stem from all the influences in our life. The moment to moment decisions and actions we take through the day shape our life and the ‘rating’ we give to our life. However, there is constant change afoot and we can harness the opportunity this creates by making decisions to commit to a particular pathway. The pathway is determined by the practices chosen in line with a desired outcome. Being determined to be the best you, with a clear vision and being coached to achieve success and long-term results transforms the experience. This is the essence of Pain Coaching.

With 100 million people suffering pain in Europe, 100 million Americans suffering and the rest of the World following the same theme, we must create the conditions for change. This starts with the understanding of pain because when people truly understand their pain, they realise their potential and a way forward. There can be a role for medication and interventions on occasion, but with this being a societal problem, there are many other actions that empower and enable people to overcome their pain. Together we can do this as a modern society. We have the means and with the costs so high, we have the impetus.

RS

Compassionate abiding

A way to approach unwanted feelings by Pema Chödrön

Man and woman holding hands at a table

Pema Chödrön writes with deep compassion about the challenges we face in the modern world. Pema and Thich Nhat Hanh are two of my favourite reads, as they bring the philosophy of Buddhism to the people in a practical way. The practices do not need to be considered spiritual, instead ways to gain insight, patience and build compassion toward ourselves and the world. They offer a great deal more than that too!

My Pain Coach Programme is a range of simple and practical skills that you use to overcome your pain and live your life meaningfully. These skills are based on understanding your pain, the key foundation from where new healthy habits emerge. Here is a wonderful practice from Pema, compassionate abiding, which is a way to bring warmness to your feelings of discomfort. We all experience uncomfortable emotions and feelings, yet we are rarely trained how to face them, instead encouraged to avoid them. These feelings are a NORMAL part of life and hence unavoidable. Therefore, having the skill to be open to these feelings is a way to ease suffering.

In relation to pain, we have many associated feelings and emotions that increase suffering. There is the pain itself and then the suffering we live from the way we think about it. When you realise that you have a choice, it is hugely empowering. ‘How am I choosing to think about this pain?’ is the question to pose to self. As you step back from being embroiled, you gain insight and actualise the opportunity to make a choice to think differently and feel better. This is why it is so important to understand pain. To understand pain is to know that you are safe and free to make choices, and to live.

The practice

When you realise that you are hooked, which is that familiar feeling you have when a habit is about to arise, you use this practice. We all have many hooks that lead to the unpleasant or unwanted emotions and feelings, from seeing that the loo seat is up to the way a partner says something, from Monday morning blues to the craving for a cigarette. Other examples include addictions, phobias, fears, prejudice, shame, and rage

The embodied feeling emerges often with a familiar inner dialogue. However, we can choose to write a new script, a positive script. Interestingly, our self-confidence is determined by what we are telling ourselves and listening to (these are different) in this moment ~ watch here. Remember though, it is normal to feel the range of emotions. We need them all, even if we don’t enjoy some of them. No-one ever said life was wholly enjoyable!

In 2 parts

Breathing in

Being in touch with and open to the feeling of being hooked, breathe in deeply, allowing the feeling to really be there. Allow the feeling to exist. We can be tempted or in the habit of pushing away. You will be aware of the urges and discomfort, and that is normal. You can be ok, you can be comfortable with being uncomfortable. You abide with the feeling.

Breathing out

As you breathe out, you ease the tension that is part of and surrounding the discomfort. The out-breathe frees us from this tension as the space in which the embodied feeling exists becomes apparent.

When to practice

There is no limit to how much you can practice. I think a useful start point is to sit somewhere familiar and practice for a few moments and over time gradually increase the length, or blend with other mindful practices. Of course, drip-feeding our selves through the day, so little and often, has a really beneficial effect because we form a healthy habit. We can also practice as we become aware of the feelings of discomfort as they arise, touching the experience with our own natural warmth and compassion. You will notice how your typical reaction softens.

We are not pushing the feeling away. Instead we are fully there and present as the feelings transform, as all feelings, thoughts and emotions do. Nothing is permanent. No matter how ‘bad’ you are feeling right now, it will change because we change, every moment, like the water of a river that continues to pass by. This fact and the science of pain that gives us a new understanding of our potential, gives great hope and reason to be optimistic. Be inspired to live well, because we can.

A life of appointments

When life is dominated by the next appointment


Most people I see have a long story of pain. Frequently there has been years of suffering that has and does impact upon their life.  For some their days are strung together by appointment after appointment as they search for an answer to their pain. The key that unlocks that door is understanding pain. To understand pain is to know what you can do to move onward in a chosen direction. Undoubtedly, we can be successful in overcoming pain because it can and does change. We are constantly changing, like the water of a river, there is constant movement in one direction. Embracing and harnessing our potential enables us to live a meaningful life.

Whilst seeking an answer, there are always boundless doctors and therapists who offer solutions. Skipping the understanding bit and hastening to a remedy or treatment is often the way, yet the foundation is not in place. We must understand our pain to gain a sense of meaning, to know that we need not fear pain and instead to focus on certain practices and skills to enable change.

Expectations are typically low in chronic pain, which affect outcomes. The promise of success followed by yet another failure hits hard. Some people even blame themselves as the self-critic chips in. Developing self-compassion is a key skill as we learn to be patient with ourselves, let go of blame and focus on living well. To be harsh towards oneself is to provoke the same biological protection as when we feel pain. Of course our expectations are based on what we know, past experience and in the moment adjudication of the likelihood the treatment will work (based on what we already know again). In essence it is a prediction as is our current perception. The wonderful thing about being human is that we can change the prediction and infer something else. It is time to expect to get better. To expect that life will be full of challenges, but to expect to face them, learn and move on in a meaningful way. This starts with understanding pain.

One of the issues with on-going appointments is that the person maintains their focus on pain in their life. There is plenty more to define the person than their pain. What we focus upon we get more of, is a loose rule. If pain becomes dominant and rents much space in our conscious capacity, then there is little room for anything else. We must make space and while we are attending appointment after appointment, no space is being carved out. But I need the appointment because I must check and see if I have…….. etc, you may say. It is true that we must elimate any serious pathology or injury that necessitates repair, but beyond that, if the focus is upon living well and practicing such skills, then getting better is possible. The roundabout of consulting rooms is not.

~ pain and injury are not synonymous 

Regular readers know that pain and injury are not synonymous. They are different. And they are poorly related. We have known that for years yet the modern approach persists in a search for a structure or pathology to explain pain. There is no such thing as pain is a body, or whole person state. Like fear, like love, like hunger. You can see none of these because they are lived phenomena, experienced by a person and embodied by a person. A herniated disc, a disc bulge, an inflamed tendon, none are pain. Pain is a state of protect that emerges in the person in the face of perceived threat. Yes, these visible changes can co-exist with pain, of course. But they are not pain and not the cause of pain. The cause of pain is a perceived threat. It is how we and our body systems (they are not separate) interpret what is going on in our body but within the context of this moment (emotional state, environment, who we are with, what we are doing, prior events etc) that determines whether we feel pain or not. You will note from this description all the opportunities we have to change pain, because pain is part of me as much as my ears or my hair so it is mine to change. The change begins with understanding pain.

So, once you have seen the relevant specialists and determined that there is no serious pathology or injury that needs repair, and it has been confirmed that this is a problem of pain, then you can focus on getting better. This is through the practice of the skills of well-being whilst maintaining a course towards your picture of success, the healthy you with purpose.

Open space in your life to live well and be inspired to reach your potential, because you can.

RS ~