Getting the best of Christmas

5 top tips if you suffer chronic pain

If you are suffering chronic pain, here are 5 tips to maximise your festive spirits and joy. You can decide upon your approach and give it your best by following some simple principles.

1. Make a plan

What is your picture of success? How do you want Christmas to be? What can you focus on that would make it memorable for the right reasons?

The questions we ask ourselves, we will always answer. So, make sure you come up with ones that self-encourage, helping you to focus on what you want, rather than what you do not want.

Think and act like the person you want to be

Make a plan each day, prioritising the key moments, punctuating them with rest and recovery time. You can share your plan with those you’ll be sharing the day with so that everyone is on board. Of course, the best plans do not always turn out the way we want, so we need to be flexible. However, if we try to stick to it in the best way that we can, often made easier by writing it down, then we are doing all that we can to be successful.

2. Motion is lotion

This is a way of nourishing your body (tissues — muscles, joints, tendons etc.). The key is to be consistent through the day. In essence, the movement is ‘pumping’ blood and hence oxygen into the tissues as well as removing the build up of toxins (that cause sensitivity).

The brain is embodied, and needs movement to survive — the brain needs a body. Pretty much everything that we do requires movement. Anything that gets in the way of the movements necessary to meet our needs will raise the perceived threat value. As many readers will know, pain is well-related to perception of threat and the state of the person, and poorly related to the tissue state.

Move to groove >>> any movement is a good movement!

A simple way of using ‘motion is lotion’ is to move and change position every 15-20 minutes, and then stand up and move around every 40-60 minutes. These are ball-park figures and it is important to work out your own need for movement. Further, you may like to use prompts and reminders until this becomes a habit.

3. 3 breaths

As often as you can remember (use reminders for this as well), stop and pay attention to three full breaths. Notice the moment when you first breathe in, the sensations in your body, and as you breathe out, the sense of letting go.

Attention is one of the skills of being well. A famous study was entitled, ‘the wandering mind is an unhappy mind’; in other words, the more we can pay attention to what is really happening, the happier we feel. Paying attention to your breath is a simple way to develop this skill.

Notice how you relax and muscles ‘let go’ as you breathe out. This is because on the out-breath, the parasympathetic nervous system is more active. This branch of the autonomic nervous system is responsible for all the important healthy functions behind the scenes: digestion, sleep, energy, anti-inflammatory activity and more.

5/5 breathing >>> count slowly to 5 as you breathe in, and count slowly to 5 as you breathe out. Continue for a minute or two, or longer

We have no direct access to our biology. It is in the dark, so to speak. However, there are one or two things we can choose to take control over to an extent. Breathing is one, with all the benefits that come with the innumerable practices that have been ‘breathed’ over the centuries.

A further use of the 3 breaths is when you feel tense, pain, frustrated, angry, upset or any other emotional state. Notice how when you pay attention to the breath, those feelings ease. This is because you have stopped fuelling them with the thoughts.

4. Meaningful connections

We need each other. We are design to connect and share and be generous. Have you noticed how your feelings change when you do something for someone else, no matter how small or insignificant that it may be? In fact, it is the little things, consistently, that make the difference, especially in a relationship.

How great does it feel to be with people who care about you, and you care about? Notice how that feeling builds when you pay attention to it (re-read the bit on attention above if necessary). Become aware of those great feelings and sensations in your body when you merely think about a special person.

Even when you don’t know the person you are encountering, can you make the connection meaningful by passing the time of day, and smiling? Of course you can! This can become the way you do it; your style.

Watch other people interact, share and be kind to each other. You will change state and feel it. Pay extension.

One way of connecting is by touch. Again, by design we have a system dedicated to light touch that is a direct way of soothing another, showing care and concern and evoking a healthy biological response. This is also a simple way for a partner to share a moment with you.

The key to feeling the effects, is to be present. This is the only moment, right now…it’s gone, and here is another…gone, and so on. Being present means that you can pay attention to what is actually happening, rather than being embroiled in the mind’s wanderings. To be present is also a skill to practice.

5. Smile. Just because you can

Notice what happens when you bring on a gentle smile. A soft upturn of the corners of your mouth. You can choose to tie this in with the now well-known practice of gratitude. The (biological) state of gratitude is one of the healthiest and an ‘antidote’ to suffering states.

Before the practice, it is important to acknowledge that all states are normal and part of the spectrum of feeling states. We need all of these states of course, as they communicate a need.

What are my needs right now? This is a great thinking tool, as you step back from being caught up in it all, and realise what it is that you need to do in this moment: move, breathe, eat, re-frame a thought etc.

What are my needs right now?

To practice gratitude is to become aware of something in your life that you are grateful for. There are many things that we can chose. Of course, whether they become apparent depends on your mood. A handy mantra here is: for a good mood be grateful, in a bad mood be graceful.

Practice: think of a moment in your life when you felt truly grateful for something. Focus your full attention on this memory, re-living it using all your senses, noticing which senses amplify the feelings. Is it the sights, the sounds, the feel? As you continue to focus on the feelings as they arise in your body, notice how they build.

Moment to moment noticing of things to be grateful for and those that bring you joy is a practice; a skill. For instance, you can decide to approach the day by looking out for things that make you laugh or smile. Then you practice.

The fact of the matter is simple in principle. The challenge is to keep focused and pay attention to what is really happening in the face of the many distractions. It is to realise that we live out a story that can appear to have been written for us. There’s some truth here in as much as we are fed beliefs from a young age, many of which are wrong, yet can limit us as we grow. Realising that you do not have to continue with the same story if it is full of suffering, is the first step to moving onward. Many don’t realise their potential, feeling that somehow, this is it. Not true. Is it time for a new story for you?

What will be your story from now?

And so, what will be your approach? How are you going to do Christmas? How are you going to do life? What is your picture of success? What principles must you follow each day to get those little wins on the way forward? Make a plan, get the right support and encouragement around you, and go for it. Each person is a miracle when you think about how we came into existence and how we are designed to grow and serve a purpose.

Merry Christmas.

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!

UP and running again

A journey of courage

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The London Marathon now in the past, we are focusing on the next run, The Royal Parks 1/2 Marathon in October. The details of the projects being co-supported with UP will be released soon, however we have two participants bravely embarking on the training journey. This is very exciting, but above all, full of meaning as they face the challenge of getting fit to run 13.1 miles. I know that they will do their best and we will be fully supporting them with a training programme and lots of positive encouragement.

Having just done the marathon for the first time, I know what it feels like to be thinking about running for long periods. However, the reality is never as bad as the thought, like most things. The actual run on the day is the icing on the cake, whereas doing one’s best along the way is success. This is a test. A test of oneself. And this is why it is such an incredible learning opportunity and a way to boost self-belief whilst improving physical health.

I will be documenting these two runners’ journeys and hopefully they will be writing their own blog entries. Sharing stories like this is inspiring to us all. We love to hear about and feel motivated by others’ achievements. They have achieved already by signing up. Now they can clarify their picture of success and think about what that looks like as they begin their experience!

RS

 

5 ways a partner can support and encourage 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 simple ways that a partner can help:

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.


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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

Pain and choice

There is one thing that pain does and that is narrow down our choices. A sense of choice has a major role in the sense of ‘me’ and who I am. Losing choice impacts upon us significantly as we feel less and less like ourselves and who we are meant to be. This is a very common description of the impact factor that I hear when listening to people enduring states of chronic pain.

Talking to people with pain as we seek to gain insight into the causes of their suffering. This provides a way to offer support, guidance and a way forward. Of course we can only move forward, but sometimes it does not feel like that! Groundhog day.

Enabling one to see their choices then, becomes a valuable and important exercise. We have many, but sometimes we just need a little help to realise and then actualise. I believe that the greatest steps are taken when this happens as the person feels empowered to steer their ship once more.

We need to know where we are going of course, a direction created by clarifying what we want as opposed to what we do not want ~ “I don’t want pain” versus “I want to live well”. Focusing upon living well motivates actions and behaviours in line with this whereas thinking about getting rid of pain keeps our attention on pain. We will only be successful, and we can be, if we have the right approach, mindset and attitude that we may have to cultivate and practice. Most I see do need to work upon these skills of attention, resilience, self-belief and determination. That is the first choice.

We can choose our approach. We can choose to engage in healthy activities. We can choose to take every opportunity to live well. We can choose to create the conditions to feel better. We can choose to have meaningful interactions. We can choose to leave some thoughts alone if they make us feel bad. We can choose to move and gradually move more as we adapt. We can choose to learn about our pain and our responses to pain, and then change them if need be. There are many choices we can make.

Of course it sounds easy when written and the doing is different. It is an experience. However, it is perfectly do-able. We are designed to change and do so every moment that passes. We can harness our potential and opportunities with simple measures, practices and skills based on new knowledge. Achieving success is with everybody’s reach although sometimes we need some help and guidance. But we can do it. This is the ethos of UP. Let us make choices to live well, create joy and face challenges with a sense of ‘I can’.

Choose ‘I can’.

 

UP supports research into pain

cropped-screen-shot-2015-10-21-at-08-20-53.pngOne of our main objectives is to raise money to support vital research that will make a significant difference to the way in which pain is understood and treated. Such research is underway here in the UK. This is both exciting and necessary in moving forward our thinking so that we can have a significant impact on the global problem of pain.

Mick Thacker has been an enormous influence upon my work and beyond, and in fact I blame him entirely for my obsession with understanding pain! I still recall the lecture he gave when I had my ‘aha’ moment, realising that there was a way forward. Not looking back since, there have been incredible steps forward to where we are now. Mick has had a huge impact upon so many people over the years and this continues. We have a lot to be thankful for and I am grateful for the opportunity to support the work he describes below. I believe that this research is by far our best opportunity to truly understand pain.

‘We propose an interdisciplinary programme of research that focuses on a new approach to pain based on the Predictive Processing Framework (PP) set out by Profs Andy Clark, Jakob Hohwy, Anil Seth and Karl Friston. The main feature of this proposition is that pain arises from circular influences that link the body (including a brain) with the world. This approach sees pain as an action-orientated perception that attempts to both identify and alleviate/limit the potential causes of actual, potential or ‘imagined’ danger to the self. We believe that this approach will extend well beyond the current bio-psychosocial model.

Working closely with philosophers and neuroscientists we will reframe our current understanding of pain using models of PP and will marry empirical based experiments into nociception with current philosophical perspectives. We plan to use these newly acquired perspectives to propose and plan a series of empirical studies that examine pain from the perspective of PP. The direction of these studies are likely to employ many different approaches across the (cognitive) neurosciences including human psychophysics and neuroimaging as well as the development of modelling paradigms involving artificial neural networks and related techniques allowing us to fully understand and evaluate pain and it’s impact on the person.’

Mick Thacker PhD. MSc. Grad Dip Phys. Grad Dip MNMSD. HPC. FCSP.
Senior Consultant AHP (Pain) Guy’s & St Thomas’ NHS Foundation Trust &
Centre for Human and Aerospace Physiological Sciences. King’s College London.
Pain Section, Neuroimaging. Institute of Psychiatry. Kings College London.
Adjunct Senior Research Fellow, School of Health Sciences. University of South Australia.

What research is UP supporting?

Pain being hugely complex and one of the greatest examples of a conscious experience means that we have many questions to answer. This includes an understanding of pain biology, pain psychology and the social dimension. Whilst all are important, it is the unification of these that is the lived experience, the phenomena of pain. This is what we must ultimately understand so that we can have a true working knowledge of what is going on and what we can do about it.

Hence we need a model that can deliver this depth of understanding and a basis for action. We are fortunate in that such work is going on as we speak, and it is this work that UP will be supporting. The yield will be the practical application of our knowledge about pain so that individuals can really know what they can do to move forward and overcome their pain. Such knowledge will also inform healthcare practice from the outset when a person presents with a pain problem — those initial messages are vital; they must be right as they often set the scene.

Chronic pain is the number one global health burden, which means that millions are suffering. This can change. This must change. This is the reason for UP.

Please support us in our mission and come and see us at The Royal Parks run on Sunday 9th October: http://www.justgiving.com/crowdfunding/understandpain

We are on twitter @upandsing and our hashtag for the run is #upandrun

RS

UP for Hyde Park half marathon

On 9th October an UP team will be running the Hyde Park half marathon, raising awareness for the understand pain campaign. Following three successful singing events at Heathrow, we are moving forward by applying to become a charity. This will create a structure that enables us to fundraise so that we can support our work in delivering the right messages about pain, empowering individuals and educating health professionals globally.

The overarching aim of UP is to reduce the suffering endured by millions across the globe. A shift in thinking so that pain is understood will enable change in the right direction, whereby we live in a world where pain is not feared but instead addressed in the right way. This means we use the right language and communication with people, focus on their needs, listen to their story, respect their experience and create a way forward with the person. Not only does UP promote change in the right direction by understanding pain, but also how we can go about this in a compassionate fashion.

Here are our immediate plans:

  1. to create a brilliant website full of high quality content that will help individuals and society to understand pain and what can be done.
  2. to promote individual’s understanding of their pain and what influences their pain so that they can be empowered to overcome their problems and lead a meaningful life.
  3. to raise money to support a research project that will further our understanding of pain so that treatment can improve.

Much more to come!

The team are really looking forward to the half marathon, which will be a lot of fun. I think that there maybe a few surprises in the crowd to look out for and a few competitions on the day. Keep following us and share with friends, colleagues and family. We need your support so that we can spread the word and reach as far and as widely as we can!

If pain

IMG_2528If pain was understood, there would be less suffering.

If pain was understood, the right messages would be given from a young age, sculpting behaviours based on what needs to be done.

If pain was understood, there would be no fear about it.

If pain was understood, we would focus on what we can do to feel better.

If pain was understood, it would be known that listening deeply is the first step to help someone transform their pain.

If pain was understood, it would be known that understanding pain changes pain.

If pain was understood, there would be an enormous amount of money available for a better society.

If pain was understood, it would sit in the realm of public health and not medicine.

If pain was understood, there would not be the reliance on medication.

If pain was understood, what would the world be like?

— this is the mission of UP | understand pain; to globally change the understanding of pain, because put simply, the world would be a better place if pain were understood.

http://www.understandpain.com