In Part I of Pain Narratives, I wrote of observing pain sufferers describe their experiences with the painful sensations of their body. I noticed there was a relationship between the language they used to convey their stories and the experiences they have had with medical advice or diagnosis. After hearing many accounts that share similar qualities of having someone almost define clients’ pain for them through graphic descriptions and negative outlooks, I decided to try helping clients use integrative, mind-body approach to help with their conceptualizations of pain.
I began exploring mindfulness and somatic sensing as ways to cope with my shoulder after being driven to the point of obsessive research on modern pain science during the dark pinnacle of my pain. I came to understand the narratives about our pain might affect our coping and healing. The language we use to talk to others about our pain affects the internal dialogue we share with ourselves, and it could influence the emotional landscapes surrounding flareups or that constant, dull presence. I believe it is important to understand the connections our mental framework has to the sensations of pain, which are signals of distress and danger from the nervous system. This is where a deeper sense of working with neuropathic pain patterns is relevant, that goes beyond a diagnosis-treatment approach found in the western medical world.
Before going further into this, I do want to say that I don’t believe medical professionals and therapists are evil and wanting to harm patients. I don’t disagree with people being treated by doctors or manual therapists (I’m a massage therapist!). I do think that the way people in a position of influence (doctors, chiropractors, physical therapists, massage therapists, etc.) communicate with patients and clients is something that needs to seriously be addressed. We cannot approach chronic pain, or any pain, without delicacy, without sensitivity, without empathy. When someone is told that their body is degenerating or shifting or contorting in graphic and desensitized clinical language, they are only being scared further into the depths of pain. Their mindset and framework of viewing their body and pain becomes negative, fearful, and shameful, probably without an expectation of healing or even finding a healthy way to cope. In this context, flareups can seriously disrupt not only the physicality of our experiences, but the heartfulness of who we are – our emotive states, our interpersonal relationships, our self-care, our ability to play and work.
Also, sometimes the words “mindfulness” or “lens of thinking” assumes a positive-only way of thinking for some people. I am not claiming that positive thinking and affirmations cure pain. Thinking strictly in positive terms inhibits deeply knowing the experiences we have as humans. Pain is very real. Pain is a human experience. The emotions of our pain body are very real. What may be able to help us cope with pain is not cheerily bypassing its rawness, but viewing it with a loving acceptance into our humanity. This is what is at the core of my own coping and what I think could help others.
Loving acceptance I consider an all-encompassing term. Its two-part name includes taking interest in yourself + making space for exploring yourself (love) and not resisting the truth of the felt sense (acceptance). Practicing loving acceptance is a way to turn inward during the painful moments, guide yourself to a familiar sense of safety in your body, perhaps relieve fear and anxiety surrounding pain, and develop a more accepting relationship with your body and your innermost self. This can help alter the patterns of thinking around pain and our general understanding of our personal pain-bodies, which could potentially help with recurring pain.
Consider this case:
Your pain seems to come in bursts, triggered unpredictably and inconsistently. When it comes, it remains for a few days, flaring up, otherwise laying dull and ever-present in your body and your mind. When it comes, it brings a compulsion of wondering what you did to bring it on – maybe you moved your body too much during physical activity, maybe it’s the position how you sleep. Now you are thinking more and more that you have to be more careful and alert when being active, or try to avoid sleeping in that position. “How long will it last this time?” you ask yourself. With certain movements you anticipate a shooting pain before it happens, and during the days surrounding this flareup you avoid moving normally and instead with care and calculation. You remember when you were active without pain only a couple years ago, and this mysterious pain that you have seen chiropractors, doctors, physical therapists for persists. You fear it will only get worse. You might have to give up things you love to do. You might have to buy a new bed. Maybe you need surgery. Your chiropractor said it’s sciatica because your SI joint is out of place but the physical therapist said it’s osteoarthritis of the hip. Maybe it’s both? Seeing both of them for a year could cure you. You waver between highs and lows of panic and depression. At this point, you don’t know how to cope beyond the fear.
We can use loving acceptance here. Here is what a practice of loving acceptance might look like, for this person and for you:
Consciously allow yourself to first feel and acknowledge what is associated with this episode. Telling yourself that “Loneliness, pain, and fear are very normalized emotional reactions to pain signals from my body” is a way to bring some sense of calm/normalization to a storm. This language of reassurance is building a stage of communicating to yourself in a conscious way.
Then, you might try to find a comfortable position for your body to sit, lay, stand, or walk. A position that eases from the sharper feeling of your pain, although the sensation of discomfort may still be present. Here, bring your focus onto the pain, in a way that allows you to just notice it, but not analyze it. Imagine a dog watching someone walk into a room, not analyzing, but simply noticing movement of a person. This is the mindset you could adopt: “Watching” the sensations of your pain as it is happening.
As your focus is toward the pain but not in it, you might notice it moving, shifting, expanding, contracting. Maybe it feels warmer, or begins to cool. Maybe it remains the same. Notice this. Try to view it not as pain, but as very interesting sensations you can explore. You could also bring imagery into it and explore colors, shapes, or even anatomy. For instance, the sensations might remind you of the color red, and they could feel like a shapeless amoeba, and of a muscle deep inside that is pulsing like a heartbeat. Again, nothing to really analyze. Just noting as an observer. This is kind of stepping away from the intense emotionality of things and giving yourself an opportunity to familiarize with your sensations in a more calm way.
Direct your focus onto a part of your body where sensation feels good. Even if it is a memory of your body experiencing a pleasurable sensation, like during a massage, where pressure is present and it feels good. Or the first moment of warm weightlessness when slipping into a warm bath or hot tub. Having your feet buried in sand at the beach. Your head being scratched by a loved one. The warmth of a pet as its body rests on yours. Really recall how it feels to experience these things, or whatever makes you feel good. Here, you are reminding yourself that your body is capable of feeling non-pain – even feeling good.
As you shift into recognizing a sensation of pleasure, notice your breathing. Nothing to force or change. Just see if you can follow your breath as it enters into your nose, throat and lungs; feel your belly move with the natural rhythm. Follow it as it returns, warming in your throat, and out of your body as your belly compresses. Can you find a sense of ease, or enjoyment here? Just tracing the breath, for however long you like. You can add a focus onto your heartbeat, too. Beating is the breath comes and goes. Focusing on the breath is an accessible act of mindfulness that is available in any moment of pain or distress. The breath is always there, and is a consistent sign of life that you can zone in on whenever you need to find a sense of comfort.
Keep the rhythm of your breath, but begin to gently shift over your gaze of attention from the breath to the pain. Do you notice anything different about the sensations? Maybe your pain has morphed from a throbbing web of sharpness into a cooler feeling, diffuse presence. Is it even still present, in this moment or when you were focusing on breathing, at all? Regardless of how your pain might have changed, remind yourself: “I am safe through this pain. My body is capable of locating and experiencing an inward sense of calm despite having felt very intense sensations. This pain may come back, and that is okay. I was able to manage my pain right now, and I can practice this again to find safety.”
How does your inner world feel as far as emotions and mindset, compared to before practicing loving acceptance? Are you more steady? Quieter? Less consumed by panic?
It is important to know that the more a practice like this is done, especially with an open mind and without expectation that you will find immediate relief, the more mindful acceptance will spread into your experience without effort. It settles into your natural mindset and way of seeing and thinking, perhaps easily, perhaps slowly. It might extend beyond the realm of pain and into other aspects of life.
Loving acceptance is not something that is typically validated or accepted in much of western culture. We are taught to move forward, faster, to be productive and to progress, to follow a linear path of forward movement in all parts of who we are. Practicing loving acceptance seems like a radical thing to do, perhaps especially when integrating it into our healthcare frameworks. It can seem counter-intuitive, even offensive to some who are living with pain. “Why would I want to be loving toward pain? Why would I want to accept it? I want to heal and be better.” Of course. Loving acceptance does not work to grasp onto pain and claim it, but to simply find peace in allowing you to navigate it when it is at its darkest instead of aggressively resisting and fighting, which can wear you down both physically and emotionally. Loving acceptance can carry us through to a place of wholeness, or self-understanding, and of coping or healing that which we never thought was possible.