When you deliver a message, there may initially be resistance. It may not be what the person wants to hear. Then, in time it starts to take on a meaning for the person, making an impact. You are sowing seeds.
Recently I received the most heart-felt email from someone who came to see me three years ago. It was wonderful to hear how well he is doing in his life now.
At the time though, he was having a really tough time with chronic pain. It was deeply affecting his life.
‘…about three years ago or so I came to you as a patient suffering from chronic pain and anxiety issues. I would say that it was an extremely low point in my life as I could not see a way that my problems could be fixed. I found myself at that time catastrophising the smallest of problems and living with a constant expectation that things would always go wrong. I suppose that I felt comfortable in the negativity since it allowed me to blame everything else for my problems and I could present myself as a damned individual. Thought patterns such as “If only X didn’t happen, then I would be happy” were a common occurrence for me.’
At the time, I listened to his story and in turn tried to help him understand his pain: what is pain? What influences pain? Why does it persist? This is the first step.
Then we moved onto ways that he could move forward: different practices, tools, and strategies. One major theme is building wellness, our greatest buffer to life’s inevitable ups and downs. To be well means that we are able to face our challenges and think clearly about what we can do.
‘I have been thinking about the influences that helped me to re-evaluate my cognitions and to take a healthier/ more proactive approach to my own health and happiness. I do firmly believe that those few sessions I had with you in London back then was the most important influence in changing my mindset for the better. You helped me realise that I truly did hold the power over my life, and only I could make the changes to improve things. I remember at the time that your words deeply frustrated me, I had wanted a miracle cure or someone to take on my problems for me, but you made me see that only I was responsible for my own happiness. Over time I became more confident and was able to deal with my pain issues far better than before. Your advice also came at a vital time in my young adult years, as I also viewed my university life and the world generally in a negative and gloomy way. Because of your advice, I felt that I wanted to try new things more and to make the most of the time I had. I felt proud of myself and was therefore able to handle negative experiences far better than ever before. I truly felt comfortable holding the reins of my own life.’
His words reflect the feelings of many people I suspect. It is understandable to wish for passive treatment to help and for the quick fix. But as with anything that really matters in life, this is not how it works. Instead, we must go on a journey and gain insights into ourselves, our beliefs and habits so that we can build on what works to take us onwards.
There is always a reason for pain
“Your pain is the breaking of the shell that encloses your understanding.
Even as the stone of the fruit must break, that its heart may standing in the sun, so must you know pain.”
~ Kahil Gibran
The meaning must be discovered within the narrative. Our role is to listen deeply and then guide when asked.
This does not always sit with the modern model and individual expectations. This is not their fault. The messages of passivity are strong in society. Control is rarely given to the person as a first step.
Instead, there is an on-going search for an injury or pathology to explain pain. Yet even if found, they offer no insights into the pain perception. It is like closely examining words to understand why someone finds them funny. You need to know the person and their life.
Medicine has a role in eliminating any serious pathology or condition that can benefit from medical treatment or intervention. Once this has been established, the person is informed and can choose.
However, not everyone wants medication or injections. Many, if not all, want to know what they can do to live their life and re-connect with what matters. This is what makes the difference. The modern doctor will swiftly refer to a therapist who can be the guide and encourager.
My contribution here is the concept of pain coaching. The pain coach sees the person first, establishes their picture(s) of success and strengths, and then helps them design a way forward. We keep the light firmly fixed on the potential to shape a positive future.
We need to help society move towards understanding the purpose of pain in an effort to reduce the suffering caused by resistance towards what is.
‘Looking back on those days feels like I am looking at a different person, and when those same thought patterns start to crop up again, I feel like I have the pride and confidence to dismiss them and instead focus on my productive and inspiring attitudes and beliefs.
You came at an incredibly important and vulnerable time for me, and I can’t honestly say whether things would be the same now if it was not for you….I have the confidence now to strive for what I want in life and to embrace the responsibility for my own happiness and health.’
It is the person who transforms themselves. It is not about changing who they are, but rather focusing on their existing resources, positive history and adding choices, tools and ways to achieve results. This is the organic approach.
In short, the more the focus is upon the treating the bit that hurts, the worse the outcome. The more the focus is upon the person, what they want to achieve and the steps to get there, the better the outcome.
My message here is one of great hope. There are many ways we can help and guide people onto something better as defined by them. As therapists we care. We can sow seeds and then water them by keeping our focus on what matters, the person.
There is hope if you are someone who suffers chronic pain right now and there is hope if you are a clinician who works with people who suffer. It starts with understanding pain and sharing the knowledge in a practical way, answering the question: what can I do to make a difference?
It starts by sowing seeds. In some cases they grow quickly and in others it takes more time. Natural variation.