Posted tagged ‘pain management’

“Pain” is a Four-Letter Word

October 27, 2008

I thought I was done with “four-letter words”. But …

Emotional and physical pain are part of being human. Not that we should expect them, but they do occur, and no one is exempt.

Western medicine has developed a vast array of drugs to combat pain, both psychological and physical. Even so, it’s the elephant in the living room—definitely there, but too often, not discussed.

People on both sides of the patient/physician spectrum have deep-seated notions about what’s “acceptable” as far as expressing pain. We all, at some level, think that it’s “better” to simply endure silently or with as little fuss as possible. “Complaining,” “demanding,” “difficult”—all these words are the last labels we want attached to us as patients.

We’re taught to “quantify” pain to try and understand it better. We say, “On a scale of 1 to 10 …” On this scale, 1 is barely a nuisance, while 10 is so excruciating it is unbearable.

If I’ve learned one thing, both as a healer and as a recipient of healing, it’s that people’s scales are all different. One person’s 3 is another’s 9.

Many people have also absorbed the “no pain, no gain” lesson a little too deeply. (I know I have—and then I wonder, “How am I supposed to relax and receive if it hurts so much?”.)

Medical students spend a lot of time learning how to fix the body, diagnose symptoms, and prescribe drugs that will produce specific results. With so many drug choices, pain can become just another symptom to assign a chemical solution to. We hear, “Tell me where it hurts,” or “Describe your pain,” but seldom are given much more than a few minutes to try and respond. Yet too often, pain robs us of our ability to communicate clearly, both with ourselves and with those trying to provide healing.

Pain is one of the biggest obstacles to effective healing. You can’t “just relax” if you’re in such severe pain. You can’t “just take some deep breaths”. Pain clouds our ability to process information, take suggestions, or sort through the emotions that get kicked up when we’re hurting.

Drugs often only add to this cloudiness, and many people either use too much of them to sink into oblivion, or avoid using them altogether in order to maintain mental clarity.

It might not make any difference at the general level whether the pain being experienced is psychological or physical. But how we, as healers or caregivers, approach our calling with respect to pain management has to flow from compassion and understanding, not simply a practical desire to “make it stop” or “get rid of it”.

The first step on this road is to acknowledge that, as healers, we are not going to be able to alleviate all pain. To think that we have this kind of power is arrogant and can be deeply harmful to us and our clients.

Second, we must go beyond simply having people rate their pain on a 1-to-10 scale, or describe it as “hot,” “cold,” “aching,” or “stabbing”. We can, and should, ask all these questions, but don’t just stop when you’ve gotten the answers you want.

Pain is a companion. Long after the appointment has ended and the prescription has been filled, people will still be living with it.

The approaches to managing it are as varied as the kinds of people we encounter as healers. What brings relief to one person with a particular condition may have no effect on a second person with the same condition. Pharmaceutical companies produce drugs that work on a broad range. If we are providing truly compassionate healing, we must target the specific ways that each of our clients can find and experience pain relief.

Sometimes, when there is no way to change the actual situation, simply being heard and acknowledged is enough to bring tremendous relief.

Pain manifests itself in innumerable outward responses. People lash out or withdraw. They cry. They stop speaking. They scream. They pass out. Pain increases the severity and duration of asthma attacks. It raises heart and breathing rates, heightens muscle tension, exacerbates inflammation, causes insomnia and anxiety, depression. It has such a capacity to stir up every realm of life—physical, emotional, psychological, and spiritual—that it is no wonder that so much “treatment” is aimed at eliminating it.

I have talked with many, many people, both as a healer and just as another human being, and heard many stories about the pain of loss, disease, disappointment, grief, loneliness, separation, disability, depression, injury, aging. Some conversations have been less than five minutes long, while others have been dialogs that span years, decades.

I don’t stand above these encounters, looking down on them and thinking, “Oh, here’s what you should do”. I try to see the circumstances from the perspective of the one I’m listening to. How would I feel, for instance, if my daughter dropped out of school, or my brother got angry and refused to speak to me for the rest of my life, or my employer let me go with lame excuses after I’d worked for ten years? What is it like to feel powerless to control myself when presented with a particular chemical? What must it be like to lose a husband after thirty years of marriage, or learn that I have a disease that will gradually rob me of my ability to think coherently? How would I respond if, on an ordinary drive, my car was hit head-on and I woke up three days later unable to walk?

The answer I have is, “I don’t know”. But I can ask questions, listen to the responses, and learn. By learning, perhaps I can pass something along to someone else in a future conversation that will help them.

And, if there is no “concrete” suggestions to be made, just the asking and the listening are a gift that goes too often overlooked.

We can find “concrete” aids to pain management—medication, meditation, music, massage, just to name a few. But there is no substitute for compassion and no prescription or dosage instructions for understanding. These must spring from the heart, without regard to how the other person will receive them, repay them, or respond to them.

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Mind Over Matters

October 25, 2008

I know, that title looks like a misprint. Should be “Mind over matter”, right?

Not really. As a healer, I am being reminded time and again that, while the physical aspects of what I do are important–pain relief, improvements in sleep, relaxation–there’s a huge component that is “behind the scenes”.

The mind-body connection is no news to anyone with even a mild interest in how we go through life. Whether you’re coming to it as a healer or as a recipient of healing (and we all fit in both categories at some point in our lives), that connection, and the interactions between the mental and physical spheres, can’t be ignored.

Symptoms that manifest in the physical realm can certainly be treated with varying degrees of effectiveness purely on the basis of their physical traits. For example, how many times have you taken aspirin for a headache, or antacids for heartburn, or cold medicine to get rid of congestion? We do a lot of those things without even thinking about it, content to just get rid of whatever physical problem is bothering us.

But because the mind and body are so closely bound up together, it’s prudent to consider what it is that underlies those physical symptoms on a psychological/emotional level. Is the headache caused by tension related to a hostile work environment? Are problems in the family so severe that they are literally making your stomach churn?

I’m not suggesting that every physical ailment springs from our minds. After all, viruses and bacteria are abroad in the land, and you can’t think or feel your way into or out of infections by them.

But the mind, and its potential to both help and harm, is a powerful force. We have plenty of new technology to take stunning pictures of the brain at work, and vast strides are being made in understanding what parts are active at various different times. We have developed a huge array of chemicals to alter how the brain works, and we continue to progress in our grasp of how people learn, acquire behaviors based on cultural influences, and process information.

But we have no way of knowing if we have reached a figurative wall in our understanding. We don’t know, for instance, what the limit is to how much information a mind can recall. We can’t quantify most of what goes on in people’s heads.

The mind is deeply mysterious, and its role in healing can be tremendous. For instance, painkillers for the most part don’t actually do anything to the nerves that are transmitting that scream of “I hurt! I hurt! I hurt!” They suppress the area of the brain that handles those transmissions. Talk to anyone who has had to rely on painkillers for a long period of time and you’ll often hear that, while they do help, they often cause mental fogginess that’s an unwelcome side effect.

Is there a way, then, continuing with pain as an example, to harness that potential in the mind to produce a painkilling effect or enhance what can be achieved using narcotics?

In a word, yes.

Not everyone’s mind is exactly alike, and while there are some general guidelines that can be useful when trying to work from a psychological starting point, the best thing one can do is listen to each client and discover what will be most effective to him or her. Someone with a highly active mind may struggle to do meditations independently, yet they may have a high degree of success with guided meditation in which the healer reads aloud. Why is this so? Because for a person whose mind is always in motion, filtering all those inner distractions–not following every train of thought–can be supremely difficult. Consequently, they feel that, if they can’t do it on the first or second try, or if they can’t do it for even three minutes, they can’t do it at all. Hearing someone else’s voice and having images described so that the mind has something to fix on can actually be very freeing for this type of client.

You won’t figure these things out by having clients fill out forms. You also won’t see this on the “front lines” of Western medicine–in emergency rooms, operating rooms, or in the ICU during serious illness.

It’s very easy to get caught up in the illusion that, as a healer, if you aren’t actually changing bandages, stopping the bleeding, or doing hands-on medicine, you’re not effective or important. Personally, I struggled with this, and still often do.

But recently, I have been reminded that there are many types of healing and, consequently, there must be many kinds of healer. To heal the body is a priceless gift. But a body without a healthy mind, spirit, or heart is no more than a complex biological machine.

I am discovering that, while I have some skill in the physical aspects of healing, my true calling seems to be more along the mental/emotional/spiritual lines. This kind of healing work doesn’t get noticed much–fine with me. It can get lost in the hustle and bustle that is modern medicine.

It’s not a one-off job, either. If you want to help someone understand their own mind and see them realize their own potential to capitalize on the vast power that is latent within them, you can’t do it in one session. Often, it can feel as if you’re going in circles, reworking the same lesson for the six hundredth time.

Yet with each pass, something is getting in, going deeper, being absorbed and incorporated, until change occurs and the person is living in a new way because they wanted to change and grow.

Listening to people, accepting their decisions without judgment, and, when you’re granted the privilege, witnessing this growth are the rich rewards we can look forward to as healers. I don’t force people to come looking for me so I can “fix” them or demand that they change. They find me, begin a conversation, and, sometimes, get something out of our interactions.

This is what matters–that we treat everyone with compassion, whether we heal with our hands or listen to another’s heart. We must all “take matters into our own hands,” think for ourselves, choose for ourselves, act for ourselves. Giver or receiver, we can only control our own self.

But, as I am discovering over and over, in ways large and small, when we embrace our true calling with joy instead of trying to be all things to all people, our effectiveness in healing skyrockets.