San Francisco

As some of you know, my household was affected by one of the many viruses doing the rounds a few weeks ago, unfortunately just before my work trip away, which resulted in a few weeks’ gap in the blog. Luckily, I managed to recover before the trip, and had a very productive time traveling to the United States and meeting lots of wonderful and like-minded people.

My trip began in San Francisco, after an eleven-hour flight from Dublin which gave me a good opportunity to catch up on my research! I stayed with a friend, who picked me up from the airport. It was wonderful to receive such a welcome in an unfamiliar environment, and reminded me how precious it is to nurture friendships, even when you don’t get to see each other regularly.

The Transformations and Transitions Retreat with Lissa Rankin MD began the following afternoon. There were seven Whole Health Medicine graduates including myself, and 20 healthcare professionals. Lissa is intuitive at creating an intimate group where everyone has the chance to make real individual progress.

The next morning, I taught the first session at 8.30am (not quite completely recovered from jet lag!). Lissa had asked if I could teach a movement session that related to Resolving Chronic Pain - most of the healthcare professionals attending were eager for new experiences to help them navigate a change to their previous career trajectory. Lissa includes three pathways in her 'Whole Health Medicine' (WHMI) graduate programme. My teaching session related to the first, called ‘Heal the Healer’, directly addressing the healthcare professionals' relationship with their own body and range of movement.

I’ll write more about that first session in detail in the next blog, as well as further updates from the trip. I’ll try to include an extra blog to catch up on those missed, as there is a lot to tell!

Progress

An acquaintance of mine, I’ll call him Fred, changed jobs a few years ago. The new job felt instantly overwhelming, and at first he struggled to get though each day. He was so busy he felt as though he couldn’t possibly get anything done on time, and was repeatedly missing deadlines. He found his new colleagues difficult to work with – those more senior were incessantly demanding, those at his level were prickly and uninclined to offer him any help, and the juniors he was trying to manage were obstreperous bordering on rude. He struggled to sleep, felt constantly tired, and frequently fell ill.

 The months passed, and things improved as he became more practised at handling his workload, and got to know his colleagues better. Eventually, he was offered a new job, and came to train the person who would replace him. He tried to ease her into it, to make helpful introductions and give her guidance that hadn’t been available to him when he started. However, she still struggled to cope with the workload, even while she was in training and only taking on a quarter of what the job involved. She missed several deadlines, miscommunicated with other teams and made several mistakes. Fred’s colleagues muttered to him that they wished he wasn’t leaving, as he was such a competent member of the team.

But rather than roll his eyes at the new person, Fred thought of his own first few months in the job, and how difficult he had found it. Only then did it hit him how far he had come. His work had become easier and easier as the months went by, and he had received positive feedback from his bosses several times. But it wasn’t that the job had become easier – as the struggles of his replacement proved – it was that he had become better at it as time went on. While Fred only wished the best for his replacement and didn’t want her to suffer, the experience of training her showed him his own progress, in a very satisfying way.

We don’t always recognise our own progress, especially if it is something gradual, which is not easy to measure. Fred’s example is very extreme, and the extent to which he was overworked is not something to aspire to. But his story is a reminder that sometimes it’s worth taking a moment to take stock, and recognise just how far you have come. Thankfully, he has now moved to a much less stressful job - and the woman who replaced him in his own role has adapted to it over time, in the same way that Fred did.

Gold medals

Just before my son started secondary school, he discovered there would be a mandatory section of his day devoted to sports. His timetable clearly showed that every afternoon he would have to spend at least an hour out in the sunshine… or more likely in Ireland, in the wet, mud and lashing rain. As he prepared to begin the school year, he was dreading it. He was an excellent student and very talented in many areas, but sports were not one of them.

Imagine his delight, then, when he discovered that the mandatory sports hour could be swapped for another suitably productive activity. He was thrilled to begin spending his time inside, in the warm, doing art. He is very creative, and hugely enjoyed having the time to hone his skills, plan projects and complement the work he was already doing for his curriculum art classes. He did still have to do PE lessons, so was getting regular exercise, he was just given the choice as to whether he also wanted to do extracurricular sport.

Earlier this week, as Team Ireland returned home from their most successful Olympics ever, he joked that we should have pushed him harder towards sport as a child, and he could have been bringing us home a medal. But it made me think back to that time, and how happy he had been to spend those afternoons doing art. I will always be grateful for the opportunities my son was given to take part in sport at school, but I am also incredibly pleased that he was allowed to choose his own areas of interest. He was encouraged to work hard, set and achieve goals, and learn new skills.

I am always awed by the talent, determination and hard work of Olympians, and always find the games inspiring – not to chase a medal, but to aim high and work hard, and to enjoy whatever areas of interest take my fancy.

The upside

As many of you noticed, I made a small mistake in last week’s email. The link to click through to my blog about the Kinesiology conference in Athlone was the same as the previous week’s link, so it actually took you to that week’s blog about sleep. As you know, the blog is published on the website at the same time as being sent out by email, meaning I include the link in advance before it’s live so it’s not possible to test it – and in this case it didn’t work! My apologies. The link still took everyone through to the website, where the new blog was already published, so I happily moved on and was ready to forget about the issue. However, there was an unexpected upside, in the number of people who contacted me directly to point it out.

There were several reasons that I began sending these fortnightly emails some years ago. One of them was to build up a body of blogs that new clients could read through when they joined, and another was to document some of the wonderful stories of resolving chronic pain from clients who were willing to share them. It is also intended as a way to discuss my research, conferences and publications, and a way to highlight interesting and useful research, thoughts and advice from elsewhere.

What I was also really hoping for was a sense of community and connection. The blogs are a way to keep in contact even with those whose sessions are less regular than every fortnight, as well as those who have resolved their pain and no longer have sessions. I always really appreciate the comments and emails you send in response to the blogs, and the discussions we have about some of them. I have never seen such a flurry of messages as I did last week! Even though it was not ideal and I apologise for including the wrong link, it was wonderful to realise how many of you had been looking forward to reading the blog. I hope you managed to find it. If not, this is a direct link (tested this time!) just in case.

As always, I very much welcome any thoughts, comments or requests you have regarding the blogs – I would be delighted to hear from you.

A rainy trip to Athlone

I recently gave a lecture to the Irish Kinesiology Conference in Athlone. Well, a lecture is what I had planned, but the event turned out a little differently! I had driven over on a Friday afternoon around 5pm, hitting the usual M50 traffic, made even worse by heavy rain and flooding. When I finally arrived I was delighted to be enveloped by the warmth of the conference room, and the friendly conference attendees – many of whom came up to introduce themselves to me, explaining that they had attended one of the Resolving Chronic Pain courses online.

My speaking spot was the following day, just before lunch. I was going to have to work hard to compete with rumbling stomachs! I had planned a formal lecture with detailed slides, but inspired by the warm welcome and relaxed atmosphere, as well as the timing of my slot, I decided to deliver something a bit more dynamic. I left my notes on the desk and spoke to the room about the importance of understanding pain neuroscience, and the role of safety and connection in promoting healing. Patients whose anxiety is exacerbated by PPD can find it difficult to be present and to feel safe, creating a barrier to progress. But when defences ease, less conscious emotions and traumatic material can start to emerge, becoming more accessible to explore, reflect on and potentially resolve. Responding to the interest from the audience, I used several anonymous case studies to illustrate my points.

Far too soon, the allotted time was up. There was just enough time to briefly talk through my lecture slides, and many of the audience members took pictures so they could look through the scientific evidence to back up these points at their leisure. We finished off with some brief movement and body-based work, to complement the discussion of safety and connection. And then it was time for lunch, and a fascinating remainder of the conference.

Sound sleep

“Sleep that knits up the ravelled sleeve of care… sore labour’s bath, balm of hurt minds… chief nourisher in life’s feast”. I studied Macbeth at school, and it was one of my favourite topics. We had to learn pages and pages of quotes off by heart, and while the vast majority seemed to be instantly wiped from my memory, as soon as the exams were over, this is one that has stayed with me.

One of the few things that hasn’t changed since Shakespeare’s time is our inevitable need for sleep, and how much better it can make us feel. Despite all of our advancements in medical knowledge and technology, there is still no substitute. In fact, better scientific knowledge has only served to highlight just how important sleep is – a fact that is still not really recognised today.

Sleep is still seen by many as a “waste of time”, and going without it is often considered a positive thing – because you stayed up late working or studying, or got up early to go for a run or get a head start on some chores for example. But those who suffer a lack of sleep – including new parents, or those with insomnia – know all too well how precious it is. A few years ago a popular book about the subject, “Why We Sleep”, by Professor Matthew Walker, opened some conversations about its importance, but on the whole, attitudes have not changed.

Stress can often lead to difficulty sleeping, and I have discussed ways to try and improve sleep, and the concept of good “sleep hygiene”, with many of you. One important and more general thing that needs to change is our attitude to sleep – recognising it as essential for both day-to-day functioning and long-term health. Time spent sleeping, or trying to get to sleep, is incredibly valuable, and should never be seen as a waste.  

As Matthew Walker writes: “Sleep is the single most effective thing we can do to reset our brain and body health each day […] unfortunately, the real evidence that makes clear all of the dangers that befall individuals and societies when sleep becomes short have not been clearly telegraphed to the public. It is perhaps the most glaring omission in the contemporary health conversation.”

Mark's story

In November 2023, after I had given a stress illness presentation to the Irish Law Society in Kilkenny, a woman approached me to ask if I would give her son a consultation. Mark, who was ten years old at the time, had been experiencing ‘tummy aches’ for 18 months. They began when three new children joined his school and started bullying him, and the adults he had trusted were unable to put a stop to it. He had since moved school, but was still feeling pain, which was worst in the morning, or when thinking about going to school the night before. He was still under stress as he had moved to a Gaelscoil, or Irish-speaking school, with a limited knowledge of Irish. He was now taking grinds, or extra tutoring, to improve. The pain was intermittent, but Mark had been consistently withdrawn, no longer the carefree child he used to be. He was assessed by a gastroenterologist, who concluded that PPD was the likely diagnosis.

His mother asked if I could help, but my immediate thought was that meeting the boy myself would be counter-productive. If the diagnosis was PPD, then I believed that Mark didn’t need another expert involved, he needed to be reassured and to feel safe. It seemed to me that the best people to do that were his parents, so I proposed that I could teach them how to help their son. Working with Mark’s mother also allowed me to understand the impact his parents’ attitude to his pain, and the way they dealt with their own stress, had on him.

I taught his mother the principles of Resolving Chronic Pain, and identified what was appropriate to pass on to Mark, how to deliver the information and the importance of the care-giver’s nonverbal communication. Through our sessions, his mother concluded that her son was still feeling the hurt of the previous bullying situation, and needed time to get over it. She and her husband also needed to rebuild his trust after they had been unable to make the bullying stop. He needed reassurance that things would be ok, and help to relax at his new school and to focus on positive experiences there.  

After our second session, Mark’s mother wrote: “After Mark's experience with the bullying, we need to build up his trust and confidence in himself and expressing his opinion. It would have been shattering for him to see that neither his parents nor his teachers could fix the bullying problem. Thankfully, a lot of repair can happen quite quickly.” 

Mark’s mother also identified that she wanted to work on her own stress, as Mark may have been picking up on her concern over his tummy aches.  

After six weeks of sessions and exercises, Mark’s pain was resolved. He no longer complained of tummy aches, and attended school without needing encouragement. His confidence increased noticeably both at school and at home, and his parents recognised his old ‘joyous’ self.  

After the fourth session his mother wrote: “We discussed how Mark has not had any tummy cramps since before the Christmas holidays, and has been happy going in to school this week - a miracle! Mags explained there may be blips going forward as Mark learns to navigate new experiences but it’s okay to be euphoric now! Mark is doing so well, with absolutely no pain…”

Greener grass

I recently went to visit a friend who lives on an island in Greece. It was beautiful, like something out of a film. A picturesque village near the sea, smooth sandy beaches, warm weather, and as much Greek yoghurt and honey as we could eat. She’s been living there for decades now, having upped sticks and moved in her twenties.

She’s built a seemingly idyllic life, even cultivating a small garden. As I sat at her outdoor table and chairs sipping a glass of wine in the afternoon sunshine, I couldn’t help feeling a little jealous of her lifestyle, and wondering what would have happened if I too, had moved to an island in Greece in my twenties. We had been in the same friendship group, and the rest of us were all surprised when she announced she was moving, as Greece seemed like an extraordinarily exotic location to us back then.

Imagine my surprise, then, when my friend mentioned to me over dinner that night that she had been wondering whether she made the right decision all those years ago, and imagining what her life might have been like if she had stayed at home. It turned out she had been feeling lonely recently, and while she has friends in Greece, had never built up quite the same community that she might have done at home.

I confided to her how I’d been feeling, and ticked off the long list of seemingly perfect aspects of her lifestyle in Greece. My amazement that anyone could find life on a sunny island anything less than absolutely faultless made her laugh, and soon she agreed that things had worked out rather well. It made me think how easy it is to assume that the road not taken would have been better, when in reality it is simply different.

Bucket list

I wrote a few months ago about my husband’s accidental entry into a 100km cycle race. He hadn’t taken part in any similar events in years, and hadn’t done nearly enough training, but signed up after being persuaded by a friend to join in. He was a little nervous in the run-up (frankly, he wasn’t the only one) – but in the end managed to get through it with a perfectly respectable time, and crucially, enjoyed the experience. He has now signed up for another, 50km race in October, and has somehow managed to convince me to join him…

Another family member recently sent me a picture of a camper van on his driveway, with the comment that he had always wanted to buy one, and had finally done so before it was “too late”. I began to wonder, is there something I should be doing before it’s too late? Travelling the world, changing career (no chance!), moving to another country? One of my children is approaching a significant birthday, and told me they had made a list of all the things they want to do before then. The idea of ‘bucket lists’ has never really appealed to me - as it seems like there is a high risk of setting unrealistic goals, then feeling guilty and disappointed if you don’t reach them – but I began to wonder if I should start making one of my own.

I couldn’t help laughing, then, when I heard the content of the list. It included points such as “make cupcakes”, “try a new sport”, “host a dinner party” and “go to the cinema”. He’s already achieved a few of them (making cupcakes was the first one), and I couldn’t help thinking of the lists of chores I sometimes make, when I add things I’ve already done just so I can tick them off and feel a sense of achievement. But this bucket list, he explained, was about creating a push to do fun things he hasn’t otherwise had the time or inclination to do recently, with an emphasis on everything being achievable so as not to create unnecessary feelings of guilt. It sounded like a great idea, and I began to think of some of my own.

Happy accident

“That’ll be €12, please,” said the friendly man at the entrance to the stately home my friend and I were visiting. “Of course,” I said, and rummaged in my pocket for my phone. It wasn’t there, so I opened my bag – but it wasn’t in there either. I must have left it in the car, I thought, and rushed back to check, making my excuses to the man.

But it wasn’t in the car, and with a sinking feeling, I had an image of my phone on charge on the kitchen table at home. We had left that morning for a weekend away, and it was now too late to go back and get it. I would be without my phone, and the wallet contained in its case, for the whole weekend. Thankfully I was with my friend, who happily agreed to pay for everything, and let me know my share of the cost to transfer her at the end. She also sent a message to my family, to let them know they could contact me through her.

I tried to relax as we began a walk around the grounds, but couldn’t shake a feeling of unease. I kept reaching into my pocket, only to find nothing there. I wasn’t sure what I was looking for, as I hadn’t been expecting any particular calls or messages, but regardless felt an overwhelming urge to check my phone.

As the weekend wore on, I became slightly more accustomed to the absence, and stopped reaching into my pocket. But it really brought home just how often I check my device. I keep it on vibrate, so I don’t really need to actively check for any missed calls in case of an emergency, and most notifications are messages which I could respond to later in the day.

By deliberate choice I don’t much use social media and have always considered that I have a good approach to distancing myself from my phone. However, the experience made me realise that my habits might have slipped recently. When I finally returned home to find it exactly where I had left it on charge, I checked it, only to find that I hadn’t missed any urgent messages at all. I resolved to have a holiday from my phone more often, and to leave the house without it again every now and then – or at least, if I need it in case of emergency, to leave it alone in my pocket for a while.