This short audio recording from Mags Clark-Smith explains what Chronic Pain is, why a lack of diagnosis can be so damaging, and what you can do to begin resolving your chronic pain.
Let's not focus on the pain, shall we?
Image: Vincent AF
Let's not focus on the pain, shall we?
So many patients are upset that they can't get a medical practitioner to give them a reason for their pain. The expectation is that every pain has a biomedical explanation. In fact this may be true, however, the biomedical function of the autonomic nervous system is often overlooked. The questions and answers below might help you to further explore this:
Might it help to change the way we look at chronic pain?
The premise behind Resolving Chronic Pain (in line with TMS / PPD*) is the neurophysiology of chronic pain. The aim is to recognise neural pathways that are not helpful to you and with the help of the Resolving Chronic Pain programme create new, more constructive neural pathways.
What is the neurophysiology of chronic pain?
The neurophysiology of chronic pain is about recognising the importance of the parasympathetic nervous system. It's ability to heal the body, and how this 'self healing' is obstructed by low grade stress. Stress activates the sympathetic nervous system stimulating adrenalin and cortisol to be produced and priming the body for 'fight or flight' synonymous with the stress response. When the body is in the stress response it cannot self heal and therefore the natural resolution of acute pain is delayed.
Stress and Fear
It turns out that the chronic pain may also be linked with fear, a close companion to stress. A key understanding of PPD is that issues the mind is reluctant to contemplate or might be deeply angry about, are expressed through pain in the body.
Chronic Pain is difficult to pin down
“Pain has always been a bit of a puzzle” says Ben Seymour, a neuroscientist at the University of Cambridge. “Hearing or vision can be traced from sensory organs to distinct brain regions, but pain is more complex, and incorporates thoughts and emotions. For example, studies have linked depression and anxiety to the development of pain conditions, and volunteers put in bad moods have a lower tolerance for pain”.
Depression and Pain
The stress response can lead to depression in a cyclic way, negative thoughts activating the sympathetic nervous system. The chemical reaction of the stress response leading to too much cortisol, depleting noradrenaline and dopamine levels so energy is depressed, replaced by apathy and negative thoughts.
The autonomic nervous system is invisible
About a quarter of those with chronic pain who contact UK charity 'Action on Pain say that their doctors don't believe them. “The problem is that chronic pain is invisible,” says chairman Ian Semmons. It is understandable that someone in chronic pain might feel upset, and therefore have negative thoughts if they think their Doctor disbelieves them.
Biomedical Solution
A balanced nervous system may be the biomedical solution that both doctor and patient are looking for.
*Glossary of terms: TMS Tension Myositis Syndrome, PPD Psychophysiological Disorders
Reference: Brain signature of emotion-linked pain is uncovered Jessica Hamzelou, January 2015
Please see Mags Clark-Smith's CPI article explaining how the autonomic nervous system works
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Chronic Pain: To suppress, manage or cure?
One of the most exciting speaking engagements for me this year was organised by Georgie Oldfield with support from SIRPA's executive board: Chronic Pain – To Suppress, manage or Cure?
All the speakers were health practitioners – doctors, researchers, psychotherapists - interested in the work of Dr John Sarno, a spine surgeon who identified TMS (also known as PPD) as a condition responsible for many cases of chronic back pain. John Sarno's daughter Christina attended the research meeting and the conference. She felt that her father would be thrilled that the work he started over 40 years ago is gathering pace.
The outcomes of this conference include plans for another gathering at the Royal Society of Medicine in November 2016, many more health professionals engaged in understanding the neurophysiology of chronic pain, a TMS research group formed by all the interested speakers and a hardship fund set up by SIRPA.
My personal guest was John Lindsay, chair of Chronic Pain Ireland. Here is what he wrote after the event:
“My congratulations on a great event.... I was really impressed by your speakers and as a result of attending the event I am going to re-evaluate our approach to Self Management of Chronic Pain. My sincere thanks for the 'guest' invitation.”
More information about what the speakers said in our forthcoming Blogs!
Glossary of terms:
SIRPA: Stress Illness Recovery Practitioners Association
TMS: Tension Myositis Syndrome
PPD: Psychophysiological Disorders
The executive board of SIRPA at the conference on 26th April 2015
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Does it matter what we believe?
Research suggests that 95% of the time our mind reverts to the beliefs we hold in our subconscious, laid down before we were seven.
Pain can be caused by the body expressing a disconnection between those beliefs and what we consciously believe now.
We particularly revert to these long held beliefs in times of stress or when we are under pressure. It appears that during childhood we learn our belief system from the 'significant' others around us - be it our parents, older siblings, other family members, neighbours, friends or teachers. We observe how they deal with adversity, joy, money, relationships, in fact every aspect of living and we adopt their beliefs almost by osmosis. These form our 'core' beliefs.
'Give me the child until he is seven, and I will give you the man'
St Frances Xavier
Jesuits recognised that a child learns without discrimination until the age of about seven, and neuroplasticity of the brain research supports this now.
Later in life as adults many of these 'core' beliefs are no longer part of our belief system on a conscious level. However, under stress or otherwise we might automatically revert to them as a gauge against which we measure ourselves and others. Joseph Pilates famously said it takes 10,000 repeats to change a movement pattern, and a similar number of repeats are required to change a 'core' belief. It is as if they are instilled within us, logically we can disown them but when under pressure they can come back into play.
Many people who have successfully resolved their chronic pain have addressed their beliefs and bravely 'reprogrammed' their core beliefs to suit their present lifestyle. Brave, because it might require digging deep, churning up a few things and then doggedly sticking with the repeats to establish fresh self selected beliefs. This may need expert support and the use of specific tools.
So it seems it does matter what we believe, as chronic pain can be the body's expression to the brain that our beliefs are not true to who we are now.
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Presentation in Westport, Ireland on Sunday 19th April
There was an enthusiastic audience of therapists at the TASK conference in Westport, Co Mayo in the beautiful west of Ireland this Sunday 19th April. Mags gave a presentation based on four case studies illustrating the nature of Tension Myositis Syndrome (TMS) within a Whole Health Medicine Institute (WHMI) framework.
Mags will also giving a presentation this forthcoming Sunday 26th April 2015 at The Royal Society of Medicine in London: The ‘Suppress, Manage or Cure’ SIRPA conference is the first TMS conference in Europe. It’s very exciting with several key speakers from USA – Dr. David Clarke, Dr. Howard Schubiner to name just two.
In Westport, there was also great excitement celebrating 20 years of TASK Ireland and a fabulous practical session covering elemental postural techniques and abdominal muscle work. Mags developed a physical social network and individuals, duets and groups discussed their ‘take away’ key points from the presentation.
Here are some of the take away points:
· Respecting individual perspectives.
· Valuing Active Listening.
· Nurturing gentle physical movement.
· Therapeutic relationship potential.
· Appreciation that each practitioner has a unique blend of skills to offer.
What skills do you think are important to resolving chronic pain? We would love to hear your views please comment below!
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Praise for RCP Virtual Programme
'A breath of fresh air' – the Virtual Programme from Mags and Siobhán
Chronic pain, defined as lasting more than three months, is not normal and it is not something that patients should have to bear. In these teleclasses, Mags and Siobhán will guide you through their approach to dealing with chronic pain in a warm and engaging way. The classes are an interactive opportunity to engage with your pain and to learn more about how to resolve it.
A single purchase gives you unlimited access to all six teleclasses, meaning that you can pause, rewind and reply the class at your leisure. There is no pressure to advance through them quickly, giving you the time you need to absorb new information and reflect upon what has been said.
Mags and Siobhán take the listener through a clear and logical six step process, inviting them to examine their limiting beliefs and attitude to pain. There are many exercises and extra resources suggested along the way, empowering you to chose how much or how little extra research you would like to do.
The content has been praised by patients as it is 'positive and encouraging. But it is realistic and shows a deep and sympathetic understanding of the difficulties of patients suffering from, chronic pain. Patients are encouraged to help themselves in a practical way, and difficult issues such as past emotionally charged experiences are acknowledged but not dwelt on.'