This is Part 2 in a case study of chronic pain recovery. It’s the story of Simon, an orthodontist living in Australia. If you haven’t already read it – here’s a link to Part 1.
My daily practice was intense. I’d do a grounding ritual in the morning. Then I’d do half an hour of meditation and MindBody practice. Then I’d have breakfast. Then, I used to over exercise (more on that later.)
I’d meditate and MB practice again for half an hour before lunch. Then after lunch I’d repeat the process. I would then continue my pain education, and half an hour before dinner I would meditate and perform MB practice for another half an hour. Sometimes I’d do a final half hour before bed. My meditation time reduced and my MindBody practice increased to the full 30 minutes as the benefits became apparent. So in effect I was doing around 2-2.5 hours work each day on various MindBody techniques.
I’d split that half hour in a particular way. I’d do ten minutes on the Observer exercise. I’d do 10 minutes on a oral/facial distraction technique. And 10 minutes on nerve visualisation. Over time this practice evolved as I experimented and refined which Mindbody techniques worked best for me.
My first Mindbody technique came from my knowledge of an anatomical thing called the homunculus. I had originally trained as dentist before specialising so I knew the anatomy of the mouth very well. I also knew that there is a lot of sensory data coming through this area to the brain.
If we look at the homunculus, this is a diagrammatic representation of the importance of various body parts in the brain. Our fingers have a lot of sensory input, so does our face, mouth lips and tongue. These areas are large on a homunculus and I needed a large area to combat the aberrant sensory input from my hands.
I can touch a tooth with my tongue and know exactly which tooth it is, even exactly which cusp it is. I know which sensory nerve I am stimulating in my tongue and teeth and I know how these nerves make their way back to the brain. Think of the London underground or the Paris metro and trace your route from north to south or east to west, visualise each tunnel each station all the other connections etc in as much detail as you can, they are all distraction techniques and this was my technique in my anatomical metro.
During this Mindbody technique I started off just running my tongue along my teeth identifying cusps and fossae as I went. This created a rich amount of sensory data which would take over from the pain messages which usually overwhelmed my mind.
I thought: “If my mouth has a massive sensory supply, then I can bombard my brain with information from this area and overwhelm the pain message.”
This worked very well for the first few weeks but it became less powerful over time, I think as my journey along my nerve pathways became second nature again, the attention required reduced, I could do it on autopilot and pain became more difficult to get into the background. To increase my techniques power again I experimented using very strong mints and chilli on the inside of my lower lip. This got my attention, but also became less effective over time and the chillies were quite unpleasant, I’m dribbling now thinking of them. Lately I’ve added very light stimulation with a very thin watercolour paint brush to my lips and surrounding skin. This has remained very effective but requires the brush and obviously privacy. It’s no longer my main technique but it was a good ‘in’ to start my progress.
So that was the middle ten minute part of my practice. The first part as I mentioned before was lying there and using the Observer. I would see myself as if from outside. I could say to myself: “Look, your leg may feel like it’s on fire right now, but you can see it obviously isn’t.”
My practice evolved over time, I added breathing, but it eventually became clear that my third technique was the best, it was also portable which is essential, if you plan to act against any and every pain intrusion during your day.
Now I do ‘The Observer’ exercise for about 2 minutes to get me in the mood and separate from the pain, I then quickly cycle into my nerve visualisation, which I’ll describe next. For the last part of the half hour I move on to a mantra in my head where I acknowledge that “ There is no danger, You are safe.” and “It’s just a b.s. message and I’m not listening.” I do this practice with my eyes open, sometimes looking into a mirror so I can see the skin below my knees.
This technique which was my third choice, eventually proved to be my most effective. I saw myself down at the nerve synapse – where the peripheral sensory nerves from your body join into your spinal cord. This is the place where – if your pain system is sensitised – normal messages get turned up, all the way to the level of pain.
In this visualisation I would play a mental version of a game we used to play at boarding school. A game I was very good at. It’s called ‘British Bull Dogs’ or sometimes ‘Bullrush’ , it’s rugby without a ball.
The game works like this: one person stands in the middle of a field, and all the other people run towards this person, trying to get to the other side. This solitary person has to tackle the people running across the field. Each person he or she tackles joins him. So by the end of the game, everyone is on the tackling side, trying to stop just one person from getting across the field.
My thought process was: “There’s amplification of the pain message happening at the nerve synapse. I used to be very good a rugby and Bullrush, and I could tackle and bring down anyone. So if I’m there at the nerve synapse, I can stop the amplified message. And the more I’m there, I’ll get support from my pain system, so there’ll be more and more of me there to help block this pain message.”
This has been the most powerful of my techniques and the one that I’ve kept going with. It works very well, and has worked for months. I combine it with breathing. When I breathe in, I imagine sucking down pain inhibitors along the descending inhibitory pathways, neurotransmitters that block the message. These days, if I’m in pain, I can breathe in, hold it and feel the pain reducing as I do this.
In a book I was reading (Neuroplastix), I’ve seen functional MRI’s of a normal brain, a brain in acute pain, and a brain in chronic pain. They’re three very different pictures. The brain with chronic pain has very large areas of activity that show up like fire. So in my visualisation now, when I breathed out, I also imagine I’m blowing out the fire in these parts of my brain.
So my visualisation was stopping pain messages going across the nerve synapse, and reducing pain in my conscious brain. After a couple of weeks of this practice the burning pain in my legs had reduced to an area the size of my hand, just below my kneecaps.
Recently I had to fly back to Scotland for a bereavement. I thought it was going to be hell, and that my pain would flare. But I was fine.
The extent of how much I’d turned everythings around didn’t ring home until I came back from my skiing holiday this Xmas. Just a few months ago I couldn’t bear to go out if the temperature was 18 degrees (64F) outside – my skin was so sensitised. But now I was able to enjoy a skiing holiday in Canada with my family.
Before I went to Canada I started to look at repressed emotions, and how they affect chronic pain.
There were older childhood emotions that I looked at, but I also addressed the more recent ones related to my pain. I also hadn’t really dealt with the emotional fallout from quitting work or not being as strong than I used to be due to my MS.
Actually I honestly think some of the locations of my pain had to do with the things I was repressing. My leg pain related to not being able to run like I used to, and my hand pain related to not being able to work.
I’ve read a number of books on the association between repressed emotions and pain and having found one that really clicked for me, I’ve spent a lot of time depth journalling. In depth journalling you don’t focus on your daily schedule or particular events, you focus on your inner experience and the dangerous emotions these events create. You’re essentially looking at Anger, Fear and Shame or milder forms of the same emotion.
Sample questions were provided but you are encouraged to create your own. Questions which strike at the heart of the problem rather than beating about the bush. It was just me, the question and a blank lined page of A4.
Powerful questions like:
‘What is your pain distracting you from?’
I did depth journalling for around 45 days. I wrote my answer to my questions each day. It took around 30-60 minutes to do this. When I’d finished writing each day, I’d rip up what I’d written and chuck it into a dustbin. I accumulated half a large dustbin full of ripped up paper.
And then one day I thought “You’ve addressed all your repressed issues (actually I hadn’t, the jumper and the ketamine question brought out repressed issues that I couldn’t reach). You may have to come back and address some of them again, but the process of self exploration has now finished. You are no longer repressing emotions. You’re not happy with having to stop work, or not doing sport, but you’ve come to terms with it.”
I had pretended in the past to have come to terms with going from working very hard, running very hard and living life at a very full pace – to doing not much. In a sense, it felt like two lives – before my illness, and after.
I pretended to myself I didn’t hanker for a return to my life before my illness, but to be honest I did. I’d go to race track meets, and come away so frustrated. I wanted to do things in the way I used to do them. I had avoided going near my old workplace, or thinking about what I used to do, because it caused pain and frustration. These repressed emotions about my illness, my childhood and my medical mismanagement had just quietly built up and were festering way, I needed to address them and remove their power.
I don’t think my pain was caused by repressed emotions. The original cause was nerve damage secondary to Multiple Sclerosis. But towards the end, negative emotions became a major component prolonging my pain and I needed to address them.
Every morning I do 10 minutes thinking about the issues I’d repressed. I ask myself: “Am I at peace with my illness?”
When I was young I was told to ‘work hard,’ and this became a major part of my identity and self worth. So I ask myself: “Am I at peace with the idea that I’ve worked hard, and it’s ok to not be working now?”
Because when I look at it objectively, I did work hard, very hard for 35 years…until I basically exploded. I never really appreciated how hard I was working myself. Nowadays I can better see when things are getting to be too much and I can dial them back, but I still overdo it.
End of Part 2. Click here to read Part 3 – The 100 Day Habit Change