What is chronic pain, and what causes it?
Chronic pain persists for months or years and can manifest in the body in various ways. There are many contributing factors to this pain level; prior experiences, beliefs, expectations, and the context from which the pain arose (this may be, and often is not singular) all play significant roles in shaping the experience.
The primary model in our society is the biomedical model. This is the search for a physical, measurable cause for pain. But this is not how pain works; fundamentally, it is the wrong model. It separates mind and body. For example, a belief that the place where it hurts in the body is the source of pain is incorrect. Like all conscious experiences, pain is generated by our body systems top-down. It’s like being at the cinema. You see the film on a screen, but it is not being generated by the screen.
Our body systems are ever evolving and changing; learning. The point when something happens (e.g. injury, illness, stress, prior traumas, how they have been handled and how they have shaped biological responses) is the surface of the pain. How our body systems respond depends on past experiences (learning to date) and the situation at the time, including how the person is. Early treatment and care also influence the trajectory.
Mind and body are not separate. This is why understanding a person’s life experiences to date is vital to understanding their pain. Some people find this hard to accept. Especially if they believe that the tissues or pathology are the cause rather than understanding their experience as an interpretation or best guess about what is happening now. The science is becoming more evident and more apparent in the mind-body connection.
Who suffers from Chronic Pain?
In theory, anyone is susceptible to chronic pain. But factors that can raise the risk include limited beliefs, adverse childhood events, existing medical conditions, injuries, social setting (e.g. poverty), and quality of relationships (including formative years — parents, schooling).
The people who struggle the most tend to have fixed beliefs and have difficulty shifting their thinking. This is not their fault. They did not ask for that kind of embodied mind, so jostling sticky beliefs is vital to getting better, leading to better actions in line with building wellness and enjoying a fulfilling life.
What are the treatment options for chronic pain, and are there therapies that can supplement medication?
As a Pain Coach, I am a guide and an encourager, offering many ways that a person can become unstuck and move forward.
There is no single therapy or treatment. Predictive processing is our best model right now (and it will evolve). It is far more complex than the biomedical model but offers many opportunities through its complexity. People are complex, life is complex, and pain is complex. A one-size-fits-all approach to treating pain will not do.
I have been a proponent of pain coaching for many years because it does just that. We work together collaboratively, giving the person the knowledge, skills and know-how they need to make a difference in their world. There are many skills and strategies that will enable a person to get on and stay on a path to shape a positive future. But this must be grounded in their thinking, understanding and acceptance of the current situation. Appreciating this will change because it always does. Impermanence is a feature of life and a powerful insight.
What is the link between chronic pain and mental health, and what self-care practises do you recommend for people facing mental and physical battles?
Mental health is a sum of its parts, and separating the mind from the body inhibits healing. Whilst our society and healthcare continue to put people into pre-determined boxes rather than shaping care to the person’s needs, I believe in a unified experience rather than separating mental, physical, or mind and body.
The self-care practice we build is bespoke, designed for the person and their picture of success. There are many skills and strategies to choose from to form the person’s daily practice: e.g. movement, exercise, breathing, mindfulness, meditation, time management, touch, communication skills, gratitude, skills of being well, skills of daily living, and decision-making.
Shaping a positive future is primarily about self-care, and with the proper guidance, support, encouragement and empowerment, an individual can achieve a better quality of life. Pain Coaching is all about giving people the knowledge, skills and know-how to self-care, build health, ease suffering, overcome pain and live their best life.
However painful, resistance to what is happening is the primary cause of suffering. The alternative is seeking to understand, finding a way through, growing and transforming your relationship with the trauma. Trauma is part of life. We aim to avoid it in our society, but this is an impossible task. Understanding the reality of things is vital to finding the way through and forward. In life, there is suffering (ageing, disease, illness, separation, loss, etc.), but there are ways to ease suffering.
What advice would you give to individuals with family members or loved ones experiencing chronic pain?
Chronic pain is a specialist field, so when seeking support, be sure to reach out to a specialist. This is your life, so it matters. Have conversations with a healthcare professional who truly understands pain and its context in your life.
You are right to include loved ones, as they are immediately affected; therefore, seeking support and guidance is essential in understanding how it can impact the person’s closest relationships.
It’s only fitting that your book is dedicated to what could be described as your life’s work. Tell us more about the main driver behind this body of work and when it will be available.
A book is a great way to reach people beyond my practice. There are millions and millions of people suffering chronic pain in the world. There is just one of me, so I want to share what I do with as many people as possible.
My aim with this book is to guide and encourage people to access their courage and strengths better to understand their pain and suffering and, in turn, ease their suffering by focusing on living well, bringing joy back to the day-to-day, and living their best life. This book is a culmination of many years in practice. A shift in a person’s understanding of their pain can make a profound difference – words can and do help people heal. A new insight and even a subtle change of direction can positively alter someone’s life.
Pain Coaching is all about the unique person, their needs and values and meeting them in skilful ways. The book grants access to my day-to-day in-person guidance and teaching and serves as a reference for individuals to empower themselves to heal their relationship with pain. The book will be available on December 1st 2023.