The opportunity to be seen, heard, acknowledged. Understood.
Having some agency, a sense of control over what is happening in your life.
The ability to move around in the world. To get up and down, tend to daily tasks at hand.
Do what brings you joy, pleasure.
To experience community.
I can imagine that many of these bring up some kind of sensation in your body as you read through the list. So many we take for granted.
I have a sense you may be missing a few, maybe a lot of these. Feeling loss or grief.
I know I am.
It’s not gone unnoticed by me that many of these are already experienced by the people I see, those I help to support through my work. It is not uncommon for people who have lived with chronic pain, often for years, to feel this sense of isolation, the loss of freedoms, work, connection with others. Well, there is a lot.
This came up up front and center when the hardest hit in our communities were those living in senior or extended care centers. They were already living in such a manner. Already in it.
Many others living with health concerns, disability, low socioeconomic status, new immigrants to our country have this as a part of their ‘normal life’. Not COVID life.
I don’t have the answers but my hope is that we bring some awareness to these issues, some path forward for the long term. Not just now.
Everyone waiting for things to get back to normal. Talk today of vaccines and yes, one can hardly wait. There is so much on hold at the moment. Much fear, uncertainty. I can feel that. Sense that.
But might we also learn from and change in some way, what is often normal for many.
Think back to when this first began and the heightened state of everyone around you. I can surely remember what it felt like walking through the grocery store as everyone was scrambling for Lysol wipes and toilet tissuse. Nervous systems all on high alert, seeking some sense of security and groundedness.
Perhaps we can begin to imagine what that feels like for so many when these big life events or ‘transitions’ happen. Injury, illness, aging, loss, grief. Can we learn ways to help with that, to sit with that, bring some care and ease to the person in need.
We’re all going to be there at some point.
Something will happen. If not before, we will grow old. We will struggle. Lose independence. Freedom. Ability to do things.
Might we provide for, care for, those who are already ‘in it’.
I can recall in an instant what it felt like when I was in a car accident just about this time two years ago. As I think about it my breath becomes short, my heart rate increases a little, I get emotional, my body tenses up almost like I’m experiencing the impact all over again. In fact just seeing a ‘deer crossing’ sign still brings about this response in my body.
I can also imagine another experience. At the same time two summers ago, I was with a group of friends… enjoying days in the sunshine, swimming in the river after a most nourishing lunch. What I notice in my body when I think about this experience is the opposite to what’s described above. Ease of breath, smiling, relaxed, heart slow and feeling all warm and fuzzy.
This happens even as I IMAGINE these two contrasting events. Interesting how my body responds and my actual physiology changes. My breath, heart rate, blood pressure, emotions, etc.
Consider how your physiology might change through the day due to various experiences, thoughts, emotions, conversations, demands that make up your daily routine.
Our body, brain, nervous system is so wise. It helps us to navigate the world around us, keeps us safe and alive, regulates all the systems within our selves. Takes in information external to us through our senses, responds to all the internal information received in our body at the same time. A rather smart organism. I am most grateful that it does all of this automatically that I don’t even have to think about it. Nope. I don’t have to remember to breathe, or make my heart pump somehow, or organize the digestion of my food.
But this not thinking about it, not noticing, or paying attention might not always be helpful.
For instance, if I ignore the fact that I’m really thirsty on these hot summer days we’ve been having where I live, I might become dehydrated. Or if I don’t pay attention to the sensations that tell me it’s time to rest, I may become over tired and become careless, not able to learn, deplete my body’s innate need to rest and replenish all these wondrous systems.
I may not notice a stress response I seem to be ‘in’ all the time. I might not easily move into a different one (parasympathetic response) one where I can rest, sleep, where my heart rate and blood pressure lower, digest my food. I might have elevated stress hormones constantly floating around in my system, thinking it needs to help ‘fight and protect’ me from something. Inflammation might occur. And on, it goes.
Life is hard. Life is stressful. No doubt about it.
What might help is to learn to recognize the signals this wise body is giving us and responding some way. How we might move into action when needed, like if I am in a car accident or if I need to change my business model due to this pandemic we’re experiencing. Or how we might move into deep rest when needed. So we can sleep. Digest our food. Help influence or decrease inflammation. Navigate with some fluidity, between the two responses.
And how might a stress response, impact our experience of pain? Can we respond in some way when noticing this? Our response might be to change something. It may be to just notice. It might be to extend ourselves some compassion, knowing these are challenging times. The first step though, is the awareness that it’s happening at all. The listening in, paying attention.
Curious to explore this a little more? Might it be helpful to learn how you might have some influence over these systems?
Creating New Pathways: change your pain, change your life begins tomorrow. I would love to have you to join us.
“When we ‘find’ our bones and allow them to assume a supporting role, muscles can start to relax. It is in the ‘undoing’ of muscles that freedom in the joints is found – and with it, greater ease in movement.” Peter Blackaby, Intelligent Yoga
How might you explore this and how might it help in finding more ease in your life, less pain, or fatigue?
Try noticing if you’re holding tension or contracting a muscle that’s not required for whatever it is you’re doing. So for example, I often suggest a person balance on one leg and notice if this creates any noticeable tension in their upper body, or jaw in order to do so. Obviously you don’t need your jaw muscles to contract to stand on one leg, but might this happen without you being aware of it?
How might you learn to release this? To relax, let go of what’s unnecessary. I think it can often be more helpful to imagine softening, rather than ‘letting go or relaxing”. How often have you been told to “just relax….”. Easier said than done.
One of my teachers used words suggesting this relaxed tone in our tissues “might feel like the texture of a soft, ripe peach.” Or I can imagine how the muscle tone feels in a baby or young child compared to what I notice in myself at times.
Make the biggest smile you can. Big, huge cheeks. Feel the tissue around your cheeks, maybe your throat, neck and perhaps even your shoulders. Just notice. Or clench your mouth, teeth really hard. Now, let your jaw hang loose. Open your mouth. Feel around again. Notice the difference.
I’ll often suggest people lay down on the floor to rest. Not your bed, not the sofa, but the floor.
Why is that?
When you lay on the floor it’s usually easier to feel the support of the ground below, in contact with your bones. So you might feel your head supported, shoulders, pelvis, legs and feet. See if you can notice that and does this allow your muscles to soften a little? This can be really hard to do. Something you might try is to first tense or contract a muscle (like we did above) and then release it so you can notice the difference.
The first step however, is just in noticing. Like anything, by practicing this you’ll often be able to sense more easily when there is tension ‘held’ in your muscles that you’re not aware of. Tension that might contribute to other changes in your body and likely fatigue, over the longer term. How might that influence pain?
The second step might then be, how to find support. Curious to explore this further?
Creating New Pathways: change your pain, change your life begins this Wednesday, July 22nd. For more information or to register:
Do you know that you can experience a HUGE amount of pain, yet have no damage or injury in your body?
Have you ever heard of phantom limb pain? It’s when someone experiences pain, yet they don’t even have the body part? Think of someone who’s maybe had their arm amputated but still feels pain there. How can that be?
Or maybe you’re someone who has been diagnosed with fibromyalgia. No obvious damage or injury can be found yet absolutely, you feel pain.
Do you know the reverse is also true? You can have NO pain and yet have ‘damage or injury’ in your body?
Have you ever found a bruise on your body yet had no idea how it got there? Or maybe you broke a bone playing one of your favorite sports but didn’t really feel pain, until you got to the hospital? There was obviously tissue damage, yet no pain. At least at first, perhaps.
Maybe you’re someone who has disk degeneration, yet no pain. According to this study (brinjikji et al 2014) if you’re 60 years old, 88% of people whose back has been imaged will show disk degeneration, yet experience NO pain. If you’re up to 70 years of age, it’s up to 95% who have what looks like damage or injury and yet has NO pain.
When you have a headache, think of a really, really painful headache, … do you think you have something broken or damaged in your head? Likely not.
So why do we think that way about other parts of our body?
Pain is weird, for sure. And complex. And our understanding of it does not always match with what’s going on. Often, we are confused by it, don’t know what to do about it and just live with it.
Don’t get me wrong. You NEED pain. Otherwise you would likely not survive. You need a mechanism to tell you something is up and you need to attend to it.
It’s the persistent chronic pain that seems to be the trouble. In Canada and most places around the world, 1 in 5 people live with it. If it were an easy fix, we would have done so by now. Two areas that the evidence tells us seem to be most helpful are: understanding pain and movement. We’ll cover both.
Well, there is more to it but if you’re curious to know how you might change, how you can influence your own experience of pain, I’d love you to join a new 6-week online program starting July 22, 2020.
Advantages of this being online?
anyone can take it in the privacy of their own home,
at their own pace
all the content is yours to keep forever, and
I’ve made it affordable and accessible so anyone can enroll. $25 week, for 6 weeks (both a payment plan and options are available).
If you or someone you know might benefit, click the link below for all the details.
I could really go on and on about breath, from many different angles and actually have been sent down the rabbit hole for a few days now wondering how I might approach this, in a single blog post.
Our breath, the in-breath and the out-breath happen quite naturally, right? Of course, they do. It is one of the most important things necessary to our survival. We do not have to think about it. It is just one of the many wonderous systems in our body, working behind the scenes.
However, if you look at how a baby breathes, and how many of us older folks breathe, you might notice a difference. How in babies and young children it almost seems like their whole body moves when they breathe. How their big, soft bellies expand with each inhale. For us, often, not so much.
There could be a whole mess of reasons, but the one I’ll explore here is one you’ve perhaps been exploring over the past week.
Muscular tension might be involved when we hold our breath, or when it doesn’t flow so freely.
Generally, muscles and tissues may become strained, fatigued over time if they are recruited, or over-recruited, ‘switched on’ a lot. We may not be aware of this, particularly if ongoing over a long period of time. It often becomes our usual ‘pattern’ rather than what might be a responding or releasing (and relaxing) as required.
There are also some areas of the body where this tension might get in the way of a full, easeful, ‘natural’ breath we see in a baby. I think of the stomach or belly area for one. How many people unconsciously hold or constrict in this area for a multitude of reasons? This, which happens to be the area containing your primary breathing muscle, the respiratory diaphragm. Or might someone hold tension unconsciously in their pelvic floor (diaphragm) muscles, again for a variety of reasons? I think of all those ‘core exercises’ we’ve been told are good for us or how often women socially, culturally, ‘suck in their stomach. Or perhaps you’ve been told to do kegels at one time or another, or hold, strengthen or tighten up your pelvic floor muscles. Which may be useful. Or maybe not.
Both diaphragms are meant to move with each breath yet with tension and tightness in one or both, might this change how we breathe?
Holding tension might not allow for a full, deep breath such as when our respiratory diaphragm moves down, creating the in-breath. Maybe, we hold tension in the pelvic floor, without realizing it and again, not allowing for optimal breath.
Now, think about what is more important to our body, to our brain, but breathing. And how this regular intake of oxygen not only provides nourishment our body needs to survive, but it also forms or influences our physiological state. For instance if we are under threat, or even perceived threat there are immediate changes to our physiology, including our breath, that takes place to aid in our survival.
Which is all great when we’ve broken a bone, need to pull our hand away from fire, stay clear of toxic fumes or something similar. Back in the old days, we would need all our senses, these sensations, to help us stay clear of dangerous predators like tigers and the like.
What happens now though, is often we are unaware of:
1. The threats (real or perceived) that we encounter on a daily basis. These aren’t likely threats like running from tigers, but threats in terms of our relationships, our jobs, our finances, our communities, our environment. How much of the news do you see, threatens your sense of safety? Does this create a sense of tension, stress, holding of your breath perhaps, in your body?
2. The response of your nervous system and subsequent physiology that accompanies this. You may have read that stress is not good for the immune system, for your mental health, etc. but there are also effects on other areas or systems that occur including your pain system. If pain is meant to protect you, yet you ‘feel’ threatened, stressed, and tense might that turn UP the volume of pain? Have you ever noticed a correlation (not saying cause, here) in your stress levels and your pain?
Conversely, how might a sense of safety, turn DOWN the volume of pain? Even a few simple words from a parent to a child such as “you’ll be okay” often turns down a pain response.
Can we learn to notice our breath and what that might tell us about how we feel?
Can we find a breath that is supportive for us, when it’s called upon?
Can we find a breath that is supportive for for us, when we need rest, find calm, sleep?
There is no right or wrong in this.
Rather, can we find a responsive, flexible breath that supports us for whatever it is we’d like to do? To live in an optimal state of health? As a first step, can be begin to notice this at all?
Personally, attention to breath and subsequent practices has had the most influence I find, when working with people who experience persistent pain. Time and time again. Though as Shelly rightly points out “the practices must be individualized to meet the unique needs of the person.” Telling people to take big, deep breaths, may not be ‘the answer’ or ‘the fix’ for everyone which is often what I see out in the main stream media. Suggesting there is some kind of ‘ideal’ breath, for all people, at all times.
I was looking at this tree (pictured above) in my back yard at lunch time today. It sways and flows. Appears strong, yet supple. Not rigid, brittle, tight or constricted. Takes in nourishment, gives back some. Might we be like this tree … A breath in. A breath out. Responding as need be, in any given moment to what life is asking of us.
I’ll be diving into this in more detail with information, a little bit of research and experiential practices in Week 4 of my upcoming online ‘Creating New Pathways‘ course. Want to learn more?
Interested to learn more about this thing called ‘yoga therapy’? Some FAQ’s plus links for ways yoga therapy can help, information for healthcare providers, where we’re at in terms of current research and yoga, yoga therapy.
I look at these flowers and wonder what happens between having a felt sense of freedom and space or that of feeling tightly clenched and constricted. What creates the dance between these two opposites in my my body, my breath, perhaps even my voice?
Recently I find myself rather tongue-tied, influenced each day by current events.
We celebrated Canada Day on Wednesday. Yes we did. Yet, this celebration doesn’t quite feel the same for me these past few years, given what I’m seeing and learning about our county’s history and what Canada Day might (not) mean for our indigenous population or others, unlike me.
I wanted to acknowledge how much I love this country. Having lived abroad for so many years I hold deep appreciation for not only the land, but the culture, society, values, all it’s people. Yet I didn’t want to not also acknowledge it’s dark history and so… I mostly said nothing.
I find uncertainty in knowing what to say, how I might use my voice regarding events unfolding, day by day. How #blacklivesmatter. The need to acknowledge the disparity and racism that exists. Which is not recent, but rather long standing. I still don’t know how to express my thoughts, even here, as I write. I have much to learn and therefore … I mostly, say nothing. Yet, that can’t be right, either.
There’s no way forward in standing still, or silence.
Usually I love to talk, to speak out, as noted in my last blog post. So this not talking does not come easy to me. However, I do notice times, places, situations where I expressly, consciously ‘hold my tongue’ as they say, for a wide variety of reasons.
What happens when there is something you want to say, but you’re afraid to say it? How does this happen in my body, this holding back, this silencing? How do I manage this? Surely, musculature is involved. Therefore my brain, my nervous system play a part. A thought or feeling proceeding it.
I wonder what happens to my breath, when I consciously hold back saying something? When there is a conflict between what I want to express but am unsure how to proceed? Or, perhaps if I don’t believe what I have to say matters. Or maybe this expressing of my self, is not welcomed in a particular environment or social context?
What effect might that have on physiology, my body, my breath? How do I even notice that in my body? What do I feel, how does that feel? Do I even notice when this occurs?
Do you ever notice for yourself, times when you don’t express yourself, hold back on your opinions, aren’t sure what to say? I can say there have been more than enough times when I have done so. In work situations, for sure. But also with family, friends, even strangers I encounter. For me, these are often situations when there is discomfort, conflict or uncertainty already permeating the air, circling into the mix. It is a pattern, I’ve come to recognize.
Today and over the weekend, try this: notice what happens to your breath when you speak with someone. Notice if you pause, give yourself time to think about your response. Notice if you allow others to complete what they’re saying or do you tend to interrupt? Can you feel your breath supporting your voice or does your voice or breath feel held, or tight? Can you notice any of this happening to the person you’re in conversation with? Do you feel comfortable or uncomfortable in what you wish to express? Do you hold back?
Or the opposite. What do you notice about your breath, your voice, when you’re singing your favorite song or in easy conversation with a trusted friend or partner?
What allows one to open up, speak freely? What might not? How might paying attention to your breath be an indicator of this?
I’m interested, to hear how it goes for you. Anything you notice about your breath, your voice. Your thoughts as you begin to speak or decide not to speak. What happens? How does it feel?
Let’s circle back on Monday and consider how our breath might have some influence or relationship to discomfort, and perhaps the experience of pain.
“Your graduation exam for this exercise is to practice breathing during an argument or confrontation”. – Donna Farhi
If you’re interested in diving into this type of exploration or other practices and how they might influence your experience of pain, I offer online 1:1 private sessions.
Such a beautiful tray of food. No wonder eating comes naturally to me. Rather like breathing. But it may not be so for you and I suggest that perhaps our breathing is not always natural either, but is rather responsive and adaptive.
I experience this in other areas of my life, as well. For instance, everything about being a mother did not always come naturally for me. It began with a struggle to breast-feed our first born. I became anxious, stressed and upset when this did not go according to plan. I had to make a call for support and learn from someone. All was well, soon enough.
Next, however, was being home alone all day in the dead of a cold Canadian winter with a baby, requiring so much time and attention. Not only exhausting (compounded by sleepless nights) but the social isolation I experienced was new to me as well, and did not come naturally. Knowing what to do, how to best raise this human being was a challenge. Parenting as being ‘natural’? In some ways, yes, of course. In many ways, not so much. When it didn’t feel natural, I felt like I failed, somehow.
Back to food and eating though. As I said, it does come quite naturally to me. In fact it comes to me far more often than I might need. Hard to resist when images like the one above, presents itself.
Mostly, we don’t pay much attention to these natural things we do until they become a problem, an issue somehow, in how we might like to live our life.
For today’s exploration let’s combine breathing with eating. How might that go?
Much to my family’s dismay I have a tendency to choke, fairly frequently, when eating. Part of it, I’ve noticed, I’m often rushing. Second to that, I’m often talking. Our dinner time is ‘family time’ and usually consists of our coming together prepared for much debate about the events and/or news of the day. When given the opportunity, I do as well, love to talk. Rather similar to the eating thing.
Meanwhile, what’s more important to survival than breathing?
Breathing is going to sneak in ‘as needed’ whether we want it to, whether we make time and space for it, or not. Whether we’re conscious of it or not.
I wonder how eating might go for me if instead of paying attention to what I eat, how much I eat, or when I’m talking, I might just notice how I breathe when I eat.
What might that bring to my awareness?
Perhaps there is something around eating that might be noticeable for you. Maybe instead of choking like me, perhaps you have a tendency to over-eat, or it could be you under-eat. Or perhaps you have some digestive issues.
Try this: Set aside one meal a day in which you do not feel any time constraints. Let yourself breath slowly as you eat. Notice how it feels to allow your belly to release as you chew and swallow your food. Monitor your breathing if you can. Notice what you feel during and after your meal. Again, try not to judge anything. Perhaps there is nothing to notice or perhaps there is.
Curious, isn’t it?
Check back on Friday when we’ll do one more exploration and it is a worthy one, I think. Also, I wonder how the movement and breathing exploration went for you, from earlier this week. You can sign up below to get all these posts.
Also, just to let you know, I’ll soon be announcing a new 6-week online course where breath is one of the things we’ll be exploring and working with. One piece of the puzzle, when we explore various aspects to consider if you experience pain. You can learn more about the ‘Creating New Pathways’ program by clicking the link below.
I was having a discussion with a client this week about the breath and how we breathe. We were talking about the relationship between our body, our breath and how breath moves in relationship to gravity. The forces of gravity, the loads we feel.
Breath awareness is often a focus in yoga. Both in yoga classes and also in a more therapeutic practice of yoga. We spend a lot of time noticing breath, feeling the breath as it moves. Noticing the length of breath, the inhales, the exhales. Where we feel the breath move, in our body.
Taking a different path, perhaps we can explore how breath might not always be moving, or moving so well. As in when you’re holding your breath. Which you might not readily notice throughout the day, unless you pay attention to it.
The basis of this inquiry is from Donna Farhi’s The Breathing Book (highly recommend the book). She states the purpose of the inquiry being:
To identify the situations and activities in which you most commonly engage in breath holding. We don’t usually recognize how much tension we invest in simple activities such as talking or cooking because we don’t recognize the situation as terribly stressful. You may be surprised and disconcerted to discover that you hold your breath in almost every conceivable situation.
Let’s check this out.
Starting today and for the rest of this week, take notice of when you hold your breath.What you’re doing when you hold your breath. Where you are, who you’re with. Make a mental note, or actually write it down so you don’t forget.
You may notice it when you’re speaking on the phone with someone. Perhaps your boss. Or you may notice it when you’re leaning over to make your bed. Or you may notice you hold your breath when your attention is really focused on something, like when driving down busy streets.
Then, you might want to see if you can change it in some way. Just breathe a little more freely if you can. Try not to judge anything, just notice.
I’ve noticed this pattern of breath holding in myself, particularly, in these days. Before I started wearing a mask I would sometimes catch myself holding my breath as I walked by someone. Or when I felt they were standing too near to me. I suspect there was some fear involved in my response. It’s like I didn’t want to take breath in, at that moment.
We’ll do more specific explorations, next week. And maybe get a little curious about how this might affect or influence pain.
Check back with me on Monday (June 29th) for more. In the meantime, keep noticing.
A half hour in a dentist chair or a 6 hour drive. Both feel about the same to me.
Why might that be?
Though dentist chairs these days are made to be pretty comfortable, the tension, breath holding that goes on there, remains. At least for me, it does.
A 6 hour drive? Well, though probably not tense I sure can’t move around very much. And for someone with really long legs the cramped space and low seat really does me in.
Now imagine you’re at work, sitting with your laptop in front of you, working on a project that has you so engaged you don’t notice how 4 hours has passed. Or maybe 6 hours. Since you … literally … moved. When you do finally move or stand up your back, neck and shoulders are complaining. A whole lot. You might say to yourself, “ach, this back. Acting up again. When will this pain go away? Probably never. It’s always there, always going to get worse as the years go by.”
Or a similar scenario, but maybe your supervisor is breathing down your back. “Get me those numbers! Why aren’t you finished already? You know how important this is… why is it taking you so long?” I can well imagine those back, neck, shoulder muscles are having a say in how you’re feeling throughout your day, as well.
You might even find it hard to breathe at times. Do you even notice that happening?
What stresses might you have in a day? Why do we call it stress, anyways? Might it be this ‘stresses’ your body, as well as your mind?
What are those little niggly things creating sensations in your body that you’re not really aware of? Not listening to. Paying attention to.
Maybe it’s not the tension, tightness, pucker, hold-your-breath, kind of stress.
It might be more subtle. The slight contraction of your jaw muscles. Shoulders lifting ever so slightly as the minutes are tick, tick, tick, moving along. The gripping of your toes, or perhaps your butt muscles.
What consequences might these create in your body over long – periods – of – time?
This is not to say that all stress is bad. We need to stress the body. That’s why people hit the gym, run for miles on end, love – love – love a sweaty yoga class. Stress can be a good thing. Create a good feeling.
What we don’t want however, is the long – slow – drip by drip – neverending – periods – of – stress.
I bet you notice the BIG periods of stress in your life. Maybe what’s happening right now, for instance. The little, or more subtle ones? Likely not so much.
And if we begin to notice, what might we do to move out of this stress state? Do we have the flexibility, variability to do so?
Repeat. Over and over.
Can we shift, from one state to another? Might we even begin to notice our ‘state of being’?
Difficult. Maybe if we slow down, find some stillness, time or space. Find that pause.
A 4-week Workshop to notice what’s ‘Just Right, For You’.
Well, much like anything, it depends. The answer is rarely straightforward and definitive.
As mentioned in the last post everyone comes in with their own experience of pain, history, individual, unique life circumstances. What might be helpful for one, will not likely be the same for another.
Below are a few comments made during a recent class, which illustrates this difference, for each person.
“I slept so much better all last week.”
“I’m not really using my cane anymore. My leg feels stronger, and I have no pain.”
“My back went out last week for a couple of days. I was flat on my back, so I used one of the (breath-awareness-distraction) practices and it really helped me get through it.”
And your back now? – Me
“It’s fine, now.”
“I’m so surprised. Normally I cannot walk around without my shoes on.”
Did you feel pain, while we were doing this (walking exploration, practice)? – Me
“No, I had no pain at all.”
I can’t say what will happen for you, or for another. Most often though, people will begin to experience feelings of calm, safety, less or no pain during class. And, some will begin to transition those responses and feelings into their daily lives.
Like most things in life, what we do, what we practice, we get better at. I would say the same, in this case. If you only practice during our class, for an hour a week, you may not see as much progress, notice as much difference. However, if you do a little, each day, I bet your experience will be similar to these others.
What I highlight to people, from both their comments and experiences is that something changed. To get curious about that, and realize they created the change.
It wasn’t something done to them.
From there, they begin to feel some hope. Perhaps a little empowered and more able to start exploring and learn to self-manage or resolve their persistent pain.