The Person in Pain

Often, when someone has persistent or chronic pain, what’s almost forgotten amidst the assessments, tests, diagnosis, and treatments, is the person. This person is not just a body with all these parts. Rather, someone who has a unique story, history, perspective and perception about what is happening with them. How pain affects almost every aspect of their life. Their worries, concerns, uncertainty about the future.

The International Association for the Study of Pain (IASP) launched it’s Global Alliance of Pain Patient Advocates in 2018, stating “this initiative seeks to better integrate the patient voice to inform pain research and its translation into new interventions to treat pain.” Below, Joletta Belton, tells her story:

I’ve been following Joletta for a long while now. Not only an advocator for the person in pain, she writes a blog over at mycuppajo, and co-founded Endless Possibilities Initiative (EPIc), which is a “nonprofit organization intent on changing the way people get access to science-based information about pain.”

Joletta also wrote the first chapter in Yoga and Science in Pain Care: Treating the Person in Pain which I’ve mentioned here before on the blog.

She writes “My protective responses not only affected my breath, but my movement too. My muscles would tense up, my joints would become stiff, my movement braced and rigid. Being rigid and stiff affected the way I moved, the way I walked, the way I sat. The way I existed in the world. The tenser and more guarded I was, the more pain there was, so I started moving less. The less I moved, the more painful movement became. Fear of more pain, of more damage, made me move even less. A vicious cycle.”

She goes on to share what helped her most over the years. The first two, on her list:

  • “feeling heard and believed, supported and empowered
  • feeling understood, as well as understanding and making sense of my pain.”

“When we live with pain, it changes who we are as people. It changes how we see the world and how we relate to that world. We protect ourselves through isolation and withdrawal, through guarding and tension, through altered thoughts, beliefs, and movements. We disconnect from the people, places and activities that are meaningful to us.”

“It is hard.”

In her conclusion, she also goes on to say “… I want you to know it takes hard work to get out of those dark places, too. I want you to know that change is possible, but it’s not easy. It takes time and persistence, compassion and courage.
… there is so much that is possible, so much that can be done, no matter how long someone has lived with pain, no matter how many limitations they may have.”

Jolette also recently contributed, wrote, the first chapter in the Meanings of Pain, Volume 2, released last month. The interdisciplinary book – the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk “aims to better understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them”.

In my work as a yoga therapist and Pain Care Yoga teacher, probably the most important part of my work is to listen to what the person in front of me is saying about their pain, their story, their life. Provide safety and support, work to empower the person in pain as they might learn to move, breathe and renew their own sense of meaning and purpose in the world.

If you are someone who suffers from chronic pain, know that there are people out there willing to listen. There is hope. Your pain CAN change.

Let’s all continue to advocate for, educate and push for more services and support for the 1 in 5 Canadians who need it most. Each and every person, in pain.

Yoga and Science in Pain Care

How might we blend yoga with science to provide pain care to people? A new book just released provides a way forward.

“Our vision is for this book to improve care for people living in pain, whether acute or chronic pain. We believe health care professionals and yoga therapists can enhance care through deeper understanding of pain, science and evidence-informed interventions. We also believe that professionals can enhance their work through integrating yoga concepts, practices and philosophies. As such, this book is meant to bridge yoga, pain science and evidence-informed rehabilitation … and will inform those committed to helping people with this largely undertreated issue that causes so much suffering in the world.” –  Preface, Yoga and Science in Pain Care; Edited by Neil Pearson, Shelly Prosko, Marlysa Sullivan

The first chapter by Joletta Belton is about the “Lived Experience of Pain” highlighting to me the need to listen to, acknowledge and consider first, the person and their experience.

“The authors provide an integrated, in-depth understanding of how yoga therapy can be incorporated within a modern understanding of pain as an experience. The book encompasses perspectives from people living with pain, summarises research progress in the field, debates theories of pain and pain management, considers the many different yoga practices, describes pain biology, self-regulation and examines breath, body awareness, nutrition, emotions and response to pain, and above all, integrates concern for practitioners and people in pain as humans sharing an intangible experience together. The authors write about how yoga therapy can provide a uniting and compassionate approach to helping people learn to live well.”

– Bronwyn Lennox Thompson, PhD, MSc, DipOT, Postgraduate Academic Programme Leader, Pain and Pain Management, Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, NZ

There are a lot of yoga books on shelves these days. Yoga for this, yoga for that. You name it; it’s being written about. The trouble with this and certainly when talking about pain is the approach is about the condition, the problem, the illness or disease. What’s often left out is the person. Which may be one of the reasons why we fail in helping people.

After all, your pain is not the same as my pain. Not only is the physical aspect different, my body different, my genetics, my structure. Almost more important is the rest of ‘me’ that’s different from ‘you’.

My life history is different from yours. My environment is different from yours. My stressors are probably not your stressors. My understanding of pain probably differs from yours. My expectations, beliefs and thoughts about my pain will be different from yours. My social structures, friends, family, work-life will all be different. So how might we believe we can just apply this ‘fix’ to everyone who experiences pain? It just doesn’t make sense, when you think about it. Particularly when we understand that pain… is… complex.

We, therefore, should look to explore and be curious about all the things that might be contributing to your particular experience of pain. Similarly, individualize the care, tools, techniques and practices with what research tells us might be useful, to change your pain.

You may have had pain for years. Like 30+ years or more. Still, there is an opportunity for change based on what we know about pain and how it works. There is much still to learn but we can change the nervous system, We can change the brain. We can change physiology and most likely all three of these have been changed if your pain has been ongoing.

Pain can change. There is hope. I will keep saying this over and over and over again …

If you’re the type that likes read and learn about this yourself, order a copy of the book, here.

If you’re the type that would like to learn from me in person or in a class setting with others, check out my updated schedule for the fall, here. New classes starting in September!

Additional notes:

Joletta Belton, as noted above, writes a blog “My Cuppa Joe” about the lived experience of pain. Among other things, she is a speaker, educator and advocate for people in pain. You can read her blog, here.

Bronwyn Lennox Thompson also writes a blog “Healthskills: For health professionals supporting chronic pain self management.” An exceptional resource for information, research, and discussion. You can check it out here.