Tag Archives: pain

Rest and healing

We live in a sleep deprived culture, and most of us do not get enough rest. However, in terms of healing, recovery, managing problems, dealing with the impact of stress on the body and supporting mental health, sleep and rest are essential. People who are ill or in distress tend to need more time to sleep and rest.

Where this gets complicated is if you are dealing with a long term chronic condition. How much rest is a good idea if healing and recovery aren’t going to happen? How much time do you devote to this kind of self care when it’s going to be an everyday issue, and how much do you push through? If you want some kind of life, to be able to work, maintain relationships and take care of your home then you can’t rest all the time, even if your body wants to.

If you rest all the time, you lose muscle tone. Your body becomes weaker and your stamina deteriorates. Most chronic conditions will wear you out and exhaust you, but if you don’t put up a fight to maintain what body strength and stamina you can, you have less to start with each day. People who are largely well will tell you not to exercise when already in pain, but if you are always in pain and it doesn’t go away, when do you exercise? How do you maintain heart health? How much do you push and when do you rest?

There are probably  no experts to consult. It’s possible they exist, but they need to be experts in both your specific condition, and in fitness and wellbeing. Most people working professionally in health and wellness are likely to know less than you do about what might work for your body. They may also think they know more than you do. I have, for example, had to explain to several yoga teachers why yoga is a very bad idea for hypermobile people.  My Tai Chi teacher had not knowingly taught a hypermobile person before and while he was brilliant and supportive, it was a process figuring out what to do with me, and he was not initially able to advise me. Equally, I’ve had health professionals tell me to get more exercise for my mental health with no scope for even having a conversation about how to handle body pain around that.

There are no easy answers here. I’ve written this not to offer answers, but to flag up the shape of the issues. For the person struggling with their body and often surrounded by contradictory and unhelpful advice it can be difficult to trust that you may be the most capable expert where your body is concerned. It may also be an awful discovery, but the odds are there is no one better informed about your body and energy levels and how to manage it than you are. Any advice you get may be valuable, but needs understanding on those terms.

For people who do not live with ongoing pain and fatigue, the issue is of recognising what you might not know. People who are largely well don’t always respond well to invisible illness in others. What you think a person can do and what they can do are not the same things. What a person could do one day isn’t a reliable measure of what they can always do. It takes time and patience to truly support someone with ongoing pain and fatigue issues. Don’t be the person who makes that stuff harder by insisting that you know better, when you might not.

Also don’t be the person who tells someone they must rest and heal and cannot do the things until they are properly well. Some of us will never be properly well, and the decision as to what it is worth hurting for, should be a personal one, and not for anyone else to dictate.


Taking pain seriously

I grew up hearing that I made a fuss about pain. It’s understandable in that what was going on with my body wasn’t really recognised  then, but still, it would have made a lot of odds if there had been a bit more kindness in the mix. PE at school was the worst – painful and also humiliating and with no sympathy at all. But, it wasn’t just school, and it included my doctor. I internalised the idea that I make a fuss and I learned not to take my pain seriously. Of course doing that means you can’t ask for help, relief, slack cutting or anything like that.

A few years ago, I saw a friend talking about hypermobility on Facebook like this was a thing that merited care and concern.  This surprised me. All of my body bends in ways it shouldn’t, but I hadn’t connected that with experiences of pain. I decided to educate myself, and discovered that hypermobility is a soft tissue issue. People like me damage easily, we feel more pain, everything takes more effort, and as a soft tissue issue it can impact on the gut and other things as well. It’s helpful when things make sense. It’s useful having some idea what to do to avoid hurting myself in the first place.

But more than this, it is validating of how I’ve experienced my own body.  I’ve experienced this information as permission not to be ok, and having spent the first thirty or so years of my life being given to understand that I make a fuss and must have a low pain threshold, this is a very big deal.

The pain is real. The pain is real enough that I am allowed to take it seriously. Taking it seriously opens the door to trying to avoid it, trying to get help, trying to manage it better. It also gives me space for the emotional impact both of living with pain and having internalised the idea that the pain I live with doesn’t matter and shouldn’t be taken seriously. It means considering that I’m not some kind of pathetic drama queen who over reacts. This is quite a shift in my self-perception.

Sometimes we do need permission. Especially if there’s been a big push in the other direction. Validation can be a powerful thing.  It’s another reminder that none of experience life in a vacuum. We’re all impacted on by each other’s words, deeds and ideas.  Wellness and healing are not isolated individual issues, they are community issues. The stories we tell each other about what our bodily experiences mean have massive impact, for well and woe.

I’m watching similar things happen around the growing recognition that trauma has real, measurable effects on the body. I think we’re moving away from old stories that hive emotions off as irrational and not situated in the body and that instead we’re moving towards recognition of people as complex beings where experience can impact on wellbeing.

We’re challenging the stories that are quick to write off some experiences as over-reacting – the medical profession does not have a good history of responding to female pain – and even worse if the women is poor, or Black, or all of those things. But this can change.  We can have new stories in which pain deserves care, and in which we don’t tell people off for making a fuss when they are suffering. We have to stop assuming that being a certain kind of person means something about whether we really feel pain or not  We can stop telling stories that block the way to getting some people’s pain taken seriously. We can do better and we can be better.


Just relax

Try to relax. I’ve heard it a lot of course. Maybe meditation would help. Try mindfulness. If you could relax, you wouldn’t hurt as much. This has come round fairly regularly over the last twenty years or so. As though I haven’t tried. As though I am so stupid that I let my body run away from me into a state of pain and misery that would disappear if only I made a bit of effort to relax. Sometimes, I’ve internalised this and added feelings of intense uselessness alongside the body pain. Oddly, that’s never helped me.

I’ve been meditating as best I can for the last twenty years. Pain makes it difficult to concentrate. Pain means that any body-focused meditation can turn into a very special sort of hell and mostly I don’t go there because it doesn’t actually help. The soreness and stiffness in my body is more complicated than can be fixed by just thoughtfully relaxing all those muscles. Also, when it’s pretty much all of the muscles, deliberately relaxing them isn’t that easy anyway. I know, because I’ve tried…  Repeatedly.

Yes, I have been told about the thing where you clench a muscle hard and then relax it. I have tried this. The odds are decent that the result of the deliberate tensing will be a rush of pain, maybe with a side-order of cramp. I am seldom persuaded that it’s worth the risk.

So here’s a radical notion. What if I, and people like me aren’t hurting because we’re doing it wrong. What if we have bodies that hurt, and cannot magically be fixed with that really easy thing you think we should be trying. What if that really easy thing, when tried, inflicts more pain? What if, living in our bodies as we do, we might be considered to have some tiny notion about what helps and what doesn’t? What if we are allowed to say no to quick fixes that don’t fix anything?

That would have scary implications, wouldn’t it? Because it might mean that your wellness is not entirely because of your reiki mindfulness yoga paleo-diet. It might be that you have been lucky so far. You might not always be lucky. Things might go wrong in your body that you can’t deal with by relaxing and being positive. Pain might be real after all and not all in my mind. Aging is out there as a possibility for all of us, with all the complicated gifts it brings. Bodies go wrong.

If the last twenty years have taught me anything, it’s that kindness is a good deal more helpful than ‘cures’. Accepting me as I am does far more to help me than yet another round of being told the one simple thing I should do to sort it all out. Being patient with my limitations helps me more than telling me why this is all my fault.


Softening the body

One of the notions that comes up in the Tai Class most weeks, is of softening the body. Relax into the posture. Soften. It did not take me very long to realise that this is a significant issue for me. I’m not physically soft. Often I’m very tense. Pain, anxiety, inflammation of tissues, and whatever else is going on in here conspire to make me stiff and tense. What would it even mean to become softer? What would I need to do in order to achieve that?

To make things more awkward, there’s a lot of stuff in my history around being told the state of my body is my fault. That I’d be healthier and experience less pain if only I could learn to relax and put some effort into that. Oddly, I’ve never found that being blamed for being tense has helped me shift towards being less tense. There was always a subtext of how I would be more useful to someone else by this means, also.

I have a lot of trouble letting go. I’m not emotionally present or expressive in most contexts. I may be making an effort not to let my face show what I’m feeling. I’m not good at opening myself to other people, or letting people touch me.

Softness would mean acceptance – largely of myself, to some degree of others. It would mean trusting people not to hate me or hurt me if I let them in close enough.

I can soften in terms of being kinder to myself. I’m exploring that with craft projects at the moment – slowing down, being gentler with my hands. If I’m not pushing hard all the time to get more stuff done, if I can drop pace with the typing, take more breaks from the mouse and keyboard, that helps with pain with in turn helps with stiffness. Taking care of me takes time, and to have that time I need not to feel under massive pressure to be doing things that don’t help me.

Trying to soften my body seems to call for a heart softening towards myself. Not seeing my body as a means to other people’s ends, not letting anyone treat me as a tool to use and not a person. Holding a sense of self-worth that allows me to be kinder and gentler with myself. Dealing with pain kindly, not pushing through it to be useful.

It’s turning out to be a complex process, but I’ve achieved odd moments of feeling myself soften –physically and emotionally. I have a long way to go and this might well be a rest-of-life sort of project. I realise that being softer would also mean being kinder to myself about the timescales in which I can make those changes. I have to ush out of my head the several people who have shamed and berated me for not being other than I am. They were never trying to help, they were only ever feeding the problem. Experiencing a genuinely kind and supportive space focused on physical activity has taught me a lot about how unhelpful some of my historical experiences have been.


What does self care even mean?

The encouragement to ‘practice self care’ floats round the internet a lot. Sometimes it rather feels that if you are still ill, still struggling, it might be your fault for not doing enough of the self care things – I doubt I’m the only one who feels this on a bad day. Self-care is a rather vague sort of notion and the prompt to undertake it rather assumes that what’s needed is fairly easy, or obvious… and often it isn’t.

If you only have mild problems, or only have one problem, then it can be easy to identify what would help. However, when you have multiple problems, what eases one can exacerbate another. Is loneliness making you depressed? But would going out to spend time people trigger your anxiety, or cost energy you don’t have, or are you in too much pain to do it? Then there’s no easy self-care answer to be had.

Trying to find the balance between being active enough to maintain some kind of health, and not wiping out your resources, is an ongoing issue for many people. Part of the trouble is that you don’t know upfront how far you can get. Will some physical activity ease the loss of energy due to depression, or lead to a panic attack that wipes you out entirely? Will the improved circulation from moving about help with healing, or will the aching muscles cost you too much? The big one for me is always, get on the trampoline to sort the dysfunctional lymph glands, or rest the sore muscles. I hurt either way, the question is, which will be worst, which outcome can I least afford? I don’t always get it right.

Sometimes ‘self care’ means trying to figure out the way forward that will hurt least, or deciding which hurt you can most afford. I’ll take body pain if I can gain some ground for mental health, most days. Except on the days when it’s the body pain causing my brain to shut down, or leaving me too open to panic.

Self-care is a lovely idea. If it’s easy to do, then the problems aren’t that big in the first place. If you can fix yourself with a few days off, a nice bath, a walk in the woods – then you were not in massive crisis to begin with. I’m glad for you, but please don’t assume that’s a measure of how anyone else is doing. And if you’re on the other side of this – if no matter how you try to look after things you can’t get on top of your problems, it isn’t your fault. Not everything can be fixed. Not everything can be healed and put right with enough care and attention. Sometimes there isn’t enough self care possible to change how things are.

Also, sometimes self-care isn’t the answer because people need caring for. If someone is over-worked, over-burdened, doing too much emotional labour, being put under too much pressure – it should not be on them to also save themselves. Pushing people towards self-care can be a way of avoiding feeling responsible for them. Sometimes, the answer is to get in there and ask what would help. Take some of the weight off their shoulders. Don’t leave them to fight all their own battles (sexism, racism, ageism, fat shaming, abelism and all things of this ilk are exhausting and take a real toll). Don’t imagine that telling someone to practice self-care is actually helping them – it’s just well meaning noise. If you want to help, make sure they have the space, the time and the resources to practice self care, because without that, telling a person to fix themselves is just adding to what they have to bear.


What if all pains are birthing pains?

This was a question Imelda Almqvist asked on Twitter recently. You should follow her – https://twitter.com/ImeldaAlmqvist

I experience a lot of pain – most days at least some part of me hurts. Sometimes all of me hurts. I also experience emotional pain especially around depression, anxiety and historical wounding. If all of these pains are birthing pains, it leads to the question of, what am I birthing?

The physical pain I experience isn’t necessarily doing anything useful – at this point I have so much self control, stoicism, coping mechanisms etc that I don’t feel there’s any case to be made for it being character building. It does sometimes come as a consequence of what I do – physical activity tends to lead to pain. My Tai Chi teacher talks about this in terms of weakness leaving the body – a nice thought form. So, I am in the process of constantly birthing a body that will carry me through the rest of my life and will hopefully be able to keep moving, even if it does hurt.

When it comes to emotional pain, I think this might be a useful question to ask. What am I processing? How am I changing? What new self am I birthing in the process? What old wounds am I exposing to the air? What can I heal? What can I make out of this? Not because it is an absolute truth that the pain is a birthing pain, but because I can chose to think about it that way.

What my experiences of pain lack, that birthing pain has, is self-announcement. Admittedly, I had a lot of trouble getting anyone to take me seriously when I was in the early stages of labour – too much stoicism and self control, not enough screaming and crying… But when you’re squeezing out a whole new person, people expect you to be in pain and suffering and struggling and are likely to try and help and will eventually take you seriously… Most pain isn’t like that. One of the problems with ongoing pain is the likelihood of being treated like you’re making a fuss, being a hypochondriac, attention seeking, lazy and the like.

So here’s another question. What would happen if we all took pain more seriously? Our own and each other’s. What would happen if all pain was taken as seriously as birthing pains?


Pain, fatigue and mental health

Pain and fatigue make moving unpleasant. However, if you’re dealing with them for the long haul, you can’t just rest. Too much rest costs you strength, flexibility, other kinds of body health and it also has a mental health impact. Pushing against pain and fatigue to be active can undermine your mental health too. There are no easy answers here, and I think some days there aren’t even any right answers available. You can only do the best you can with what you have. Anyone telling you that some fairly simple thing will magically fix you does not understand the nature of the problem.

When dealing with short term problems, ‘listen to your body’ is good advice. However, when the hurting is long term, and all your body wants to do is avoid pain, this doesn’t work. Modest exercise encourages blood flow which can help with healing. Lymph fluids don’t have any pump to circulate them and they need moving about – which means you have to move about. Muscles get weaker with lack of use, and everything gets harder and hurts more and you circle into even smaller spaces with less scope for living. Keeping moving is hard, figuring out how to do it safely is hard, and not everyone who is a professional in this area reliably knows what is safe for whom. Yoga and mindfulness are not actually good for everyone.

The conclusion I’ve come to is that it may be better to take risks with my body and focus on maintaining my mental health. If I can keep my head together, I can manage the pain and fatigue. If I plunge into depression and anxiety, bodily wellness cannot save me. So, when there’s a tension between different needs, I look most at what will best serve my mental health. There are so many days when listening to my body results in a set of contradictory messages. Bits of me need things that other bits of me will find difficult. I trust my head. In practice, my head is the bit of me that keeps the whole show on the road. If I can focus, if I have willpower to deploy, if I can reason well – I can manage everything else that much better.

It works for me – as well as I think anything can. It may or may not work for anyone else. What you’re dealing with is personal, and probably complicated in its own ways. How you navigate has to be personal, and it has to be based on your needs and priorities. Sometimes, no matter how positive you are, how much you focus on healthy life choices, doing all the right things, sometimes bodies still go wrong and hurt and decline to move much. It may mean you don’t entirely know how to manage some aspect of what you’re dealing with. It may also mean there are things that happen that cannot be managed, they’re just how it goes. When focusing on wellness, it is important to remember that there isn’t always a magic combination that will make you perfectly well, and if your body hurts it is not proof that you’ve failed in some way.

For some people, a change in diet or other lifestyle features can solve a problem – if that’s you, great. But I’ve also watched people trying to find magic bullets for problems and not getting anything to work. I’ve seen that turn into strange, faddish diets that rapidly caused more harm than good. I’ve seen it turn into a fear of doing all kinds of things. If trying to be well is narrowing your life options then it may not be working. Not everything is fixable, and learning to make the best of what you’ve got can be the most helpful and most liberating thing.


Adventures with Ankles

Most of my joints will bend the wrong way(s) under any kind of pressure. It’s only in the last few years that I’ve grasped that this is a thing with considerable implications. It explains much of why I hurt, and why I get tired a lot. The tissues supporting my joints are softer than normal, so everything takes more effort, and I’m more likely to injure myself, including micro-damage. When I was first dealing with fatigue issues in my teens, I’m not sure anyone was aware of this sort of thing. No one asked about my joints.

My ankles are especially bad. I spent my childhood falling over a lot, running was scary and difficult. But, I’ve persisted, kept moving, walked, danced, swam, did what I could with this body and tried not to hurt it too much. I hold pens and chopsticks the ‘wrong’ way to alleviate hand pressure. I hold bows the wrong way, I probably type wrongly as well, but I get by.

A few weeks into learning Tai Chi it became apparent that I couldn’t get the knee and toe positions right for most stances. It’s a small knee bend. My teacher talked a lot about not bending knees the wrong way – clearly used to a lot of older students with dodgy knees. I started exploring what was happening between knees and ankles and realised I was loading the joints badly. Thus started a massive program to re-think how I stand and walk.

My ankles default to rolling outwards in response to any kind of pressure (i.e. being stood up). This probably makes me more likely to fall over, and I suspect it puts pressure on my knees and thighs. One of my hip joints is very loose as it is and often problematic. To correct my ankles I had to get more weight onto the inside of my foot. I focused on my big toes. I did it when practicing Tai Chi, and also when walking, and at first it really hurt, and gradually it’s got easier.

This in turn has got me looking at my toes. I’ve never been a serious wearer of pointy, heeled shoes so my toes aren’t much distorted by that, but they do all roll towards the middle. Getting my weight in the right place has meant training my toes to spread out a bit more. I need to build toe strength! When learning new moves I have to figure out how I’m going to get my ankles to the right place, and this can be tricky with bigger steps, but I’m getting there, and my teacher has been supportive and helpful.

I’ve learned a lot about my body in recent months. I’ve learned things that I wish I’d known when I was a child, struggling with sports lessons. I wish my teachers had known. I wish my doctors had known when I started having fatigue issues. I spent so long with body pain being treated like an over-reaction, fatigue being treated like drama, the poor co-ordination that goes with hypermobility being treated like a personal failing or lack of effort. It’s hard to ask for help when you’ve been convinced that your body is fine and your mind is the problem. I’m getting there now, and it’s changed how I feel about myself and what I do with my body.

I’d internalised so much of that sense of my body issues just meaning that I am a crap person in some way. Having a clear sense of the mechanics has been empowering, and allows me to feel better about myself. I get tired more than the average person because everything takes me more effort. I hurt more because I take more damage. It was never all in my head. And now that I’m dealing with it as a thing happening in my body, I might even be able to improve the situation for myself.


Magic, illness and discipline

Most forms of magical and spiritual practice depend to some degree on concentration. It is feasible to do contemplative meditation when you can’t concentrate – by having an object that you return your thoughts to, for example. It is feasible to undertake prayer or ritual with an unfocused mind, but it is probably less effective.

Spell based magic is all about your will. There’s nothing like pain or illness to reduce the power of your will, and to make that kind of focused intensity difficult to maintain. All of us will go through times when we don’t have what it takes to act magically. Some of us will be like that most of the time. So, what do you do if you want magic in your life, but can’t rely on having the attention span, the concentration, the focus or the willpower to work it?

Aim small. Ignore the useless advice that if you can’t meditate for half an hour you should meditate for an hour. Better to have five minutes of quality engagement than a longer stretch full of frustration and misery. Look for acts of magic and spirituality that operate on a scale you can handle. Look for ways of working that allow you to come back regularly and do a small thing. Don’t tie yourself to fixed times because you might not have the clarity at those times. Work when you can.

People who are hale and hearty can be very comfortable telling people who aren’t to try harder. If you are ill, the limits of what you can do are often a simple fact. Trying to push for more can often result in a backlash that lets you do even less. Only you can judge this. Experiment on your own terms and don’t feel pressured into doing things the way other people think you should.

Look for opportunities for magical experience and transformation rather than acts of deliberate change. Being in a ritual can be transformative. So can sitting out with access to trees and birds or water or sky. Having an altar and spending some time with it can make room for things to come in. So can creativity.

Pain and illness can make it hard to think that good things of any shape can happen. The longer it goes on, the more it can lock you down and make you feel limited. Looking for small moments of beauty and wonder can be a way to offset this a little. Sometimes there are blessing amongst the miseries. There don’t have to be, and it isn’t your job to be relentlessly cheerful or to find shiny blessings in a shit storm. But at the same time, there’s much to be said for making the best of what you’ve got in whatever way you can.


Pain and meditation

Most meditation practices seem to start by centring you in your body. Breathe deeply. Be mindful of your physical presence. Gently relax your muscles. You know the routine. The trouble with pain is that being aware of it is the last thing you want. I’ve yet to experience a pain that I can’t suffer from more by paying it close attention.

Some pains I can soothe with the awesome power of my mind, but the truth is that the awesome power of my mind is fairly limited, and sometimes of no use at all. It’s especially useless if the pain is in my head or face to begin with. It’s also a lost cause if I don’t have the concentration to meditate, and there’s nothing like pain for wrecking my concentration.

(As an aside, this is not a request for pain management advice of any sort, there’s a lot of specific detail missing here, as there often is when people talk about pain. This is not a thinly veiled request for guidance about how to deal with pain. I am dealing with my pain, these are observations arising from what I’ve been doing. Onwards…)

Unfortunately, sleeping calls for a period of just being alone in my head with whatever pain I’m feeling. So, while often the solution to meditation not helping with pain is not to meditate, on the edge of sleep, I really need all the help I can get. A meditation practice that can take me away from the pain and into some other head space can really help.

I visualise the pain itself as being like a big door surrounded by flames. My challenge is to get through the door and into the headspace where I don’t feel the pain. Now, normal meditations encourage us to be calm, to feel gentle, peaceful emotions. I have found that doesn’t help me deal with pain. However, if I set up a visualisation or a pathworking that evokes really strong emotions, I can become sufficiently involved with it to take me out of my bodily awareness. This creates the weird situation that being in pain may be the best time for me to try and work on difficult emotional things. I stay away from things that cause too much fear, because panic is not conducive to sleep.

I can’t say how or if this would work for anyone else, but it might. You need to plan what you’re going to work with and pick things that you personally will find emotive in intense and powerful ways. You can’t use any of the normal settling in techniques because they’re all too body centred. I tend to picture the fiery door, gather my wits and dive headlong into the most intense meditation I can think of. Sometimes it doesn’t work, but when it does work it allows me, eventually, to go to sleep, and that’s quite some blessing.