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A Holistic Approach

to Chronic Pain

Revisiting the mind-body connection to curb the chronic pain

Currently, about 21% of the global population is suffering from chronic pain¹, this means 1 in 5 people. The first time I heard this number I thought it had to be an exaggeration, it cannot be that so many people are walking around with pain on a daily basis. But the more I looked into it, even on a country by country level, the more I was confronted with the numbers and found that it is indeed accurate. In some countries the numbers are even higher. For instance, in the US, it is said to be as high as 30.6%¹ of the population, and also in the UK this number is above the average, at 23%², according to the UK’s National Institute for Health and Clinical Excellence (NICE).

How are we to understand that in our modern world, at the pinnacle of medical ingenuity and sophistication, we are seeing more and more chronic physical disease […]? This sentence comes from the first pages of the book The Myth of Normal (2022), by Dr. Gabor Maté co-written with his son Daniel Maté, and they pose an excellent question. How is this possible? The book covers various angles when it comes to our ailing society and how we got here, but I want to focus on just one angle: the mind-body connection. Or I should say disconnection.

You might wonder; why is this disconnection important, and what has it to do with chronic pain? When was the last time a medical professional has asked you ‘How are you feeling emotionally?’, or ‘How would you rate your current stress levels?’? As trivial as this question seems, especially when dealing with physical pain, in majority of chronic conditions this is more significant than we believe. As Dr. Howard Schubiner highlighted in his presentation for Optum Health Education (OHE), many chronic pain conditions – from headaches, fibromyalgia, IBS , pelvic pain, to chronic back and neck pain – have been proven to be primarily brain induced³ ⁴.

What this shows is that our brains have more to do with what we feel in our body than modern medicine likes to admit. Schubiner isn’t alone in trying to highlight this connection. As Dr. Rachel Zoffness points out even more boldly: “Pain is both physical AND emotional 100% of the time”⁵. There are no exceptions. These are recent examples, that are backed by neuroscience, yet, there is case-based research dating back to the 1980s, where the late Dr. John E. Sarno started seeing this same trend among his patients. He noticed that most of the chronic pain could be healed from a psychological approach⁶. His methods were criticised by the medical community and didn’t get widely adopted, but his success can be measured by the lives he changed, which is hard to ignore when reading the messages on the website, created in his name, by people who recovered thanks to his mind-body approach.

Nowadays, it is easier to measure the mind-body connection thanks to modern day’s brain scans that can show you exactly what part of the brain is triggered when dealing with different impulses or different forms of pain. But even with recent neuroscience backed research, the mind-body approach is still not widely adopted. Modern day healthcare providers are not taught to ask a patient how they are doing emotionally, how their stress levels are, generally there isn’t time to get into that with a patient, and these questions are rather left to psychologists. It isn’t a shortcoming of any specific individual, it is a system that has developed to become so hyper focused on pathology, and the separation of mind and body, that we forget to zoom out and look at humans for the complex beings that they are.

We need to start taking a more holistic approach to chronic pain, and healthcare in general, instead of labelling holistic as ‘alternative’ or woo-woo. Ironically, there is nothing new-age or alternative about the idea of the mind and body being connected. The idea that they should be seen as separate is an invention of the last century. So let us zoom out together, to reopen the path to health for chronic pain suffers. Asking these questions could be the first step in getting to the source of the pain.

6 concrete tips for chronic pain sufferers

What are some things you can do if you are suffering from chronic pain, and what you have tried so far hasn’t really worked for you?  Here are some concrete tips:

1. See if you can find out what your body is trying to tell you. Pain is a messenger, it isn’t random, it is your body trying to tell you something. Instead of focusing on your pain as the enemy, try to see it as a way of your body trying to communicate with you. Try to get to know it, to see what is going on beneath it.
2. Focusing on something that brings you joy will calm down your central nervous system, letting it know you are SAFE. When it knows it is safe, that you are safe, there is no need for the pain signals
3. Focus on your daily wins, your accomplishments, NO MATTER how small. If you take note of them every day this will become easier. Refocusing on what goes well will strengthen those neural pathways overtime, making it easier for your brain to take this route.
4. Pacing into activities that you would like to pick back up, slowly and safely, can teach your brain it is actually safe to do this activity. The challenge here is to go slow so you can gain back the confidence in your body
5. Have patience and compassion for yourself. Recovery is possible but takes time, and relapses are part of the journey. The most important thing is to not stress yourself into healing but to take small steps, and show yourself compassion during setbacks.
6. There are more and more practitioners specialised in chronic pain, using a mind-body approach, that can help you on your journey. If you think you can benefit from a personalised approach, look for certified professionals in this field who can look at your case from a holistic perspective and set up a safe plan together with you.

Rebecca Salama 12/07/23

References

1. https://paindoctor.com/chronic-pain-statistics-2021/
2. https://cks.nice.org.uk/topics/chronic-pain/background-information/prevalence/

3. https://www.optumhealtheducation.com/sites/default/files/191205-Chronic-Pain-Schubiner-Slides.pdf

4. https://www.emedevents.com/online-cme-courses/webcasts/chronic-pain-reconsidered-the-role-of-neural-circuits-in-the-brain
5. https://findingmastery.net/rachel-zoffness/
6. https://www.nytimes.com/2017/06/23/science/john-sarno-dead-healing-back-pain-doctor.html

#fightingfearcommunity #fightingfear #LGBTQ+ #LGBTQblog #queer #LGBTQcommunity #queercommunity #livingwithchronicpain #mindbodyhealing #chronicpainrecovery #healingchronicillness #chronicpain #biospsychosocial #neuroplasticpain #healingchronicpain #fibro #fibromyalgia #chronicbackpain #chronicfatiguesyndrome #paineducation #holistichealthcare

Diary of a healing journey

As a pain coach I get to see the most incredible transformations. A few months ago, I worked with a person who had been dealing with pain all over their body for years. They were diagnosed with fibromyalgia. This is one of the more common conditions I encounter, and can be extremely debilitating, often going hand in hand with chronic fatigue and brain fog. The transformation I saw happening in the 4 months we worked together was amazing, and therefore I want to share some of their journey here today, to give hope to those who are dealing with their own chronic symptoms.

Starting point

Let’s start at the beginning. There were several different symptoms this client was dealing with, which is common with fibromyalgia. They were suffering from leg and foot pain, sore wrists and hands, brain fog, IBS, mood swings and dizziness spells. As they told me in our first session, they had always been very active: going to the gym, doing yoga, walking, and biking a lot. Following the condition, there were days that even walking felt too painful, and the times they felt well enough to do yoga, they regretted it the following day because their body was just screaming at them and so they started going less and less. The fatigue also let them to want to cancel a lot of social activities, but the guilt didn’t help, and made them feel worse. Or they said yes when they were too tired or sore to go, resulting in an inability to enjoy themselves. It felt like a vicious cycle, that wasn’t getting any better with time.

When the pain started a few years ago, the first step, as usual, was to go to the doctor. There, all the necessary scans and tests were done, and since there was no clear answer to the persisting pain, the diagnosis was fibromyalgia. I hear this a lot. Furthermore most people are told, it is just “something they have to learn to live with’’.

During our first session the word acceptance came up a lot, because they wanted to learn to accept the current situation and learn to live with the pain. One of the questions I like to ask here is: do you believe you can heal? This is an important question because it determines a lot about the healing journey ahead.

When dealing with chronic symptoms, the name says enough: ‘chronic’ means persistent and is considered to be ‘for life’. In the majority of ‘chronic’ pain cases, this is simply untrue, and healing is possible. My first step in the journey with a client is to explain more about pain, how it develops and manifests, and how it become chronic. Usually, this simple understanding gives people hope, and they start to believe that they can, in fact, recover.

Doing the work

With the understanding of the mind-body connection, we could start taking the first steps towards healing. For this we need to look at a combination of things: the body, the mind, and the environment of a person. In this specific case it meant the following:

• Body: What we often see with chronic pain sufferers, is that when something starts to hurt, the instinct is to rest, and do less. When dealing with acute pain and injury, this is indeed the right approach. However, in the case of pain lasting longer than 3-6 months, this means there is something else going on. If the body hasn’t healed by then it is a mind-body connection problem, also referred to as neuroplastic pain. Here, the approach is to build up activity in a safe way, in order for the mind to collect new proof that movement is safe to perform. We set up a pacing plan together and tracked this week to week. The aim is to not overdo it either because then you risk reconfirming that activity is dangerous, keeping your nervous system on high alert, which leads to increased pain signals. In a short period of time, they started walking more, doing yoga, yet still avoiding heavier work out, which was reintroduced later in the journey. Change was gradual but noticeable. So was the joy.

• Mind: When dealing with heavy emotional situations, whether in your day-to-day life, or in the past, if we don’t process this and release the tension, this will build up in the body and can manifest itself as physical pain. This was also the case here, where the sudden illness of a parent and care for them, took a huge emotional toll. As often the case, we tend to deal with it and remain strong, brushing it off as ‘just a normal part of life’. Yet, we can also be strong, while at the same time, process the feelings that are going on inside, in a healthy way. One does not exclude the other. By becoming aware of the stress it has caused and understanding what this can do to your body, they were able to release some of it through journaling and in-session exercises. They explained feeling physically lighter after doing this work.
  

The Power of Therapist Matching for LGBTQ+ Individuals: Empowering Your Journey to Authenticity

Seeking therapy is a courageous step towards personal growth and mental well-being. For LGBTQ+ individuals, finding a therapist who understands their unique experiences and identities can be transformative. In this blog, we will explore the benefits of therapist matching and the positive impact it can have on therapy outcomes for LGBTQ+ individuals. Let's dive in!

Understanding the Importance of Therapist Matching:
The LGBTQ+ community faces distinctive challenges that can significantly impact mental health. Discrimination, prejudice, and societal pressures can contribute to feelings of isolation, anxiety, and depression. Having a therapist who shares similar experiences and identities can foster a safe and inclusive environment, where individuals can openly explore their thoughts and emotions without fear of judgment or misunderstanding.

Research Data on the Benefits of Therapist Matching:
Multiple studies have highlighted the positive impact of therapist matching on therapy outcomes for LGBTQ+ individuals. A study published in the Journal of Counselling Psychology found that LGBTQ+

individuals who worked with LGBTQ+-affirming therapists reported higher levels of self-esteem, lower levels of psychological distress, and greater satisfaction with their therapy experience. Another study published in the Journal of Homosexuality revealed that LGBTQ+ individuals who received therapy from LGBTQ+-identified therapists experienced greater improvements in mental health and well-being compared to those who did not.

The Benefits of Queer LGBTQ+ Therapists:
1. Understanding and Empathy: Queer LGBTQ+ therapists possess personal insights into the unique challenges faced by LGBTQ+ individuals. They can provide a safe space where clients can freely express their concerns, fears, and aspirations, knowing they will be met with understanding and empathy.

The Harmful Impact of Pink Washing on the LGBTQ+ Community

Pink washing, also known as rainbow capitalism, is a marketing strategy employed by corporations that use the LGBTQ+ community's symbols and identity to promote their products or services. While it may seem like a positive initiative at first, pink washing can have a detrimental effect on the LGBTQ+ community. This blog aims to shed light on the negative consequences of pink washing and its urgent need to be addressed.

The Exploitation of Pride:
Many corporations jump on the Pride bandwagon during the month of June, using rainbow flags and LGBTQ+ slogans to market their products. However, this form of performative allyship often lacks genuine support for the community. Such actions can be seen as a mere attempt to increase sales, rather than a sincere commitment to LGBTQ+ rights.

Tokenism and Superficiality:
Pink washing often leads to tokenism, where corporations use a single LGBTQ+ individual or a small group of them to represent the entire community. This approach reduces the diverse experiences and struggles within the LGBTQ+ community to a single, marketable image. It fails to address the systemic issues faced by the community, such as discrimination, violence, and unequal rights.

Negative Impact on Activism:
Pink washing can divert attention and resources away from grassroots LGBTQ+ organizations and activists who are genuinely fighting for equality. By associating with corporations that engage in pink washing, the community risks losing its voice and diluting its message. This can hinder progress towards achieving true equality and social justice.

Corporate Hypocrisy:
Some corporations that engage in pink washing have been found to donate significant amounts of money to anti-LGBTQ+ politicians or support policies that harm the community. This hypocrisy not only undermines the LGBTQ+ cause but also perpetuates a cycle of discrimination and harm.

Embrace your inner Superhero - Power of internal validation. 

Hey there, Fear Fighters! Today, we're diving into the wonderful world of generating self-worth through authentic internal validation. Get ready for a rollercoaster ride of casual banter, scientific insights, and a sprinkle of humor. Buckle up, and let's embark on this self-discovery journey together!

Picture this: you walk into a bar, and everyone's eyes turn to you. You feel like Lady Gaga at G A Y, right? But here's the catch – what if I told you that relying solely on external validation is like chasing a mirage in the desert? It might quench your thirst momentarily, but it won't sustain you in the long run. 

Cue the entrance of authentic internal validation, the superhero of self-worth! This concept revolves around recognising and appreciating your own unique qualities, accomplishments, and values. It's like having a personal cheerleader inside your head, cheering you on even when the world seems to be sleeping.

Now, let's get scientific. Studies have shown that self-compassion plays a crucial role in building authentic self-worth. When you treat yourself with kindness, understanding, and acceptance, you're nurturing your inner superhero. So, next time you make a mistake, don't beat yourself up – give yourself a high-five for being human and learn from the experience! Self-compassion isn't, "there there it's ok let me hold you tight and not let anything bad happen to you", but it's also not "Die bitch die for being so stupid!". It's more like "Hey, it's ok you did that, next time you will know better. We got this!". 

But wait, there's more! Authentic internal validation also helps you break free from the comparison trap. We live in a world where Instagram filters make everyone look flawless, and Facebook feeds are filled with highlight reels. It's easy to fall into the trap of comparing ourselves to others, but remember, comparison is the thief of joy.

Instead, focus on your own journey and growth. Celebrate your wins, no matter how small they may seem. Did you manage to finish that one gym session you've been trying to do all week? Give yourself a round of applause!

Why I tolerated abuse?

Today I wanted to explore this very sensitive issue which I think many of us have experienced in some shape or form in the LGBTQ+ community and so I will give my own experience to shed some light on the topic and my thoughts around this and why I tolerated it and really shouldn't have. 

I attended the annual Pink Therapy conference on the weekend of 12-13^th of August 2023 and one of the talks presented was by Rima Hawkins on “Working with intimate partner violence in GSRD intimate relationships” which is covered in the book Relationally Queer, chapter 9. Although I’ve explored this topic in other ways through my workshops on Male sexual abuse and sexual abuse as experienced by Sex workers I have not really looked into detail abuse and violence in intimate relationships.

Rima lists the different types of Intimate partner violence (IPV) or domestic abuse which include :-

• Coercive control (a pattern of intimidation, degradation, isolation and control with the use or threat of physical or sexual violence).
• Verbal abuse or vilification.
• Psychological and/or emotional abuse.
• Physical or sexual abuse.
• Financial or economic abuse.
• Online or digital abuse.
• Stalking and harassment.
• Family violence such as forced marriage, female genital mutilation and so called ‘honour crimes’.

Like many Queer people I am not unfamiliar with at least 1 of the above types of IPV, the one that really stands out for me however is the online and digital abuse I experienced in one of my previous relationships. Now, online or digital abuse can take many forms which includes, digital sexual abuse which can be anything from taking sexually explicit pictures or videos of you without your consent to internet stocking, phone hacking, social media and email hacking. For me, it was the internet stocking, social medial and email hacking that I experienced. My ex’s would go through my phone without me knowing, they stalked me on social media by creating fake profiles and this is just what I became aware of. My feelings are now that if they could do this, they probably did other things too that I’m not aware of.

Now the big question is why did I put up with it? Well, firstly that answer has a number of reasons but to list the top ones,

1. I felt it was justified following me cheating on them (despite them cheating on me and me never doing that to them)
2. It didn’t feel it was abusive even though I knew it was
3. I wanted to “make it work”

I want to explore these 3 reasons a little with you here.

1. I felt it was justified following me cheating on them

This is a common reason for accepting and tolerating abuse or violence of any kind. We feel our dishonesty and betrayal means we can 1. expect abuse and or violence, 2. forgive abuse of violence and 3. deserve abuse or violence. This is not true and does not serve you, them, or the relationship. It simply consolidates a toxic dynamic between you and your partner/s. Discussing what happened, why it happened, and re-contracting and re-constructing your relationship will be more helpful than accepting abuse and violence. Of course, there will be the need for healing and forgiveness, but I don’t feel accepting abuse and or violence is a way to apologise.

Embracing Your Truth and finding compassion and support for LGBTQ+ individuals

In a world that often fails to recognise the beauty and resilience of LGBTQ+ individuals, it's not uncommon to find oneself grappling with feelings of shame and self-doubt. At Fighting Fear, we see you, we hear you, and we're here to offer a hand to guide you through the journey of self-discovery and healing.

Understanding Your Journey:

We understand that the path to self-acceptance can be riddled with obstacles, especially when societal norms and expectations seem to weigh heavily upon your shoulders. Let's explore together the roots of shame and how they intertwine with your unique identity and experiences, creating a space where your truth can be acknowledged and honoured.

A Safe Haven for Healing:Within the walls of therapy, we invite you to shed the layers of shame and self-doubt, knowing that you are stepping into a sanctuary of compassion and understanding. Our LGBTQ+ professionals are not just therapists; they are companions on your journey, holding space for your pain and your triumphs with unwavering empathy.

Celebrating Your Intersectional Identity:In our community, diversity is not just welcomed—it's celebrated. We recognise the intersecting layers of your identity, from your race and ethnicity to your gender identity and sexual orientation. Every aspect of who you are is valid and worthy of love and support, and we're committed to ensuring that our therapy services reflect and honour your unique experiences.

A simple guide to being a Queer Ally?

Being an ally to LGBTQI+ people is all about support, understanding, and making sure everyone feels included. Plus, it can boost your own feel-good vibes! Here's how you can be the ally that everyone wants in their corner:

1. Educate Yourself
Dive into LGBTQI+ history and issues. Think of it as a fascinating crash course in kindness and empathy. It’s like Hogwarts, but for real-world magic!

2. Speak Up Against Discrimination
Hear a homophobic joke? Time to channel your inner superhero and shut it down. Think of it as giving ignorance a swift kick in the pants!

3. Support LGBTQI+ Organisations
Get involved with groups that champion LGBTQI+ rights. Volunteer, donate, or just show up at events. It’s like being a part of the Justice League, but with rainbows.

4. Create Inclusive Environments
Make sure your workplace and social spaces are welcoming. Imagine if every place felt as cozy as your favourite pub. Advocate for policies that make everyone feel at home.

"You're too Fat to be Gay:" Breaking Body Shame and Embracing Self-worth in Queer men. 

A patient of mine once received a message on Grindr that read, "You're too fat to be gay." This cruel comment, stemming from a meme circulating on social media, exemplifies the pervasive body shame within the LGBTQI+ community, particularly among queer men—gay, bi, and trans men. The pressure to have the perfect body—lean yet muscular, with a six-pack, tall, and impeccably groomed—can lead to serious mental health struggles, including anxiety, depression, and eating disorders. This narrow ideal of hypermasculinity is relentlessly reinforced by social media and stereotypes in porn and mainstream media, making many feel their bodies are never good enough.

As a psychotherapist, I see firsthand the impact of these unrealistic standards on queer men's mental health. Many of my patients grew up lacking diverse role models, internalising the belief that they must conform to these standards to be seen as attractive and valued. Social media platforms like Instagram and TikTok exacerbate this issue, promoting filtered images of perfection that distort reality and set unattainable standards.