How to treat the Back of your Mind

I work with many people who have  chronic back pain and we talk a lot about avoiding pain triggers – no twisting, no heavy lifting, use good body mechanics.  Recently, one of my clients told me that he had to avoid triggers of his mind.  He was talking about how he avoids depression and stays clean despite his physical pain.  And he’s been very successful.

So how do you avoid triggers of your mind?  You can take a few lessons from your back.

  • Don’t reach while you’re standing on a ladder. Always start where you are, and pick the fruit that’s within reach.  Don’t try to stretch to the inaccessible just because you see something you want over there.  Move the ladder if you have to – meaning you find a new approach.  Or find a new tree.  But don’t overreach.  If you do, you’ll either get frustrated or have a fall.
  • Wear good shoes. I talk to so many people who’ve gone for all kinds of back care – physical therapy, massage, trigger point injections, you name it – only to discover that the problem wasn’t really in their back.  They were walking funny, and the foot bone’s connected to the ankle bone and the ankle bone’s connected to the knee bone and the knee bone’s connected to the hip bone and the….well, you get the idea.  A little foot problem can throw the whole shebang out of whack.  When it comes to your mind, it’s a matter of checking out what you are standing on – What’s important to you?  What meaning have you found?  In other words – what’s your foundation?  Does it keep you in a healthy alignment?  Or do you need a new pair of shoes?
  • Pay attention to what you’re doing. Some of the biggest acute pain episodes I see happen when people just do things without thinking. They’re off in their minds somewhere while their body is doing something else until – WHAM!  You can’t avoid triggers if you’re not paying attention to what you’re doing.  You have to be present.  You have to be bring your awareness to the present moment and make choices about what you can and can’t do.   You have to define some healthy boundaries.
  • Intervene when the pain is small. Another good reason to be fully present.  You’ve got to be paying attention to how you feel to be able to notice pain when it’s still small.  Then, you’ve got to be willing to interrupt what you’re doing and make some changes before the pain gets so bad that whatever it is you’re doing screeches to an abrupt halt and puts you into spasms.  And it’s much easier to change direction when the momentum is small.
  • Get distracted. It’s a paradox, I know, but getting distracted and paying attention can work together.  It’s called focus.  Getting distracted isn’t the same as ignoring pain or pretending it’s not there.  And it’s not numbness.  Getting distracted is making a conscious choice about where you want to put your attention.  You choose to focus on what feels better.  One of the most effective strategies for coping with pain – in your back or in your head – is to put your attention on something else.
  • Don’t push through the pain. There are teachers and coaches who will tell you to “push through the wall”.   We know some of them. We’ve studied with some of them.  But we don’t agree with them.  Pain is a signal.  Your body (or mind) is flashing a red light, yelling “STOP!”  If you try to push through back pain, you make it worse – much worse.  You do more damage.  It’s no different with your mind.  If your mind is screaming “PAIN!” don’t keep pushing yourself down that same line of thinking.  You don’t undo pain by causing yourself more pain.  And if your mind is screaming “FEAR!” maybe it’s because you’re not ready to do whatever it is you fear.  It doesn’t mean you should stop there, immobilized.  But we don’t believe it means you should just “push through the wall.”  Fear can signal two things – REAL DANGER! or the need for more preparation.  Listen to which of these it is.
  • Pace yourself. This goes a long with “don’t push through the pain.”  Don’t keep pushing when what you need to do is pull.  Have a balance in your life.  Make sure you’re having some fun.  Take time for relaxation.  It really puts things into perspective – Let’s you step back from whatever is troubling you and just give it a rest.
  • Get a good night’s sleep. If you don’t allow yourself enough time to sleep – or if you’re not sleeping well – your pain will seem worse than it really is because you’re more sensitive to it.   So skip the midnight snack.  Quit falling asleep in front of the TV and just go to bed.
  • Don’t go there. Ever see those wide black elastic belts for back support?  They actually have long vertical “spines” in them, called “bones,” that poke you in the ribs if you try to bend too far.  If a thought hurts, don’t let your mind go there.
  • Use support. Those elastic belts also give support where your muscles may be lacking.  To avoid triggers of the mind, it helps to have support.  Somebody to remind you (and maybe even give you a gentle poke) if you’re going too far in the wrong direction and give you a little extra strength until you  build up your muscles.

Anyone who has lived in chronic pain knows – you either find a way to live with it and manage it, or it controls your life.   It’s a choice that has to be made every day.  You may have to exercise self-management moment by moment, but when you do, the pain yields.

And when all the strategies you use to cope become habits that serve you without any conscious effort on your part, you’ve begun to adapt – to learn a new way of living.  The pain may still be there, but it’s not who you are.   It has no power over you.  It may even disappear.

“Lift Correctly” Photo by Anders Sandburg on Flickr Creative Commons


The Gift of the Dark Angel: Coping with Pain

My barn having burned to the ground,
I can now see the moon.
– Mizuta Masahide, 1688


Several years ago, I suffered through a painful 9 month course of chemotherapy.  The pain was so severe, and so relentless, that I didn’t know how I would get through it, and I seriously thought about quitting the treatment.

There were three things that helped me cope with the pain and I’d like to share them with you, because I know that some of you are going through very very hard times.

The first support was that my doctor gave me the choice of whether to continue the treatment or not.  He didn’t power struggle with me at all.  He was absolutely kind but there was no push.   So there was nothing for me to resist.  It was my choice.  His only advice in making my decision was to consider this:  “You never want to look back with regret.”

The second was a book that was given to me by a friend.  The book was The Gift of the Dark Angel by Ann Keiffer.  It’s an intimate portrait of one woman’s recovery from depression – and how she ultimately found blessings in her struggle.  The book made me look for meaning in my experience. It inspired me to try to look beyond the pain, to try to find my own dark angel’s gift.

The third support was given to me by a doctor-friend that had severe and chronic back pain.  He told me that anyone who lives with pain has to find their own way to cope, a strategy or tool that works for them.  No one can find that for you – No one can give it to you.  They can only tell you, and remind you, that it can be found.  They can wait compassionately beside you while you look for it.

He gave me a reprint of an article – I still have it – called What Good is Feeling Bad: The Evolutionary Benefits of Psychic Pain by Randolph M. Nesse.  The article talks about how pain is protective, like a messenger.  It gave me a kind of  respect and appreciation for pain, similar to the gift of the dark angel.  But where the Gift of the Dark Angel was warm and emotional, Nesse’s article was cognitive and analytical.  I needed them both.  Nesse inspired me to mentally distance myself from the physical pain, to learn to watch it from some other part of myself.

Ultimately, it was these three things: the freedom of choice, the decision to find the gift, and the cultivation of the “witness,” that helped me to cope with pain.

I’ll tell you another story from that time.  Perhaps someone close to you will read this post too, and understand something very special in it.

I was holding it together pretty well.  I’d gone through surgery.  And hemorrhaged more than a week after surgery – necessitating more surgery.  And I was still pretty calm overall, I think.  Until… “The Meltdown.”

My father had come down from New York to be a support and one night I heard only a portion of his side of a phone call, and I totally misinterpreted what was being said.  I started yelling and crying and ranting like a lunatic.  I saw real panic in my father’s eyes, but I couldn’t stop.  The dam had burst and the flood was loose.  I don’t think I was even making sense.  And Charles came towards me, and without speaking, he lifted me up like a child in his arms and carried me into the bathroom.  He set me down, while he ran a bath.  I was still yelling and crying.  He gently took off my clothes and set me down in the warm tub, and when the warmth seeped in and soothed me and calmed me, I was quiet.  All the while, he never said a word.  He didn’t have to.

Photo by Simon Carrasco on Flickr Creative Commons Attribution 2.0