| George Russell, M.A., D.C.
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 The
Mysterious Case of Sam
"Why do I have
this pain?" It's a question we often ask our
doctors. And yet, as often, we aren't really
interested in gaining a deeper understanding of the
dynamics of the pain. We want the pain to simply
go away and never come back.
When
it's possible for me to make a patient's pain go away,
never to return, I'm happy to do so. But my real
interest, my deep desire is not in fixing-it is in the
transformation of the patient.
Each one of
us has completely different underlying dynamics, and
therefore we have different issues to resolve in order
to find wellness. In my years of working with
people and pain, I've found that no two "low back pains"
are alike. While pain may exist in the same place
on each person's body, the cause of the pain varies from
person to person. The thoughts and feelings
connected to the pain, triggered by the pain, vary as
well.
The path to healing, then,
must to be adapted to each individual.
Sam's Rib
Sam is a
new father and a member of a delightful and brilliant
family that I have been treating for several
years. He came to me last year with ribcage pain
that only occurred at night while he was sleeping.
Invariably, the pain would wake him. Sam and I
discussed his physical regime (he is an athlete), the
type of bed he sleeps on, and his sleeping
position. Through movement analysis, I discovered
a postural problem that was putting stress on his
back. I fitted him for orthotics to help correct
his posture, and coached him on how to stand, lie, and
stretch the tight areas of his back. After that
initial visit, Sam checked in with me by phone or e-mail
every once in a while to discuss his on-going problem as
he changed jobs...and diapers. Sam was paying
attention to his posture, and was very open to thinking
in larger ways about what might be causing his pain, but
his pain mysteriously persisted.
Our habits
can be mental, emotional or physical. Habits of
posture and behavior, even habits of thought come from
and create sensations, pleasurable and painful. We
may be able to co-exist with our habits for decades
without an awareness of them, and therefore without
feeling the need to change them. But when a
long-held habit crosses paths with an event-whether it
be a happy event, such as the birth of a child or a new
challenging job, or an unhappy event, such as an
accident or an illness-injury, and then pain, can
occur.
We all now know that psychological
pain can lead to physical pain. Feelings are
called "feelings" because they have a physical component
to them. But that doesn't mean that our pain
always and only is "in our minds." Any person with
chronic physical pain will carry around psychological
pain, and the words and actions of this person can
often-to the frustration of friends, partners and
doctors-seem to come from "psychological
problems." Conversely, the patient who has the
desire for deeper understanding of the dynamics of his
or her pain will question and examine all the
corners. The thoughtful patient will not only
search for a structural solution but will examine job
and leisure activities, the way he or she walks, sits,
and sleeps, and, of course, the thoughts and feelings
that come from and give rise to action and
feeling.
Diagnosis is not merely a
conclusive definition of the patient's problem.
While Sam did indeed suffer from "rib misalignment" and
"muscle spasm," we both understood the limitations of
that description. Rather, diagnosis is a creative
and collaborative art. It is a dialogue that
begins in the doctor's office and continues on in the
mind and body of the patient. It is a hunch that
leads you to try a remedy. Then you evaluate the
result and make your next move. And the process
continues.
A few weeks ago, I received a
most rewarding e-mail (abridged, here) from Sam:
Dear George,
I want to give
you an exciting update on my back pain. As you may
remember, the pain started early last summer. It
only occurred after I had been sleeping for
awhile. Sometimes it would be so painful that it
would wake me, and I'd have to get up for awhile.
When it was really bad I felt like my torso was in a
vice grip. I saw you and had insoles made for me,
and I used some of the exercises you prescribed for
awhile. Things seemed to get better, though the
pain never went away completely.
Something
made me think that the remedy had to be mental more than
physical. I knew back pain is often the effect of
stress and tension, but I didn't know what to do with
that. But at the same time, at some point I just
thought, this is ridiculous. It did not feel like
any physical work was going to help. Even when I
did yoga regularly it had no impact.
I
decided to order one of John Sarno's books; a friend had
told me about him a few years ago. I got "Mind
Over Back Pain" and skimmed through it in a day. I
couldn't really relate to the patients in the book, I
wasn't much interested in his medical explanation, and
the message about back pain stemming from tension was
pretty simple and easy to grasp. The thing is that
I feel like I'm a pretty self-expressed guy, so it was
hard for me to imagine that I was holding onto some
tension that needed expression. But the book did
get me to start turning that question over in my
head. Where was I holding onto
tension?
Then a night or two later as I was
experiencing back pain at around 3am, the thought
occurred to me that the impact that the back pain was
having on me was to wake me up at night--just like Naima
does every night to feed Gabriel. Don't get me
wrong, I'm not a guy who just lets his wife do all the
night time work. After Gabriel was born I'd get up
to change his diaper and keep her company a few times
each night. But lately we'd fallen into a pattern
where he was feeding just once or twice a night, and I
was sleeping through it. I began to think that it
was okay for me not to get up.
I
realized though, that the pain had started during
Naima's pregnancy, when her own discomfort was keeping
her up. Classic case of sympathy symptoms, I
thought. Looking back, it was around when she got
more comfortable that the pain lessened. And it
was only lately, when I'd started to sleep through
Gabriel's nighttime wakings, that my pain got
stronger. And while Naima was willing to get up on
her own at night, she was clear with me that she
appreciated the "moral support" when I got up at night,
even if for a moment or two.
So, I thought,
I get it. This pain is a reminder to me to wake up
at night. That's what it does to me in actuality
anyway: causes me to wake up. And so this week I
decided that I would wake up when Gabriel woke up.
I told Naima, "When he gets up, I'll get
up."
And then I started talking to
the pain. I'd feel it and say, "Thank you for the
reminder, but I've got this." In other words, I've
got it taken care of. On Wednesday night, I
noticed that the pain had shrunk to a specific spot in
my ribs. Still strong, but not all over my
side. And then last night...no pain! A
little tightness, but not the sharp pain I felt
before.
I hope I'm not writing you too soon
(knock on wood), but I think I figured this out.
I'm very excited. I'm trading dealing with
the back pain for soothing Gabriel or helping Naima--a
great trade by any measure.
Best,
Sam
 Sam
is the patient's real name. He was happy to be the
subject of this newsletter, and to have his e-mail
reprinted. |
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Have you heard
of gyrotonic? It's a fitness
technique that creates strength, length and freedom in
the spine with simple movements that just about anybody
can do. I've been doing it myself for some time,
but this winter I had a painful right
shoulder injury, and now it's gone, due mostly to
gyrokinesis, which is a form of gyrotonic done without
equipment. My teacher is Aviva Geismar, a brilliant
teacher who
assists many of the classes I teach. I'm
taking Aviva's weekly
class on Fridays 1:30-2:30 PM , right near my
office. To learn more about this class, or
about Aviva and her teaching, email me or click
here. | |
Got
resilience? This is from the Tao te Ching,
translated by Stephen Mitchell. It was
brought to my attention by the acupuncturist in my
office, Corey DiStasio:
Men are born soft
and supple;
dead, they are brittle and
hard.
Plants are tender and pliant;
dead, they are
brittle and dry.
Thus whoever is stiff and
inflexible
is a disciple of death.
Whoever is soft
and yielding
is a disciple of life.
The
hard and stiff will be broken.
The soft and
supple will
prevail. |
| Four week resilience
group this summer! Thursdays, June 18 - July
9th. Sign up in advance; space is
limited! | |
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