"Helplessness and immobilization keep people from utilizing their stress hormones to defend themselves. When that happens, their hormones still are being pumped out, but the actions they're supposed to fuel are thwarted. Eventually, the activation patterns that were meant to promote coping are turned back against the organism and now keep feeling inappropriate fight/flight and freeze responses. In order to return to proper functioning, this persistent emergency response must come to an end. The body needs to be restored to a baseline state of safety and relaxation from which it can mobilise to take action in response to real danger." I love this passage from Bessel Van Der Kolk in the book "The Body Keeps the Score". Stress physiology and persistent pain often go hand in hand. How does this present?
- Poor sleep
- Poor digestive function
- Altered menstrual cycles/reproductive function
- Low mood
- Low energy etc. As someone who works with persistent pain, I ask my clients if they experience any of the above. It is usually a sign of a very stressed physiology. Part of my ethos as a practitioner is to help someone who is suffering from a lack of resources, to become resourceful. This follows many forms (probably the subject of another blog post) and the biggest one is identifying the contributions to an unresourceful state. One of the common source of this is the topic of today's blog - Failed Treatments. Failed Treatments usually end up being very damaging for a person who experiences persistent pain. And unfortunately they are very common. I don't think that this is a lack of care for the person getting treatment from a health care professional. Usually it is that the health care professional does not recognise the extent to which the person is depending on them for resolution of symptoms, and if/when they are unable to provide that resolution, this affects the person seeking help. If you are someone who has experienced failed treatments, let me know if the following rings true for you.... As I see it, failed treatments usually reinforce the beliefs/statements that "nothing can be done for you", "you will have to live with this for the rest of your life", "I'm going to be like this forever" etc. What happens when those statements are proven correct or are "fortified" - you are likely further stressed out by it. More adrenaline, more cortisol, more physiological reasons to keep you out of a hormonal state that will allow you to gather resources and recover. When this happens, you are likely to circulate more adrenaline, and often times it seems that this vicious cycle means that a person is living in a state of hypervigilence or hyperarousal. This may also go hand in hand with a person becoming hyper alert to threat. As we know increased levels of threat means that you are likely to experience more pain and symptoms. This becomes a very vicious cycle very easily. What I have been working on in clinic lately is the hypothesis that failed treatments themselves become a form of threat because they reinforce the threatening beliefs that a person will never get better. Speaking about this with clients has been really important for them as they have the chance to express their fears about not getting better and have their fears recognised. This in itself helps to break that cycle of stress physiology that is contributed to by fear and anxiety about never overcoming their symptoms. More importantly, they feel like someone is listening to them and they have told me that IT GIVES THEM HOPE AGAIN.
HOPE is the most important thing for people with persistent pain. Failed Treatments nibble away at your hope and your belief that you will overcome your symptoms. Expectation for treatments being "the treatment" can cause those nibbles to become bite sized chunks which rapidly erode your confidence and send you slipsliding down the pathway towards stress physiology and a vicious cycle of symptoms. If this rings true for you, please speak to your therapist about it, it really helps to enable yourself to express your fears and this usually will help you to begin to move past them. As always, thanks for reading and if you are seeking help, please get in touch. #PainAndMovementSpecialist #MusingsFromATherapistsMind #ClinicalExperience #Hope