Stress = Pain = Stress

Stress and pain are intimately related.

In our case, often, being stressed causes pain AND/OR pain causes stress. Psychological therapies – including hypnosis, meditation, and relaxation – may help break the cycle.

For pain therapists, these treatments, which focus on the relationship between the mind and body, are considered mainstream.

For other health professionals, they may be considered alternative or complementary therapies.

And for the layman, they may be considered hocus pocus!

Regardless of how they are labelled, there is evidence that for many people they work.

Hypnosis

fate2For many, hypnosis brings to mind a parlour game or nightclub act, where a man with a swinging watch gets volunteers to walk like a chicken or bark like a dog. But clinical or medical hypnosis is more than fun and games. It is an altered state of awareness used by licensed therapists to treat psychological or physical problems.

During hypnosis, the conscious part of the brain is temporarily tuned out as the person focuses on relaxation and lets go of distracting thoughts. The American Society of Clinical Hypnotists likens hypnosis to using a magnifying glass to focus the rays of the sun and make them more powerful. When our minds are concentrated and focused, we are able to use them more powerfully. When hypnotized, a person may experience physiologic changes, such as a slowing of the pulse and respiration, and an increase in alpha brain waves. The person may also become more open to specific suggestions and goals (such as reducing pain!) In the post-suggestion phase, the therapist reinforces continued use of the new behaviour.

Benefits of Hypnosis

Research has shown medical hypnosis to be helpful for acute and chronic pain. In 1996, a panel of the National Institutes of Health found hypnosis to be effective in easing cancer pain. More recent studies have demonstrated its effectiveness for pain related to other conditions. An analysis of 18 studies by researchers at Mount Sinai School of Medicine in New York revealed moderate to large pain-relieving effects from hypnosis, supporting the effectiveness of hypnotic techniques for pain management.

If you want to try hypnosis, you can expect to see a practitioner by yourself for a course of 1-hour or half-hour treatments, although some practitioners may start with a longer initial consultation and follow-up with 10- to 15-minute appointments. Your therapist can give you a post-hypnotic suggestion that will enable you to induce self-hypnosis after the treatment course is completed

To find a hypnotherapist, speak to your doctor.

More reading on Hypnosis: Look into my Eyes

Find a licensed Hypnotherapist:

The American Society of Clinical Hypnosis

American Psychotherapy and Medical Hypnosis Association

Mind Motivations – For US, UK and Australia

Therapy Tribe – for US, UK, Canada and Australia

Meditation

Meditation involves using a number of awareness techniques to help quiet the mind and relax the body. The two most common techniques are:

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  • Transcendental meditation. The patient repeats a single word or phrase, called a mantra, and is taught to allow other thoughts and feelings to pass.
  • Mindfulness Meditation. The person focuses all of his or her attention on thoughts and sensations. This form of meditation is often taught in stress-reduction programs. Want to give this a try?

meditationBenefits of Meditation

Studies suggest that meditating can increase pain tolerance, activity levels, and self-esteem and decrease anxiety, stress, depression, and use of pain medications.

Mindfulness meditation has been used successfully in programs to reduce pain and improve mood in patients with chronic pain from a variety of conditions, including headache, low back pain, chest pain, and gastrointestinal pain.

Because there are varied forms of meditation and opinions about requirements for training, there is no formal certification or licensing process for instructors. Training requirements differ widely by institution. If you would like to find a meditation instructor, speak to your doctor or a friend, who may be able to recommend one.

To practice meditation, repeated meetings with the instructor may not be necessary. A recent study examining the perception of pain and various mental training techniques has found that relatively short and simple mindfulness meditation training can have a significant positive effect on pain management.

Relaxation Therapies

Relaxation therapies include a range of techniques with the goal of reducing stress. In addition to meditation, the major types of relaxation techniques are:

  • Progressive muscle relaxation: Also known as systematic muscle relaxation and Jacobson relaxation, this technique involves slowly tensing, briefly holding, and then releasing each muscle group in a systematic fashion, starting with the muscles in the toes and moving upward. During this exercise, the person should notice the differences between tension and relaxation.

MINI-RELAXATION PROCEDURE (for those on a tight schedule!)

For relaxation to be of the most benefit, you need to learn how to relax and calm yourself instantly upon your awareness of tension or irritability. While a 20-30 minute relaxation period is great, and very pleasant, you cannot escape and listen to your tape or do your long practice when you are tense in traffic or irritated with your family or co-workers.

A mini-relaxation is done as follows:

  1. Take a deep breath and raise your shoulders slightly (until you can feel increased muscle tension).
  2. Starting at the top of your head, focus on letting go of muscle tension (beginning with the muscles across your forehead). Allow sensations of relaxation, release, and heaviness to flow downward from your forehead, downward through your face, shoulders, arms, torso, and legs and imagine all the muscle tightness and tension draining right out your feet. Exhale as you allow the tension to drain away, and use your “key word” as you do so (this may be Relax, Peace, Calm, Serene, Ocean or any other word or phrase that denotes deep relaxation to you). Be certain that your deep breath was a deep diaphragmatic breath.
  3. This whole procedure should take no more than about 30 seconds (and can be done in as little as 10 seconds if that’s all the time you have). At the end of this period, go about your business regardless of how relaxed you feel.
  4. Repeat this process many times during the day, at least 20. Use the coloured dot procedure to remind yourself to do a mini-relaxation, preferably several times an hour. Place coloured dots in places you will see them often: your telephone, kitchen faucet, refrigerator, bathroom mirror, the door frame of doors you walk through frequently, your notebook or appointment book that you consult frequently, and even cut a small part of the coloured dot to place on your watchband. Whenever you see the coloured dot that is your reminder to do a mini-relaxation: deep breath, raise shoulders, let go of muscle tension as you breathe out and drop your shoulders, while repeating your ‘key word.’ You will notice that you become better and better at producing sensations of relaxation in a very short period of time, as you practice this over days and weeks. Do not extend your mini-relaxation more than one minute. If you are still tense, continue with what you are doing, and do another mini-relaxation the next time you see a dot, or the next time you are aware of feeling annoyed.

NB: A note of caution regarding relaxation if you are driving your car: Never practice long periods of deep relaxation while driving. Never listen to a deep relaxation tape while driving. Frequency is the key! The more you practice relaxation, or mini-relaxation, the better you will become at releasing stress and tension quickly and effectively.

Autogenic training: This technique uses visual imagery and body awareness to achieve relaxation. The person imagines being in a peaceful place and then focuses on different physical sensations, such as heaviness of the limbs or a calm heartbeat. People may practice on their own, creating their own images, or be guided by a therapist. Patients may also be encouraged to see themselves coping more effectively with stressors in their lives.

Breathing: Breathing techniques teach people to breathe effectively to relieve stress. While placing one hand on the chest and another on the belly, the person is instructed to take a slow, deep breath, taking in as much air as possible. During this, the belly should press against the hand. After holding their breath for a few seconds, patients are instructed to slowly exhale.

Benefits of Relaxing

According to a 1996 National Institutes of Health report, there is strong evidence to support the effectiveness of relaxation techniques for reducing chronic pain related to a variety of medical conditions. Other benefits may include reduced muscle tension and insomnia and increased activity level.

chronic comic 167The best way to learn relaxation techniques is with the help of a trained practitioner (although you can find many guided meditations, etc. on the Net). Usually these techniques are taught in a group class and then practiced regularly at home.

There is no widely accepted license for practicing relaxation therapy. However, it is often practiced by therapists and psychologists. Ask your doctor for a recommendation.

More reading on Relaxation: Relax

Risks of Mind-Body Therapies

Although mind/body therapies don’t have the risks of medical or surgical therapies, there have been rare reports of adverse reactions from them.

  • If you have poorly controlled cardiovascular disease, experts recommend avoiding progressive muscle relaxation, because abdominal tensing can cause increased pressure in the chest cavity, slowing of the pulse, decreased return of blood to the heart, and increased venous pressure.
  • If you have a history of psychosis or epilepsy, you may wish to speak with your doctor before trying meditation. There have been reports of some people having further acute episodes following deep and prolonged meditation.
  • Hypnosis or deep relaxation can sometimes worsen psychological problems in people with post-traumatic stress disorders or a susceptibility to false memories. Its use should be avoided in patients with borderline personality disorder, dissociative disorders, or with patients who have histories of profound abuse. Because competent hypnotherapists are skilled in recognizing and referring patients with these conditions, only appropriately trained and experienced practitioners should undertake hypnosis.

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Another Yoga Experience

After lots of experimenting and trying out different classes, I think Mommy and I have found our Yoga class – the class we went to yesterday was called Yoga Therapy.

The guy who took the class has lots of letters after his name – Dip Health Ch Grad Dip Psych. He is a clinical hypnothterapist, psychotherapist and yoga instructor. The problems addressed by psychotherapists are psychological in nature and of no specific kind or degree, but rather depend on the specialty of the practitioner. Guess what? My dude (JA) specialises in Chronic fatigue and Fibromyalgia.

Psychotherapy aims to increase the individual’s sense of his/her own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behaviour change that are designed to improve our mental health.

The class itself was incredibly gentle – each movement was explained carefully. There were even instructions on getting up and down from the floor, to ensure we didn’t hurt ourselves. There was a lot of talk about Breath Awareness.

Did you know?

  • Air contains on average 21% oxygen, 68% nitrogen and the remainder is other gases.
  • Breathing oxygenates the blood stream, and releases spent gases
  • Breathing assists in temperature regulation and the release of toxins
  • Breath awareness and conscious breathing allows maximum oxygen absorption
  • Breath awareness assists in controlling emotions and enhances positive thinking.


At the end of the class, there was a lovely meditation – the problem was the more I relaxed (feeling like I was sinking into the ground) the more any pain I had seemed to rise. I was lying on my wonderful, butterfly decorated, purple yoga mat, on my back and the ache in the ache in the back of my head seemed to rise upward and fill my cheekbones. The top of my hands and feet (the highest part of them when lying down) were shooting electricity. I actually had to sit up part-way through. Not sure what that was really – it has never happened before or when I meditate. Any ideas?

JA was incredibly excited, when I spoke to him after the class, and told him I had FM. In fact, we had trouble shutting him up. And Mommy was very excited with the idea that we had found ‘The One’ (you know – that person who is going to cure us?) – definitely a fortuitous meeting. Me? I’m taking it all with a grain of salt – I got excited after the first 10 or so doctors/healers. I shall withhold my future excitement until I see results.

So, I went to Yoga…

This will be a two part post. The plan is to give you a balanced view of my yoga class, so part 1 will be written while still on my exercise high. The next part will be written tomorrow (in real time, but not blog time) so, if there are any FM repercussions, I can let you know.

Part 1

I introduced myself to the dude who was holding the class – have you ever noticed that all male yoga teachers have ponytails? – letting him know about my condition and that I have never attended a class before this.

It all started very nicely. He turned on the relaxing music, lit the incense and we all sat on our mats with our legs crossed and our hands together (like we were praying) in front of us. Inhale…exhale. Concentrate on your breath. Then he told us to put our hands on our knees, palms up. Inhale…exhale. Concentrate on your breath. Next, put your dominant hand on your belly button and your other hand on your heart. Breathe in and feel your belly button go out. Exhale and feel your belly button move towards your spine. Breathe in and feel the breath move to your heart. Let your heart grow. Inhale…exhale. Concentrate on your breath. Hey! I can do this! Next we stood up straight; breathe in, lift your arms above your head and join your hands above your head. Then bring your hands down in front of you, back to that prayer position. Prepare yourself then let go of everything, letting your arms fall to the floor as you exhale. Still cool. Place your hands on the mat, take your left foot, then your foot backwards, moving into the downward dog position. My legs don’t move that way, dude! Then roll yourself down into the plank position. What? How? Now move your forehead and chin to the mat then push yourself up into a cobra. What the hell are you talking about? Then down again; then back into the downward dog.

Now this wasn’t as easy as it sounded (?) but I will admit that at the end of an hour, I appeared to be able to do this basic series of positions much more smoothly. The series is known as the Sun Salutation, and is meant to be practiced at the beginning of every yoga session. It is a way to warm up your body and focus your mind for the session. I was sweating profusely by this stage.

From the above series we moved into a forward lunge (supposedly by just moving my leg forward and NOT falling over!) then leaning to the side and rising (yes, at the same time) and moving into a half-moon pose then twist back, do the full series again and the lunge and moon thing on the other side. (Or don’t! and have to stop and rest in the child’s position while the rest of the class continues)

The really good thing about this is that you get to see how the rest of the class is doing. Other people are losing their balance, or resting, or looking on questioningly. This is really good to know – you don’t feel like quite a (politically incorrect) SPAZ!

There’s a ton of other positions: warrior 1, warrior 2, warrior 3, fish, Lord of the Dance pose, etc – but the best one I saw, that totally spun me out was the shoulder press:

This amazed me. And I think that I would have been able to do this except that my bum weighs SO much that I can’t lift it. Otherwise, I would have been a shoe-in! Instead Yoga Dude set me (the only real beginner) up against the wall so I could lie flat with my legs spread up in the air, against the wall. Imagine being at the gynaecologists – now, you’ve got it! Mind you, after a while, it was quite comfortable.

My favourite position was right at the end, called the corpse.

I went to the class alone and had to giggle all by myself (although everyone was very nice – they were also very serious about yoga). This would be great to do with a friend (especially the first few times) – who else will be able to tell embarrassing stories to all your family and friends?

Somehow, after all of this, I came away energised and refreshed (just in time for pizza for dinner – you really can’t expect me to cook after all of this!). I’m feeling light and buoyant and absolutely nothing hurts (knock on wood!) I don’t want to go to bed tonight because I don’t want to lose this feeling…you may just need to remind me about it in the morning!

Part 2

I have been awake for 2 hours now – waiting…is something going to hurt (more than normal)?

And guess what? No real pain; nothing very different from the normal FM wake up – other than I still feel energised (despite only having 5 hours sleep compared to yesterday’s astounding 10!)

So, I think it’s safe to report (and I’ll let you know if anything changes) that my yoga experience was pretty good. Note to all: I’ve been told that every yoga class is different (sound familiar?) so, for those just trying it like me, attempt to find a gentle or beginner’s class; introduce yourself to the instructor (he can then keep an eye on you); and have a giggle!

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Pilates Pleasure

Yesterday, I downloaded my FREE 14 day pass to the local gym (which is very local – it’s about 500 metres down the street!) and went to have a chat to a lovely lady about my condition and what her gym could do for me. We talked about the yoga and Pilates sessions; and we talked about what would happen after the 14 days was up. (I had to explain that I was absolutely broke and had to be very careful about where I chose to invest my limited funds.) Firstly, she gave me an extra week on my pass. Then she said that, if I find the classes are working for me, she could work out a special price so I could attend just those classes and not have to pay for the use of the entire gym. WOW! Nice lady!

To today:

Getting out of bed early, so my body will be functioning (not necessarily well), for a 9.20am Pilates class is not easy, but I’m motivated and I promised you guys a report…

So, I just got out of the shower (yes! I had a shower) after cooling down from the session. And I gotta say: Whoo Eee! (that’s a shout of glee!)Am I feeling energised! Already my muscles ache – but it’s a different sensation than the FM pain. It’s the pleasurable awareness that all my muscles are there and have been stretched and manipulated. (For those who don’t have sex very often, it’s sort of like the day after feeling…yeah, you feel tired and achy but hey! It was worth it and let’s do it again!)

Now I didn’t do that kind of stuff!

We did Mat-based Pilates (not so easy to get up off the floor at the end, though) – this is a series of exercises performed on the floor using gravity and your own body weight to provide the resistance. The central aim is to condition the deeper, supporting muscles of the body to improve posture, balance and coordination. By focusing on your core strength, you (supposedly) enhance the little muscles in the body so you’re better able to support the larger ligaments, tendons and joints. Pilates is a very intense stretching class that incorporates workouts for your abdominal, leg, arm and back muscles – I found the stretching remarkable (it was like my poor, exhausted muscles could finally open up and take a breath of fresh air) and it’s nice to know that I still have some flexibility. Strength-wise? I have none! Anything that involved holding up my own body – even standing on my tippy-toes – was challenging. But it’s only the beginning of my learning curve…

Pilates encourages you to think about how you perform everyday movements. It heightens your body awareness; it helps you ensure your body is working at its optimal level all the time. Pilates will give you more of a holistic result than most other exercises regimes. It will make you focus on your breathing which is great for improving circulation and relieving stress. It is alleged to be a fantastic way to balance out your health and wellbeing.

Pilates is actually great for people with injuries, weak muscles and particularly bad posture because it encourages you to strengthen your problem areas in a relaxed and low impact way. (NB: It is advisable that anyone with serious injuries consults their doctor or physio though. Pregnant women should also get the okay from their doctor before proceeding.)

Now, tomorrow (or maybe even later on today) I know I’m going to hurt – I’m hoping it is the spent muscle type of hurt and not the FM hurt (but I may be kidding myself – I’ll let you know then).

Joseph Pilate

But I’ll know exactly who to blame: Joseph Pilates developed the yoga-like moves to rehabilitate Second World War soldiers. He then modified the style for injured dancers and so the modern-day method was born.

I’m looking after the beautiful Z tomorrow too, so I had better not hurt too much – playing with Z involves at least one walk to the park and a lot of kicking (then chasing) a ball around. I then have hydrotherapy so the warm water will soothe my tired, spent, exhausted, weary, drained, fatigued, wiped out body.

From just sitting on the couch last week, I‘ve suddenly got a REALLY busy schedule!