When I recently took part in a “Love Your Body” blog post for Girls Gone Strong, it struck me how *none* of these fitness goals/body image crusades have ever actually helped me.
When my fitness goal was being lean and getting that six-pack, I initially felt a new sense of control because of it; yet eventually I realised it wasn’t the answer I needed. When my fitness goal turned to what I could do over how I looked, I initially felt empowered by it; yet eventually I realised it too wasn’t the answer I needed. The current “trend” of learning to “love your body flaws and all” seems wonderful and liberating … but I’ve come to realise that after the initial surge of feel-good hormones, I can’t seem to actually do it! Why doesn’t anything stick?!
If nothing really changes after I get an answer, perhaps I am asking the wrong question. Or maybe I’m hoping the answer to one question will be the answer to all questions.
I have managed to be on both sides of this: both the seeker and the answer-giver. I started to feel less like I was really dealing with the right question when I was left feeling dissatisfied and empty with each answer. Each time I’d think: “yes! That’s that’s where I should be”. At best I’d end up faking it hoping to one day wake up “there”… but why do I feel I need to fake it? What do I think “it” will bring me? And more importantly, what was wrong with where I was at?
These fitness/body image messages all rely on the same concept: the reader believes that there is something wrong with themselves. If “Fitspiration” messages appeal to you, somewhere there is an underlying belief that you will improve yourself only if you look a certain way (i.e. you need improving); if “acceptance” messages appeal to you, the message only makes sense if you believe there is something wrong with your thinking or feelings about yourself (i.e. “you shouldn’t want to change, you should love yourself”). Rather than actually help, they seem to feed into fear, into perfectionism, into the underlying message that something must change: either yourself, or the way that you think about yourself. It’s still saying that you will feel better when you’re here; it’s what you need. But where is “here” and why is it somewhere you want to be? It’s just confirming over and over again what you already feel: where/who you are isn’t enough!
For me, I’ve realised that I tend to feel an enormous pressure to keep earning my value from places that don’t offer me any. These goals make me promises that they’ll be just what I need. It goes like this: I want to feel valued so I look for what’s valuable … and I try that. What does it mean when I don’t make it? It reinforces my belief that my value is contigent on achieving something else; it’s “evidence” that I’m still not good enough.. The goal is not the answer, it’s a condition to another condition that takes you further from even asking the real question.
I see all these goals/achievements and narratives we formulate about ourselves as bricks that we build up around us like a giant cold wall (maybe with paint on the outside). We build a version of ourselves who we like more, who we maybe even love. But there are always a few cracks or missing bricks (getting damaged in storms like failure, self-doubt, cognitive dissonance) that we desperately try to fill in just to keep our true selves from being seen. We keep looking for new bricks and before we know it, we are locked behind this wall feeling more anxious, less loved, maybe more alone. We might even wonder: “why don’t I ever feel good enough?!” or “why can’t I just be happy?”.
What if the wall fell down, maybe I start pushing some bricks away. With those “badges of honour” shaken off, there I am naked and vulnerable, full of shame for being less than I think I should: Can I love myself now? It feels mighty uncomfortable and I feel small and insignificant… but I am also feeling the heat of the sun on my skin, and radiating a healthy glow. Can you see me past your wall? Can I see you?
Perhaps the better questions I need to ask myself are:
- What do I think I lack that these things (being leaner, being stronger, loving my body) will give me?
- What does it mean if I don’t achieve these things?
- What does it mean if I do?
- Why are any of these things important to me at all?
As Timothy Keller put it:
“To be loved but not known is comforting but superficial. To be known and not loved is our greatest fear. But to be fully known and truly loved is, well, a lot like being loved by God. It is what we need more than anything. It liberates us from pretense, humbles us out of our self-righteousness, and fortifies us for any difficulty life can throw at us.”
You don’t have to read these five strategies in order, but if you want to, you can read the previous ones here: Part 1 and Part 2.
I have often felt under some kind of slavery to my pain; like it was a cruel master taking away all my freedoms and my happiness – it’s the pain’s fault that I feel this way! This is a way of life I did not choose and it was one from which I could see no escape.
There are different ways you can respond to things like this … and, if I’m honest, I tend toward being negative. It’s hard for me to break free of thoughts and actions that actually make things worse. Now that I know that emotions, stress, worry play into a pain experience, it’s no wonder being helpless and self-obsessed (always thinking about my plight) only drags me down and makes me hurt more. Am I really a slave, though? Even if I was, is it possible to think in a way that at least frees the mind and soul which filters through to the body? YES there is!
Become as a child and….
Play/ use your imagination
When I was too sore to do any kind of weight training, I resorted to swimming. I love to swim, but I love lifting stuff more 😉 The compound has a nice big pool and the summer nights were hot enough to enjoy a few dozen laps… but I didn’t feel much better! Actually, swimming up and down was pretty boring! So one night, when the pool was empty, I decided to become that mermaid I used to imagine as a child just diving, tumbling and creating a narrative in my head about what I was *really* doing in this “sea”. I began enjoying the challenges of chasing imaginary fish and swimming from imaginary sharks. I did handstands, swam along the pool floor and broke all the rules of normal adult swimming etiquette.
Guess what happened to my pain? I have no idea, because while I was in “play mode” I lost all awareness of it.
And so, rather than go to the gym and second-guessing my movements, posture, alignment etc, I simply transported myself into another world where push-ups were part of a competition or some other kind of fun thing. I began thinking about these movements in a completely different (and imaginary) situation.
As a child, I was super imaginative and I could be or do anything! I’ve lost a lot of that in adulthood, but I want it back! I want to use play and imagination to break down the walls I have built around myself.
A friend of mine (who I will hopefully interview on his pain experience) has used play remarkably well to move without pain. He uses the natural environment to create situations that he has to use many of the typical exercises he would have performed in the gym. He told me how when he’d go to the gym, Chin-ups and Pull-ups became impossible because as soon as he went to do them, his pain got really bad. He changed the environment (to a tree) and could leap over to a branch and do a muscle-up type movement PAIN FREE!
Not only is this awesome because it’s fun; it’s awesome because it proves that pain doesn’t always = injury. He had no structural problem that would justify the removal of that type of movement from his training. And just because you have more pain at certain times, doesn’t mean there is some injury getting worse. Remember: pain is an indicator of perceived threat by the nervous system and there are many systems and factors that influence your brain’s decision on whether pain is “necessary” and how much pain is “needed” <– and sometimes this decision is based on an over-reactive system.
Play and imagination might help “rewire” the circuits, because if a certain movement, in a certain situation has been causing pain, you can begin to show your nervous system that this movement doesn’t hurt in a different scenario. My friend was still doing pull-ups, but it was in a novel situation that then might allow his system to adapt and reduce pain if he returns to the gym. Maybe he can imagine he’s back in the forest, like I imagined I was a mermaid in the sea 😀
But that’s not all!
When I’m not exercising, I have found that being light-hearted, care-free, silly, and even just being caring and generous toward others (basically, forgetting about my own problems), I do not notice my pain, unless I happen to move in an awkward way.
You might say: “well, it’s impossible to be like that all that time!” and I agree. But what this knowledge has done for me is reduce the anxiety and catastrophising that I do because I *know* how much I can affect the suffering that accompanies my pain. I might have some level of pain each day, but I can remember how that pain can seem less or more simply by what “mode” I am in. While there have been days that I felt I couldn’t take any more, every day has been a day that I *have* overcome – and that is victory!!
I truly hope you will try this strategy and I pray that you can be “as a child” 🙂
Isn’t it ironic that during the time I am writing these 5 blog posts, I have a major flare-up of my pain! Perfect time to practice what I am preaching, eh? And also learning way more about the physiology of pain. In Part 1 I discussed how the nervous system is the place where pain happens and it is influenced by many factors and systems. If you want some additional reading on the systems involved, here is a GREAT article explaining them: A Systems Perspective on Chronic Pain.
Today I am moving on to another important strategy to help your pain. Even if you are not religious you might have occasionally felt a pull toward the transcendent (especially in times of need) and perhaps even said or thought a prayer. For me, prayer is the most important layer to helping my pain, but I am aware that not everyone will identify with this. For that reason, I will write both about my personal experience from prayer, but I also cover a very good alternative and complement to prayer: meditation.
2) Authority of Prayer
I pray because I can’t help myself. I pray because I’m helpless. I pray because the need flows out of me all the time, waking and sleeping. It doesn’t change God, it changes me.
-CS Lewis
Pain can easily bring you to the edge of yourself. A place where helplessness can turn into hopelessness. A place where a horizontal gaze often turns into a vertical gaze. Will that gaze go up or down?
I choose UP.
During my early years as a Christian (both as a child and while wandering from my faith), my reasons for praying had often been about asking God to take away my troubles, which is reasonable, right? The state I had been in as I prayed was one of loss of belief that I can get well and I confess I was asking for healing in order to help me believe that I could get well (if I get healed, then I’ll have faith). What I have realised (albeit through my own experience and reading about prayer) is that faith (even so small or weak) must come first. It is in knowing God’s will that I can pray with authority over my pain and hand that burden over to God while being confident that He will always help me. Healing might not always take the shape of my pain being gone (although this has happened), but prayer has helped deliver me *from* the clutches and control of pain. It steadies me on the edge of myself and gives me the strength and perspective to deal with it. I look for good in the situation and see how my experiences may even help others.
Prayer also opens me up to being vulnerable. I find I want to handle everything alone but through my faith I have often reached out to fellow believers to pray for me, which has always helped. Something I realised over the last few weeks was the one thing stopping me from praying or reaching out for prayer … was pride. So prayer also keeps me humble, which reduces the stress and anxiety related to trying to appear strong and together to others:
“For where two or three have gathered together in My name, I am there in their midst.”
– Matthew 18:20
So what does science have to say about prayer?
It seems from most studies that if you are religious you are more likely to use prayer as part of your coping strategies. If you are not religious, is there much use in praying to a God you don’t believe in? Probably not since God’s will “works” (if you like) with Faith. However, there are many examples (anecdotally) of people being healed through the faith of others. That being said, the act of prayer by a non-seeking person (someone who is not genuinely seeking God) appears not very effective. However, meditation has been shown to help people with chronic pain (both religious and non-religious) which shows at least a little of what CS Lewis meant when he said: “It doesn’t change God, it changes me.” I wonder if belief in meditation makes it more successful? After all, someone who is mediating or praying half-heartedly seems less likely to benefit from them. If you feel impatient and frustrated while trying to meditate, you won’t reach a meditative state. While “proper” prayer doesn’t require the achievement of a specific “state”, faith and [expectant] hope in a positive outcome seems to be a very important part (and not just of prayer, but of any treatment option).
Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours.”
– Mark 11:24
The other thing to consider is the role that perceived responsibility can have on your pain. This is just my own speculation, but I wonder: if you believe that you are responsible for your pain, then are you going to cope well with that? Carrying a burden of blame could make things worse. One of my pet peeves at the minute is seeing biomechanical explanations of pain on the internet. I get a deep righteous anger when I see someone saying that my 10 year chronic pain is because I am weak, my muscles imbalanced, my breathing is dysfunctional. But on top of that is this idea that the solution is singular. So, I have suffered all this time and the answer is that I sit wrong? **FACE PALM** Come on! Why are we so quick to reduce everything? We now know that chronic pain is poorly correlated to tissue damage, posture or biomechanics, so let’s stop fuelling the obsession of our bodies failing us. Let’s, instead, learn how to listen to what pain *is* telling us: there is a threat alarm going off and that is *not* your fault. Further, the threat may be physical, emotional, or spiritual as it often depends on many factors, including your beliefs and experiences. This article about the beliefs that rural South African women hold make me wonder: Do we (in the “West”) focus too much on our bodies? I wonder what impact all this biomechanical reductionist information is on the trust we have in our bodies?
Another confounding factor to my pet peeve is this idea that you’re broken, but someone else has to fix you. It could encourage learned-helplessness.
Consider now the act of prayer (or meditation) could help to transcend the idea that you are only a body. Realising that makes pain seem smaller and less threatening (IMO). Using prayer to both “off-load” the feeling of guilt, shame and pressure to get fixed (structurally) and affirm your body’s healing ability can empower you to “get up” and get on with living as you realise your greater purpose. You see, pain rarely just goes away, so there has to be a plan to help you get on with life while you are getting better. And even if you still believe your pain is being caused by a structural “problem”, then you can still use other techniques to help you cope as you “fix” it. You might actually be surprised by the results.
So, are you learning helplessness or are you practising hopefulness? What is your inner narrative?
“I can’t, sir,” the sick man said, “for I have no one to put me into the pool when the water bubbles up. Someone else always gets there ahead of me.”
Jesus told him, “Stand up, pick up your mat, and walk!”
– John 5:7-8
In the Gospels, Jesus often says “your faith has made you well” and he emphasises the importance of belief in many group and individual healings. When Jesus returns to his home town it is written that he cannot perform healing or miracles because of the unbelief, which reinforces the need for faith during prayer. Faith gives you authority because you expect your prayer to work.
Let me just add a footnote to this: We must be careful not to fall into helplessness if we don’t receive the desired outcome right away. It is very easy to assume you aren’t getting better because you lack faith and so the burden falls back on your shoulders. Does a lack of healing (in a sense you want) and repeated prayer indicate a loss of faith? No! We are told to persist in prayer to strengthen our faith and keep the channel of communication open to God so we do not fall prey to what Satan wants us to believe. Faith needs to be practiced. And I think this is something many people struggle with. Not seeing the desired result (no pain) can be discouraging, but it is also an opportunity to practice trusting God and continuing to place it in His hands; always seeing the bigger picture:
Therefore we do not lose heart, but though our outer man is decaying, yet our inner man is being renewed day by day. For momentary, light affliction is producing for us an eternal weight of glory far beyond all comparison, while we look not at the things which are seen, but at the things which are not seen; for the things which are seen are temporal, but the things which are not seen are eternal.
– 2 Corinthians 4: 16-18
If prayer is difficult for you, you can begin with short one-line prayers even asking God to help you with any unbelief or couple it with mediation on the Word.
Scientifically, I don’t expect there to be much in the way of strong evidence for the use of prayer in the future. It is too difficult to measure and it is impossible to account for the presence of absence of prayer from others.
So prayer may be a different kind of natural meditative state, or it could be supernatural and an essential part of expressing your full humanity.
I choose to believe that it is both.
New to meditation? Here are 3 resources to help you on your way:
– Meditation for Beginners: 20 Tips for Quieting the Mind
– Mindfulness Meditation for Pain Relief
– MyCuppaJo
My chronic back pain is no secret. In fact, it was one of the reasons I started to exercise. I was told I had Ankylosing Spondylitis (albeit a mild form) and that exercise would “stop your spine from fusing”. The doctor did a good thing encouraging me to move more, it’s just a pity he also didn’t explain how pain works. Perhaps I can use my experience with pain to help others who have pain in a way I could never have done before. What I am going to share over the next few weeks aren’t just 5 things that have helped me (although they have); these are quite possibly some of the best options out there to help your current pain or any future pain.
Before I begin I want to underline something very important: these methods don’t work overnight and ought to become part of every day life so that you can begin to change how you think and respond to pain. When I first saw some success from these methods, I was filled with hope and confidence in them and I felt “cured”… but what I hadn’t adequately prepared for was the occasional relapse. It is during the “bad” days that you need these strategies to be well ingrained and for that faith in the process and the journey to keep your nerves “intact” (pardon the pun). It’s very easy to allow the distress of pain to rob you of hope in the bigger picture and for you to fall into the trap of assuming that you have regressed to square one and you no longer believe that the strategies are working. That is why it is so important to always count your blessings and remember each improvement and set your mind on positive things, rather than always on thoughts like “am I still in pain?”.
I wanted to make this one blog post, but after writing out the first strategy, I realised it might be better to split this information into smaller parts to help you assimilate it all. It can be a lot to take in.
1. I learned more about pain
For years we have heard from Doctors, Physios, Chiros, Massage Therapists, and even Trainers (and I am guilty too) of spreading misinformation about the causes of pain.
“Your leg length is off”
“You have flat feet”
“Trigger points”
“Your pelvis is out of alignment”
“you’ve blown a disc”
“Your back is a ticking time-bomb”
“I just have to look at you squat and my knees hurt”
“Watch you don’t wreck your back when you deadlift”
“Your diaphragm is dysfunctional so all your pain stems from there”
“You have bad posture and that’s why you have neck/ shoulder/ back pain”
“Oh, you have back pain? Your Glutes are weak and you have tight hip flexors.”
The list of things I have heard is endless.
Basically, what seems to happen is that therapists correct what they think is “off” and pain might initially improve. So they rationalise this like so:
– You have pain and X is tight
— Work on X’s tightness
— pain improves
—-therefore X was the cause of pain
Bingo!
Hmmm, NOPE!
There is a rather large body of evidence that now shows us that posture, structure and biomechanics are poorly correlated with pain. Meaning, they are unlikely causes of pain and improving or “fixing” these play less of a role in healing pain than was believed for a long time. And, if someone tries to explain your pain’s origin as a tightness, imbalance, weakness, poor motor recruitment, poor breathing, poor alignment – close your ears. Treating said tightness etc might help, but that is not proof that it was the cause!! This is very important to remember. Think of it this way: Are you sore because you’re all twisted up or are you twisted up because you’re in pain?
Being somewhat lazy and a little rusty on how to reference properly, here are a few blog posts that have great authors who did that work for me. If you’re anything like me, you might appreciate reading a blog article that is making sense of the research, rather than reading the research itself.
– The Ultimate Guide to Pain
– The Real Reason You Still Have Back Pain
– Does Posture Cause Back Pain?
And, of course I enlisted the help of my very smart and handsome husband, Dr Jonathan Fass, DPT in an effort to iron out some commonly held myth-beliefs about pain and injury. Find that HERE and remember to check out the list of resources at the end of that article too.
Yes, there are other resources, but I like these ones because they cover all the basics. And that is always the best place to start. Lay the foundations and build the rest as you begin to understand it.
So what is Pain?
I felt it was important to talk first about what pain isn’t (a signal that comes from the muscles, joints or bones) so that we can better grasp what pain is (a signal that comes from the nervous system, and is governed by the brain). Pain is not always indicative of tissue damage/injury, and it is not proportional to damage. If you have more pain today than yesterday, this does not mean there is more (or any) damage. When you have pain, your brain has received danger information from one or many locations within your body (via the vast network of nerves) and has decided that it warrants some pain to change your behaviour and protect you from something that is *perceived* as a threat.
And I get how confusing that is!!!
When I first heard this stuff (a couple of years ago) I failed to assimilate it because I got defensive and thought it was suggesting that my pain was all in my head (as in, imagined). But actually, *all* pain from is the brain (and nervous system) – even if it’s just a stubbed toe.
At this point I want to highlight something so that you don’t misunderstand me. I am not saying that pain is somehow not physical. It is physical, but these physical changes and responses happen within the nerves and brain. Before, I always thought pain came from damaged tissue and it told my brain it was in pain, but this is not the case. The nerves deliver a message about what’s happening (toe got stubbed on the table) to the brain and the brain then decides whether pain is needed. However, sometimes this system doesn’t operate as we would expect.
For example:
You stub your toe just as a lion jumps in the room. Are you going to have pain in your toe? NO WAY! Your brain will delay that until you are safe enough to tend to your toe.
And there are many other times when the brain and nervous system respond in ways that really do not make sense if all pain is from injury:
Have you ever discovered a cut or bruise that you didn’t know how you got?
Does your pain get worse when you’re stressed?
Does your pain get worse when you’re tired?
Ladies, do you feel more pain before or during your period?
So, pain is a response (like an alert) from the brain to a danger signal from the body. BUT, the “alert” may be very very quiet (only a little pain) or VERY VERY loud (lots of pain). And if you’re like me, and your pain seems to get worse for no apparent reason, it can be very disconcerting and cause much unnecessary confusion and angst. This is why knowing how the nervous system interprets information will help reassure you that when you get a bad pain, it may not be because something has gone seriously wrong.
So what amplifies that “alert”?
Now consider each of these things potentially “ramping up” your nervous system’s alarm sensitivity, making that alarm ring a little bit louder:
– Not knowing about how pain works and what it means
– Stresses (family, work, money, health worries or fears)
– Thinking the worst (catastrophising)
– Fearing movement because you believe it is causing damage
– Depression and lack of sleep (this can be a vicious cycle for someone who already has pain)
– Loss of motivation to train (maybe because of fear or depression or hopelessness – or being told not to train by a well-meaning physio or doctor)
– More pain
– Fear of pain itself
– Beliefs about your pain and/or diagnosis
– Oh and even hormones, temperature and your immune system can contribute to your pain *experience*.
There are more things that could potentially go onto this list, but you get the gist.
Factors like these can play some sort of role in your pain experience. Even if you do have an acute injury, it is still helpful to understand why some days your pain may seem worse, even when healing is under way. Pain does not mean something isn’t healing. The body is very good at healing its tissues, but sometimes after an injury the nervous system becomes more sensitive as a way to guard from a repeat injury. After all, if anyone has ever been in severe pain, you’d do anything to prevent it happening again, right? So, depending on your circumstances, your beliefs, your history etc etc your pain experience will differ greatly compared to someone else. But you also have a lot of control over many of these factors – and that is great news! And even if you can only influence your knowledge about pain, that has been shown to help pain.
Pain as an experience.
No one has the same experience of pain because there are so many factors involved in pain’s creation: memories, beliefs, smells even. But guess what? That means *you* (the person dealing with pain) have more control over it than you may know. It is quite helpful to become proactive about your pain triggers – without obsessing on them. If stress is a trigger, then you can use some of the other strategies to help with that. If beliefs are an issue for you or fear, then this educational strategy will really help.
For years I expected someone else to fix me. Either by massaging away my tight fascia, teaching me “good alignment”, correcting my “dysfunctional breathing or movements” or by prescribing me better medicines. These strategies are called “bottom up”. While many of those things can help pain, they don’t get to the root of it and you often end up seeking more treatments and getting more investigations, which don’t have as much success long-term. Since pain is governed by the brain, then surely we ought to focus our attention there to see what can turn down the alarm. The best pharmacy, after all, is right between your ears.
By using the next 4 parts of this series, you will learn a total of 5 “top-down” strategies (education is also a “top down” approach) to radically influence your pain.
Life and death is in the tongue.
Do I still have pain? Yes, but it is MUCH better than it was, but the main thing is that I don’t respond the same as I always did – which was the belief that there was something wrong with my tissues, joints, posture, breathing etc. I thought I was broken and I was at odds with my body. But now I see that my body is healing and movement is good. Avoiding movement (and this happens if you begin to believe that some movements or postures are “bad”) can actually cause you to have the very pain you are trying to avoid.
Which brings me on to another issue that comes from the words and reactions of therapists, doctors, trainers, and even the beliefs within a society about pain. There is a good amount of research into something called the nocebo effect (the opposite of placebo). Basically this means that the beliefs you have about your situation can make things worse. For example: If someone is told they have “blown a disc”, how do you think that will affect their beliefs about their back? It could potentially make them fear moving their back (because they believe pain = damage) and this fear increases the alert which increases the brains output of pain to protect that “weak” and “vulnerable” area. Pain is protecting against a false danger. This person could live for years in chronic pain because they started to fear moving their back. And they may actually begin to get other pains (in their hips, down their legs or their sides) because they have become so stiff and “braced” in order to support their back that these muscles never stop bracing. Can you imagine clenching your fist all day every day? That would eventually hurt, right? So these words can have real negative effects on people’s lives. Instead of being told that discs herniations are very common, that they heal and movement is good, they are told never to lift or flex their back again. Plus backs are strong and the disc may have had very little to do with their original complaint.
But don’t take my word for it – read the articles and set yourself free from believing all pain is caused by tissue damage.
Here’s another little list from smarter people than me who have listed the research.
– Nocebo Effect: Your Power of Suggestion May Harm Clients
– Spinal Discs, osteoarthritis and degenerative joint disease with pain
– First, Do No Harm – language can harm!
Now you have 1 major tool to help you reduce your pain. Just understanding pain has been shown to reduce it.
Pretty awesome, right?
I expect there will be a few questions after reading through some of this material. Feel free to ask and I will try my best to clarify anything.
Also, if you want references for anything I have said, I will be happy to provide them in the comments.
Additional Reading Material:
– Therapeutic Neuroscience Education (2013) by Adriaan Louw
– Explain Pain (2013) by David Butler and Lorimer Moseley
