When I need to come back to myself, I reach for the music that I know by heart. It quiets the stories running wild in my head. It calms and steadies me. It allows me to see more clearly. It brings me a special kind of quiet joy. I've been needing that lately.
My parents loved Simon and Garfunkel. Many nights as a little kid I would fall asleep to side one of "Bridge Over Troubled Water" (if you don't know what "side one" means, ask someone over 40). On weekend afternoons, my sisters and I would lie next to the stereo speakers, listening and singing along.
Later, when I was home as a young adult, my dad would play Simon's 1986 album "Graceland." He made me a tape of it that's probably still in box somewhere my basement. It's some of the happiest music I know.
The music from that time of my life is a balm to my soul. It lives in my tissues, in my heart, in cellular memory. And so, when I need comfort or when I am filled with joy, I often come back to it. I can momentarily forget everything and just dance to it in my kitchen. Or I play a sad song and sit with my pain and grief. I know every word of pretty much every song in Paul Simon's repertoire. It brings to mind what I most loved about my father, who died from a sudden, massive heart attack in 2000, at age 62. I see his smile and feel his warmth and love - and his appreciation for music.
So it's not surprising that I was listening to Paul Simon on a walk this week when I got a flash of clarity about something I'd been struggling with.
Just before my husband Lonnie's cancer diagnosis I was well on my way to being pain free after 30 years of chronic back, neck, and shoulder pain and four spinal surgeries. (See the posts in the Reprocessing Chronic Pain series in this blog from October-November 2021). Using mind-body modalities, I had mostly eliminated the pain over the course of about a month. It was stunning. I'd literally tried everything and then this worked so fast. Clinical trials have proven it to be remarkably effective with all kinds of pain. Put simply, Pain Reprocessing involves decoupling chronic pain from fear, anxiety, stress and other negative emotions. This in turn calms the brain's alarm system. When the brain is less alarmed, pain levels decline. It's elegant in its simplicity but challenging more to put into practice when you've had pain for a long time. And, it worked for me.
Through the course of Lonnie's treatment I was still largely pain-free, despite the stress, the frenetic pace, all the sitting and driving. The benefits I'd achieved were sustained, incredibly. But after the 8-week treatment ended and his healing began, the pain came back. I was devastated. I was angry. I felt like I'd been robbed. It felt impossible to imagine I could get back to where I'd been in October ever again. I tried re-reading Alan Gordon's book (the guy who invented Pain Reprocessing Therapy (PRT)). I tried doing the practices that had worked before. I just couldn't do it. There was too much distress, too much vigilance in my system. In that state, I couldn't work with a process that centers on developing a felt sense of safety. I felt anything but safe. I realized I had to give it some time and try again when things had stabilized.
Meanwhile, about 6 months ago, I started having sharp pain in my left upper arm with certain movements. It was new and felt like something acute, an injury. In October, an orthopedist diagnosed it as "impingement syndrome," meaning a nerve in my shoulder was getting pinched every time I raised my arm or reached behind me. It seemed straightforward enough - and, in my mind, different from the chronic back pain, which I fully understood to be "neuroplastic." The shoulder issue was "real," it was "structural," so I figured I'd get it treated. Two weeks ago, I started a course of physical therapy.
The first thing the PT told me was that the problem was partly due to disk compression in my neck. He gave me neck exercised to do and worked on the muscles along the tops of my shoulders (aka the "upper traps"). "Wow," he said, "these are so tight. Do you feel that knot?" Those muscles have been tense, tight and hard as rock for at least 20 years but most of the time I don't feel any pain there. I wanted to say to him, "that's not the problem I came to you for. That's a long-term chronic issue. I came here because it hurts to raise my arm."
But I accepted his logic - that the neck must be involved with the shoulder problem - and I went along with the PT program. I went in twice a week for heat, electric stim, massage, and an exercise program. I did my neck exercises every 3 hours as directed. I dutifully stretched the upper traps. I did shoulder exercises that I was instructed to do "only to the point of pain - but not to actually create pain." When they wanted to introduce a new exercise, they prefaced it with "this might hurt, and if it does, stop right away." Can you say "nocebo effect?" Of course it hurt. I was tense as hell from waiting for it to hurt and worrying that I was doing more damage. I was visualizing the traumatized nerve. Then the thought came that I wasn't making any progress. It quickly became a downward spiral. But I didn't see that right away. I was too busy being a good patient.
This morning I was listening to an Alan Gordon podcast and it struck me that the physical therapy was contradicting everything I had learned - and successfully applied - back in the fall to become pain-free. The diagnosis and PT made the pain more "real." They put me in the mindset of a patient, a person with a disorder, an injury, a broken part that needed fixing. They focused my attention on the painful areas. They generated vigilance in my system (is it getting better or worse? What's your pain like on a scale of one to ten, is it radiating down the arm, etc.). They planted in my head a visual of compressed disks in my neck. They created fear around any activity that involved looking down - using my phone, cooking, vacuuming, even walking down the stairs. These, I was told, create disk compression and irritate the nerve. I became hyper-conscious of my posture and made constant corrections. I did arm lifts that I was told would trigger pain if I went too far (so they did trigger pain and a lot of fear of that pain). I worried I was making it worse. I moved my arm less and less. I fretted over the ergonomics of my desk and computer. And - this is crazy - I started having the same pain in the other arm. That was completely new.
So today, on my walk, as this all began to register, I realized that the PT was making things worse. I was more fearful. I was more aware of the pain and more alarmed by it. I was also worried about my neck, which I had not been thinking about at all before. I felt a twinge in my hand and thought, oh no, the pain is radiating further down. That's bad.
As this came clear to me, I switched off the podcast and put on Paul Simon's "Kodachrome." Instantly I felt lighter. There was ease and relief. I sang and danced the rest of the way home. Then I called and cancelled the rest of the PT sessions. I already feel better.
It's going to take some time to deprogram the fear and vigilance that the PT triggered. I will keep doing the things they taught me that feel good. This isn't about throwing the baby out with the bathwater or thinking in absolutes or binaries. I'm not saying the PT has no value - it's an amazing resource and it served me incredibly well after back surgeries. It's just tricky with chronic pain because the medical model is based on pathology and it highlights the ways that pain limits you. It trains you to be vigilant and reinforces the idea that pain is dangerous. That makes pain stronger.
Two months into my husband's recovery, I am feeling more resourced, less frantic, less depleted. And so I feel ready to get back with the program. I've started again with pain reprocessing and the other mind-body practices that worked for me before. I send my shoulder messages of safety. I track the pain with interest and curiosity but without alarm. I talk to it - I tell it the pain "you're not real." I reassure my shoulder, "there is nothing wrong with you. Those are just sensations generated by movement. There is no danger." I breathe and mindfully relax the tension in my neck and shoulders. I listen to happy music and sing along (but only when no one else is home). I think about my dad. And I dance and move my body any way I want to - even the ways I was told were "bad for" impingement syndrome.
You see, it's not just about reducing fear. It is also about increasing positive energy: joy, pleasure, optimism. Music does that for me.
We are such miraculous and complicated creatures. No one intervention works for everyone. But there is so much promise in these mind-body modalities for chronic health challenges where nothing else has helped. Unlike classic medical interventions, they can do no harm. They have no downside.
I know from past experience that I learn through teaching and working with others. So, in the coming months I'll be launching a small-group coaching program to teach and lead people through their own individualized mind-body pain healing program. These will be groups of 3-5 participants who meet with me weekly on Zoom to develop a healing practice that works for them.
If this is something you'd be interested in, please email me: dana@danabarronphd.com. More details will be coming soon.
I encourage you to go back and read my blog posts from the series Reprocessing Chronic Pain which I posted in October and November 2021. They walk you through the process, the research that supports it, and my experience with it.
And please share this with anyone you know who lives with pain of any kind - headaches, back pain, stomach pain, pelvic pain, arthritis, bursitis, tendonitis, repetitive strain injuries. If the pain has been present for more than 3 months, it's chronic - and the fear-pain cycle has been activated. It can be reversed. It really does work. It requires practice, support and reinforcement.
And, like healing of all kinds, it works best in compassionate connection with others.
I love to hear your feedback and reactions - as well as your own stories. So please reach out at dana@danabarronphd.com. And please share this blog with others.
If you'd like to read earlier blog posts on a variety of topics, you can find them here.
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