Post #6 in the series "Reprocessing Chronic Pain"
It's been a roller-coaster of a week. At the most stressful moments, when my body reacted with pain, I feared that I'd lost all the progress I'd made and that this system wasn't going to help me after all. I was almost embarrassed - but also sad - looking back at the optimistic post title "It's Working." Will the next one have to be called "Oh Well. Not So Much?" But it's never that simple. I had built a solid foundation and though there were unexpected pauses in the construction process, I'm not starting over from scratch every time I return to the PRT practices.
I had a real light-bulb moment last Friday when my husband and I went to get our booster vaccines at the local grocery store pharmacy. I'd been having pain on and off all day and by the time 4:30 came, which was when we'd made the appointment, I was tired and cranky. We arrived right on time. They said, "have a seat. There are people before you." I felt a surge of irritation. The complaining story that played out in my head went something like this. "Ugh there are 4 other people here. Are they all waiting for vaccines? There seem to be two pharmacy staff behind the glass doing nothing. What's going on? Why are they just sitting there and not calling people in? I knew we should have gone somewhere else. I bet they are totally incompetent here." I'm usually pretty understanding and patient, especially with health care providers in a pandemic, but when the mind is set to complaint mode, the stories are not so nice.
I stood, pacing. Then I sat. I felt pain in my low back and left shoulder. "I'm so tired. It's been half an hour. How much longer? I just want to get this done and go home. I have that stew to make when I get home. I figured this would take no more than 30 minutes and I'd be home with plenty of time to chop veggies and potatoes. I'm going to be in too much pain to stand at the counter by the time we get home." Anyone who has experienced chronic pain or fatigue will be familiar with this inner monologue - especially when things don't go as planned. We only have so much energy - so many "spoons" to spend in a day. Real dread and terror can arise when we think we are going to run out before "everything gets done." It can be the beginning of a downward spiral.
I looked over at my husband who is one of the most patient people in the entire world (unless there's a rude or careless driver. That ticks him off big time). I shared my frustration. Even as I was speaking the words, I realized that all I was doing was telling myself a story that was creating tension in my body. He gave me a reassuring look and took my hand. He let me know, without speaking, "being stressed is not going to get us our vaccine any faster. Relax. It will all work out. I'm right here with you."
So I paused. I breathed into the pain. I got curious. What would happen in my body if I changed the story I was telling myself about sitting here waiting? I glanced over at the other folks who were still sitting there too - there were two adults and two young kids. The kids were squirmy and restless and I'm sure the parents were feeling impatient also. But they were playing and laughing and eating snacks. Rather than resent them for being "in front" of us I just smiled at how cute the kids were. I felt our interconnectedness, our common humanity. I evoked gratitude for the pharmacy staff, doing a hard job, probably underpaid, rushed, and pressured. I focused on the calm energy coming from my husband. I did a quick body scan, relaxing and letting go of tension where I could. "You're safe, you're fine, it's going to be ok, this will pass" I said to myself, hearing Alan Gordon's voice. And the pain faded.
When we were finally called back, the tech came in with the wrong vaccine. She was annoyed, and said she'd have to go back into the pharmacy and prepare the other one. More waiting. Another surge of irritation arose, but I caught this one. The tech looked really stressed. I said to her, "no worries, I'm sure this process is hard and stressful for you and I really appreciate what you're doing. Take your time. No rush." I don't know if she smiled - we were all masked - but I saw a little light in her eyes. I was smiling. And I felt a warmth in my chest.
The problem that was causing stress in my body was NOT that we were being kept waiting, or that it was taking too long, or that the tech made a mistake, or that I had a beef stew yet to make that evening. The problem was my attitude, the story in my head. It became so clear to me in that Acme store that afternoon. Change the story, change the mind, change the body. The pain didn't bother me the rest of the evening and the beef stew was delicious (first time trying a new Instant Pot - those things are amazing!)
Before she administered the vaccine, the tech ran through the long list of likely side effects. She said that people were reporting worse side effects with Moderna, which we were getting, than Pfizer. She said her mom had gotten it and her arm blew up to three times its normal size. I listened to her, understanding that medical professionals have to warn people about side effects, but also wishing she'd stop. I could feel the nocebo effect working on me as I got nervous about what the next couple of days would be like. The nocebo effect is the opposite of the placebo effect. If you are told that something will hurt, and then you're given something completely harmless, you will feel the pain you expected to feel. The brain doesn't just react to stimuli. It predicts based on past experience, expectations, and new information.
The next day was horrible - I had severe joint and muscle pain everywhere. It felt like my body was in a vice. But I knew it was a side effect of the vaccine. I knew it would pass. So I laid on the sofa, watched a really bad Tom Hanks movie and some reruns of Seinfeld, and felt sorry for myself. It really really hurt. But I wasn't angry or scared. Just miserable. And the next day I felt better.
There have been difficult moments dealing with this family medical issue the past couple of weeks but I keep talking to myself. "You're safe. You're not in danger. There's no need for a pain alarm. This is under control. You're doing all you can." I do the brain training exercises and calming meditations. The pain comes and goes but it doesn't escalate into a full-on flare. That's good enough for now.
The folks who developed PRT emphasize two important principles: trust the process (stay the course), and let go of attachment to outcome. If you exert too much effort with the healing strategies, you're still sending signals of alarm to the brain. Pressure and urgency = fear and tension = pain exacerbation. These are the exact same instructions that Buddhist meditation teachers give. Just sit on the cushion. Don't exert too much effort. The mind will wander. Bring it gently back. Repeat. Don't evaluate the "quality" of your meditation. Just sit. Be patient and, most importantly, be gentle with yourself.
Kindness and compassion counteract anger and fear. I'm not saying to deny or stuff negative feelings. (I've tried that. It was a disaster). The challenging emotions need to be honored, felt, processed, discharged. But look out for the negative or judgmental chatter in your mind. It's a habit that most of us have. We can reprogram the inner monologue the same way we can rewire the fear-pain circuits. Like all new skills, changing the story is a practice. It slowly grows easier and more automatic with consistent application. Everything feels better when we can evoke connection, kindness, and compassion - for ourselves and for others. Our world desperately needs more connection, kindness, and compassion right now. It starts on the inside, with each one of us.
In case you missed them, you can read the previous posts in this series here. You can also explore my earlier blog posts on chronic pain and food and body image, going back to 2019. To be notified when a new post is published, please subscribe. You can learn more about me on my website. And you can reach me at firstname.lastname@example.org. I'm also on Facebook and Instagram. And please forward this to anyone else you know who is dealing with chronic symptoms of any kind.