Posted in Weekly Blog

Pain Management

It had been requested by the group to look at ways of managing pain. Chronic pain, often with an undiagnosed cause, and for which medication is not effective affects about 7.8 million people in the U.K, 25% of whom have lost their job and 16% of whom experience such bad pain that at times they feel as if they want to end their life. (These statistics are from 2009 and cited by Corrie, Townend and Cockx , 2016). We considered a CBT coping model of coping with chronic illness, also presented by the above authors.

Because human beings are not easily compartmentalised into separate parts that function independently of each other, this model considers a number of factors; physical, environment, the impact of medical professionals, our thoughts and beliefs about illness, the social relationships that we have and support, the culture we live in, the level of activity we engage in, our emotional state and resilience. All of these areas affect our experience of pain. For pain “is simultaneously a sensory and emotional experience” (Dima, 2013).

Our medical journey can sometimes be very discouraging and disheartening when no diagnosis is forthcoming and we get passed from department to department with no resolution for the pain. When our emotions are affected by a sense of hopelessness or stress this can increase our sensitivity to pain. The things we tell ourselves about pain can contribute to our emotional state and maintain pain e.g. I will never be well, I will get worse, or we may hold images that are upsetting and unhelpful. We are also affected what other people or our culture tell us about pain. Group members talked about messages they had heard such as ‘well-you’re not getting any younger’. The level of activity people engage in is important-overdoing it leads to more pain, more injury, more recovery time and less wellness. Inactivity due to fear or beliefs about the pain maintains it and contributes to a reduced sense of overall wellbeing due to isolation and not engaging with pleasurable activities. Group members spoke about the importance of balance and how they continued normal activity although sometimes needed to moderate this at certain times but didn’t stop doing things altogether.

Group members spoke about how important it is to have support and how significant this is to them. Research shows that such support how ‘pain is perceived, expressed and experienced’ (Corrie, Townend and Cockx, 2016). Medical professionals and other social contacts can help or hinder what we tell ourselves about our pain and acceptance of illness and what we can manage.

Group members shared what helped them to deal with pain. Some said that a ‘mind over matter’ approach had been very important in helping them to push through very painful physio exercises to recover as they knew they felt better afterwards and eventually recovered completely. Using the mind differently, some people definitely recommended mindfulness as a way of coping with pain. Mindfulness involves observing what is happening in the body in a non-judgemental way. Clinical trials showed that mindfulness can reduce pain by 57% and for some up to 90%, brain imaging showed how the brain is soothed by mindfulness.

We talked about the importance of noticing our bodies. When we are in pain, or worried we become tense, we hold our bodies rigid and inflexible, this can both cause pain and exacerbate existing pain, so relaxation is important. As a group we have often used breathing techniques together as a form of relaxation and noticing where we are holding tension. One group member talked about a technique of full body stretching, as in if we think about how a cat stretches fully:

Image result for stretch like a cat

It was said that when animals stretch, they don’t do specific targeted stretching but just go for it….you don’t see bears doing shoulder stretches, however I did find this fun yoga bear workout!

People spoke about other activities which create the natural pain killers, endorphins, like exercise, and singing.

We spoke also about external and internal locus of control, and how much we believe we have power over elements of our circumstances or how much we believe we are helpless. As we looked at the model of managing chronic pain we could see areas where we could feel like we have more control:

Biological and physiological factors-if we are stressed this can increase the experience of pain, so finding ways to relax and calm down the threat system can help, such as breathing, nice walks and things we enjoy.

Psychological factors-the things we believe about our pain can sometimes increase our experience of it, so being aware of beliefs and reality testing them can be helpful, for example the group member who told us about believing that the physio exercises were helpful for healing helped her to push through and heal rather than giving up.

Social context and support-many group members today realised how important it is to have supportive relationships and places of support, isolation or lack of support can increase stress and upset emotions which can exaggerate the sensation of pain. For example many group members often leave the group feeling better than when they came in, this is an example of feeling soothed which can help pain.

Behavioural responses and level of activity-here we spoke about balance. It is important to do the right level of activity that we can manage. Pushing ourselves too hard can result in worsening pain, leading to the necessity of inactivity, which can in the long term worsen pain. Not enough activity can increase our sensation of pain but is also likely to lead to more isolation and missing out on things we enjoy. This can be to do with our thoughts and fears as well that activity may be bad for us, so growing confidence may be important. People spoke about for example taking a walk each day, and that sometimes they may need to walk for 5 minutes rather than the usual 50 minutes, but they are still managing to go for a walk.

Sport, Train, Active, Fitness, Training, Sporty, Play
Posted in Weekly Blog

Having fun increases our well-being

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While preparing for our group programme in advance we are always mindful of the need to make sure it is finely balanced between light topics and others that are a bit heavier. After having a few deeper sessions it felt nice to mix it up today having a session on fun!  It’s something that is so important for our well-being which sadly at times we can all too readily dismiss as un-important.

We did an exercise using spiritual cards and asked group members to choose a card that meant something to them. People found this useful as it provided an outlet to communicate how they felt. After this we played the card game adaption of the popular game show, ‘Catchphrase’. By the end of the game the scores between the two teams were fairly equal!

We finished with a look at what people’s favourite movies where and why. This evoked a discussion about the emotional attachment certain films held for people. Some of the films chosen were, ‘Cinema Paradiso’, ‘Kung Fu Panda’, ‘Back To The Future’, ‘Riding In Cars With Boys’, E.T., ‘Bridget Jones’s Baby’, ‘Mary and Max’ and ‘The Godfather’ It was so nice to feel the passion and energy this brought to the conclusion of todays’ group!

Pop corn with soda and movie shows

Posted in Weekly Blog

Equality in Society

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So! We just put it out there today; Equality in society…what does that mean for people?  What were their experiences of being treated equally or unequally?

Interestingly the group went straight to gender inequality, especially sexual assult on women, a topic that is currently headlining most days as society is rocked by the prevalence of this much hidden issue for so many decades which is now surfacing more and more.  It was felt that although policy and awareness had changed, it was attitude that really mattered, and unfortunately there was still a lot of ‘dyed in the wool’ ways of seeing women and men that both genders still subscribed to with many gender stereotypes still being upheld.

In this group we often talk about the language which we use, and that by changing the language we can change the culture.  So as long as men and women, or boys and girls are brought up in opposition to each other this doesn’t help equal relationships.  For example ‘the battle of the sexes’ is language that pitts people against each other.  Phrases like ‘boys will be boys’ or ‘that’s just how men are’ makes acceptable what is unacceptable and what does that mean anyway? Why do we describe men who display sensitivity, nurturing, creativity as being in touch with their feminine side?  Why can that not be seen as being manly.  What is wrong with ‘running like a girl’? Someone suggested that sometimes maybe male violence is not helped by the message that emotions must be supressed because ‘big boys don’t cry’. And as we also often talk about in this group, our culture makes it hard for men to talk about their difficult feelings resulting in suicide in young men under the age of 45 being the biggest cause of death.  Some of our cultural language and attitudes are not helping men to be emotionally healthy and free

We also touched on how having had an episode of being mentally unwell, or having a diagnosis created inequality as people continue to see you as a patient forever after, even in long periods of wellness.  Unfortunately, people have experienced a shame and a silence around being off work with mental illness, it’s just not seen as being the same as being off with a physical illness.

We considered the inequalities of income, particularly in the stigmatisation of people on benefits being seen a scrounging and not contributing to society; which raises the question of whether its only financial contribution which is seen as valid?  If so how do we value the contributions of those who are retired or ill?

If equality is the state of being equal in status and opportunity we considered education and those who do not have equal access to the same learning opportunities, often influenced by income or area or gender.  Malala Yousafzai highlights the importance of education for all:

“I speak not for myself but for those without voice… those who have fought for their rights… their right to live in peace, their right to be treated with dignity, their right to equality of opportunity, their right to be educated.”  Malala Yousafzai

People in the group were feeling optimistic about equality increasing in future generations, recognising that younger people are more open and accepting and also the media is more open about some of the above issues.  A good example of this is shown in  the LGBT community where the younger generation have played a big part in helping change negative attitudes and inequality which  have been felt by those in the community.

A different way of understanding it maybe to think about equity; responding equally to need, which is different from giving everyone the same.  Equity gives each according to their need as the picture below demonstrates:

IISC_EqualityEquity

 

 

 

 

 

 

 

 

 

 

Posted in Weekly Blog

Stages of change

 

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Today we looked at how people could make positive changes in their lives and ways to do this. This group’s ethos is very much built upon movement and progressing to a place of hope from low points of despair.

For some, the very thought of change invokes a fear of the unknown. This can be really debilitating and make you feel like you are stuck in a situation you want to change but are scared to (C.S. Lewis picture quote above very much captures this). Once you make the decision to change it can feel like you are taking a leap of faith, trusting that you have made the right decision and are able to deal with whatever comes your way.

We used the ‘Stages of Change’ template for today’s exercise with people using the model below;

trantheoreticalmodel-stagesofchange2

e.g.

1. Pre-contemplation – I enjoy smoking, I don’t have a problem with it.

2. Contemplation – Smoking could be bad for my health?

3. Preparation – Evaluating how to stop smoking.

4. Action – Going to smoking cessation group to learn tools and stop smoking.

5. Maintenance – Sustaining recovery and not giving in to a lapse.

In conclusion, we do realise how daunting change can feel but if you plan it out in steps like the above tool you are giving yourself a far better chance of achieving your aims.