Most people accept that the feeling of love exists.

Each person having their own experience.

That love exists then, despite being invisible.

So why when people say they are in pain, is there disbelief?

Why are some people dismissed?

🧵 #thepaincoach #chronicpain If they said that they were hungry, would they be believed? You cannot see hunger.

If you laugh, where is the funny? You can’t see it.

.@Womenworking Essential reading for:

All in healthcare
All in education
All employers
All leaders

All.

@gabriellecj
@emilyhwilson

(1) Having worked with so many women suffering persistent pain, it has long been an area I wanted to understand and have been studying.

The narratives, the biology, the sociocultural dimensions and importantly, how they interact and unify as the lived experience.

(2)

What the biomedical model does… 🧵

Well or unwell.

Mind or body.

Healthy or sick.

#thepaincoach #chronicpain

1. #thread Fortunately more and more clinicians are noticing that despite being trained to think this way, it does not work. Why?

Real.

#thread 🧵

Many people have been led to believe that we need to look for something to blame for our pain.

A single cause.

A body part or system perhaps.

Blame the bit that hurts.

#thepaincoach #chronicpain

1. Yet it is not that bit that is in pain. You are, the person.

The person feels pain, not the body part or the brain.

We want something tangible to blame. Something you can point at—‘there it is; the cause.’

Why does my pain persist?

There is a kind of stuckness.

Not that each pain experience is the same — this cannot be, because each moment is new.

A #thread 🧵by #thepaincoach #chronicpain 👇 There was an expectation of getting better but the reality was different. Things you tried did not work. Perhaps your timelines were inaccurate: it often takes longer than you think.

You are doing your best

Often, it’s easy to listen to the self critic.

And harder to acknowledge that you are doing your best.

#thread 🧵
#thepaincoach #chronicpain Considering the circumstances — what is going on for you right now?

This gives perspective. A wider view.

One that is more realistic and less driven by lofty expectations.

There’s nothing to fix

There is a traditional idea with pain and injury (they are completely different) that we are fixed by someone.

I disagree.

#thread #thepaincoach #chronicpain #pain Despite the fact that the system of healthcare training is all about finding something to fix, a problem, and then fixing it.

Somewhere in there you may remember a person.

Let’s turn that on it’s head.

I can🧵1/7

Focus on what you can do, rather than what you can’t.

This is the start. The baseline.

#thepaincoach #chronicpain #pain 2/7

Think of something that you have stopped doing or is limited.

Next, clarify what you can do. What is realistic? Considering the circumstances.

Eg/ I want to go for a coffee with a friend.

Expectations-Reality

When our expectations don’t match reality we feel bad.

This is a common problem facing people suffering persistent pain.

🧵 1/7 Cont… 👇 #thepaincoach #chronicpain 2/7 Expectations of what you can do, what you feel you should be able to do and what you can actually do often mismatch. This feels bad.

Some people don’t recover from sports injuries as expected.

Their pain persists.

🧵#thepaincoach #thread 👇 Return to training and play is stop-start, feels like a step forward and then two back. Or hasn’t happened at all.

They are stuck.

👇

What is pacing, really?

A thread.

Pacing is a strategy that is often recommended to help people suffering persistent pain.

There are different ways of doing it.

Here is the way I do it with the people I see.

#thepaincoach #pain
👇 The important principles:

* Plan your day
* Prioritise what matters
* Periodise your time like an athlete/peak performer

👇

How do you manage painful moments?

What are your existing ways of coping? Reacting?

What do they do for you?

Which ones work and which don’t?

Cont… #thepaincoach #pain

👇 The ones that work you can build upon—they are skills. And then add more choices.

For example, some people find that breathing awareness is a way to apply the brakes when pain and emotions are becoming overwhelming.

👇

Pain is a lived experience that needs a person to live that experience.

A person is made on non-person.

Just as a car is made of non-car.

#thepaincoach #pain

👇 A person emerges from many cells, atoms, molecules, processes that are not that person and don’t have person-ness.

A car has wheels, doors, engine bits, seats, none of which have the properties of a car. They are just those things.

👇

How do I understand your story?

How do I understand your world?

How do I stay in the room with you?

And see what you need behind what you say?

Are questions I ask myself.

#thepaincoach #pain

👇 How does my chatter go quiet? By being present. By using mindful breathing, and coming back to the present by breathing.

Then I can sit with the person, you, and be here to listen deeply.

👇

Can you tell the difference between what is happening right now rather than your interpretation of what is happening right now?

This is what happens when you practice contemplation.

#thepaincoach #pain

👇 There are commonly differences between the actual experience and the story we tell ourselves.

👇

We have beliefs about pain.

Most people have experienced pain (a rare few can’t) and have been told things about it.

The one thing the person knows is that it hurts and has a particular quality—the actual experience.

#thepaincoach #pain

👇 Then there’s the story. What we tell ourselves: What has happened? What it means? What’s the cause? The future? All are highly convincing yet often wrong.

👇

With chronic conditions such as persistent pain, fibromyalgia, CFS, ME and more recently Long Covid, people are still dismissed when their tests show nothing of note.

Cont… 👇 #LongCovid #MECFS #Fibromyalgia #pain #thepaincoach The idea that a negative test (or tests) means that there is nothing wrong is ignoring the plain fact that there is something wrong.

👇

You won’t find the cause of your pain on a scan or a x-ray.

🤔

Cont…

#thepaincoach #pain Firstly, you cannot see pain on a scan or in the person. There is nothing to see.

👇

You want to grow as a therapist or clinician.

In particular, to help people who are suffering persistent pain, whatever their circumstances.

Different ages, backgrounds, circumstances, occupations.

Persistent pain affects people right across society.

Cont… 👇 How well equipped are you to help them?

Do you understand pain sufficiently well to be able to help the person understand all their experiences?

Do you have the skills and toolbox to help them navigate the way forward to shape a positive future?

👇

There are different types of session that we have.

But first of all, they are always focused on you.

#thepaincoach #pain

Cont… 👇 Initial session to meet, clarify what is happening for you in your world, and your picture of success.

👇

How do you communicate?

To others and yourself.

Is it the same or different?

Can you listen deeply, to see the needs of the other person, but also yourself?

Can you recognise the roots of suffering?

Cont.

#thepaincoach #pain #communication #compassion

👇 See the nature and cause of suffering, which allows you to help.

You use loving speech to people you care about.

Do you use the same language to yourself?

👇