Wednesday, July 25, 2012
I am trying very hard to reduce my intake of NSAIDs. I have for the last nearly four months been in chronic and increasing back pain. I'm not the type to lie around suffering out of martyrdom when the show must go on, so in order to be functional, I've been hitting the over the counter pain medications pretty hard. But that cannot go on forever (I'm feeling toxic). I'm trying to take more time to sit with this infernal sensation that travels and migrates, and generally causes me a great deal of grief on many levels. So today, not having taken any Naproxin/Aceteminephen combo, my back is paining me something fierce. I've taken to my bed, shifting incessantly trying to get comfortable. Which is not happening. My dog and my laptop are my faithful companions. If I don't put my mind somewhere I will go mad. A friend of mine mentioned the work of John E. Sarno, MD, a retired professor (at 89) of clinical rehabilitation medicine at the New York University School of Medicine. Actually, I think he still teaches, but just recently gave up his clinical practice, which is pretty impressive. I've read a couple of his books, and I will give a brief summary of what might be up with this pain: Dr. Sarno has treated around 12,000 patients who have come to him with pain conditions of one sort or another, armed with CAT scans and MRI's showing erosions, herniated discs, degenerative disease, yada yada yada. His message? It's not proof that what's hurting you is your "diseased" body. Many studies have compared MRIs of people suffering from pain to those who do not experience pain, and there have been no real differences. Many people have spinal abnormalities who do not suffer any pain at all. He asks why on earth would lying on a soft bed or sitting down create excruciating pain in places the material isn't even touching? Why can some people carry their kids around no problem but then be in agony when they try to touch their toes? With decades of clinical experience under his belt and a track record of a 90% cure rate (without surgery or drugs), he says with good authority, "Hogwash". So why the pain? The underlying issue with the epidemic of chronic pain and illness our culture is experiencing now, he feels, is psychosomatic. He uses that term tenderly because he knows some people might interpret it as pejorative, and he in no way means it that way. He very compassionately explains that the debilitating pain many people are suffering is indeed real, but way more than should be justified by their "injuries". What he uses as treatment, very effective treatment it seems if 90% out of 12,000 have been incredibly relieved is this message: What you are experiencing is Tension Myocitis Syndrome (TMS), which is basically a harmless but excruciatingly painful deprivation of oxygen to the site of suffering. He believes this because every healing modality which brings oxygen to the affected area like deep massage, passive movement, TENS, stretching, and warmth, brings temporary relief. So the big question is why? Why are we suffering? And why is it that whenever many of us enjoy a cure of one thing, something else creeps up to replace it? I see people OBSESSED with chasing down the absolutely perfect diet to heal their tummy and behavioural troubles, people going to every possible bodyworker out there to find "the" right modality to heal their body's mysterious suffering, people downing anti anxiety meds for their panic attacks (all part of the TMS picture). Of course they are, they are desperate for relief! I myself have been on this hamster wheel all my life. I have suffered some kind of chronic pain or health issue since early childhood...."nervous tummy" (as a kid I couldn't go out of the house without getting stress nausea), as I got older I developed a bad case of OCD in which I counted every breath and swallow I ever took in sets of five. I studied psychology at the time and by learning about it, got it way under control naturally and it ceases to be a problem today. When that stopped, I developed chronic throat issues. I was emaciated and ill from constant tonsilitis and was a wreck from all the antibiotics. I got my tonsils out and then serious IBS started once I got to enjoy relief in my throat. That continued for many many years, sometimes the pain so awful (I've had several babies naturally, so I know real pain) and scary, I'd pass out and end up in the hospital. Interspersed with this was always some area of chronic, annoying musculo/skeletal pain and/or anxiety issue, as well as never ending insomnia. But the muscular pain at that time wasn't debilitating, because the IBS was taking care of that..it was just annoying...enough to be a distraction sometimes. As I got older, I started developing migraines (sometimes the see auras, pukey type) around my cycle. I finally got really really serious about my health and cut out all wheat, sugar, bad oils and chemicals, and started training for a half marathon. I felt on top of the world. My IBS was totally under control and the migraines were GONE (and continue to be), as well as the chronic upper back and neck annoyances. Plus, I was looking like a very in shape hottie for a mother of four, if I do say so myself. Then, just around the time I was really finding my groove as a runner, reveling in good health and loads of energy in my 40's I NEVER had in my 20's, I started developing some severe perimenopausal symptoms and this hideous back pain that has me in bed now (by the way, I caved and took some Tylenol...couldn't think anymore). I have had a uterine biopsy, pelvic/abdominal ultrasound, x-ray, cultures, and blood tests. Nothing unusual. I am waiting for an MRI, but being in Canada, unless I fork out the cash to pay for it out of pocket (yes, I have private insurance that will cover it, but having a largish family, that dent would be sorely missed in the interim), my appointment is in May of next year, I kid you not. So this happy, healthy, in shape person has been, within the space of a few months, transformed into a badly anemic, agony suffering, and I'll admit pretty depressed person. I could run 21 K without a problem, now I can't walk without wanting to faint and am breathless after 2 stairs. I used to fling my kids around and could assume yoga positions that would rival a contortionist, and now can't even sit for more than 5 minutes without whining. Why? Why would my pain be increasing if I haven't run since the pain began? A human being can snap a bone and it will heal within a matter of weeks. I've had my tonsils ripped out of my throat, and it healed no problem, but it makes me tired to speak now. And no, it's not age, because chronic pain is much more prevalent in people under fifty or sixty. Logically it would get worse and worse into the senior years if our bodies went kaput after a certain time. But it doesn't. This is what I have gleaned from reading Dr. Sarno's book The Mindbody Prescription: Healing the Body, Healing the Pain, and I imagine this message delivered personally to all those whose health has been checked thoroughly to rule out serious disease (because sadly, that does exist), but continue to suffer, by this kindly great-grandfather type, patient and chock full of wise experience: Your conscious mind presents itself to the world in one way (a good person who tries to do the right thing, or a perfectionist, or a "type A"), but at the expense of the expression of your unconscious mind, which is like a tantrumy 3 year old vying for attention. In order for your conscious mind to reign supreme and maintain your good image and thoughts of yourself, your ratty little subconscious "must" be stopped from wreaking emotional havoc. The body (specifically the brain) acts as a mitigating force between the unconscious mind's repressed intense "negative" emotions and the conscious mind. Basically, the body creates TMS to distract you from harsh emotions, namely rage, that threaten to injure the image you have of yourself and ensure the world has of you. Sure, change your diet, get exercise, and you'll find healing in one form or another. Until.... For example, here is the plight of regular mom: sure, you love your kids and would die for them, but there's a bit of a taboo about moms saying, "I'm feeling goddamn resentful of my brat today, who didn't leave my boobs alone all night and now I'm angry and exhausted and wish he had an off button." No, instead you LOVE breastfeeding and BELIEVE in the beauty of attachment parenting (and you DO...just not every freakin' second, but you don't like to admit it to yourself or others). It's all about the kid, after all, and you try so hard to be a great mother. So you repress those "unacceptable" feelings of anger, and you have a chronically sore neck and skin break outs. You may get on top of them with herbs and homeopathy and diet changes. But if you are a sufferer of TMS, which, though it feels physical is entirely psychological, guess what? Something else will creep up. Dr. Sarno has seen it time and time again. My first reaction to the kindly doctor's message was, "You're a quack, Sarno! You're saying this pain is potentially all in my head?! That I have a raging psychotic three year old inside who, because my body checks her expression, causes me all these horrible symptoms?! Boo!!!!" Sarno's reassuring answer is "No, it's not all in your head. That would be demeaning for sufferers to believe that of themselves. I trust the pain is extremely real. But it's not harmful, and you are not really injured or ill if all tests have come back normal. Look back at your history." And I sheepishly have to say, maybe the guy is right. I mean, it wouldn't hurt to try his method, right? It's cost free, and the greatest risk is that nothing will change. There's also a chance I might heal. It's not like I'm eschewing seeing my family physician (who is AWESOME) to keep on top of things. So why not? And what is the good doctor's method, you may ask? It is to emphatically shift belief gears, to know on a deep gut level, that there is nothing seriously wrong, that the pain is simply TMS, a sensation brought about by a harmless, slight deprivation of oxygen to the paining area. It is important to know the symptoms are born of psychological reasons, namely the body's kind attempt to repress the socially unacceptable emotions of rage, shame, grief, etc. One does not have to change one's personality, or to go into a fit of primal screaming, but to simply be aware that repressed emotions are the root cause of the suffering. Not the every day rages we feel (though they certainly exacerbate pain), but the ones we don't know about or are loathe to admit to ourselves lest they ruin our Polly Anna image. It means talking to our brains and saying, "Hey, Brain, I know what you're doing! I know you're trying to create subterfuge, but guess what? I'm in control now, and it's not working. In fact, since we're communicating here, why don't you send some extra oxygen over to this hurting place?" When our conscious minds have full access to all of our psyche and can process things honestly, perhaps the culture of unconscious minds will shift to be less needful of reacting with rage to things. But for now, it is what it is, and we are quite underdeveloped in that realm. Sarno asks us to take time daily to reflect upon these principles, that by going over his instructions, the brain will "get" the message, and stop feeling the need to repress the emotions. It takes time, but for many, just reading his books have evoked a cure, the message of empowerment that strong a medicine. Pretty cool. And he insists, for all those naysayers, this is not a placebo effect. It is real, clinical medicine, simply created by the mind. In fact, he believes it is usually the back surgeries and physiotherapy for the boo boos that are placebos. He warns that if you are a sufferer of the psychological condition of TMS, something else will start hurting eventually, until the brain stops interfering with the unconscious emotions. More of his instructions: When the sufferer feels safe to do so, knowing on a cellular level there is nothing actually wrong, she MUST assume all regular activity. To baby one's back or allergies or tummy is to acknowledge that what's going on is physical, and it's just not. Stopping therapies that focus on structural healing is also important, or obsessing about what's causing allergies, etc. is crucial. Here is where I differ from Sarno and would argue with him: he believes giving up one's chiro, acupuncturist, osteo, physio, homeopath etc. is important. This may be true if all these people were doing were trying to affect a structural cure (he is a medical doctor, after all, so is interpreting energy medicine in a very earthy, clinical way, which it isn't always). But from experience I believe much of this work is deeply energy based, and creates access to the somato-emotional links that are behind many health issues. I think this approach, however, must be intended by the client and the practitioner, which is how I enter into receiving and giving bodywork. I call my massage table "The Confessional" and have mopped away rivers of tears of grief and anger that create space and resources to access greater energy for healing. That's just my two cents. So that's Sarno's work in a nutshell. His books are a few hours read and much food for thought. I'm willing to give it a go, so I have been starting a Rage Diary, as instructed, to write down my life pressures from where I began 'til now. I look around globally at my many doula sisters on Facebook, and regard the beautiful nurses I get to work with in hospitals as a doula, and I am deeply saddened by how much many of them suffer from chronic physical ailments. So many nurses are barely functional from back pain. Many doulas and midwives too, myself now included as one of those "back pain people". I've been thinking about the root of that in relation to women working within this technocratic birth culture, and I have a bit of a whackadoo theory if you care to hear me out. Maybe it's pain talking, maybe it's real. It's just a thought. Birth used to be women caring for women almost exclusively. Medicine came along and usurped that, desecrating the traditional knowledge female healers and midwives had. The archetype of the Sacred Feminine was destroyed in many ways quite effectively, turning many practitioners of midwifery, herbalism, and ceremony into stake fodder. This is a historical truth. During "The Burning Times", a period of about three hundred years, generated by The Crusades and The Inquisition (Ah, Religion), millions of people were murdered, the vast majority of them women. So much knowledge has been heartbreakingly lost. The dedication of Anne Freye's book Holistic Midwifery Part I is to those lost midwives, and I have known many a birth worker, even medical ones, to feel the ancient tug of a heartstring at these words: To my sister Healers Witches Wise Women Midwives Who for hundreds of years Were burned and tortured and died by the millions as your children looked on. To those who locked arms and walked into the sea Rather than submit to the inquisitor's torments. For the wisdom that went with you Mostly unwritten, but never forgotten. For all you knew and shared The care you gave And the courage it took To continue in the face of truly Overwhelming odds, For your strength; a source of continuing inspiration To you, dear Sisters, I dedicate this book. Parts of this process of the domination of patriarchal knowledge over women's bodies can obviously be seen in our hospital birthing culture. And I don't mean that patriarchal has to do only with men, it's just an approach, a paradigm. You just have to witness this once to see evidence of this belief system in action: a woman, perhaps a mother of several children, yells, "The Baby is coming!" only to be examined by an often young childless medical resident,confined to a place and position she'd really rather not be but submits for the sake of this clinician, found to be a number of dilation, station, and effacement, deemed that it is clinically improbable that she could feel a baby heading for her vagina at this point in time, and told "No, your baby is not coming yet." (then Doula catches the baby who falls out in one push about a minute after the resident walks out the door). Subtle evidence of Power Over Birther is everywhere, no matter what positive things we say about technological advances, justified by how it's all so much safer for Mom and Baby. Now clearly while I have some issues with it, I don't want to knock the advent of a patriarchal participation in childbirth, because many advances have created the opportunity for more living mothers and babies. I feel that our home births are safer now because if things go south fast, the trusty hospital with excellent surgeons and technicians can get us out of a pickle and save us and our babies if we so choose. Medicine has much to share in terms of knowledge and support of the birthing process and for healing sick mothers and babies, and many midwives keep up to date with medical skills so they are better prepared for emergencies. Many doctors are curious about "older" ways of baby catching, and are open to learning from midwives who practice more traditionally. All good stuff when applied properly. So when used in balance, the marriage of Matriarchy and Patriarchy can be a wonderful thing in any given birthing room, no matter who the practitioner. One doesn't need to usurp the other, though essentially it clearly culturally leans strongly in favour of a more masculine approach. For now. We're working on it. By being a normal birth advocate, I'm not saying we should get rid of Medicine and that all women should birth at home. Not at all. But witch hunts aren't entirely over. On both ends, now. Until that stops and we value both sides and create a good partnership, mothers and babies suffer. Until then, there is much to emotionally process. Anyhow, this is to say in my infinitely tangential way that I think many female birth workers carry around a lot of rage not just for the authority over women's mysteries that were taken from them beginning centuries ago (call it an ancestral grudge), but also because of the here and now atrocities that are performed sometimes. And I think it causes them pain. We see women push massive babies out of of their pelvises and most heal up just fine. We see Cesareans, being cut deeply into the body, and they usually heal without too many lasting effects. Epidural needles are jabbed into a sensitive place, perineums are cut, and while for sure there is risk of injury, MOST of the time, people end up reasonably physically okay. Is the fact that birth workers are on our feet a lot, lifting things, running around, etc. REALLY at the root of why we have so much pain, as the stories of birth workers with pain believe? I mean, that's all in a day's work, and our ancestors had it a lot harder, eeking food out of fickle Earth, not having any time to chill in front of Facebook, not having chiropractors and Tylenol, etc. Yet doubtfully they suffered chronically and physically as we do. Here is where I can suddenly see a caged, rabid 3 year old in a fit of rage dying to come out and beat people up: as a doula, I am probably one of the most diplomatic folks you know. A lot of doulas and midwives are. I'm told time and time again, "Wow, you see the good in everything." And on a conscious level, I actually do. I stand by my feelings that there is not a lot of healing in contempt of different birthing "camps", and that by building bridges between a Matriarchal and Patriarchal approach to childbirth, we can create happier parents, better outcomes, etc. I absolutely do feel that every woman has the right to choose the best birth for her if she can, and deserves love and support for those choices, even if they're not the choices I would make. I take offense to many hospital routines that impinge upon the normal process of birth, but don't think it's done out of malice. I try very hard to understand where that side is coming from and have compassion for their position. And I think I truly do succeed with a full heart. I work hard on being a conscious person, looking for Higher Road choices and regarding people with love. But it probably means there's some pretty heavy anger build up lurking too in the psyche of the conscientious birth worker. Because our conscious minds are not the same as our unconscious minds. I try NOT to project anger and judgement onto situations, and I think the situations fare better for it. That is one level of living. But the anger that naturally ensues from witnessing perceived injustice or abuse HAS to go somewhere if there is no space to process it in the moment, because higher consciousness actions must occur to heal a situation. So apparently that repressed energy is going towards creating strong physical pain. Just watch night shift nurses clutching their backs and shoulders between treating patients, especially if there's an attending doctor they're not too fond of yet can't rear up against for fear of losing their job. As I said, I am keeping a Rage Diary, and I encourage my doula trainees to keep one too, if they might want to prevent their health and quality of life from being harmed by unprocessed anger. Anyone suffering from chronic pain that has not been diagnosed as a dangerous disease might want to do so too. I can see my "good" self struggling all the time with projecting myself into the world as a decent, loving human. And that's fine. Projecting rage onto someone doesn't help anyone. But I'm real too. And if I don't own my emotional reactions and give that 3 year old a safe, loving space to tantrum, I won't be able to continue my work. Even when I write my blog I'm conscious of everyone who might be reading, and try not to create too many waves. I think there are probably doctors, nurses, midwives, friends, my mom, clients, religious conservative folks etc. who are reading this, so I have to be "good" and not create waves. But this is probably not helping my pain much, as it makes me less "real". If you only knew how many times, when repression breaks through and rage sets in, that I want to rant, "Do you know what I just saw that fucking douche bag do to that baby?!" Or how sad i get sometimes when, after explaining all the benefits of breastfeeding to a client they end up formula feeding from the get go because despite my Herculean efforts, they have no faith in their miraculous breasts or would rather enjoy the freedom of bottles and formula more. Or how I feel that I want to hurt someone when I see rushed fingers "making more room" for Baby to come out (because God forbid those hands can't be sat upon with patience), thus contributing to perineal pain and trauma I see my poor clients suffering terribly with when I visit them at home. Or when my family know I'm suffering and the house falls entirely apart without my ability to participate in its upkeep. My conscious mind accepts these things and processes them through lenses of compassion and understanding...my unconscious mind, like all unconscious minds (and we all have them), gets right pissed off. And that's okay. It's got to go somewhere, right? So from now on, instead of pretending I'm a saint who is not enraged by things and can simply let things flow off the loving aura of my conscious self, I'm going to own it down and dirty in a little black book (but NOT like Stuntman Mike's black book, if you've seen the film Death Proof!!). And I pray this will help to heal the pain my body carries to try to prove in futility to itself I'm not an illogicial, irrational, walking human dichotomy like everyone else. If you made it to the end of this long ramble, thanks for listening. It was good therapy.