How to understand the clues to what’s really hurting your patients.
“It feels like a rock in my shoulder”, Marie says after I ask her to describe her pain to me.
My next question is, “Where is it, exactly?” She puts her hand over the muscles on top of her shoulder blade. OK, it’s getting clearer.
Onto my next question. “When is it?” When it started and when it shows up. Knowing when it started is a clincher to pain detective work. Marie isn’t sure, “I just noticed it was bothering me one day and it keeps coming back, more and more.” Now I know we’ve got what I call a “creeping issue.” It crept up into her life and got into her framework.
I ask when this feels worse; morning, night, grocery shopping? Anything stand out? The pattern of timing isn’t clear for her, “It’s more when I’m stressed,” she says…
Ahh, so stress is the “when”. This is a big clue that we’re talkin’ about
inner conflict creating a bio-mechanical breakdown
(rather than the other way around).
Maybe you’ve seen a patient or even had symptoms similar to Marie’s before yourself. Ruling out causes like physical trauma from a car accident, rollercoaster, or rock concert, we have to start looking even deeper for clues to what this pain is asking for.
There Are Two Sides of Pain
Listening to How Pain Speaks
Pain speaks… is it saying, “Please lower your mouse – I can’t hold up our arm like that!”
“Please stand up to our boss – we are not a doormat!”?
This example describes the different subtle influences of a bio-mechanical breakdown and an inner conflict. Getting to the bottom of what is the root cause of pain means figuring out if there is an inner conflict that creates a bio-mechanical breakdown or if there is a physical cause for it.
To find out which holds sway over Maria’s body and what it’s trying to say we have to dig deeper into the information she has shared.
We talk some more about her stressors and discover she’s taking care of aging parents, working, and has an eighteen-year-old getting ready to go to college.
Some days feel so chaotic she wishes she could duplicate herself to get it all done. She says, “I get so overloaded, my eyes hurt, and my shoulder gets locked up. I can’t even turn my head!”
This is an answer to my question, “How is it?” I’m asking what is it like; it’s description. We get to dig into our beloved adjectives (please allow for grammar stretching here).
Language and Body Messaging
Looking into the link between language and body messaging, we have to pass by the overthinking mind and let these words be descriptive. This is key to unlock the understanding of what’s really hurting your patient.
Here are Marie’s words…
“Like a Rock
What does that sound like to you?
What might be an inner conflict in this circumstance?
Breaking Down The Language into Solutions
Here’s my take on this, see what you think Marie needs two big things:
# 1 Addressing the bio-mechanical breakdown.
Never underestimate the effectiveness of a headset over a shoulder-cradled phone! Little tweaks like that can prove to be permanent game changers for pain relief. You may need to still need to do some soft tissue work for your patient, (heck, do that anyway-it’s good for them) but for the lasting change – remove the cause.
#2 Address unresolved emotions caused by an inner truth unsaid.
Her language told us what she needed. She needs a load lifted off of her. Her body has told her it’s stuck, it’s carrying the weight of the world, and can’t see any other way out.
If this sounds familiar to your patients, it’s time for the tougher questions, the ones they have to be truthful and brave to answer. It needs to be answered by the person they want to be, not the person they feel they are right now. Here are a few examples. Be sure to really stress the importance of having them answer the questions from the viewpoint of what they desire their life to be like.
Am I really the only one who could do this?
Am I carrying something that doesn’t belong to me?
What do I need to confront to feel empowered?
How can I take better care of myself to be able to do this?
Or my personal favorite tough question in short form,
This is a great opportunity to encourage your patient to spend time journaling or meditating to help them really dig deep into the inner conflicts that are causing biomechanical breakdowns.
The Good News
Marie started being open to looking at her situation differently, asking for help (and getting it!). She had to take a hard look at her belief that she has to overachieve to be enough, and that it was selfish to address her own her needs. She made a schedule of her time to ensure she eats healthy meals and has a little fun-friend time pre-planned and not skipped.
She got four acupuncture treatments and felt 90% better. A lingering awareness of pain remained, keeping her in remembrance that she isn’t out of the woods yet. She decided to come in once a month to continue to nourish her body, listening to my often repeated advice, “All caregivers must get care.”
A Lifetime of Care
Treating chronic pain is not about returning to a previous state of comfort. It is a transformation of self and the self’s relationship to the world. It is allowing a person to shake all their puzzle pieces out on the floor and see a new way to put them back together.
We as holistic healers are there to help guide our patients as they create these new versions of themselves. They have to do the hard work of making the changes, while we give them the gift of supporting and witnessing the transition.
Proper Care Strategy
Whether their pain is bio-mechanically centered or triggered by the neurological connection to their feelings and emotions, providing physical bodywork is a very helpful tool to begin with. You open the door to the deeper conversations.
Although finding the proper care routine for your patients can take a bit of trial and error, it will get easier as you recognize the signs. Patients often times don’t recognize what triggers their pain until they are asked to examine their lives in a different manner. If the treatment plan you created doesn’t seem to be accomplishing its goals, don’t be afraid to seek out additional answers from your patient.
Re-frame thier inner-conflict. Start asking the harder questions, and start acting on those answers. Don’t forget to keep listening. Let’s not leave the inner pain out of the healing conversation nor separate it from the body. It’s never a bad idea to stay in contact with the way their body is communicating with them.
Asking the Right Questions
Let’s walk through the questions you need to be asking your patients when you are first evaluating and then KEEP asking them throughout treatment. Feel free to reach out in our Holistic Business Facebook group if you get stumped by your patient’s answers. In the INFlow program you get the support to master this skill and challenge the way you interact with your patients.
Where is it?
Exactly where. See my body zone chart to get a clue as to what issues may be trying to be heard.
When is it?
(When did it start and when does it return?) Rule of thumb, body pains in the mornings is more joint arthritic, night time more likely muscle weakness. Look at activity-related associations. Keep an eye out also for emotional triggers for pain.
How is it?
This is Chinese medicine’s forte. We call it a climate. The specific description can clue you into both the physical nature and the emotional nature. This is where you are watching for those adjectives that will give you greater insight into the cause of the pain.
Which side of pain is dominating?
You rule out physical causes first. The bad pillow or couch potato slouch, the automobile trauma that is knowable. If there’s no known cause, or it doesn’t seem logical as to why it keeps hanging around then you start to entertain the notion that their body is showing you something from their vulnerable side that is yelling for attention.
What is the tougher question? (listening required)
What is their inner conflict that comes up when this hurts? What descriptive words do they use that are a metaphor to this conflict? How can this situation change? Even better, How can they change the way they relate to this situation?
If we listen to what they say when they are speaking, we get clues to what their body messages are trying to tell us to change in the form of pain. They already have an idea of what they need, we don’t need to tell them how to change their life. But what we can do in the face of pain, is ask the right questions.