In this article I strive to expose some of the emotional components of pain that may be affecting our patients, clinics, and/or ourselves. Like mentioned in parts 1 and 2 covering the physical and chemical sides of pain (found in the March and May issues), the emotional side of pain can have a perfect storm of contributors, with multiple starting causes.
We have all most likely felt pain caused by emotional causes/contributors ourselves. If you haven't said the words, "All this stress is giving me a headache," I'm sure you have heard it from a loved one or patient. Maybe it is the dreaded muscle spasm along the outer UB line bordering the scapula during or after a stressful event. You know the kind that make you want to cry while moving your neck or taking a deep breath.
Other times it is that realization that an unfortunate injury gives way after a time of great emotional demands. Have you noticed how simple things like picking up a newspaper or sneezing can have more extreme painful effects at times when our patients are under great emotional distress? It is my intent through the next few pages to provide some helpful reminders, ways to easily make our treatment sessions more effective, and provide a few resources for our patients and ourselves. TCM is a complete medicine, I think it is our duty to figure out a way to provide the most complete session for every one of our patients in the most efficient way possible.
Emotional Imbalances Manifesting as Pain
Pain is only one of the many manifestations of emotional imbalance we have learned through our extensive studies of TCM. Different emotions effect the organs systems, meridians, and channels uniquely depending on the person and circumstances.
Emotions Change Everything
Emotion is a deep concept. It transcends singular affect as it is Qi, or a vibration frequency, that influences every particle of us. Animals can sense our emotions, and I believe most of us have tapped into that instinctive sense many times as well. We can "feel" when we are not wanted or liked by another person even when they have not acted on it. With our change in mood or emotion, comes changes in every part of our body - physically, chemically, and functionally. Our temperature changes, breathing becomes modified, brains fire uniquely, organs release chemicals, and our posture changes with each adaptation to our emotional state.
Emotional thoughts have been studied for changes in physical appearance of red blood cells, or water crystals under the microscope. With these changes comes different outcomes to stimulus. Our food is digested differently, outward energy shifts, our movement is done in different form, and exercise is recovered from differently. Our immune system is charged or compromised dependent on how we feel, how supported we are, and how threatened or secure we perceive ourselves to be.
Common Locations of Stress Referral Pain
Low back/groin
Knee
Shoulder/scapula
Neck
Headaches
Chest pains
Not Always When You Would Expect it
The timing of our stress-induced symptoms can be perplexing. A quick reminder I tell patients when skeptical of any emotional involvement comes from an analogy I started using after a patient returned from Las Vegas. While on vacation in "Sin City" this patient was typically eating poor quality foods, staying up late, sleeping poorly, drinking alcohol in excess, and sitting for hours in smoke filled casinos. Yet he felt great while there.
It wasn't until he returned to his relaxed and healthy lifestyle that he felt sick and came down with a cold. It's a great reminder that when our bodies are excessively stressed, whether in fun, fear or battle, we enter "survival" sympathetic mode. Once we return to a parasympathetic mode then we may feel and process the effects that fight or flight had been covering up, and letting accumulate subconsciously.
Our Bedside Manner Can Be the Catalyst for Change
As doctors, educators, and practitioners of medicine, we can encourage our patients to look at symptoms differently. Empowerment for them to take responsibility for their own health may be found through you. In many traditional cultures a natural therapy is built into their way of life. A time to come together and share what is going on in your life with those closest to you. This is found with the afternoon tea or evening meal in some cultures, while others have a morning coffee/tea or movement time.
This in person social bonding seems to be less common in our society and trending toward replacement by technology/social media. However, we have an opportunity to be present with our patients. To listen and make them feel heard. To sympathize, encourage, and support them every time they come in for a treatment. Multiple studies show the power of our bedside manner. I believe it works with an emotional vibration that has the ability to supercharge any treatment we choose to combine it with. However, to influence this state of peace within our patients we must have a peaceful mind ourselves. Through a cleansing breath and focus just prior to your patient visit you can be more present and genuine.
The Daily Ritual
It is important to perform maintenance for our emotional stress levels. As taught to me by the Neuro Emotional Technique (NET), when we activate our "fight or flight" sympathetic nervous system, our body needs to process the event and assess how to adapt for our future health. If our central nervous system deems that stressful event a negative impacting event, we heighten our senses to such stress and are burdened by it as a survival mechanism. However, when we can find the good and positive aspect of a negative event our bodies can have a more balanced and appropriate response.
Finding the "Good" in Bad Situations
I know this can be a sensitive subject to broach with a patient in crisis, but leading with a positive outlook, and seeking out the silver linings of the situation is one of the most powerful things we can do for the healing process. We might not know of any good that can come from the awful events some of us go through. However, if we remain open to the fact that there can be good to come from even the worst events, our bodies will respond differently through the healing process.
One way is to view the experience providing knowledge and wisdom that can help others. Another way is to consider that we may have been a part of a bigger purpose and plan that included that experience in order to be prepared for something greater than ourselves. Knowing you may be the one who can give back because of your specific life circumstances changes the way your body responds to stress.
Shake, Rattle, and Roll
Have you been with a dog after they get in a scuffle at the dog park? Or with an animal that is scared during a thunder storm? You will notice that they commonly quiver. This quiver is not numbed or repressed like we humans most often do. But rather it is a way to release the bound up electromagnetic charge that was created by the stressful event. Try the following physical acts when appropriate to help process a trauma:
Move and stretch
Shake it off
Jump up and down
Scream
Restore diaphragmatic breathing
Roll your shoulders back
Tai Chi, Qi Gong, Yoga, and/or posture practices
Forgiveness and Letting Go of Trauma
To thrive in health, we strive for balance. A balance of being present, experienced from past, and inspired toward future betterment. The effects of trauma, emotional stress, and crisis can alter this balance. The mind can become hyperreactive, distracted, and fatigued. One key step in rebalancing the mind comes through forgiveness. However, we might not consciously perceive what our instinctive mind has triggered. I have instructed my patients to use the following forgiveness affirmations every night before bed (prior to the sleep cycle that takes the day of events, creating subconscious patterns of thoughts/beliefs/fears). For best results look for the difficultly in saying these silent and aloud. Repeat these with as many details (feeling specifics, people, etc.) as you can.
I forgive myself for my feelings of ...
I forgive _______ for my feelings of ...
I allow others to forgive me for my feelings of ...
Higher power, I ask you for forgiveness for my feelings of ...
Complete Treatments
Can we make our visits more complete with holistic thought processes and recommendations? Addressing the patient with physical, chemical, emotional, and electromagnetic balancing techniques by adding:
Compassion
Attentive bedside manner
Emotional homework recommendations
Movement
Breathing exercises
Stress relieving herbs/tea/aromatherapy
Thermal therapies
I sincerely thank all the wonderful leaders who have created such wonderful resources to learn from. I apologize to those I have not included here, as there are so many wonderful resources/techniques that I cannot name them all.
As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Though the creation of a financially sustainable, health-promoting model feels far away today, we are casting a vision for a full return on health, believing that this compels us to keep one foot firmly rooted in caring for the sick and the other foot firmly founded in maintaining health. Shifting from a fee-for-service model to value-based care using a phased approach is paramount.
Laser therapy has emerged as a powerful tool in the realm of traditional Chinese medicine (TCM). This new modality fits beautifully into the toolbox of the modern acupuncturist, as it can be used as a hybrid form of stimulation to acupuncture points, meridians, organs, nerves, and symptomatic areas in a new way that blends both moxa and energetic needle-like responses.
