Pain-work: The art of state change

Because every part of us is constantely being affected by innner and outer influences we are all in a constant state of flux. When we are in pain we often, consiously or unconsiously  work against this notion : The search for a path out of the pain can become a desperate search for a static state where everything is just right; where we imagine that we will be in control. But what if this is not the way to navigate? What if the one thing we need to master in our work with pain is instead the capacity for state change, as supposed to holding a fixed state? And what is the one pre-requisite for being able to do this?

The nervoussystem is, according to Dr. Stephen Porges,  most of the time responding not to the real world but to our subconcious interpretation of the signals that our “neuroception”  picks up.

yeshi-kangrang-iuqxv7kFj64-unsplash

Photo by Yeshi Kangrang on Unsplash

Neuroception is the term Porges coined for the unconcious part of our nervoussystem which is constantly  on the lookout, assesing our degree of safety from both internal and external dangers.

We know what it feels like when our neuroception senses danger. To be in a “fear-brain”- state of mind is exhausting and also narrows our experience of reality, and when we experience long term pain our neuroception tends to bombard us with signals that we are in fact in danger.

Stressors and sensitivity

When giving a talk about Pain at the Timani sertification at the Musician´s Health and Movement Institute the other weekend the topic of “Stressors” came up. Stressors, as in the things or situations in our lives which, depending on their number, can increase our sensitivity to pain.

Pain is a complex phenomenon consisting of several systems giving, receiving and interpreting information. The basic role of pain is to alert us to things which are potentially harmfull and to make sure we choose the most expedient way of action to avoid  injury. (For the curious mind: Here is a nice article, only in Norwegian, sorry, about the different pain systems and how the plasticity of these systems, their ability to change, can be both a blessing and a curse (article: smertens nevrobiologi))

However, our subjective experience of pain is also depending on our degree of sensitivity which is directly affected by the amount of stressors in our life and our ability to tolerate them. A stressor might be any social factor, lifestyle factor or health factor which, for you personally and at this particular moment in your life, is adding a strain which is increasing your sensitivity.

The Cup of Tolerance

In his free downloadable “recovery strategies – your pain guidebook” Greg Lehman, physiotherapist, chiropractor and strength and conditioning specialist, adresses the psychosocial riskfactors in pain and injury management from a neuroscientific perspective.

He introduces the “Cup of Tolerance” as a metaphore for when the stressors in our life exceeds our ability to carry them. Working with stressors involves becoming aware of them, and removing them or increasing our tolerance for them, or in Lehmans terms “building a bigger cup”. A first step is, however, becoming aware of our stressors.

But what if becoming aware of our stressors results in a feeling of despair and helplessness? Like one of the participants in this weekend sertification shared “I became aware that most of my stressors are factors in my life over which I have no control”.

Fear = either – or

This is a great chance to adress something important to remember when it comes to stress and pain:

When we experience pain from a state of unsafety our mind is very often caught in the fear-brain mode mentioned earlier, and here´s an interesting thing about this mode:

Fear-brain tends to collapse every situation into binaries:

“My only option is to stay or go, to confront or avvoid, to put down my foot or let everything slide, to react in an xx-way or to shut down”.

 

In other words: when our brain is caught in fear and unsafety-mode it tends to be blind to the myriad of available possibilities that every situation acctually holds and limits our choices to two or three which usually both tends to be extremes.

It also holds the notion that in an imagined future situation where we are adressing our stressors in some way “I” will be the only person who are changing and that the other people involved in the situation will be unaffected or only affected in a negative way by my altered reactions or actions.

Our fear-brain is blind to the fact that every change, no matter how small, has butterfly effects.

Feeling safe

Therefor the pre-requisite for being neurologically able to adress anything which might add to our present pain-situation is always to find a gentle way to navigate into a sense of safety.

What makes you feel safe? Here is a list with some of my favourite strategies. Make your own and use it as a way to support yourself when you want to work with adressing stressors from a state of flexibility and safety.

  • A warm waterbotle on my stomach
  • Lots of physical safe contact from people I trust
  • Close contact with the ground
  • Hugging big trees
  • Lying facedown on gras
  • Touching different textures (rugs, cloth, floorboards, rocks, earth, grass, water, sand)
  • Soft humming
  • A burning candle
  • A special selection of breathing exercises
  • A special selection of mental exercises
  • The presence of other self-regulating people
  • Slow concious movement
hamza-el-falah-367656

Photo by Hamza El-Falah on Unsplash

The effortlessness of the expert

It takes a lot of effort to make something look effortless

– Steven Sondheim

When we witness an expert performer in music or in sport the word “effortless” often springs to mind. However, most people are (hopefully) aware of the amount of work actually needed to reach this level of mastery. Therefor “effort-less” can´t necessarily mean that something is “without effort”.

Hånd på klaviatur

A seemingly “effortless” performance is indeed the result of a sophisticated physical and neurological coordination which creates a subtle fluctuation between tension and relaxation in the parts responsible for the movements and to master this coordination is at the true core of every excelling performance.

Excessive and static tension

In a body performing at a high level of function there is very little excessive tension present, each part of the body has just the necessary amount  needed to perform the task.

A lot of us carry an excessive level of tension in certain parts of our bodies, both when we are performing tasks and when we are seemingly relaxed. Changing the tensional pattern of our body takes a long time, primarily because most of us are unaware of much of the tension present in our bodies. In our minds we have a tendency to think that:

TENSION = PAIN

so that when a part of our body is not performing as it should according to its design we may not necessarily attribute the lack of performance to excessive tension as long as it´s not causing us any pain. But the presence of tension is not necessarily visible only through pain but also in restricted movement, non-optimal coordination  and affected performance.

Changing a pattern requires that we first become aware of it. Do a simple exercise: Stand on all fours and allow your stomach to relax and sink down like a hammock.

dav

All the way…

Take some time (think a couple of minutes) to let your stomach completely give in to gravity. You will probably experience that  what you thought were a full relaxation is just a fraction of the potential and that as the seconds pass you will sense more and more micro-releases in the tension in your belly.

Most of us spend an excessive amount of energy constantly sucking in our stomach, so much that when we are in a position where gravity naturally pulls our organs forward we have a problem releasing that tension because it has become a more or less constant and unconscious pattern.

But constant static tension also means restricted circulation and our abdominal region contains things that are dependent on good circulation in order to function properly.

Like your digestive- or reproductive organs.

A constant excess of tension makes it harder to relax but more importantly: it also leads to a limited ability to activate and relax your muscles at different degrees.

A healthier alternative is a constant fluctuating pattern of tension and relaxation where our muscles have the option of not only being in an on/off mode but rather cycling constantly through different degrees of tension/relaxation according to what is needed.

Not this:

av-paa-bryter

but this:

Trinnvis bryter

Coordination = using what is needed

When we want to make a movement we have multiple choices  as to how to make our bodies perform that movement. If you intend to pick leafs of the ground in your garden you could use a crane to do the job, it would just not be very practical. Keeping your lower arms extended horizontally in front of you for several hours every day while typing on your computer requires a certain activation in your muscles but the coordination or distribution of workload between those muscles is decisive when it comes to how straining this activity will be for your body. Skjelett

And you can switch the activity of typing with pretty much any other activity, like walking, dancing the tango or playing an instrument.

So why would we use more than we need?

Our muscles are controlled by our neurology. A motor unit consists of a nerve attaching to certain muscle fibres of a muscle. The greater amount of fibres it attaches to the “bigger” the movement the nerve controls. In what we call fine motor skills the motor units attache only to a few fibres and the amount of motor units working at the same time and (hopefully) in coordination is very great, on the opposite side of the scale we have large muscles where a single motor unit controls a great amount of fibres and make them all move at the same time giving a high degree of leverage and force with a lesser degree of coordination needed.

But having the neurological hardware to be able to move the different parts of a muscle independently to one another is not the same as actually being able to do this. Through lack of regular use muscles can become neurologically “lumped together” so that we are not able to differentiate between them any more and differentiation is the key to coordination: if I can’t differentiate between the different muscles in my body I am not able to make them to move independently of one another.

Coordination is the ability to decide  what parts of a muscle  to activate  and how those parts are to move  relative  to each other  and to other muscles of the body.

Some people have a natural tendency for good coordination but for most people the “default” coordination is a result of the sum total of how you have used your body up to this moment which is a highly individual matter for most of us.

Therefor training is sometimes needed.

tadas-mikuckis-hbnH0ILjUZE-unsplash

Photo by Tadas Mikuckis on Unsplash

Both Timani and Nutritious Movement ar methods which are all about coordination and fine-tuning this amazing magical thing we call our body in order to move towards the realm of the effortlessness we all can benefit from – whether we are experts or not.