Where do you turn when medication and medical treatments do not relieve persistent, debilitating pain? What can you do when pain interferes with work, family, and social life and you no longer feel like the person you used to be? Relying on firsthand experience with severe nerve pain, author Sarah Anne Shockley accompanies you on your journey through pain and offers compassionate, practical advice to ease difficult emotions and address lifestyle challenges. Her approach helps reduce the toll that living in pain takes on relationships, self-image, and well-being while cultivating greater ease and resilience on a daily basis. Dozens of accessible, uplifting practices guide you every step of the way from a life overcome by pain to a life of greater comfort and peace. The Pain Companion also offers profound insights for medical practitioners and invaluable guidance for anyone who loves or cares for others in pain.
|Publisher:||New World Library|
|Sold by:||Barnes & Noble|
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About the Author
Retired surgeon Bernie S. Siegel speaks, writes, and runs support groups in his effort to empower patients. His books include Love, Medicine&Miracles and 365 Prescriptions for the Soul. He lives in Woodbridge, Connecticut.
Read an Excerpt
Life Taken Over by Pain
In the fall of 2007, I developed thoracic outlet syndrome (TOS) due to prolonged computer use in a nonergonomic office setup. Simply put, the area between my collarbones and first ribs collapsed, severely compressing the space to less than 20 percent of its normal width on both sides of my body.
This compression was excruciating, squeezing a major artery, veins, nerve ganglia, and the large scalene muscles running down from the neck to the first ribs, all of which must fit through this relatively small space.
This caused intense burning sensations in my neck; deep aches in my palms, wrists, and neck; and shooting pains in my neck and forearms. A continuous migraine headache often flared alarmingly, setting the right side of my brain on fire. I had flu-like dizziness, weakness, fatigue, and loss of mobility and functionality in my arms and hands.
Anything that required me to use my arms away from my body, even the smallest lifting, pushing, pulling, reaching, grasping, or carrying caused a sharp spike in pain levels. I could barely turn or tilt my neck to either side, up, or down, and I had to move my whole body slowly and carefully to look at someone next to me. I walked extremely slowly, leaning forward, like a very ancient person in bad shape.
In an effort to restore myself to health, I tried numerous approaches to healing, both traditional and alternative. Although some of them brought temporary relief, none actually healed the TOS, and the majority of them immediately made things worse by further irritating the nerves and tissues. After I tried a new approach, it usually took a number of days, and sometimes weeks, for the flare-up to calm down and the irritated nerves and swollen tissues to return to a more stable state.
Pharmaceuticals were also unsuccessful in relieving the nerve pain or aiding my overall condition. Instead, they created disagreeable side effects that added to the mélange of unpleasant symptoms already affecting most of my body, so I quickly stopped using them.
Since I couldn't dull the pain, I dulled myself instead and withdrew, becoming very still and quiet. It hurt to breathe deeply, so I sat propped up with pillows, my hands turned up and open, trying to breathe as lightly as possible and waiting for deliverance. If I waited long enough, I reasoned, the pain would go away and my body would receive the healing it needed through my careful stillness.
By the fall of 2008, I had been in intense, unceasing, and debilitating pain for the better part of a year, and I was not making any appreciable headway toward healing through either traditional or alternative methods. I felt as if I'd embarked on a nightmarish ocean liner heading out into dark and rough waters on a voyage with no predetermined destination and no way to disembark.
At first, I had thought everything was about to get better, and I would simply rejoin my life where I'd left off. It was an excursion I hadn't desired or asked for, but at least it would soon be over and I would carry on with life as usual. Every other malady I'd suffered had always ended. I had always healed before. Always.
But that's not what happened.
Many months passed before I fully understood the extent of my injuries. After an MRI scan and a series of diagnostics, my neurologist carefully explained that the extent of my TOS was unusually severe. Sadly, he informed me that I couldn't expect to heal anytime soon, if at all, and in fact, the condition was often progressive; it could steadily get worse.
In a two-hour consultation, a leading thoracic surgeon went over my status with me comprehensively, explaining that there really wasn't anything he could offer except a surgery of dubious merit in which my top two ribs would be removed. The recovery period would be very painful and protracted. And for me, it wouldn't be a permanent solution; I could expect my TOS to return.
These prognoses landed like dead weights. I had to come to terms with the fact that I would most probably not be returning to work or my normal activities. Ever. Along with living in pain, I realized that I was going to have to deal with the stress of making do with very reduced financial circumstances over a long period of time, as well as the ongoing sadness and distress of having had my normal, active life disappear, virtually overnight.
With the understanding that I was going to be physically impaired and in pain for a very long time, most likely the rest of my life, I entered a period of intense emotional challenge. My usual positive attitude faltered, and I began to experience decreased well-being and a constant barrage of worries about the future. I woke each day in the same dark state of mind, my body in extreme pain, and the condition of my life feeling the same, the same, the same, bleak morning after bleak morning.
Before my injury, I had considered myself resourceful, positive, intelligent, and capable. I certainly didn't expect others to figure things out for me. My inability to restore my body to health, therefore, was a source of deep frustration. Virtually everything I was doing to heal myself was leading nowhere constructive and often made things worse. What was I missing? What was I doing wrong?
* * *
You have become such a forceful presence; it is almost like living with another person. My whole life has been hijacked by you. Other people say you come and go. You give them breaks for hours or days or even weeks, but you've decided to keep me company every single minute of every single day.
I realize now that the twinges and aches I felt at first were only your early scouts. Now you're here in full force — pressing, insistent, nasty, intense. You are unstoppable and all-pervasive. And you stay and stay and stay.
Why have you decided to stick with me so relentlessly, so adamantly, and with such passionate dedication?CHAPTER 2
The Submersion of the Self
When we experience severe pain, constant pain, insistent pain, the situation quickly becomes overwhelming. So much of our attention and energy is directed toward dealing with the pain that we can feel submerged underneath its demands.
The choices that have to be made, the responsibilities we still have despite a physical impairment, and the sensations of pain themselves seem to be drowning us. It becomes difficult to think clearly, to have conversations, to be available for life, to be available to the self.
Pain, therefore, rules our experience. It dictates how we can and can't use our bodies. We do only as much as it allows us to do. We sleep only as much as it allows us to sleep. When it has something to say, we are its captive audience. We interact with others with less enthusiasm and less energy. We become worn-out and discouraged, completely at the mercy of its whims.
Pain becomes our primary focus. That is its nature. Its presence is all-encompassing. When pain is either very severe or very long-lived, it can feel like a separate entity, a being with its own mind.
It is like living with something or someone else in our bodies, a power unto itself, which we must serve. It has its own agenda and keeps its own schedules. Its needs are immediate and seemingly insatiable. We spend a great deal of time and energy bowing to it, taking care of it, trying to ease it, or imploring it to leave.
Tasks that were easy before become difficult and exhausting. Before the brain even attempts to tackle a problem or meet a demand, it feels overloaded and overwhelmed. Things that require a response — the phone, a question, paperwork — can seem like an invasion or attack. So little of us is left that is not overtaken by pain, there remains almost no energy with which to make decisions, to think, to feel, to love.
After living for days, weeks, and months with pain as the director of life, we can lose sight of our own primacy, and the primacy of other people and situations that are important or dear to us.
It's easy to feel irritable with everyone, with life, with ourselves. Part of the irritability is from the constant braying of nerves in pain, of course, but part is the frustration of not being able to control it. It feels like our bodies are no longer our own, and that is truly a very frightening invasion. It's too close, too intimate.
In addition, there are the stresses that accompany every waking moment, including the uncertainty about healing — if and when it will happen — and the unknowns of how to survive practically and financially.
We must face difficult questions, often meeting them with limited physical, mental, and financial resources: What will happen if I can't take care of my children? What if I can no longer pay my mortgage or rent? Should I take a specific drug? Who will help me make sense of all these forms? How will I go shopping, do the laundry, clean? How can I afford to pay someone to help me?
Being in constant physical pain is like living underwater. The pain sensations are not only felt in the body; they seem to become an extended energy field around the body, creating a separate reality that no one else shares.
There is no one inside your world of pain with you; you are utterly alone there. Even others who are also suffering do not share the same pain.
The sensation of pain, then, creates boundaries around the entire experience of life. It becomes the environment and the substance in which the self is immersed. The world recedes, often to a seemingly unreachable distance. Only echoes of it remain. Normal life seems remote; everything is filtered and distanced by the field of pain and the stress that comes with it, surrounding and penetrating all experience.
* * *
I am trying everything I can think of to make you happy. To make you calm down. To make you go away. I have tried eradicating, releasing, relieving, mitigating, cajoling, begging, and ignoring you. Yet you are astonishingly resilient. You refuse to budge. Almost everything I do makes you louder and more insistent.
Today I was alarmed to discover that the only sensations I have left are painful ones. My entire body is a burning, painful structure. If there is a part of me that is not in pain, I can't feel it anymore. You have taken over my entire experience of my body!
Are you trying to push me out of my body? I don't believe I am this pain, but where am I? What is left of me?CHAPTER 3
When Pain Won't Leave
Typically in Western medicine, one of the first things a doctor does for us when we're in physical pain is to provide medication or therapeutic treatment that eases the discomfort. A treatment is considered most successful if it not only addresses the physical ailment but substantially reduces or eradicates pain. In fact, in some cases, the only "cure" available to us is pharmaceutical pain relief.
Of course, most of us are very happy to be on the receiving end of pain relief when we need it. Having the goal of easing pain serves the important purpose of helping us become more comfortable so our bodies can rest and thereby heal more quickly. This is all well and good if the pain does end, the purpose is served, and we heal. However, as we well know, not all pain responds to medication and treatment.
When our doctors have run out of options and we continue to experience ongoing, even debilitating pain, when the level and duration of the pain tests the limits of our patience and our doctors' expertise, what then?
Because we generally treat all pain in the same way, and because we have the understandable, but unattainable, goal of ending all pain as quickly as possible, the persistence of pain can't help but imply a level of defeat.
When well-meaning doctors and therapists offer timetables and expectations for our recovery that don't work out, it can oddly and unjustifiably feel like we are ailing in other ways: We aren't a good-enough patient, our bodies haven't responded correctly, something else is wrong with us, we're not normal, we must be malingering.
Our condition of continued pain can seem to morph from something unavoidable as a result of injury or illness into something unresolved and lingering, perhaps even appearing suspicious to others not experiencing it themselves.
This puts us in a very uncomfortable position. Because pain medications and healing protocols work on some kinds of pain, but not ours, we may feel that our chronic condition is a negative reflection on us: There is something wrong with us for continuing to experience pain.
We may feel abandoned by the medical establishment, which may metaphorically throw up its hands. Left to our own devices, we become, in many ways, our own last resort, yet we have no idea how to access the switch to turn the pain off.
Our distressing lack of clear movement toward healing is only underscored by the positive suggestions of others (Have you tried X?), the barrage of drugs we have taken to no avail, and the various treatments we have undergone with mixed or little success. It can appear that it isn't the drugs or the treatments that have failed, it's us.
When pain remains despite pharmaceuticals, physical therapies, surgeries, or other forms of therapeutic treatments and alternative modalities, instead of applying more of the same, we need to consider changing course altogether.
In my experience, short-term pain and chronic pain require very different approaches to relief and ongoing management. Chronic pain is a very complex condition involving much more than just the physical symptoms of the body. It includes emotional and psychological aspects as well, due to the incredible stresses of living with pain on a daily basis, and the ramifications of basically losing one's life to pain.
* * *
Why are you still here? I am frustrated and annoyed. I seem only to be getting worse, and you are not leaving. You, Pain, have moved in.
I didn't recognize the You of you for a full ten months. I treated you with respect, yes, but with the respect due a temporary lodger. I kept expecting you to leave. I dealt patiently with the extreme discomfort of your constant boarding because I assumed it was to be short-lived.
You are like a guest who shows up, unpacks in the living room, pulls out an old brass horn, and starts playing loudly and out of tune. Tirelessly you play on day and night as if to discover who will wear out first. I have. I'm worn-out. Stop. Please. Just go away.CHAPTER 4
Feeling Bad about Feeling Bad
If your pain is new, you may still be in a degree of emotional and physical shock — shock from the illness or injury and shock from the trauma of having your affairs, your work, your life, and your relationships superseded by pain.
You may also suffer from post-traumatic stress disorder (PTSD). PTSD is a condition that occurs after severe stress, change, sudden loss, or injury — or, as I have found, from long-term disability, chronic pain, or a life- changing illness.
PTSD can cause you to become easily overwhelmed, highly irritable, disoriented, and terrified for no apparent reason and to suffer from insomnia and nightmares.
Living in pain for an extended period of time elicits its own strong emotional and psychological responses as well. These occur because of the physical discomfort we are in, obviously, but also because we are apparently losing the battle.
We are at the mercy of something that has moved in and taken over our experience. We fear that, in some hidden and insidious way, we are to blame for both its existence and our lack of success in making it all better.
Some of these intense emotional responses include grief, sadness, loss, shame, blame, resentment, failure, isolation, loneliness, and powerlessness. Because these emotions are powerful, and because they may live with us for as long as pain abides, they can eventually override our experience of ourselves and our lives.
They are understandable reactions to a life that has been overtaken by pain, but as time passes, we may lose our sense of who we really are.
Days of joy and ease recede into the distance, and it begins to seem as if we have always felt this bad. We have trouble remembering how to laugh freely, what our bodies felt like without pain, and what it was like just to feel generally okay.
Living with constant pain, I initially wanted to minimize any and all further suffering, so I tended to ignore or deny the emotional pain that I was also undergoing.
Ultimately, this was not a helpful choice. Over time, the experience of physical pain and our emotional responses to it can become interlocked, each cementing the other in place. They weave together like a Celtic knot, seemingly inextricable.
Some emotions are contractive reactions to pain. When we are locked in these emotional states, the body responds by tightening and contracting. This contraction of the body serves to further lock bodily pain in place.
It inhibits the free flow of breath and the free movement of life force and renewing energy through the body, and it impedes healing. Examples of feelings that tend to contract and tighten the body are resentment, bitterness, blame, and anger.(Continues…)
Excerpted from "The Pain Companion"
Copyright © 2018 Sarah Anne Shockley.
Excerpted by permission of New World Library.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of ContentsIntroduction
PART 1: PAIN MOVES IN
Chapter 1 Life Taken Over by Pain
Chapter 2 The Submersion of the Self
Chapter 3 When Pain Won’t Leave
Chapter 4 Feeling Bad About Feeling Bad
PART 2: THE EMOTIONAL LIFE OF CHRONIC PAIN
Chapter 5 Pain’s Emotional Traps
Chapter 6 Guilt and Shame
Chapter 7 Anger and Blame
Chapter 8 Victimization and Powerlessness
Chapter 9 Fear, Anxiety, and Stress
Chapter 10 Isolation and Loneliness
Chapter 11 Invisibility and Silence
Chapter 12 Physical and Emotional Exhaustion
Chapter 13 Sadness and Loss
PART 3: MEDITATIVE APPROACHES TO PHYSICAL PAIN
Chapter 14 Discovering Pain’s Purpose
Chapter 15 The Body Made Wrong
Chapter 16 Finding a New Approach
Chapter 17 Communicating with Pain
Chapter 18 Soothing the Wild Animal
Chapter 19 Introduction to Meditative Exercises
Chapter 20 Releasing Breath
Chapter 21 Unlocking Contraction
Chapter 22 Paying Attention to Pain
Chapter 23 Shifting Your Relationship to Pain
Chapter 24 Loving the Places that Hurt
Chapter 25 Imaging Pain’s Form
Chapter 26 Giving Pain What It Wants
Chapter 27 Writing Pain a Letter of Complaint
Chapter 28 Pain As Messenger
Chapter 29 Telling Pain Your Story
Chapter 30 Listening to Pain
PART 4: WHEN PAIN IS THE TEACHER
Chapter 31 Resistance Is Futile
Chapter 32 Having Compassion for Yourself
Chapter 33 What I Learned From Pain
Chapter 34 The Nature of True Healing
Chapter 35 Enlisting Pain as an Ally
Chapter 36 You Are Not Your Pain
Chapter 37 Some Concluding Thoughts
What People are Saying About This
“Shockley writes the companion text she wishes she had after being diagnosed with thoracic outlet syndrome. By focusing on emotional, as opposed to physical, states of pain — loss, grief, shame, terror — she provides an invaluable primer on making lifelong healing choices.” — Library Journal “Sarah Anne Shockley learned about pain the hard way, by experiencing it and being incapacitated by it. But she met the pain, and she worked with the pain, and she is offering you the benefit of her experience in this helpful, gentle book.” — from the foreword by Dr. Bernie S. Siegel, bestselling author of The Art of Healing “The Pain Companion is a practical, insightful, and compassionate guide for chronic pain sufferers. It is beautifully written and sensitive. For those who have searched to make sense of chronic pain, here is a packet of understanding — a place where hope and possibilities live.” — Amber Wolf, PhD “I would call this the go-to book when nothing else works when you have chronic pain. The intuition, wisdom, exercises, and meditations offered by Sarah Anne Shockley are helpful beyond measure and can assist you on your journey to find your true self. This is a must-read book.” — Michael A. DeFino, DC “The Pain Companion offers important insights into the world of chronic pain. Sarah Anne Shockley gives a comprehensive and profound look at the meaning within the experience of pain. I highly recommend this book for anyone, especially for people living with pain, caregivers, and medical and rehabilitation professionals.” — Thaïs Mazur, OTR, PhD, coauthor of Do No Harm “The Pain Companion is a must-have for both pain sufferers and therapeutic practitioners practicing pain relief. Taking from her own life experience, Sarah Anne Shockley offers practical, deep, insightful ways of living with constant, twenty-four-hours-a-day pain, allowing readers ways to shift their mental, emotional, and physical approaches to pain management. I recommend The Pain Companion to all my chronic pain clients.” — Dr. Celestine Star, DD, AH CH, BCI LC “A wise, thoughtful, heartfelt autobiography and manual. It beautifully lays out the negative emotions and limiting habits that so often accompany pain and offers strategies for coping and healing.” — Carol Banquer, MD “It is so valuable to hear directly from someone who has lived through it herself and developed an approach to pain management that addresses all aspects of living in pain. I highly recommend this book for anyone living with pain or working with people in pain.” — Pam Dent, OTR “The Pain Companion is an excellent resource and companion for those with pain. Learning how to become empowered through one’s pain journey is incredibly important. Sarah Anne Shockley shares valuable insights and approaches to living with and managing chronic pain. This is a fantastic read.” — Nicole Hemmenway, vice president, U.S. Pain Foundation “This very important book on making life with pain easier offers valuable advice and ideas that could only come from someone who has lived through it. I wholeheartedly recommend it to anyone experiencing chronic pain and suggest that practitioners read it to gain a greater understanding of the challenges their patients in pain live with.” — Tracy A. Newkirk, MD