Episode Transcript
[00:00:00] Speaker A: You.
[00:00:00] Speaker B: Hey, thanks so much for listening to this message. My name is Jason, and I'm one of the ministers here at the Madison Church of Christ. It's our hope and prayer that the teaching you hear today will bless your life and draw you closer to God. If you're ever in the Madison area, we'd love for you to stop by and study the Bible with us on Sundays at 05:00 p.m. Or Wednesdays at 07:00 p.m. If you have questions about the Bible or want to know more about the Madison church, you can find us online at Madison church.
Be sure to subscribe to this podcast as well as our Sermons podcast Madison Church of Christ Sermons. Thanks again for stopping by. I hope this study is a blessing to you.
[00:00:38] Speaker A: All right, well, as I said, my name is Karen intricin, and the topic that I got tonight is dealing with chronic pain syndrome. I've got it on. Good.
This is a topic that is.
Well, how many of y'all are in healthcare? Anybody? A lot of people. Yeah. This is a very, I don't know, complex issue for a lot of people. Not only medical, but in the mental health profession, we see a lot of that from time to time.
Chronic pain is something that about 30% of Americans struggle with.
There are a lot of risk factors. We won't go into all that, one of them being aging.
But like I said, so it's really something that even as a nurse, when I was a nurse for 30 years, it's something that's very complex, very individualized treatment. And lucky, I was telling Rita, Bill, now, the psychology is kind of caught up with the science. We have a lot of understanding now about how the brain functions and where the pain centers are. And there's just a lot of things we can do, not just medically, but there's procedures that can be done. But we're going to just go over just a little bit of information about that if you want to raise your hand. I'm just curious, how many of you all do have chronic pain?
There's about, I don't know, maybe 15 people or so. So that's about typical.
What I wanted to distinguish, first of all, chronic pain and chronic pain syndrome are two different things. And what I wanted to talk about was chronic pain syndrome, which is basically when you have chronic pain, but also there's a lot of what we call comorbidities that go along with it. They can be like anxiety, depression. It can be relationship challenges. There's just a lot of things that go into chronic pain that really impacts you in a really devastating way. People that suffer from it, it is not an easy. It can be one of the most debilitating things there is out there. So my heart goes out to people that really do have that challenge.
But like I said, there is a little bit of a difference between that. But our objectives tonight are going to be basically just to look at how our nervous system and our stress response impacts chronic pain and then to identify some skills that might be effective in breaking the chronic pain cycle. That's what we're going to be talking about tonight. And one of the definitions, this was from the association of Pain Management.
I just kind of paraphrase it, but it says, chronic pain is defined as pain that lasts over three months, interferes with one's ability to perform activities of daily living, socialization, and disrupts occupational goals. So that is a very broad general statement. There's a lot of other things that it impacts, but that's basically their definition.
This is kind of my definition.
A condition where pain occurs every day is something I didn't ask for. It wasn't my fault, but is making my life more difficult and keeping me from being the person I want to be.
That's kind of the way people that have chronic pain look at it.
It's almost like in some ways, you feel kind of like a victim. You just feel like there's a lot of things that you've got robbed from, and it makes it hard to enjoy life. So that's kind of a little more realistic definition.
Let's see this video I wanted to show you all. Let me see if it's going to pop up here. Yeah, this is something I got off of the VA Gov pain management website. It's just a little two minute video, and it kind of just metaphorically explains kind of what it's like for people that have chronic pain. So I just want to play this for you. It's just a couple minutes.
[00:05:00] Speaker C: It's hard to know how to move forward once. Chronic pain energy.
It helps you think of a person with chronic pain like a car with four flat tires. Our expectation is all we need is one medication or treatment that will take away the pain, but it only puts air in one of our tires. We still have three flat tires and cannot move forward.
Perhaps the medication or treatment has provided 25 or 30% relief. Let's leave that there and ask ourselves what else we need to fill our other three tires so that we can resume our life's journey.
For each person, the necessary combination of therapies and interventions will be different based on individual needs. Unlike traditional medicine, where the patient is passive, living a full life with pain requires that we become active participants.
We need to work with our healthcare providers to find out what we need to fill up our other three tires. Biofeedback, physical therapy, counseling, pacing, nutritional guidance, a support group, and a host of medical treatments are a few ways to fill up our tires. Once we have all four tires filled, it's our responsibility to maintain our car. We wouldn't take it back to the dealer and ask them to fill it up with gas or wash our windshield. That's our responsibility.
If something goes wrong with the car, we take it in for checkup. It's the same with our wellness.
You see, pain management is much more than one simple treatment. It takes a team effort with the person with pain taking an active role to live a full life in spite of chronic pain.
[00:06:50] Speaker A: It's kind of easier said than done, right? But I think that the reason I like that video and I wanted to show it is because it shows that it needs to be a collaborative effort between the patient, the client, the treatment team. Medical. There's a lot of, like I said, psychological factors that impact chronic pain syndromes. And again, there's a lot of physical therapy, occupational therapy. There's a whole lot of things. We're going to go over that later in the slide, in the presentation. But it's easy to give up hope, I think, when you're in it a long period of time. And so I'm hoping that if anything, this presentation will maybe impact people that do suffer from that, so to speak, to either seek help or be more on board with their healthcare practitioners. But I think one of the things, too, about the video, it talked about an individualized treatment plan. We've got opiates, we've got all these muscle relaxers, we've got all this pharmacology.
But God kind of wired us to have our own endorphins, our own pharmacology, so to speak. And I think it's a matter of tapping into some of that. Sometimes it's easier for some than others. But, I mean, some of you all remember giving birth. Maybe you all did lamas, maybe you didn't have any. So there is ways to. Of course, that's more of an acute pain thing. That's not really chronic pain. But what I'm trying to get at is there are ways that your brain can suppress pain responses.
And so, again, it's something that can be learned, really.
All right, so this is some of the causes of chronic pain I've got here.
It can be like physiological injury, like an accident or something. A lot of disease processes, of course, especially neurological type. You've got neurogenic pain, which is like nerve damage. That can be a really difficult thing to deal with. Like, just different things like that. Psychogenic is another one, they say, and that is not.
And I don't say this word very often, but it's not about being crazy. I don't like that word. And I'm sorry I'm saying it, but that's just what comes to mind right now. It is not that, but there is a component to pain that can be triggered when there's not really a physiological reason to have pain. Okay. We all have emotional pain, right? I mean, different things happen in our lives, and we feel pain, depression, anxiety can cause physiological things to manifest in our bodies. And so that mind body connection is really important. And one way that we know that will help people that suffer from chronic pain is to have a good understanding of how they can maybe look at things differently, and maybe it will balance things out for them to some degree. It's not going to make it go away. But if we can inch down, one intervention might inch down your pain, 10%, 15%, maybe something else might do it, another ten or 5%, then that's kind of what we're learning. That works.
Let's see, what else? The low level of endorphins. Endorphins are something. They're a hormone, basically. They're not really neurotransmitters, but they are kind of. And I like science, so excuse me. You all just chew me out if you don't like this part. But they're basically in the pituitary gland in the brain. That's what releases our endorphins, and it's a response to stress or pain.
There's the pituitary hypothalamus and the adrenal axis that kind of secretes things when we're under stress, whether it's a physiological stress or mental stress, whatever. Like cortisol. That's one of these stress hormones you hear about, right? Well, like I said, we also have endorphins that are released, and they're hormones. And what they do is kind of like, if you know anything about, let's say, an opiate and how it works, it binds to certain opioid receptors in the brain, and that's basically how that works. Well, God made our bodies to where we have this natural, like, free flowing endorphins that are kind of like morphine, endogenous morphine, really, on some people.
And what it does is it will bind to those receptors just like opiates do.
Not the same receptors, but very similar. So that's how I think if we can learn to kind of tap into our natural pharmacology, so to speak, in our bodies, I think that might be helpful. And some people may, can decrease some opiate use and things like that. But these skills are kind of hard to learn. But like I said, they definitely can be learned.
Let me see.
States of low level endorphins can be like depression, obviously, anxiety, even addiction, even impulsive behavior. Sometimes there is a hormone imbalance in the endorphins. So again, these are things that kind of cause that. Now, does anybody know any natural ways to boost endorphins? I just thought I'd ask. I mean, has anybody ever heard about anything like that exercise?
Yeah, it doesn't have to be huge exercise like go to the gym for 2 hours. It can be even 1530 minutes walks every day. Yeah, that's a good way. Anything you enjoy, whether it's sitting and looking at a beautiful sunset, whether it's watching your child's expression as they're engaged in something, little bits of joy and gratitude that can boost endorphins. And I know it's hard sometimes to be grateful for things because life throws us a lot of curveballs, right? But I think if you can learn to develop that attitude, then I think those are things also. There's things like dark chocolate, believe it or not. Little bits of dark chocolate. Yeah, I love that. That's great. That's one thing I don't mind doing. Right? Yeah.
There's like art, music. It doesn't have to be creating art. It can be like just viewing art and getting just that visual image and that impression from the art, whatever. Acupuncture is another one.
Laughing boosts endorphins. So there's a lot of things we can do naturally to boost endorphins. So I wanted to make sure you all knew that.
I'm sorry. I've had a lot going on in my life, so I'm not as smooth as I should be. So I apologize at a time.
The endorphins. The only other thing I wanted to say about that is there's different types of endorphins. There's like 20 different ones.
But the beta endorphins are the ones that are helpful to us in the stress and pain responses. So I did want to mention that, because that's the important aspect of that.
This is something I think is important. It's hard to incorporate sometimes with these topics, spiritual and emphasis sometimes on the things that we talk about. But I do feel like the Bible does speak a lot about people that are suffering.
God is aware of our suffering. I mean, look at the New Testament. Look at how Jesus ministered to the sick and the crippled and all that. He had empathy. And God, he understands our suffering, too. I mean, he made us right. He understands the way our bodies work, and he understands when we're struggling. So I think just helping, just really reminding ourself of that, that even though it feels like we're alone and isolated and nobody cares, perhaps sometimes God is always there, and that can be helpful. Again, God is in control. I mean, Isaiah 45 seven talks about God is in charge of everything, basically.
Psalms 34, that's like a chapter. And it talks about a lot of suffering there. And it says that God's ears are open to the cries of his people and that I'm trying to read my own writing. And God can come near to the broken hearted. He is really attentive to that. And like I said, sometimes when you're really struggling and you're by yourself, that's very helpful.
It says that he saves those who are crushed in spirit. And sometimes that can describe people that have these challenges.
And also, the last point I wanted to make is that pain may have a purpose.
Even though we don't really get it and we don't like it and we don't understand it, it still may serve a purpose. It might make us more dependent on God, for one thing.
I'm trying to think. I think the old saying was something like, the more we as humans see our need, the more we are able to see the face of God or something like that. The more we identify our needs in this world or physically or whatever, the more we're likely to lean toward God. So that's something to be said. Maybe. Pain teaches us patience, endurance. I mean, there's a lot of things that can be beneficial, let's say, for that.
It also, I think, allows people to minister to other people. If you know somebody that has chronic pain and they're not able to do things, it gives us a great opportunity to minister to other ladies and people. So I think that's a really good thing, too.
Any questions or comments about that?
If you're like me, you're kind of sick of looking at these things right here. This is like the catch all medical, everybody says, oh, you just got to exercise, you got to eat right. You got to do it. But it really is true. I mean, a lot of times with prevention, with pain management, arthritis, for example, being sedentary is not a good thing. It makes you stiffer. We say motion is lotion kind of thing. And so, again, there's a lot of things that this is just basically things that can be adapted to chronic pain, and it's things that are good for anything, really, like, to just a life of, you know, one thing. Becky and I, we always do a lot of stress reduction.
We hopefully, if we don't have time, I mean, don't run out of time, we'll be doing one at the end of class. But I teach a lot of mindfulness meditations and things like that, relaxation skills. The reason that's so important in chronic pain is because now we know, based on the brain science, and we're going to get in that in a minute, that I think Becky talked about anxiety and how the brain fires and the limbic system goes nuts and all that. It's very similar to chronic pain. And so now that we know that, we know what works to kind of help tone down that autonomic nervous system. So it's basically the things like the deep breathing, like progressive muscle relaxation, if you're able to do it, guided imagery, any kind of mindfulness meditation.
In meditation. I don't know. Some people think, okay, it's like sitting around like a buddhist monk or something. It's really not.
I know a lot of people, especially in the church, they're like, I don't really get what you're saying, but it's something that's very practical and you can incorporate into your daily lives. Mindfulness is so I think that's something that, like I said, we're all about that exercise. They say even just 30 minutes, 20 minutes a day, maybe just a walk would be helpful. Just keep moving. Diet is a big thing. Of course, this is the anti inflammatory. It's mainly just a lot of organic fruits, vegetables, not red meat. I'm not a dietitian, but I know dairy can cause inflammation for some people. So what I read is, basically, it's like the whole fat dairy is worse than just, like, the low fat. And sometimes yogurt, like, especially greek yogurt, doesn't really cause inflammation for a lot of people. So they definitely say that's okay for most people.
Let me get some water, y'all. I'm sorry. Throat is getting dry. Okay. This is a bunch of minutiae right here. And I don't know if you all can see it, but basically, I'm just going to cut to the chase. The pink, where the brain is, that's basically the most important thing.
And what it does is it's basically talking about how we've got certain structures in our brain. Like I said, these are some of the ones that are in the autonomic nervous system that are activated during anxiety and stress. It's the amygdala, it's the hippocampus, it's the ACC, which I can't say that word exactly in the middle, so I'm not going to. But the one, two, and three on the brain, those are areas where they get revved up during pain, especially chronic pain. Okay, now, what we know is that this area at the top, which I don't know if you all can see, it's number four, but that's called the dorsilateral prefrontal cortex.
And the left side, especially in people's brains, has a lot of ability to desensitize ourself from pain and to interpret pain in a different way. There is one on the right hand side, but it's a lot smaller, and it's not really in the temporal area like that is, or close to the temporal area. But like I said, this is the area that we now know that if we can learn to activate that part of the brain when we're having these pain sensations or whatever it is, then we know that that can be helpful to us, and we're going to talk about how we do that in a little bit.
Basically, that's really the only thing I know. There's a lot of information on this slide I would highly recommend. There are a lot of wonderful apps on. If you have a smartphone and you have chronic pain, this curable app is one that I've come across. I'm not endorsing it. I'm just saying I've glanced over it. I think it has a subscription. So I haven't looked over the entire thing, but I do find that that had a lot of scientific information that I thought was really helpful.
So that might be something that you think about doing. I've also got a list at the end of the presentation about some other resources for you.
What we know, not only is that the dorsal lateral prefrontal cortex, not only is it inhibits pain, but also we can learn to desensitize the pathways. I think Becky might have mentioned about neuroplasticity. Did anybody, y'all remember that word, neuroplasticity? Anybody remember what it is? No. It's where our neurons can actually change and adapt and prune themselves and get stronger in certain places based on thinking patterns, based on behaviors, based on whatever. So this is something we know now that we can do with chronic pain, is that we can start forming better pathways that are working more for us. Does that make sense? Not to say that it's going to wipe out your pain entirely. This is not a magic wand here. But what we know about the brain is if we know how to access this part of the brain through strategies that we're going to talk about, then we know that we can tone down our pain response. Okay? So that's really important. And I think it's kind of exciting.
And when I talk about sensitization, nerve sensitization is part of chronic pain, the issue with chronic pain, because, again, these pathways, they fire up. They fire up. If you've got chronic back pain, let's say, and it's been there for 15 years, it's not getting any better as you get older, right? But you know that when that thing fires up, there's a pathway that is formed, kind of like a loop, a circuit, and it goes up to this part of your brain. This is the dorsal end of where stimuli, external stimuli in our bodies. This is where it ends, right here in this part of the brain. So again, we know that that pathway gets really strong because it's just firing and fired and firing sometimes. So what we know now is things that can interrupt that desensitize that a little bit. And this is a great example, and it's also a good example of kind of psychogenic pain. I had a friend that worked in the ER one time, and she came to me. We were, I don't know, went into each other cafeteria or something, and she said, you will not believe what happened. She said, we had a man come in, he was a construction guy, and he had this big old spike, almost like a railroad spike, in his boot, like it was right through the top of his boot, all the way sticking out to the bottom. He was screaming, yelling. I mean, he was in such pain, right? Well, I don't know if you all know this, but if you impale an object somewhere, you're not supposed to pull it out. Does anybody know that? I don't know. Anyway, all right, so they left it in, transported him to the emergency room, right? Well, after they got his shoe off, it went right between his toes. I mean, the big toe and the other toe he barely got a scratch, right? But he was really feeling the pain, you know what I mean? Because he looked, and, I mean, he was sincere in his pain, right? I mean, you're not saying he wasn't in pain. But after they investigate, like I said, so that's kind of the way our mind can kind of play tricks on us sometimes.
I mean, I'd be probably doing the same thing, right?
Like I said. So again, that mind body connection is really key.
I've heard of police officers, too. Like, if they get shot with a bulletproof vest on, it definitely hurts. But, I mean, some of them, they think, like, oh, I've gotten shot. And then after they peel it off, you know, it's just like a bruise or something, but they really think it's like they punctured a lung or something. So it's just, you know, everybody's different with their pain responses.
Let me see.
In case you didn't see that last slide because of a little smile, this area in the purple at the top left, that's the one we're talking about, that area of the brain that is kind of involved in the pain responses.
The next thing is, this is a pain cycle, and I just basically want to talk to you all about this.
And basically what's happening is we have a pain at the top, and the pain is signaling in our minds, okay, something's wrong. I'm not safe. I'm getting some damage here. Something's not right.
By all means, I'm not telling you to ignore pain. I'm not saying that we all should investigate pain, right? Especially if it's a new onset, if it really has accompanying symptoms to it. Like, you got a headache, and then you got nausea and vomiting and things like that. But what I want you to see is that how we look at that pain.
I had a guy one time that liked to exercise, and he was riding. He liked his stationary bike, and he rode it about 10 miles a day or something.
Well, he comes to my office and he says, I think I've got a blood clot.
And he interpreted the pain in his calf from having a blood clot. Now, I'm not there to say, no, you don't have a blood clot. That's not my job. Right. As a therapist. Right. But that's how people can misinterpret pain. Once we talked about it, and he said, well, I did have trouble with that side of my bicycle, and I rode five more miles or something like that. And so, again, once he started kind of rationalizing in his head and got rid of that. Oh, my goodness. I've got a blood clot mentality. Then it sort of made sense to him why he had this pain. Right. And so I think oftentimes, especially again, I'm not saying ignore pain, by all means, don't do that. But I think sometimes our interpretation of how we interpret it can create more stress and anxiety, and then that furthers our pain response. That's all I'm saying. So nobody knows you don't have a way to look inside your arm and understand why it's hurting, right. By all means, go to the doctor. But all I'm saying is there are certain things that we know, kind of like ways that we think that tend to be more problematic, create more anxiety, therefore it causes more pain. Does that make sense? So it's kind of a vicious cycle. So again, once you have the anxiety and you're thinking there's damage or whatever, then what do you do? You focus on that more, right? You think, oh, man, my legs really hurting, or, oh, man, I just can't, what's going on here? So it's almost like your brain trips you and you start hyper focusing, you become hyper vigilant. You know what I mean? Sometimes.
And again, I'm not saying that's not necessarily a bad thing, but it's kind of negative in the way. If we're wanting to portray a state of calm, if we're wanting to keep our bodies calm and relaxed, then that may not be an effective way to do it. That's all I'm saying. So, like I said, hyper focusing on the problem, that can be a challenge. And then, of course, with that down at the bottom, it talks about changes in the nervous system. Again, when you focus on what you focus on matters, I tell people that all the time, if you're focusing on all the negative and, oh, my goodness, this is going to be a brain tumor and whatever, instead of seasonal allergies, that kind of thing, then obviously that's going to create that more anxiety. Right. And then you're going to have more pain. You're going to feel it, you're going to be under a stress response. It's just kind of a vicious cycle.
And again, that causes more pain and then we get more anxiety. One thing I see a lot with chronic pain people is they're afraid. They're fearful of movement. Like, if they're feeling really good one day, they think that's not too bad. They tend to overdo, which gives them a rebound effect, and they're hurting twice as bad the next day. You know what I mean? But what I'm saying is they are afraid of movement.
And so that's something that's very. You have to know yourself, you have to know what is in your guidelines, so to speak, and try to stay within that if you can. And I know that's not easy because life is complex. But anyway, that's something to be said for that. These are some skills that we talk about in therapy sometimes.
This is basically a short list that are things that I found personally that can be helpful or that we teach clients. And I'm not going to really read all these, but one thing the doctors tell you, let's say if you've had surgery, that's, again, not chronic pain, I understand, but with pain, and let's say you've had surgery and you get like a few pain pills, what do they tell you? Stay ahead of the pain, don't wait till it gets really bad and then take a pain pill because it takes 30, 40 minutes. Right. So that's one thing we've got to do, is if you are on medication and it's prescribed and you're doing it like you're supposed to, we need to just stay ahead of it. There's no harm in taking medication if you need it.
Again, the motion is lotion. We need to be moving. Even if it's something simple. It can be yoga, it can be simple stretches, it can be walking, leg lifts, whatever.
Monitoring our thoughts about pain, that's something that we deal with quite a bit.
Again, do we always jump to the worst case scenario every time we think about something going on with us?
That can be a challenge.
We've also got prayer.
God is always there.
Sometimes that prayer can be very helpful if you can take your desires and needs to God.
Sometimes if the pain is mild to maybe in the moderate area, you might can just distract your way out of it. Not all the time, but like I know you moms in here, you all had days where you just had a headache or something and your kids are kind of maybe getting on your nerves a little bit or something. You don't really feel you're just kind of biting your tongue or something. But I'm saying those are times where that headache, you can just kind of put it aside because you've got to do what you need to do to take care of your family. So sometimes distracting find distracting things to do that aren't really taxing.
Maybe it's doing some creative thing. Maybe it's doing needlepoint maybe it's doing. There's a million things you can do, but just getting your mind off of the pain when it's mild in the moderate category sometimes can help.
Again, CBT, that's a form of therapy. I talked about that a few weeks ago.
Again, that's where we're looking at our thought patterns and seeing if those are helpful or are they creating further distress in our lives. That's basically what that is. And then I always think it's helpful to talk to yourself. Not like really, but in your mind, self talk is very important. Right. And give yourself, say, you know what? The pain is really bad today, and I really don't want to be in this position, but I've made it through last Tuesday and I'm going to make it again.
Just something like that. Give yourself some affirmation that as bad as it is, it's not going to stay that way forever.
Anything you can develop a mantra. Sometimes those things can be very powerful. People put them on their mirrors. People put them up wherever. Like I said, sometimes you'd be surprised how little things like that can be helpful. Again, we talked about mindfulness, relaxation skills, and yoga is great for pain.
Gentle yoga, not the hot yoga or any of that stuff, but the hatha, the flow yoga. That can be something that's very helpful. So that might be something you think about doing.
What happened? There we go. These are some other effective treatments for chronic pain. Some of these are in the counseling realm on the right.
Some of them are in the medical, physical therapy, occupational, aromatherapy, certain scents they say helps pain. Can't remember what I read now, but I think lavender was one. I can't remember. But again, acupuncture is one. I know people here that's got spinal cord stimulators for chronic back pain and leg pain, lifestyle changes, all that kind of stuff. The stuff on the right. And there's a few other things. There's something called pain reprocessing therapy. I don't do it. I don't really know what it is, but there's a lot of different things, mental health wise that people can do, and I'd be more than happy to. I really would like to learn about that biofeedback, hypnotherapy, all those things. Support groups.
That's a big know. It's hard to find in this area. There used to be one that Huntsville hospital put on and the wellness center. I'm not sure if it's still there, but sometimes being able, if you can go to support groups that can help you identify people that have the same struggles and you can hear what works for them. And I really like support groups. I think they can be very good.
These are ways that I just kind of, off the top of my head, thought about how counseling can help people.
Of course, there might be. If you've got chronic pain and it's been going on a long time, there's a grief process sometimes with that, especially as you get older, you can't do what you once did.
Maybe your family roles change, you're not able to take care of your family. Maybe your husband or somebody else has to do a lot of the stuff.
So there's a lot of identity issues that come up with that, disturbances kind of thing, self image.
People feel like they're not good for anything sometimes because they don't have the energy or they just feel so terrible and bad sometimes.
And I think one of the big things, oh, my goodness, we're running out of time. One of the things I found out, and this is something I really hone in on as a therapist.
By the time people hit my door sometimes they've been to 40 doctors and it's been ten years, especially with autoimmune disorders. And that's something us women, that's one of our fortes. I hate to say it, the dysautonomia realm of autoimmune disorders is very hard to pinpoint.
And like I said, there is a bit of trauma that people come to my office with sometimes because they've been so invalidated by their doctors for over a long period of time, they just don't get it. They think they're making it up, whatever it is. They just feel victimized by the medical system, too. They know there's something wrong.
And so usually as a last resort, that's when they come see us. Because all the medical people are like, we don't know. We can't figure out what's going on with this person. And so sometimes we can help people like that because like I said, everything else has been ruled out. But like I said, the trauma of that can be very upsetting to people.
Learning about stress responses, how to tone down that nervous system. Like, we're talking about the interpretation of pain catastrophing, how we think about pain. Like I said, the fear of movement, learning condition responses, and how if we can learn other responses to the pain stimulus, then it will help us. You know what I'm saying? So that's something we can do.
I don't do EMdR for pain therapy. I don't know, Becky. Have you ever done that? I've never done it, but there's a guy on YouTube, Mark Grant, and the lady that taught me, Emdr, she had been to some of his stuff and he's written some books. But there are know EMdR for pain therapy. That's another avenue that you can do.
But like I said, this is basically, sometimes it's just about accepting.
When you're already maxed out on medicine, you've done everything you can do as far as managing your lifestyle and whatever.
Sometimes accepting what is is a better alternative than fighting what you want.
That takes a lot of energy to resist what reality is sometimes for people. And so sometimes just simply accepting you know what, it doesn't mean you like it and it doesn't mean you're happy about it. But acceptance can start the healing process for a lot of people sometimes just instead of fighting it and things like that. So that's something that we kind of talk about sometimes.
I don't know if any of y'all ever heard of the spoon theory. I don't know. Some of you, you have heard it. Okay. Julie's laughing. She's laughing at me. But I don't know. I don't know who invented this. I know it was somebody else. It wasn't me, but I've heard it in a seminar, I don't know, four or five years ago. And I think with chronic illnesses sometimes if you have one, something like this can be kind of helpful. And it's not scientific, but basically what it is is a way of looking at your day to where you can be okay with what the pain is that you're experiencing.
There's a lot of.
I'm going to show you this. This is really tacky and I'm sorry.
This is spoons. Okay, so let's say each person maybe has ten spoons, and spoons represent activities that you've got to do that day or something. So let's say if you have chronic pain, and let's say you're given ten spoons and you have to last, those ten spoons are units of energy or units of normalcy in your pain response. So you start out the day with ten, all right? And every time you do something that creates more pain or it takes out a lot of energy out of you, pep out of your step, then you subtract spoons. All right, let's say you wake up and you've got chronic pain. It's really bad. Let's say it's bad. Well, then that one spoon, you start out not with ten, but nine. And I'm sorry, I don't have ten spoons, but like I said, so if you wake up and you have chronic pain, then you're already starting out with less spoons the day. The goal is you want to make sure your spoons last as long as your day does, okay? That involves pacing yourself. That involves prioritizing and planning your day. Right? I mean, that's what it is. So if you think about that like a big task, like unloading the dishwasher might take one spoon, right? But if you got to drive your kid to school and then you got to walk them in and you got to do something that might be depending on how you're feeling. So by the end of the day, do we have anything left? I mean, that's the thing. And so one thing about the spoon, and I know it seems simple, but if you think of it about allotting my typical day and what is a five spoon activity that I have to do? You know what I mean? What is four spoons? What is two spoons? And you need to pace yourself around those. If you've got big things that you need to do and you know it's going to take a lot out of you, then when's the best time of day for you to do that? Is it like, maybe right when you get up, is it like lunchtime? There may be patterns in your behavior and the way you feel. So again, it's about knowing yourself and knowing if there's any patterns and then understanding.
If I do this activity and it's a five spoon activity right off the bat, then I'm not going to have much left for my family at the end of the day when they come home from work. So that sort of helps. Am I making sense? I don't know. Does it make kind of sense? And again, it's all individualized. You've got to determine what the big things are. But like I said, it is a good way. It gives you a little better manageability over things sometimes. And I know that people with disautenomias in particular, like pots, I know several people with that. And they know that if they go watch their nephew's baseball game out in the hot sun or whatever, then they're not going to be able to work the next day. Right.
I've got people that plan their days like that. Like, if they really want to go see their all star, their nephew's been all stars, then they go to that game. But they know what it's going to cost them and they make arrangements in their schedule the next day where they can clear the schedule. So it's about manageability is what I'm trying to get at. And we all have the capabilities to.
It seems impossible sometimes, but I think we all have the capabilities to really be better managers of things like that.
I guess I've lost my.
I hate technology.
Let's see. I know our time is up and I'm not going to have time to do these are some resources. We're going to do a mindful body scan, but we don't have time. And I'm so sorry about that.
If you all want to take pictures of this with your phone, if you're interested. These are some really good scientific things. YouTube, they're all from pain centers. Stanford University. They have a big pain clinic up there. I've also got a lot of apps on your phone. Some of them are free, some of them are not. I would highly encourage you to get on this Va gov pain management website. It is free. You just have to set up an account. You don't have to be a veteran. They have wonderful resources.
They've got excellent resources in there for pain management. So if any of you struggle with that, that is a really good thing that I would highly recommend.
Any questions about anything.
I know we've kind of went through it pretty quickly.
All right, I guess we're done. And I apologize for going over. No questions. Thank you very much, ladies. I appreciate your attention. Bye.
