Stronger Than Chronic Pain: Week 3

Contents

You Made It! Week 3 Exercises: Brain Training Writing Exercises Meditations Resources

You’ve made it to week 3! You have already done so much hard work in the past two weeks. I’m really proud of you and I hope you’re feeling proud of yourself as well.

You may already be feeling some relief from your chronic symptoms, or you may not yet - that’s totally normal. If you’ve been experiencing these symptoms for months, years, even decades, it can take a lot of work to start feeling a difference. 

As much as you can, without being perfectionistic about it, try to do this work daily.

Week 3 Meeting Recording

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Week 3 Exercises:

Brain training

This week, we will continue and add upon the brain training exercises from the previous weeks, as well as begin working with our triggers and playing with our symptoms. Some of these exercises you can do throughout the day as they come up, and others (like working with triggers) you will need to set aside some time for.

1. Continue the exercises in week 2, adding bilateral stimulation. 

Bilateral Stimulation (BLS) refers to a physical, visual, or auditory stimulus that is presented to both sides of the body in an alternating fashion. It is a principle competent of Eye Movement Desensitization and Reprocessing (EMDR) Therapy, which can use a laterally-moving dot on a screen that you follow with your eyes from side to side, buzzers held in each hand that offer a small vibration, or stereo headphones that sound off in alternating sides. Bilateral stimulation can also be done manually, by crossing one’s arms over one’s chest and alternately tapping on one's shoulders. Walking is also a very accessible form of bilateral stimulation. (Mazzei, 2021).

BLS has been found to reduce emotional activation and to activate parts of the brain that are associated with emotional processing and higher level thought functions, namely the limbic system and the prefrontal cortex, respectively. By activating these areas and reducing emotional activation, one can more easily access and process past and current stressors and traumas. 

For this week’s brain training, repeat the exercises from week 2, while engaging in bilateral stimulation by either crossing your arms in front of your body and alternately tapping on each shoulder, or by going on a short walk, even if it’s just around the block or up and down the hall. 

Here is a copy of the week 2 exercises:

  • Take a deep breath, and remind yourself that there's nothing wrong with your body. Remind yourself that you're healthy, and that your symptoms will pass. 

    Talk to your brain and tell it that you know it is trying to warn you that you're in danger. But you’re safe. Tell your brain that you can deal with the pain and that you're not afraid of it, and that you know that the pain can't harm you. 

    Remind yourself that these symptoms are learned neural pathways that you can unlearn, and that there's nothing wrong with your body. Tell your brain that it can relax, and that you can deal with whatever stressful situations are occurring. 

    Take a few more deep breaths, then move on with your day.

  • Take a deep breath, and take a few minutes to talk to your brain. Tell your brain that emotions, even big ones, are normal and healthy to have. Take another deep breath. 

    Now, tell your brain that you're not afraid of big thoughts and emotions. Tell your brain that they're normal to have and they cannot hurt you. Tell your brain that you are learning to deal with feelings without having reactions that cause pain and physical symptoms. 

    Thank your brain for alerting you that something in your life is needing attention or movement. Tell your brain that you're going to deal with the things causing these emotions, and that you are very capable. Tell your brain that it doesn’t need to cause uncomfortable symptoms, because you are handling things. Tell your brain that it can relax and allow the symptoms to fade away. 

    Take another deep breath and go on with your day. 

  • Stop and take a deep breath. Take a moment to speak with your mind, and tell it that this activity or trigger is healthy, and it will not hurt you. Tell your mind that this activity or trigger does not have to cause pain. 

    Tell your mind that even if this activity or trigger does cause pain today, it is because you have learned that neural pathway, not because what you are being exposed to is dangerous. Tell your mind that you are working on building new neural pathways, and soon you will be able to do this activity or be exposed to this trigger without having pain or symptoms.

    If your learned neural pathway with this trigger is very strong, it may be helpful to almost chant or lecture this to yourself while engaging in the activity. For example, I used to get migraines every time I did strength training exercises with my upper body. So, when I was healing my chronic pain, as I was working out, I would repeat to myself, over and over: 

    “Working out is good for my body and it is safe. It’s not going to hurt me. My body is safe. Strength training is good for my body and doesn’t have to cause pain. If it does cause pain, that’s because of the learned neural pathway, not because strength training is dangerous. I’m working to unlearn this pathway so that my brain can know that this activity is safe, and eventually do it without causing pain. I am safe, this is good for my body…” etcetera etcetera.

2. Working with Triggers

Choose one of your triggers from the list you made in week 1. 

Think back to when you first noticed this trigger causing your symptoms. Try to remember what was going on in your life around that time. Were there stressful events happening in your life at that time?

See if you can remember back to the first time you made the association between a trigger and your symptom … Was there any way that this symptom somehow protected you from the hard or stressful things that were going on in your life? Maybe your symptom allowed you to remove yourself from a scary or unpleasant situation?

I remember one time when I was a teenager, and my dad had dragged me to a political action that took place in the high heat of a Colorado summer. I did not want to be there, and I had voiced that to my dad, but he made me go with him anyway. I started getting a headache, and when I voiced this to my dad, he allowed us to go home so that I could be in a cool, darkened room. I did not realize this consciously at the time, but some part of my subconscious brain learned that if I am in pain, I will not have to do the thing that I don’t want to do. My subconscious brain also learned to associate being overheated and bright lights with migraines. This is a moment when this neural pathway (heat and light triggering pain) began to be formed in my brain. Then, the next time I was exposed to heat and bright lights, and possibly also didn’t want to be doing a thing I felt forced into doing, my brain knew just what to do: create the sensations of pain, and I will have an easy out. 

See if you can find any of these connections in your own life.

3. Play with Your Symptoms

People in pain tend to think in extreme negative metaphors that can make the pain feel more burdensome emotionally, which can make it feel physically worse. When I used to get chronic migraines, I would imagine a vice grip squeezing my temples and an ice pick hacking away at my skull. It did not help me feel better. 

I learned that if I can think of my sensations in a more neutral, or even positive way, it offers a mild pain relieving effect, as well as making the sensations emotionally easier to bear. I learned to think of my pain as a sensation, and say to myself, “I’m not feeling as comfortable as I’d like to feel,” or “My neck is not as relaxed as I’d like it to be” instead of thinking of it with extreme negative imagery. It seems stupidly simple, but it actually did help me feel less intensely affected by my sensations. 

In this exercise, we can even take it a step further to think of our sensations in silly or even funny ways. 

Do this exercise anytime you notice you are feeling unpleasant symptoms. First, take a few deep breaths. Identify where in your body you are feeling the symptom, and imagine it as your favorite color, or maybe as sparkles. Take a few more deep breaths to visualize this. You can even say to yourself, “my shoulder is feeling very purple right now,” or “my lower back is sparkling.”

You can even get more silly and abstract with this. If you have a headache, you can think of it as squirrels skittering around in your head. Try to choose something that is silly and makes you laugh or smile, not something that grosses you out or feels heavy.

In doing this, we are trying to shift your assessment of your symptoms from “pain” to a sensation that is less heavy, and more light, or maybe even interesting or funny. Try doing this exercise anytime you notice your sensations.

Writing Exercise

This week, the writing exercise is unsent letters, and I have also included some supplemental writing exercises. I recommend trying both a couple of times, and then spending more time doing whichever feels most productive to you.

1. Unsent Letters

In this exercise, you are going to be writing letters that you will not send, to someone with whom you have had a difficult, painful, or traumatic interaction. Or, you can choose to write a letter to a current stressor, to a personality trait, to a body part, or to your pain or sensations. In your letter, you are going to say whatever needs to be said to the recipient. Then, once you have completed the letter, you are going to reflect on what you have learned from this person, what you gained from interaction (if anything), and the ways you have grown as a result of this relationship. 

  1. Write at the top of the page, “Dear _____,” Write your letter, saying whatever you need to express. When you are complete, sign the letter. 

  2. Write the following phrase three times: “It is helpful to explore my relationship with _____.” If this feels corny or silly, remember that we are working with the subconscious, and the subconscious needs lots of repetition to integrate new information. 

  3. Now, write a short letter to yourself reflecting on:

    1. What you have learned from this person or interaction.

    2. What you learned writing the letter, if anything.  

    3. How you have dealt with issues related to this relationship.

    4. How you plan on dealing with this issue, or similar issues in the future.

2. Supplemental Writing

If you are enjoying writing as a therapeutic tool, or if you feel it is helpful to slow down your thoughts and process them on a deeper level, then I recommend doing these supplemental writing exercises this week, in addition to doing the Unsent Letters exercise daily. 

You will start by making another set of lists, and then you will do a 10 or 15 minute free write on one of the topics from these lists.

  • List everything that you are grateful for. These can be things about yourself, your community, your life. Anything. When we are in pain, it is easy to focus on the negative. But all of us, no matter how hard our lives are, can find things that brighten our days and inspire us. Where we put our attention is a powerful tool, so being cognizant of things in our life that are good can often help us feel a bit better.

  • Forgiveness is not something we offer to someone for their benefit. It is something we do for ourselves, so that we no longer need to hold onto the hurt of what was done to us. It does not mean that it was okay what the other person did, or that they are not responsible for harm. 

    I love this quote from author Jonathan Huie, “Forgive others, not because they deserve forgiveness, but because you deserve peace."

    And also this one from Oscar Wilde: "Always forgive your enemies; nothing annoys them so much."

    List people who you would like to forgive for the harm they have done to you in the past, so that you can let go of the emotions that you are holding onto around that harm. Also include things you would like to forgive yourself for.

  • List all of the things that make it hard to get better. These may be things about your chronic pain that benefit you, or ways in which your pain has become part of your identity. 

    As an example, here is my list of my barriers to healing: 

    • My chronic pain can be used to get out of doing hard physical labor.

    • My chronic pain can be used to get out of doing things that are emotionally uncomfortable or scary.

    • My chronic pain can be used to get out of work/family obligations.

    • My chronic pain can be used to get care from other people.

    • My chronic pain can be used as an excuse for not pursuing my childhood passion of being a gymnast.

    • My chronic pain can be used as an excuse to take care of myself instead of having to take care of others.

Now you have your new set of lists. Pick a topic from one of them and free-write for 10-15 minutes.

Meditations

Sensations Like Clouds

This meditation, like the body scan, is another version of safety reappraisal, which involves noticing sensations in the body and retraining your brain to interpret them as non-threatening, rather than dangerous. We will also work on letting go of our desire for a specific outcome of how the sensations shift, thereby giving them less power over how you feel.

Of all the meditations in this program, this is the best one to do when you are actively in pain.

Week 3 Meditation: Sensations Like Clouds (10 mins)
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Resources