What with all this study of pain I thought I would have a look at emotional pain. Now scientifically this is a bit tricky; pain needs to be felt somewhere, it needs to be unpleasant and you want it to stop. So far so good, but you can locate pain in a specific area and know it’s pain (even though we now know it isn’t generated by that area). When you feel emotional you may have physical symptoms; but you know that they are not the heartbreak, grief or sadness. So technically emotional pain isn’t pain, but it is something we experience and it has consequences.
For one thing if you are sad or grieving pain will be intensified or prolonged; it can also be the trigger for physical pain. This is part of the bio/psycho/social paradigm; we tend to put pain into the biological category but what about the person experiencing the pain? Surely that is a bit of everything? Biological, the fact of pain, psychological the surrounding emotions, social how we behave under these circumstances.
Part of trying to help someone in pain is to listen to their story, see what has happened, how have they got to this point? With my new knowledge also looking at clients beliefs, experiences and expectations is also important.
There is evidence to show that children who were neglected or abused have a greater chance of developing chronic pain syndromes in later life. Clients who have a loved one, close family member or health professional who is hostile or disbelieving about their suffering will have increased levels of pain. You would be surprised how often I witness this, I can surmise a lot by what and how people talk about family and friends. Or consultations they have had, ways they have been spoken to and treated.
Sometimes clients defend themselves by tightening up their muscles and become stiff and probably achy; sometimes their defences are overwhelmed with a drip feed of hostility and they are constantly ill. Some people are perpetually angry or resentful, which is both exhausting and damaging to themselves. Some people are truly stuck in incredibly difficult situations to which there is no obvious resolution and it feels all you can do is sympathise.
When I talk to a client I listen to what they say (and what they don’t) notice how they speak and move, obviously the first thing is to exclude pathology as far as possible, but after that it is trying to assess what is the driver in the problem? Is it physical/emotional/social how is this playing out in this clients life and where do we need to focus our efforts?
We are an awesome and fabulous mixture of all that has gone before and all that is happening now.
It makes for very rich and interesting conversations.
Full fadom five thy father lies; Of his bones are coral made;
Those are pearls that were his eyes: Nothing of him that doth fade,
But doth suffer a sea-change Into something rich and strange.