Listen, See, and Adapt

By: Loolwa Khazzoom, Founder, Dancing with Pain

April 23rd, 2012 • Living with Chronic PainPrint Print

Stories are hard to tell, because oftentimes, the beginning of a story is several stories back; and so to understand the full significance of a story, one must tell several. But who has time for that, so I’ll just tell this snippet:

I think there are very few people in the world who can understand the nuances of chronic pain without having lived through it themselves. And so there are very few people in the world who can interact with and guide people in chronic pain, in ways that are healthy and positive.

I am eager to find a personal trainer. But I have to be very careful to find someone with a keen awareness of and sensitivity to limitations and “mine fields.” At this stage in my healing process, my body is strong; and I live a predominantly pain-free life. I am able to engage in many activities in which I was unable to participate for years. But little things can trip me up. I can bike 25 miles, no pain, no problem, for example, but then if someone passes me quickly, forcing my body to contort at a certain angle, I can end up in pain.

I want to lovingly, gently, and skillfully identify and strengthen those parts of my body, so that I can once again live a life where I don’t have to give a second thought to shaking hands or walking in crowds or any of the things that able-bodied people take for granted.

So today I went to an event, through which I met a personal trainer. I asked him a number of questions, to see if he was a good match. At the beginning, when I brought up chronic pain, he responded, “Well pain is often emotional. Do you know that?”

Whoa. We had talked for all of 10 seconds. How about first asking someone if she knows the source of her pain, before jumping into the self-appointed role of diagnostic pop-psychologist? Aside from which, how about getting to know someone before getting into that discussion at all? It’s a very loaded question, and chances are that people living with pain have experienced a ton of judgment about the source of their pain, as well as medical stumbling blocks – namely, doctor attitudes – getting in the way of healing their pain.

Then there’s the piece that much of the time, it doesn’t even seem useful to figure out the source of pain. I have witnessed people spending copious amounts of time, energy, and resources on trying to figure out what was “wrong” with them, only to end up exhausted and in despair. Instead, we can focus on actions that will manage or alleviate the pain, regardless of the cause and source.

When we have an illness, disability, or some variation of a chronic health condition, we are vulnerable. People can make all kinds of projections and judgments, which can leave us feeling unsafe and off center. I think it’s so important for anyone in the role of healthcare provider to take an attitude of curiosity and discovery, and to really listen, instead of making snapshot assessments.

I did continue the conversation with this guy. I told him that I have these little hidden areas of weakness in my body, and that I need someone with acute awareness who will be able to detect when I have hit one of those places. Shortly after, he was telling me how he has people do stand-up paddling in the river. I told him that my ankles are one of my weak spots and that I’d like to work up to paddling, but that it seemed like something unsafe for me to start off with. He assured me that he’d worked with all kinds of people rehabilitating from this and that, and how there is a short learning curve, etc.

In other words, he wasn’t listening to me.

When I work with someone, I need that person to really pay attention to what I’m saying. I know my body exceptionally well. I’ve been through a whole lot with it. I have learned the subtle nuances of what does and does not work. But even if I were coming from a place of fear, it’s as important to listen to and honor that fear as it is to listen to and honor a physical limitation.

Body workers do not need to push clients to where they feel unsafe. Instead, they need to be creative and find stepping stones for helping clients feel safe. When we feel unsafe, we shut down. When we feel safe, we expand. When a body worker goes to a place of judgment or pushing, instead of listening compassionately and openly, and finding solutions, it is right at that place that the body worker can end up doing more harm than good.

A few years ago, I was working with a personal trainer. I was making a lot of strides in strengthening my core. Then one day, the trainer had me doing a move where I was walking sideways – right foot out to the side, left foot comes in and closes the distance. The trick was she wanted me to do the movement slowly, so that it engaged all kinds of tiny muscles. I couldn’t do it. I kept trying and trying to will my right leg to move out, but it just couldn’t.

I kept asking my trainer how to do it, and she kept saying the same technical instruction. Instead, in that movement, I needed her to recognize that the movement was too difficult for me. I know it sounds crazy. How could someone who was otherwise walking, biking, etc, be unable to move her leg out to the right?

Mind over matter, listening to my trainer, I did the move. I didn’t feel any pain when I did it, so I didn’t realize I’d entered into a danger zone. By that evening, however, I was unable to walk. For months.

People are really into this whole “personal responsibility” thing these days – meaning I should not have done the move. But there are subtle nuances that are being overlooked when saying someone should take 100% responsibility for their actions. I think that we each need to take as much responsibility as we can for our behavior, but also recognize that there is a dynamic interaction between people.

When a client is on a massage table, or working with a personal trainer, or in the doctor’s office, there is an implicit exchange where the client is trusting the practitioner. The client is there for a reason. The practitioner is the one with the expertise. And in order for this kind of relationship to work, ie, be effective, there is a certain amount that the client has to hand over the reins to the practitioner. I am not saying hand over the power, but yes to a certain extent, allow the practitioner to guide.

I was very vocal in my sessions with my personal trainer. Whenever I was able, I told her that I had hit my limit or that I was entering my pain zone or even that I was feeling apprehension that I might enter my pain zone. I was very much of a self-advocate. But when I was in that situation where she was asking me to do something that felt so simple, and I “couldn’t” do it, I didn’t understand what I was encountering.

Now I know that if it doesn’t flow, my body is telling me “not now, not yet, find another entry way.” But I didn’t know that then. And maybe my trainer didn’t either. But I think it’s something in which personal trainers, and all healthcare practitioners for that matter, should be trained: Watch closely. What is the client telling you, without telling you? Always err on the side of safety and caution.

In my dance classes, I always remind my students that they never, ever have to go into their pain zones. Back off from the movement. Do it more gently or more slowly. Move another part of the body instead. Stop physical movement altogether and dance in your mind. If you are not sure if a movement will cause pain or not, don’t do it. Err on the side of caution. Dance with the parts of your body in which you feel safe, confident, pain-free, secure.

Lo and behold, in my classes, people are able to move parts of their body that they hadn’t been able to move in years.

When we ditch the judgment (for real, not just lip service and platitudes); when we give permission to be wherever we are; when we find how we can do things, instead of trying to force ourselves to do things and creating storylines around why we can’t, then magic can happen.

There is something very sick about the alternative health movement. It is plagued with people who claim a benign “spirituality” that is in fact a dogmatic religion that encompasses shame and blame and that effectively silences the dissenters, because of the “Scrooge” type storyline embedded in any resistance – ie, if you protest what they say, it’s an indication of how angry you are, how your karma is all screwed up, or whatever.

Just yesterday I was in conversation with some people who were talking how angry they feel about this whole notion that children choose their parents – ergo, if you were abused, it was your spirit making the decision to get this set of lessons out of life. How different is this thinking from the thinking that leads Middle Eastern countries to stone to death girls who were raped, for the crime of being the victim of rape?

In my opinion, this thinking was introduced by people who did not feel the strength or ability to respond effectively to the overwhelming injustice in this world. Like the abused child who chooses to believe that the abuse is her fault, these people decided that we create our realities – ie, that we actually do have power over everything. And so, rather than focusing our attention on the matter at hand – working to bring light and justice to the world – we spend our lives busily trying to fix whatever is purportedly wrong with us inside, ie, whatever it is that is “attracting” the negative energy.

It is brutal thinking that leads to a whole slew of consequences, both blatant and subtle (including the assumption that pain is caused by emotional distress), that slows down and otherwise interferes with personal and communal healing.

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