Pain, Healing and the Spiritual Nature of Exercise & Avoidance

I'm still "In Pain's Classroom" and I've learned more about healing through the physical therapy process. I want to share some of these lessons and connect it to the courageous work the vets are doing in Menlo Park.

When I first injured my back, I wanted to avoid all pain because the intensity of the initial injury hurt so ridiculously bad. Any position that caused the slightest shock to my spine or discomfort in the lower back region was to be avoided all together. I couldn't take any more physical suffering; I'd hit my limit. I had been hurt enough and by God, there would be no more of that. For the next month or so I ritualized my life attached to the goal of pain avoidance. I made a discipline of stillness and holding my breath. I mentally recorded every possible and impossible posture and made decisions about where I could go and what I could do in accordance.

And then avoidance stopped working.

The positions that saved me from the primordial pain gave way to new aches and disfigurations. The muscles overcompensating began to cramp and swell. I was tired all the time from holding myself in unnatural positions. I couldn't stop taking the muscle relaxers because something hurt all the time. The muscle relaxers made me tired. The tiredness annoyed me. Vicious, stupid cycle. (I'm going somewhere spiritual with this...stay with me)

So I went to physical therapy. I opened to the idea that someone might have a better way and plan for my healing. This gentle, beautiful soul retrieved me from the waiting room. His degrees from Santa Clara University hung on the wall next to pictures of his baseball playing sons ages 4 and 7. He stood at 5'2, 2 inches shorter than me; he was quiet and methodical, asking questions about how it all happened, what hurts now, what I wanted to gain from PT, etc. He had me lay down on the table. He showed me a 20 minute regimen of stretching and strengthening techniques. "Do it everyday" he said with soft assertion. "Okay" i said, and then added "anything to relieve the pain." I left his office and noticed, when walking to my car, that my back hurt worse after doing that 20 minute practice session than it did when I walked into Kaiser. Damn. But the next day I felt worlds better.

Did I say "anything to relieve the pain"?

For the last 3 weeks I've been trying to stick to the routine. Truth be told: I can't stand holding those poses or the immediate physical sensations that follow. It hurts like hell. Some days I flat refuse to do them. Here's the kicker: the day after the day I chose not to do my PT, I pay a big price for my negligence. If I refuse to do my strengthening and stretching not only do I lose healing momentum but my primordial injury pain rears its ugly head.

Now begins the sermon...

I work at the National Center for PTSD. Every week I hear stories of primordial injuries and the aftermath. When people first experience a traumatic event life changes its ritual structure. Whatever ritual structure folks pick up, whether its pain avoidance, controlled pain exposure, or something else, there's a way in which the event drastically alters perception/behavior/relations/etc. Some people develop PTS, some don't. Those who do often find that what enabled them to move in the wake of trauma stops working. For instance many folks drink in order to decrease PTS symptoms but eventually self-medication turns into alcohol-dependence regardless of symptomology. Vexing and perplexing cycles. It's hard, once you've been injured or experienced trauma, to admit that your own coping mechanisms have turned against you. In fact, every time we get a new patient I'm astounded by the courage it takes for them to admit they need help. In essence, they are admitting someone else might have a better way and plan for their healing.

And it hurts worse before it gets better. In order to heal (which is a life long process) one has to drop coping mechanisms that have held life together and pick up new behaviors/actions heretofore unexplored. Risk. It takes risk. And it takes daily practice. Name your feelings instead of repressing them. Communication and socialization instead of isolation. Pray and meditate instead of engaging adrenalin-enhancing behaviors. "Do it everyday" we say with soft assertion. Those who do find reward. Those who don't usually feel relief in the moment and find drastic consequences in the near future.

Before this 3rd unit of CPE I knew little about the spiritual nature of avoidance. Avoidance of the good, even when it feels comfortable, leaves one wide open to the prolonging of pain. Exercising the good, even when it hurts a little, invests in a future of healing. Do it everyday and perhaps more importantly, make sure you have friends that praise your persistence.