Module Four - Move with Joy
Part Two
Session 3 - Begin to Move with Joy
In previous modules you learnt that the pain you experience is created by your brain. In fact, for several weeks you have been incorporating the changes and using the techniques demonstrated in the videos.
Listening to the audios
Doing regular relaxation
Practicing neuron moments emotional release.
You will be feeling different about your pain or certainly have a different relationship with your pain.
However, starting to move and do exercise can be fearful and you require more help.
Client story.
A woman in her 60s had been making good progress and we were having a talk at the end of a treatment session. She had been sitting down beside my desk, now in the process of getting up to go home.
Watching her prompted this conversation.
“Why are you carefully moving forward in your chair” I asked.
“I'm getting ready to stand up. I have to move forwards in the chair because I know it's going to be painful” she said.
This prompted a short discussion which I call “expecting pain” or EP.
I explained that every time she was getting out of the chair, she was reminding herself that it was going to hurt, it was going to be painful.
As you've already learned if we keep sending messages to ourselves especially using the “P word” everything will get harder, and the pain will increase, strengthening that neural network in your brain.
Graded Movement - learning to move with joy
I'm going to use this example to demonstrate how you can begin to move with joy and change the neural pathways you have developed over the years with expecting pain when you move.
This is an introduction to what is often called graded movement.
At times a very difficult concept to understand and even harder to put into practice.
If we have a pain in the knee, it is incredibly hard to recognize that there isn't a pain in the knee, it is just a message in our brain. This is not what we have spent a lifetime learning!
Introducing Pain Reprocessing #1
Stay practicing this audio until you find your pain has lessened and stress or emotions has been released.
Introducing Pain Reprocessing #2
In this audio you will move from #1 to thinking about moving the painful part of your body as you real and release.
Part one of graded exposure to movement – imagining movement
Now I will introduce imagery movement - thinking about doing a movement.
This is interesting and often the key to those with chronic pain returning to natural movement. Imaging movement is when your brain is thinking about the movement, say, of lifting an arm or leg.
This movement involves the brain, effectively doing a bit of role play, without any actual movement of your limb.
As a consequence, imagining movement is one of the principles of not only discovering if your pain has neuroplastic symptoms but also a way to treat chronic pain.
So, let's use this example above of the lady getting out of the chair, the problem could be knee pain.
I'm going to explain a process called graded exercise or graded movement.
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The first step is to find a comfortable chair maybe the one you've been using for your relaxation for the past several weeks or months.
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Next connect with your slow breathing to put you into parasympathetic nervous system.
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Next you think about moving your knee (for you it may another part of your body that is painful).
Generally, what will happen with neuroplastic symptoms when you imagine or think about the pain you will feel the pain.
Generally, in the area where this pain lives though sometimes it may move to a different part of the body.
When you imagine moving your graded exposure begins. You breathe a long slow exhale and perhaps you bring in the skills that you have already learnt and found useful from earlier in the program.
With practice the pain level you experience with imagining by clearing emotions or by self-calming will decrease.
Sometimes this may happen quickly, sometimes it may take longer, and some days may be better than others. As whatever is happening in your life can influence your pain level.
Part two of graded exposure – beginning to move
When you have brought the pain sensations to a lower level with your imagery you may feel confident to actually do the movement.
For instance, it hurts when you stand up or it may hurt when you walk.
Now for most of this program you have been sending positive messages to say that your body is OK, or don’t worry brain “I’ve got this”.
You now know the pain messages are just coming from a somewhat mixed-up brain you have begun to retrain and to build positive neural circuits.
When you are ready to begin the process of returning to normal movement, it is done bit by bit and yes it may be painful.
As a consequence, have small training sessions at the same time have a really pleasant conversation with your brain to encourage it to be with you on a positive journey to bring more movement into your life.
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At the same time use your breath.
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Use your positive words,
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Slowly over time increase your movement and your exercise.
Positive effects on the amygdala and hippocampus
These changes in neural pathways, changes in thoughts brings us back to the amygdala from module two and three.
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Removing the fear of movement that causes the pain.
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Remember that alarm system, from the star diagram, we need to quieten.
We also need to learn that it is safe to move and to exercise and to return to the things you love to do before pain got in the way.
Also in module two, the hippocampus, the part of the brain to do with learning and memories, it too can benefit from exercise.
Session 4 - Restoring movement can take time.
If we have been in bed for several weeks with a virus
We've been unable to move because we have an injury
Our muscles notice the lack of use.
They can begin to atrophy in a very short time if not used.
Therefore, this change in muscles needs to be acknowledged when you have been in chronic pain for months or years, unable to move freely.
Often you do only a set group of exercises given to you by a physiotherapist, for a specific body part.
Many of the movements you do because chronic pain has caused you to restrict your movement,
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You're not as flexible.
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Your movement doesn't flow in the same way as it used to.
This restriction in movement will impact the health of your muscles, and hence your general wellbeing.
Once again, I bring you back to compassion and self-kindness. So that yes, when starting to do graded movement and graded exercise you have to remember you are asking muscles to do something they haven't done for a while so they're very likely to complain.
If you remember times when we have overused muscles in the past, when you didn't have chronic pain, they could get very sore.
Therefore, I'd like you to acknowledge that restoring movement to your body is just naturally going to cause some pain and stiffness that is not the chronic pain that you've had for so long.
Importance of movement to restore muscles.
Here is another important point.
We need to move.
I have an example of a problem with not moving muscles not exercising them enough.
The photo shows a man who had a right knee replacement but was not given sufficient rehab following his operation.
As you will see in the photo his right lower leg has less muscle than the other leg.
The reason I’m showing you this is because this program is about the need for holistic healthcare.
And one part of your recovery journey is to begin to move without fear and to be able to restore your body to fully function in all areas.