Since 2006, I have also found the idea of a valued life goal is particularly important when I work with people who are struggling with the impact of severe chronic pain and their daily challenges of managing chronic pain.
For success in most areas of life we need to know where we are heading.
To change the impact of chronic pain goals for the future become very important.
Otherwise persistent pain can leave you completely engulfed by pain, morning till night, often keeping you awake at night unable to see any future.
Can a Vision Impact Longstanding Severe Chronic Pain?
I often describe the valued life goals, terminology that Peter O'Sullivan uses, as a vision. This sounds stronger and more aspirational!
We often hear of businesses and large corporations having a vision or a mission, such as the purpose of Coca Cola:
"To refresh the world and make a difference"
It's been doing that since 1886.
I Just Want To Be Pain-Free!
When new clients come to my clinic all they want is to be pain free. They want a therapist, any therapist to magically remove their pain. Sadly, after so many years magic is just not there.
Using my "Jean Therapy" philosophy and by both of us joining together to make changes, their pain can be reduced, sometimes we do find a little magic. One of those magic moments I'll describe later in the article.
One way that I encourage a client to talk about their future hopes and widen our discussion away from 'fix my pain' is the 'light at the end of the tunnel' metaphor.
However there are clients having so many challenges of managing chronic pain they no longer believe there is light at the end of the tunnel as far as their life, enjoyment and well-being is concerned.
Like the photo, too many clouds can fully obscure the beautiful mountain beyond
Worry about Pain can Cause Fear About Future
One client, call him Dave, when asked what his goal was for his journey with me said "there's nothing". He was depressed, just functioning on a daily basis after recovering, or almost recovering, full mobility following a stroke.
Depression Can Impact Chronic Pain Management Goal Setting
Dave decided "there's no light at the end of the tunnel", then he added "just blackness".
For that session we, probably more of me than him, decided to focus on just loosening a brick in the wall that blocked his life tunnel.
Two sessions later after loosening a couple of bricks, he admitted light was shining through. The main breakthrough came when we age recessed to when he went to primary school. He had a bad stutter. Although a clever student, school was torture because of his speech impediment.
Powerful Changes Happen After Finding A Future Vision
As an adult his stammer was minimal. We cleared memories, emotions and trauma from his past that had impacted his present health. Imagine my joy when his wife later told me, following treatment he was collected by a friend, socialising and restarting hobbies - something he hadn't done for years.
Rarely these days do I work with stroke survivors? But also kinesiology really improved his movement as well as his enjoyment of life. Whenever I see him now we laugh and he concedes the "tunnel of life", is no longer blocked.
Powerful Goals for Chronic Pain Relief
The idea of the blocked tunnel provides a way that’s easy to visualise and understand – ‘I’m stuck’! At the same time allowing clients to express or share the difficulties they feel on a daily basis. All without judgement. I believe in the need for a vision that can draw a person through the pain they have endured for months or years.
In the past years my clients have shown many times that finding, understanding and being aware of their blocked tunnel is game changing for them. A thoroughly well discussed, fully blown vision is becoming the most important key to my treatment.
To discover a motivating vision can be a difficult process for clients. They cannot imagine or have positive thoughts. Until we, often with much discussion, find a wish, an idea that can be transformed into a future vision.
What we often discover is mostly but not always completely unrelated to their pain enabling their pain the chance to subside.
Do General Everyday Pain Management Goals Provide Help - Maybe Not?
As I write this, I consider two things are important. First, just everyday goals or aims are insufficient. Goals such as:
Ø Being able to go back to work for half a day
Ø Walk to the shops
Ø Collect your children from school
Secondly, pain can be there due to the absence of vision in their life. As with Dave above chronic pain sufferers live or exist in a blank blocked tunnel. A visit to some of my client notes reveal diverse 'vision goals'.
Ø Find a new career
Ø Ride in a buggy with my children over bumpy sand dunes
Ø Return to study - something different they always wanted to try
Ø A long awaited holiday to their distant home country
This blocked tunnel idea could be the reason why medication, bodywork, exercise and meditation fail to noticeably impact on the severity of chronic pain conditions.
Vision of Long Awaited Holiday Begins Pain Reduction Journey
It's important not to underestimate the power of a goal or vision that is really relevant and meaningful for your client. The process of finding this type of goal requires the pain practitioner to form a relationship with each client.
This second example of a meaningful vision incorporated into treatment helped a woman who had trigeminal pain for 12 years. During COVID lockdown unable to get help she increased her medication taking 10 gabapentin (300mg) tablets each day, plus dosulepin and clonidine that some days made little impression on her pain.
How Her Vision Helped Severe Chronic Pain
Sarah's, not her real name, immediate family immigrated to New Zealand from Holland when she was a child. She struggled during her 20s, a mother, as a single parent of two children doing hard physical work to keep the family fed.
The tunnel analogy sits well here - I imagine tunnels in coalmines being dragged along in the dark, pushing through, surviving each day. Her thoughts and work fully focussed on her children. Again during treatment we were focused on de-baggaging the stress that accompanied the trauma she had experienced.
I remember the day when we started to talk about what she really wanted to do. That was to have one last visit to Holland with her daughters. Impossible due to lack of money and the chronic pain trap that kept her tired, worn out and still tramping one step at a time down the dark tunnel as she done all her life.
Pain Relief Begins: Pain Remission Starts: Pain Free At Last
From that consultation changes began to happen. The trip to Holland was just a wish, transformed into a vision that she brought into her mind, just thinking or perhaps seeing the streets and the places that had been her ancestry.
It seems that once this conversation happens, changes begin without really delving into or bringing up the vision, seemingly putting it out there lifts a black cloud or removes the plank from someone's eyes.
Both of these case studies illustrate the importance of recognising and releasing emotions. Emotions are an integral part of living with severe pain, particularly fear of what the future will be.
Also emotions that we have expereinced in life prior to injury or developing pain should be part of chronic pain that has not responded to treatment.
Everyday Pain Treatment Goals Not "Cutting the Mustard"
This brings up the goals that various therapists use, about getting back to work for half a day. Aaagh, how uninspiring and boring that sounds!
The idea of a vision can lift people, mentally, emotionally and then physical changes can happen. An interesting thing to note is generally, just me or another therapist will be the one with whom they share their vision.
The moral of the story, if you are struggling with the challenges of chronic pain is to start the search for a meaningful and motivating vision that can move you forward. And if you are a pain clinician reading this - help your chronic pain patients find a goal that has vision, not everyday functions - we all need our dreams!
The ideas and experiences in this article or those of the author and should not replace any medical advice.
However there is one piece of research that I found interesting that has some relevance to this article. It discovered the goals of patients and their primary care physician for chronic pain management did not match - that's a problem!
Henry SG, Bell RA, Fenton JJ, Kravitz RL. Goals of Chronic Pain Management:
Do Patients and Primary Care Physicians Agree and Does it Matter? Clin J Pain. 2017 Nov;33(11):955-961.
Jean Jordan - Naturopath
Want to find simple effective ways to reduce your chronic pain without increasing your stress and overwhelm? This is where I can help! Ideas can be found in the articles on my website. You can sign-up to regular blog or spend time using some of the collection of self-help techniques.
After over 20 years of having my own pain clinics I started Natural Pain Solutions to reach more people, rather than one person at a time. Therefore when I completed my postgraduate pain management studies I wanted to spread the word about holistic self-help techniques that people can use at home. Learn more about me here.
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