It’s different when the tables are turned. When I’m the one on the table as the patient, rather than being the clinician. Not that I ever really stop being the clinician, but it is a different experience. When I am the one waiting for results. When the pain is mine and the struggle is with my own brain.
The cornerstone of my clinical practice is getting better as opposed to your brain wanting to know what has happened. But, in the face of uncertainty, it is easy to fall into its negativity bias when nothing is familiar and fear enters the picture.
One third of acute respiratory disorders, 40% of GI disturbances, and 20% of cancer and autoimmune diseases are idiopathic in nature—meaning there is no known cause. When navigating the medical system, and also navigating your own brain and nervous system, this can add an extra layer of complexity and unease, as we are not comfortable in the pocket of entropy and mystery.
In the face of this, there are a few things to know about pain and our response to it:
- Pain is a defensive output. The brain is in the business of making predictions as a means of protection—using perceptions based on past experiences to lead us to conclusions and actions. But sometimes we need the right frame to be more holistically confident to engage with our environment and body. Inaccurate perceptions can lead to anxiety and confusion, but also to ill- advised action or inaction.
- Pain inhibits muscles, that is part of its protective mechanism; but, somewhat counter- intuitively, it also inhibits kindness and empathy. One would think that our own pain may make us more able to feel for others, but not while we are in the middle of it. It takes so much of our energy to deal with pain that we do not have the bandwidth for additional physical tasks or emotional stressors. So, try not to be a wounded hater.
- Sometimes the pain itself becomes too much and we become disembodied to disconnect and override the sensations. While this is a short-term solution, in the long-term it leads to the pain becoming chronic. There is a time when we need to accept where we are in the present, with confidence in our current state, versus trying to return to a previous version. I have been privileged that when I was treating patients my pain was more manageable and I was able to gain more trust in my body. Neuro rehab demands imagination that is not broken down into usual sets and reps, but involves problem-solving—the kind that is more difficult to do when the problems are your own, yet come more practically while working with patients. Yet, conversely, while I am obviously a proponent of accessing health services, as a patient I am finding there comes a time when we lose our self-agency. We are seeing the concept of spectrum show up in various areas of society, like gender and politics, and it can also be applied to our approach to health. Where at one end of the spectrum is over-management, at the other end is self-agency, we can find the middle ground where we continue to be active participants and decision-makers in our own process. As a clinician, we can be focused on being evidence-based and looking at outcomes; but there is a kind of qualitative calculus that exists when it comes to people’s challenges—looking at what is important to the individual and to quality of life.
When deciding what is important to you and what you need to do, that narrow bandwidth that pain creates can complicate things. At that point, when your focus is too broad, being able to shrink it down to simple tasks and focusing on getting better in one aspect of function makes it more manageable. For myself, being able to roll from one side to the other became a measure of progress.
Yet sometimes progress can seem miniscule and, when that happens, we need to focus on effort rather than outcome. To cut ourselves some slack—to not defeat yourself or feel defeated. To ask yourself if you are hurt or are you hurting, and to acknowledge that you can be hurting and still be anti-fragile. To manage the parts of your health that are still within your control.
But it is important to remember that healing is not linear and it requires courage to face the unknown. It also helps to have the emotional bubble wrap of clinicians and friends to maintain the belief you may lose with regressions, frustrations, and agitations. You need an ecosystem of people who believe in you and encourage you, while acknowledging that you sometimes need to be specific in indicating in the kind of support you need.
There is healing value both in asking for help and in helping others. When we learn how to be, then we know what to do. Life makes us all wounded. Let the healing begin.
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Dr. Tabrizi is a chiropractor, osteopath and a passionate member of both the local and scientific community, whose goal is to teach that the pursuit of optimal health and wellness is much more than being symptom-free. His practice is rooted in the philosophy of treating the person rather than just treating the illness or ailment. As a result of his interdisciplinary training, Dr. Tabrizi has developed a neuroscience-based therapeutic education approach to treating his patients, focusing on healing illness from a wider perspective, placing equal responsibility on patient as well as practitioner. Dr. Tabrizi aims to educate his patients and provide them with the tools and framework needed to integrate pain management and healthy living into the fabric of their everyday lives.