Hank's Pain
Introduction
‘Pain is no longer pain when it is past.’
(Margaret Junkin Preston)
‘Endure and persist; this PAIN will turn to good
by and by’
(Ovid)
The word pain is derived from Greek ponos and Latin paean. Pain is, without doubt, the most distressing common experience, yet it has no precise definition. Also, there is no specific organ that we can associate with pain. We don’t have a pain organ, although all organs can experience pain.
Pain has obvious sensory qualities, but it also has emotional and motivational properties. It is usually caused by intense noxious stimulation, yet it sometimes occurs spontaneously without apparent cause. It normally indicates physical injury, but it sometimes fails to occur when extensive areas of the body have been seriously injured. At other times it persists even after all the injured tissues have healed.
Man has been afflicted with pain since the beginning of evolution. As the records of every race are examined, one finds records of the omnipresence of pain. In every civilisation and in every culture, prayers, exorcisms and incantations are found which bear testimony to the dominance of pain.
It is natural, then, that since its beginning mankind should have been engaged in its quest to find ways of controlling and eliminating it. To the present day, we have managed to find some methods of eliminating some types of pain, or reducing it, or managing it. We have even developed some concepts that help us to understand it.
During the course of this book, I will show some of the giant strides that we can take to understand it more, to at least reduce most types of pain, and even to eliminate pain that has defied all other forms of treatment.
Probably the earliest attempts at managing pain included physical therapeutic methods, like rubbing or massage or exposure to cold water from streams and lakes, or using the heat of the sun and later that of fire. Pressure was also used to benumb the part to lessen pain.
When primitive man could not relieve his own suffering he called on the head of the family, very often a priestess or sorceress, or a medicine man. As the centuries rolled by, man’s idea of the cause of pain underwent a change. With the origin of Christianity, a new concept of pain relief based on divine healing through the laying on of hands and prayer – still very strong today.
In addition to prayer, priests employed natural remedies consisting mostly of medicinal herbs. The use of herbs came to us from ancient times, before recorded history. They had been used by primitive man, who had experimented with various plants as foods, discovering that some of them were helpful in relieving pain. Their use was gradually taken over first by the priest, then by the medicine man, and then by the early physicians.
We’ll be discussing the merits of different foods, some of which can induce pain, others which can be helpful in reducing pain.
The use of analgesic drugs derived from plant life was prominent in all ancient cultures, using such plants as the poppy, hemp and henbane. The hundreds of years of the Middle Ages contributed comparatively little to man’s knowledge of alleviating pain. The Renaissance engendered a great scientific leap that made many remarkable advances in science, particularly in chemistry and physics. But it hardly made any contribution to the relief of pain.
The new era of analgesia began in 1772 with Priestley’s discovery of nitrous oxide. This period was culminated by the first public demonstration of surgical anaesthesia at the Massachusetts General Hospital in Boston in 1846, by Morton. In 1817 Frederick Sertuner has published his paper naming the new alkaloid of opium after Morpheus, the Greek god of dreams. The importance of getting pure crystalline drugs from previous crude and uncertain mixtures was eventually realised, and very soon after other opium alkaloids were isolated.
The chance findings of the pain relieving properties of Willow bark by an 18th Century English village priest named Stone was one of the beginnings of finding better analgesics. Acetylsalicylic acid, known as aspirin, is still widely used, often as a first choice pain remover.
Synthetic chemistry began to produce narcotic analgesic compounds that proved to be equal, if not superior, to the natural opiates. Inhalation analgesia and anaesthesia was being introduced into surgical practice, and another method was being initiated in France, the USA, Ireland and Scotland: the introduction of the metallic hollow needle in 1843 and the syringe in 1853.
The isolation of cocaine in 1855 was a milestone in the conquest of pain. Many primitive people of South America, Africa and Asia were already aware of the use of coca leaves for the relief of pain of the larynx and pharynx.
The 19th Century produced yet another great advance in the conquest of pain by surgical methods. As soon as it became possible to operate without fear of infection a number of surgeons throughout the world independently began to attack the age-old problem of pain by permanent interruption of its neural pathways.
After the discovery of X-ray by Roentgen, deep penetrating roentgen rays were employed in the treatment of severe and persistent pain. The place of X-ray therapy in the treatment of pain of carcinogenic origin is still in extensive use.
The entire concept of the mechanism of the feeling of pain has changed recently. Melzack and Wall discovered the Gate Control Theory of Pain. Basically, the theory of pain proposes that a neural mechanism in the dorsal horn of the spine acts like a gate that can increase or decrease the flow of nerve impulses from peripheral fibres to the Central Nervous System (CNS). This theory coincides with the acupuncture treatment of pain.
In 1973, Snyder and Pert found out during their researches on drug addiction that there are some clusters of cells in the brain that attract narcotic drugs. They termed these cells as opiate receptors. The cells were used by the body to attract natural enkephalins that bring relief of pain.
The latter stages of the 20th Century saw developments taking place within Alternative Medicine in very interesting, novel, and effective ways. We’ll be charting these new concepts throughout this book.
Of course, I could have given a more account of the history of pain, like this:
“Doctor, I have an ear ache.”
2000 B.C. – “Here, eat this root.”
1000 B.C. – “That root is heathen, say this prayer.”
1850 A.D. – “That prayer is superstition, drink this potion.”
1940 A.D. – “That potion is snake oil, swallow this pill.”
1985 A.D. – “That pill is ineffective, take this antibiotic.”
2000 A.D. – “That antibiotic is artificial. Here, eat this root!”
1
Functional Neurology and the
Mechanisms of Pain
We used to think about what pain is, how the body perceives it, how we can treat it mechanically and chemically. At the risk of oversimplifying this, let me give you the conclusion first:
‘If there was no pain there would be no doctors. The relief of pain was the prime objective of the doctor to improve his patient’s quality of life. And since pain is experienced as an emotion, pain removal becomes an important mental goal in improving the quality of life.’
Patients probably go to doctors more commonly for pain relief than for any other reason. The average patient says, ‘It hurts here, it hurts there. Give me something to stop the pain.’ Pain is what primarily brings them to the office. Pain, discomfort, and dysfunction. The doctor is judged, oftentimes, by his success in relieving pain.
It’s often considered that the best pain explanation we have is the Melzack Wall Gate Theory of Pain, which I touched on in the previous chapter.
These were two researchers who came up with the theory of a spinal gate concept of pain, and basically what they said is, there’s a spinal gate that switches back and forth from the large neuro-fibres to the small neuro-fibres. And pain is produced when the gate switches to one direction and pain can be relieved when you can get the gate to switch back to the other direction. And it doesn’t matter which position it was in to start with.
Part of the explanation is that when you bump your knee and it hurts like crazy, you can rub your knee and make the pain diminish – because the rubbing sensation goes to the brain on a different nerve fibre than the pain sensation – that diminishes the brain’s sensation.
That has been the main pain explanation for many years. But even at best, it was just a theory.
Now, other researchers are saying that’s a bunch of baloney. That’s not the way the body perceives pain.
In the opening paragraph of this chapter, I gave you the conclusion of an article. The opening sentence of the article is, ‘The Malzack Wall Theory of Pain is dead.’ Long live the new neurology of pain.
So what is this new neurology? You understand that we have all kinds of nerve endings in our body and those nerve endings measure temperature, pressure and sensation. We have special sensations in our body that measure sound, hearing, taste, smell and vision. But you notice there are no organs specifically for pain only. There are no nerve endings for pain only.
You cannot pinpoint a certain place in the body and say ‘this anatomical structure right here is for the purpose of registering pain.’ We don’t have pain nerve endings, or a special sense for pain only.
So the most revolutionary thing I’m going to tell you is that pain is perceived in the emotional part of the brain. In the frontal cortex of the limbic system.
What does all that mean in common language? It means, pain is an emotional experience.
An emotional experience that can be brought about by several different methods. But if it is an emotional experience rather than a cut and dried physiological process (a switch flipping from one position to another position), it greatly changes our approach in the way we treat it, and how we perceive it.
You understand that you have to have a new concept about something before you can deal with it. And how you deal with it depends on your concept of it.
So, to summarise what I’ve said so far, it boils down to this: we experience pain, we are aware of pain, but technically we do not sense pain. And I don’t want this to be a play on words only. We do not sense pain like we sense hearing or sight. We experience pain, we are aware of pain, and pain results in an activation of certain neurons in the brain – in the area of the cerebral cortex of the limbic system.
Let me jump ahead and give you an example. Don’t we all know of experiences that we have either heard of or had ourselves? Where people have been subjected to some kind of trauma where they should have been in immense pain? Like the soldier on the battlefield who got his arm blown off and he kept walking – he didn’t even know his arm was missing! How can we explain that? That’s proof right there that the body is more powerful than just a pain being an automatic phenomenon.
Pain is experienced, we become aware of pain, but there are certain requirements for us to become aware of it. And if these requirements are not there then we’re not aware of it.
Pain is experienced through several methods.
One is a mechanical deformation of the sensory nerve endings from physical sources, such as trauma, pressure, a pin prick. In other words, these nerve endings can become physically deformed by some type of trauma that can alter the nerve ending which sends a message to the brain, and we become aware of pain as a result of that trauma.
Another way we experience pain is a chemical reaction. In other words, the nerve endings can become depolarised – which means activated by a chemical reaction. The reaction could be thermo-stimulation, but most often it is due to a chemical change.
To simplify it, there are basically only 6 chemicals that can cause this. And 4 of these chemicals are the result of inflammation in the body. Inflammatory responses. The other two are the result of muscular fatigue.
In other words, muscular fatigue can cause the production of chemicals that can lead to a depolarisation of the nociceptors.
These are the 6 chemicals that are in the body that are capable of depolarising the nociceptors:
· Histamine
· Prostaglandins
· Kinins
· Serotonin
· Potassium ions
· Lactic acid
Three of these chemicals, histamine, kinins and prostaglandins are also neurotransmitters.
What I’m saying is that if we can control these substances in the body we can control pain.
So the new functional neurology of pain is now something that we can sink our teeth into, that we can do something with. With the Malzack Wall Theory we were helpless most of the time. There was no effective way of preventing the spinal gate flipping back and forth – although acupuncture did offer some relief.
Now we can do something about this.
If our goal is to control pain, we have to consider all aspects of the generation and transmission of the nerve impulses that result in pain. And that would include an evaluation of the body’s chemistry to determine if there’s a chemical basis for the pain.
Doesn’t all this sound like an over-simplification of pain? Of course it does, and you’re quite right if you thought it. I agree with elements of this new concept, but it doesn’t take into account other things that we know about pain.
I’m going to discuss a whole lot of different issues throughout this book, but we have to start somewhere, don’t we? Let’s take a different view now.
Pain appears to have 3 components:
1. a stimulus, physical or mental
2. a physical sensation of hurting
3. the reaction of the person experiencing it.
Before we can offer any kind of treatment we have to make a number of assessments based on what a person tells us, any behaviour responses we can observe, and some knowledge of the physiological, psychological, cultural, environmental and nutritional aspects of the individual patient.
We can learn most of that from asking the right questions, and I have prepared a questionnaire that I developed for patients at my Pain Clinic in London. It is reproduced in Appendix B.
Let’s take a look at the functions of pain.
1. as an adaptation for protection against injury
2. to inform us that something is amiss
3. as an indirect aid in the repair and replacement of damaged tissue.
With regard to #1, because of pain we may decide to move away from the painful stimuli, or we may learn to prevent a recurrence of the injury.
In #2, slight pain warns us of slight damage, which may then be attended to before more serious damage results – i.e. pain tells us that a tooth is decaying, and we attend to it before an abscess forms. Pain not only warns us of trouble but often tells us where the trouble is, i.e. tells you which finger has a splinter in it. It is also one of the most important symptoms of disease, and we can learn a great deal from knowing exactly what type of pain is present and where it is located.
In #3, rest is often the best single aid to healing. Pain often enforces rest; if severe enough, it may impose absolute rest in bed, or merely enforce rest of the injured part, i.e. it immobilises a broken arm, facilitating the growth of new bone, which heals the fracture.
Pain has various characteristics, e.g. there may or may not be damage to body tissue when pain occurs. The pain of grief can cause mental suffering that does not involve tissue damage. The amount of pain is not necessarily in proportion to the amount of damage occurring in the body.
Some people experience the pain of anticipation, e.g. the misery of anticipating pain when the dentist is about to drill and repair a cavity. People also view pain differently, e.g. some may wish to be thought of as brave and sturdy, and may therefore describe their pain casually as though it hardly existed, even when it is considerable; another person may show great concern and anxiety when the pain is minor. In other words, we can’t always make an accurate assessment based on a patient’s own description.
A patient may experience any one or all of the following phases of a pain experience:
1. the anticipation of pain
2. the sensation of pain
3. the aftermath of pain
In helping a person cope with pain we need to recognise which of the above 3 phases he/she is in. Ideally, we can help most when he/she is in the first phase, since we can begin to condition him/her favourably for the other two phases.
When a person has pain, he/she usually exhibits non-verbal signs, which we should be able to recognise; a person may frown, grimace or cry; he/she may pace the floor, grip onto a bed or chair, or clench jaws or fist; he/she may show signs of anger, fear, frustration or worry; or there may be tense, firm muscles in the affected area.
There are also signs that the patient cannot control; pulse and respiratory rates will increase, blood pressure may be elevated, or he/she may faint; the pupils might become dilated.
Then there are the types of pain. The accompanying brief descriptions might help us to quickly understand the nature of a patient’s description:
1. sharp – quick, sticking, intense
2. throbbing – usually from an inflammation, adjacent to an artery
3. dull – not as intense or acute as sharp, possibly more annoying than painful
4. diffuse – covering a large area
5. shifting – moving from one area to another
6. intermittent – coming and going
7. boring – of an excruciating nature, usually in a bone
8. gnawing – severe type of pain, usually that of a tumour invading surrounding tissue
9. aching – over-action of a weak part or muscle
10. spasm – like a ‘stitch’, caused by violent exercise
11. griping – agonising pain, caused by irritation of bowels, bile-ducts, ureters, etc.
12. burning – certain types of dyspepsia, due to the action of excessive acid, gastric juice, and burns of skin
13. referred pain – experienced in part of body that is not the place of injury or disease, e.g. people with gallbladder disease often complain of pain in upper back or shoulder
14. phantom pain – pain felt in an amputated extremity (which proves that pain can be felt without having tissue damage and without nerve roots from the painful area to the brain)
15. vascular pain – very severe pain arising when the blood supply to tissues, especially with muscles, is cut off
16. headache pain – because it is such a common symptom in so many diseases, it would be of little value to list all the causes here. There is a special chapter on this subject. Certain diseases, however, have headaches as a presenting symptom, and these include:
all forms of meningitis and encephalitis
cerebral tumours, abscesses and aneurysms
diseases of the nasal and paranasal
sinuses
hypertension (in some cases headache might be slight)
migraine.
2
Types of Pain –
Organic & Psychogenic
It is often claimed that organic pain (OP) is always additionally complicated by psychogenic factors. While this may be so as a consequence, it is not necessarily valid as a cause.
Some, but not all, organic disease (OD) is accompanied by pain. Leaving aside the question of whether we are going to offer any treatment for the disease itself, we should nevertheless be able to offer treatment for the pain and also for the individual’s attitude towards the condition.
Examples of OD that have been successfully treated by some of the techniques to be discussed are:
· cardiac disease, in which many sufferers have terrifying expectations, which may lead to a complete domination of the physical condition by the anxiety neurosis which has been created
· diseases of the joints and bones, which frequently carry a heavily influencing psychological element, as does
· carcinoma and sarcoma
· multiple sclerosis, whose symptoms are so emphatically riddled with psychogenic factors
· intestinal diseases, in which the influence of the psychic element on secretion of the gastric juices is very strong
· gynaecological diseases, such as leucorrhoea, menstrual troubles, hyperemisis gravidarum have a strong psychogenic elements, as does vaginismus
· bronchial asthma
Many experiments have been conducted on animals to test whether endorphins and enkephalins (pain-killing hormones produced in the brain) can be artificially stimulated and released. While this has been successfully done on rats, mice and cats, it must be remembered that when applying the same concept to humans we have to take into account the complex psychological factors that surround pain.
It is useful to think of pain perception as a complex interaction between the physical stimulus that causes the pain and the psychological reactive component to it, sometimes called the ‘hurt’.
In most clinical pain situations, the physical component fortunately is not so severe that it saturates the entire perceptual channel, leaving no room for the reactive component, the hurt. When the physical stimulus causing pain is that intense, it often leads to surgical shock, or other kinds of unconsciousness. Should the patient retain consciousness with an overwhelming physical pain – e.g. passing a renal stone, suffering acute pancreatitis, or receiving a crushing blow to a limb – psychological factors are of minimal importance in controlling the pain. However, in most clinical pain situations, the reactive component is important and provides greater flexibility in the perception of the pain.
A classic example is to compare soldiers wounded in battle with a matched group of surgical patients in a general hospital. Beecher (1966) found that the soldiers reported minimal pain and rarely requested pain medication – even when faced with appalling physical injuries – whereas the surgical patients demanded drugs for pain relief.
The soldiers were grateful to be alive and wished to remain as sharp and alert as possible in order to continue being alive. They also saw it as a way out of the war, since they would expect to be repatriated home. Consequently, they processed their pain stimulus very differently from the surgical patients, to whom pain represented an interference in the flow of their lives.
Treatments
There is a wide range of remedies available, including drugs, homeopathic remedies, herbals, VibroFusion, and others. Some of these will be given in Appendix A.
In this section, I want to discuss hypnosis, which I have always found to be particularly helpful in relieving many types of pain, including very severe pain.
Before inducing a trance, or giving any other kind of ameliorating treatment, it is often useful to put the patient through a short lesson in pain perception. This exercise impresses upon the patient the fact that he/she can control his perception of pain by controlling both muscle tension and the amount of attention that he/she pays to pain:
‘If in addition to the original pain you have, you react by tensing muscles around the painful area, the muscle tension alone can produce more pain. You are thus inadvertently producing even more pain than existed in the first place, as you try to cope with the original pain.
‘To make this clearer, make a tight fist, stretching your arm out straight. Now make a fist 3 times greater than that, and concentrate on the pain you feel as a result of this muscle tension. Now, let the fist open and notice how the pain from the muscle tension dissipates.’
The second part of the lesson is to ask the patient to produce pain in a different manner:
‘Now pinch the web of skin between your thumb and forefinger until you feel pain. All right, now stop, and let the pain go away. Now try it again, the same way. Only this time, look at that painting over there on the wall (or any other object in the room) and tell me what you think the artist was trying to say.’
Ask the patient in which of these 2 experiments he/she experienced the most pain. Patients, as a rule, will experience more pain in the first experiment, because in the second exercise their mind was distracted by focussing attention on the painting (or object).
Pain Tracing
Because organic pain sensations sometimes come and go (intermittent) or may be some distance away from the actual location of the injury or disease (referred), it is useful to locate the real source (pain epicentre).
We can do this by inducing a trance and then asking patient to put an index finger firmly on the point where pain is felt – without applying pressure – and counting up to 10. If pain has moved, then patient again places finger of other hand on new pain point before moving first finger, and again counts up to 10. Repeat this as often as necessary until the pain ceases to move to another place. This final place is the epicentre, from which the pain is emanating.
Glove Anaesthesia
This is an old technique, but one which has been very effective in diminishing or even removing pain.
After the induction:
‘Imagine yourself sitting in a dentist’s chair. Picture the lights in the room, the feeling of the chair, the smells and sounds of the dentist’s surgery. Remember the time when he injected some novocaine into your gum? Remember how quickly it removed any pain sensation you’d had?
‘Try now to re-create that feeling of the pressure in your gum and the gradual numbness spreading throughout your jaw and cheek. Feel your cheek getting more and more numb, that numbness spreading throughout your cheek and mouth.
‘Now, when you are ready, let your hand float up and touch your cheek and feel how numb it is. And as you feel that numbness, let the numbness spread from your cheek to your fingers, so that your hand begins to feel numb.
‘Then let your hand float over to touch that part of your body in which you feel some discomfort, and let that numbness spread so that it becomes a filter through which you experience discomfort, and you learn in this manner to filter the hurt out of the discomfort.’
The patient is instructed not to fight the pain, but to focus upon the numbness instead. In this manner he/she is simultaneously distracting away from the awareness of pain. The subject uses intense hypnotic concentration to focus on a comforting sensation. At the same time, he/she uses the constriction of peripheral awareness to ignore the hurt associated with the pain.
This concept of combined awareness of numbness and pain, of filtering the hurt out of the pain, is a formula that enables the patient to acknowledge the presence of pain, and at the same time be aware of something else – the numbness. This is a kind of parallel or dual awareness.
There are some patients, unfortunately, in whom the thought of a dentist’s room and gum injections, serve to create additional fears and anxieties – to the extent that they are unable to relax. So it is usually beneficial to ask in advance how they feel about dental situations. The advantage of using the gum injection, of course, is that for those who have experienced it, it is a memory of numbness that they can easily recall, hence its effectiveness.
For those others who hold too much fear of dentists, or may never have experienced a local anaesthetic, there is another method of Glove Anaesthesia:
‘Picture yourself standing in front of a gas stove (or electric or wood). On a table to the left of the stove is a pail of icy cold water. Standing on the stove itself is a pail of warm water. You can see these pails in front of you. As soon as you can see them, nod your head (wait for nod). All right, you see them clearly now.
‘Dip your left hand into the pail of icy water. Plunge it to the bottom. As you probably know, salt water can become colder than fresh water before freezing, and so the water into which you have plunged your hand is actually below the normal freezing point of water, so far as temperature is concerned. It is below 32 degrees Farenheit. It is colder than zero degrees centigrade.
‘Your hand is now extended to the bottom of the pail of this extremely cold water. At first your hand feels very cold. But then it begins to feel numb, numb and insensitive, numb and unfeeling. Just leave your hand there as it becomes more and more numb. Soon it will become so numb that it will lose all feeling.
‘Now, while your left hand continues to get more and more numb, plunge your right hand into the pail of warm water. As you do so, you begin immediately to feel the warmth creeping through your flesh. Now, I’m going to turn the heat on under the pail of warm water, and make the water hotter.
‘While I do this, the icy water remains colder than ice, and your left hand becomes completely numb and insensitive to all feeling. Now the heat under the pail of warm water is making that water hotter. As it gets hotter and hotter, your right hand is going to become very sensitive. You have had a burn at some time in your life, haven’t you? (wait for nod) The burnt spot was very sensitive to touch, wasn’t it? (wait for nod) As the water gets hotter, your hand is becoming very sensitive. Your right hand is becoming more and more sensitive, and soon it will reach the point where you can no longer stand it.
‘When you can no longer stand it, say ‘Ouch!’ right out loud, and pull both of your hands out of the pails. (wait)
‘Now your hands feel very different. Your left hand is cold and numb. It is completely insensitive and without feeling. Your right hand is very sensitive, painfully sensitive. And you are using your sensitive right hand to determine the exact spot on your body that has been experiencing so much discomfort lately. Place your fingers right over the spot where you have this discomfort. (wait) Good.
‘Now place your cold and numb hand over the exact same spot. And as you do so, removing your right hand, you can become aware of all the numbness leaving your left hand, and that spot of discomfort is becoming intensely cold and numb. And as it becomes more and more numb, so you can notice that the discomfort that you experienced before has just about gone. And your left hand can drop away as soon as the discomfort has left and you have transferred all the numbness to that spot.
‘And both your hands are returning to normal now. Your left hand has become warmer and your right has become cooler, less sensitive. Both hands have now become normal, but that other part of you that had some discomfort has now become cold and numb, and the feelings of discomfort have gone.’
The Glass Case
This is another technique, also involving hypnosis. After the induction:
‘As you relax more and more with each breath you are taking, so you can see, there in front of you, a glass case. And you can put inside that glass case the part of you that is experiencing discomfort. See it right inside the glass case, and as you continue to look at this part of your body inside the glass case, so you can see a white substance – perhaps a gas, or a liquid, or just light – begin to flood inside that glass case.
‘And as that part of your body inside the glass case becomes totally immersed in this white substance, so you can become suddenly aware that the discomfort you have been experiencing has lifted. And as soon as it has completely gone, or has become reduced to a level that is satisfactory to you, then you can just return to me in this room and open your eyes, feeling wonderfully relaxed and better in every way.
‘And the wonderful thing is that if the discomfort should return, all you need do is sit quietly, just as you are sitting now, and as you take a few nice deep breaths, allowing the breath to go all the way down into your stomach, so you will experience this wonderful relaxation radiating throughout your entire mind and body.
‘And then you will see this glass case suspended in front of you, and you will place that part of your body that is experiencing discomfort inside that glass case, and you will watch as the white substance enters through the top of the glass case, and completely bathes your part with this white, purifying, cleansing glow.
‘And when the white substance has removed or diminished your discomfort, all you need do is count from one to three, and as you count from one to three you are opening your eyes, and you are feeling absolutely wonderful – on top of the world. So happy and relieved, and relaxed.’
Why hypnosis often works in the elimination of pain is that the subject becomes relatively inattentive and unconcerned about all stimuli to which the therapist does not specifically refer.
It should also be noted that any patient suffering from OP or any chronic pain might also have a secondary depression condition, and this might need to be incorporated into the treatment as a matter of urgency.
We also need to consider that physical ill-health is very often a means of defence against internal conflicts. It is not therefore necessarily a simple condition that needs to be got rid of; it may have an important, positive role to play. We will consider these aspects under Psychogenic Pain.
There are many other techniques for dealing with OP, some of which involve the use of Kinesiology. If you are not aware of the various types of kinesiology available, I’m sure you will be able to find a local kinesiologist able to help you.
Some of these methods are:
· Trauma Delete
· Homeostatic Set Point
· Autonomic ‘stretch’ points
· Trigger point therapy
· Dermatomes as therapy
And, of course, there is Pulsed Electromagnetic Therapy, which has nothing to do with kinesiology, but which I have used effectively even on such chronic pain conditions as those caused by cancer and arthritis.. There are practitioners who use this type of therapy, and there are also manufacturers who produce a home-use electromagnetic gadget that you can purchase.
Psychogenic Pain
It is important to realise that if a person has pain in his/her body it very often masks pain in the mind. Most human beings shrink from pain and, ultimately, they shrink from mental or psychogenic pain (PP) even more than from organic pain, or bodily pain.
There is a strong tendency to endure, and get used to, and if possible, ignore and forget whatever causes pain while going on living with it. It is as if humans secretly hug to themselves and fear to lose whatever it is that acts as the fundamental cause of PP.
It is often unwise to rid a person of a physical complaint if there is any reason to suspect that it is psychogenic. It may turn out that the bodily disturbance is an escape from, and a protection against, a much more intolerable mental disturbance. That is why, often, people who are cured of one physical ill are liable to quickly develop another one in its place.
Every practitioner comes across people who are hypo-chondriacal, always over some imaginary complaint. If you succeed in reassuring them about one, they merely invent another. Their friends lose patience with them after a while, and one may feel inclined to blame them as being over-indulgent and self-pitying, and accuse them of seeking sympathy. But clearly, such people have a compelling need for a bodily complaint to attach their anxiety to.
Since the physical complaints of hypochondriacs are not real, they cannot be the source of the anxiety from which they suffer. They have to invent a bodily scapegoat to lay their burden of anxiety on, otherwise they will have to face the acute mental pain of conscious awareness of their real trouble.
Before an attempt is made to drive people out of their hypochondriacal defences, or to ‘cure’ them of a genuine though psychogenic illness, it is necessary to know whether their real anxiety is of a kind which it is possible for them to face.
Not all organic disease is psychogenic, but more and more diseases are now coming into the class of psychosomatic disorders, where organic illness is linked to mental and nervous tension.
On the one hand there are the hysteric aches and pains, backaches, neuritis in limbs, headaches, and even paralyses. On the other hand there are the general anxiety-symptoms such as palpitations, perspiration, indigestion, tremor, leading steadily on to the far more serious psychosomatic group of diseases such as gastric and duodenal ulcer, sinusitis, glandular disturbances, asthma, eczemas, heart conditions, and so on.
Behind all these ailments of the body lies mental pain. Serious disturbances that are not psychogenic may still give a much-needed respite from mental pain.
I once had a Jamaican visitor on a stand at a health exhibition I was attending who was blind in both eyes. He asked if could help. I looked carefully into both eyes and observed that the pupil of his right eye had misted over and completely disappeared. The pupil of his left eye, however, seemed normal. He explained that he’d had a sight problem in his right eye some years earlier and had gone to an eye hospital. They injected directly into the right eyeball, but his sight had never recovered in that eye. A few years later, he experienced a similar sight problem in his left eye and he once again went to the same eye hospital. They wanted to inject into the left eyeball, which he declined. Within minutes of leaving the hospital, he lost all sight in the left eye, which had not recovered up to the time I saw him. I said I didn’t know if I could help but I could try. Working on the basis that the loss of sight in his left eye could have been brought on by fear of the injection – what we could call hysterical blindness – I gave him some hypnosis. Within minutes, his sight had returned in the left eye and he left in a kind of daze. I never saw or heard from him again, so have no idea if the return of sight had persisted or not. I can only hope so.
The optimistic ideal of the progress of allopathic medicine and the discovery of more and more ‘wonder’ drugs, until all physical illnesses and pain is mastered, is a total fantasy.
The fact is that the more progress allopathic medicine has made, the more psychological illness has been unmasked and forced to the front.
Physical illness, for many people, cannot be dispensed with until we have found out how to rid the human mind of its stores of unconscious repressed anxiety. Where that mental pain is so severe that the sufferer cannot cope with it if it is drawn into consciousness, then it will be repressed and turned into physical pain that is easier to bear than PP. Or else it will be dammed up behind one or more of the other defences that we’ll be examining.
Often, therefore, it is not simply a question of getting rid of bodily illness per se, but of whether we can give a patient something better to put in its place, either as a defence against, or more radically to bring about a reduction of, mental pain.
There are many people who have been so harshly dealt with in life from the start, their personalities are so deeply disturbed emotionally, and their minds at deep unconscious levels are so occupied by bitter conflict-situations in which unsatisfied need, fear, hate and guilt are constantly aroused that they have little chance at all of ever being fully healthy, happy, creative and well-adjusted.
One of the major factors barring the way to major changes of personality is that the breaking up of rigidities of personality based on repression and other mental defences can expose a person to so much mental pain that he cannot or will not stand it alone. And every therapeutic effort to reach the core of his/her problem is blocked by stubborn resistance.
Fear can become terror, guilt can become intolerable dread of punishment, and the morbid fear of having committed an unforgivable sin, anxiety and apprehension can become utterly paralysing, grief and depression can become crippling melancholia – just as anger can become destructive rage.
These, then, are just some of the factors that lie behind PP. We obviously need to tread very cautiously in our attempts to deal with it because we can never know in advance exactly what lies behind all the obstacles and barriers we meet along the way.
It is by no means generally understood that all humans live in two worlds at the same time: an outer material world and an inner mental world. And that these two worlds do not always coincide or act in harmony. Most people today are verbally familiar with the concept of the unconscious mind (U/M) but they have little feeling for its reality – for the simple reason that it is unconscious. It plays no obvious and open part in our everyday life, until one learns to recognise the signs of its presence and power.
In this hidden region lies the ultimate cause of mental suffering and pain. If we want to try and ease or ameliorate PP we can only do so by using methods that enable us to transcend our own conscious awareness and reach inside the unconscious.
In Kinesiology, we have a few methods that enable us to bypass such things as conscious and unconscious minds as though they don’t exist. They are, after all, only concepts, originally laid down almost as Natural Laws by psychoanalysts like Sigmund Freud, Carl Jung, and Alfred Adler.
One of these treatments, demonstrated in Appendix C, is called Trauma Delete. Not every kinesiologist is aware of this technique, however, and it might be a good idea to ask a therapist if he/she is able to give this treatment before making an appointment. As to its efficacy, I can only say that I have demonstrated this method in front of huge audiences – 5,000 or more from all over the world – inviting anyone with any pain to come up and be treated. In the 20 or so years that I have used this technique, I have NEVER had a single failure. Not one. I have resurrected the careers of Olympic athletes who had been told by their medical doctor they would never compete again, and countless thousands of other sufferers. I even completely removed pain – in front of a huge, standing-room-only, audience and videotaped – from a young Chinese lady who had broken her foot only that very morning and had been in terrible distress.
So, the treatment works, but please make sure you go to a kinesiologist who is able to do it. It is described, from start to finish, in Appendix C. It is, without doubt, the most effective treatment of most types of pain. And it usually takes no more than a couple of minutes. With an audience of 5,000, it takes little imagination to consider how many people would make the trip up to the podium for treatment – and I never left any hall until everyone who needed treatment got it. So it’s very fast and very effective.
Let me tell you briefly about another case I had, a lady from Switzerland named Ursula. At the age of 12, she had smashed through an unseen glass door. Her right leg had been horribly gashed, but the mental pain was far greater. When I used my technique on her – 32 years later – we discovered that the real pain she’d suffered throughout all those intervening years had been because her parents had not been at home at the time. It was a neighbour who had heard her screams and rushed her to hospital. She told me a few days after the treatment that when she’d had a bath on the evening of the treatment, she could feel the warmth of the water on her right leg. It was the first time she had felt warmth since the accident had occurred. Although she’d been able to walk perfectly all right, she’d never had any sense of feeling down that leg. Until my treatment! 32 years later!
That’s one of hundreds – probably thousands – of cases I could tell you about. But hey, let’s worry about your pain, OK?
Treatments
We usually think of all pain as being conscious. After all, if we’re not aware of it how can we have any pain? Which is about as naïve as assuming that the ice you see pushing out of the water is the extent of the iceberg.
Most practitioners have probably, at some time, examined a badly swollen arthritic joint, of which the individual has declared no pain whatsoever. A really good test of this – for hypnotherapists only – is to obtain an ideomotor response (IMR) and ask if there is any subconscious pain in a particular joint.
Subconscious pain, unlike most other types of pain, usually acts in accordance with hypnotic suggestions to evaporate away. A common side effect of this is to create a ripple effect which tends to ease away conscious pain in surrounding muscles and tissues.
Restructuring
One of the most effective and, therefore, one of the most important techniques for dealing with PP, because of its versatility in manoeuvring the mental processes that control pain. But it does have a basic requirement: the establishment of a multiple IMR. Having established that, one can proceed:
‘I want you to go to that part of your U/M responsible for the discomfort you have been having in your ………. (name part with pain), and as soon as I am in contact with that part just allow your ‘yes’ finger to lift up so that I will know. (wait) Good. And the first thing I want to say to that part is to thank it for using the discomfort in your …………. (name part) to draw your conscious attention to a need for action.
‘Although this discomfort has served a very useful purpose in the past, I’m wondering if that same useful purpose is still being served? If so, please indicate that to me by lifting your ‘yes’ finger. If, on the other hand, your discomfort is no longer serving a useful purpose, you can indicate that to me by lifting your ‘no’ finger. (wait)’
[If answer is ‘no’ then you can suggest that the U/M should consider letting the discomfort go, which it will usually agree to do. If the answer is ‘yes’ and discomfort is still serving a useful purpose, you can proceed as follows:]
‘It is reassuring to know that a useful purpose is still being served but I’m wondering if that same purpose could now be served by some other function. Would you consider setting up a substitute in place of the present discomfort so that the same purpose could be served?’ (wait)
[If answer is ‘no’, you can ask if the U/M would be willing to consider setting up a substitute at some time in the future. If so, you can narrow the time down to when that will be, by asking the appropriate questions. If answer to previous question is ‘yes’, proceed as follows:]
‘Since you are willing to consider allowing a substitute for your present discomfort I want to go to the creative part of your U/M and ask it to create at least 3 possible alternatives for consideration. When you have created at least 3 possible alternatives, please indicate that to me by lifting your ‘yes’ finger so I will know. (wait)
‘Good. Now I want to go back to that part of your U/M responsible for your present discomfort and ask it to review all the possible alternatives that have been created, without any obligation to accept any of them. When you have reviewed these alternatives would you indicate that to me by lifting your ‘yes’ finger. (wait)
‘Good. Now, having reviewed all three alternatives offered for your consideration, is there any one of them that you would be willing to allow as a substitute for a trial period of, say 30 days?’ (wait)
[If answer is ‘no’ then go back to creative U/M and ask it to create 3 more potential alternatives. Repeat the procedure. If ‘yes’ proceed as follows:]
‘Good. So now we know that you would be willing to substitute another behaviour for your present discomfort for a trial period of 30 days. So I want you to now make the substitution and allow your present discomfort to complete evaporate and drift away.’
Cloud of Smoke
After induction:
‘As you continue to breathe easily and deeply, you can become more and more aware of your discomfort. And as you become more and more aware of your discomfort, so you can begin to transform it into a cloud of smoke.
‘A small cloud of swirling, turbulent smoke that seems to be continually changing its shape. And as you continue to watch this cloud of smoke changing its shape, you can become suddenly aware that it is changing into the shape of a person. Someone you recognise ... and you recognise also that this person has caused you some hurt. And there are things you can say to this person that can relieve this hurt. Are you ready to say those things now? Are you ready to do what is necessary to remove that hurt?’
From that point, you can usually allow the person to conduct their own barrage of emotional release until it becomes obvious that they have released all they need to. Then bring them out of the trance in the usual way.
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