The Man Behind the Curtain

Pain does not equal damage.

You are more than your pain.

These ideas are easy to understand, yet difficult to adopt. Imagine if we (patients and practitioners) could embrace these attitudes. Imagine if we cohesively united to change how we think about and treat chronic pain. Imagine pain no longer as a nebulous force in our lives, but a defined and logical biopsychosocial process.

I am currently attending the Combined Sections Meeting for the American Physical Therapy Association (APTA) and listened this morning to Dr. David Butler and Dr. Lorimer Moseley's "Explaining Pain" lecture. What an experience! It took them less than four hours to shake my fundamental understanding of chronic pain. One of the topics they broached was utilizing and choosing the right metaphors when explaining pain. Looking back over my writings, I am slowly realizing I took the wrong approach when discussing my pain. Remember this poem I wrote? It was one of my favorites because I thought it perfectly represented my inner battle:

In the Ring

My life is a constant battle
of bruises and bullies.
Are you fighting too?

Remember, dear friend.
Our scars do not deform us,
they define us.

Go another round.
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At the time, this poem made perfect sense to me. I was a fighter, I was strong. My body was a battlefield and I would fight pain to the end. Herein lies the problem. How can you win a battle against yourself? This warrior metaphor is detrimental to our healing process. If we expend all our energy fighting ourselves, how can we begin to heal ourselves? It reminds me of The Wizard of Oz. We need to look at pain less as the booming and flashy "Great and All-Powerful Oz," and more as the man behind the curtain. We need to get close and see pain for what it really is, instead of standing back and marveling at its power. We need to stop giving strong metaphors to pain and building it up to be some large force we are waging war upon. It's time for the lights and smoke to dissipate and time to become better acquainted with our pain.

It's a scary thought- to become better acquainted with your pain. You make it out as some great enemy, yet the only way to defeat it is to befriend it. After listening to the Explaining Pain lecture, I reflected on my fight with pain and realized it should be my pain journey. I started feeling better a year ago when I was a semester into my physical therapy program. Yes I had several surgeries, PT, prolotherapy leading up to that point that contributed to my relief, but I also had the power of knowledge that school provided. I was forced to look at my pain systematically, to understand what was hurting where and how I could strengthen or stretch the affected muscles or quiet the spasms. I learned to reduce my stresses outside of school, to work on my relationships with family and friends, to attend yoga classes regularly... to start loving my body and stop seeing it as a battleground.

There is still much to be learned about pain and its process. But it is time to stop fighting our own bodies, and start fostering understanding of why we experience pain and what we can do to lower our contributing factors. Wizard of Oz writer L. Frank Baum told us, "Pay no attention to that man behind the curtain," but that's exactly what we need to do.