Pain Management

I lay no claim to any particular skills in pain management. My experience has been of the past three months. In November 2017 I had planned surgery for a total knee replacement. I think I underestimated how difficult I would find it. There was the constant pain. Day and Night. I couldn’t find an effective pain killer. Then the inconvenience of not being able to drive. Or, much more of a loss, not being able to cycle anywhere. I became used to taxis for the shortest journey. The loss of independence was not something I managed well. At the time of writing it feels that I might be getting better. The pain is diminishing and I can drive- a mixed blessing!

The writer Henri Nouwen said “When we honestly ask ourselves which person in our lives means the most to us, we often find that it is those who, instead of giving advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a warm and tender hand.”

I was talking with one of my patients recently about what it means to be human. How did he know, he mused, that I wasn’t a robot programmed to respond in an appropriate way to his conversation. I don’t think I’m a robot but his question was interesting. My thinking is that whilst I try to respond empathically, I also try to link unconscious materials and make links between the past and the present. I also will bring the focus onto myself using my experience of my patient to think about how our relationship might reflect their other relationships. I like to think this is beyond a robot’s abilities.A large part of the work of therapy is achieved in the relationship between the therapist and their patient. if this is a good match, then risks can be taken; challenges made and help offered.

Nouwen talks about the value of feeling cared about( of knowing that one is valued. This is at the heart of all healthy relationships- including that of counsellor and patient. ( This is one difference between seeing me or answering an on line CBT questionnaire!)

So, what can I learn from my past months of pain? One lesson has been the value of feeling loved and cared for by my wife. And a great deal of sympathetic support from my friends. I also came to learn to appreciate and recognise the good things I have Inside me. My pain has not, mostly, been too awful physically. Emotionally it has been difficult at times.)I would not do well if I were seriously disabled.)

As a counsellor I see people who are in emotional pain due to any number of causes often beginning in childhood. My work here is to help them find a way of talking about things that have long been buried. For most of my patients this is a slow process. They begin with a sadrightforwad narrative about their life. “I’m married. I have 2 children. My husband loves me. So why do I feel so lonely all the time?” Another story is “My wife and i are separated at the moment. I love her to bits and our kids. i couldn’t bear it if anything happened to them. But i have problems with anger. A red mist comes down and i’ll lash out at anyone. The wife. The kids. It doesn’t matter who. She says she’s not coming back. i don’t blame her. But i miss her.” Tears often follow this introduction. From here we walk together quietly and carefully, trying to see the underlying story. An anxious and depressed mother and Grandmother so often leave the next generation as damaged as themselves. Violent father’s who “don’t take “no shit from no-one”all too often produce sons who have never learned how to expired need .Or vulnerability. So they lash out. With awful consequences. Then the work goes on and we talk about self worth. About allowing oneself to be vulnerable. i point out the ways in which they are taking a huge risk by coming to see me! And add that, so far, the risk has paid off. That in my room, they are seen and acknowledged in their own right as Persons.
So, just as being hugged, loved and held can help with physical pain so the same process can help with the healing of emotional paiPain Management