Are you telling yourself scary stories?

Often people feel mindfulness is about sitting and learning to relax and although you may say there is an element of this (and studies show the calming effect on the nervous system). It's mainly about recognising your thoughts and not getting lost in them, notably the worrying ones! Have you ever had that thought that you keep getting dragged into, or those moments of fear about bodily symptoms? A famous quote used in mindfulness a lot is ‘Between the stimulus and response there is a space, a space to choose our response. In our response lies our growth and our freedom’ (Viktor E Frankl). Mindfulness can be a real freer, a pattern breaker. Say for example you wake up with back pain, this back pain sticks around for the day and it’s there again the next day. You start to think and think and check your symptoms regularly, maybe you refer back to previous episodes of back pain you've had or things you've heard, people you know with pain (even more significant if close family members) or you hit the Internet for diagnosis and we all know where that ends up! These are all examples of hyper-vigilance, thinking and feeling into your symptoms too often, this just shines an unnecessary spot light on your pain, and can have a very physiological effect. We can basically tell ourselves 'scary stories' and the more unsafe we feel about our pain the more pain our systems can create. A vividly imagined thought, can trigger a bodily response, a change in body chemistry and change in the response of our nervous system, for better or for worse. So when we become more aware of our thoughts and inner workings we can stop the snowball effect. Imagine the same scenario when at the point of back pain onset (the stimulus) we were able to stop and choose a response, the healthier response. In my mind that would be to reassure ourselves that this episode of pain will pass, even if it goes on for a few days or weeks (another famous quote I use is ‘this too will pass’), if it helps, around 80% of us will have an episode of back pain (me too a few times!) and only 1-5% of this is the serious stuff (this is screened in clinic) that we need significant medical attention for. The problem we have in our current climate is that back pain has become something to be feared and our ‘vulnerable’ backs need to be protected! I treat them like any other body part. In clinic a lot of my work goes into what us Physios call the subjective part of the assessment where the patient tells their story. As a junior physio I looked at this as a short section that leads into the physical (objective) assessment which at the time seemed the most important part. However the subjective is undoubtedly the most valuable part of the assessment, an opportunity to gauge the thoughts and beliefs of my patients and also my chance to reassure and promote confidence in the person with pain.

This may involve discussions on reducing 'symptom checking', beginning to recognise thoughts on pain before they snowball and often an introduction to mindfulness via apps or simple breathing exercises. Learning these techniques can turn a scary story into no story at all.

#Lowerbackpain #Mindfulness #thoughts #hypervigilance