By Becky Curtis
This article is the second of a two-part series, published in conjunction with the May 9 Out Front Ideas Webinar. Part I was published here on May 2.
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MY STORY
When chronic pain entered my life, I became the ultimate cure seeker. Like many people with chronic pain, the idea of living the rest of my life with it was unacceptable; I had to find a cure. I knew the source. Chronic pain didn’t creep into my life gradually; it came in violently yet without warning. One minute I was driving through one of the most beautiful valleys in Montana, the next I was tumbling with punishing force through the barrow pit along the highway.
Dirt filled my mouth, the smell of hot engine oil mixed with the scent of sagebrush, filled my nostrils, and I couldn’t move from the neck down. I fought to breathe, and my life felt as if it was slipping away. In fact, it was. My crushed spine took away my autonomic reflex to breathe and my punctured lungs gradually took away my capacity for air. My life was in danger.
Sitting there, strapped into the ruins of my Jeep Grand Cherokee, I was completely helpless — the ultimate passive patient — there was nothing I could do except crunch the dirt between my teeth, fight for every breath, and tell my husband, “You don’t want me like this, just let me go.”
His reply became a source of hope, “I love you from the neck up,” he said, “Keep breathing!”
Incredibly, some old friends happened upon the accident and were shocked to discover the victim was me. They too provided essential support. One stood outside by my window with my husband, encouraging and supporting him as he coached me to breathe. Another got in the passenger side, sat down next to me, stabilized my neck, and encouraged me to hold still and wait for the ambulance.
Once the paramedics arrived, they carefully removed me from the wreckage, transported me to the ambulance, and my husband coached me to breathe all the way to the hospital. Breathing was all I had left.
The hour-long drive to the hospital in Butte brought me into the capable hands of an ER Doctor and his team who inserted a chest tube, inflated my lungs, and saved my life. A top rate neurosurgeon on call that Father’s Day fused my neck between C3 and C5, removed the shattered body of C4, and gently placed a cadaver bone and titanium plate in its place.
I spent several days in an induced coma as the swelling around my spine went down and gave me time to heal. When I woke up, I woke up to a whole new reality, and a whole new chapter in my life. My diagnosis: C4 burst fracture, incomplete spinal cord injury, incomplete quadriplegia. As my Neurosurgeon broke it down into laymen’s terms, he finally smiled, looked me in the eye, and said, “You're going to walk again!” Those five words became the motivating “bright side” of what had otherwise been a very dark place in my life.
The next year of recovery proved his words to be true; I regained my strength, and despite partial paralysis and major sensory issues, I found my new normal and regained my life. Then chronic pain crept into my life, and within a few months I felt like I was right back where I started: Paralyzed in the driver’s seat, fighting for my life.
COACHING: HOW IT WORKS
That’s how it is for people with Chronic Pain: They feel like they are paralyzed, unable to move, helplessly trapped in a body of pain, unable to breathe. Except they don’t feel like they are in the driver’s seat at all… the pain is. Pain takes the wheel, swerves off the road and tumbles them helplessly through the barrow pit of life. The scene is one of violence, suffering, dirt kicked up in their faces, and no way out. No longer in control, they find themselves locked in the trunk with pain at the wheel. There, in the darkness we find them kicking and screaming to get out, they hope someone will hear them and have the keys to unlock their problem and set them free. Most often, it is assumed those keys will take the form of some procedure, pill, or cure that will free them from the claustrophobic confinement of Chronic Pain.
The truth, however, is that while they feel trapped in the trunk, they are in fact paralyzed at the wheel. What they need is someone to come alongside them, slip into the front passengers seat, and begin the process of coaching them: “Move, Breathe, Think,” and “I love you from the neck up, keep breathing.”
Coaching specializes in empathy. A friend I was talking to recently put it very well, “Empathy says, ‘Me too!’” Or putting it another way, to rescue somebody trapped in a pit, empathy jumps down into the pit with them and says, “Me too! Wanna figure out a way to get out of here?”
So pain management coaching slips into the front passenger seat next to the paralyzed one in the driver’s seat and says, “Me too! Let’s come up with a way to get out of here.” Pain management coaching recognizes the client may have no courage left of their own, so the coach offers what I like to call “contagious courage.” Contagious courage is a positive affect that verbally or non-verbally says, “Let’s come up with a way to get out of here.”
The “Let’s” part of the phrase is critical, because the coach is not stepping in as the expert, the coach comes alongside. It is not a “listen to me” or “follow me” relationship, it is a “me too” relationship that affirms and recognizes the client’s own latent expertise in pain management. The latest pain management research makes it perfectly clear that the best pain management strategies are patient-driven. They require active engagement on the part of the person with pain, not helpless passivity. So, when a coach sends the message, “Me too, let’s figure out a way to get out of here,” the word “let’s” sends the client the subconscious message that she has a role to play in this process. She is an expert too! In fact, because she is the only one living in her own skin, she knows more about her pain experience than anybody, and she is the most qualified person to assess and to treat her pain.
A client needs to begin to recognize this fact before he or she can own it enough to act on it. They may not know it yet, but they are the expert of their own pain experience, and once they feel empowered to be engaged in the diagnostic and therapeutic process, they are well on their way to getting their pain experience under control.
Notice I prefer to use the term “pain experience” instead of just saying “pain,” and the reason for this is that pain is an experience. Until a nerve signal arrives at and is processed by the brain, no pain exists, and the adage “no brain, no pain,” may seem like a no-brainer, but it’s true. Pain is 100% experienced in the brain. Now this does not mean a person’s pain is “all in their head,” but what it does mean is that neither tissue damage nor strength of pain signal coming from a certain part of the body equals the intensity of the pain. Ultimately the brain interprets the signal, assesses the extent of danger to the body and assigns an adequate “experience” of pain to that signal.
What this means, is that the management of pain is more of a neck-up process than it is a neck-down process. While the source of the pain may be a smashed toe, the experience of, and therefore the solution to the pain, is in the brain.
Coaching can take great advantage of this fact. It’s just one more reason why the person with pain is the best and most qualified expert for correcting it. This means that while pain has paralyzed them for quite some time, they remain in the driver’s seat, and once encouraged by their coach, they can begin to take the necessary steps to retake the wheel and take their life where they want it to go. The following story from a client of mine illustrates the impact coaching can have on somebody.
A CLIENT’S STORY
“Before Chronic Pain came into my life, I was described as a vibrant mom, wife, artist, and a caregiver my elderly patients adored. I never dreamed, when I broke my back lifting a patient, that the pain would never go away, and that I would later develop fibromyalgia.”
“I begged my neurosurgeon for surgery because it was the only hope I had left. Instead of saying ‘Okay,’ he stipulated that I go through a coaching program designed to help me understand my pain and my brain before he would operate. It’s an understatement to say I was frustrated. For weeks, I was bitter and uncooperative, but my coach calmly met with me each week by phone and promised the program would help if I stayed with it. Eventually I let the words ‘I can help you’ sink in, and began to put some of the pain-management strategies into practice. And that was my turning point.”
“Six months later I was out of my recliner and back in my flower garden and studio. Eventually I knew I could manage my pain without pain medications. I also went off Disability (the first of my doctor’s patients to do so in his 30 years of practice!). I’m very proud of that. Today I rarely suffer with pain — the strategies I learned from my pain management coach help keep me in control!”
“When I first began sharing my discoveries about pain management coaching with medical providers one common phrase kept coming up: ‘This is the missing link!’ They would say. I think they are right. In my experience, pain management coaching bridges the gap between known pain management modalities and the implementation of those modalities in the patient’s home. Time and time again people who work with patients in pain tell me ‘My patients are stuck. They don’t move forward. Nothing seems to work.’ Essentially, they are telling me, ‘My patient is really the only one who can change his pain experience, but he doesn’t know it. He’s in the driver’s seat, but he thinks he’s in the trunk unable to make the next move toward managing his pain and regaining his life.’”
“My dream is that one day pain management coaching will be standard of care for people with chronic pain, and that everyone who finds themselves paralyzed in the driver’s seat of pain will have someone who can sit beside them and say, “Me too, let’s come up with a way to get out of here.’”
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Author: Becky Curtis
Founder, CEO of Take Courage Coaching
