How Mark beat his pain

I had been Mark's doctor for years and knew him as a hardworking professional and devoted parent. After retirement, he suddenly developed face pain. We ruled out all usual causes, consulted various specialists, and even tried a pain clinic with no success.

At this point, I felt it was possible that the pain was functional and asked Mark to try a brief experiment: I suggested that he recall a beautiful occasion in his life, preferably one that engaged all his senses. He was asked to fully reimagine being there and reliving each small detail. He closed his eyes and allowed this to happen. After several minutes, he opened his eyes and smiled. His pain, that had been plaguing him for weeks had eased. He was amazed.

 I suggested Mark see a psychologist, not for mental illness but because psychologists with an interest in functional conditions have the skills required to assist in exercises such as these. They also may explore life circumstances, past and present that could be contributing to his pain. Though initially sceptical, he agreed. The results were remarkable.

Mark not only was able to learn to control his face pain, but he came to recognise how he had learnt a highly defensive mental attitude from a young age, when his parents had taught him to believe they were living with a daily threat to their safety due to their cultural affiliation.

He slowly came to realise that he had lived for decades with an inner tension, an existential threat, and that this had finally manifested in physical pain.

He committed to a daily practice to ease this tension and adopt a practice of calm acceptance and gradually his pain began to ease.

It’s important to say that while Mark eventually identified a factor in his past that contributed to his pain, not everyone has these. Many people with functional symptoms cannot find any cause – but fortunately, there are means to manage the symptoms regardless.

Mark had several factors that enabled his recovery:

-          He had retired and had no obligations to others as his children were adult

-          He was willing to trust the idea that he could change his brain to free himself from pain

-          He could afford the therapy

-          He had the personal discipline to practice daily the exercises

-          He was patient and accepted that his lifelong state of mind would take time to change, and he would have some bad days along the way

-          He was about to enter a new relationship and wanted to be free of such a debilitating symptom

-          He had the support of his children and friends

Nevertheless, I have a lot of admiration for anyone who can change such a lifelong habit, much of which was unconscious.

Why does not everyone who lives with childhood threats or hazards develop symptoms? And why do some people develop symptoms with no obvious cause?  We don’t know. It is like why some people never eat sugar but still get diabetes and some people eat a stack of sugar and never get diabetes. It is presumed that there is some genetic reason for this vulnerability.

Regardless of the cause, it is vital to understand things about persistent pain.

And that is an important distinction. Everyone has experienced the pain we suffer due to injury or illness. Pain in this situation is helpful to protect our bodies and allow us time to recover.

But pain that persists, even after the original problem has resolved, is a very different thing. That requires a different approach if you hope to recover from it. Next week, we will explore more deeply into the nature of persistent pain – and what you can do to minimise it.