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Acupuncture Today – July, 2011, Vol. 12, Issue 07

Exploring The Link Between Pain and Trauma

By Pamela E. Ferguson, Dipl. ABT (NCCAOM), AOBTA & GSD-CI, LMT

Recently, my 20-year-old niece in Europe was hospitalized following the removal of her wisdom teeth. In the hospital, she was placed in a unit with women who had their jaws rewired after being beaten by their boyfriends and/or husbands.

It was a profound life lesson for my niece to see domestic violence up close. She is currently experiencing severe physical discomfort following her stay in that unit. I wonder how much of this reflects the compounding effect of that hospital dynamic? I have emailed some acupoint advice to her, and began to track progress carefully in case her healing process is slower than the norm. I am concerned that she could relive the same trauma every time she has dental work or a tight TMJ in the years ahead.

It is common knowledge that trauma and pain are interlinked. How exactly? Let's explore.

Buddha's Twin Arrow Theory of Pain

Buddha often spoke about the "twin arrow" theory of pain - when the actual physical pain is compounded by the memory of trauma associated with that pain. The sensation of pain can be triggered by memories or prompts long after the actual physiological damage has healed. In clinical practice, I frequently encounter the "twin arrow" theory in patients years after accidents, physical or emotional violence, and traumatic experiences while giving birth.

Grappling with the "twin arrow" theory requires a diagnostic art and a subtle interaction with the patient that goes way beyond treating meridians and acupoints. It requires the sort of mindfulness Jon Kabat-Zinn PhD, (famous founder of Mindfulness-Based Stress Reduction).

Whenever a new patient comes to me with a lingering pain that defies medical diagnosis, this is the first question I ask - "When did the pain start? And what was happening in your life at that time?" I have often discovered that a woman's lower back or pelvic or sacro-iliac problems dated from a traumatic physical or emotional experience during labor and delivery that was never really acknowledged or dealt with postpartum.

Accidents and Trauma

A patient I will call "Stella" came to me suffering from painful fibromyalgia that started five years ago. "What happened five years ago?" I asked. Stella told me her husband was killed in an auto accident when their car was hit head-on by a drunk driver. Stella was in the driver's seat, but escaped with minor injuries except deep guilt, and told me her physicians assured her the fibromyalgia had nothing to do with her accident. "Oh?" I said and asked if she felt comfortable reconstructing the accident using a large pad, colorful markers, and toy cars. This helped her externalize the incident and review a pattern of injuries she hadn't noted at the time. I also advised her to return to the scene of the accident, in her mind if necessary, to use harmonizing visualization not only for that slice of the road, but for her own fragmented qi. This exercise helps to move stuck or traumatized qi from the road and from the consciousness, and has helped many of my patients overcome bizarre side effects from accidents, like breathing difficulties and tinnitus. After we practiced some simple qi gong, I treated Stella's GB meridian and some appropriate acupoints and her pain subsided. It took a single session, plus a recommendation to join a local qi gong group so she could maintain the momentum. Her pain levels continued to drop dramatically. If we hadn't tackled the origin of her pain she would still be seeking different therapies for relief.

Giving patients a measure of control over trauma-related pain helps, along with the sort of creative visualization that can actually soothe the pain centers of the brain.

Discovering what gives patients joy or creativity can inspire patient and therapist to craft such appropriate imagery. An old friend of mine in Europe, (an MD who is wheelchair-bound following a fall that damaged her spine) can actively minimize pain and discomfort when I engage her in imagery in emails that describe wind rustling through eucalyptus leaves, or the fragrance of jasmine on a warm summer evening. She literally inhales the sights, sounds and smells of nature especially the wind chimes and potted plants on her lovely patio , moving qi through her paralyzed legs with a tingling sensation.

At a friend's request, I made a housecall one evening when I lived in New York City to give Shiatsu to an elderly gentleman whose arthritis and recent widowerhood meant he had problems falling asleep at night. When I stepped into his apartment I noted the photographs on display from his youth where he is playing tennis. This inspired me to suggest that before he went to bed each night, perhaps he could walk up and down the long corridors of his apartment lobbying or serving imaginary tennis balls. He loved the idea and called a few days later to say the movement not only eased his arthritis, but was also a fun exercise that relaxed him and helped him sleep.

I had a similar experience with my mother. After my mother had a heart attack and hip replacement surgery, I helped her walk again using imagery and steps from the beloved activities of her youth – tango dancing and field hockey. She used to dance the tango like a dream, and every time she remembered this, an energy and joy went through her body, easing stiffness and pain. She moved with ease, two simple steps forward, one back. Similarly when she graduated from a walker to a walking stick, she swung the latter like her old hockey stick.

Her mobility improved rapidly compared with others in their late 70s who experienced similar surgery and struggled through standard procedures of physical therapy. The key here was to use movements she knew well and loved. It wasn't surprising to hear that tango music and steps actually helped minimize shaking from Parkinson's disease. So, I experimented with this while teaching a group of physical therapists in Dresden, Germany a few years ago. We invited one of their patients to join me in some simple tango steps. The man was a musician so he responded immediately. Within seconds his hands stopped shaking. I advised him to turn on tango music and feel the rhythm enter his body at any future moment when shaking hampered his mobility.

The Poetry of Acupoints

When working with kids who had experienced pain or fear after a trauma or accident inspired me to dot meridians or key acupoints with stickers. Kids were able to choose from a selection I always carry with me – happy faces, animals, tiny hearts, five element dots, flowers, and cars. This made it easy to teach kids some points they can activate by applying the stickers themselves whenever they feel pain or fear.

It's good to place a line of the same stickers on their favorite teddy bear or doll to help kids remember these locations.

I also use dots in appropriate colors of the five elements on points to ease pain in adults, too, and encourage them to tune into the poetry of the point's name and function. While activating LI 4 (Joining Valley) and LI 5 (Yang Stream) for problems ranging from constipation to a general pain or to a local hand or wrist pain, or headaches, it's creative to encourage patients to visualize a fresh stream of qi moving through the hand or moving on like a jetstream to the distal problem area.

Via Skype or phone calls, I make special use of visualization when advising patients or family members across the country. When my brother was hospitalized recently in Canada with a double lung embollism and in severe pain, I advised him to imagine his lungs as bagpipes and then to blow healing qi through them, and to do this whenever he felt pain or fear. He adores bagpipe music, so he loved the image. It also gives him a measure of insight and control at any time of the day or night, or when he takes his medication.

Recommended Reading:

  • Shambala Sun – January 2011 – ("The Healing Mind")
  • TIME magazine: "Understanding Pain" March 7 2011
  • THE PAIN CHRONICLES: Melanie Thernstrom (Farrar, Strauss&Giroux- New York - 2010)

Click here for more information about Pamela E. Ferguson, Dipl. ABT (NCCAOM), AOBTA & GSD-CI, LMT.

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