Saturday, June 21, 2008

The Power of Ow

So I've been reading Eckhart Tolle. In general I try to do whatever Oprah recommends, praise be she. But this guy - I'm just not sure. He writes about the power of now, coincidently the title of his book. His basic message seems to be: live in the moment. Granted I'm only 36 pages in at the moment, but I'm not sure what he is going to write about for 311 more pages! That's a lot of now... He claims the past and future don't exist, tells us to let go of the ego (now THERE is a complicated word... has Mr. Tolle read Ayn Rand?) and to think less.

This got me thinking (!) about pain perception. He spends many pages asking you to observe your thought process, to watch your mind think, to disassociate. I wonder if we can't do the same with pain - recognize that it is just that - a sensory perception. He writes that by dwelling on past pain (physical and emotional) we recreate and maintain that painful state.

Pain is emotional. Rare is the patient who will say 'it hurts, but it is just pain'. Pain is rarely 'just'; rather it is unfair, all-encompassing, and unique - no one else could possibly understand our particular pain. It can't be quantified, though we doctors try, asking you to rate it from 1 to 10 - but really, what does a 7 feel like? If my pain is an 8/10 and yours is a 4/10, do I hurt twice as much? What does pain FEEL like? Teenage boys, what with their fabulous communication skills sum it up best: "Derek, what does the pain feel like?" " hurts." Insightful. By definition pain is a subjective experience, though we don't usually remember that it is just that, an experience. It seems to be more of a state of being: we are IN pain.

I treat a psychologist with whom I have many interesting discussions about pain and perception and mind-body connections and disconnects. He mentioned that he was studying meditation, and that it has been noted that the brains and pain perception patterns of chronic pain patients are different than those of 'typical' people. We talk about 'body scanning' and meditation for these people. Basically, let's say your right knee hurts. A lot. You hurt and hurt and hurt, and your body is always very focussed on your pain. Nerves work on synaptic connections and demonstrate plasticity, that is to say that nerves can modify their firing patterns in response to repeated stimuli. In non-nerd language that is to say that your brain can change. So, think about knee pain knee pain knee pain... and the nerve pathways that convey information about knee pain become very active and easily activated. And since pain is just a nerve message, the message becomes more constant, more present. Your knee hurts ALL the time, it is all you think about, all you feel.

Using meditation and 'body scanning' techniques, you can change these pathways. Use plasticity to your advantage. Rewire your brain. Often done at the end of a yoga class, you focus your attention on different body parts, working your way up the body. When you focus on the ankle, you focus only on that joint. You feel the individual bones there, you send your breath there. You *see* your ankle, you feel the air on your ankle, and nothing else. Move on up, to the shins, to the knees. The important (and challenging) part of this is to observe and perceive, but not judge. When 'scanning' the knee, we might note that there is pain. That it throbs, that it feels heavy. Observing the sensation, but not emoting it. In other words, "the right knee hurts", not "my KNEE is KILLING ME!!!". Onward and upward, to the thigh and beyond.

By practicing sensing parts of the body other than the chronically painful knee, we start to deactivate the constant brain-knee pathway, and activate the brain-rest of the body pathways. It is new-agey, but it is also science. Living in the now means letting go of our pain, and when that is less possible, because hey - it hurts, noting it and moving on. Treating the cause of the pain and accepting that right now we need to deal with this situation, but not defining ourselves by it, or worrying about it.

Hmmm. Eckhart Tolle might be on to something. I'll finish reading the book ( of these days, I have been recently sidetracked by a book titled "Twinkie, Deconstructed", all about where each of the ingredients in a Twinkie comes from. The origins of high fructose corn syrup, polysorbate 60, modified corn starch. It is a fascinating, if not nerdy read.)... where was I... damn thought-tangents...

Gah. If anyone needs help staying in the 'now' it is I. But at least my knee doesn't hurt!

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