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Self-treatment of chronic pain symptoms with mindwork

This is an excerpt from Fibromyalgia and Myofascial Pain Syndrome by Devin Starlanyl.

Bodywork is more effective when your mind is quiet. Mindwork includes methods to defuse the hyper-stress reaction cycle and the central sensitization that amplifies pain. If FM is part of your life, you could be in stress-response mode much of the time. You can modify this, even if your job or life is stressful. Mindwork changes the way you look at the pain you have and the life you have. If PTSD is part of your challenges, talk to your advisor before attempting any technique.

Mindwork includes techniques you may know already: use of humor, pacing, reframing, self-hypnosis, distraction, affirmations, biofeedback, and body scanning. It helps to learn mindful breathing. It’s integral to so many other mind and body therapies, and a way to remove the habit of paradoxical breathing. One of the first things to occur when we are in pain or otherwise stressed is that breathing becomes shallow. Release the TrPs that restrict breathing, such as those in the serratus anterior, intercostals, and diaphragm (see the gallery). There are instructions in this book on establishing proper breathing.

Pacing

There has been some confusion about pacing and avoidance and chronic pain patients, and I think when it comes to others, too. Major behavioral patterns are separated into pacing, avoidance, and overdoing (Burrus et al., 2020). Activity pacing is an integral part of pain management. Many programs focus on reducing pain-contingent avoidance of actions to improve functioning. Yet good pacing behaviors in chronic pain patients can show up as “avoidance” or “kinesiophobia” results on tests (Hadzic et al., 2017). Talk to anyone testing you to avoid this confusion.

Music can be soothing, uplifting, or disturbing. Repetitious sounds can be extremely irritating to some of us. This can be unsettling if it is liturgical music and you are trying to worship, or intrusive if your neighbor has a loud radio and you’re trying to contemplate something else. It can be dangerous if the repetitive sounds are coming from a crying child. If you are in what may be considered overload, remove yourself from sound and other stimulation.

Music structure can profoundly affect the ability to learn visually. “Notably, compared to a control condition, listening to well-learned, regularly-structured music (music with high predictability) significantly facilitated visual sequence” (Ren et al., 2024). If you are trying to learn something visually while music is played, the music can significantly affect your ability to remember. “Concurrent music can modulate visual sequence learning, and the effect varies depending on the interaction between both music familiarity and regularity, offering insights into potential applications for enhancing human memory.” The authors found the right music could result in “quicker learning and retrieval speed. Conversely, learned but irregular music (where music memory violated musical syntax) significantly impaired sequence encoding.” They also found something surprising. Their lowest expectation for this improvement pairing, unlearned irregular music, also caused significant memory enhancement.

Explanations of techniques such as positive imagery and visualization are easily available. What other tools do you already have? My mindwork files include a folder of pictures that I can use to “enter” virtually. This is something that you can practice and is a form of meditation. Use all your senses. You may enjoy “visiting” the ocean shore, complete with salt spray and the sound of waves, for example. Even on snowy days in the world, I can snorkel or climb mountains. Weightlessness states, even in the form of imagined snorkeling, diving, or spacecraft, may ease pain sensations.

I also have copies of meditations I have found useful. I keep a notebook of cartoons and stories I find amusing and have started others on my computer. I also created a safe space in my mind to visit when I need it and have a sacred space in my apartment with photos of those I love and any special prayer needs at any given time. I practice mindful living.

What is your life path? My path is spiritual. My life and work are part of my baptismal covenant. Long ago I took a vow of stability to continue to serve people with FM and MPS. I use many types of meditation, including listening, like an open-ended prayer. Dialogue goes both ways.

You may have seen or read about Olympic athletes visualizing their movements to improve performance. I found a paper proposing mental imagery could be used to ease fascia (Abraham et al., 2020). Your fascia may respond to imagery; even the cells in the deep fascia. One paper proposed mental imagery blended with fascial and muscle tissue, proprioceptor function, and pain. One of its authors is the foremost authority on fascial anatomy. If you look up Dr. Carla Stecco’s work, you can get more of an idea of fascia on a cellular level. Figure out what area you want to treat and look up the anatomy figure in the gallery. I’ve used mental fingers to press out my SCM muscles, make my abdominal diaphragm more flexible, and deal with the nerve compression.

Reframing is a technique I use so often it’s become automatic. What seems difficult can often be “framed” into a different perspective. You can change the way you perceive blocks in your path. I start by changing words such as “obstacle” to “challenge.” There was a wonderful illustration of reframing in a Garfield comic strip (Davis, 2023). During the first two frames, Garfield is watching an autumn leaf, caught by the wind. His thought balloons are heavy with sympathy. The tiny leaf is separated from the only home it ever knew. It’s being tossed by currents, not knowing where it will land. In the final frame, the leaf has a different perception. The only word in the wind-caught leaf’s thought bubble is a gleeful “Wheee!”

Mindwork, if your mind is foggy, may come in the form of physically cleaning out a kitchen drawer. Uncluttering that drawer may be a metaphor for uncluttering your life. Pick a small goal that’s easy to achieve and do it. I also use unstructured prayer. Spirituality, with or without a religious group, can minimize depression for those with health problems (Lucette et al., 2016). Your beliefs should be meaningful to you and be a positive force in your life.

Be careful when using any set of standardized questionnaires (Offenbaecher et al., 2013). Many psychologists and sociologists use questionnaires. You may want to look at them now, in case any of your care providers uses them. I find some problematic. They can frame certain behavior as a psychological problem, whereas it can be a positive behavior for us. These questionnaires were set up by using questionnaires. Psycho-emotional evaluations don’t take into consideration the needs of people with TrPs or FM sensitivities. Sometimes you leave a party earlier because you are tired and need to rest or do physical therapy, and not because of social maladjustment.

Do you have a tactile object that helps you manage stress, such as a worry stone? It could be a crystal, a stone designed for such uses, or a rock from a travel spot. As you go about your life mindfully, one may come (or be given) to you. As you hold your special object, focus on it, relaxing to the texture of it. Feel its shape and note the way it looks. Rub it gently. Allow yourself to relax and control your breathing. Try this when you need a quick break. Once you get in the habit of associating the object with comfort, you can shift into a tension-relieving state whenever you hold it or even think of it.

Find a program of combined mind and body activity such as t’ai chi or yoga that works for you and can be adjusted to your needs. These activities help sleep quality in people with chronic pain (Doorley et al., 2021). T’ai chi seems as effective as aerobic exercise for people with FM (C. Wang et al., 2018). The longer you’ve practiced, the greater the improvement. It’s helpful to have a teacher who will modify your lessons as your needs require (Starlanyl, 2001).

More Excerpts From Fibromyalgia and Myofascial Pain Syndrome

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