Neuroscience, chronic pain and PTSD

[Sulis (Sara Firman)]

This extract quoting Martin Rossman MD, author of Guided Imagery for Self-healing is from an excellent article by Loolwa Khazzoom that appeared in AARP Magazine, Jan/Feb. 2009. The article focuses on a dancer who endured many years of chronic pain after an injury in a ballet class. I think is it also quite informative for approaches to studying aquatic bodywork in warm water in those suffering PTSD that includes pain.

'While acute pain appears in areas of the brain that are connected to tissue damage, chronic pain lives in other areas of the brain - the prefrontal cortex and limbic systems, which the brain uses for memories, especially emotional ones'.

In some cases,'the pain lives on long past the time when the body tissues have healed'. Repeated thoughts and emotions create nerve pathways in the brain. Chronic pain impulses travel along well-worn pathways.

By using techniques such as guided imagery to build new pathways, 'the pain pathways can become less active'. Guided imagery is among more than a dozen alternative therapies that have been scientifically documented to ease chronic pain when drugs can't.

[Laura Srygley]

This is an interesting article, thanks for posting it Sulis. I would like to have a better understanding of how we as aquatic bodyworkers can facilitate changes is pain pathways. Does it just happen on it's own, or can we be more of a guide for our clients? This video of Dr Robert Scaer talking about trauma and different types of chronic pain is very interesting as well:

http://video.google.com/videoplay?docid=3742165246830785946#

[Sulis (Sara Firman)]

Yes, I thought of your mention of Robert Scaer's work when I saw this too.

I'm in the process of reviewing client comment forms and noticing how some reference visual imagery that arises spontaneously during sessions and others don't.

I'm going to compile some of these imagery descriptions. Perhaps they will help suggest some effective forms of guided imagery specific to our work in water.

This is just one example of where I think gathering anecdotal information from clients (and our own experiences as practitioners) could indicate avenues to explore.

The same article notes that the latest trend in pain management is to take a 'more comprehensive approach to treating chronic pain, a "bio-psycho-social-approach"'.

That said, when I explored links in the article to people experiencing chronic pain, I found that they felt that medicine and physical therapy were not meeting their needs for this holistic approach.

The reason is the lack of 'scientific proof' which then leads to lack of insurance cover. And the added suffering that results is unfathomable. But the internet (blogging) is helping people to express this.

I believe that if alternative practitioners were willing to collect and share their findings (scientific or not) that would be an important resource too. I'm hoping the Ning sharing will lead us toward that.

[Laura Srygley]

I like the idea of collecting visual imagery from clients. I get so much feedback from clients about such interesting images that I have never heard of, and then fail to write them down most of the time! Today I will start bringing a notebook to write them down.
I noticed you were talking to someone about collecting anectdotal info about watsu, what other types of things are you wanting to collect? I will be happy to share with you, as I see 6-10 clients a week now.

love to you,
Laura

[Sulis (Sara Firman)]

Thanks Laura! You can also asks your clients to keep imagery records and even help them to see how these might relate to dreams and inform creative work they do.

Right now I'm looking through all my old client records (including surveys) 2002-2007 and seeing what patterns appear and how my previous recording system could be built on.

Later this month, I'll be presenting some of my thoughts at the ATRI conferences in Chicago -Alternative Aquatics - Documentation and Intuitive Skills . That should give me some good input too.

I'll then be sharing my recording system which others will ideally adapt to suit their particular setting (yours for example), and looking at ways to collect and collate all these.

For now, its so worthwhile to keep records of your experiences and things your clients say or write - I think you do this anyway but I encourage you to continue and elaborate.

There is nothing wrong with anecdotal information* - it's so valuable to review in your own practice and I think that there's much scope for collaborative data base building.

At ATRI I'll be making a case for why some of these things do not (and cannot) fit into the scientific/ evidence-based methodology. We need to recognize and appreciate alternatives.

You'll see a bit more about this in the Aquatic Research Group I created here. Not that scientific method isn't valuable - but it does have limits that are not often spoken of.

I so appreciate your input as I have been unable to practice regularly in the last couple of years. I've been using the hiatus to review and demonstrate why our work is so important!

[Sulis (Sara Firman)]

I came across this article just as I was reviewing some client records and found one that I thought would make a helpful post on my aquatic bodywork blog. I was doing a series of sessions for an ex-dancer who was very flexible and easy to move in the water but who had also begun to experience serious pain. These sessions alerted me to the issue of pain - a subject not well understood by medical science. I think, as Loolwa's work is showing, it is also an area needing far more responsive awareness from those who do not suffer it.

Here is my post Feedback after aquatic bodywork: Pain Your comment very welcome here or on the blog post.