What Hurts?

October 1st, 2009
By Dana Steiner, MA, LCPC, BCPC, Body-Mind Psychotherapy Topic Expert Contributor

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In my practice I am often visited by clients who have both physical and emotional concerns. Often they have been to numerous medical specialists in hopes of alleviating a “pain” that continues to go undiagnosed and or untreated. They are frustrated, I am excited. Why?? This is my key to where therapy needs to begin. Sometimes we are plagued by a nagging ache, stomach problems, headaches, etc. The bottom line is the physical pain has been either unexplained by medical doctors or minimized as in our heads. The latter is probably the most accurate (though there are cases where medical treatment or second opinions are required). Through the examination of these symptoms in regards to when they started, what was going on, how they have responded to any treatment, and what makes them better or worse, I can learn a tremendous amount in regards to the client’s emotional pain.

Although eastern medicine has always incorporated both the mind and the body when treating patients, western medicine has a far way to go. Granted, many physicians in our country are more open to the idea of the connection between body and mind however this often goes unrecognized. The result is a patient who is frustrated with symptoms that continue to negatively impact their lives.

When I begin working with such clients, I first make it a point to address them as my client. Saying they are a patient not only sets up a hierarchy that is not helpful to counseling, but assumes they are sick and I will treat them. This is not how therapy works. In my view, clients are in need of tools and I am here to provide the appropriate tools and support their use in alleviating the client’s “pain” both physical and emotional. The physical pain is real however once medical issues are ruled out, the psychic pain is generally the root cause.

A common complaint that illustrates this issue is a feeling of exhaustion. Again, these clients have seen physicians (often several) and have been unable to get a diagnosis or relief. Once a sense of trust is established, I am able through active interviewing, to get a sense of the possible reasons for the pain. If my client is confident and trusting of my abilities (which is essential to any successful therapy), we begin to peel away at the source of the pain. It is not unusual for emotional pain to increase while physical pain decreases. Our bodies are magnificent at alerting us when something is wrong. The biggest hurdle is being open to listening and responding to our own cues. Too often, we ignore the symptoms or look for the quick fix in a pill.

By increasing my client’s awareness of bodily signals (including the pain), we can literally chart the scenarios that seemingly increase or decrease the physical pain. This is the start of opening the emotional pain, hence the increase of emotional awareness and discomfort. Unfortunately this is also the time when most people will leave therapy. It literally becomes painful however that is a sign that we have begun to identify significant emotional experiences that are invading the person’s ability to lead a fulfilling life. Those clients who continue are positively compensated by a sense of empowerment with new-found knowledge and often decreased physical pain. We examine how the pain impacts their life and clients are often surprised at the positive reinforcement they are getting from the pain. An example is when there are marital problems that have not been addressed but are increasingly distressing. One of the spouses may find their exhaustion is much worse when they are at home. The result is they retreat to rest but are in actuality retreating from the marital discord. It is much easier to take a nap than to begin a difficult discussion with one’s spouse!

This is just one example of how body and mind work together and how psychotherapy can alleviate both areas of pain. A tremendous amount of research is taking place in researching this connection and how both medical and mental health professionals can utilize this profound connection to help those with whom we work. This idea that mind and body are interconnected can be a difficult concept to accept. It means we have greater control over our health than we realize. What we do with this information is up to us.

 

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©Copyright 2009 by Dana Steiner, MA, LCPC, BCPC, therapist in Gurnee, IL. All Rights Reserved.

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