I am often visited by people who have both physical and emotional concerns. They have visited numerous medical specialists in hopes of alleviating pain that continues to go undiagnosed or untreated. While they are frustrated, I am excited. Why? This is my key to where therapy needs to begin.
Whether it’s a nagging ache, stomach problems, or headaches, sometimes we experience physical pain that goes unexplained by medical doctors or minimized as in our heads. By examining these symptoms, in regards to when they started, what was going on when they started, how they have responded to treatment, and what relieves or worsens the pain, I can learn a tremendous amount in regards to my clients’ emotional pain.
Although Eastern medicine has always incorporated both the mind and the body when treating people, Western medicine has a ways 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 in their practice. This results in a person feeling frustrated with symptoms that continue to negatively impact his or her life.
When I begin working with such clients, I first make it a point to address them as my client. Calling them patients not only sets up a hierarchy that is unhelpful 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. I am here to provide the appropriate tools and support their use in alleviating a 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 to get a sense of the possible reasons for the pain by interviewing them. If my client is confident and trusts my abilities (which is essential to any successful therapy), we begin to peel away at the source of 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 pain—we can 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 leave therapy, as it can become painful. That emotional pain, however, is a sign that we have begun to identify significant emotional experiences that invade the person’s ability to lead a fulfilling life. Clients who continue are positively compensated by a sense of empowerment with new-found knowledge and, often, decreased physical pain. After examining how the pain impacts their life, clients are often surprised at the positive reinforcement the pain gives them. For example, when marital problems that have not been addressed are increasingly distressing, one of the spouses may find their exhaustion is worse when they are home. The result is that they retreat to rest but are actually retreating from marital discord—it is much easier to take a nap than to begin a difficult discussion with a 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 about this connection and how both medical and mental health professionals can utilize this profound connection in our practices. The 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.
© Copyright 2009 by Dana Steiner, MA, LCPC, BCPC. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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