Patients describe pain in many different, and importantly, individual ways. I encourage personal descriptions of the experience however they may sounds. This is simply because I believe that it is an important as part of the process of dealing with pain to be able to express the very subjective feelings of pain in words that feel appropriate to that person. These words emerge from our language centres of course, just like any other, however we can consider that the underpinning neuronal network in the brain is likely to be part of the pain matrix. We are therefore engaging with this activated matrix in a positive way by encouraging expression and validating the description. We of course then swiftly follow with pain explanations to give meaning to the experience.
Recently a rather nasty shoulder pain was described to me ‘like the nerve endings are having a rave in there!’ These words emerge as part of the overall expression of the pain experience with its physical, cognitive and emotional dimensions that interact. How can we approach such a description? Well, I think that this gives us an ‘in’ via the way in which we respond with our language, seeking to find a solution that will quell the description, for example, ‘..in that case, we need some chill out in there’. The patient agreed and we looked at some practical ways of doing this with understanding, confident graded and nourishing movement, use of other body parts and brain based strategies using mirrors and illusions to dampen the ‘rave’.
Share your metaphors here. I’d love to hear them.