What is somatic tracking and how can it help my pain ?

somatic – affecting or characteristic of the body as opposed to the mind or spirit

We are often so good at attending to others that we forget to attend to ourselves. This subtle neglect can have emotional and physical consequences.

Remember the last time someone asked how you were. Didn’t it feel wonderful just to be checked in on?

Somatic tracking is about checking in how we’re feeling in our bodies. Find a comfortable seat and try it now. Are you aware of any physical sensations in your body? Perhaps in your chest, tummy, back or shoulders?

How would you describe this sensation? Is it:

  • a tingling, a tightness, a clenching?
  • sharp, dull or achey?
  • warm or hot?
  • unpleasant or pleasant?
  • in one area, or multiple?

And when you pay attention to the sensation what happens? Does it:

  • intensify or subside?
  • expand or contract?
  • move from side to side or up and down?

Whatever it does, it’s OK. You’re not fighting the sensation, and you’re not frightened by it. You’re not trying to make it go away; you’re just observing it, with curiosity and no judgement.

By doing this you are attending to your internal state, treating yourself with love and giving your brain the message that it’s safe.

Somatic tracking works because it teaches our brain to reinterpret signals from our body through a lens of safety, thus deactivating the pain.

Neuroscientists have found that paying attention to our bodily sensations mindfully (on purpose, in the present moment, non-judgementally) can actually shrink the ‘fight or flight’ centre of our brains – the amygdala.

You don’t need to set aside hours of your day to carry out this practice. The goal is to attend to yourself on a moment-to-moment basis: while you’re working, while you’re reading, or while you’re lying down in bed – any moment during which you can simply stop, observe and give yourself a little love and attention.

The following is a ‘Somatic Tracking Exercise’ from the BCH Center for Mind Body Medicine.

Somatic Tracking Exercise

(Source: BCH Center for Mind Body Medecine)

Remember that pain (or anxiety, nausea, or dizziness) is your brain’s alarm signal. When you do this exercise mindfully, it is teaching your brain that the pain or distress is not dangerous to you, and that you are safe and in control of the situation. By simply examining the painful sensations without emotion, your brain is learning that the pain or discomfort is nothing to be afraid of, and without the fear, the pain loses its power. The goal of the exercise is not to get rid of the pain. In fact, the more you try to get rid of the pain, the more you are telling your danger-alarm mechanism that you are in trouble, and the more likely it is to continue to run the alarm pathway of pain, anxiety, or discomfort. The goal of the exercise is to teach your brain that it is safe and in no danger, but you don’t care whether the pain changes, or gets better or worse while you are tracking it.

When should I do this exercise?

Practice this exercise when pain, distress or negative sensations or thoughts happen any time during the day. When you find yourself using your normal avoidance strategies to get away from the pain or distress you are feeling, take just 2-3 minutes and do a somatic tracking exercise to mindfully explore and examine your pain or discomfort. (You can then go ahead and do your avoidance strategy if needed.)

Directions

When you notice pain, distress, or other negative thoughts, take two minutes (or more if you like):

1. Notice it with interest, maybe even with a little curiosity, but with no emotional reactivity. Almost like a hiker who reached the top of a ridge and is just looking at the landscape on the other side with interest. Pay attention to how the pain moves around or changes in quality but do so without emotion.

2. Accept it as happening right now but realize that this thought or body sensation is transient and caused by the brain. Say to yourself “It’s just a thought, a sensation, or neurons firing.”

3. Remind yourself that since these are just sensations, they are not in any way threatening to you. These sensations are not dangerous and cannot harm you.

4. Tell yourself “I don’t need to do anything about this right now because this is not harmful, and it will pass.”

5. Tell yourself: “I’m okay. I’ll be fine. There is actually nothing wrong with my [back/head/stomach/chest] because I am healthy and strong.” Or say “I am safe, and there is no danger from these nerve impulses. I am safe. I am not in danger.”

The podcast by Curable, hosted by Alan Gordon, LCSW (Founder of the Pain Psychology Center) and Alon Ziv

Here is a useful 11-minute somatic tracking guided meditation from the app Insight Timer.

How to write your way out of chronic pain

What is journaling?

There are many forms of journaling, but the one I found the most effective in dealing with my own chronic pain was ‘therapeutic journaling’.

Therapeutic journaling is a simple and effective way of releasing the pressure valve on our own internal pressure cooker – which, for sufferers of chronic pain, is often close to bursting, since they are the most likely to repress their emotions so as not to cause a fuss or upset anyone. They are often people pleasers, goodists, stoics and perfectionists, making it harder for them to express the silent rage, resentment, distress, pain, frustration, fear or worry they are experiencing. They would prefer to be the sounding board for another person’s worries than ‘burden’ another with their own.

This is why therapeutic journaling can be such an effective outlet for their unexpressed thoughts and emotions. It allows them to free themselves of pent up emotion, see an issue objectively and gain a sense of perspective.

Put simply, therapeutic journaling involves writing down all your thoughts and feelings without censorship, judgement or the fear of anyone else reading your words. It’s an honest outpouring of emotions.

Your journaling time is private and is your opportunity to let it all out. No holds barred. You can be as angry, hurt or upset as you wish. Use foul language if it helps and don’t even think about spelling errors or grammatical correctness (this can be somewhat challenging to the ‘Type T’ personality).

It can help to imagine yourself as a 5-year-old having an enormous tantrum. Use phrases like ‘I feel angry/sad/hurt/mad because……….’ Don’t hold back and don’t be frightened or ashamed of what comes up.

Write, offload, then delete, throw away or burn. It will feel liberating. Any anger, resentment or shame you feel will lighten and the pressure will release. You will often physically sense the tension leaving your body.

How does journaling help?

Creating an awareness of your thoughts, good or bad, separates you from them. When you can detach yourself from your thoughts you are able to look at them in a more objective manner and gain a different, more positive, perspective on them.

Scientifically proven to do you good..

Clinical studies have shown that journaling can:

  • Reduce pain
  • Allow healthier emotional reactions
  • Reduce fatigue
  • Improve sleep quality and duration
  • Reduce symptoms of depression
  • Reduce stress reactions in relation to a traumatic event
  • Reduce and regulate heart rate

Could journaling be upsetting?

If you have experienced particularly traumatic events in your life, you may initially find journaling too direct or upsetting. This is not to say that journaling should be avoided, rather that other strategies or treatments may be necessary first in order for you to reach the point of feeling safe to journal. Please do seek help from a professional counsellor or therapist if you feel this would be beneficial.

Getting started

Find a quiet room where you won’t be disturbed. First thing in the morning, when others are still asleep, or not requiring you attention, is a good time to write. Take a few deep, calming breaths and make sure you have something comfortable to sit on. Don’t overthink things, and don’t plan what you will write.

Choose your preferred style (you can alternate depending on your needs):

1)      Unsent letters to people who have upset you (past or present). This has two possible benefits: you get to tell the person what you think of them without fearing their reaction, and the act of forgiveness is very healing. Of course, you can always just be bold and tell them to their face! Realistically though, good, kind, conflict-avoiding people pleasers often find this very hard to do.

2)      Exploring emotions in the here and now, and gently inquiring into the thoughts that led to those emotions. Was it really the spilt milk on the floor that upset you, or was it the many small but challenging events leading up to that minor incident that resulted in your angry outburst?

3)      Exploring a traumatic or upsetting event in the past and writing to shed light on how this is bringing up emotions in the present.

Any of the above can take more than one attempt, in order to work through the layers of emotion we hold onto and repress – often likened to the layers of an onion. The goal is to be able to put these thoughts into perspective, reframe them and move on. Please don’t attempt to move onto the next stages before first really allowing yourself to feel the feelings and express them fully, without judgement or criticism. Be a passive observer of your thoughts.

The following guide, written by Georgie Oldfield, founder of SIRPA (https://www.sirpa.org/) in the UK, contains some really useful information on journaling, including the helpfulness of visualization techniques at the end of your journaling, and expressing gratitude for what is going well in your life https://www.sirpa.org/wp-content/uploads/2019/07/7-Tips-for-successful-Therapeutic-Journaling.pdf. Georgie has also written a very helpful eBook called ‘Journaling for Health’ https://www.sirpa.org/product/journaling-for-health-ebook/

Sometimes, you may feel the need to search around a little when you begin to write, so try asking yourself the following to help get things going: Am I annoyed, upset, angry, frustrated or disappointed about anything or with anyone?

How long should I write?

How long is a piece of string? Don’t overdo it (journaling can sometimes feel a little emotionally draining), but allow yourself sufficient time to release the thoughts and associated tension you’re holding onto. Nicole Sachs, creator of JournalSpeak™, recommends 20 minutes of journaling, followed by 10 minutes of meditation. This could be in the form of a relaxing guided meditation, or a silent meditation where you observe the thoughts and feelings that arise from the journaling. Allow them to wash over you without judgment or attachment.

It can also be helpful to ask yourself ‘what have I learned?’, ‘has anything good come of this?’ or ‘how can I reframe this?’

Reframing means changing your perspective on a given situation to give it a more positive or beneficial meaning to you.

Then destroy your writing! Rip it up, burn it, delete it.

As Nicole Sachs (https://www.thecureforchronicpain.com/) says ‘Repressed emotions are only powerful in creating pain if they don’t have a voice. Nobody needs to hear this voice but you’.

(I hope journaling will help you, as it did me. This is no longer a daily practice for me, but I find it useful as one of my tools to occasionally return to if I feel any symptoms returning).

Could my personality be contributing to my chronic pain?

Almost a year ago, I developed lower back pain. At first I thought I had pulled a muscle ducking under a tree branch while out running with a friend. I took it easy for a few days and the pain seemed to subside. But then it came back, and with a vengeance. It remained with me on and off for a year and was often so severe that I had to hold onto pieces of furniture to support myself when rising from a chair or my bed, or when brushing my teeth.

I’m a runner and, when my pain first appeared, I was training for my first 50km ultra run. Thankfully I was able to complete this, and felt no pain during that special day (this became a very important piece of ‘evidence’ for me to refer back to once I began my healing journey).

Thereafter, the pain became more permanent and, like most people, I followed the traditional medical model of treatment: Xrays, MRIs, osteopaths, chiropractors and physiotherapists, but nobody was able to ‘heal’ me. It was only later on that I realised I was capable of healing myself.

I often left an appointment feeling worse than I’d felt going in. Each practitioner offered me a new nugget of negativity: I was diagnosed with hip arthritis, disc generation, flat back syndrome, lumbar sciatica, convex left inflection, discopathy of L4-L5 and L5-S1 with a trapped nerve and a 9mm pelvic imbalance, meaning that sexy wiggle wasn’t so sexy after all! The MRI showed arthritis in the lumbar region, some swelling at the vertebral endplates and a trapped nerve around L4-L5. It all sounded pretty scary, and I’ll admit to shedding tears in my car on a few occasions. I was advised to stop running by everyone I encountered, including my aerobics teacher at my once-weekly class. For a while, I listened to them. They were the experts after all, weren’t they?

Then I got fed up of not being able to run. After running for twenty years, I felt it had become part of my identity and who I was. It was a form of stress relief, gave me a sense of freedom and empowerment, was my only social activity and made me feel strong and motivated to cope with life’s challenges. Besides I didn’t suffer symptoms whilst I was running, something that should have been a significant clue that the cause wasn’t a physical one.

Acute pain or chronic pain?

The body naturally heals tears, breaks and other musculoskeletal injuries in around 12 weeks or 3 months. After this point, what started as acute pain becomes what is termed ‘chronic pain’. It was frightening for me to identify with this category. I later discovered how fear would fuel the pain fire.

A book that would change my life

After months of desperately searching for someone to ‘fix’ me, feeling frustrated and close to desperation, I came across a podcast that mentioned a book, credited with healing someone of their lower back pain. It was called, Healing Back Pain by Dr. John Sarno, Professor of Rehabilitation Medicine at the New York University School of Medicine and attending physician at the New York University Medical Center. I was filled with hope for the first time in months.

I read the book, and although I didn’t have a ‘book cure’ as some people have claimed to have experienced, Dr Sarno’s words completely resonated with me, and I saw myself on every page.

Dr Sarno explained that the terrible terms I had been diagnosed with were part of the normal ageing process. They were what he termed ‘normal abnormalities’. It shocked me to learn that the spine degenerates from the age of 20 and that if anyone my age (I’m 46) were to have an Xray or MRI they would almost certainly be found to have some form of degeneration in their spine too.

The fact that these ‘normal abnormalities’ could be present in the body without causing any pain was a revelation to me! This discovery became an important part of my journey towards becoming pain free. The second impactful discovery for me was the notion that certain personality traits made it more likely for some people to suffer from chronic pain.

According to Steve Ozanich, in his book ‘The Great Pain Deception’, there is a Type-T personality. The T stands for Tension and is taken from ‘Tension Myositis Syndrome’ (TMS), also known as tension myoneural syndrome or mind body syndrome – the name given by Dr. John Sarno to the numerous psychosomatic (relating to the interaction of mind and body) musculoskeletal and nerve symptoms and conditions, most notably back pain, but also tendonitis, fibromyalgia, plantar fasciitis, coccydynia (pain in the coccyx), gastric conditions, neck and shoulder pain and carpal tunnel syndrome.

Type-T personality traits

  • Perfectionism – Does every project or task you undertake need to be perfect and do you ignore your own needs and feelings to accomplish a task?
  • Goodism/People-pleasing – Do you put the needs and desires of others before your own? Do you play peacemaker in a dispute and do you keep your thoughts to yourself, even if you disagree strongly with someone?
  • Legalist – Unlike perfectionists who seek to do the right thing, legalists seek to be right. Responsibility and upholding their commitments are common among legalists. Legalists also hold themselves to extremely high standards that can breed feelings of unworthiness and self-hatred.
  • Stoic – Do you find it awkward or difficult to express your emotions? If people saw you express your emotions, do you think they would think of you negatively?
  • Anxiety and Fear – Do you think that if you are honest with people they will reject you? When your family members go somewhere, do you worry that something terrible might happen to them?
  • Low Self-Esteem – Do you feel that other people know more than you or are usually better at things than you are? Do you question your ability to do things?
  • Hostility and Aggression – Do you sometimes overreact to an issue or event or do you place your frustration onto something less severe and less difficult to talk about than an underlying issue? Do you have deep issues you avoid discussing that are associated with fear or shame?
  • Dependency – When making plans do you prefer if other people take the lead? People with this trait often choose careers that have security yet lack any sense of challenge or reward.

Source: TMS Wiki site https://www.tmswiki.org/ppd/TMS_Personality_Traits)

If you can relate to the above character traits, there is a strong chance you are repressing your true feelings, and that the subconscious resentment you have over this will be felt in the body as pain.

This was a turning point for me, as I realised that the pain I was experiencing was merely a very natural way of my body telling me ‘you’re repressing your feelings to please other people and I’m trying to let you know’.

According to the famous 13th century Persian poet Rumi:

For the first time for a very long time I started to ask myself what I was really feeling and what I wasn’t allowing to surface. It was this repression of my emotions that was causing my body to remain in a stressed, over-adrenalized, anxious state.

The brain cannot distinguish between a real threat and a perceived threat, and my own unexpressed thoughts, desires and fears were manifesting as chronic pain in my body.

I needed to learn how to turn off this stress response.

Part 2 ‘How to Turn off the Stress Response’ to follow….

The problem with TMS..

..is that it can be a (bleep!!****) to shift! Here’s what got me thinking:

I just got back from a 12k run and now I’m scared to bend down and take my shoes off….what the hell?! I had to have a word with myself: “You have just comfortably run 12k on dirt tracks, grass and road. You can certainly bend down to take your shoes without experiencing pain”.

So, what did I do? I bent down in the most relaxed way I possibly could, (it still twinged a little) took off my shoes, then bent down 5 more times more confidently just to tell my brain it was OK! And it was.

I cannot possibly do justice to the work of physician and TMS rock star Dr John Sarno without quoting him directly. I hate to stumble over my words when there are important messages to share:

..psychological stress occurs from a negative perception of events. when we think we want some specific thing – but in our judgement – we got something else, or nothing at all, we become stressed.

Tension is the body’s physical response to that stress. Stress is perceived within the mind, and tension is real within the body. TMS is a real physical mindbody effect that begins as a perception within, and permeates the corporeal body as crippling pain, illness and fatigue (from the book ‘Dr John Sarno’s Top 10 Healing Discoveries’ by Steve Ozanich).

Dr. Sarno contended that you don’t always have to eliminate the tension to heal, but it certainly helps if you can. The idea in tension reduction is to change the perception of the need to fight or flee to one of surrendering, and the body will not react as strongly (from the same book).

We hold fear, anger, sorrow and resentment in our bodies to protect ourselves from the pain of really experiencing the full brunt of the pain those emotions cause us, and to maintain the persona – to show that, outwardly, everything is going well in our lives. The problem is that those feelings are held in the body as unpleasant physical sensations unless we deal with them. Many of these thoughts threaten our ego and we’re too concerned with how others perceive us, so we push those feelings downwards and inwards.

Most people see TMS as a weakness, but it isn’t. Strong, kind, generous, thoughtful and selfless people are classic TMS sufferers. They hide their emotions for the sake of others, constantly putting their own needs on the back burner. They don’t want to accept or recognise that these perpetual acts of pleasing others and not themselves is building resentment within them – “No, I’m not a mean and angry person! I’m perfectly happy to serve others……..my needs are unimportant…….it’s all fine”. The TMS protective mechanism acts as a ‘crutch that keeps the person walking, but crippled’ (Steve Ozanich).

Pain is the mind’s way of telling us we have unmet needs and unresolved emotions. Fear of facing these is the great motivator for the cycle to continue. Running from it feeds it, keeping it alive, allowing it to manifests in various physical and psychological forms.

The only thing that satisfies the hunger of fear is surrender – to who you are, to what already is, to Truth (Steve Ozanich).

This is my lesson to you, and to me. Love, accept and forgive yourself, and the rest will follow xx

Truth! My medical results

The truth is there is nothing wrong with me

physically that is. It’s a huge relief that hasn’t quite sunk in. But it needs to, if I’m to stand a chance of getting rid of this chronic back pain that I have endured for over six months.

This morning I went to see my GP to discuss the results of my X-ray, MRI scan (for my lower back) and the blood test I was advised to have.

The conclusion was that I have a flatter than ‘normal’ back (I don’t have a curve in the lower back where I should have one) and a herniated disc, but nothing pressing on a nerve that would cause any pain down my legs. I’ve had pain down my legs; this just proves that is either emotional or just tight muscles (or a mix of both!). I have pain in my lower back constantly, but there is nothing in those results that accounts for this pain.

“Surgery is not advised” said my doctor, “and you can carry on running”. Not that I had any surgery planned or intended to stop running!

But it just shows, to me at least, the importance we give to the opinions of people in the medical profession. I realised that, although I thought I had fully accepted my diagnosis of TMS (tension myoneural syndrome) I hadn’t really. There was still a thread of doubt that my pain was caused by a structural abnormality.

I realised I have been muddling along for a few months, trying to get better, but still (unconsciously) seeing the pain as the result of something wrong with my body, and not with my mind.

From the insightful book ‘Dr. John Sarno’s Top 10 Healing Discoveries’ by Steve Ozanich: People who believe their body is broken remain in pain. Those who believe their body is okay, tend to heal.

So, it really is high time I 100% (not 99.9%) believed that my body is NOT broken. I have, what Dr. Sarno would call, ‘normal abnormalities‘ in my spine. The spine starts to degenerate from the age of 20 (yes I was surprised by this fact too!), and many people have herniated discs without any pain, or any knowledge of them. If spinal structure is the problem in back pain, then why does the rate of back pain drop off after the age of 50?

(From page 15 of ‘Dr. John Sarno’s Top 10 Healing Discoveries’) We are far, far stronger than we think we are. Healing occurs when you no longer fear the pain. It takes confidence – and fear is a lack of confidence. As long as she fears the pain, she will have reoccurence.

As for my blood test, I’m low in iron. Nothing more, nothing less. I have some iron tablets to take and I may as well do – I’ll be needing lots of it for the physical training I plan to do!

Rigorous physical movement teaches the brain to react differently to movement (Steve Ozanich again).

So, I left with my ‘certificat medical’ to prove it’s safe for me to run and with my goals firmly set in my mind: a half marathon in May, a marathon in September and an ultra run in October! (shit I’ve said it now, I suppose I ought to now enter those last two ;))

Have confidence my friends. Work on the fear. Understand where it is coming from, and don’t stop moving.