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Pain Medicine

Sometimes healing works from the inside out, on emotional as well as physical levels

PAIN GETS OUR ATTENTION. Fast. When we're suffering, all we want is immediate relief. Pain is usually the first sign that something is wrong: We've cut a finger, sprained an ankle, slipped a disc, pulled a muscle--or something deep inside us needs tending, even if we don't know what.

It's something we've all experienced, yet pain, especially the chronic type (which lasts a month or longer), is one of the most mysterious medical problems. Gary Thomas, M.D., head of the Pain Management Center at Cabrini Medical Center in New York City and one of the new breed of pain specialists, points out that pain's elusive nature is implicit in its technical medical definition: "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage." That unpleasant experience can be very real yet have no obvious physical cause. Take chronic back pain. It is now second only to the common cold as a cause of lost work time. Yet many people with chronic back pain have no discernible structural problems, such as disc bulges, according to Atul Gawande, M.D., who researched pain as a fellow at the Harvard School of Public Health. Conversely, spinal MRI scans show that disc bulges are common in people with no back pain at all.

Even among those who have been diagnosed with a physical problem, there isn't necessarily a relationship between the intensity of pain and the severity of the condition. Other ailments that cause pain, such as chronic fatigue (persistent exhaustion, accompanied in some cases with a lingering, low-grade fever) and fibromyalgia (serious and chronic muscle pain) can cause suffering for years, but are, from the perspective of modern Western medicine, of unknown origin.

Contributing to this mystery is the fact that people react to pain differently. An athlete in the middle of a competition may not notice a serious bruise or fracture until the game is over. And some patients who die of horribly invasive cancer have no pain, notes Thomas. "It's the way people perceive pain and also the way pain is processed in the body that makes it hard to get a handle on," he says. Interpretations of pain can vary even in the same person. Thomas recalls a patient with back pain whose MRI revealed metastatic cancer in the lumbar vertebrae. "Before he was diagnosed, he rated his pain as a three on a scale of one to 10," says Thomas. "After the diagnosis he gave it an eight. He said he pictured the tumor eating away at his tissue. The pain he experienced had to do with what he felt the pain represented."

On the most basic level, pain is what we experience when stimulated nerve endings send messages to the brain. But when there's no apparent cause, or the physical problem doesn't correlate to the severity of pain, other factors may be at work. Studies point to issues like loneliness and job dissatisfaction, notes Gawande. Pain has been a subject of scientific study since ancient times, when it was discussed in medical texts from Assyria, China, Egypt, Greece and India. Many of today's pain treatments, including the opium poppy, were also used long ago.

The manipulation of the life force, called prana in Indian traditions and chi in Chinese, was discussed extensively in texts dating from 2800 B.C., and today the concept is being rediscovered in the West. While many American physicians currently treat pain as an almost exclusively physical phenomenon, some medical doctors and holistic practitioners are looking at patients as a whole being and integrate Western and Eastern outlooks. These practitioners believe pain is connected to blocked emotions and negative beliefs or thought patterns. From their perspective, our souls speak to us through our bodies and pain is a message that something needs our attention. "Our bodies and their symptoms are part of our inner guidance," says Christiane Northrup, M.D., author of Women's Bodies, Women's Wisdom (Bantam Books, 1994).

Thoughts and emotions are aspects of chi, or subtle energy, somewhat akin to what Westerners call consciousness. "Every thought we think and every emotion we feel has a biochemical equivalent," Northrup says. And, she points out, many of these feelings and thoughts are deeply unconscious. Even if we're not aware of them, they get "translated" into neuropeptides, amino acids found in brain tissue that relay messages between the brain and body. Cutting-edge researchers believe neuropeptides are the physiological components of emotions like anger, fear, sadness and joy. And pain is an emphatic summons "to get us to go inside," explains Rosalyn Bruyere, an energy healer and head of the Healing Light Center Church in Sierra Madre, Calif.

Though we'd all like an instant fix, lasting relief for chronic pain is more complicated than swallowing a pill. Steroids, anti-inflammatory medications, opiates, neuropathic and nerve-calming medicines can all help reduce physical pain, but they can't cure it. And sometimes these pharmaceuticals cause serious side effects. Meanwhile, studies are beginning to find that therapies such as yoga, meditation, acupuncture, long-distance healing and even prayer can provide significant relief to people who are sick and in pain. No wonder, then, that in 1997 alone, Americans spent $21 billion visiting alternative practitioners, according to a study published in the Journal of the American Medical Association.

Some of the leading hospitals in the United States are responding to this cry for help--as well as to the flow of money streaming away from the conventional health care system. Memorial Sloan-Kettering in New York City and the prestigious California Pacific Medical Center in San Francisco are just two of the highly regarded hospitals that have established complementary care units to treat patients using acupuncture, massage, guided, imagery, relaxation, meditation, energy healing and spiritual counseling.

But choosing the right alternative therapy can take time and patience. (Before finding effective relief with energy work, you may have to try massage or acupuncture first.) Often the search for results brings up buried emotional issues, and sometimes that's more than the person bargained for. Elusive as it is, chronic pain can be conquered, though you do need the open-mindedness to try new approaches and the willingness to listen to messages "behind" the symptoms. Below are stories of four people who conquered pain and transformed their lives by looking deep into their inner beings for healing when drugs and other standard treatments failed.

Back to the Future

Christine Saball-Tobin, a practicing nurse in Pittsfield, Mass., injured her back lifting a patient in the critical care unit six years ago. Her diagnosis: compression fracture of the spine. Saball-Tobin's back pain was debilitating for her, and tough for her husband and coworkers to fathom. Some wondered if she was exaggerating. "When the injury first occurred, I couldn't stand at the kitchen sink and do dishes," recalls Saball-Tobin, now 48. Her physicians prescribed muscle relaxants and rest. The muscle relaxants made her feel spacey, she says, and rest didn't suit her active lifestyle. In addition to her career, she was running a successful health and fitness business, raising three sons and catering to a husband who was holding down three jobs of his own. Saball-Tobin went back to work as quickly as she could, determined to rise above her misery. "I was in so much pain," she says. "I would go hide in the women's bathroom and cry."

The injury was in the vertebra situated directly behind Saball-Tobin's heart. "It was very symbolic," she says referring to suppressed emotions that later surfaced. Out of desperation, she turned to alternative healing methods, starting with yoga and massage. Her massage therapist recommended an energy healer who could go beyond the physical by working with the subtle energy system of the body, or chi, through what energy workers call "laying on of hands." From an Eastern perspective, chi is a universal force that also energizes our bodies. Suppressing emotions or thinking painful thoughts disrupts chi and can lead to pain and illness. But where acupuncturists use needles to manipulate chi, energy healers use themselves as a conduit to channel what some call the divine healing force of the universe through intention, consciousness and hand placement. As the flow of chi is balanced, suppressed emotions and other unconscious thoughts are often released--as is physical pain. Clinical studies have shown that during such energy work sessions, the heart rate and brain waves of the client actually shift in response to the healer.

As Saball-Tobin's sessions progressed, she came face to face with many feelings she had blocked by staying busy. She realized she was dissatisfied and unfulfilled in many areas of her life--both at work and at home. Yet in an unconscious effort to ignore her feelings, she had been taking on more than she could bear and putting others' needs ahead of her own.

Saball-Tobin says it took two years for her physical pain to heal. As she addressed emotional issues, her life began to change. She separated from her husband and has recently finalized their divorce. She went on to become a certified energy healer herself and now works as a psychiatric nurse focusing on mind/body issues. Six years after her injury, Saball-Tobin's back is mostly painfree, although it still acts as a warning system. "Every once in a while, if I overdo things, I can feel a little nudge in there," she says. Overall, her perspective of people's illnesses and pain have been transformed, as has her approach to life. Now Saball-Tobin says she makes her own needs a priority and doesn't push herself as hard. "I had healing throughout my life," she says. "It wasn't just my back."

Flower Power

Today Judy Griffin is a happy and healthy herbal and aromatherapy practitioner who runs her own successful business. But at 27, she was desperately ill with a severe case of Crohn's disease, a chronic inflammation of the intestinal wall that has no known cause or cure. The disease can cause symptoms like chronic diarrhea and may eventually lead to intestinal obstructions that require surgery. X-rays showed that her small intestine had become twisted and infected. Her ability to absorb nutrients was so compromised she was forced to subsist on liquids.

Griffin, now 50, says she prayed for help during regular bouts with excruciating abdominal pain. Her prayers were eventually answered in the form of an intuitive inner voice that suggested she look for relief in her garden. There, among her flowers, the Fort Worth resident put her doctorate in nutritional science to use. Griffin drew upon her chemistry background as she captured the substances that make flowers blossom and give off scents through a method called steam distillation. Her backyard experiments eventually turned into a business specializing in flower essences and aromatherapy products. They also led to a cure for her pain.

Flower essences, which are applied topically, send messages to the brain that affect the parasympathetic nervous system and promote relaxation. As the essences eased her emotional stress, Griffin says she began to feel better physically. "The stress was the catalyst that made the disease happen and kept me from healing," she says. The remedies also helped her confront her tendency to be involved in abusive relationships. Some of the first plants Griffin turned to were ordinary ones, like snapdragon and yarrow. Just as the scent of a rose can lift our spirits or inspire romance, Griffin claims the flower essences heightened her discernment and helped her shift psychological boundaries.

Plants and flowers, of course, are the basis for the earliest medicines, such as the salicin from willow bark which used to be the active ingredient in acetylsalicylic acid (aspirin). And today, some of the most potent medicines are still derived from botanicals, such as the heart medicine digitalis (extracted from the dried leaves of foxglove). And flower remedies are recognized among alternative practitioners as a way to heal emotional distress. "Smell is the only scent that goes directly into the limbic area of the brain, which controls emotions," says Shiva Carr, L.Ac., an acupuncturist on staff at Elixer Tonic and Teas in West Hollywood, Calif.

Flower essences are not a standard Western medical treatment, but Griffin is one of the countless thousands, or maybe millions, who say they helped her by bringing buried emotions to the surface. In Griffins case, she had to confront her interactions with others. "I had attracted abusive relationships of every kind," Griffin says. "I never saw myself as a victim. But I was putting out those vibes."

After six years of working with flower essences, Griffin learned through X-rays that her small intestine had totally regenerated. Her Crohn's disease has never recurred, and now that her symptoms are gone she's able to eat normally. The self-supervised therapy also compelled Griffin to make changes in her personal life. She ended her marriage, which she considered another abusive relationship.

Griffin now heads her own company, Herbal Health, which produces and distributes flower essences, essential oils and herbal tonics. She also wrote a book called Mother Nature's Herbal (Random House, October 2000) and consults with people who are facing serious illnesses or want to transform their lives. The Healing Environment Program, a complementary health care program at Baylor Medical Center in Dallas, uses her flower essences to help soothe cancer and pain patients. Griffin says she even looks like a different person now. "I was wearing my anger, which I didn't realize at the time," she says. "No one who meets me today would even recognize me from old photographs. I look younger now and my body looks healthy."

Emotional Healing

For more than 15 years, Sharon Perry's life had revolved around her allergies. Whenever she ate fruit or tree nuts like walnuts or pecans, her throat closed up. Because of her sensitivity to birch trees and grass, the Wilmington, Mass., resident hadn't been able to go outside during the spring for more than a decade. She also suffered from four or more serious sinus infections every year. Eventually her allergies became so severe that her throat constricted whenever she ate salad or other vegetables. For Perry, a vegetarian, that was a serious problem.

In 1997 Perry, now 32, consulted Dan Kinderlehrer, M.D., a holistic physician and energy healer in Boxwood, Mass. Kinderlehrer prescribed shots of anti-immunoglobulinE (anti-IgE), an antibody that fights allergens. Whereas standard Western treatments for allergies work by blocking symptoms of reactions, anti-IgE shots, a promising experimental treatment, block the immune reaction that causes hay fever and other allergies. In Perry's case, the shots helped. Soon she was able to keep windows open and eat bowls of strawberries whenever she pleased. "That was a miracle for me," she recalls.

Then, in October 1998, just when she thought her life was finally on track, Perry became sicker than ever. It started with a severe cold and an excruciatingly stiff neck; she could hardly move her head or torso. Intense pain in her neck radiated all the way down to her hips and up to the base of her skull. In January, Perry was diagnosed with fibromyalgia, a condition characterized by pain and stiffness in soft tissue. In a frantic search for relief, she visited two chiropractors, three massage therapists and an acupuncturist. Nothing worked. Then she returned to Kinderlehrer. In his assessment, the allergies and fibromyalgia were symptoms of a deeper emotional issue. Until these emotions were brought to the surface and confronted, he said, Perry would continue developing physical problems and pain. He suggested energy healing, and Perry decided to try it.

Even during her first session, Perry experienced some relief from her pain. "Right away, I noticed my body had relaxed," she says. As her treatment progressed, Perry began to acknowledge feelings about her parents' divorce that she'd suppressed since childhood. "I could have said, `I had no problems.' But when we dug down deep, there was a little girl still holding on to [the divorce and its aftermath]," she recalls. "I was disappointed and hurt."

As Perry worked through emotional issues, her muscles began to relax. Within a few months, she was free from pain and flexible enough to begin working out again at her gym. Now Perry is not only more physically comfortable, she feels at ease with the past. "I have a better understanding of where my mom is coming from. And about my dad, I am at peace on a deeper level."

Spoonful of Medicine

Marlene McKenna's doctors had been reassuring her for years that her mild intestinal problems were no cause for concern. In 1983, after surgeons removed melanoma growths in her neck and back, she thought the problem was gone. But the next year, her pain suddenly intensified and was accompanied by indigestion and nausea. Then, in February 1986, one physician discovered that the cancer had spread to McKenna's colon and told her she had less than a year to live.

McKenna's doctors suggested chemotherapy, but when they couldn't guarantee it would help, she decided against it. She turned from her "awful" diet of fast food, sugary snacks and soda to a strict macrobiotic diet, composed of whole grains, fresh vegetables, beans, sea vegetables and soy products (fish is optional). The diet, which relies heavily on lightly steamed or boiled foods with little or no fats, is balanced according to Chinese principles of being in harmony with the environment. She also took aim at her hectic lifestyle. McKenna, a driven over-achiever, was a successful stockbroker and mother of four. "I was always among the top five producers at work," she recalls.

From the start, as McKenna notes in the book she wrote about her experience, When Hope Never Dies (Kensington Books, 2000), the simple macrobiotic meals left her feeling full but light. "There was no mistaking the feeling after eating a bowl of rice: I felt a little more stable, a little more balanced and a lot more energetic." The diet made McKenna realize her nervous system had been running on overdrive.

Advocates of macrobiotics believe the diet soothes the system by changing the body's reaction to stress. "Food itself is energy," explains Phiya Kushi, director of the Kushi Institute in Boston, an organization that promotes macrobiotic eating. "It becomes your cells and your organs. It produces your hormones and all the things that give you your emotional reactions."

At first, the cancer continued to rage through McKenna's system, causing skin eruptions and new tumors. Yet her macrobiotic counselors assured her that toxins were finally being released from her body. Soon, just as they had predicted, McKenna began to feel more energized. She also found herself feeling gratitude for her food, her life, even for her illness. In general, she felt more contemplative and peaceful.

McKenna's pain began to subside and eventually disappeared. In October of 1986, an MRI showed no signs of cancer. But the change in her life was even more profound. "I never tell people it was the diet that cured me," says McKenna, now 50. "The diet, as even Michio Kushio [the founder of macrobiotic cooking in the United States] will tell you, is just one piece of this. It's a way of life that develops around macrobiotics." Cleaner eating, McKenna said, cleared her body of tension and toxins.

Healing that affects both body and mind, whether through meditation, diet, yoga or energy work, is certainly not a substitute for Western medicine. It may not always cure a physical illness or completely resolve pain. It also takes courage, fortitude and a willingness to experiment. But more evidence is showing that it can be a powerful complement to conventional treatments--and often a more lasting "cure."

If the body is the messenger, doesn't it behoove us to listen to the message? Getting to the deeper levels of pain can transform and improve our lives. And sometimes, this inner work can radiate throughout our bodies, uprooting the underlying causes of pain.

step-by-step pain relief

1 See your physician and discuss appropriate pain-relieving medication.

2 Start a gentle exercise program like tai chi, yoga or breath work. "Breaking a sweat releases natural endorphins and gets people to feel their bodies again," explains Gary Thomas, M.D., director of the Pain Management Center at Cabrini Medical Center in New York City. "These exercise regimens can be adopted by people who are severely immobilized. Even simple breathing exercises can help.

3 Maintain a healthy vegetarian diet. Start by cutting out excess sugar and fat.

4 Keep a journal; record your dreams; get support from a therapist, energy healer, spiritual counselor or life coach who can help you assess your goals and the best ways to achieve them.

5 Make time for yourself because you're worth it.

DIANE GOLDNER, a journalist and healer in New York City, is the author of Infinite Grace: Where the Worlds of Science and Spiritual Healing Meet (Hampton Roads, May 1999).

Diane Goldner, who wrote "The Other Side of Pain", has done extensive research on alternative healing and authored the book Infinite Grace: Where The Worlds of Science and Spiritual Healing Meet (Hampton Roads, 1999). She has written for the New York Times, American Health and USA Weekend and has plans to launch an online magazine called the Golden Spirit Network (goldenspirit.net) in 2001.

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