Resting Your Moped

When I was much younger I had a small beautiful motorbike. It revved like mad and made a lot of noise. The combination of a small engine and my adolescent need for speed meant that the throttle was full open whenever possible and the Rev counter lived at 10,000 rpm just before the red line. I was always wringing every last ‘drop’ of performance out of my little motorbike.

Some of my friends went even faster by revving even harder and straying into the red zone, but this was dangerous because little engines tended to explode when revved into the red zone – as I was eventually to discover myself.

I was thinking about all this revving, roaring and plodding as being like life with chronic pain. A lot of people are ‘revving like mad’ on the inside but going slowly on the ‘outside’. The engine that is revving is the stress engine or to give it its proper name it’s the Sympathetic Nervous System or Fight and Flight response. This uses up lots of power and is the ‘bogeyman’ in Pain Management.

Just like the adolescent’s need for unrealistic speed, most people want to keep things the same despite the limitations that come with a change in health. This leads to frustration and constant ‘red-lining’. There is redlining pushing the body further than it ‘wants’ and red-lining pushing levels of stress and anxiety to the max. The two feed off each other and are the two vicious cycles of Pain Management (Overactivity rest cycle and Pain Stress Cycle).

In pain the ‘red line’ is the tipping point at which over-activity leads to flare up. In stress the ‘red line’ is the tipping point where ‘good stress’ starts to work against you and becomes Distress. Unlike little motorbikes, people don’t explode when they go in to the red, but they do suffer a lot. Suffering comes in the form of flare-ups of pain and high levels of stress.

If you are living under constant unrelenting stress, then it will be constantly and unrelentingly winding your pain up and making life harder in every respect.

Clearly red-lining makes the experience of a medical condition worse than it has to be. People say that they ‘have no choice’, but this is a bit like an adolescent saying they ‘have to go as fast as they can’.

The need for speed and the need to keep everything the same regardless of ability is driven by the beliefs we hold. Our beliefs can be helpful or unhelpful. They change if we realise that they are unhelpful or if we learn new facts or get a different perspective.

The point that I am making is that the experience of living with chronic pain is often characterised by living at the limits of capability. People try to live at 100 percent of capacity in or near the red zone. This is a precarious existence because this means living under a constant high level of pressure. In this situation everything will be hard work and break-downs will be common as all parts of the system are under maximum load. In motorbikes living in the red zone leads to high fuel consumption and engine fatigue. In people it leads to stress, fatigue, sleeplessness and flare-ups-or just plain misery.

To improve things it is important to reduce stress on the system. With the motorbike this means regular maintenance and riding a bit slower. This reduces fuel consumption and increases engine life. It also means riding is less stressful and you start to wonder why you ‘had’ to go so fast in the first place.

In people it means looking after yourself more and going a bit easier on what you expect of yourself. Like the motorcyclist you’ll start to enjoy better fuel consumption (less fatigue); and less stress as you realise that you don’t have to do everything at 100 mph.

To change a habit you need to step back and calm down so that you see things clearly. With my motorbike it happened when the engine did eventually blow up after too long in the red zone on a hot day. With people things might need to get really bad before you realise that you need to change something. Often others will tell you to slow down, but you won’t want to listen- you’ll know it’s right but…. Positive change occurs when you gain a different perspective from others in a similar situation or after a period when the ‘system’ is under less load.

To reduce the load on ourselves we need to start stopping. We need to experience ‘reduced revs’ or just switch the engine off on a daily basis. This all means making rest and relaxation a new priority. Many people will say that they just can’t do this – but in my experience this is because inside they somehow don’t really want to. Addressing this is a central issue in pain management.
If rest and relaxation came as a pill then everyone would take it. One lady said to me that she’d really got a lot from breathing and relaxation techniques but gradually ‘just ran out of time’. Even though it had helped her she still couldn’t give it 5 minutes in a day. This illustrates how the priority to be busy eclipses everything.

There are various ways to rest and relax. At its simplest we relax when we focus on something other than our problems; so this means doing anything that takes your attention in a positive way. It usually means doing something that you enjoy. A regular focus on deliberately breathing slower for 5 minutes three times a day makes a big difference because this slows everything down and is the opposite of what happens in stress. You can add a distraction to this like counting your breaths or going on a journey and then you experience a deeper kind of relaxation.

There are lots of ways to rest and relax. These come easily once you give them the priority they deserve. Unlike motorbikes, if you go slower on the inside you’ll function better. Put simply: reduce stress and all sorts of things improve.

This article first appeared in the Chronic Pain Ireland Newsletter Vol: 23 Issue 4/ December 2015

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