Fibromyalgia Pain Science Education - Mind-Body Practice - Somatic Tracking

Episode 12 - Fibromyalgia Pain Science Education -   Mind-Body Practice - Somatic Tracking
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This episode continues pain science education of fibromyalgia. 

Because pain involves both the mind and the body, mind-body therapies may have the capacity to alleviate pain by changing the way you perceive it. If you've been in pain for a while, your brain may have rewired itself to perceive pain signals even after the signals aren't being sent anymore. 
The body-mind techniques, including somatic, guide patients to focus on their underlying physical sensations. 
Somatic work is a great addition to traditional psychotherapy. 
I recommend doing both cognitive and somatic work to help alleviate pain and other fibro symptoms. Somatic work relies on body awareness and physiological regulation.
Several somatic techniques help specifically well patients with pain and trauma. This episode focuses on somatic tracking as an example of using somatic work to help with pain and healing.

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Transcript

episode 12. 

Today we are talking about body-mind techniques known to alleviate neuroplastic pain. 

As I explained in the previous episodes, because pain involves both the mind and the body, mind-body therapies may have the capacity to alleviate pain by changing the way you perceive it. If you've been in pain for a while, your brain may have rewired itself to perceive pain signals even after the signals aren't being sent anymore. We also talked about the fear-pain cycle and the effect of stress on your pain and general health. 

Many are familiar with the benefit of mediation, breathwork, mindfulness, yoga, positive thinking, visualization, massage, grounding, dance, sensation awareness work, etc.  

 The body-mind techniques, also called somatic techniques - guide patients to focus on their underlying physical sensations. 

Somatic work is a great addition to traditional psychotherapy. 

In the previous episodes, I discussed some basics of the cognitive approaches involving thoughts, feelings, beliefs, and cognitive stress responses. 

I recommend doing both cognitive and somatic work to help alleviate pain and other fibro symptoms. Here is why. 

Cognitive approach, Cognitive Behavior Therapy, as a classic example, focuses on how thoughts influence emotions and behaviors ("top-down"). It helps identify distorted cognitive beliefs and maladaptive behaviors and replace them or create more adaptive self-beliefs and behaviors. It relies on insight and behavior change.

 Somatic Approaches focus on how the body influences thoughts, emotions, and behaviors ("bottom-up")

They help people become aware of body sensations and procedural memories. They target underlying dysregulation in the nervous system that causes or maintains symptoms. They help create greater control over debilitating symptoms and unconscious dynamics.

Somatic work relies on body awareness and physiological regulation.

 Because our thoughts influence feelings and actions and our body sensations, such as pain and other symptoms, can influence our thoughts - the combination of both psychotherapy, such as CBT or coaching as well as somatic work will produce the most significant benefit to patients with neuroplastic pain and other central sensitization symptoms. 

 Several somatic techniques help specifically well patients with pain and trauma. 

Somatic experiencing developed by Dr. Levine is a method that works to release this stored energy and turn off this threat alarm that causes severe dysregulation and dissociation. 

Another method used more recently, focusing more on pain, but can be used on other symptoms, is part of the Pain Reprocessing Therapy, led by Alan Gordon and Dr. Howard Schubiner uses a technique called somatic tracking. 

I like somatic tracking because it is easy to use and effective. 

Other body-mind work may be a good addition, like yoga medication, but typically require preparation like a set as side time, class, video, etc. 

 Somatic tracking, once mastered, can be easy to use; it is quick and flexible. I use it with my patients and also teach them how to use it. 

Somatic tracking combines mindfulness, fear reduction while utilizing positive experiences. The ultimate goal is to look and experience pain and other somatic symptoms through a lens of safety, reducing the nervous system activation, rewiring the pain-fear connections. 

Learn how to re-interpret the sensations your body produces, such as pain and other symptoms, that start being processed in the primitive brain and connect these sensations to the thinking brain. You want to start seeing these sensations not as danger signals that activate the nervous system into the fight or flight response but as safe signals. 

 One condition that must be true, for somatic tracking to work, you and your brain need to be on board that your pain is neuroplastic or incorrectly wired in the brain. If you have questions about neuroplastic pain, please go to previous episodes. Understanding and accepting that fibromyalgia is a brain processing problem is a big step. Accepting that there is no structural damage, that the brain incorrectly processes pain, opens the possibility of you getting better. It will change the messaging in your brain and nervous system from one of fear and danger and safety and hope. If you continue holding on believing that your symptoms are due to tissue damage, that there is something structurally wrong with your body, as the cause of your problems, your brain will never get out of the cycle of danger and overprotection. If you embrace the fact that the brain can make mistakes, that it can misinterpret safe signals from the body as they were dangerous ones, you can start the processes of rewiring the brain, reprocessing pain, reprogramming your brain. 

There are 3 steps to somatic tracking. 

1.    Mindfulness. This fancy word means that you focus on being aware of what you're sensing and feeling in the moment, without interpretation or judgment. So, your goal is the pay attention to pain (and other fibro symptoms) without fear or judgment. Just be aware of your pain and other sensations. This can be hard if you have feared pain for so long. 

2.    2nd component of somatic tracking is sending messages of safety to your brain. This technique is proven to significantly decrease fear. It is also called safety reappraisal- an assessment of something dangerous in a different way as something safe. You can start reprogramming the brain processing problem by reinforcing that the sensation is safe. 

3.    The 3rd component is the observation of your physical sensations with curiosity and lightness. Paying attention with lightness is a critical component, also called positive affect induction. Scientists study this component by making patients look at happy images, funny videos, favorite songs, humor, anything that creates a positive atmosphere that lightens the mood, reduces fear, and promotes relaxation. It is not about laughter but making sense of the inner sensations in a positive and light way. You are creating curiosity about your sensations, exploring them as new to you. 

So you are trying to look at your pain or other fibro symptoms through a new lens- without fear, through a lens of safety. You are rewiring the brain to interpret the sensation correctly. 

Every component is designed to reduce the feeling of danger and create a sense of safety. 

So you are looking at your pain without judgment or fear. Safety reappraisal reminds you that the sensation is not dangerous but safe. And the light mood allows you to explore the sensations in a curious and safe way. You are rebuilding a relationship with your pain. 

The next episode will have a somatic tracking example or script that you can use to do it or use as an example to write your own. 

 A couple stipulations. 

If your pain or sensation is severe, you need to wait until your pain is moderate to light. You actually need to have some pain for the brain to learn this pain reprocessing practice. It's like practicing swimming without water. You don't want to start learning how to swim in the deep end of a pool or out in the ocean - your fear may overwhelm you. You need some pain to practice, but not too much pain to be overwhelming. 

You may need to do an activity that induces pain - if you have more pain seating, you may need to sit for a bit until your pain starts so you can process it. You may need to walk to induce back pain. 

When would you do it? When you are in pain or distress and catch yourself either treating it or avoiding activities that trigger it - like if the pain is with seating, you get up or use heat or ice. Instead, take just 2-3 minutes and do somatic tracking to explore your sensations and examine pain or distress mindfully. Once you are done, you can use your avoidance or treatment. You may start with just a few seconds if it feels overwhelming. The more consistent and frequent you are with somatic tracking, the better your results will be. What you practice makes it stronger. 

 Like with other somatic work like meditation, closing your eyes may help you focus on your inner body sensations; it reduces visual input. Unless you are inducing pain that requires your eyesight, obviously, there is no need to walk with your eyes closed. 

 As you observe sensations in your body, start with observing pleasant sensations first, you are sending messages of safety to your brain. Feel the breath, or slightly pleasantly touch your skin, rubbing your hands together, stretching your leg, moving your foot. Be creative, curious, delighted. Do it in an easy and effortless way, knowing that the very act of paying attention in this way to your body is teaching your brain to feel safe. Then you add pain or symptom observation. Many find it helpful not to call it pain but a sensation. Your brain may associate the word "pain" with immediate discomfort, something you need to get rid of. The brain processes all sensations, pleasant and not, so the goal is to process the painful sensation, as you would any other sensation. 

  As you start exploring somatic tracking, you will try to do it perfectly like anything new. Like a new diet or something you are trying to implement in your life, you may find yourself fixating on steps, being afraid to make a mistake. It will not promote a light mood. It may stress you out. Also, trying to observe pain because you had pain for a long time may lead to additional stress. If you are trying to follow your pain, learn your sensation, like a schoolteacher grading a term paper, with intensity and laser focus, looking for every spelling mistake, missing comma, and grammar, you will not achieve the positive affect. You are trying to look into your inner self with curiosity, like watching a sunset or looking through a beautiful bouquet of flowers, noticing different flower types, shapes, colors, textures. You are appraising pain through a lens of safety, without fear and judgment. 

Also, if you are trying really, really hard for the pain to go away, it will not. 

It's like telling you not to think of the color red. The more you fixate on fixing it, the more stressed out you will get, and the feeling of danger will be reinforced. So, lower your expectations. Enjoy the process, be curious and light. Expect that pain may or may not resolve, or it may move or change. You are not a mind controller, and you are letting your brain do its job. 

Just like breathing and digesting, the pain processing by the brain is done automatically. You are just trying to facilitate a safe and calm environment for the brain to do its job. Imagine putting a 1000 piece puzzle together on a Sunday afternoon; you were looking forward to figuring it out, imagining a beautiful final product. Each piece is unique and tightly fits into the big picture. If someone stands next to you, yelling to do the puzzle faster, better, stop looking at each piece so long, what's taking you so long?? Will you enjoy this puzzle? Will you put it together faster? 

The healing process will be a journey, and if you have been in pain or with other fibro symptoms for months or even years, it can take time to learn and establish new brain and neural pathways. It may take a month, many months, or year or years, depending on your past. Healing has no timeline. 

Healing comes gradually, with some ups and downs, periods of calmness, and flares. 

Your brain will send you many messages of drama, disbelief, self-sabotage. Like a teenager who does not want to do dishes, it will argue and find excuses not to do this work or why it was not helping or needed. 

Our brains want immediate gratification, an easy way out, an effortless life. It's normal and should be expected. Our brains are wired for efficiency, ease, and pleasure. Healing and change are not easy or efficient. We try to make it pleasurable by sending our brain safety messages with ease and lightness. 

 The next episode is part 2 of the somatic tracking, where I will show you the practice or example of somatic tracking. 

 You may try somatic tracking a few times, come back to this episode and listen again. I also have full transcript of the episode, you can find link in the show notes. 

Please email me at rheumcoach@gmail.com if you try it or if you have questions. I would love to hear from you.

If you are not part of my newsletter, please sign up; the link to sign up is on my website listed in the show notes. 

Thank you for listening.