Pain. It's a complicated thing. Thank goodness, a lot of research goes into figuring out pain. What is it? Where does it come from? Without going too far down THAT rabbit hole, I'm going to focus on one aspect of pain. Due to pain's complexity, it is not completely useful to only focus on getting rid of it. Why? Because pain is so contextual. Let me give you an example. Last week, there was a rainy and all around glum day. Over 75% of the patients that came in the door that day were also just as glum and reported more pain. Did the rain turn the pain dial up? I don't think so. Did the brain adjust to the environment? Absolutely. So only focusing on pain can actually be... inaccurate in a sense.
As most of you know, my husband Kyle is a teacher. I recently discovered that they encourage their students to make goals based on the WOOP strategy. I got super jazzed about it because it was something I had heard a while ago on a podcast and at the time I thought is was brilliant! Then it got shoved somewhere into the depths of my brain, long forgotten. But now, it is being revived and shared with you!
WOOP was developed by Gabriele Ottingen, author of Rethinking Positive Thinking (I love a good bashing about toxic positivity, by the way. "Everything happens for a reason?! Give me a break). It is essentially a well-researched blueprint to follow in order to help you organize your goals or as she calls them, wishes. I think this is the perfect tool to use to direct some attention on the "why" of the healing journey instead of staring into the void that is pain. The perception of pain is tricky. Organizing the "why" using the WOOP strategy is concrete.
The "W" is for wish. What is it that you desire? Yes, having pain go away is a perfectly good wish but take it a step further and attach it to something you love doing. An example is, I would like to hike with less pain. Perfect! The first "O" is outcome. What would achieving your wish look like? In my example, what does hiking with less pain mean? Spending more time with loved ones, getting to be in nature, getting a good workout, seeing wildlife, etc.
The second "O" is my favorite, hence has its own paragraph. It stands for obstacle but specifically, what are the obstacles within me? Ah yes... don't look out there. Look inside here. What could be keeping you from achieving your wish? This gets heavy into the psychosocial and emotional side of things. The sticky, gritty, but oh so good stuff. This list can be tough to read and some of them might make you think, 'That is ridiculous! Not me!' Why does it make you think that?
Some internal obstacles could be the following:
fear of failure
fear of getting better (yes, it's true for some people)
fear of getting out of shape or gaining weight
fear of what others think
fear of missing out
feeling helpless or powerless
anger towards your body or the circumstances
worry that things will never improve
a strong identity with the activity the pain is keeping you from doing
past experiences that fuel your attitude and beliefs
negative self talk
low self worth
feeling that you're broken or defective
feeling less than your peers
a strong identity with your pain or disability
secondary gains: for example, the increased attention you're receiving because of your pain is pleasurable
the ability to get out of or avoid things because of your pain
negativity biases: focusing on what you can't do more than what you CAN
This list is hard! I know it is! But the truth is, I see parts of this list weekly in the office. These things are real. You have to be honest with yourself. Do any of these things resonate? I will tell you a personal story from about 5-6 years ago. I had wicked pain in my foot after a 50-mile race that took me out of running for a good part of 6 months at least. After much digging with a therapist, I realized I was telling myself that I didn't deserve to run anymore because my race had gone so poorly, according to me. Isn't that crazy?! But it's true! Spoiler alert, we don't get to control our thoughts. The saving grace? We get to control our reactions to our thoughts but the key is being able to realize they are there. Before the grand reveal of that thought in my therapy session, what did I do? I kept walking on it. It hurt every step. I would just get angry when I felt the pain and walked anyway to show it who's really the boss. I would even try running sometimes when it was already sore only to walk back home. When I finally realized my stinkin' belief, I wore better shoes that protected my foot and allowed the relief I needed while I was at work. I didn't try to push running. I starting playing for MY team. I had more compassion for ME and my body.
Whew, okay, now that the deep stuff is out of the way, time to move on to "P". This is, what is your plan?! What are baby steps that can be mapped out along the way? Sure, it is likely the plan won't go EXACTLY that way but you will have a general idea of where you're headed. With a plan, there can be intention about each choice you make. There is a "why". Parts of the plan can include various therapies, nutrition, modes of exercise that don't increase symptoms, stress management, spending time with loved ones for support, and sleep management.
Pain is certainly real. It is the human experience. Everyone feels pain with varying intensities and frequencies throughout their lifetime. If you find yourself wanting to address your pain, try using WOOP to guide you. You might be surprised at what begins to unfold.
If you would like to find out more about WOOP, visit their website here.