About 5 years ago I injured my back, by falling whilst cleaning windows. I know, what kind of fool cleans their windows?! To put it in context, I was working too hard, I had tonsillitis, my father-in-law was coming to stay and the windows were filthy. I thought just a quick clean would do the trick. (I should just say at this point, that although I’ve learned a lot since about not trying to be superwoman, I realise that sometimes accidents just happen. This is not about blame!)
I fell, hard and completely unable to break my fall, landing on the edge of some stacked roof tiles. I didn’t fall from a great height, otherwise I might not have been writing this blog at all, but in the initial moments after I landed three thoughts flashed through my mind: “I can’t stand up”, “that hurts intensely”, and “I just nearly hit my head on a stone well, in front of my two young children, and I was centimetres from killing or paralysing myself”. In the months that followed I discovered it was that last thought that was the most significant.
Investigations followed and it became clear that I hadn’t fractured anything in my spine, but had forced part of my spine sideways, so my pain was related to muscle damage rather than anything more significant. I felt quite frustrated that I was in agony, but “bruising” didn’t feel like a suitable description. I was judging myself for making a fuss about something that “wasn’t even a fracture”.
The reason I’m sharing this story, is that during this time I learned a lot about pain. The book that most helped me was “Mindfulness for Health” by Burch and Penman. This describes how the actual physical sensations of pain in our body can be described as “Primary Suffering”. These are the messages that go from an injury, or illness, or problems in our nervous system, to the brain and we feel them as pain. However we also have thoughts, feelings, emotions and memories associated with the pain, which might include anxiety, stress, worry, depression, exhaustion or fear for the future. This is our Secondary Suffering and the pain we experience is a “fusion” of both Primary and Secondary suffering.
Often I notice that people feel quite challenged by the idea that our thoughts affect the level of pain we experience. I know I felt a little embarrassed when I considered this might be true. However this is not saying “it’s all in the mind”. It’s saying “we can’t separate our mind from our body”, and there is great benefit in discovering the meaning of the pain for you.
For example, when I fell, the significance of nearly dying in front of my young children had such an impact on me, the pain I felt had an added layer of trauma. The fact that I couldn’t pick up my three year old daughter caused me great distress, which also magnified my physical pain. I was afraid of the impact on my daughter, and I felt less able to be a Mum.
When I tried to go for a short walk with my husband and children, just down the lane next to our house, I found myself 500 metres from my home, in tears, unable to get home because I couldn’t walk any further. This time it was my fear for the future that really heightened my physical pain.
The book includes a CD of guided meditations, which introduce the idea of softening into pain (rather than fighting it), and reducing our secondary suffering, through awareness and breathing. It was astonishing to notice that I could reduce my pain by (subjectively) 50% using these techniques. I also learned to pace myself – just doing half of the washing up and resting, rather than battling to the end of a task. This was completely against my nature, which had previously used striving as my main tool for success. And it made me challenge my beliefs and assumptions. I had to face up to my pain, and learn to adjust my expectations, in order for my pain to reduce.
What I didn’t realise during those early months, was that I was learning an incredibly useful tool, that applies to so many emotional states, and which I’ve turned to repeatedly since I recovered. Professionally, as a GP, it was helpful to look out for the secondary suffering and to ask patients directly about the impact of any symptoms, because allowing them to voice their fears, beliefs and assumptions enabled them to release some of their secondary suffering.
I also started to notice that secondary suffering was influencing me in many other ways. When I’m angry, I now know that judging myself for feeling angry just adds another layer of suffering. When I feel anxious, I now know that criticising myself for feeling anxious, makes me more anxious. And when I feel all grumpy and “out of sorts”, being mean to myself about not being a perfect human, just makes me feel worse.
Using meditation practice, I have learned to peel away the secondary reactions to my feelings, and started to explore the emotions themselves. Sometimes my anger is justified, at other times it is making me aware of something I need to change, or an assumption that may be incorrect. Sometimes my anxiety is trying to keep me safe, or reminding me I need to ask for more support. And my grumpiness is usually my “resistance” to something that I’m fearful of, or something I’m not wanting to tackle (like GDPR!).
Until I had my back injury I instinctively knew that we all have reactions to our own suffering, but really experiencing severe pain and noticing how much my pain reduced when I released my secondary response, was a revelation. At the time of my injury I had no idea that my sudden feeling of mortality was so significant. It took me a while to recognise that my existential crisis was contributing significantly to the level of pain I was experiencing. I needed to accept that an accident had nearly caused my death or paralysis, which would have been witnessed by my very young children. I also needed to accept that trying to do everything and be superwoman, wasn’t working any more. It was time to start a new chapter where I took care of my own precious life, as well as my children.