The 7 A’s of healing come from a book by Dr. Gabor Mate, called When the Body Says No and as I read through them, it became very clear that the 7 A’s to healing from a cancer or other chronic health condition are applicable to those experiencing persistent pain. As a physiotherapist taking a holistic approach, I often find therapy gets stuck when these areas are not addressed or deemed important to the healing journey.
Although I may not be the one specifically addressing these factors, I want to highlight their relevance to an inter-disciplinary approach to healing. There is no, one therapy or one pill to resolve a long standing issue. Often it requires the help of different people, all working toward a common goal…Your goal.
I will highlight the 7 A’s and apply them to persisting pain.
- Acceptance
- Awareness
- Anger
- Autonomy
- Attachment
- Assertion
- Affirmation
Acceptance
This has to be the first step. Acceptance is often confused with “giving up” or “being the victim.” Acceptance has nothing to do with that. It is simply being open and honest with ourselves about where we are currently, accepting that our body has unpleasant sensations and that these sensations are currently preventing you from doing certain things. It is about accepting all the thoughts and feelings we have towards our current health but not letting these thoughts and feelings paint the future.
Example of accepting: “Today my body feels tired, I have tingling and stabbing pain in my back and am finding it hard to motivate myself to get dressed. “ You are acknowledging what you are feeling in the present moment and staying present in the now. When we bring that presence we also open the door of opportunity to see change too. How you feel right this moment may feel different in the next moment. This takes practice and there are specific techniques that can help.
It is going to be very challenging to move forward in a healing way if you cannot accept yourself. This may mean delving deeply into one’s self and challenging beliefs around “being worthy” and being “enough” to be whole. If you are stuck here, the best place to start is with some psychotherapy. They can help you gain different perspective as well as provide you techniques to help foster self-worth and acceptance.
Awareness
Dr. Mate talks about awareness as the ability for emotional truth recognition. He says many people lose this ability to sense the difference between people’s words and the truth of their emotions and this includes our own words. Are you able to detect if the words and thoughts are alignment with your gut feelings?
He says being able to perceive your emotional reality would help release the fear that we are not strong enough to face the truth of ourselves. How good are you at perceiving your inner bodies state? Can you sense your tone, the quality of your smile, how you are feeling and where you feel it?
Are you able to identify the signs of stress in your body? Do you know what your body feels like, when it feels in danger?
Did you know that pain is a signal of actual or potential danger?
In the Book The Stress of Life, Selye listed numerous body sensations as signs of danger; pounding heart, frequent urination, headaches, backaches, anxiety, irritability, diarrhea, sweating, over-reacting and the list goes on.
How well do you associate these sensations to an emotional state? Fostering this kind of awareness can unlock clues to your healing. Learning how to do this requires you to become curious about everything you are feeling. Not sure how to get started, start with psychotherapy.
Anger
When anger is suppressed, repressed or acted out unregulated, it is an abnormal release of this emotion that can have many negative health consequences, including pain. When anger is expressed and experienced in a healthy way there is a release of energy, tension and anxiety.
Anger is a powerful emotion with a lot of energy. Learning healthy ways of expressing and dealing with the energy of emotion is healing. Firstly anger is not only a physical experience but it also has a cognitive one too. Meaning when we experience anger it is usually because something has triggered us to feel this way. Are you able to experience anger while thinking about it, why did I just get so angry? What triggered this feeling and how can I best address it.
When it comes to pain there can be feelings of anger; anger over the timing of pain starting, anger about the situation that caused the pain, anger about how it’s disrupting your life, anger over the fact that no ones believes your in pain, anger over a lack of support and the list could go on. These thoughts and feelings can add to secondary pain.
Primary Pain is the actual injury or experience when the pain first started.
Secondary pain is not about the tissues or structures involved but how we think and feel about our experience that can increase our level of distress. Mindfulness based practices talk a lot about targeting the secondary suffering.
Do you find yourself feeling angry? Want to explore different ways of addressing it? Here are a few examples of what might help people with the emotions and energy of anger, walking, exercise, mindfulness practices, meditation, talk therapy, journaling, yoga, being out in nature. This is just to name a few.
Autonomy
This can be challenging to explain. Autonomy is being able to foster the development of internal self control. Meaning, when someone asks you, what is it that you want from life and your relationships, or this therapy session? Being able to answer these questions from an internal state of self, I want this versus answering from a place of what other people expect me to want and value.
Autonomy is about being able to move through the healing journey the way we want, with our mistakes and victories. The sense and feeling that we are in charge of our lives. Autonomy is then the ability to decide, live and speak our own truth. If you can develop your own sense of personal boundaries, lots of healing can take place.
When you are in pain, it’s about being able to decide what happens to your body through the healing process. Often times people don’t know what to do about their pain, so they come to a physiotherapist. Its important that the physiotherapist explains what is happening and what needs to be done. But the most important aspect of the healing journey is your decision. Does what the therapist said makes sense to you? Do you agree with their approach? Does it feel like the right thing to do for you?
Attachment
This is not only about how other people show us support but how open we are to receiving support from others. The “I’ll do it myself attitude” may not be the most helpful when dealing with a chronic or persisting problem. We are hard wired for connection and it is important for us to have attachment and connection in positive ways that support our healing journey. When we lack these attachments to self, others and purpose, healing can be challenging.
Assertion
Assertion is about being able to be our selves, in the way we are. We can declare to the world…This is who I am. There are no actions or reactions required. It is simply a state of being our self. We do not need to justify our existence or worth. We are worthy. Fostering the ability to express our authentic self is very important. Again this may be further explored with a life coach, spiritual life coach, psychotherapist or religious figure.
Affirmation
Dr. Mate talks about 2 types of value affirmations. He says when we affirm, we make a positive statement and move towards something of value.
The first value is our creative self. We all have an urge to create something. This can come in the form of writing, speaking, cooking, crafting, music, art. What value do you want to create in your life and the world? When was the last time you were still enough, quiet enough to hear your own creative self speak? Nevermind, actually doing that creative thing.
The second value is the affirmation of the universe, that we are connected to everything and everyone. We are not alone, cut off from existence. We are part of the whole existence. Our place, our role on this planet matters. It should matter to you and when it doesn’t, we feel isolated, disconnected, unworthy and the world seem cruel and unloving. If we can foster these 2 affirmations in a healthy way, the energy of healing can flow.
Physiotherapy
When I am treating “chronic” persisting back pain or a persisting pelvic pain condition, I am assessing for these disconnects. I need to be able to identify these aspects so that I may best serve you by making referrals to the appropriate healthcare practitioner. If diet is a problem, then I involve the naturopath, when emotions are problem, a psychotherapist, when your spiritual connection to a higher purpose is a problem then a spiritual life coach.
We need to dig deeper past the physical sensations and begin to look at what these sensations mean and what they represent in your life experience. Its not uncommon when I have people working on a movement based exercise that emotions come up. They are coming up because they have been locked in your tissues. Once I get your body moving better this energy moves too. Movement, breathing and exercises are some of the approaches we use to help move energy, change sensations and release tensions which may subsequently move emotions.
If you are curious to dive deeper into how our experiences earlier in life, set up our behaviours that may have lead to our current situation then Dr. Gabor Mate’s book: When the Body says No is a great read.