Episode 6: The 5 core steps of the Winning At Fibromyalgia MethodIn this episode I introduce the 5 core steps of my Winning at Fibromyalgia Method. I have worked hard to distill it to just the main 5 so that it is short and simple.
Today I am bringing you episode #6! It is so far my longest episode and possibly the most exciting.
I am explaining my “Method” how I approach fibromyalgia in my practice. It incorporates and summarizes things I learned from multiple years of rheumatology practice, attending, and listening to lectures on the topic of fibromyalgia, and attending courses of providers who treat (and often cure) chronic. It is a method I use on myself, as I have a mild to moderate case of myofascial or fibromyalgia pain in my back. I have worked hard to distill it to 5 basic steps and I will be sharing them with you in this episode.
Before I dive in, I want to mention that I do not talk about any medications that are frequently used in patients with fibromyalgia. The reason for this is that in my coaching practice, I do not prescribe medications. They CAN help but are rarely a long term solution on its own. I only rarely see cases when a medication works on its own, without the person doing any extra work. It does happen, but not that often. So I will not spend any time on medications today.
Another comment or disclaimer I need to mention is that The pre-requisite for working with me (whether privately or in my clinical practice) or applying this method on your own is that you do have a confirmed diagnosis of fibromyalgia. Which is best accomplished, IMO, by a rheumatologist. Reason for that is that as rheumatologists, we are uniquely trained to recognize and weed out all different sources of pain. So that’s a really important step “0”, ground 0, so to speak, before you can dive in the deep work of “Winning at fibromyalgia” method we will discuss here.
So, Are you ready? Here it is
The 5 steps of my unique WINNING AT FIBROMYALGIA method are:
1. Be open to learning the concept of
neuroplasticity
Believe 2. you
can and deserve to feel better 3. .
4. Practice sending
messages of safety to your brain 5. .
Feel and process all of the emotions 6. .
Listen to your intuition 7. and let it guide you.
That’s it. 5 steps. Simple.
Let’s dive in each one.
Step #1: Be open to learning the concept of neuroplastic pain.
I have had many patients tell me that just the mere act of explaining the concept of neuroplastic pain literally lit the bulb in their head and they understood for the first time how their emotions are related to the pain. As a brief summary – neuroplastic pain means the pain you feel is REAL but is not caused by the injury or structural damage of tissues that are hurting (whether it be back, or arms or legs or any other body part). It is caused by misfiring neurons. Misbehaving neurons. Neurons that are misinterpreting neutral or safe information from the body as unsafe and translating it into pain. Brain is making a mistake.
WE ALL Know that stressful situations can cause symptoms – e.g. blushing in certain people (including me) when embarrassed, tightness or knots in the stomach when nervous, heart beating fast and sweaty palms – we accept those as normal and physiologic. We also accept that the symptoms described above are brief and resolve on their own.
But many people balk at the idea that physical PAIN ALSO can be a physiological response to stress. As if it was something to be embarrassed about. But guess what? It IS. Research has shown this. Pain in patients with fibromyalgia is facilitated through the SAME MECHANISM – of activating the “flight or fight” response. The difference is that it does not turn off. The neurons connections of pain pathways loops do not turn off, their pain volume is turned up.
Many people talk about pain in FM as just the pain volume control problem. It is volume control problem DUE to chronic stress, unprocessed emotions and all the past hurts dating as far back as our childhoods. Our memories, every single experience of our life is stored in the billions of neurons that compose our brain. Some of them are wired together through similar painful experiences, they created a NEURON SIGNATURE. And that gets activated when the “critical” threshold has been reached.
And as I mentioned many times before, the pain IS REAL, as documented by multiple studies with fMRIs (functional MRIs).
Understanding of neuroplastic pain, where it comes from AND THE FACT THAT IT IS NOT PERMANENT/it does NOT HAVE TO BE permanent, brings about a breath of hope. Because pain pathways CAN BE REWIRED 100 percent. Which brings me to #2 point.
Step #2. Believe you CAN and DESERVE to get better.
This has been arguably the toughest part for me on my own journey. And I have found to be the case with many of my female patients. Believing we CAN AND DESERVE to get better.
We often carry various burdens, sometimes dating way back to our childhoods, that we are not deserving of good things in life, or good health, or whatever good. It has been shocking to me to discover that I myself struggled with it, and MANY other women, including women physicians, have the same issue. At the same time, becoming aware that it might be your problem is a source of hope. Because believing one can get better is written all over the research studies and demonstrated by multiple success stories. Women with pain DO get unburdened from their pain, IT is a fact hence it is ok to believe it is possible for you too.
Believing we are DESERVING is separate from believing in a possibility of getting better. I struggled with this a lot and had a breakthrough in this belief (or rather, dis-belief) after hearing a comment of one of the prominent life coaches in my recent coaching program. It went something like this: “our innate essence, our pure SOUL, is inherently lovable”. The light went off in my brain, and I felt an instant relief.
How to go about this in general? IMO, it helps to identify where the idea of not being deserving comes from. My lack of belief in being deserving came from all the past wrongs I did (usually related to uttering hurtful words to family, or coworkers). I believed all the things I done wrong in my life made me undeserving. Nothing could be further from the truth. We are all humans and we all make mistakes. Hurting other people feelings does not make us undeserving, it means we have some faulty thought processes or beliefs that we need to work on. It makes us human. And forgiveness is available to each of us. If we give ourselves compassion, like we do to other people we love, we are able to see that making mistakes is human, it does not make us undeserving. Eventually my “disbelief” was released when I believed that I can forgive myself for all the past hurtful things I said. It is a process though, and it does not happen overnight.
Believing is a HUGE step in getting better and I cannot overstate the importance of this. Power of belief has been written about by many authors, Dr. Bruce Lipton and Benson just to mention a couple. There is now scientific evidence that the power of belief can heal. Or harm. Our mind is very powerful and if we believe we can get better we usually do.
Step #3. Deliver messages of safety to the brain!
Another important one! Here belong the somatic tracking, fierce self-compassion and any other technique, of mindfulness or meditation that installs stillness and feeling of safety and calmness. It is also referred to as relaxation response.
We talked about how neuroplastic pain is a result of chronic irritation/activation of the flight or fight system (sympathetic nervous system) of which main hormones are the adrenalin and dopamine and cortisol. The brain needs to be calmed down, and it is achieved by activating the PARASYMPATHETIC nervous system.
We deliver messages of safety by calming our breathing, our thoughts, observing the sensations/pains in our body and telling brain – “it is ok, it is just pain, and we know where it is coming from. I am ok, my body is ok, you are ok, brain, it will be ok”.
I heard a very helpful comparison to what it means to activate a parasympathetic nervous response. The person explaining the process compared it to imagining you need to calm a scared child or scared self when you were little. You would soothe the child with calm voice, hugging and talking in a low voice and giving messages of safety and reassurance that everything will be ok. And our brain is behaving like a scared little child sometimes.
This is where FIERCE Self Compassion comes in also – recognizing all the emotions or difficult situations we are going through and giving ourselves love and compassion like we would to a good friend or someone we love.
When our breathing and heart rate slows down and blood pressure is lowered by eliciting the relaxation response, during somatic tracking or practice of self-compassion, our brain gets the messages of safety and reassurance. The practice of activating the parasympathetic nervous system literally activates the healing response. Chemicals produced by neurons during the relaxation response literally counteract the toxic effects of the chronic stress response. Your body starts healing DURING the practice of mindfulness, self-compassion and somatic tracking.
Step #4. FEEL and PROCESS all of the emotions.
So this is the step that is equally important to all the other steps. I talked a little bit about the importance of addressing emotions in the last podcast. People with chronic pain often have a lot of emotional distress, related to the pain but also to the current and past charged interactions or events in their lives. Often times the emotions were not being able to dealt with for one reason or another so the person suppressed them and just bottled them up.
Unprocessed emotions can manifest in myriad of ways, of which pain is just one. I don’t mean to talk about all the ways unprocessed emotions are detrimental to us. The most common examples are chronic irritability, or eating or drinking as ways of coping with unpleasant or difficult emotions.
I want to zero in on emotions as they pertain to chronic pain. Anger, guilt, resentment, all of them have a role in chronic pain. Mutliple studies have shown that processing and releasing the emotions leads to improvement in pain and overall life quality.
Possible avenues for release include EAET (emotional awareness expression therapy), IFS (internal family systems) and literally ANY THERAPY that allows for processing of the emotions related to current and past pains and hurts.
It can happen whatever way you know that works for you. I have searched many years to discover that IFS (internal family system) method is the best for me. It may be the same for you or something else. We will explore together what are your ways of coping and what would the most suitable step to engage in if you have not discovered your preferred method yet.
The bottom line of this step is to go back to the upsetting event, feeling the things you felt in the moment and REWRITING the story, in your imagination, of how you would have preferred to handle the upsetting event. It is/has been truly transformative for me.
Step #5. Get In touch with your intuition And let it guide you.
Your inner core self, your intuition, is like the all knowing guide that will tell you where you need to go. It is that little voice that you often feel, but many times don’t listen to, that knows what is best for you.
Dr. Lissa Rankin refers to it in her WHMI course as the inner pilot light.
Sometimes we call it gut feeling.
Steve Jobs had the best quote on this. He said: “"Have the courage to follow your heart and intuition. They somehow already know what you truly want to become.”
IN essence, our core self is calm, wise, curious, compassionate, loving, and having a lot of clarity.
Our inner self what is best for us and where it would like for us to go.
If we listen, amazing things happen.
If we don’t listen, interesting things happen. Sometimes we have pain, sometimes we feel uneasy or we can tell something is off.
The reason I mention intuition here is that following our inner wise or core self has implications on how we perceive our lives. If we live out of integrity with our core true beliefs, we often find ourselves feeling frustrated or stuck or irritated or angry or all of the above. And often we can experience pain.
Our inner core self can make us bold things, that sometimes others would judge or disapprove of. I am talking about people pursuing their dreams by changing careers, signing up for a school, or new course, asking for a promotion, asking for a raise, speaking up on behalf of others, becoming an activist. Or it can be ditching an old friendship if it does not feel it is serving us. Following our intuition can have MANY forms and it looks different for each of us.
I suspect we will talk more about this step in some of the future episodes but I considered it important enough to incorporate as one of the 5 core steps of my program.
I do need to mention one other disclaimer here at the end.
I DO NOT consider winning at fibromyalgia being pain free. What?? Yes, you heard me right. I do not believe that in order to live a good full life, free of fibromyalgia burden means being completely pain free. Don’t get me wrong, it IS nice to be pain free but I have found it is NOT required to be pain free in order to feel good. So how do I DEFINE a successful end to my method? For me personally, success means feeling good, healthy, strong, strong enough to do things I need to do and to enjoy life on my terms. Some pain is not a deal breaker – if it does not consume me.
So these are the 5 steps of my method (WINNING AT FIBROMYALGIA).
Shoot me a message if it piqued your interest.
Book a call with me on my website.
I would love to hear from you.
More good stuff to come from me in the future
https://www.martinaziegenbeinmdcoaching.com
