What’s a little pain?

Politicians are making the decisions about your health treatments. The so-called ‘opioid crisis’ undermines ownership of pain management by doctor & patient, and policy takes their power. The facts give lie to their strategy. The Aust Bureau of Statistics reports that prescription drug overdoses, as determined by the doctor’s opinion for death certificate, needed intervention. The truth can be found in the Coroner’s forensic toxicology reports, where judge Sara Hinchey reports that Valium alone kills more Victorians than all the opioids combined. The GP lacks training in mental health appropriate to prescribing of anxiolytics eg Valium, and hence doesn’t realize the error of writing fixes for personal problems on script. I attended the Monash/Alfred Psychiatry & Life up-skilling course (PLUS), but only a few med students did so. A medic’s knowledge gaps are filled in by on-the-job learning, and rather than dash hopes I’ll sweeten the bitter pill through comedic device:

Marketing 101: to show your own product in a better light, disparage the opposition. Opioids – bad; anticonvulsants & anxiolytics & antidepressants – good. You could combat this perversion of practitioners for the sakes of profit by going to first principles, and studying for yourself the mechanisms of pain. An excellent presentation for MS sufferers is linked. But those bullet points form nothing more than a list of problems. Start again: reconsider your relationship with pain. And self-efficacy is the answer to breaking free.

I’ve just returned from ski patrol duties at Mt Stirling. Encouraged by others, out came the race skates – and within 1/2hr I was struggling to get breaths in, or words out. It’s a fast way to travel eg the 42km race record for the Kangaroo Hoppet is 1/2hr faster than world record marathon time. But up and down mountains? Words fail to describe the hurt. And don’t get me started on the sport of boxing! Muhammad Ali was no fool, but his rope-a-dope strategy of taking blows from then heavyweight champion of the world George Foreman meant unimaginable hurt. Until his opponent wore out, opened his guard a little, and lost the tournament. This too was Tony Abbott’s strategy, tho’ he lacked skill as a boxer and so took his fights to parliament.

Abbott at Oxford.

No pain, no gain?

Sports-ground torture, for our entertainment. Theirs is pain by choice. Suffering comes from inability to have any other option. This means that it’s reliant upon a perception, an attitude – as a victim of cruel fates, disempowered and dependent, waiting on a miracle. Already many doctors have realized that there’s no shortcuts via a pill, and Schubiner & Sarno (UnlearnYourPain.com), or Daniel Lewis (Pathways2Wellbeing) are notable exceptions to their industry. Their courses rely on you making the changes, upon which better health depends. Lewis’ quoting of Hippocrates “The natural forces within us are the true healers of disease” comes from his experience as a rheumatologist and using the very latest biologically engineered drugs, but his meditations are yet another century older – and from India, rather than Greek. Dr Craig Hassed, after just a few years as a holistic GP, started in the late 80s training Monash med students in mind & body. Mindfulness isn’t just a therapy, it’s the answer to getting benefit from all those meds which are supposed to help. Mindfulness, according to the conclusion of a review of all the evidence, alleviates symptoms, both mental and physical, in the adjunct treatment of cancer, cardiovascular disease, chronic pain, depression, anxiety disorders and in prevention in healthy adults and children.

Another meta-analysis, of 25 ‘gold-standard’ randomized control trials, ‘Acceptance- and mindfulness-based interventions for the treatment of chronic pain’ found that the most significant effects were delivered through Acceptance and Commitment Therapy – again, championed by doctors eg Dr Russ Harris who as a “GP became increasingly interested in the psychological aspects of health and wellbeing, and increasingly disenchanted with writing prescriptions“. Walking away from a fight shows guts, which comes from strengths training. In this case the decision to open up to our full experience with pain, will reduce the harm.

Of course, this all throws the onus for wellness back onto oneself, but isn’t that something you’d want ownership of? In a world driven by convenience, where ideas used to be expressed in essays but are now neatly confined to tweets, the notion of effort seems archaic. Why do a course on stress or pain management, when there’s the option of a pill! The exceptions standout from the crowd, such as Shannon Harvey – whose remission from lupus inspired her documentary ‘The Connection’.  I finish with a plug for a brill guitarist, whose instrumental album ‘Words Fail’ launches in Melb on 14th July. Every track expresses feeling, but I’m incapable of appreciating that talent as I’ve no musical skill, so turn to his earlier vocal “What’s a little pain“. A song from a broken heart is a match for any outcry of pain… and the same fixation upon hurt is evident. “Why do I remember the songs I hate” speaks to me of ‘earworms’, the way we get stuck in negativity. The more we wish to be rid of that annoying lyric, the stronger it becomes.


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