How to Structure a Pain Education Class When There Are More Flavours of Pain Than Coffee
Pain is unique, personal and has far more flavours than any coffee order we could ever imagine. Each of the older adults in my embodied anatomy class live with pain. In February I taught a block of Understand Pain classes. I did this because knowledge is analgesic. They already understood the biomechanics of their joints - it was time to explore what else might be driving their pain. This was a departure for me, but I knew a little pain science from studying neurological rehabilitation and being a huge fan of Noigroup. The link to the class videos is here and links to my class handouts are here.
These classes were helpful at a superficial level and I got some good feedback from participants. Someone still uses her breathing techniques during medical procedures. Another thinks of me as she lunges repeating “smooth, fluid and easy” and “pain does not mean tissue damage.”
Now that I am studying pain management I see that I need to teach these classes in an entirely different way. Pain is far more multi dimensional than the anatomy of the acetabular femoral joint. People who live with pain need to be properly listened to and have a platform to share their stories. Their pain will drop as their psychosocial functioning rises. For the first half of each class, we will need to be able to chat and interact. The class size will need to be small, I will have to keep it to eleven people so that we can all have a turn, and so that everyone is on one zoom screen. Participants will also need to take a far more active role in knowing their pain and thinking about culture’s perception of pain. The program will need to be longer and also include guest speakers -from U3A's large pool.
The first class will focus on establishing our baseline. We will fill out the Brief Pain Inventory and chat about it as a group. Does it encompass our actual pain experience? Would it have been filled out differently in the middle of the night or while chatting with friends? What questions does it miss out? How do things such as gender and our upbringing influence our response to pain? With those questions in mind we would then write about our pain. We will describe how the pain feels as well as its impact on our life - using words not just numbers on a scale. Before moving on to our exercise circuit we would look at Moseley and Butler’s protectometer to help us identify things that help us feel safe and things that make us feel a sense of danger. For homework we will create our own protectometers to talk about next week.
The second week will focus on goal setting around improving physical and emotional function; quality of life; and reducing the impact of pain on life. We will also aim to connect and forge friendships, with the idea that the group can carry on without me after the end of the course. My goals as a teacher will be to help people feel ready to understand their pain; feel in charge of their health; feel confident in their ability to manage their pain; and to know that they are worth the effort.
Over the rest of the term I will alternate with guest speakers such as a nutritionist and psychologist. I will use my original six classes as conversation starters along with prompts from The Pain Toolkit; lecture notes and ideas from my pain management course; and the Explain Pain handbook. The prompts will ideally enable people to come up with practical solutions for their own life.
The final class will need to be reflective. Have our BPI scores changed? Have our pain stories changed? Have we achieved any of our goals? Were we happy with the class? Did it help? Who dropped out -and why? This program may evolve into an evening support group for working age adults. It may not. What I do know is that my pain management course has given me the impetus to read widely and deeply about a fascinating subject that affects both my lovely class participants and close family members. If I can help them in a small way what a victory that will be. Because after all: