Training The Whole Person: Supporting Clients' Physical, Psychological, Spiritual and Social Health.

The overarching message of the course that I am studying at the moment (SURG 0133: Chronic Pain), is that pain is complex. It encompasses the biological, physical, social and emotional aspects of a person. My main takeaways from lectures have been:

• We can’t take a reductionist approach to the problem of chronic pain.

• It is a reflection of the society we live in.

• Quality of life, not a pain score, may be a better indicator of treatment efficacy. And most importantly

• Prevention should be the focus of chronic pain medicine.

In my reading for my essay on neuropathic pain I came across this image from here. It illustrates that chronic pain treatment needs to be centred around active coping strategies. People need to be moving, improving their sleep, managing their stress, eating well and participating socially through working and connecting to life goals.

I am a movement teacher, I specialise in helping people living with pain. I use movement, mindset and anatomical education to help them move smarter so they can do the things they love. So when someone contacted me after winning a personal training session with me, I thought that I would use the opportunity to expand the focus of our session beyond body and mindset which is my usual approach. I asked them if they would be open to having a Health MOT with me. In a ninety minute session I listened to them talk through their pillars of health. We chatted about how much time they spend in nature; about their sleep; about their movement; their nutrition; their hobbies and what they do for relaxation; their place in the community, their friends; and whether they felt that they were living their values. I then asked them about their stress levels: some people don’’t have enough stress in their life and are bored, some people have too much and feel overwhelmed.

The person that I spoke to was incredibly honest and open with me and had experienced difficult life events. When I asked if they had seen a therapist - they admitted that they had tried but it wasn’t for them. Time away in a holiday home where pottering and repairs filled the day, and time with grandchildren were things that made them happy. When looking at their health and their life as a big picture - they could see that high stress and the resulting poor sleep needed to be addressed before anything else.

This session was a wake up call for me - I don’t talk to my clients this deeply usually, yes we do a PARQ but health is so much more than knowing that a person has been cleared by a doctor to exercise. Giving someone an hour and a half to be properly listened to was a gift. I left them with the homework to take a hard look at their work life balance and reassess. At my one month follow up this was their response:

It looks like I’ll need to check back in another month’s time.

I also decided to try this as a one off zoom class - the accompanying blog post is here

It was well received:

These class participants are facing difficult decisions. As older adults they feel vulnerable to Covid and so stay at home to protect their physical health. In doing this they are compromising their other pillars of health. They are socialising less; they are moving less; they are not living their full lives; and their stress levels are very high. I left it to each of them to decide what was the right health decision for them.

I have also developed this exercise into a 10 minute session that I used with my meditation class. First they copied my picture of a house and then they drew their own house in another colour. Every line in the house corresponded to their diet, movement, hobbies, social interactions, sleep and living their purpose. The tree outside reflected their time in nature their termite was stress. Each element’s size depended on whether it was acceptable (short line), good (medium line) or very good (full line) on each category. They then needed to assess how balanced their house was.

I will be using this Health MOT as an initial first session with all new 1:1 clients from here on in. I will repeat the class and the short exercise too. It helps prioritise our focus and helps the client understand that movement is a part of living a healthy life - but only one part. Pursuing hobbies or relaxing are not things to feel guilty for either. Our down time shores up our physical, psychological, spiritual and social reserves against stress.

I would not have adopted this approach if I had not been reminded to look at the bigger picture. It has been further reinforced through learning the physiological role that nutrition, downshifting, exercise and sleep have in reducing inflammation. Inflammation is the enemy of chronic pain after all.