*Image and story shared with permission and anonymised*
This image is not the end of treatment for this person, but an achievement we are celebrating. It is part of a long piece of work, is not without pain, and should not be taken out of that context.
A picture can say a thousand different words to a thousand different people, but when a client shared this image with me it spoke to me.
On the one hand, this is image is a person running through a beautiful part of the land within which they live. Enjoying a family jog in the sun, full of the joys and the knowledge that they are sharing their passion with their young children - and with each other. To passers by they are expressing their identity as a family committed to exercise and the outdoors. Individually, they are embracing and living their values as people that love to run.
And yet there's pain.
There has been pain.
And there is the uncertainty of what the future of that pain may be.
Living with persistent pain (pain that is present for more than 3-6months) can be a daily, minute-by-minute, internal struggle with an experience that no-one can see in a world that can feel inflexible, unyielding and unforgiving.
So how does someone get to this point? I've no fancy answer here.
The journey towards this image has been a long, challenging and at times, emotional one. However, she felt 'ready to take the step'.
Being 'ready' is an interesting topic. We have no way of knowing if a person is ready or not. That is an entirely unique, personal and probably not easily communicated experience that you may not even be aware of yourself. But, without a doubt, it's important.
Readiness, often called willingness, is that forward leaning energy towards taking unknown steps and allowing something unpleasant to 'be'. Often we think or assume that the unpleasant thing we are allowing is pain, but of course this might be very difficult or may not show up as the most distressing. It could be disappointment, frustration, anger, self-loathing, fear and well this list could get quite long...
What if accepting pain or distress is part of the work required towards doing the thing that you really want? What if we could find a way to use that acceptance of pain as a bridge? And what would life look like if you were able to do some of the things you miss most, but they came with pain? Would you do it? Would it be easy?
That's what I see here.
I see a person that is using all the skills of allowing, embracing and accepting here. Channeling her flexible capacity to forgive herself - and the action of running. Because it's not perfect, but it 'is'.
Pain and the pain of pain comes along too, like a shadow on the grass. It joins, moving along with your moving. Acceptance here might be a making peace with your shadow. A gentle acknowledgement that right now, it's coming with you. But maybe we can change the nature of it's coming with you. And maybe that feels somehow easier?
Is this treatment?
The word 'treatment' can feel uncomfortable here. You might treat a skin infection with an antibiotic cream, but when it comes to supporting people with pain, we don't know what the active arm of the intervention is. Instead we are trying slip into the body-self-world of the person, listen and connect on a human level. We are zooming in to the way the body works biologically and then zooming out to how this sits your world. Looking at behaviour and thoughts, as well as metaphor and knowledge. Reflecting collaboratively on whether something is useful for you, rather than just poking around hoping something changes.
The role of the therapist in this modern pain care is holding the space for a person to be curious, scared, conflicted and committed. To open up space for expression and playfulness, for passion, for drive, for challenge... for set-backs and step-ups.
To jog alongside, and ultimately, be left behind, when it's the right time.