Early in August, my group presented our final self-evaluations. Since I had a lot of money left on my meal card, I treated us all to lunch from Publico, a wonderful taqueria on Gene Friend Way. They have a remarkable fish and chips burrito, and I also really like their vegetarian burrito, with chipotle crema added. Their French fries are superb.
That week at the palliative care team meeting, someone shared about a patient’s intractable pain. She listed all the medications that had been tried, along with acupuncture. She asked for help from the group, and I briefly described a few ways of using meditation to address pain. The woman jokingly asked if I was available to see the patient that day.
One of the things I mentioned was to do a body scan, guiding the patient in moving her attention from her feet to the top of her head, to help her inhabit all of her body, not just the part that hurts. I also suggested asking the person to focus on the very worst part of the pain and then to move her attention gradually away from the epicenter, until she arrives at a part of her body that doesn’t hurt at all. My final suggestion was drawn from Somatic Experiencing: to ask the patient to focus on the pain, and then on a part of her body that is completely free of pain, and then, on her own schedule, to shift her attention back and forth between these areas. Like the first two methods, this reminds the person that there are parts of her body that don’t hurt, and also keeps the nervous system from getting stuck in pain-resistance mode. Pain is unpleasant without a doubt, but resistance to it can make it much worse.
An interesting thing I learned around that time is that the brain does not have different pathways for physical, psychological, emotional or spiritual pain: pain is pain. Therefore, addressing any of these kinds of pain can lessen the overall intensity of the pain.
Early in August I saw a young patient several times that a number of chaplains saw; all of us liked her. Earlier in the year, we had a didactic where we learned that a wounded person always also has a healer built in. I could really see that in what this patient had to say on one day. I told her that I could hear her clarity about her immense difficulties and I could also hear her wisdom.
I noticed in her chart that other chaplains had tried various techniques with her: breathing in this or that way, thinking of things to be grateful for. In my longest visit with her, I focused on taking in what she was saying, and a very interesting, subtle thing happened. She would say, “I have such-and-such lousy experience every day during physical therapy.” I would imagine what that would be like as I looked back at her, and then I would see a little shift in her eyes, which to me looked like what is true being seen and accepted. That is, I would think, “This is what is happening for this person,” and then it was almost like she was seeing and accepting the same truth: “Yes, this is what is happening.” This happened three or four times in the course of our hour-long visit. I also pointed this out to her as a way of affirming indirectly that she had the capacity to be with what was happening. In that visit, I noticed that she was moving organically through an emotional landscape, with anxiety, sorrow, joy and hope appearing at different moments. When I left, she said she felt better.
In our final couple of visits, I decided that I wasn’t doing enough stuff relative to what other chaplains were doing, and I found myself throwing a laundry list of techniques at her: think of it this way, use this mantra, let’s do a guided meditation. The result was that, for the entire duration of both visits, she was stuck in anxiety, and the connection between us seemed to go flat. It was much better when I just listened and did my best to imagine what things were like for her.
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