My understanding of CBT is that is one of a family of therapies that work very well with restructuring the mind so it is not so reactive and get agitated. I am not sure what that has to do with physical pain management, and maybe that is a failure on my limited knowlege of CBT. I do
know that there is no such thing as an unversial method that works equally well for everything, for all people, in every situation. There may be principles that can be distilled and applied broadly, but the specific method would change as it is applied.
I think there are better methods than CBT for what you want to achieve ... but who knows, I am wrong, and it is worth finishing the rest of the course to find out.
r ranson wrote:Sleep - I don't see how this is helping, but I do it anyway.
But it's the same problem as always. When I say to a doctor that I have insomnia, they assume it's thoughts that keep me awake. They cannot hear that thoughts are not the problem. It is SUPER EASY TO TURN OFF MY BRAIN AT NIGHT. I go to a calm place, maybe reply a favourite movie in my head. It's my body that cannot shut down. I'll spend the whole night laying down being calm and daydreaming because worrying about not sleeping doesn't make it better (or worse), it is just boring.
If you are able to still your mind when going to sleep, you are doing better than the vast majority of the people living in modern, urban lifestyles. I know people who have been practicing mindfulness years in order to gain some kind of spiritual enlightenment, and are unable to reliably still their mind. You also have a fairly developed visualization and concentration skill if you can replay your favorite movie at length. Those are all powerful skills.
In your case, your mind is not agitated... but the body still remains agitated. Why isn’t the body following the mind? If it were me, this is where I pull out the tools I learned from other disciplines that work with the body so that the body can follow the mind. By remaining in calm abiding while you are aware of all of your body at once (so similar, but not exactly the same as a body scan), the body will eventually follow the mind to stillness.
Some things that might help with that:
(1) Learn to deliberately relax the muscles (when sleeping), and let it collapse to the point where you are aware of the sensation of gravity pulling on your physical body. You are remaining aware of the muscles while at the same time, disconnecting the voluntary excitatory muscles, and allowing those muscles to stop fighting gravity in order to support your frame. You start from the outside until the deep muscles can relax.
(2) Our bodies have to breath, so there is some kind of movement. Here, you are remain aware of the breathing while disconnecting the voluntary control over the breathing. By allowing the breath to absorb the mind, the breath can take the mind through all the little nooks and crannies of the body, and thus, the body will eventually start following the mind into stillness.
(3) There is a network of soft tissue that connects throughout the body. It wraps around each internal organ and threads its way through the muscles. They are not controlled through voluntary excitation, but oddly enough, they will respond to the mind. The Chinese call this network the “huang” within some specific body disciplines, and there is no equivalent name or concept in the modern, English-speaking culture. (The closest is something I read a couple years ago about the discovery of a “new” organ, the network of soft tissues that surrounds all the other internal organ; the researchers had not even come up with a name for it). This whole network converges on the diaphragm. The top of the diaphragm itself fuses with the pericardium, the protective sac around the heart. This network can be trained by strengthening the connection of body and mind, such that with every cycle of breath (movement of the diaphragm), this network can inflate and deflate, smoothing out tensions, help a bit with blood circulation and lymphatic movement. Although it takes time to train, the little bit I have been able to do has helped with regulating the tensions and pain held in my body.
I know this sounds more the same: boring stuff to do at night. I think a better lens to view this though, is less about it being boring, and more about purposefuly resting and recovering the body. The lens in which you view this matters, because the body will follow the mind. If it is boring to you, and you see no purpose in it, then the body will follow that attitude that it is idling with no purpose. If this is a period of deliberate rest and recovery, then although not much seem to happen, there is a purpose. The body will follow that attitude that it is time to rest. Maybe it will start cycling down because it is not being asked to be ready to provide energy to do something, flush out stress hormones, start repairing and restoring in ways it couldn’t if it needs to be ready to go.
I know that in the permaculture practices, we can’t keep expecting the land to produce all the time. There are natural cycles of rest that happens. Winter is a time of low activity is needed before the burst of activity in Spring. Well, one’s own body is also a complex, interdependent ecosystem of cells that come together into something greater than the sum. It has its own feedback loops, reserves of bioenergy. Like soil that has been depleted, the body can be depleted too. The ecosystem have its own “pain” signals, same as the body. An ecosystem also has its own stress and recovery responses, same as the body. All the things you know about taking care of the land share principles with the skills for taking care of your body.
r ranson wrote:Pain - The body and mind are connected. If the mind is agitated, then the body tenses and if we are emotionally stressed then the body gets ready for a flee or flight which releases lots of chemicals. Muscles tighten, digestion goes wonky... all that stuff. The way it's presented is that CBT provides some tools to help reduce the agitation of the mind and emotion which reduces the physical stress response. Breaking the cycle there, instead of trying to drug the body.
Have you looked into alternative, holistic medical practices? For example, TCM (traditional Chinese medicine), CCM (classical Chinese medcine), Ayruveda may provide alternative treatment that are better for chronic conditions. Caveat: it also depends upon the practitioner. There are practitioners who look at your whole body system, observe and interact, use small and slow solutions, although they may not use those exact words and concepts. (There are also practitioners who use a more mechanistic, reductive approach, which won’t work as well as going to a mainstream doctor). Some practitioners are at the more secular end of things and others are at the more woo end of things.
I’m just suggesting these as something to consider. If your present course of treatment gets you in a better state of health, that’s great. If it does not, it isn’t the end of the road.