Fibromyalgia management is controversial today in both traditional and complementary medicine circles. Researchers and health care practitioners are seeing mixed results from a variety of cutting-edge protocols. Following are the details of one success story involving a combination of methods, and a summary of the resources which helped make it happen.
I was fortunate to have an opportunity to follow Mrs. M for a period of three years. Given a chronic problem, and her age (50), there were many variables to her condition. This article is a retrospective tale of our collaborative journey toward health.
The Problem of the “Cure” As with so many others afflicted with the disease, conversations with members of Mrs. M’s fibromyalgia support group revealed a shared belief they had an “incurable disease.” They apparently deduced this diagnosis from their physicians’ inability to provide a “cure.” By accepting the condition deterministically, any potential for optimism was defeated. This detrimental outlook confirmed a point made by Daniel Goleman in his book Emotional Intelligence: “Historically, medicine in modern society has defined its mission in terms of curing disease — the medical disorder — while overlooking illness — the patient’s experience of disease. Patients, by going along with this view of their problem, join a quiet conspiracy to ignore how they are reacting emotionally to their medical problems — or to dismiss those reactions as irrelevant.”1
Physician Joanna Vishio wrote, “It’s the unknown that often makes people scared stiff.”2 Facing the lack of definitive cure as a goal, Mrs. M and I began our search for moments of temporary relief. We discovered that gradually both the duration and the points of pain relief for her expanded and accumulated. She began to experience a process toward wellness, rather than a method for cure. As she made this translation of expectations, Mrs. M also began learning to let go of a massive, habitual tension pattern.
The uniquely American valuing of heroic (yang-dominated) medical interventions is part of our “frontier culture.”3 The epitome of this mindset for fibromyalgia is the removal of the cranial bone to decompress brain tissue.4 Meanwhile, less dramatic (and less costly) interventions remain under-reported. One unfortunate consequence of the heroic approach is that the client expects the practitioner to deliver magic. Tragically, the client remains ignorant of his habit-level biomechanical problems and maintains a disempowered status with regard to his health.
When I met Mrs. M, she had been incapacitated for three years even though she had been compliant with all medical recommendations. As she and I studied her symptoms and speculated on possible causal factors, she gradually gained a more objective viewpoint toward her disease. Learning together became the therapy: we discovered her tolerance to physical and emotional pain. The mind-body interface became the healing space. In his book, Healing Back Pain: The Mind Body Connection, John Sarno describes the use of awareness and education in his intervention with tension myositis syndrome, a milder form of fibromyalgia.5 As Sarno advocates, Mrs. M and I constructed the problem in such a way that she could feel entitled to a solution to her condition.
The Intervention Strategy
My conceptual frame of reference was grounded in the neurophysiological stress profile so aptly described years ago by Kenneth Pelletier.6 The indelible imprint of early trauma history is now recorded in Linda Leuken’s human study.7 The unresolved loss of Mrs. M’s parents was the root of her stress pattern. Our goal was to create enlightened self-care to soothe deep wounding, a state of being to which she had adapted over the years. Mrs. M’s change can be described in thematic steps:
1. Learning to feel without the habitual, cognitive filters.
2. Learning to let go.
3. Listening to the previously unacknowledged emotional language expressions as they are discovered in the body.
4. Having accountability for attitudes that exist as embodied habits.
5. Setting a goal: Self-management through awareness of limitations and new freedoms.
Phase #1: The First Year
Feeling, plain and simple.
Unlearning the pain habit was a slow process. Sessions began with structural corrections using myofascial work. Just as her physical excursions of movement were limited, so was her imagination. Her entire being operated within the sympathetic nervous system range. Constriction was pervasive: hoarse voice, elevated blood pressure, frequent illness, tight-chested shallow breathing, tight jaw, furrowed brows and squinting eyes. She was a picture of John Upledger’s description of the stress response as “the big spender,” squandering her life energy.8 She existed at the adrenal-dominated alarm stage, and saw the world through tunnel vision. The autonomic emergency system kept her immune function depleted, making her physiologically off-balance.
Mrs. M began to discover through her illness that doing less was safe. Coaching for physical balance was the most effective awareness intervention used during this time. Her postural attitude consisted of a stomping walk and a calloused temperament, in short, a woman who had fought to get anything at all. The challenge was for her to feel expansion in muscular tissue and to bring her head up and look around. As her tissues thawed, she found enough energy available for her awareness to expand.
Phase #2: Learning to Let Go
Or looking for a good night’s rest.
The human being’s difficult marriage of power and perception has a long cultural history. The ruler has often silenced the seer. Mrs. M seemed to be fighting that conflict alone, and the old control mechanisms had prevailed. Mrs. M saw her pain only in muscular terms. To gain a peaceful coexistence of these forces within her, Mrs. M required some parasympathetic tone. She needed to soften, to open the gaze and joint spaces, to expand the torso, to digest and to accept kindness.
The doorway to Mrs. M’s interior perception came by way of a workshop I attended on Linda Burnham’s System of Facial Rejuvenation. Mrs. M agreed to be my regular practice subject. RejuvSM, a system combining energy with carefully developed techniques of patterned strokes that activate major nerve centers on the head as a method of redefining and releasing facial features, became the method of choice for most of our sessions. Encompassed in the ideology are the concepts of presence (the need to be fully here in our hands and in our minds, bodies and spirits), trust, loving and communication. As Mrs. M’s jaw relaxed over time, she began to share the stories of her life. Imprinted memories of unreasonable external pressures and punishments had dominated her formative experience. The emotional pain was more difficult to bear than the familiar body pain had been, yet she persisted with the process.
So how do you get to the parasympathetic cache? Rejuv proved sufficient. First, Mrs. M had never experienced an encouraging or tender environment in her childhood. The guarding and constriction around the shoulders, neck and head became an obsolete defense. She let go into the invitation to discover the experience of receiving comfort. Her attention moved from the body to the seat of perception and social awareness (brow and eye band of the head, and the face and throat, respectively). Mrs. M experienced the Zen-based concept of loving kindness, which is a foundation of this light pressure protocol. She responded by sensing safety. Thus the parasympathetic power was tapped. The autonomic switch had been thrown and was announced by gastrointestinal tract churning and gurgling. Repetitions of this experience gradually reversed the visceral conditioning of a lifetime. The body, seemingly unattended, continued to improve its natural elasticity and flexibility. The balancing of the visceral and musculoskeletal systems was now underway.
Our initial expectation of Rejuv was limited to the cosmetics of Mrs. M’s stressed countenance. Instead, the work revealed more trouble, notably Kenneth Dychtwald’s description of the deep-set eye problem and immobile neck.9 Her view of her world began to be more receptive with this work. The worried furrows at each brow melted as she became willing to let go of the worry habit. Issues were peeling away. Dyctwald’s prediction came to be: “The throat is said to be the doorway that announces the beginning of an emotional and spiritual ascent into one’s inner self.”10 The heart-mind link had occurred, and was visible. Increased awareness brought its own momentum. Mrs. M gathered her life story in photos. We studied her facial character lines and celebrated recent improvements as victories.
Continued in tomorrow’s post . . .
By Valerie Whiting, M.S, OTR/L, LMT, who teaches at Roane State Community College and maintains a private practice in Knoxville, TN.
Originally published in Massage & Bodywork magazine, April/May 2001.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.
1 Goleman, D. Emotional Intelligence. (N.Y.: Bantaam, 1995) p.165.
2 Vishio, J. “Fibromyalgia: The Search for Relief,” Advance for Occupational Therapy Practitioners. (Nov. 15, 1999):8, 20.
3 Webb, W. The Great Frontier. (Univ. of Texas Press, Austin: 1979).
4 Burton, T. “High Hopes: Surgery on the Skull for Chronic Fatigue? Doctors Are Trying It.” The Wall Street Journal. (Nov. 11, 1999): A1, A8.
5 Sarno, J. Healing Back Pain:The Mind Body Connection. (N.Y: Warner Books: 1991)
6 Pelletier, K. Mind as Healer, Mind as Slayer (NY: Dell: 1977).
7 Luecken, L. “Past Leaves Indelible Imprint on Health”. OT Week (Dec. 3, 1998): vi.
8 Upledger, J. Craniosacral Therapy II: Beyond the Dura. (Seattle: Eastland: 1987).
9 Dychtwald, K. Bodymind. (N.Y.: G.P. Putnam’s Sons): 187-240.
10 Ibid. p 187.
11 Goleman, D. op. cit.: 27.
12 Ibid.: 26, 208.
13 Rhunke, A., Wurzburger, A. BodyWisdom. (Rutland, VT: Charles Tuttle Co: 1995): 100.
14 Lewis, R., “Getting the Head to Really Sit on One’s Shoulders-A First Step In Grounding the False Self.” (1985, unpublished manuscript):8.
15 Jung, C.G., Memories, Dreams, Reflections. (Vintage Books Ed., 1989): 245.
16 Farhi, Donna. The Breathing Book: Good Health and Vitality Through Essential Breath (Canada:)
- Questions to Ask Your Doctor About Fibromyalgia (everydayhealth.com)
- Your Fibromyalgia Travel Guide (everydayhealth.com)
- Help for Fibromyalgia-Related Fatigue? (everydayhealth.com)
- The Secrets To Improving Your Fibromyalgia Symptoms (curesfibromyalgia.com)
- DrSugar on Fibromyalgia (fitsugar.com)