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July 27, 2022

5 Takeaways from Interpreting at a Chronic Pain Management Center.

*Names changed for confidentiality

 

“I really like to smell flowers,” says Yolanda,* gesturing to the roses she has just drawn.

Her brown curly hair is tied up into a high bun. Pink, teal, and mango-colored flowers are embroidered onto her felt white shirt.

“I did that a lot at my grandmother’s growing up. The butterflies liked them too,” she continues.

I’m at a pain management program, language interpreting for Spanish-speaking participants who were injured at their jobs. Living now with chronic pain, the patients have been unable to continue working the way they once did.

Markers and magazines lay spread across the table as we create our art, the room quiet apart from the faint sound of colored pencils against paper. Yellow fills in a sun, brown a roof, green the grass, blue and red and turquoise a bird.

Behind the row of treadmills to our right, a diagram of the muscular system hangs from the wall—next to a half dozen multicolored exercise balls stacked on top of one another.

One participant draws a peaceful sanctuary to retreat to during a pain flare. Another sketches the body part most affected by his injury, alongside the tools and care that could help to alleviate it. Still another draws his injured back in a healed state (per the art therapist’s suggestion).

I look over at Edna’s drawing; she and her family are eating fallen fruit beneath the trees in her grandmother’s village. They are “eating to their hearts’ content.”

Later that day Miranda,* a Nicaraguan immigrant, who lives on a boat and refuses to buy anything with plastic, will show us how to make smoothies, kombucha, and spring rolls. She will teach us about healthy gut bacteria and balancing our ratios of omega 3 to omega 6 in food intake.

Participants will also attend dance therapy, meditations, psychology of pain classes, and on-site doctors’ and psychologists’ appointments.

~

Pain is our body’s alarm system, the instructors here explain. Its intent is to keep us from reinjuring ourselves. It is adaptive in the sense that it discourages us from repeating behaviors that might endanger our survival.

“We need pain. There was once a man born without any pain receptors, and he didn’t last very long,” the instructor explains. “He didn’t stay away from things that were dangerous. Things that could kill him. Fire was able to ravage him.”

Distinguishing between actual bodily harm and the body’s over-activated alarm system can be difficult, though—because the two feel similar.

Chronic pain is unique, in that even once the original wound is healed, the body not only keeps sending out pain signals to the previously damaged area, but to others that weren’t involved in the original injury. As chronic illness author Sara Ramey wrote, “Things had been going so badly for so long, my body had relearned its own status quo, and the new normal was to set off all the alarms, all the time, even if the intruder was long gone.”

Both forms of pain are real—but one (the kind created by the body’s alarm system) falls much more within our control. Programs like the one I interpreted attempt to supply participants with tools like CBT and mindfulness to dial down the former pain’s intensity.

In addition to just interpreting while I was there, I also learned a bit about the difficult realities of living with chronic pain.

Here’s some of what stuck with me.

1. The importance of tending to without hyperfocusing on. Or, the line between avoidance and intense hyperfocus.

For years, I understood a small fraction of what these residents were going through. I’d been bothered by brain fog, anxiety, and an overall sense that something wasn’t fully right in my body (years later I’d be diagnosed with Celiac disease). Despite these symptoms, I plugged along regardless, doing my best to function while using short-term Band-Aid solutions like sugar and caffeine.

Tinnitus and brain fog are probably my most pronounced symptoms of chronic discomfort nowadays. If I’m alone in a quiet room, the ambient noise in my head sounds like fried circuitry. Some constant level of external background soundscape is necessary in order to drown it out. For someone who likes quiet as much as I do, this can be hard. Often, I’m faced with choosing between two options: distract myself from the unpleasant symptoms, or sit with and pay attention to them.

In meditations at the chronic pain management program, participants and I turned toward our discomfort. We brought awareness to each individual body part and paid attention to the accompanying sensations, without fighting or trying to alter them.

“When I close my eyes, I see scary things, and I see beautiful things,” said Maria,* who sat with her hands crossed over her lap. Silver bracelets adorned her wrists.

Other participants found similar catharsis. It wasn’t uncommon to see tears running down faces by the time we’d all opened our eyes. This leads me to say that while hyperfocus may intensify suffering, just the right amount may help alleviate it.

2. The connection between mental and physical pain. Tending to mental health to alleviate physical pain.

“Do you ever notice how after you get in a fight with your spouse, your physical symptoms get worse? Or what about after you have an unpleasant interaction with your coworker?” asked the psychology of pain instructor. The participants nodded.

“When I’m in pain, I snap at my wife more,” commented Normando, an older tan-skinned, blue-eyed Mexican gentleman, from his seated position on a purple exercise ball. Normando often smelled like wintergreen gum and wore a watch with a brown leather band. Wisps of grey hair spilled out from under his green hat, while a chocolate lollipop hung from his mouth—a substitute for the cigars he gave up smoking a few years back.

“Our emotional pain and our physical pain are connected,” the instructor went on. “This is why talk therapy is often a part of the chronic pain treatment plan.”

Physical pain triggers mental distress, and vice versa—often in an endless loop. Many of the participants couldn’t sleep because of it. The sleep deprivation worsened their mental health, which in turn worsened their physical pain—and so went the cycle. Relationships with family members became strained, as pain can weaken our ability to communicate as effectively. It can also give sufferers an understandably shorter fuse.

Instructors highlighted that we can reduce some of the stress of one (or at least keep it in check) by tending to the other.

3. The importance of movement. Even when it slightly hurts, it can still be healthy. A little bit of pain isn’t necessarily a warning sign or a signal to stop.

Participants did exercises against their blue mats while the room filled with the sounds of waves washing against the shore.

Me duele (it hurts),” one of them said.

“Don’t force it then,” the instructor responded. “Or take a quick break. The goal here is to move just enough to prevent the muscles from falling into disuse. If we stay idle, they’ll stop working. But we don’t want you to push yourselves too hard either and make the pain worse.”

As a sophomore in high school, I fell in love with running. It significantly helped with my depression and anxiety. Where before I’d always seen it as a chore, after spontaneously deciding to jog a few laps around the track one day (barefoot, like I’d seen the varsity girls do), I became addicted. I loved the way I felt afterward—weightless, limbs like jello, head buzzing (with endorphins, I’d soon learn), mind cleared of its customary fog.

Those endorphins can be so helpful to chronic pain sufferers—even though the effort it sometimes takes to uncork them can feel Herculean. If you’re a pain sufferer, lowering the bar a bit can help you along. So can being gentle with yourself, and a willingness to get creative.

“You may not be able to workout the way you used to, and that’s okay. Just aim for some level of movement, while trying to keep out shame and shoulds. They have no place in your treatment plan,” instructors said.

Gentle seated dance exercises were another form of movement. The participants picked the music; sometimes it was Marc Anthony, other times country hip-hop. One day, a Pitbull song that Mariela* and her husband had danced to at their wedding played as we danced in our seats.

4. The healing property of connection.

Prior to the program, participants had spent the time freed up by their job loss at home by themselves. That idle time gave more space for their pain to consume them.

“No quiero estar en la casa todo el dia porque me pongo triste. Aqui, es bueno que esté rodeada por otra gente,” said one participant. (“I don’t want to be at home all day because I get sad. Here it’s good to be surrounded by people for a little while.”)

Sharing laughs also promoted cohesion. One time we slowed the talk speed down to 75 percent on a YouTube video to make it easier to interpret. Once it had finished, no one remembered to change it back to the default [speaking] pace—so later that day, Cyndi Lauper’s voice came on extremely slowed down.

“It’s the gothic version,” one participant joked.

Other instances of humor and levity: one woman joked that I spoke Spanish with a Russian accent.

Seeing them together reminded me of how communities are a coming together of such varied individuals. Each bring something different to the table while also finding common ground.

Though each of the participants differed temperamentally—and some in terms of values—they still found areas to bond over. I observed how carbon copies of themselves weren’t necessary for experiencing the benefits of connection. Perhaps their human-ness was a compelling enough commonality.

Words exchanged, consistent presence, the willingness to share your self with your neighbors—be it through conversation, food cooked, stories told, or the lending of an ear—through these we fight the desolation, I wrote at the time.

I love how author Lidia Yuknavitch puts it: “It won’t matter where people were from, what origin their bodies have. It will only matter that they travel together, like a new organism formed in the leaving of a place, a mash of languages and fears and desires. Like a new species emerging from water to shore.”

5. Finding purpose, even when pain has changed your life.

Formerly active participants could no longer partake in rigorous walks, bike rides, or hikes as they had before. They faced needing to think outside the box to find newer hobbies that could substitute these old ones.

“You’ve gotta have purpose. You’ve gotta have it to distract you from the pain,” said Ernesto,* a participant who often wore black tank tops and his dark hair spiked up. “Without purpose, you’ll deteriorate. Your mind chews itself up. It makes the pain worse.”

A past-time he’d taken up was crafting toys and figurines out of scrap metal. Another’s hobby was fishing, an activity that his dad had gotten him into back when he was seven.

“Muy hermoso,” he recalled, of how the salmon in the Feather River would jump through the air like glittering dolphins. He explained that August was the best season for it, when the salmon were most abundant.

The pain is still a reality. While hobbies alone won’t make it go away, they can help to alleviate it.

“If you’re absorbed enough in what you’re doing, it brings relief, at least for a period of time,” Ernesto said.

~

The disheartening reality about chronic pain is that it may always be there. But mindfulness can help to reduce it.

Forging community, taking up past-times, tending to mental health, and finding newer, more gentle forms of movement can all help those it afflicts to coexist with it. So that maybe it can convert from an all-consuming roar into more of a faintly bothersome, but manageable, background hum.

~

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