SEASONS OF PAIN
By Gary L. McCorkle PA-C
Copyright 2015, Gary L. McCorkle PA-C, All Rights Reserved
Fifty percent of the population have been abused. Many of them live with painful physical symptoms ranging from occasional pain to day to day constant pain or disabling anxiety attacks. Anything that tries to bring painful memories to the surface can cause real physical pain or anxiety as a distraction from the emotional pain. Understanding that they have control of this condition helps to ease the pain.
I have come to think that many chronic pain syndromes like fibromyalgia are caused by painful secrets. The very nature of a secret is what makes them so hard to treat. No one talks about them. And even harder yet is that everybody’s secrets are different and everybody handles their secrets differently. What’s also puzzling is that not everyone with traumatic pasts are affected with chronic pain. What matters to me is that too many people have painful symptoms that are not understood and have not been diagnosed or treated appropriately.
It doesn’t seem to matter if the abuse or neglect is mental or physical. Many of these people have been abused, raped, or victimized in ways that would make Hollywood shudder.
From The Author
I have been practicing family, urgent care and emergency medicine since 1978 as a Physician Assistant. My interest in MindBody medicine started when I read “Spontaneous Healing” by Andrew Weil MD ,”Healing Back Pain” by John Sarno MD and the books by Bernie Siegel. Dr Sarno has written several great books on this subject since and I recommend that you read any or all of them. These authors as well as many others since have opened my eyes to my patients suffering and their healing like never before. I have a list of recommended books and movies on my material page.
The Obligitory Disclaimer
The opinions presented here are not the philosophy of any clinic I work in or accepted by the mainstream practice of medicine. There are no studies I can quote and no tests available to prove they are correct. They are a collection of concepts that I have gleaned from many varied sources over my life. Some I picked up in school or independent study. Most came to me be simply observing and talking to thousands of patients with chronic pain syndromes. Please use the information with that in mind.
This booklet explores potentially fearful subjects like past abuse. It may be bothersome to some individuals. My hope and prayer is that it is more helpful than painful to everyone that it touches.
Please consult your healthcare provider before making any changes to your treatment plans.
The Undiagnosed Epidemic
Fifty percent of the population have been abused. Many of these people suffer from chronic pain syndromes that occur as a result of their coping with their past.
The term diagnosis literally means TO KNOW. It has been my experience that health care providers don’t know enough about their patients because they don’t ask about stress or past abuse. This may be because it makes them uncomfortable or they don’t want to make their patients feel uncomfortable. Or it may simply be because they don’t know what to do once they have obtained the information.
Physicians don’t often delve into their patients’ thoughts or feelings because the practice of medicine is based on hard science. Often times in that model, if you can’t be helped with a pill, you can’t be helped.
Psychologists, on the other hand, explore thoughts and feelings. A very small percentage of my patients have had therapy. Many of these tell me they have reconciled with their abusers. My question to them is “do you still have physical pain?” Of course their answer is yes. That is why they are in my exam room.
This booklet is an attempt to help all of the people that have either, or both, of these types of health care providers and still have chronic pain.
The human body can suffer terrible physical and emotional pain with no physical damage occurring. Migraines and fibromyalgia are two examples of this type of pain. No physical damage occurs in either condition. Yet they both render their sufferers completely helpless to do or even THINK about anything else. The same goes for chronic neck and back pain or anxiety. For our purposes now understand that your subconscious mind has control over every part of your body every second of the day.
Our mind has complete control of every physical process of our body including the flow of oxygenated blood to all cells and tissues moment by moment. When tissues are deprived of oxygen several metabolic changes take place that cause pain. One example everyone is aware of is a heart attack. Tissue that gets less oxygen hurts. Tissue with no oxygen dies.
Blood vessels expand and contract as needed to supply oxygen and nutrients for muscles and other tissues. For example imagine you are sitting at a desk reading this book and you decide to go to the refrigerator and get a cold drink. You stand up, balancing on each foot as you walk and reach forward to get the drink and return to sit down, all the while maintaining perfect balance and blood pressure. When you stand blood vessels in your legs constrict to move blood toward your brain so that you don’t pass out. Blood vessels expand and contract as needed for each muscle and cell that is working. Your heart and respiratory rate increase as needed to supply oxygen for the work you are doing each moment. That complex series of events required perfect orchestration of thousands of instructions from your mind to your muscles and blood vessels. All of those instructions were carried out perfectly without conscious thought. As you can see from this simple example it is easy for you mind to direct or limit blood flow anywhere in your body.
Another concept of the mind controlling our blood vessels is blushing. There is no time lapse between the trigger and the reaction. Blushing, however, causes the vessels to expand. The conditions we are considering here cause vessels to constrict causing ischemia and pain.
The literal translation of the word disease is the prefix DIS which means without and EASE which means among other things the state of being comfortable. So the word disease means being without comfort.
When all of your thoughts are focused on physical pain you are distracted from the underlying emotional pain. Any painful symptom can act as a distraction.
Everything that you have ever done, as well as everything that has ever been done to you, is in your subconscious.
Visualize you memories like computer files. As you bring a file to the surface the good and painful thoughts and feelings in that file come to “mind”. For example what were the eight colors in you crayon box in kindergarten? As red, blue, yellow, orange, green, brown, purple and black come from the abyss you may visualize your teacher or the classroom, the smell of glue or the feel of those bulky crayons. Now count backwards from ten to one. You now have two files open. You have numbers, colors, and possibly smells and touch sensations floating around in your conscious mind. Where did they come from? They came from the same place your first day of school or you first date live. They are buried deep in your mind with everything you have ever experienced. As memories come to the alert state they bring their associated emotions and feelings to the surface with them. Colors and numbers may come across without any particularly good or bad emotions, unless you were abused by colors, crayons or numbers. If however you are asked about you father, mother, spouse or anyone that has mistreated you all of the associated fear, rage, pain and feelings of helplessness try to rise with those memories.
Deep in your subconscious mind is something I think of as FEAR FILTERS. These are unseen mechanisms that protect you from reliving the emotional pain of your past. Your mind sends messages to various body parts and constricts blood vessels to limit flow of blood enough to cause pain but not physical damage. The more horrible the memory – the more pain may be needed as a distraction. It’s like having a heart attack in various parts of your body. This often happens in many parts at the same time, as is the case in fibromyalgia.
Another important point to remember is that this pain is real. It’s not “all in your head” like you may have been lead to believe. It may originate in your mind, but it is causing real physical pain in your body. And more importantly IT CAN BE AS PAINFUL AS YOU NEED IT TO BE.
Certain times of the year my waiting room fills with people with painful complaints more than others. The two most obvious Seasons of Pain are Mother’s Day and Father’s Day. Those are two times of the year we are forced to think about our parents and relive either wonderful or painful thoughts and emotions. When card shops start advertising these holidays people with this disease can’t help but relive the rage and horror that try to come to the surface. Christmas, birthdays, wedding anniversaries etc… can also trigger the pain.
Anything that triggers memories of a painful situation or abuser will attempt to bring the emotional pain to the surface. It can be a song on the radio, seeing a car like they drove or having a conversation about them. Anything that re-minds you of them can cause a need for physical pain as a distraction.
I am focusing mostly on abused people for this booklet because there are so many of them out there suffering. This syndrome also afflicts victims of trauma, war, auto accidents or the loss of a loved one.
Any memory that causes emotional pain can cause physical pain.
Profile and Healing
It is my belief that this condition cannot be treated, it can only be healed. Many of these tormented people have several doctors. Each one prescribes medications, tests and therapies for their area of expertise with little or no overall relief of the pain. When one doctor eases the pain in their part of your body your mind can shift the pain to another part.
Some people are told by their doctors that their disease in incurable. In the case of this disease INCURABLE means only curable from within.
Many of the patients I have encountered were in my clinic looking for specific medication, hydrocodone and carisoprodol. Hydrocodone is an addictive narcotic pain reliever. Carisoprodol is an addictive muscle relaxant that acts on the brain and creates drowsiness. While it is called a muscle relaxer it’s never been shown to relax any muscles. This combination of drugs must do something to comfort the pain but it is obviously not a cure for the dis-ease. These patients are labeled DRUG SEEKERS by many providers and their stories are as varied and creative as their imagination allows. Most providers could write a novel or two with the stories we have heard in the attempts to get these or similar drugs. I find it more appropriate to think of these patients as TRANQUILITY SEEKERS. Like many other providers I try not to enable their disease by giving them dangerous amounts of their requested medication. I do however make an attempt to explain their disease process to them and place them on a path of healing by opening their eyes to their past and the true reason for their suffering. I always direct them back to their own providers, suggest therapy and give them the homework that is provided in this booklet.
Most of my patients haven’t minded being asked about past abuses. In fact they were overjoyed that someone finally asked. I have learned communication techniques that help me explore their feelings and get permission to continue with this form of healing. It’s important to be non-judgmental. It is of utmost importance to be understanding and caring.
I have seen hundreds or maybe thousands of people with this disease. I remember one very busy shift in my urgent care clinic when I saw twelve in one day. I am almost always the first health care provider to ask about past abuses with each of these people. Here are a few examples of patients, and patient types, that walked into my various practices over the years.
Patient number one is really several patients and the most common in my experience. They are 40 to 60 year old females with fibromyalgia who have been mistreated by her father, brothers, past boyfriends or husbands. They are either single or their current husbands are very loving, supportive and concerned about their well being. Many of these women have divorced one or two abusive husbands and the one that they are now with is finally good to them. They are in too much pain to enjoy their life. They are very conscientious and work often in spite of their pain. For some reason they tend to become caregivers like nurses, paramedics or therapists etc… Although not always. In most of the clinics I have worked in one or more of the nurses I worked with had been abused in the past. If they are mothers they take excellent care of their children as well as other children. If a child needs something they tend to be the one that helps them get it. I have come to see them as the earth’s caregivers. Their ability to help others is incredible in spite of their constant pain issues. Father’s Day or Mother’s Day are only one, or two, of her many “Seasons of Pain”. Their pain can be triggered by a conversation with a brother, sister or friend about their abuser. Many of them have reconciled with, and love, their abusers. Yet they still suffer great physical pain. Their gastroenterologist, rheumatologist, neurologist, orthopedist or family physician have never asked about past abuse.
Patient number two is a fifty five year old female in my clinic for another migraine. After examining her chart I discovered that she had been in the past four years on the same date with a migraine headache. A stress history exposed that the day was her abusive mother’s birthday. Although her mother had been dead for many years she still suffered that day with pain year after year.
Patient number three is younger than most patients with fibromyalgia. She was 26 years old. She was very well dressed and in the company of a loving and supporting husband and well behaved adorable children. When I shared my theory of past stress causing pain she denied any history of abuse or pain. She said she had always had a perfect life except for being in pain all of the time. I left the room for a few minutes to finish my charting and when I returned she was in tears. Further questioning revealed that she had been raped in college and had never told anyone. The rape occurred around the time of year she was in my clinic.
Patient number four came to my clinic around Father’s Day. He was a very angry 260 pound male with chronic low back pain. He had multiple tattoos and was wearing jeans, a leather vest and motorcycle boots. He was angry that my partner had not given him hydrocodone the day before and was returning to the clinic to demand what he needed. Again after a very gentle stress history he revealed that his parents were divorced when he was young and he had lived with his abusive father. He remembered one morning as a child taking his father a beer to the table for breakfast and minutes later his father died at the table. His mother got custody of him and she and future boyfriends continued to abuse him.
Patient number five was actually a diseased family. One of my patients that suffered from recurrent migraines was brought in repeatedly by her mother for her pain shots. A few months later I saw the same mother with a different daughter that was visiting from out of town. Daughter number two was also suffering from a migraine. Again after a few simple questions I discovered that the mother, who had long since been divorced, had been abused by her husband and the daughters witnessed her abuse. In this incident the mother did not have a chronic pain history. She was not even my patient.
Patient number six was a thirty-something year old man that presented for medication to prevent anxiety. He had a job he liked and was going to fly to an interview for a position that would move him into management and further up the corporate ladder. He said that in the past when he would travel to job interviews he would suffer anxiety attacks and fail the interviews. I asked him about his past. During his response he pointed to a baseboard in the clinic and described his father picking up a piece of baseboard from their kitchen floor that was his favorite thing to hit him with. I asked if his father made him feel unworthy or tell him he would never amount to anything. Of course that was the case. In this situation the “season” was job promotions and believing his father’s curse caused him to fail. His distraction syndrome was anxiety not physical pain.
Patient number seven was a very sweet, sad lady with fibromyalgia in her 30’s. She shared with me what’s probably a common insight for many of these tortured people. She weighed over 350 pounds. She had been abused by her brothers, cousins and boyfriends most of her young life. She noticed that when her weight was over 200 pounds men stopped looking at her and abusing her. At 350 pounds she was invisible. She said she could walk through a crowed mall and no one would even look at her.
Patient number eight came to my clinic on December 27th. He woke up with terrible back pain. I watched as he had trouble getting out of his truck and walking into the clinic. He denied any injury. He said that occasionally his back just “acts up”. A stress history revealed that he had lost a son to leukemia seven years prior. I asked him what time of year his son died and he said in September. I asked when his son’s birthday was. He started crying and said “he would have been 18 years old today”.
Another condition I will mention because it is so common is growing pains. Many children suffer from stomach aches or physical pain that could be stopped if someone would look for stress in their lives. When taking a history from a child I ask if they like their school and their teacher. I also ask if any of the teachers are mean or if there are any mean kids at school or in their neighborhood. I’m amazed at how many times parents don’t have a clue about day to day stresses in their child’s life.
“To stop the pain change your mind”
When you accept the fact that your mind is causing your pain you won’t hurt yourself anymore. The pain stops. The cure is being aware of this process. This is a gross over simplification, but then again this article is designed to start your investigation.
Visualize this disease process as having “monsters” hiding deep inside your mind. An example I use to illustrate this point is a scary movie. It has been said that the scariest monster is the one you can’t see. Most people that have been abused don’t go to scary movies because they don’t like being startled or scared. They have had more than enough of that in their lives. People that like scary movies, however, would sit through a movie called “The Monster in the Closet” on the edge of their seats for ninety minutes looking at a closet door until the end of the movie when the door is opened and it is exposed that the monster is a frightened child that simply needs to be recognized, understood and loved. It helps me to visualize the sad frightened child wearing a clown suit with floppy shoes and a big red nose. You, of course, can visualize your inner child as you want or need. People could never watch that movie again and be scared in the same way once the ending, or truth, is exposed. It would simply lose its ability to cause fear. In the case of chronic pain sufferers it loses its ability to cause pain.
What do we do?
The cure of this disease is to learn that it exists. If you have pain that your doctors can’t find, explore your past and see what monsters are there. Any pain that distracts your attention can be caused by this condition.
Talk to your doctor about your past. Find a therapist to work with and read Dr Sarno’s books. Share this knowledge with loved ones. I have seen many patients help their abused siblings or parents. A child that grows up witnessing abuse of others may suffer the same as if they were abused.
Two of my favorite movies that explore this phenomenon are “Joe vs. the Volcano” and “The Kid”. “Joe vs. the Volcano” is a silly comedy with deep meaning. Joe was a fireman that developed this condition. He is always in pain. The best scene in the movie is in his doctor’s office when he is getting “another” set of normal lab tests and his diagnosis of having a “Brain Cloud”.
My favorite line is:
“There is nothing wrong with you that has anything to do with your symptoms”.
This concept is huge! Read it again until you understand its meaning.
There is nothing wrong with your body that is causing the pain. In fact you have to have a strong healthy body that is functioning perfectly to have this painful dis-ease. The pain it is creating to distract you from the memories of the rage, horror or helplessness from your past or present abuses is a normal protective response built in at birth.
Joe’s pain was a distraction from the fear that continually attempted to rise from his subconscious.
“The Kid” is about a man that grows up with mental and physical conditions that are caused by childhood events. I recommend you watch both movies a few times until their meaning sinks in.
It has been my experience with others that when you believe and “own” this information you will have less pain.
My favorite book for fibromyalgia suffers is “Freedom from Fibromyalgia” by Franklynn Peterson and Nancy Selfridge. The forward to this great book was written by John Sarno who endorses its contents.
Another thought I share with patients, and now with you, is what if you have multiple ailments and only 10% or 20% or 50% of your pain goes away. All in all a couple of movies, books and quiet introspective thought are a pretty cheap cure for an untreatable disease.
It has also been my sad experience that some people have a deep need for their dis-ease. When I worked in psychiatry we had a saying:
“My brother thinks he’s a chicken. We’d cure him but we need the eggs.”
I don’t remember where this concept comes from but it explains why some people can’t stop their suffering. It doesn’t matter if it’s financial or emotional support or simply a lifelong self image that they need to keep. If the pain is necessary it is very hard to let it go. I still believe that with good counseling that those issues can be resolved even in the most difficult cases.
The McCorkle Maneuver
I find it interesting and sad that it is easier for some people to have sympathy for victims of a birth defect than it is to find the same sympathy for victims of a life-defect. We can help provide healing for both once they are discovered. A simple stress history can reveal the cause of many patients’ pain syndromes. Many people, including some health care providers have an attitude of “get over it” when they discover past abuses of others. That is like withholding the Heimlich maneuver from a choking victim. They are both suffocating in their own way and can both be helped with appropriate maneuvers. The McCorkle maneuver is taking a stress history from all patients and providing understanding and referral. I pray that no one is every withheld treatment again.
I will leave you with a few poems that I have written on the subject.
What is the “caring” we provide?
Is it molecules or atoms far deep inside?
Or caring for people with unfulfilled dreams.
Or easing the pain of life’s sad extremes.
What makes us decide to spend our life
To help others deal with their pain and their strife?
Is it the love of science or a search for the truth?
Is it tests and potions or compassion we choose?
If only we knew the right words to say
They would tell us the things that get in their way.
Their pain is a harbor, a safe place to hide
From the terrible memories kept deep inside.
We tell them what’s wrong we can make right
With potions and powders and tests we provide.
But in the end they often feel
“They” failed again because “We” did not heal.
Those that get sick are the ones with the ghosts.
The questions they want to answer the most
Are the ones we are taught not to ask
“What happened to you in your past
That changed your life in this way
From happy child to sad dismay”?
The irony is we truly care
But are never told our love to share.
We’re taught by those that own the tests
A pill will serve thier needs the best.
While pills at times are potent tools
And give scientists things to do
To find compassion is the start
For only love heals broken hearts.
Some are taught by word of deed
They are not worthy of the love they need.
The problem with their self-esteem
Is their parents prophecies.
Since childhood they were taught
“What you want matters not”.
This will curse them all their life
Buried down deep inside.
Their lack of worth and self exteem
Stops their ability to dream.
“I won’t achieve the things I try”.
“I’m a loser in this life”.
To break this curse they must see
Mom and dad spoke foolishly.
They were just bad parents with lousy skills.
Probably mistreated kids themselves.
This is a reason not excused
For there’s NO excuse for abuse.
The damage that is blindly done
May last that child all life long.
The good news comes when someone tells
“Mom and dad had no spells”.
That disbelief of the curse
Will give them back their self-worth.
Everyone deserves true love.
It’s one thing we’re all worthy of.
It’s the reason we are here.
To share true love without fear’
I know you always tried to hide
The bruises you supplied.
Under clothing I could wear
So no one would know of my despair.
I would go to work or school
In long sleeve shirts when it wasn’t cool.
While from the world we could hide
The bruises are all still deep inside.
In a place I try to never go
From time to time they overflow.
It’s usually at a time
When I think ou you I find
They are all alive and well
A reminder of the living hell.
At these times I get a pain
Of my head or back I will complain.
None of my doctors can find the source
But they’ve never asked about my life’s course.
I’m told the pain is a distraction from
The many things that you have done.
That someday it will go away
When I figure out you’re why they stay.
It’s ironic that after all these years
I still harbor all those fears.
At least now I know why I suffer so.
I’m still hiding bruises from long ago.
SEASONS OF PAIN, THE OTHER SIDE
When you live with pain all your life
It’s hard to believe there’s another side.
Especially when you doctor has told
There really is no further hope.
For their bag of tricks holds no cure
For emotional stress of a childhood curse.
It’s not their fault they were never taught
To treat your body they must know your heart.
Pain is a distraction and a great one too
To distract your mind from past abuse.
Parents, lovers or passers by
At times do things that make us cry.
If it’s bad enough we will find a way
To keep it in a hiding place.
In a place we try never to go
Unless we are forced to do so.
What does it cost to guard that door?
How much pain must you endure?
The pain is worse when the memories rise
From the abyss in which they lie.
So any thought that brings to mind
Memories of those that made you cry
Bring horror and rage to the light.
Rather than relive the rage
Your mind creates physical pain.
It stops the flow of blood to cells
Creating pain to distract ourselves.
It’s like a heart attack in you back,
Your head or gut or your neck.
With such great pain you no longer dwell
On events that made your life a living hell.
At times this is a seasonal thing
Father’s day, Mother’s day or anniversaries
That brings the thought of the ones that hurt.
So in May or June if your pain is worse
You may be a victim of this curse.
When card shops start to play that game
For many begins their season of pain.
To learn to live on the other side
You need only accept that you hide
The memories that cause the pain
And tell your mind you will no longer play that game.
For once exposed you no longer need
The distraction that makes your spirit bleed.
And spend your life in sweet sun and rain
And suffer no more seasons of pain.
WHAT DOES IT HIDE?
Life’s roller coaster goes around
On every curve emotions found.
Some bring laughter, some bring tears
All will linger thru the years.
Each memory that we replay
Emotions tied to that day
Are brought to life once again
Just as strong as they were then.
To those mistreated in the past
The rage and horror always last.
Memories will never fade.
One year or a hundred is all the same.
To block the outrage from our thoughts
Our brain devised a clever plot.
It creates pain of a new kind
To distract from pain in our mind.
It’s easier, it seems, to live
With physical pain than to give
way to the memory of emotional rage
From the horror that occurred at an earlier age.
The mechanism is not seen
By any tests or miracle machines.
It’s not “in your head” or “in your heart”.
It seems to come from an invisible part.
To cure this disease is to know it exists
To ask the right question of you “does it fit?”.
For reasons unknown the rage and the pain
All go away once you’re on to their game.
So if you have pain your doctors can’t find
Just ask yourself “what does it hide?”.
Then tell your mind you’ll no longer play.
And when you believe, it all goes away.
I will leave you with a song I wrote. It’s called shadow.