Trigger warnings for the fibromyalgia mind

“Courage is resistance to fear, mastery of fear-not absence of fear” ,Mark Twain

Neuroscientists can now tell us amazing things about the brain, they are the experts on the nervous system. The argument that there is or is not a ‘mind’ is no longer relevant. A mind without a brain and a brain without a nervous system is not feasible. It is the mind that alerts us to fear, which may or not be a threatening situation. It is the brain within the processes of the central nervous system that responds to this perceived danger, affecting the tissues, causing pain.

In June I attended a month in the Chronic Pain Clinic. Each day we were made aware of the importance of our own minds as we lived with chronic pain. We were encouraged to use breathing exercises to produce relaxation in order to break the cycle of pain produced by muscle tension and to relax the nervous system. Equally as important were the pacing strategies: breaking activities into small parts that were more manageable. Knowing, as I do, the personality patterns of those of us with fibromyalgia, I can say with certainty that we are high achievers and want to accomplish many tasks as quickly as possible. Pacing is very difficult for us. Self-talk was encouraged in order to practice ‘letting go’. The motto was: ‘DO-REST-DO“,finding a baseline within which we can work, stop, rest and do again. I warn the readers it isn’t an easy task practicing these strategies on a daily, almost moment by moment routine!

In all of these daily activities it is crucial to understand the mechanisms, the triggers, that precipitate anxiety, depression, fear and a host of other emotions to which neurons (nerves) respond, and which produce alarm signals from nociceptors. Nerves in the tissues respond to various conditions such as chemicals, mechanical issues and temperature. (Note: it is raining and my body has responded in a negative way, bringing on pain. It is my responsibility to work today with my mind to reassure it that we, that is my mind and body, are not in danger.) There are some neurons that are responsible for the danger signals that are sent to the spinal cord and the brain decides whether or not the situation can be ignored from the danger neurons (nociceptors). Input from the body can send messages of danger , sensory input from the spinal cord to the brain. Muscles increase their tension and the nervous system prepares for flight and heightened vigilance. These are very simply the processes within the brain and the central nervous system that produce the many symptoms of fibromyalgia, most notably pain.

Heightened vigilance is a constant with fibromyalgia. It is raining, what does that mean to my mind? A few hours ago the sun was shining. Is this change something the brain should be aware of? After decades of living with a hyper-aroused nervous system, my poor addled brain cannot differentiate between change that is not harmful and that which should sound an alarm. The struggle continues. Weather is a trigger for me, but I can’t control the weather! I can work towards controlling my mind.

Fear, the root cause of anxiety is insidious. It wears down the physical and emotional aspects of our lives. Ailments, like fibromyalgia develop from our perception of fear that is often unwarranted. The mind spins out of control and unhealthy images invade our mind, sending false messages to the brain.

In her audio tape Pema Chödrön helps us to understand the triggers that perpetuate our suffering. She asks: What is causing our pain? What would happen if we did not struggle against it? Today, I am asking myself this question after a restless night with intense discomfort. I call my pain Hortense and I speak to her regularly, saying that although I understand she is warning me – what makes her think I am in danger? I tell her to leave me alone for awhile as I need to practice my breathing. Sometimes it works. It takes practice as she has lived within me for 50 years and is relentless. Oftentimes though I can look back and understand what the trigger has been, usually it is too much excitement or taking on more than I can handle and she is sending me a message.

It is the holiday season. Public excitement is everywhere. I can’t indulge too much in all the activities or I will suffer for a few days afterwards. It is a huge trigger! Yet, I am drawn to the stimulation. It is addictive. “Quiet, Hortense. Come back in a few hours. I am not open to your presence right now. I will heed your warning.”

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