Have you ever worked with a client who cannot consciously acknowledge improvement even though their body shows clear signs of it? Many people can be attached or even addicted to their pain. As hard as this can be to understand, it occurs partly because the pain or condition associated with it can become part of someone’s identity. For these individuals, their sense of self is intertwined with their physical symptoms and the rituals that they create around them.
Eckhart Tolle said, “If you were truly conscious of it, the pattern would dissolve, for to want more pain is insanity, and nobody is consciously insane. The painful body, which is the dark shadow cast by the ego, is actually afraid of the light of your consciousness. It is afraid of being found out. Its survival depends on your unconscious identification with it, as well as on your unconscious fear of facing the pain that lives in you. But if you don't face it, if you don't bring the light of your consciousness into the pain, you will be forced to relive it again and again.”
As massage therapists, we are privileged to be part of the process of bringing light (awareness) to our client’s unconsciousness by helping them identify with the benefits of the therapies we offer. One essential part of this process is having clients fill out a complete intake form on their first appointment. Intake protocols should gather information about not just where clients feel pain/restriction. Still, they should also help the therapist understand how the symptoms manifest in everyday life, i.e., a client can’t walk/stand for more than X minutes without experiencing excruciating pain (a 9 on a scale of 1 to 10), can’t climb more than X number of stairs, can’t sleep more than X hours a night without waking in pain, etc.
By gathering specific data that gives a glimpse into the limitations and frustrations of the client’s daily life, the therapist creates markers that enable them to demonstrate improvement even if they are not consciously aware of improvement. For example, after several sessions, a client suffering from a chronic pain condition may respond to the question “What specific improvements have you gained as a result of our sessions together?” with “Well, I don’t know about any specific improvements. I still hurt all the time, but it feels good when I am here.” If the therapist conducted a thorough intake/assessment during the client’s first session, the intake form could help the client identify and directly observe improvements of which the client is not consciously aware. If the client reported not being able to walk for longer than 5 minutes without pain on the original intake and then reports on the re-assessment that he/she could go shopping for 20 minutes without having to sit down, the therapist could point out the improvement.
Using the client’s own words to help them observe changes in their body, abilities, and pain symptoms is a powerful tool to help clients mentally transition as their body physically transitions. Clients sometimes become so used to their pain and its presence in their lives that they do not know how to let it go or don’t recognize that it is gone. Sometimes, they may even be afraid to accept that they can do more for fear of being devastated if the pain/restriction returns. Using comprehensive assessment tools that take some of the subjective perceptions out of play and replace them with more objective markers can help therapists guide clients through this sensitive terrain.