Reading the Massage Magazine special issue on pain relief I am reflected into how working with pain differs in my hospice massage practice from more traditional modalities.
A couple of months ago I was working with an intern at an inpatient hospice. We went into see a woman with cerebral palsy who was not on our list of referrals.
Sabrina had spent most of her life in hospital wards. Her body was a roadmap of surgeries and called out loudly for tenderness.
Sabrina spoke of her legs and back being in great pain. She continued to speak of her discomfort as I positioned myself sitting comfortably at the foot of her bed. As I slowly lifted the sheet to assess her right leg my heart shed a tear for the dwarfed limb that was exposed.
I cupped my hand around the thigh and softly spoke," I am honored to offer this limb some tenderness....I feel your leg loves the attention.... I’m so glad we’re here."
While gently holding and tenderly petting this leg Sabrina replied, "If someone had done that years ago I might still be at home."
I covered the leg as Sabrina asked me to touch her back. Although she was in a lot of pain she requested that a nurse position her onto her side so I could touch the exact spot.
After positioning was completed I sat comfortably behind Sabrina on her bed, uncovered her back and with Sabrina’s permission I came very close. With one hand slipped under her head pillow as to hold her, I simply laid my other hand on her back and said, "Oh I know you have been in pain for a long time. I'm so glad we’re here."
As I became comfortable, slowly exhaling, I felt Sabrina going to sleep. Her pain had been validated. She expressed her gratitude before the silence..
After a couple of minutes I slowly removed my hand from underneath her pillow and changed places with my intern.
The Everflowing intention is never to remove pain from someone’s body. The intention is to validate and honor the symptom ology that is being experienced, and to create an environment where the client’s anxiety about having pain can be eased.
We are in a culture that insists that pain is something we have to get rid of. We essentially make pain wrong therefore when pain appears we are afraid of it getting worse; we defend ourselves, hold ourselves tightly. We want the pain to go away. This directs a profound degree of energy to the pain, and creates anxiety.
As an Everflowing practitioner, I want to create a resting place as I walk into a room or up to someone’s bed; a place of stillness first, and then a place of very gentle movement like a breeze or a soft wave of water as the tactile relationship begins. A place where there is no resistance; a vulnerable place.
This is achieved through slow body movement, slow speech, slow audible breathing; and my willingness to find my own place of physical comfort; just being comfortable and breathing as I slowly speak to my client. I am just a witness.
This resting place, this alternative rhythm, eases a lot of tension in the room. There appears to be more empty space and the client might begin to find comfort as well.
If I can stay grounded and comfortable in body and mind then the static and resistance has been broken. The cycle has to reestablish itself.
This change in the pain cycle can cause a decrease in the pressure being experienced by the client and give the client an alternative strategy for coping with the pain.
Pain is multidimensional when someone is dying and may be my client’s most familiar response to his or her condition. I cannot assume that alleviating it is the kindest strategy. I feel I must validate the existing relationship and give models for reestablishing a more compassionate communication with ones self and one’s environment.
This is the Everflowing approach to pain. I look forward to your sharing your approaches and stories.
Blessings
Irene Smith www.everflowing.org
