A New Look at Pain.


Body in Mind

The Reign of Pain is mainly in the Brain.

A Happy Brain feels less Pain.

I am Safe.

Pain depends on the Balance of Danger and Safety cues.

                                                     In                In

                                                     Me              me

What is lacking? Loving support.

When I first moved into my unit at the Retirement Village I felt very alone.

Money was a big issue.

Then, I fell out of the bed I had borrowed from Management, banging my arm and foot against a nearby desk. This caused shock and considerable pain and bruising. The ambulance attended and I was advised to see the GP next morning.

Thankfully, no bones were broken but I continued to have severe back, leg and knee pain. On investigation by specialists, I learned my back was a mess of problems, untreatable and prescribed codeine based painkillers. 

I have been on the waiting list for the pain clinic at the Royal Hospital Hobart since November 2016.

This year the Government have decided that taking opioid based medications, even on prescription only basis, is not a good treatment so the GP tried to cut me off “cold turkey” with  the result I ended up in hospital with uncontrolled high blood pressure.

So, next thing I tried is laser acupuncture every week for about 3 months. At the same time, weaning myself gradually from the pills.

Then the Pain Revolution Team rode their bicycles into town to teach the latest theories about pain www.painrevolution.org 

The Local Pain Educator Program is a community based health promotion initiative that helps raise awareness of educational models for pain relief in a biosychosocial model of care.

From this teaching I have learned to find alternative ways to tell my body that I am SAFE now. I don’t need pain to protect me. I can change my thoughts, beliefs, peers and fears of past events.

The relationship between the body, the brain and the mind is complex and magnificent, which is why lots of people are investigating it. This website focuses on attempts to better understand the way the body, brain and mind interact.

Research into the role of the brain and mind in chronic pain

BJSM British Journal Sports Medicine

The lead scientist, Prof. Lorimer Moseley, is particularly interested in the role of the brain and mind in chronic and complex pain disorders. Through collaborations with clinicians, scientists, patients and thoughtful friends, the team is exploring how the brain and its representation of the body change when pain persists, how the mind influences physiological regulation of the body, how the changes in the brain and mind can be normalised via treatment, and how we can teach people about it all in a way that is both interesting and accurate.

 This website includes links to published articles, current projects, teaching resources for clinicians and lecturers, books, seminars and conferences and other info that the team thinks is intriguing, important or irresistible.

The Body in Mind team includes collaborators in research experiments and clinical trials, bloggers who are kind enough to contribute to the BiM blog, and our research team at Neuroscience Research Australia (NeuRA) and University of South Australia (UniSA).

Professor Lorimer Moseley

Professor Lorimer Moseley is a clinical scientist investigating pain in humans. After posts at The University of Oxford, UK, and the University of Sydney, Lorimer was appointed Foundation Professor of Neuroscience and Chair in Physiotherapy, The Sansom Institute for Health Research at the University of South Australia. He is also Senior Principal Research Fellow at NeuRA and an NHMRC Principal Research Fellow.

He has published over 280 articles, five books and numerous book chapters. He has given over 140 keynote or invited presentations at interdisciplinary meetings in 30 countries and has provided professional education in pain sciences to over 15,000 medical and health practitioners and public lectures to 35,000. His research group outreach videos and articles have attracted over 3.5 million views/reads.

Lorimer Moseley PhD FACP

University of South Australia, Australia

Public Transport a part of living for Elders.

Professor Lorimer Moseley (PT, PhD) is Chair of Physiotherapy at the University of South Australia and a professor of Clinical Neurosciences. people.unisa.edu.au/lorimer.moseley

He combines Oxford rigour with a laconic and very popular Australian style of communication. In this podcast he addresses the questions: 

What’s new in our understanding of the spinal cord? 

What should we be telling patients? 

Is the ‘hands on, hands off’ debate a useful one? 

How do you feel the profession is performing right now? 

On the subject of what should we be telling patients, he argues we should train them to ask clinicians 3 questions. 

1. How do I know my pain system is over-protective?

2. What can I do to retrain my system to be less protective?

3. Am I safe to move?

You can find his patient website ‘Tame the Beast’ here: www.tamethebeast.org/#home

You can find his academic/health professional website ‘Body in Mind’ here: www.bodyinmind.org/

And is previous BJSM podcast was on tendons. It has had >17K listens: ow.ly/5OGN30gkaD7.

And here is a link to the Pain Revolution website: www.painrevolution.org/

BJSM

BMJ

BMJ Journals

Sports

medicine

3 November 2017

Am I safe to move? Professor Lorimer Moseley: New understanding of pain and focusing on the patient by BMJ talk medicine is licensed under a Creative Commons License.

About


Since I was a small child I have always been puzzled by the question “What is the Meaning of Life?

It has only been in this last year that I have truly had that question answered.

Finding the path between ORDER and CHAOS.

Choosing the positive, with love, and creating equilibrium.

Our ultimate goal is to travel a route that will take us on a long, long journey over a vast period of time, where we will explore the potential of our mind as well as achieve great intellectual conquest, which is reward in itself, but is not the final reward.

There have been steps along the way, through many denominations, starting with Anglican through to small home groups.

Integral theory was a fascinating journey into more truth on my quest.

This is the ultimate quest for us:

to return to where we rightfully belong, and that is to the One who created us, so that we can be One with Him.

I have travelled a long path, experienced much, created a family, run a business, discovered spiritual truths and now in my later years I am living in a Retirement Village in Hobart, almost at the end of everything but happily keeping in touch through modern technology.

Giving up old habits and ways of thinking is required every 10 years or so, otherwise our lives become stale.
Every new chapter creates opportunity for more adventures.

More to life than Bingo


This year 2016 has found me in a new location, Hobart, Tasmania and with a new passion.

I have been studying Jean Gebser’s Ever Present Origin as part of an on-line Book Club,

It is quite an intense but rewarding journey through structures of consciousness.

To me, it seems like a Mythic Journey and here is a poem by my favourite poet that says it all.

Mythic Journey

by John O’Donohue.

A journey can become a sacred thing:

Make sure before you go,

to take the time

to bless your going forth.

To free your heart of ballast.

So that the compass of your soul

might direct you toward

where you will discover

more of your hidden life,

and the urgencies

that deserve to claim you.

Ageing in Place


cakeLiveable Communities, ageing in place in 21st. Century.

The purpose of this article is to identify some of the pressing problems that people face as they age, in particular where and how they live, and to suggest a range of possible solutions.

Ageing in place is a concept which focuses on both where and how an elder lives, self managed, highlighting quality of life issues such as health, housing, transport,safety and opportunities for education, recreation, volunteering and social interaction.

Ageing in place isn’t just a matter of building accommodation. It’s about choices, enabling seniors to stay in their own homes in comfort and security for as long as their health and financial circumstances allow.

Flexible, affordable solutions are required, for the time when an intervention of an illness or unexpected crisis causes a person to require alternative accommodation, often in the same area where their local GP and shops and friends remain.

Some could require assistance from current health services, but remain able to make decisions and enjoy their life, as before.

Frail aged residents would need live-in nursing help and compassionate people to provide relief from loneliness, helplessness and boredom, with eventual palliative care.

The impetus for calling attention to this need comes from first hand experience of our peers:

  • Inability to find residential accommodation in the area after a fall, leading to isolation in a nursing home too far away for friends to visit.
  • No respite care available during the winter months when current housing was unsuitable in order to remain healthy.
  • Sudden illness requiring temporary care, before recuperation and return to home.
  • Relocation of family members to be closer to other family inhibited by cost.
  • Availability of visits from local long standing GP’s desirable.
  • Access to ongoing basic health programmes at clinics in the area.
  • If an Elder, living alone at home, is required to go to hospital the stay is likely to be longer than usual, because no care is available at home after release. Thus costing the State more.
    High security of blocks of flats is an issue. In an emergency, the resident could become inaccessible for care givers.
    Transport is also a big consideration, isolation because of lack of mobility is common. Those who are no longer driving don’t easily enjoy the independence of getting their shopping done or visits to friends or medical appointments.

    Of course, public transport is hardly a panacea for the problems of the frail elderly. Trudging to a bus stop or train station, climbing up stairs and dealing with schedules and bad weather, lack of seats may simply be too demanding. And Community Transport can’t possibly handle the volume that the “silver tsunami” will produce.

    So for many senior boomers, the availability of that bus or train may be the single most important factor in allowing them to live the good life — or, given the realities of ageing, the pretty good life.

We are interested in a place where those who are relatively well and mobile can live long term, and also facilities for those who suddenly and unexpectedly are no longer able to function independently, maybe for a short period.

How do you Play? by Ben Michaelis, Ph.D.


Quiz: Do You Play?

1. Do you consider yourself a playful person?
(1) Absolutely. Playing is essential to living.
(2) Kind of. I would like to play more but sometimes I have a hard time letting go.
(3) No way. Play is for kids. I’m not a kid and I don’t feel comfortable playing as an adult.

2. When do you play? 
(1) Often. I try to bring my sense of play to almost everything I do. If you take life too seriously it gets boring. Let's have fun.
(2) Every once in a while, with a small number of trusted people.
(3) I never play these days.

3. Do you consider your imagination to be an important part of who you are? 
(1) Yes. I am constantly dreaming up new ideas for my future and imagining exciting new horizons.
(2) Sort of. I am a practical person and so I spend most of my mindshare on reality, but occasionally I imagine or daydream about a brighter future.
(3) No. Who has time for imagination?

Add up the scores (1, 2, or 3) on the three questions and look below to learn how playful you are these days.

Do You Play? — Add It Up!

Total Score 3-4: You have retained your spirit of play in your adulthood. Feel free to read on but only if it doesn’t get in the way of your play.

Total Score 5-6: You value play but may have difficulty doing it very often. Keep reading for strategies on how to play in ways that feel comfortable to you.

Total Score 7-9: You have left play in your past, but that’s okay. It’s never too late to get it back. Let’s learn how together.

If you tend to have difficulty playing these days, you are not alone. Imagination and play often get left by the side of the road in our adult lives, not because we experience a sudden shift in values at some specific turning point, but because we become distracted by the demands of daily life. As adults we take on responsibilities and do what we must do to survive. We relegate play and imagination to the status of a spare-time activity — what people often call a “hobby” — rather than making them central to our lives. And while play and imagination may not be critical for surviving, they are imperative for living a meaningful and joyful life. After all, if you can’t use your imagination to explore your next big thing, how can you possibly get there?

Even if you played with abandon in your early years, it is possible to lose the spirit of play in adolescence as you labor under the demands of looking cool in front of peers or appearing capable or polished to parents. If you were fortunate enough to retain your spirit of play through your teens, it can still be siphoned out of your life when you enter adulthood because of the never-ending demands of daily life. Because many of us spend so little time imagining and playing, we may not know how to use our imaginations in a way that feels safe. I have heard many patients suggest that they have a hard time playing with ideas or different roles because they are afraid that they might encounter embarrassing or shameful thoughts.

The fear that delving into your imagination will open Pandora’s Box and lead you down the road to ruin is, unfortunately, all too common, but unfounded. If done properly, exploring your innermost ideas and fantasies will lead you toward redemption, not perdition. The way to cross the threshold to play is with freedom and boundaries.

Freedom and Boundaries

Your thoughts and feelings are a part of you — even the ones that you don’t like. If you feel ashamed of ideas that come to mind because they seem to reflect poorly on your moral character, remember: They are just thoughts. Regardless of whether you like your thoughts or ideas, they are in your head, not outside of it. Acting on some of your ideas may cause you and others great pain, but experiencing them in your mind cannot. Your mind is playing with ideas, and it is far healthier to explore them in your mind’s eye than to try to hold them back. Most of the time it is the repression of unwanted thoughts that causes problems, not the thoughts themselves.

So how do you get into the place where you can play without judgment but still retain the boundaries to keep you and those close to you safe from limitless indulgence? With your Play Space and Play Tools.

Your Play Space

One of the greatest ideas from childhood is the play space. Designating a room, or even part of a room, as an area for imagination and creative exploration is one of the best things you can do for a child — or for an adult, for that matter, because it gives them permission to use their imaginations within the structure of a space that is set aside expressly for that purpose. Having the authority to open your mind in a designated area gives you both the freedom to imagine and the boundaries of knowing that whatever you dream up or create does not need to be subjected to the rules of reason that govern the rest of the world.

If you are feeling stuck, consider creating a play space where you can think and imagine possibilities for yourself. You can do this in your car, on your train ride to work, or while you are making dinner. Your location is less important than your orientation. The key is giving yourself the freedom to come up with new ideas or things that you want to do or be. At the beginning, it may be useful to pick a consistent time that has a defined beginning and end so you know when you will be open to exploration and when you have to put your imagining aside and deal with the pesky nuisance of reality.

Your Play Tools

When you are young and haven’t yet learned to negotiate your world with words, which usually happens around age 2, you think in feelings and images rather than in sentences and logic. During childhood, if we are fortunate, we use lots of different tools to express ourselves. Paint, puppets, collage, blocks, colored pencils, and clay are all great play tools that can be used to stimulate and express your imagination. One of the great things about these play tools is that by using them you may be able to access ways of thinking and feeling from long ago, before words got in your way.

Take a moment and think back to your childhood. Were there certain play tools that you tended to use? What were they? Could you use them now in order to jump start your imagination about what’s next for you?

Now that you know where you want to play and what you might want to play with, go out there and just do it, Nike style! Play, play, play with abandon!

The more you open your mind to playing with new thoughts and ideas, the more comfortable you will become doing it. Your imagination is a muscle — use it or lose it. When you play, don’t worry about accomplishing or achieving anything in particular — just open your mind and let it run free.

Leave the rules at the door. Whether you like to paint, make puppets, do collage, or mold with clay, go into your play space and just play. Let your mind off its leash. You’ll be glad you did.

As for me, I’m going out to play too. I’ll catch up with you in a couple of weeks when I get back!

For more by Ben Michaelis, Ph.D., click here.

For more on emotional wellness, click here.

 

Spirituality in the Later Years.


Prayer of St Francis

Falling Upwards by Richard Rohr.
In Falling Upward, Fr. Richard Rohr seeks to help readers understand the tasks of the two halves of life and to show them that those who have fallen, failed, or “gone down” are the only ones who understand “up.” Most of us tend to think of the second half of life as largely about getting old, dealing with health issues, and letting go of life, but the whole thesis of this book is exactly the opposite. What looks like falling down can largely be experienced as “falling upward.”
In fact, it is not a loss but somehow actually a gain, as we have all seen with elders who have come to their fullness.

  • Explains why the second half of life can and should be full of spiritual richness
  • Offers a new view of how spiritual growth happens?loss is gain
  • Richard. Rohr is a regular contributing writer for Sojourners and Tikkun magazines

This important book explores the counterintuitive message that we grow spiritually much more by doing wrong than by doing right–a fresh way of thinking about spirituality that grows throughout life.

In the second half of the spiritual life, you are not making choices as much as you are being guided, taught, and led—which leads to “choiceless choices”: these are the things you cannot not do because of what you have become; things you do not need to do because they are just not yours to do; and things you absolutely must do because they are your destiny and your deepest desire. Your driving motives are no longer money, success, or the approval of others. You have found your sacred dance.Now your only specialness is in being absolutely ordinary and even “choiceless,” beyond the strong opinions, needs, preferences, and demands of your first half of life. You do not need your “visions” anymore; you are happily participating in God’s vision for you. . . . Our dreams of our early years have morphed into Someone Else’s dream for us. -Fr. Richard Rohr
Richard Rohr
Richard Rohr, O.F.M. is a Franciscan friar ordained to the priesthood in the Roman Catholic Church in 1970. He is an internationally known inspirational speaker and has published numerous recorded talks and books. Wikipedia
 

Art for the Later Years.


Healthy Ageing via the Arts. A video about EngAGE produced by the James Irvine Foundation in 2011.

For Healthy Aging, a Late Act in the Footlights

 
By TINA ROSENBERG
Fixes

Fixes looks at solutions to social problems and why they work.

What kind of old age will you have?

Many of us look forward to spending retirement expanding our world — traveling, trying what we never had time to do, taking classes that give us new knowledge and skills. These activities are not only desirable in themselves, they help us to live longer and healthier lives.

But they are not within everyone’s reach. Absent money and a sense of possibilities, retirement can become more time to fill with television. “We see people without money, who had very hard lives, who are not aware of their own potential,” said Maureen Kellen-Taylor, the chief operating officer of EngAGE ,a program in the Los Angeles area that provides arts and other classes for some 5,000 people — the vast majority of them low-income — living in senior apartment communities. “They just had to get through life, taking care of things, and the idea of following a dream was not on their radar screens.”

That’s why the Burbank Senior Artists Colony is remarkable. Opened in 2005, it is a mix of market-rate and low-income apartments. The building looks like an upscale hotel but is built for the arts, with studios, a video editing room, a theater and classrooms.

Residents may arrive with no previous artistic experience or skill as an artist — but artists they become. The theater group that Sally Connors participates in is working with a troupe in London, via Skype, to write and perform a soap opera. Walter Hurlburt shows his oil paintings — for sale — at the colony’s periodic art exhibitions. Residents work with students from a nearby alternative high school to do improv theater, make claymation films and art from recycled items. Suzanne Knode wrote a short movie, “Bandida,” about an elderly woman who takes the bus to rob a convenience store. Then the residents filmed it — and Ira Glass’s “This American Life” television show filmed them — and submitted the film to the Sundance Film Festival. “A pistol, a plan, and sensible shoes,” says the poster.

The Burbank colony is the showpiece of EngAGE, an organization started in 1997 by Tim Carpenter. He was working for a health care company that built primary care centers for senior citizens when he met John Huskey, a Los Angeles developer of affordable housing.

Carpenter and Huskey began to talk about how to combine what each of them was doing. They had originally contemplated establishing acute-care health centers in senior apartment buildings, but now had a different idea. “We live in a society that’s very acute-care based — we wait till someone’s sick,” Carpenter said. “We decided to try to get people to take on healthy behaviors without having to go to the doctor.”

Carpenter, who had a background in the arts, started in one of the complexes built by Huskey’s company, Meta Housing, in Duarte in 1997, by teaching writing himself. The program soon expanded to more buildings. In 2005, the Burbank colony opened — the first one in which EngAGE had a say in the design.

EngAGE now brings arts training, wellness programs like an annual Senior Olympics, and computer and other classes to 27 senior apartment buildings in the Los Angeles area, and will add another eight over the next year, including two  — in North Hollywood and Long Beach  — that, like Burbank, will be designed for the arts. The NoHo Senior Artists Colony will open in October with a 77-seat professional theater in the lobby. Burbank and the Piedmont Senior Apartments in North Hollywood have a mix of market rate and subsidized apartments, but the other 25 are all for low-income seniors. Most of the residents are living on less than $15,000 a year. They pay $400 to $800 a month for a one- or two-bedroom apartment.

Basil Alexander at an EngAGE annual Senior Olympics, a multi-generational event that allows seniors participate in competitions in wellness and the arts.Gene Schklair for EngAGEBasil Alexander at an EngAGE annual senior Olympics, a multi-generational event that allows seniors to participate in competitions in wellness and the arts.

The classes are demanding  — no one is gluing macaroni to paper plates  — and the teachers are pros, either laid-off schoolteachers or artists. The dance teacher at the Portofino Villas site in Pomona, for example, is Trina Parks, a dancer and actress who was the first seriously lethal and first African-American Bond girl  — she played Thumper in “Diamonds Are Forever.”

Carpenter calls this approach the opposite of the assisted-living model. Assisted living centers provide whatever medical care is needed. They usually have a great dining hall. There are buses to the mall and trips to see plays. “These are things that don’t help people that much,” Carpenter said.

Everyone knows that staying physically fit is important to remaining healthy in later years. (A good summary of the evidence is here.) And we know that mental fitness is also crucial.

But certain strategies are better than others. “Doing Sudoku helps the part of the brain that does Sudoku,” said Michael C. Patterson, who used to run the Staying Sharp program at AARP and now is a principal in MindRAMP, a company that advises institutions working with senior citizens on promoting brain health in aging. “You need to exercise the full brain.”

And it has to be a serious exercise, Patterson says. “Part of the process is you set a goal for yourself, and did you achieve it?” he said. “Making potholders is not going to do the trick.”

Creativity in aging is Patterson’s business, of course, but the idea is amply supported by research. (The National Center for Creative Aging is a good place to start.) One of the best all-around exercises for older adults is doing theater. The researchers Helga and Tony Noice (she is a psychologist, he is an actor) gave nine 90-minute classes to a group of adults. Some did theater training, some trained in visual arts and another group did nothing. After four weeks, the differences in cognitive function were astonishing. The theater trainees scored nearly a 60 percent increase in problem-solving ability (with visual arts, that ability declined) and the gain was sustained. The Noices believe that theater is especially good for the brain because it requires engagement on many levels  — emotional, physical and intellectual.

Not inconsequential: theater is fun and social, so people stick with it. Some of the visual arts students dropped out, but none of the actors did. “When you really get involved in a creative project, it’s physical exercise, mental stimulation, socializing, your stress goes down and it’s enjoyable  — something you will do,” said Patterson.

A study done at the University of Southern California found that more respondents in EngAGE programs reported that their health had improved in the past year, while in a control group, more people reported that their health had worsened. A study carried out by Century Housing, one of the top lenders to EngAGE’s communities, put a dollar figure on the gains. In the program, it found, 25 percent fewer people than in comparable groups needed expensive interventions such as nursing care. The savings came to about $9,000 per year per resident.

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Read previous contributions to this series.

EngAGE gets its money in part through fund-raising, but two-thirds of its income comes as payments from the senior complexes where it works. These buildings, in turn, stay afloat mainly through federal tax credits for low-income housing, said Huskey. The program is highly competitive, and projects are more likely to win tax credits if they have a local financial contribution  — for example, from the Los Angeles Community Redevelopment Agency, or from banks, which by law must invest in their communities, including in low-income areas.

EngAGE is an important selling point for these groups, Huskey said. “They would much rather have a project that has a better story of how it’s affecting people’s lives. They want to do well by doing good.” Huskey said his company was approaching Charlotte, N.C., Austin, Tex., and Minneapolis about starting senior artist colonies in those cities. “What started out as self-serving desire to get a 15-minute head start on my competitors has become a great thing,” Huskey said.

Sally Connors thinks so.  She and her husband had five good years after his lung cancer diagnosis, and they used them to travel. After he died, Connors, a junior high science teacher, thought she would spend her time reading, walking and doing genealogical research. “I wouldn’t be going out and doing things,” she said. “I would be very bored.”

But she had a daughter in Burbank, and one day they drove by the colony. “Why don’t you live there, Mom?” her daughter said.

“I’m not an artist,” Connors replied.

“But you could be,” her daughter said.

That was five years ago. Since then, she has taken every single class EngAGE offers in the colony. She’s been in every theater performance. She had dreamed as a teenager of singing with a band — now she sang “Sentimental Journey” and “Blue Moon” with a band at a Fourth of July celebration. She wrote a two-minute screenplay, cast it, directed it, produced it and showed it as part of a film festival in the building. She’s part of the theater group working with their British counterparts, and mentors high school kids. She’s studied drawing and acrylic, watercolor and oil painting.

At 78, she does yoga twice a week and works out with a personal trainer. “I would be a lot older than I am right now if I hadn’t found this,” she said. “Definitely older mentally. I have a friend I don’t call anymore. For her everything is wrong  — I can’t do this because I’m too old. That would have been me.“

“All those years I spent thinking: ‘If I only knew then what I know now,’” said Suzanne Knode, who counts “Bandida” — her first writing ever, at 63 — as the start of a new life.   “But I said, ‘Wait a minute. I know now what I know now. And I’m still alive.”

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