Treating the Body and the Mind
For centuries in western medicine, there has been a tendency to perceive illness as physical or mental.
Having worked for 16 years as a physiotherapist in mental health, more often that not, I saw strong links between the body and mind.
A person with chronic unremitting pain took an overdose, overwhelmed by her illness.
I needed to treat the pain, but also listen to the distress and teach muscular relaxation and coping strategies to decrease pain.
Episodes of hyperventilation, and panic attacks were frequent symptoms, but nonetheless frightening. An understanding of how the emotions and thinking interact with physical patterns of breathing, and re-training chest movement, helped break the cycle.
With mild and moderate depression, exercise can help to lift mood. Exercise produces endorphins, which are similar in structure to opiate drugs such as heroin. Endorphins act as natural pain killers and anti depressants.
Their mood enhancing qualities are missed by the injured athlete, unable to exercise. People who exercise regularly are found to be more confident, to have higher self esteem, and to be more outgoing. The anxious person can benefit from exercise through relaxation of muscle tension, following hard muscular activity, and sometimes as a result of absorbing the mind in the rhythm of movement. Anxiety has been found to increase a person’s sensitivity to pain. When an individual feels more in control of his or her pain, anxiety decreases, and less pain is reported.
As early as 1964, giving patients information before and after surgery led to less use of painkillers, a better physical and psychological state, and discharge from hospital three days earlier than expected. Knowledge alone, however, may increase anxiety; the provision of skills for coping is more helpful in relieving pain and anxiety.
Depression is another factor which will lower pain threshold; if someone is given full involvement in their treatment, and shown empathy, it can help the depressed person who experiences physical pain. People who feel awkward and uncomfortable with their bodies may begin to develop more positive feelings about their physical and sexual selves, following certain kinds of movement or therapeutic touch. Creative movement, such as dance, or gentle loosening and stretching movements can help to integrate different parts of the body and build confidence and well being.
Relaxation techniques and massage can increase acceptance of the physical self, which may have been affected by past traumatic experiences. The physiotherapist who is sensitive to a person’s emotional state finds that there are many ways of working with or through the body which can enhance a person’s well-being. Often the most effective approaches are those which involve the body and the mind. Holistic treatment can help a person feel more integrated, more at one with him or herself.
It is not always important to discern whether we are affecting the body or the mind, or indeed to ponder whether a health problem stems from the physical or from the thinking part of us. The approach used by a chartered physiotherapist could perhaps be described as the orthodox alternative. The methods used are natural, not involving drugs or surgical techniques. Heat, ice, exercise, mobilisation, electrotherapy, massage, relaxation, advice and information can be offered following a detailed assessment of the problem. Ideally, any good therapist will advise a patient how to influence pain or disability.
To explore physical and psychological factors affecting the condition will bring even more benefits than focusing solely on the body. The release of tight muscles, the freeing of breathing and tension patterns within a physiotherapy session often allows emotions to surface, and the opportunity to talk about these feelings may be useful. My counselling training allows me to explore thoughts and feelings with a patient if they wish.