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RUTH: a case study on ME part 2

Last week I introduced Ruth; a young client with ME whose case study I anonymised for a book by Dr Grahame Browne on pain management. It was one of the Human Givens series so I focused on demonstrating many of the HG principals. 


In reality, however, I had already integrated other models; the most helpful of which in connecting the previously separate worlds of coaching and counselling, was holistic life coaching. 


In Ruth’s first session, as with many first sessions, there was a high expectation that this intervention would help. Not just from her but from me too. I find the first session is a critical opportunity and window for change. 


Firstly the psychological connection has to be made. Rapport must be built quickly. When you have the luxury of 10 or more sessions, perhaps the therapeutic relationship can be allowed to develop slowly. I find most of my clients, whether primarily counselling or coaching, want to see results quickly.


 Quite rightly too; people just want to feel good and get on with living their best lives.


 Ruth arrived at my office feeling hopeless and desperate. It was my role, right from the outset, to create an expectation of recovery; firstly by helping her understand the role of the mind-body connection in maintaining the ME and, secondly, to give her practical tasks that would helps her calm her emotional over arousal and trigger her reticular activating brain system to look for improvement.


 RUTH: PART 2


By session 2, it became clear that Ruth was practising the breathing technique and using it to calm the emotional brain. With a calmer frame of mind, we could commence the real psychological work and address the issue of pain.


 We talked about pain and how the body perceives it. When stress is high, the spinal pain gates open and pain feels greater. Also, if the brain notices a pain and thinks it is an alert to a problem, it pays greater attention than to a pain that is considered insignificant.


I explained to Ruth the natural filtering system within the brain, the Reticular Activating System (RAS) which allows subconscious information to filter through to a conscious level. We only hold around seven pieces of conscious information at one time, but we are processing millions of pieces of information subconsciously.


For example, until I say to you ‘your left foot’ you are unaware of it. It is simply your left foot doing what your left foot does all the time. But when you direct your conscious attention towards it, you become aware of the level of warmth or cold, the pressure of the foot on the floor or the slight pinch of your shoe on the heel.


And so it is with back pain for instance. If you think it means something is really wrong with you, you will pay it greater attention. RAS will allow sensations to come to consciousness, which might otherwise drift into the background of awareness. It is not uncommon for people to ‘symptom scan’, in other words, look for evidence of illness. Of course what we focus on is what we get. If you focus on pain, you get more pain!


 Our discussions around lifestyle involved the implication of full spectrum light on mood and wellbeing. Full spectrum light has an immediate impact on mood. It enters the retina and is directed onto the brain where it produces serotonin, our feel good hormone. This has an effect on how you feel.


It’s interesting to know that, indoors we receive around 100 units of light, or lux, per hour, but that outdoors on an overcast day, we receive 7000 lux per hour.


Outdoors on a sunny day, we can receive up to 100,000 per hour and this has real implications for wellbeing as the first thing we do when we are ill or depressed…is stay indoors. Lower serotonin equals greater pain perception, and the downward spiral continues.


Ruth could see that her current lifestyle and excessive sleep pattern may well be implicated in prolonging her pain and illness and she resolved to take action.


Ruth’s appetite was also poor as she had nausea as part of the picture. We discussed the importance of a diet which would stabilise her blood sugar so that she would have more constant energy levels. She should eat protein at every meal and ensure that she ate something every three hours throughout the day.


Next week. Part 3 when we create bespoke visualisations to target the pain…


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