Chronic Migraine Pain: The Way Out
Chronic Migraine Pain: The Way Out
Part 2: My head still hurts
Need A Recap?
Weeks 3-6
Last night, my husband and I went to our favorite restaurant in Westport, CT to celebrate big career news. We shared a chopped salad and braised short ribs over these incredible, giant ricotta gnocchi with truffle cream sauce. Yes I am still a vegetarian—basically—don’t at me.
I have spent the past few weeks practicing the Pain Reprocessing Therapy method introduced by Alan Gordon, LCSW in his book called The Way Out: A Revolutionary Scientifically Proven Approach to Healing Chronic Pain, but I am stuck in a rut. So, for the first time in months, I treated myself to a beautiful glass of California Pinot Noir. Wine is a certain migraine trigger, but since I’ve had migraines every day with no breaks for weeks, it seemed moot. Why not enjoy the damn wine? I’m going to pay for it whether I drink it or not.
I used to drink wine to get drunk. Like a fine wine, I’ve matured and blossomed with age and now I enjoy pairing appropriate wines for the meal I’m having to enhance the flavor. I drink a lot of water between sips or glasses and rarely exceed two glasses. Migraines notwithstanding, this post-child bearing almost 40-year-old body has 0% interest in processing more than 12 ounces of wine.
The good news: the migraine didn’t resurface for several hours after the wine (usually it’s pretty instant). Bad news: I had to take a triptan in the middle of the night to sleep, and Excedrin in the morning. But that could happen any time.
Strategies
I recently went off Wellbutrin, a mood stabilizer, and replaced it with Abilify. My doctor and I felt that Wellbutrin might have been contributing to the migraine frequency and severity. It’s hard to say, but the ability to drink a reasonable amount of alcohol again without being debilitated for the next 2 days—2 weeks is progress.
As a sufferer of chronic daily migraine, it sort of doesn’t matter what I do, but what I do can affect how I feel, i.e. longer duration, more severe intensity, faster onset. I call her Marjorie and she comes by every day. Just like in a relationship, the more I get to know Marjorie, the closer we get. Pain begets pain.
Herein lies the catch-22. Because of the volume of pain I experience, it trains the neural pathways to continue sending those pain signals. Every night I get into bed and, as part of my Pain Reprocessing Therapy, say, “No need, brain, there’s no danger here,” but the pain persists. Perhaps it’s because this way of practicing PRT is defensive, rather than offensive. It probably works well for people who have chronic pain, but maybe not constant pain.
Switch It Up
I’ve begun practicing PRT when I don’t have pain from medicinal relief. Those might be the most beneficial times to tell the brain, “See! We’re good. No pain signals, and everything’s fine, keep at it.” Positive reinforcement, like training a dog or a toddler. Instead of telling my brain not to do something, I’m now trying to tell it to continue doing what I want it to do.
With the proper mood stabilizer, it’s easier to do the other strategies, like catching my fears, and embracing positive sensations. This morning, I was transferring my seedlings to larger containers and trying out a new grow light for my plant terrarium. I knew what he was thinking, “Last year her tomatoes came too late, we got one head of broccoli, a mutant head of cauliflower, 18,000 zucchini, a lot of money and time wasted, and discouragement.
“Even if my garden fails again this year,” I told him, “I really enjoy this little hobby of getting seedlings going. It might fail again, but that’s ok.” I embraced the moment and even articulated it.
I confess, I've not been practicing the somatic tracking. Sometimes I feel too busy or too bored to focus on the thing, that damn Marjorie, that I wish would disappear. Out of sight out of mind. Except, in this case, it is an important practice. There are times I feel I’m almost “catching” myself feeling fake pain, and once I focus on it, the brain is like, “Oh shit, she saw us doing what we’re not supposed to do.”
Planning Ahead
Two changes to practicing PRT going forward:
Return to the somatic tracking when I’m experiencing migraine pain.
Practice retraining the neural pathways offensively, when I’m not actively in pain.
Make that 3: be more consistent with the first two.
It is hard practicing a mind-body therapy. There are no instant results. It can take weeks, or months, depending on how long the body has experienced pain. It’s easy to give up on it for those reasons, but the lack of results likely coincides with the lack of focus and possibly a change of strategy.
I shouldn’t—but I will—enjoy a lovely glass of $7 Kirkland Malbec because it’s stupid good and I want to. Before I do so, and while I’m actively enjoying it, I will reinforce to my brain that we are safe, we are operating exactly as designed, we are entitled to enjoyment, and comfort.
Leave a comment and let me know if you’ve tried Alan Gordon’s PRT methods and what you think.
Stay tuned for PRT Part 3… →