When it comes to living with chronic pain, most patients are aware that something must change for them to get better.

Most people with back pain or neck pain start with changing their posture.

When the self-directed intervention doesn’t work, they seek the help of professionals such as chiropractors or maybe massage therapists for some postural correction work.

For most cases, the results are underwhelming. Research tells us that posture is poorly correlated with pain and that an effective pain management strategy should address both physical and psychosocial factors.

This is also known as the biopsychosocial approach.

Recovery is a skill you can learn

Michael Bungay Stanier, a Rhodes Scholar as well as the author of The Coaching Habit, gave a short lecture on change as part of the WBECS 10th anniversary program.

In his lecture, he made references to Heifetz’s work on technical vs adaptive change.

If we were to think of recovery as a skill – which really it is if you start thinking about how many athletes “intuitively” self-manage their own injuries with considerable success – we can look recovery from a competency perspective.

How competent are you at working yourself to a pain-free state?

life coach, competence, awareness

In psychology, we can break competency down into four stages:

• Unconsciously incompetent: you don’t know how bad you are at recovering.
• Consciously incompetent: you are aware that you don’t understand or don’t know how to get better (i.e. recovery).
• Consciously competent: you are pretty good at doing what it takes for recovery if you put your heart and soul into it.
• Unconsciously competent: you instinctively know what to do when you experience pain or injury without having to think about it.

If you stumble on this blog post, you are probably already aware that you need extra help to find freedom from pain. This is great! This is usually when people make the most progress.

Most people in your stage are probably looking to take action and here is my question for you:

Are you looking to depend on some one for pain relief (i.e. some one to take your pain away) or are you looking to find your own freedom from pain*?

*As opposed to be given freedom from pain

If you belong to the first group, then most likely any chiropractor, TCM acupuncturist, physiotherapist, or massage therapist will be able to help with that. Most patients who choose that route of care do feel a significant improve in symptoms after their sessions.

The downside to that approach to pain management is that the relief tend to be temporary, i.e. your symptoms tend to come back. Most of you would be familiar with this pain-no pain cycle.

If you belong to the second group, you are sick and tired of your aches and pains always coming back, I have another question for you:

What is one thing you can change in your lifestyle right now that will bring you one step closer to your recovery goal?

Take a few minutes to consider that. When you have decided on what is the one thing you can take action on, I highly encourage that you physically write it down somewhere.

Easy change vs hard change

change, chronic pain, life coaching

All of you are here because you are looking for a solution for your chronic pain/injury problem.

Most people would consider going for a pain-relief service. You are thinking you would check-in for a chiropractic adjustment or a session with a stretch therapist. It is very likely you would feel better after. However, the results tend to be short-lived because nothing has changed.

You are back to life as per usual once you have had your treatment.

This is comparable to going for a haircut. You make an appointment with your preferred hairdresser and it’s all done for you without requiring you to know or understand what is going on.

For the rest of you, you are sick of depending on some one to feel better.

You want to take charge of your own well-being and you’re looking for a long-term solution.

In short, you’re looking for change.

So, we are going to circle back to Heifetz’s work on technical and adaptive change. For simplicity, we are going to refer to it as easy change vs hard change.

The conventional approach to change (or competency)

When we think of bettering ourselves, most of us are probably thinking of the easy change approach.

You identify the problem. You figure out what is the change you need to make.

Once you’ve done that you find a teacher. The teacher can be a person, a book, a YouTube video, or in this case a blog.

You walk away with some learning points and you start to introduce them to your daily life.

As you start to see improvements (or de-provements), you repeat the same process again – find a teacher, pick up bits and pieces of information, start to implement them in daily life.

This is easy change. It is a know-do cycle.

You consume information and you put it to an action.

It works for heaps of stuff. Like, when you are using a new phone or computer for the first time. You’d probably explore around a little. When you get stuck, you’d Google your problem or question. Based on what you learn from the internet, you’d experiment more until you get it.

It makes total sense.

This pretty much describes the easy change, know-do approach.

If you really want to understand why this know-do cycle doesn’t really yield very good outcomes for recovery, we discussed the possible reasons in our blog post on Instagram rehab.

The complete overhaul approach to change (or competency)

The hard change is, as the name suggests, hard.

It doesn’t refer to the difficulty of the task/change itself but rather how challenging it is for you to successfully transform.

Weight loss could be an easy change for some people while at the same time it is a hard change for others.

Virtually everyone would know that weight loss comes down to two things: energy intake (i.e. diet) and energy output (i.e. exercise).

However, knowledge alone is often not enough for breakthrough. This is why weight loss is a hard change for some people.

For most parts, an “easy change” attitude would not work when it comes to hard changes.

So, think of what is the thing you have been trying to crack but not really getting anywhere with. Maybe consider your new year resolutions. How far along are you in achieving them?

Have you been repeatedly engaging an “easy change” strategy for what maybe potentially a “hard change” problem?

Remember, the know-do cycle doesn’t work with hard change. Accumulating knowledge and experimenting alone aren’t enough for a breakthrough. If it did, it would be an easy change.

If you have been living with chronic pain and can’t seem to break out of the painful-pain free cycle, recovery is likely going to be a hard change for you.

Understanding your goals

smart goals, goal setting

If you are still reading this, you’re probably pretty committed to change. You are about 1200 words into my blog post by this stage.

So we know you want to be pain-free. Let’s talk about how recovery may look like for you.

First, understand which stage of competency are you in.

Are you aware that you have a pain problem that needs fixing but don’t know how to get started OR are you getting results with your self-directed recovery but you want to take it to the next level?

• Consciously incompetent: you are aware that you don’t understand or don’t know how to get better (i.e. recovery).
• Consciously competent: you are pretty good at doing what it takes for recovery if you put your heart and soul into it.

Second, accept that it’s not going to be an easy change.

Third, reframe what you want (i.e. freedom from pain) into a tangible project you can work on.

I cannot emphasised enough the importance of having goals. Without goals, you don’t have an anchor of what you are working towards.

It’s easy to change what you are working on half-way through it and eventually getting nowhere.

If you need help, use the SMART criteria. I highly recommend that you use it for your goal setting. If you find that it’s too much effort, for the very least, make sure what you are working towards is measurable and time-specific.

“I want to be pain-free” is neither measurable nor time-specific.

“I want to be able to sit at the computer for eight hours with 0/10 pain”, however, is both measurable and time-specific.

How to kick-start hard change?

Now that you have a tangible goal and something that you can check yourself back against as you work through your recovery journey, let’s dig deeper into why recovery is a hard change for you.

To capture the value of this exercise, I highly encourage that you commit both your time and your focus to self-reflection.

Step 1: Confess to yourself what you are not doing

Yep, we are going to dive straight into your vulnerabilities. If you are not feeling uncomfortable or embarrassed as you work through this, there’s a good chance you are not being honest with yourself.

So, confess to yourself … what are you NOT doing?

Signing up for a gym membership is great but if you are signing up for a gym membership with NO intentions of going, it makes total sense why you are not getting the results you are after.

While setting an action plan alone may be good enough for easy changes, kick-starting is about delving deeper and to bring your awareness to what you are not doing.

Perhaps you came across this while you are Googling to find out the cost of chiropractic treatment or to figure out who is the best chiropractor in Singapore. That’s great. But, are you planning to take action upon your research findings?

Hard changes are hard for us because we find ways to collude with ourselves so we don’t have to do what it takes.

That’s not to say that it’s you’re a terrible this. This is normal behaviour and it happens to all of us when it comes to our own hard changes.

It’s important to be non-judgemental and kind to yourself as you work through this. Remember, as long as you are genuinely working through your vulnerabilities, you are already a better person than who you were before.

Step 2: What are the prizes from this not-doing behaviour?

There are reasons why we choose not to do what we did not do. Part of delving deeper is to see if we could perhaps bring some light into these lesser-thought-of areas.

Perhaps you decided to hold off seeing a chiropractor because you wanted to save money. Given the price of chiropractic treatments that may somewhat make sense.

Perhaps you are already fit and healthy so you think you don’t need extra help. You don’t want to be dependent on another person.

“Prizes” are the excuses we just to falsely justify our inaction. They are short-term wins that are comfortable but ultimately egocentric.

There are there to “protect” you from doing something different (i.e. change).

Step 3: What are the punishments?

Punishments are the true cost of your inaction.

In chronic pain cases, choosing to hold off your treatments will inevitable result in delayed recovery, which may lead to poorer sense of well-being.

Very often chronic pain also negatively affects work productivity, relationships with your friends and family. Most patients don’t realise this because they are so used to their pain.

Take a minute to consider the last time your back was hurting at work. Did it distract you from the task at hand? My guess is that it did. How about the last time your neck was hurting so much over dinner that you weren’t fully present and engaged?

Living with chronic pain does come with its consequences.

For some of you, it may also lead doing less of what you love – perhaps you stopped reading because prolonged sitting gives you neck aches and soreness. Perhaps you stopped running because your knee hurts after every run.

Most of us don’t think of symptoms this way. However, living with chronic pain does indeed come with an opportunity cost.

Step 4: What are you going to do now?

Recovery is not something that happen with the snap of the fingers.

Like everything worth pursuing, long-term results take time, effort, and commitment.

Through steps 1 to 3, you should have more clarity of where you are at the moment. From there, you should be able to develop an action plan to start working on the hard change.

I have two more questions for you:

• What is the biggest takeaway for you so far?
• What are you going to start working in this week?

You see, self-reflection is where the magic happens.

Take some time to consider what you have read so far. You have invested the time to read Now take it a step further by encouraging yourself to find value in what you have consumed.

Remember, when it comes to hard change you are not looking for a teacher.

You are going to find a person on Google who has what you want. That doesn’t mean you are going to get what you want from him or her. When working with hard change, another book or another course is not going to make a difference.

Discover the difference the right chiropractor can make

At Square One Active Recovery, I walk with my clients through their hard change so they can get the results they so deserve.

I take a coaching-based approach to help my clients co-construct their very own pain solutions so you won’t have to keep coming back. Yes, it will be challenging and I almost exclusively only work with hard change.

If you are tired of living with chronic pain and you are ready to take action, book in for an appointment me to discover the difference the right care can make. Yes, hard change is difficult. No, you don’t have to work through this alone.

I can help.

 

Your Recovery Journey Begins Now

Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, chiropractor Jesse Cai founded Square One Active Recovery to deliver recovery goals in just 12 weeks.

Not getting results from your chiropractor, TCM doctor or physiotherapist? Book an appointment to discover the difference the right care can make.

*We do not offer short-term pain solutions such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.

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