(Faure - "Pavane")
When your body has been injured and the trauma has left permanent physical changes, you will need time to heal from the emotional scars as well as the physical scars. Complete healing from the physical injuries may indeed not be possible, but in order to move on with your life and make it liveable again, you need to learn to find ways to accept and get to like your new self.
Adjustment to the physical injuries caused by a trauma often demands those changes in your life; it may no longer be possible for you to go back to your previous work or to pursue the old hobbies or sports that you may have enjoyed before the trauma. As in Antonia's case, your circle of friends will often change, too. People frequently say that during a crisis your true friends emerge. People often find that those whom they thought of as friends before the trauma turn out not to be true friends, and yet new, more understanding friends emerge instead. Sometimes, because of the physical injuries, there can also be a real sense of isolation, because you may not be able to get about as much or as easily as you did before your trauma.
So, the first step toward learning to live with the physical scars is often to accept that you will have to make certain changes in your life. The next exercise is designed to help you look at those areas of your life you may need to change.
1. Take your notebook and write down all the things you used to be able to do before the trauma. Then give yourself a score anywhere between 0 - 1 0 for your past quality of life (where 0 = poor and 1 0 = very high quality of life).
2. Now write down all the things that you are doing now. Again give yourself a rating anywhere between 0 - 10 for your present quality of life.
3. Calculate the difference between your score of past quality of life and your score for present quality of life and make a note of this. What do you notice? Did you expect there to be such a difference in scores? Is this discrepancy really justified? Or would you like to try to redress this unequal balance? (Or maybe you are one of the few people who have already mastered this and the scores are not all that different after all!)
4. Now write down all the changes that you would like to make to help increase your present quality of life. Of course, these need to be realistic and to take into account any changes in physical condition. Nevertheless, there are probably many things that you could be doing despite the physical changes, that so far you have not tried. Give yourself an estimated rating between 0 - 1 0 for your quality of life if you really managed to make these changes. Would you be satisfied with this score? If not, maybe you could think of some further changes you would like to try.
5. Order the changes that you have listed in terms of how easy you think they would be to achieve. Select the easiest change first and write down in your notebook what you have to do to achieve this first change and how and when you will have done this.
6. Try to work towards the easiest changes first and once you have mastered them, advance to the more difficult ones in your own time. It might be helpful if you could get a partner or friend to help you achieve those changes.
Also don't forget to re-rate your quality of life at intervals and remember the challenge is to improve quality of life, regardless of the physical changes you have experienced!
Now that you have begun to work on reinstating quality into your life despite the physical changes it would also be helpful if you learned to reconnect with your body and reintegrated the hurt or changed parts with the rest of your body. Your goal is to learn to accept your body and your self as it is now.
After severe physical injury it can be difficult to accept the changes to your body image and to start to see yourself as a whole person again. It is quite understandable that you find it hard to accept your new self and your altered physical image. However, your old body image has changed and now you need to give yourself a chance to get to know and familiarize yourself with your new body image.
The following exercise is designed to help you with this, but take as much time as you need and only work on this when you feel ready. It gives you the opportunity to explore your present body as it is, in order to welcome and learn to accept each part of yourself.
1. The task is for you to reclaim each part of your body separately. Start with those parts of your body that you feel either positive or neutral about (do not choose any parts that carry any negative feelings for you), for example you could choose to start with your elbow or your wrist (if those parts of your body haven't been changed by the trauma and you don't feel negative about them).
2. Set aside 5 or 10 minutes every day and work on your chosen part of the body. When you were a baby you spent hours just looking, touching and exploring each part of your body in order to get to know and to familiarize yourself with them. Just as when you were a baby, allow yourself to discover that chosen part of your body all over again. Examine how the skin looks, is it smooth or rough? Allow yourself to feel it, touch it, stroke it. Think about its function and how it has served you over the years that you have been together. Do this every day for the next three days.
3. By day 3 start writing a letter of appreciation about this part of your body. Acknowledge what a wonderful functional part of your body this is. Write down all that you appreciate about this part of your body, make friends with it.
4. On day 4 allow yourself to buy a small, inexpensive present for this part of your body, for example, some cream or oil, a feather or a ribbon. It should be something that you can put on it, use to stroke it with or even give it a little massage, to show your appreciation and care. Let it know in that way that you accept it as a part of yourself.
5. When you are ready to like and accept this part of your body, move on to other parts of your body until you feel ready to learn to accept those parts that have been damaged by the trauma. When you are ready, go through the steps of this exercise as you did with all other parts of your body Allow yourself to really get to know those injured parts, to look at them closely, to feel them, to touch them and in your own time to welcome them back as part of your own body by proceeding to Steps 3 and 4. In your letter of appreciation you may also recognize how brave that part of your body has been and how hard it must have been to be rejected and unloved for so long. Explore, if you can, ways to love or like this part of your body.
Remember:those damaged parts are with you now in this way because your body has accepted them after the trauma. So, it is not your body but your mind that has rejected them! Your task now is to help your mind to find ways of befriending and accepting them as part of your new whole being.
When physical pain following injuries becomes chronic and persistent it can seem like an inescapable and constant reminder of the trauma. At this stage there may not be any medical solutions to remove your pain completely, but you can still learn ways of controlling the pain, rather than it controlling you and your life.
If you are suffering from chronic pain and feel that it has taken over your life, the following exercise might be helpful:
1. If you are suffering from chronic pain, ask yourself how many activities you have stopped doing because of the pain.
2. Ask your partner or another person who knew you well before the trauma what they have observed you giving up as a result of the pain. Make a note of all those activities that you have lost in your notebook.
3. Now look at your list of lost activities and decide whether there may not be one or two of these that you could modify so that with time you might be able to manage them despite your pain?
4. Write yourself a program to help you towards achieving this. For example:
Aim:To walk into town again.
a. Work out how many steps you can manage presently, (e.g. 300 steps).
b. Next, decide what number of steps you would like to have increased your mobility by for the next week. Decide on a small increase, e.g. 350 steps.
c. Now practise walking a little more every day until b the rest of the week you have mastered 350 steps. Congratulate yourself if you manage this. If not, try again for another week, until you have achieved this goal.
d. Then work out what your aim for the following week is and continue in small steps until you have mastered your aim of walking into town.
e. Once you have achieved your first aim, set yourself another aim to work toward. 5. If you can't identify anything from your list of lost activities that you would like to work toward, think of an activity that you haven't done in the past but that you would like to be able to master. Proceed in the same way with small incremental steps.
Now that you have taken steps to control your pain rather than allowing it to take over your life, you could explore some additional techniques to help you manage and feel more in control of your pain.
1. When you next experience a pain, ask yourself the following questions:
a. If your pain was a shape what shape would it be?
b. Would it be smooth or rough? Are the edges round or jagged?
c. Would it be solid or liquid?
d. Imagine yourself touching it. What would it feel like?
e. Would it be hot, warm or cold'7
f. What colour would it be,?
g. If it could make a noise, what noise would it make?
h. How loud would that noise be?
i. Now notice its size. How big is it?
j. Whereabouts in your body is it? Right inside or more
on the periphery? 2. Now explore how to change its image.
a. Think of how your pain's image would need to change in order for the pain to be less intense and powerful.
b. If you could change its colour to a more healing, soothing colour what would it be'?
c. If it could change its shape and size, how would you do this?
d. Imagine it turning into a liquid and flowing out of your body.
e. Imagine changing it into lots of little parts, which are less intensive and painful than the big shape of pain that you first pictured.
f. Explore any change of the image that is different from the original image that was associated with your pain. Another example would be for you to imagine healthy cells fighting and conquering the pain, with the pain running away. 3. Allow yourself to be as open and as explorative with your image as you like. People often find that the less they concentrate on the actual physical sensation of the pain, the less they notice it and the more likely it is that some of the pain intensity can be reduced. In order to achieve this it is important that you make your image as strong and powerful as you can.
4. Practise this exercise as often as you can (several times a day). Give yourself a rating between 0-10 for pain intensity (0 = no pain, 10 = the worst you have experienced), one when you first notice the pain and another rating again after you have done this exercise.
Use your notebook to start a pain diary, in which you record each time you use this exercise. Give yourself time and be patient - don't expect the exercise to work the first time but keep sticking with it!
Finally, recognize that your decision to take more active control over your pain is a very positive one and the first big step toward mastery.
(Faure - "Pavane")