Treating the body by treating the mind

If you are like me, you have had at least one infuriating encounter with a doctor who suggested your pain is more or less a figment of your imagination. And perhaps an equally frustrating encounter with a doctor (or a string of them) who claimed to have the cure. To be fair, it must be difficult for a doctor who has never experienced constant pain to sound compassionate rather than condescending while suggesting that if I do X I will be better, and it must be difficult for many doctors to admit that pain is something they don't know what to do with. If I had an insurance copay for every time I've heard a flummoxed doctor say, Have you tried ice? Or physical therapy? Or Advil? Or Effexor?...well, let's just say I'd be having a massage right now. I wish it had taken me less time to understand the complexity of chronic pain, and to come to appreciate the doctors who acknowledge my pain is real without claiming they can fix it.

It turns out that while pain is not exactly a mental problem, it is not entirely mechanical, either. Distress about pain can augment suffering, just as much as frustrating encounters with doctors can. A recent study (summarized here) suggests that treatments designed to minimize psychological distress can also relieve physical suffering. The research targeted people with chronic low-back pain, and focused on treatments such as cognitive behavioral therapy and biofeedback. Though the study did not compare the effects of psychological treatments with those of more conventional approaches, it did show that subjects found some relief from physical pain by controlling their mind's response to it. The study contributes to a growing body of evidence on the complex relationship between the mind and pain . In my view, as long as we don't use such research to suggest that pain is any less real, the advantage of psychological treatments is that they treat patients by empowering them to understand and treat themselves.

The grueling pain of a glorious past

Last Sunday's SF Chronicle profiled 30 members of the San Francisco 49ers team who 25 years ago made football history with The Catch. But the story was not about reliving the glory days. Rather, the story focused on the painful aftereffects of living every football player's dream. The majority of those interviewed are significantly disabled with pain from repeat injuries to their once-strong bodies. Three have had joint replacements and an additional 9 already know they will need one in the future. The players are in their 40s and 50s, and, though once they were in prime physical condition, some now are unable to complete the most basic of tasks, such as climbing stairs and buttoning shirts.

Some of the players regret what they have done to themselves, while others say they would not do anything different. The story provides a glimpse of the futures of today's players, who are often pushed to be bigger and to play harder than their predecessors. At least today's star athletes are paid better than yesterday's--they will be able to afford the best in artificial joints and spinal fusions.

Unidentified caterpillar

Reflections

Hummingbird

This as-yet unidentified hummingbird hung out on a tree several feet from me for a couple of minutes while I was hiking two days ago. I believe this is a male Anna's hummingbird or Broadtailed hummingbird. Photo quality isn't great, and this is as close as I could get without blurring.

Years gone back

The creators of the RealAge empire (which I took for a test drive a few days ago) are profiled on CNN.com. Surprise--the 60-year-old founder's 'real age' is 42.

Misplaced beauty

Above: Eucalyptus in bloom

Eucalyptus trees are a (some would say unfortunate) recent addition to North America's plantlife. They are native to Australia, but have spread throughout the world, arriving in California, apparently, during the mid-1800s.

It is easy to see how insidious the eucalyptus tree can be. In the park I hiked in yesterday there are many native trees, but where the eucalyptus grow they grow alone, staking out their territory at some distance from the next. I believe this is because they take so much space and water from the ground with their large roots they make it difficult for other trees to grow nearby. And where they grow the trails are crusted with the leaves, pods and bark that the trees shed.

Despite the extensive damage they can do to native ecology, the trees are gorgeous and useful. I regularly grab a freshly fallen leaf as I hike, break it open, and breathe in the strong scent to open my lungs as I begin an uphill trek. This seems to help my mild asthma as much as a remember my inhaler helping when I used it as a child. The towering trees are beautiful from a distance, and each bit of the tree is pretty in its own right: the long and slender leaves, the seed pods and emerging blooms, the bark that peels off of the trunks in large strips.