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Listening to Pain

In the silence of listening, we will learn more about a client’s pain.

In art, often what we find beautiful is in the negative space. In life, we can keep pushing forward after a quiet rest. The experience of pain is no different. We can learn more about a client’s pain in the silence of listening.

The complex and often nebulous understanding of what we feel and the ability to describe it can be a lot like analyzing an abstract painting. What are we really looking at? What story is this picture trying to convey? And so, as a bodyworker, how do we listen to what our clients are telling us?

Two facets of listening can affect our ability to hear what the client is feeling—the first is the client’s ability to listen. How well are they listening to their body? How well do they understand their own anatomy? And, more importantly, how articulate are they about their experience? But it is important to understand that the story your client will tell is already formulated. There is nothing you can do to change this story. Which means your job is going to be how well you listen to what they say.

This leads us to the second facet. How, exactly, do we interpret the story our client is conveying to ensure the work we do is effective? There are a few important rules to remember when it comes to listening. And I’m not talking about the traditional ones like “repeat what they tell you” or “nod your head every so often.” Being present is a crucial skill—and one you can master. Following are some basic fundamentals you can start incorporating today.

1. Enter every conversation assuming you have something to learn. Your understanding of anatomy and physiology is amazing. You most likely have a greater knowledge on the subject than your client. But this may not work to your advantage. Take, for example, sciatica. You are well educated on this topic. You already know the technical definition of sciatica—the compression of the sciatic nerve at the point of exit from the spine. But the “sciatica” your client feels might be the experience of a deep pain in the hip, or a shooting pain down the leg, or a numbing in the foot. These can be the result of any number of other dysfunctions or issues they may not have connected to their current problem. For instance, a chronic low-back overuse injury may result in a guarding pattern that may mimic sciatic-like sensations. Take a moment to learn more about their experience, their day-to-day activities, and their health history. You will gain so much wisdom from this.

2. Don’t equate their experience with yours. Your client is opening up to you about how driving has become extremely difficult or how the pain in their hip has limited their ability to play with their kids. You may have suffered from a similar scenario, or you may know someone who has had a painful sciatic experience. But now is not the time to retell that story. And this is not your audience. Allow your client’s narrative to be in the spotlight. They are paying you to be heard and to find relief—not to hear about more pain.

3. Ask open-ended questions. Try not to feed the client options. It is incredibly difficult to describe pain. Allow for the pregnant pauses that arise when someone is trying to describe what they feel. It may seem helpful to offer options with some of the more common words associated with pain. Sciatic pain can, in fact, feel “electric” or “burning.” But their response will be toward the dynamic word that is in your question. It is what the human brain wants to do. If you guide them toward a description, it is much easier to agree and latch on to that suggestion. Instead, ask “What was that like?” or “How did that feel?” Your client may surprise you. The words they choose may help you realize that what they are actually experiencing is a deep trigger point in the quadratus lumborum or adhesions in the hamstrings and not sciatica after all.

4. In the words of American author and psychiatrist M. Scott Peck, “True listening involves the setting aside of the self.” To really listen to what someone is saying, you’ve got to know your personal opinion and put it on the back burner. You may know, for example, that being overweight contributes to sciatic nerve compression and dysfunctions that create hip and leg pain. But if you hold judgment around this issue, you are now listening through a narrow tunnel that will inhibit your ability to hear the whole story. If you don’t like cubism, you will never understand Picasso. If you don’t like something about your client, you will never see their whole story. In being present, genuinely listening to the words, and intently watching mannerisms, your understanding of their experience will have a clarity and a depth that will reveal more about what their pain really is and where it is coming from.

The best part about listening is that there is always something to hear. In the silence, in the stillness, and in the negative space, we can learn about the most amazing things. Be prepared to be amazed.


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