Somatics,Spatial Awareness,and Chronic Pain

Living with Chronic Pain

Acute pain is essential to survival. It is a useful signal that exists to keep us safe and alive. It tells us to avoid doing things that hurt us—like touching a hot stove—or it provides a warning that something is amiss in our body that needs to be addressed. But for some people, acute pain becomes chronic. When a person is experiencing chronic pain, his/her conscious awareness tends to be narrowly focused on the sensation of pain; as a result, his/her movements become increasingly constricted. The person can become identified as a “chronic pain patient,” and as a result his/her sense of a healthy whole self may be compromised. In the absence of a condition that might be worsened by certain movements—such as a broken bone—movement therapies can be the ideal strategy to widen the person's focus and make it more expansive.

People diagnosed with an autoimmune illness, osteoarthritis, fibromyalgia, and other illnesses are likely to have varying levels of pain. Teresa D'Angelo, founder of Live Love Move, a somatic education company, describes her experience with severe chronic pain resulting from rheumatoid arthritis over an eight-year span: “My inner world consisted of finding a way to relieve the pain. […] The stress I felt was simply to get through the day and focus on the work in front of me. However, in the brain fog I was experiencing, that was not always doable. I couldn't think clearly at times and had trouble comprehending my work” (email correspondence, May 26, 2020). Without long-term relief, she lived day-to-day. “I had my medicine regime laid out at my bedside during a ‘flare-up’ so that when I awoke in the morning, I wasn't in excruciating pain,” she notes. At some of the most challenging moments, she recounts asking her husband to open a jar and turn a door knob, getting up and down the stairs of her house on her behind, and, when she was able to drive, doing the manual shift with her left hand. What helped her was the Nia dance practice, a mindful somatic method that is inspired by dance arts, martial arts, and healing arts. The movement classes helped her move out of the mindset of pain: she learned how to move her body gently and in ways that felt healing, liberating, and enabling. D'Angelo started teaching movement classes once a week, which gave her a purpose in leading others.

Spaciousness and Somatics

Spatial awareness is an important concept for somatic practitioners. In somatic dance classes, like in other types of dance practices such as contemporary dance, participants develop the awareness of how they move in space and in relation to one another. In Nia dance classes, students move diagonally, in rows, in a free formation, in circles; they travel through space, moving backward, forward, to the side, and around the other dancers. They reach toward the space above, dance with arms reaching to the space in front, to the sides, or at the back of the body, and sink onto the floor to do crawling, creeping, rolling motions, or rest in stillness. In Contact Improvisation movement sessions, participants explore the space between two dancers, the space between a dancer and the floor, a dancer and the wall, and a dancer and an element of nature, such as a stone or a tree.

What makes these explorations somatic is the invitation to always keep connecting to sensations and how the movements make us feel. Moving through space, you can ask, “What do I feel in my feet? Can I sense my pelvis in relation to my ribcage and head? Where do I sense pleasure and relaxation as I walk at the perimeter of the space I am in? As I move backward, what if I imagine that my eyes are at the back of the head? What is happening in my spine as I go toward the floor? What would it feel like if I surrendered all the weight of my body and any feeling of tension to the earth?” These different ways of movement, paired with inner awareness, develop agility, range of motion, and movement variety; they help participants make healthy choices about what types of movement feel good for their bodies and increase their awareness of the space around them.

The ability to tune in and maintain awareness of subtle sensations and how movement makes us feel are vital for people suffering from chronic pain. Tension and accumulated stress, emotional habits, challenging life circumstances, trauma, and physical injuries can create pains and aches in the body that provide a constant undertone to daily activities and a returning sense of pain and discomfort. ^1,2 At the background of discomfort and pain, neutral or pain-free alignment might not be easily accessible. Gentle, subtle movements, careful listening of the body, and checking in with the emotional, mental, physical, and imaginative aspects of the self can begin to restore the sense of what “neutral” and “free of pain and discomfort” might feel like.

Somatic methods such as the Feldenkrais Method^® and the Alexander Technique aim at helping an individual release tension and tightness and find a greater sense of comfort and ease in movement. Somatic practices support alignment and posture, so that we can conserve energy and refrain from unnecessary tension and postural imbalances. With proper alignment, the inner organs have space and are not squeezed; the bones, muscles, and the nervous system are not compromised. Taking time to improve the sense of alignment and release of tension and muscular holding patterns can awaken the sense of ease in clients with chronic pain.

Continuum Movement

Continuum Movement was introduced in the late 1950s by dancer, somatic pioneer, and author Emilie Conrad (1934–2014). The practice incorporates sound, breathing, and small, mindful, fluid, nonchoreographed movements that rise from within. It aims to awaken the participants' awareness of the fluid system of the body: “The fact that our body is composed mostly of water is significant in our capacity to be self-referential, transformational, and better able to effortlessly respond to circumstance by cultivating an open bio-system/organism.” ³

In a Continuum session, a practitioner might have a sensation of floating on a calm sea and feel gentle waves around the body and inside the body. Conrad described her felt connection to the fluid body: “I can feel the waters of my eternal ocean beckoning to me with sweeps of wave motion … My head disappears under water, my hands become a blur, my body is permeable, and my skin no longer wraps around me. I am this water. I am these waves.” ³ In 1974, she pioneered a protocol for spinal cord injury and from 1974 to 1979 participated in a research study conducted by Dr. Valerie Hunt at UCLA. The study demonstrated that “fluid, primary movement is essential in our ability to innovate. Enhancing these fundamental movements has a potential to create a rich intrinsic environment that brings forth new insights in our understanding of the human body and its potential to create alternate systems.” ⁴

In Conrad's vision, fluids in our own system have a resonance with lakes, rivers, oceans, and fluids that might exist elsewhere in the cosmos. She believed that awareness of the water element inside our own body might make us feel connected to large bodies of water outside of ourselves. Conrad explained, “The concert of existence places me in resonance with our biosphere, meaning that at this moment there is no ‘body’ no separation; I am part of the swirl of bio-morphic unfolding. I am not bound by culture or language. The deepening of sensation allows me to be without category. I transfer the moisture of my cells, join the wet of the grass, the pour of the ocean, the stars that watch over the night. The plants breathe, my skin is wet, we are here.” ⁴

The subtle, fluid, wavelike motions, images, and sensations can be soothing and healing for people with chronic pain. Continuum teacher Elisabeth Osgood-Campbell suggests two exercises. In the first, she encourages the participant to “awaken the place of positive tone” (personal interview, March 29, 2020). “In Continuum, there is a standing invitation to be curious about what is new because the work is about dropping beneath habitual patterned movement and habitual patterned ways of thinking. I invite people to notice a place in the body where they have a sensation other than chronic pain,” she says. She invites the participant to notice a place in the body that feels neutral and/or has an association of positive tone, a sensory quality that is different from the sensations they associate with chronic pain. “Spaciousness,” “warmth,” “coolness,” and “pulsation” are examples of such sensations. The client then offers a gentle breath into that space and activates the imagination through guided meditation. Perhaps a gentle movement will emerge. “Invite the awareness to dwell in something other than pain for a couple of minutes, long enough to give a different message to the nervous system, a moment of recognition of ‘this is what neutral, without constriction or pain, feels like,’” Osgood-Campbell explains.

Another exercise is based on the breathing exercises developed by Conrad and is called “lunar breath.” Conrad experimented with different types of breath to dive into the inner landscape of the body and to neutralize emotional or physical pain. “Lunar breath” evokes images of moonlight and the soft gentle energy of the moon. “With the tip of the tongue, sense the soft palate at the back of the roof of the mouth. Then relax the tongue, inhale and exhale normally. Try inhaling up from the back of the throat and neck to the soft palate. You can also imagine that there is an air filled tube around the neck with tiny pinholes. Imagine that the air disperses softly out from these imagined pinholes as you exhale. Perhaps a soft sound will emerge, as if you were holding a shell to your ear.” This exercise can be done sitting or lying down. Exercises such as the “lunar breath” and “noticing positive tone” can, over time, cause sensations of openness in areas where one previously sensed tightness, pain, and constriction. Tiny spaces of openness might occur.

Tamalpa Life/Art Process

Tamalpa Life/Art Process, developed by dancer, visionary, performance artist, choreographer, and author Anna Halprin and her daughter Daria Halprin, employs multiple arts to increase participants' awareness of their inner space and their environment. Participants access the knowledge of the body through moving, writing, drawing, and solo performance. An exploration might include an invitation such as “if your legs could speak, what would they tell you right now?” Participants delve within, dance with this question, draw, and write.

In Tamalpa Life/Art Process classes and workshops, students are invited to interact with nature. For example, they are being asked to observe the nature around them and find a place or an element from nature that speaks to them and spends time in that place or with that element. They can draw that natural element or create a movement performance in that setting. They might use leaves, stones, grass, sand, rocks, trees, tree roots and trunks, flowers, hay, and berries as sources for inspiration to name a few. They learn to commune with nature and feel supported by it and a part of it.

Elisabeth Osgood-Campbell, also a Tamalpa facilitator, has noted that when people are being asked to draw their bodies and body parts after their sensations and imagination have been activated through dancing, in 90% of the cases, elements from the natural world emerge: in their drawings, legs and feet become vines or plant leaves; tree branches will grow out of their arms; their hearts transform into flower blossoms. These drawings show that when we sink into our somatic sensory experience of our bodies, images of the natural world arise. “In some deep part of us, we know that we are mammals, a part of the natural world; we need water, nature, to stay alive,” Osgood-Campbell opines.

Working with natural elements and images that evoke nature can have a healing effect. Focusing on body-based and nature-based imagery that is resourceful and brings a sense of support or relief to the nervous system is a way to slowly resolve trauma patterns in the body. “When trauma patterns in the body start to dissolve, mental and emotional patterns that inhibit one's wellbeing start to dissolve as well. Shifts can start to happen on any of these levels first—physical, mental, or emotional,” Osgood-Campbell notes.

Somatic Strength Training

As I have discussed elsewhere, a mindful embodied approach can also be applied to traditional strength training exercises. ⁵ In strength training, we usually focus on the contraction, such as the biceps contracting in a biceps curl. But we can also focus on what is happening in the opposing muscle group and sense the counteraction, the release, such as the lengthening of the triceps in response to the biceps contracting or the lengthening and releasing of the hamstring muscle in an exercise for the quadriceps. Working with the muscles and bones from a somatic mindful perspective can bring about sensations of ease and alignment and increase the sense of well-being and awareness of the space inside and outside the body.

In BodyLogos©, a conditioning method developed by dancer, Tao minister, and author Tammy Wise in the 1990s, each conditioning exercise is accompanied by a visualization of energy orbits, which can help move the “stuck” energy and create a sense of spaciousness in areas that previously felt tight. The method relies on a psyche-muscular map, where the main muscle groups are connected with certain emotional qualities (quadriceps are associated with moving forward in life; biceps are associated with pulling in what we desire). Participants can use the map to add affirmations or contemplations as they are working on a particular area of the body. For example, working on the chest muscles, you can ask yourself, “What does my heart want to connect to in life?” Trying to release habitual gripping in the hip flexors through stretches, you can ask, “Is there an area in my life where I am exerting too much control instead of cultivating ease?” These contemplations engage the mind and imagination and help the participant look at his/her life holistically—with physical, mental, and emotional awareness.

As one physical awareness exercise to help with chronic pain, Wise recommends a subtle exercise that aims to develop a sense of alignment and release deliberate tension from the muscles. The client lies comfortably supine with arms and legs extended, hands placed palms up about one foot away from the body. Wise guides us through the exercise:

Take a deep breath and allow the weight of your body to relax into the ground. […] Let go of all your efforting. As you experience your bones' weight released, experience the earth as your universal great mother. […] Pay particular attention to the weight of your shoulder blades and your elbows. Feel their weight equally connected to the ground. Now using as little muscular effort as possible, slowly reposition your hands palms down on your solar plexus, the soft spot where the ribcage separates. Be sure to maintain the groundedness in the shoulder blades and the elbows as your arms rotate through space. Again as easefully as you can, return your hands to their original position. Notice whether some of the weight in your shoulder blades and elbows lightened as you moved. Slowly repeat this back and forth movement until you can keep your shoulder blades and elbows fully weighted throughout the movement. As you explore this movement, notice how heavy the lower arm actually is to move and how the weight fluctuates as it arcs toward an alignment with gravity. That's when the wrists are directly over the elbows. Notice when your bones align with gravity, you experience the arms as weightless, yet your bones are just as heavy on the ground. Recognize how all muscular effort ceases to exist when the bones align, as if a hand from above came down to support you. The weight you are experiencing is that of your bones. The weightlessness you are experiencing is the release of tension in the muscles. The more aligned the bones, the less muscle tension. Alignment makes everything easier. ⁶

This exercise can be done at any point during the day or as a way to prepare for night's sleep.

What these three practices and numerous other somatic methods share is the belief that finding release from chronic pain asks for patience, time, the ability to discern subtle physical sensations, and the support of the imagination. Emotional, physical, and mental awareness intersect in the process of finding ease.

Conclusion

By way of conclusion, I would like to offer another meditative exercise to help build awareness of the inner and outer space and possibly find soothing. Find a natural element in your surroundings. If you can go outside, this element can be a tree, a garden, a river, a bush, a flower bed, or a view of the sky. If you are inside, this element could be a plant, a stone, a feather, a view of the trees or the sky from the window, or a photo of a natural element or a landscape.

Spend some time in the presence of this natural element. What do you notice about the colors of the sky, the hues of the river, the shapes of the branches? Take these observations in. How does being in this place or in the presence of these natural elements make you feel inside? As you inhale and exhale, take a moment to sense your body and to turn within. How do you feel physically, mentally, and emotionally? Do you notice any sensations in your body? As you continue to inhale and exhale, close the eyes and notice whether some part inside the body starts to soften and surrender. Let some tension, pain, or worry release from the body. Do you see any images when you look inside? Perhaps a color or a landscape surfaces. Feel what it is like to be alive, aware of your inner sensations, and connected to the particular environment that you are in. Allow your mind to travel beyond your physical surroundings to another landscape, land, or environment. Where would your imagination like to take you? As you inhale and exhale, feel what it is like to be one element on the earth, a part of it, and supported by it. ■