February 26, 2011

PAIN Part 5: Resources for Pain Management

Part 1, "An Introduction to the Subject of Pain"
Part 2, "My Personal Pain Story: The Pink Porcupine"
Part 3, "Creativity in the Midst of Pain"
Part 4, "What Others Have Written on Pain and Suffering"
Part 5, "Resources Related to Pain Management"

Please bookmark Appalachian Morning or click at this link to add it to your RSS Feed or Google Reader as I will update these posts from time to time. You can also follow along on posts by "liking" Appalachian Morning on Facebook.

Disclaimer: I am not a psychologist. physician, physiologist, or therapist. I have no medical or mental health training whatsoever. Therefore, no advice, medical or psychological, is intended or implied by any of the posts in this series on PAIN.

Thank you for going with me on this journey to learn more about how we can cope with pain, if and when it does appear in our lives. Here are some resources you might find helpful.

Pain Management Resources on the Web

The American Academy of Pain Management

American Academy of Pain Medicine

American Chronic Pain Association

Various conditions related to pain

American Pain Foundation

Pain: Chatrooms and Discussion Boards

American Pain Society

Guides for Persons with Pain

The Journal of Pain

Chronic Pain Information Page

Counseling / Pain Management Centers by State

International Association for the Study of Pain

Global Year Against Acute Pain: Oct. 2010 - Oct. 2011

Pain (Journal)

National Pain Foundation

National Institutes of Neurological Disorders and Stroke

How is pain treated?

Pain Connection: Helping People with Chronic Pain and Their Families

Pain Recovery Online

Partners against Pain (for Patients and Caregivers)

StopPain.org: Dept. of Pain Medicine and Palliative Care, Beth Israel Medical Center

Physical Medicine and Rehabilitation (Physiatry) is a specialty of medicine concerned with the diagnosis and treatment of aches and pains and other disabling conditions. Board-certified physiatrists complete four years of medical school as well as a four-year residency program, and many physiatrists also do fellowships in specialized areas of rehabilitation medicine. This training develops skills in the areas of orthopedics, neurology, and rheumatology. Physiatrists are therefore skilled in determining the cause of a patient's symptoms—nerve, muscle, joint, bone, ligament, etc.—and treating the patient’s condition. In addition to the conventional use of medications, physiatrists have expertise in the use of modalities (hydrotherapy, ultrasound, transcutaneous electrical nerve stimulation, etc.), exercise programs, manual techniques, equipment (splints, corsets, braces), and coordination of therapy programs. Source: http://www.rehabmed.net/patient_ed/physiatry1.html

Conditions treated by physiatrists

February 23, 2011

Homemade trading card for kids; tiny spirit dolls

A few years ago I was trading Artist Trading Cards (ATCs) enthusiastically with folks all over the world. It was wonderful. (See an earlier post on this subject.) I like to create ATCs using collage, drawing materials, and/or paint. I did several cards focused on personality traits and behaviors. In looking back on these cards, I see that they could be great gifts or projects for children. Young children could be given the cards as a reward. Older children could be encouraged to create their own "encouragement" or "friendly qualities" card. Or cards for "hopes and dreams," "goals," "favorite quotes," or even "special relatives." Religious families might encourage cards to teach verses such as the Beatitudes. Others might create cards based on principles important to their culture or family. I simply like to make cards that feature the traits I want to see in myself and in my children.

A few years ago I also made many small figures I called "Spirit Dolls." Some where eight or ten inches in length; others were quite small. I came across two of them the other day and thought these would be great little dolls for girls to make and collect. The heads are made of Cernit (a brand of polymer clay that bakes in the oven), and formed using rubber face forms sold in craft stores such as Hobby Lobby. The bodies are made from popsicle sticks wrapped with yarn. They can be decorated with beads and specialty yarn, even feathers. They are my version of "worry dolls," as they would carry one's worries, like tiny angelic icons.

February 18, 2011

PAIN, Part 4: What Others Have Written on Pain and Suffering

Part 1, "An Introduction to the Subject of Pain"
Part 2, "My Personal Pain Story: The Pink Porcupine"
Part 3, "Creativity in the Midst of Pain"
Part 4, "What Others Have Written on Pain and Suffering"
Part 5, "Resources Related to Pain Management"

Please bookmark Appalachian Morning or click at this link to add it to your RSS Feed or Google Reader as I will update these posts from time to time. You can also follow along on posts by "liking" Appalachian Morning on Facebook.

Disclaimer: I am not a psychologist. physician, physiologist, or therapist. I have no medical or mental health training whatsoever. Therefore, no advice, medical or psychological, is intended or implied by any of the posts in this series on PAIN.

What Others Have Written on Pain and Suffering

We're nearing the end of this little series on pain, and I've said all that I know to say... Today I'd like to quote those with professional experience in pain, illness, and/or suffering, or with personal experience that has impacted their professional life.

It may seem as if the idea for this pain series began with my experiences and grew from there; but actually it began with my purchasing a book years ago, not long after 9/11, and pulling it off the shelf in early January of this year on a day when I was in considerable facial pain from cellulitis (a tooth abscess that had migrated into the tissues of my face). I didn't feel like reading women's fiction, or anything mysterious, or even one of the many beautiful illustrated art books in our home. It was the weekend, and while I had no other responsibilities, I didn't feel well enough to paint, bake, shop, or write.

The book is by Kathleen A. Brehony, PhD, and titled After the Darkest Hour: How Suffering Begins the Journey to Wisdom. There is more wisdom in this book than I can detail here, and I appreciate the way Brehony not only shares her impetus for writing such a book but delves into different religious and philosophical traditions on this subject. There are many wonderful passages, and I'll begin my list of "What Others Have Written on Pain and Suffering" with After the Darkest Hour.

"American writer Christian Bovee made the case for the idea that it is our relationship to the circumstances and the events of our lives rather than the events themselves that determines how we will see them." (p. 59)

"When we are immersed in periods of suffering, most of us feel it will never end. At those times, it helps to remember that the Latin root of the word suffering itself means 'to allow' or 'to experience.' In the midst of turmoil brought about by an unexpencted loss or change, very often we have no answers that ease our anguish; we simply must 'be' and experience the full pain of our loss. This is a particularly difficult notion in our culture, where we have learned to look for simple solutions, magic pills, or quick fixes to short-circuit the pain of suffering. It can be helpful to remember that even in the midst of our anguish, the wheel [of life] continues to turn. We can be certain that even in the blackest night our situation will change again. (p. 49)

"Pain is a common way through which we come to understand that our life has a transcendent aspect, a larger dimesion, and realize that 'my life is not just about me.' This transformed consciousness allows for the birth of true compassion (a word that literally means 'to suffer with'). This heartfelt tenderness removes all barriers between oneself and others so that we can experience oneness with each other and the universe. I find that it is easy to recognize those who have true compassion; it is apparent in their interest in other people, their empathy, and in their eyes, which seem to look on the world and everything in it tenderly. What we also usually learn about truly compassionate people, as we come to know them, is that most often they have suffered some great loss. (p. 35-36)

"[Carl Jung] believed that when we understand that we are all part of a world in which suffering is inevitable and universal, we can better understand how to grow through that pain. (p. 21)

"Mystics of all spiritual and wisdom traditions agree that suffering is the only key that opens the door to transformation of the soul and psyche. It is by way of pain, they say, that we come to terms with our true destinies, our true selves, and form an authentic relationship with God." (p. 13)

~Kathleen A. Brehony, PhD, After the Darkest Hour: How Suffering Begins the Journey to Wisdom (2000, Henry Holt and Company)

The following insight comes from my long-time friend (and former college roommate) Katharine Pumphrey Knapp. When she and I traded confidences in my parent's guest bedroom in August of 1978, the night before my first wedding, we had no idea what life was holding in store for us and how our youthful optimism would be tested. A wonderful teacher and gifted with children, Katharine went on to add additional degrees and qualifications to her name, and has a successful practice as a therapist for women and children in Charlottesville, Virginia. I asked for her input on the subject of pain:

"I believe that pain often gets confused with one's identity. We can become THE PAIN since it can command such attention. I've seen clients who allow the pain to sabotage their 'SELF', and hold it hostage. It can define us if we let it, and I've seen people give up on life, talking about it all the time and blaming others for not understanding how BAD it has made life. I've also seen folks live in denial, in anger about other things when the real issue is not addressed. The poles of west or east do not sustain health. A balance between sharing and caring for oneself, needs to be mixed with finding a passionate form of living with this aspect of life. Pain then becomes just one part of what we experience in life, NOT the defining aspect or SELF.

"Another thing that I discuss with depressed clients who have to manage chronic pain is this: The body holds memory in tissue, as well as in the frontal lobe of our brain. This means that the experiences that often get associated with pain, or the
experience that may have been part of what caused the pain (if an accident, or activity, or especially if our 'choices' were involved), get logged onto the computer not only at the site of the brain (executive functioning), but into the living tissue. Then we reinforce the highway of patterns—making associations of pain and feeling. Over time these can be linked and hard-wired into the body. Then we get a negative feedback loop and the pain and feeling (like perhaps victimization, guilt, anger, hopelessness, etc.) are linked. This can trigger a personality change. When offering help to others about this, I suggest that they consider first baby steps in building new highways in the brain and body connections. Before we can alter hard-wired conditioning, we must add in new highways (if you will grant me the metaphors here). By going down the same street, we end up at the same destination. Let's build new roads.

"So, I encourage loving the body (which is often hard when in pain and the body is the enemy). I start with asking folks to massage their hands or feet (unless these are the source of pain). It lets them discover the joy of meeting their body again, of loving it, accepting it, enjoying positive feedback as they are gentle and kind to their own body. After awhile, we look at new ways to nurture the self and the body. I'm over simplifying it to be sure. I work with folks a lot on this subject."

"I have lived with chronic pain for years as well. It has been worse lately. What I have learned is to build in distractions that seem to take my mind off of it and on to other things. Of course this does not always work, but often it does. Having broken my back, lived in a wheel chair, and currently deal with on-going issues, it's just worth focusing on other things. i love my work, my family and my friends. I enjoy creating beauty which takes my mind off of the pain. I remember when this was a harder choice, and worked less often. I think that our focus helps us regulate our reaction to the pain. It does not take it away, but helps us create dissociation or distance from it." Katharine Pumphrey Knapp, LPC Services for Women and Children

Katharine is also the mother to two grown sons. The youngest was recently accepted into medical school and, like his mom, will be helping to heal others.

A few years ago, I stumbled across an online post, "A Sudden Illness: How My Life Changed" by Laura Hillenbrand, the author of Seabiscuit and Unbroken. In the article she describes her personal health challenges. In reading it, I was struck by not only her honesty, but by how she persevered in her creative projects while battling an illness that sent her to her bed, robbed her of energy and the experiences many young adults enjoy and baffled her physicians. Here is a link to a recent (Nov. 28, 2010) Washington Post interview with Hillenbrand, that discusses her books and her illnesses. Here is a quote from the article:

" 'I have to detach myself completely from aspirations,' Hillenbrand says, discussing how she has learned to cope with her illness. 'I hardly ever listen to music anymore because it arouses all of this yearning in me.' She numbs herself to the things she cannot have."

This approach is also discussed in Brehony's After the Darkest Hour and I have found it a helpful attitude in the creative work that I do that is not "for hire." For me, keeping my focus on the process is key to not only doing my best work, but maintaining a healthy attitude toward rejection, disappointment, and unrealistic expectations. Even when doing creative work for a fee, rather than watching the clock and calculating a time-to-money ratio, it's best for me to focus on the process, the joyful creation of whatever, the privilege of being paid to do work I enjoy.

Another book that I purchased a few years after 9/11 was Coping with Public Tragedy, edited by Marcia Lattanzi-Light and Kenneth J. Doka, (2003, Hospice Foundation of America). Each chapter has a different author and I've pulled some interesting quotes out for you to read. Keep in mind that the subject of this book was disasters, events, and tragedies that are of a public nature; not pain or illness, per se, but public suffering. Yet I found the insights helpful as I re-read parts of the book while thinking recently about pain.

"Janoff-Bulman (1992) described an assumptive world as 'a conceptual system, developed over time, that provides us with expectations about the world and ourselvees' (1992, p.5). She argued that the most fundamental of these assumptions are 'the bedrock of our conceptual system" and are those that we are least likely to challenge' (1992, p. 5). In particular, Janoff-Bulman suggested that the most fundamental assumptions held by most people in the assumptive worlds are likely to be of the following types: 'The world is benevolent,' a conviction that is typically applied to people and to events... ; 'The world is meaningful," a conviction that there is a relationship between a particular person and what happens to that person... ; 'The self is worthy," a conviction that one is essentially good, decent, and moral in character, as well as wise and effective in one's actions.'

"Janoff-Bulman conceded that everyone may not hold these three beliefs, but she argued that they are at the foundation of many individual world outlooks even when the individuals in question do not think this is what they believe. She also contended that such assumptions are broad and adaptive, but not foolhardy, because they 'afford us the trust and confidence that are necessary to engage in new behaviors, to test our limits' (1992, p. 23). Tramatic events challenge the most fundamental counvictions in our assumptive worlds."

"Loss, Grief, and Trauma in Public Tragedy," Charles A. Corr (Chapter 6, p. 68), Coping with Public Tragedy, edited by Marcia Lattanzi-Light and Kenneth J. Doka, (2003, Hospice Foundation of America) Reference cited: Janoff-Bulman, R. (1992)
Shattered-assumptions: Towards a new psychology of trauma. New York: The Free Press.

"...the playwright Samuel Beckett expressed his own deep-seated need to write: 'one writes not in order to be published; one writes in order to breathe' (Ref. Mitchelmore, S. 2002, After the Disaster [online], Spike magazine).(p. 206)

"... in times of tragedy we desperately seek out those among us who can see beyond logic, analysis, reasons, idealogies, politics, and minister to our broken spirits. We need artists of all descriptions who can arouse our numbed or raw emotions and provide insight, catharis, sanity, connection, even consolation." (p. 206-207)

"In Zorba the Greek, Zorba asks the questions, 'Why do the young die? Why does anybody die? ... What's the use of all your damn books if they can't answer questions like that? What the hell can they do for you?' The young scholar answers him: 'Well, they tell me about the agony of the man who can't answer questions like yours.' "

(Kazantzakis, N., Zorba the Greek, 1952. Quoted in Bertman S., 1991. Facing Death: Images, Insights, and Interventions, Taylor and Francis) "Public Tragedy and the Art" Sandra Bertman (Chapter 17, p. 215) Coping with Public Tragedy

Twenty years ago, for a short time I saw a counselor who recommended several books to me. One was entitled Feel the Fear and Do It Anyway (which has been brought out in new editions and audiobooks since the time I read it.) My favorite quote at this time was Eleanor Roosevelt's "I must do that which I fear most." And while I know this post is on pain, not fear, it seems to me that fear is often a "frenemy" of pain; and it never hurts to seek to overcome our fears. So, I was also drawn to a book with a similar theme, and this quote from it:

"...we can let the circumstances of our lives harden us so that we become increasingly resentful and afraid, or we can let them soften us and make us kinder and more open to what scares us. We always have this choice." The Places that Scare You: A Guide to Fearlessness in Difficult Times by Pema Chodron, author of When Things Fall Apart

Judith Voirst is one of my favorite authors, and when searching for information on pain I wasn't disappointed in looking within her book Necessary Losses:

"It is easier to grow old if we are neither bored nor boring, if we have people and projects we care about, if we are open and flexible and mature enough to submit—when we need to submit—to immutable losses. The process, begun in infancy, of loving and letting go can help prepare us for these final losses. But stripped—as age does strip us—of some of what we love in ourselves, we may find that a good old age demands a capacity for what is called 'ego transcendence.': 'A capacity to feel pleasure in the pleasures of other people; 'A capacity for concern about events not directly related to our self-interest.; 'A capacity to invest ourselves (though we won't be around to see it) in tomorrow's world.

"Ego transcendence allows us, while perceiving ourselves as finite, to connect to the future through people or through ideas, surpassing our personal limits by means of some legacy we can leave to the next generation. As grandparents, teachers, mentors, social reformers, collectors of art—or creators of art—we can touch those who will be there when we are gone. This endeavor to leave a trace—intellectual, spiritual, material, even physical—is a constructive way of dealing with the grief we are feeling over the loss of ourselves."

~Judith Voirst, Necessary Losses: The Loves, Illusions, Dependencies and Impossible Expectations That All of Us Have to Give Up in Order to Grow (1986, Ballantine Books) p. 32-33

It seems common to being human to wonder why bad things happen to good people. I have not struggled with this as much as some do, because it seems to me that life is unfair and capricious and if something bad happens to my neighbor but not to me, it seems only a result of luck and circumstance. Tomorrow it might be my turn to be in the wrong place at the wrong time. Overall, I feel very fortunate and seem easily to realize that others are far "worse off" than am I.

What is of more interest to me is to think about why some people can take the awful experiences of life and grow from them; learn from them...while others crumble under the weight of sorrow and disappointment. This topic is what prompted Broheny to research the ideas within After the Darkest Hour and are noted as well by Frank Parkinson in his book Post-Trauma Stress:

"We tend to think that life is fairly safe and secure: 'Bad things happen to other people and not to me.' Our general experience of life is that most of us do survive without being involved in major accidents or disasters. Our very strong defense mechanisms are there to protect us from becoming overanxious. We live our lives as optimists, in the fase belief that we will live forever and that harm or danger will not touch us.

"When we are suddenly confronted by a traumatic and shattering experience, our safe little world can collapse or be turned upside down, resulting in confusion and fear.

"...these events make us aware that we are not invulnerable. We are mortal. We can die. Life is neither secure nor safe. ... These experiences can cause intense fear and anxiety, as well as the loss of security and confidence in yourself, others or life in general."

~Frank Parkinson, Post-Trauma Stress: Reduce long-term effects and hidden emotional damage caused by violence and disaster (2000, DeCapo Press) p. 15

His Holiness the Dali Lama continues on with this theme:

"Even for those who do not believe in future lifetimes, contemplation of reality is productive, helpful, scientific. Because persons, minds, and all other caused phenomena change moment by moment, this opens up the possibility for positive development. If situations did not change, they would forever retain the nature of suffering. Once you know things are always changing, even if you are passing through a very difficult period, you can find comfort in knowing that the situation will not remain that way forever. So there is no need for frustration.

"Good fortune also is not permanent; consequently, there is no use for too much attachment when things are going well. An outlook of permanence ruins us: Even if you accept tha there are future lives, the persent becomes your preoccupation, and the future takes on little import. This ruins a good opportunity when your life is endowed with the leisure and facilities to engage in productive practices. An outlook of impermanence helps."

~His Holiness the Dalai Lama, translated and edited by Jeffrey Hopkins, PhD, Advice on Dying and Living a Better Life (2002, Atria Books) p. 42-43

In Healing and the Mind Bill Moyers interviewed many interesting people. One such person was Jon Kabat-Zinn, PhD, author of Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness, who spoke on the subject of pain and meditation:

Kabat-Zinn: "...if you look at it [pain] carefully, you'll see a sensory component to the pain which is just sensation. It can be very, very intense, and the mind will habitually interpret it as noxious. But if you understand it, you may be able to tolerate it better. ...But often...no precise physical cause for the pain may be found. Sometimes you have to learn to live with certain kinds of pain. Pain is the sourrce of enormous disability in our society."
Moyers: "But how does mediatation help deal with pain?"
Kabat-Zinn: "It allows you to learn from your own inner experience that pain is something you can work with, and that you can actually use pain to grow. Sometimes you have to learn how to work around the edges of your pain and to live with it. The pain itself will teach you how to do that if you listen to it and work with it mindfully."
Moyers: " 'Mindfully,' meaning—"
Kabat-Zinn: "Meaning that when pain comes up in the body, instead of focusing on the breath, you just start breathing with the pain. See if you can ride the waves of the sensation. As you watch the sensations come and go, very often they will change, and you begin to realize that the pain has a life of its own. You learn how to work with the pain, to befriend it, to listen to it, and in some way to honor it. In the process of doing that, you wind up seeing that it's possible to feel differently about your pain. "Sometimes, when you focus on this, the sensations actually go away. ... I don't say, 'Well, just fantasize about something that will be so interesting that you'll forget about your body.' I say, 'Go into the body, go into the shoulder, go into the lower back, breathe with it, and try to penetrate the pain with your awareness and with your breathing.' So it's the opposite of distraction." ...the more you are in distress from pain, the worse...the physiological consequences. If you can learn to be comfortable within the pain or anxiety, the experience will be completely changed. ...you're not trying to make the pain go away. ...we actually move into the stress or pain and begin to look at it, and to notice the mind's reactions, and to let go of that reactivity ... And then you find that there is inner stillness and peace within some of the most difficult life situations."

Jon Kabat-Zinn, PhD, author of Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. As quoted in Healing and the Mind by Bill Moyers (1993, Doubleday) p. 119-120

Moyers also interviewed Dr. John Zawacki: "...Some patients have pain they can't control. When we don't know what causes that pain, and pain medication hasn't worked, and the pain clinic hasn't worked, we have sent patients to the stress clinic to learn how to live with their pain and sometimes to overcome it." (John Zawacki, MD, as quoted by Bill Moyers in Healing and the Mind, p. 146).

I am always interested in the connections between various things that interest me. How does pain relate to art? How do words relate to images? And...how does reading relate to pain? Well, Ode Magazine addressed this issue in its October 2010 issue in the article: "Reading, writing and revelation: How the written word helps refresh body, mind and soul" by Ursula Sautter.

"Whenever the stabbing pain in her knee becomes unbearable, 17-year-old Mackenzie Bearup picks up a book and starts to read. Usually, it's a teen novel or a mystery. But Bearup will read 'anything that takes my mind away from the agony, that allows me to think of other things.'

"Reading and healing have an age-old association. In ancient Egypt, libraries were known as psyches iatreion, 'sanatoriums of the soul.' During the Renaissance, the poetry of the Psalms was thought to "banish vexations of both the soul and the body,' according to Italian humanist philosopher Marsilio Ficino. And, as far back as the beginning of the 19th century, the American psychiatric community was discussing reading as a therapeutic technique.

"Now, science is starting to prove what readers and writers have long known: Words cana help us repair and revitalize our bodies as well as our minds. As a result, bibliotherapy—reading specific tets in response to particular situations or conditions—is becoming more and more popular among psychologists, physicians, librarians and teachers."

Sautter goes on to explain bibliotherapy and its many forms and states that "Doctors or therapists write prescriptions in the context of a practice setting, or individuals explore what works for them at home." I found it interesting to learn what books therapists recommend and the personal stories she shares of people helped in times of illness, pain, or suffering by the simple act of reading particular stories. Sautter shares that in the U.K. physicians have the option of prescribing "self-help manuals to those seeking medical attention for mood disorders." Tens of thousands of people each year receive these presecriptions.

As a publisher and writer, I found this article to be one of the most interesting I've come across. I was interested to learn that Ms. Sautter is also the author of an article in Time magazine, back in 2002, titled "Dining in the Dark" about a restuarant where waiters are either completely blind or visually handicapped.

In Pain, Part 5, I will share with you the resources I have found that seek to help those with pain.

Pain—has an Element of Blank—
It cannot recollect
When it begun—
or if there were
A time when it was not—

It has no Future—
but itself—
Its Infinite contain
Its Past—enlightened to perceive
New Periods—of Pain.

Emily Dickinson

Postscript: On the day of my last post on this topic, Time Magazine arrived in our mailbox and the cover story? Pain. There is a lot of helpful information in the issue, especially related to research, medicine, and alternative treatments. Time: Health Special: Chronic Pain; The End of Ouch? (I suggest ordering a copy of the print or e-magazine, full version, because there is a lot of good information in the magazine that is not freely available on their website.)

February 15, 2011

Visiting a Friend Turns an Ordinary Day into Something Special

Today, after visiting the dentist, I finally felt up to a drive to visit my dear friend, David, who was so ill at Thanksgiving that he had to go into a Hospice House. He rallied, though, and after a week was able to return home, but due to the remote location of his home and other factors, he decided to close up his home and say yes to the kind offer of friends to live in their spare room for a time. He is doing so well; no need for a wheelchair or walker, and his memory and wit are back full force.

We had a great lunch discussing books and politics. I showed him my Color Nook and we talked about Time magazine's latest article on "Singularity" and David's first trip to the opera at age 10, in NYC. His mother was a fascinating woman, the top female executive in advertising in the 1930s. After seeing the first opera performance his mother asked him if he liked it. "Oh yes!" was his reply. "Would you like to go back tonight?" And that day, March 12, 1937 (I believe he said), my friend, as a child saw two performances at the Metropolitan Opera.

David's father was the headmaster of a boys prep school in Albany, New York. He spent 13 years in military school, some of the time reciting the names of all Russian composers while marching around the school grounds. His only sibling, a sister, died at age 13 of rhumatic fever; his father was taken with a sudden illness and paralyzed. David carried his father in and out of the house in the days before power wheelchairs and handicapped access ramps.

Educated at Harvard and the University of Edinburgh ("educating the world since 1583"), David is the only person whose grammatical corrections I welcome during our conversations. He tells me he wrote a book about his life once, typed on a manual typewriter. But he destroyed it. Not having the opportunity to read his manuscript bothers me, for I love his stories. The one about taking the Queen Mary to Europe. He was invited to a party on the first class level where he met several famous people who enjoyed his company and invited him back each night; he still remembers the cabin number. He remembers the time the Queen Mary, Queen Elizabeth, and the Normandie (I believe it was the Normandie) were all docked in NYC at the same time. He remembers the first time he saw the Manhattan skyline, coming down the Hudson River on a boat with his mother. He fell in love with it and had the freedom throughout his childhood to visit his mother there every weekend. Early in our friendship we spent a day at the Columbus Museum of Art. In the 20th century section, David provided stories about a few of the artists who were showing in New York City during the late 1930s and '40s.

David is the father of five children, but the daughter he was so close to, a talented actress of whom he was so proud, drowned in an upside-down car in a pond two weeks after her wedding, decades ago. July is always a difficult time of year for him.

A soldier and dressage horseman during WWII, an interior decorator, a playhouse manager, hospice volunteer, David has been a wonderful friend to me since we met twelve years ago. I can say anything to him, or nothing. And he is the only person, other than my husband, who ever hears me swear, though I usually do it just to make him smile.

Lucky Press was only a year old when I met David. He has listened to me discuss each new title and read many of them, too. He has thanked me a dozen times for giving him a coffee table book on the history of Monte Python, but he gave the book back to me in early November before a stroke. I didn't want him to give it to me, I thought it meant he was leaving me forever, but it only meant things were changing. He was dying and not upset about it, he told me.

Today, as we were driving back from the little dive of a lunchenette, we were listening to beautiful classical music and David said, "I know now what is sacred." "What?" I asked. "Life," he answered. "Life is sacred." And then we talked about him attending services at Chartres Cathedral in France, a building I have only read about in art history class years ago. And in this man, this friend, I realized how much those in their 80s and 90s have to share with us. If we'll only take a drive, share a lunch, ask a question, and listen to the answer.

Here are photos from my drive today. An now I must return to work, as, thankfully, the dentist feels the infection in my face IS healing (after 4.5 weeks) and I must just allow more time for the healing to take place). I am going to believe that, take the rest of the super-antibiotics, and keep taking, and drawing, pictures!

February 10, 2011

PAIN, Part 3: Creativity in the Midst of Pain

Part 1, "An Introduction to the Subject of Pain"
Part 2, "My Personal Pain Story: The Pink Porcupine"
Part 3, "Creativity in the Midst of Pain"
Part 4, "What Others Have Written on Pain and Suffering"
Part 5, "Resources Related to Pain Management"

Please bookmark Appalachian Morning or click at this link to add it to your RSS Feed or Google Reader as I will update these posts from time to time. You can also follow along on posts by "liking" Appalachian Morning on Facebook.

Disclaimer: I am not a psychologist. physician, physiologist, or therapist. I have no medical or mental health training whatsoever. Therefore, no advice, medical or psychological, is intended or implied by any of the posts in this series on PAIN.

PAIN, Part 3: Creativity in the Midst of Pain

So many of my feelings and beliefs about creativity and how it relates to pain stem from the experience I had as a teenager over an eighteen-month period when I was ill with mono and then a benign tumor in my neck and three surgeries related to it. I would gather my sewing box, sketchbook, miniature poodle Suzi, and small b/w TV and, with Vernor's ginger ale close by to counteract the peroxide mixture I had to gargle with, I would retreate to my bed for the day, making tiny felt creatures and sketching farm scenes in pencil.

Perhaps it should be pointed out that I was a bit of an introvert, already enjoying creative pursuits, and I had the encouragement of my parents and the time to give to experimenting with arts and crafts. I also had a wonderful high school art teacher, Mrs. Catherine Lotze, who inspired me and even invited me into her home to show me the beautiful things she and her mother before her had made. So, though my love of making things did not begin with illness, the illness gave me time to nourish the tiny seed of creativity genetics or environment or parental guidance (or a mix of all three) gave to me.

    In 2006 and 2007 when I was working on Open Your Heart with Pets: Mastering Life through Love of Animals, I solicited stories about people and their pets. Many of the stories I received concerned the manner in which the writer's pet had comforted and cared for them during illness. And, as I delved into the subject of pain this month, I found another commonality: many folks use creativity as an outlet to express or escape from pain.

    When I am in discomfort or pain (in my layperson's terminology, I am using "discomfort" to indicate pain that only marginally interferes with undertaking one's usual activities and "pain" to indicate a level of feeling that does significantly impact one's normal activities), I can pick up the tools I'm using for the book illustration project of that month, work on my novel-in-progress, or grab some needlework and, perhaps like a person who has learned to meditate well, I mentally dive into the task at hand and my focus is on it and not on how I feel. Not on what hurts. Art takes me away the way nothing else can, or ever has.

    When I put down the creative task and try to watch what for me is mindless TV—or talk on the phone, do laundry, or fuss in the kitchen—everything my body feels floods back. For me, creativity is truly an escape, and I wonder, sometimes, if those closest to me know how much of an escape it has been. For, looking back, that escape was not always a good thing. There were things—issues, problems—that at times needed addressed, but for me I went to the comforting thing I knew: making something. Controlling tangible materials to create something I judged as good. But, we'll save the psychoanalysis for another time and for the purpose of this post let's assume delving into creative work is a good way to cope with pain.

    Surprisingly, some of my best work has been done when I've been ill and/or in pain. The collage below was done while recoving from a hysterectomy in 1994. I piled magazines on my bed and, scissors in hand, cut out images that related to me and appealed to me as a woman. This was a few years before I started my own business, and the company I worked for had given me a health leave of six weeks. My mother came to stay with me for a few weeks to help with the household and children and this allowed me the time to recover and to delve into something purely for fun, cutting and pasting magazine images; something I've liked to do since I was a little girl.

    In 2002, I spent a winter month ill with something I don't even remember now, and decided to paint some watercolors of birds. My "Birds of the World" painting was born, which has sold many prints at Cafe Press and also led to a commission for two watercolors, one of scarlet macaws and one of an eagle.

    The work featuring abstract shapes that follows is one of a series of drawings I created using Sharpie markers. This was in the winter of 2006 and every evening after work I settled into a small faux-leather chair, alone in my centuries old house after my sons flew the nest. A wooden tray on my lap to hold a pad of Bristol Board and a table nearby for every color of permanent marker Sharpie makes, I would listen to the TV as I recovered from a painful illness that drained me of energy, sapped my strength with fever and medication, and introduced me to a new level of pain and discomfort. (Fortunately, after an operation later in the year, I made a complete recovery.)

    Once I did the first drawing in what I note in my computer files as "bold abstracts" (shown above), I was hooked and did many versions using Sharpies and then later branching out into Prismacolor and also in acrylic (see two images below). This was a big breakthrough for me in terms of my "fine art" work (as opposed to illustration or work-for-hire) and it all started when I was ill. It was a purely right-brained process putting these shapes and colors down. I did a very simple sketch of shapes first, but the placement of colors was purely intuitive. I never thought about whether or not these drawings would sell or show... I delighted in the process and these drawings are some of my favorites that I've ever done. (You can see more of these at http://www.gallery.janicephelps.com/.)

    There is a sterotype and misconception of artists as being unhappy, addictive, dysfunctional creatures toiling away in a poorly lit studio alone, with holes in their sweaters and not enough to eat because they've sacrified everything for their art. This may be true of some creative folk, but I do not think it is a prerequisite to creating masterpieces, or even simply art that is worthwhile to the artist and to those who enjoy it in homes, businesses, and museums. I don't smoke or drink alcohol, and other than a brief time working at a table set up behind a furnace in the basement of the rental house I shared with 8 other women in the late '70s, I've not toiled away in darkness, and now live in a nice home with heat and a/c and skylights. I'm responsible and dependable. So, what gives? Does my subconscious think I have to pay for my good fortune by getting sick? No, I don't think so.

    I think it far more likely that the physiology of my body is such that certain malfunctions are likely to happen, given the right circumstances of time and place and whomever I am in contact with (in the case of germs) and perhaps the stress in my life at that time. I can minimize risk through behavior and personal management, but there is only so much that I can control.

    I've come to think that what is more likely is that I learned at a young age to cope with pain by escaping into a world of creative endeavors. When focusing on the process of making something unique, my brain successfully blocks out pain. When faced with severe pain, it is a different matter, of course. In the rare times in my life when I've been too ill to draw, craft, or read, I know it's serious. Yet, even at those times I have closed my eyes and thought about future projects, even when I was unable to act on my thoughts right then.

    One of my very favorite books is The Diving Bell and the Butterfly by Jean-Dominique Bauby, the 43-year-old editor of Elle magazine in France. Struck by a sudden, paralyzing illness; unable to speak or move anything but his left eye, Bauby communicated his thoughts to an assistant and the results are this slim, heart-breakingly beautiful book. (I cannot believe that the hardcover edition is no longer available; but luckily you can obtain the paperback, Kindle, or audio version.) The publisher states: "Rather than accept his 'locked in' situation as a kind of death, Bauby ignited a fire of the imagination under himself and lived his last days--he died two days after the French publication of this slim volume--spiritually unfettered." I read Bauby's book for the first time over a decade ago and know that it was one of the most influential books I've ever read, and it remains so.

    It is important that when we are busy with the responsibilities of life, the sacrifices we make for others or the things that we must do simply to live in the world, or coping with pain or illness, that we take time, at least a bit of time, to enjoy the beauty around us, in the way that is right for us (in other words, not what someone tells us we should appreciate or do or create, but what really is right for us). The photo above shows petals from coral-colored roses. I loved their color and the way the petals look against the white plate. Here, also, is an image that is reminiscent of a painting; but it is simply the sunlight coming through the windowshade of the 100-year-old house I used to live in. Just seeing this, gave me hope. So, you see, even if you are not able to create something, your mind can be thinking creatively. It can "go there" and comfort you.

    I've enjoyed making Artist Trading Cards (ATCs) and here is a fun one I made using the gold foil lining from a package of French cigarettes my husband had. The cigs got tossed, but I kept the pretty foil and added to it dried daubs of acrylic paint and a saying I liked. I later found, when reading Elizabeth Edwards' autobiography, that she had this saying painted on a wall in her home, I believe in the kitchen. That made the ATC even more special to me. (You can find many ATC trading groups online and trade with others all over the world. A good way to interact with others if illness keeps you homebound.)

    In Pain, Part 4, I'll list things that others have said about pain. But I'd like to include here a few words by fellow blogger/writer/artist February Grace. I asked her to weigh in on the pain-creativity connection:

    "I’ve been using creative thought to distract myself from pain since childhood, though I didn’t realize that was what I was doing until a few years ago. While there are definitely kinds of pain that no amount of creativity can divert your attention from completely, personally I find that no matter how bad it gets, if I can even for a few minutes direct my thoughts purposely toward something, someone, or somewhere else of my choosing, then the pain seems more tolerable. Creative thought is something I still have control over, even when I have no control over what my body is doing to me.

    "You never know, either, where those thoughts can lead. The novel I’m currently working on came to me as an idea in the middle of a night last summer when I was too sick to even lift my head or open my eyes. The pain was immeasurable, and aside from it, all I was aware of in the room was the sound of the three-clocks-in-one I have on the far wall, all ticking. I focused on that sound, one thought led to another, last fall I started writing the book and now, it’s a story dear to my heart."

    In Summary:
    It's my hope that in times of health you will find a creative outlet. Let go of needing to be really good at the thing you are interested in, whether it be music or painting, needlework, poetry, writing, or baking... Whatever it is, enjoy the process, treasure the journey and appreciate the results as an indication of the willingness within you to try new things.

    Begin this practice when you are well and strong and then, if the time comes when you find your well-being challenged, you'll have a creative outlet to escape into. It will feel familiar—like a comfortable sweater or a pillow that seems perfect in every way—an ideal place to rest, recharge, and locate the peace you need to heal.

    February 9, 2011

    Grace's Lament: A Poem by a Fellow Blogger

    February Grace posted the poem below on a Facebook poetry group page during the recent Snowpocalyps. I loved it and asked permission to share it here with you. Accompanying the poem is a wonderful winterscape painting, also by February Grace.
    Visit February's blog, Pitch Slapped, and you'll find more creativity, written and visual, as well as a wonderful community of writers who comment on 'Bru's blog about writing, and more.

    (Please note: I will be posting Pain, Part 3: Creativity and Pain here at http://www.appalachianmorning.blogspot.com/ this coming Saturday, February 12.)

    Grace's Lament (...or Frigid Temps, High Whinge Advisory)
    February Grace

    Thirty-nine winters of snowy 'bliss'
    you’d think that I'd get used to this
    or that I'd finally move, but no
    dark Janus rules, and I am owned

    February, ordinary
    contrary, I feel statuary
    frozen, stone-thrown, pottery
    my joints all stiff and doddery

    First sweater, coat, next scarf then hat
    the gloves and boots come after that
    hands too cold to grip my keys
    I’m deafened by my chattering teeth

    My feet too wet, my hair too dry
    static shocks send locks awry
    can't change the fact my skin is cracked
    despite the gloss my lips stay chapped

    I could scratch spin on the street
    though I’ve lost sensation in both feet
    as I chip at ice that's seized the car
    I envy the high temp on Mars

    I wish all this would finally end
    for my mitten-shaped, fair-weather friend
    they say our trees will bloom come spring
    at this point plants seem fictitious things

    I start to think that Sol's a myth
    or simply has ceased to exist
    death by terminal case of 'blahs'
    ...'til I see he's citizen of Oz

    Dear friends who email such sweet notes:
    pictures tanning, beaches, boats
    "the weather's fine, wish you were here!"
    ...no Christmas card for you next year!

    I'm kidding--please do send those shots
    --'vicarious' is all I got
    at least I know there's someone who
    is warmer now, than is Ms. 'Bru

    There's only one advantage clear
    I see to ever living here
    so I tell myself as I bundle, snug
    "...no poisonous snakes and no big bugs!"

    © 2011 by February Grace. All rights reserved.

    February 2, 2011

    Serendipity and Social Networking

    My son, Bryce, is profoundly hearing impaired. Recently, I was searching online for related information and stumbled upon Stephen Parrish's blog and Jan. 14th, 2011 post "The Sound of Running Water." It was a very interesting post on his sudden deafness (from a virus), which doctors have told him is temporary.

    I then saw that Parrish is the author of The Tavernier's Stones. Being interested in all things book- and writer-related, I contacted him on Facebook and asked to be his FB friend. This morning, his acceptance greeted me, while the collosal winter storm "enemied" Chicago.

    I clicked on Parrish's profile page on Facebook and found my way to his website. Listed there are many reviews of his novel and this description:

    When the well preserved body of a seventeenth century cartographer suddenly floats to the surface of a bog in northern Germany, a 57 carat ruby clenched in his fist, the grisly discovery ignites a global race to find the Lost Tavernier Stones of popular European folklore.

    I've been wanting to read something outside of the genres I typically favor...and I love maps and stones...so I'm going to put The Tavernier's Stones on my to-buy list and look forward to reading it. Here is a link to his book on Amazon.

    But wait! That's not all!

    I went back to Parrish's blog to see if there was a new post, and then noticed the bookcovers along the right margin. There, at the top, was 41 Things to Know About Autism (Good Things) by Chantal Sicile-Kira. Hmmm.... autism is a subject near and dear to my heart, as many of you know, so I traveled over to Amazon to look up Sicile-Kira's book, which just came out last year in March (one month after Lucky Press published There Are No Words by Mary Calhoun Brown, which features a young girl with autism who travels back in time to save her grandfather's friend).

    So, as I now return to Facebook to check the status of a dear new friend who recently had oral surgery, I am struck by the serendipity already in place in this morning. To those who discount social networking as irrelevant and a waste of time (and who may not, I suppose, even be reading my blog), I want to tell them, "No, it isn't. Not for me."

    Facebook has brought me in contact with Kim Austin, a wonderful photographer in Austrialia. (Feast your eyes on some beautiful seaside photos here.) It has connected me, better than my initial mailed letter ever could have, with Rachel Simon, a wonderful author I've appreciated for many years but now have gotten to know even better as I read her posts and blogs about the pre-release tour Grand Central Publishing launched her on for the May 2011 release of The Story of Beautiful Girl. I've learned so much from her, much of it through her FB page, which alerts me to her blog posts.

    Thanks to social networking I've met so many wonderful artists and writers and readers and people with a connection to the subjects I'm interested in: books, writing, publishing, disabilities, dogs, painting, altered arts, museums, restaurants, photography, creativity, scrapbooking/journaling, and crafts. I've also been able to share information about my business, Lucky Press, and notify folks who are interested in my writing and artwork about the projects I'm working on, as they are discussed on my blog and in comments at Facebook.

    There is so much to learn and do in this big, wonderful world and Facebook is just one more tool that connects me to everything I love in life. What's not to "like" about that?

    Find me on Facebook.
    Follow my creativity blog, Appalachian Morning, on Facebook.
    Follow Lucky Press on Facebook (the publishing company I founded a decade ago)
    Follow my husband, Mark Van Aken Williams, who is also a writer, on Facebook.

    Janice Phelps Williams
    Athens, Ohio