In this session, pain expert Tim Beames shares strategies to help patients make New Year’s resolutions that relate to meaningful lifestyle changes for managing pain.
He talks about strategies and how to support your patients in the process:
Key points:
– Making small, achievable changes regularly over time for profound effects.
– It’s important that the patient sees value in the change and has adequate support, reflection, and reward to help make the changes stick.
– The focus should be on enjoying the process rather than just the endpoint.
– Explain Pain gives patients the understanding and practical tools to empower self-care and management.
Courses
A full list of Tim’s upcoming Explain Pain & GMI courses can be found at www.noigroup.com
Clinical Discussion Group
Come and join the NOI Clinical Discussion Group; it is free and open to all: https://www.facebook.com/groups/243578159913567
Hey good morning Tim morning Happy New Year oh yeah you too and and to everybody else yeah yeah welcome everybody come on in thank you for signing up and thank you for joining live it’s good to be back we love doing these Tim don’t
We yeah it’s nice I I enjoy it yeah yeah I do really enjoy it morning Hilda from Belgium thank you for uh letting us know that you’re here and in the comments if everybody uh would like to let us know where they’re joining us from oh Katherine from hot and sunny Western
Australia cannot tell you how cold and miserable is here in York in the UK really really uh wintry morning Sandra Oh David Bolton hi welcome back from Sunny Sardinia I think uh Sandra good morning Rosie good morning Cindy good morning from Singapore Ruth you’re in York too hello um Carly from Cambridge here
Welcome oh Carol from Frosty Melvin welcome everybody thanks very much for joining live wonderful to have so many people here for our first explain pain in the clinic of 2024 okay so I’m just going to kick straight off uh because we always seem to run out of time on these and there I
Know that Tim’s got a lot to cover this morning so uh I’ll just get my little romped so I don’t forget anything so hello and a very warm welcome to this explain pain in the clinic my name is Joanna and I am director of noi in
Europe and I am joined today by my good friend and principal noi teacher Tim beams morning Tim Tim Tim has been a noi teacher for well over 15 years he has taught literally hundreds of explain pain courses to thousands of clinicians all over the world Tim is an active clinician himself specializing in
Complex and persistent pain he is also founder of an organization called laub stifi which is an online platform for clinicians to learn about the latest developments in clinical practice and pain research Direct ly from the research and pain specialists around the world I think Tim has dropped the link
To leub in the chat so if you want to have a click through and check that out uh you can find out a bit more about Tim and that side of what he does they have a wonderful podcast uh that’s well worth taking a look at Tim is also author of
The grad motor imagery handbook with David Butler and Laura Mosley so uh a little bit about these sessions these are designed to give you a taste of explain pain and how to practically use it in the clinic some of you will have already done an explain pain course possibly with Tim so these
Sessions will reinforce what you’ve already learned and expand a bit as well uh but if you’re new to explain pain these sessions will give you a a really good taste of what to expect in the core course so just a couple of things to mention before we start Tim will be
Talking talking for about 20 minutes if you have any questions please ask them in the Q&A or in the chat we’ll keep an eye on those as we go um and if you want to watch the recording of the session you can watch it in the on our fairly
New YouTube channel and I’ll drop the link to that in the chat once Tim gets started so it’s also available in the noi clinical Discussion Group which I’m just going to pop the link to that in the chat as well so today uh we’re going to be talking talking
About resolutions New Year resolutions and how we are patience to make rehab habits stick so Tim would you like to give us a a little idea about what you’re going to be talking about today yeah yeah well the idea came from um New Year New Year’s resolutions as you say and
Um and what I’m going to talk about encompasses um first of all why why bother like why bother making them in the first place um what you could consider if you are making some and we we the direction here is obviously in terms of therapeutically
Um uh how you go about making them make more sense or have more value how you can more easily uh commit and follow and maintain motivation for them um there are links as well to explain pain and uh the ideas around Behavior change relating to explain pain and then if
We’ve got a bit of time I’d like to just drop in some little tips and hints and and things to to make things um more achievable for everybody as well so yeah that’s that’s my sort of General flow thanks very much looking forward to the conversation so um let’s kick off so New
Year’s resolutions yeah I I always hated like the idea of New Year’s resolutions like can you imagine um dry January or whatever it is in the UK at the moment um because um there might be a merit to going a whole month and not drinking alcohol for some
People brilliant but um if we’re starting to think about what this means for a person recovering from Pain um uh it habit and and making resolutions relate to I think nicely to Lifestyle Changes meaningful Lifestyle Changes um and um what we’re starting to see more and more and more Joe you know
Very much U um about the troubles that a lot of us have um essentially getting someone on board to to um shift and change and adopt new lifestyle habits um the research is saying that that’s really important I I mean lifestyle habits are important both in terms of the maintenance of uh poor
Health uh for instance um but also you know good or better or helpful habits are relating to recovery as well and Recovery strategies and well-being so it’s it despite the evidence suggesting that this is important for us to to look at and to work on and to understand a
Bit more it um it doesn’t make it any easier um getting someone on board with this process as well so yeah that was my thoughts um I personally I I not that we get any money for it but there are a couple of books that I think are helpful
To read The Power of Habit and atomic habits um I don’t know for those of you who who are readers then then check them out because they’re really really helpful books Charles DG’s book on The Power of Habit I read about six years 7 years ago something like that but anyway
It it sort of stimulated um in me a need to test out some of the ideas in there and develop some new habits some new healthy habits so I was doing a lot of traveling at the time and we were developing some cses in France weren’t
We and basically I used to sit in the uh lectures with Marie talking French and I thought I probably should be able to listen to some of it and understand a bit of it and uh so I took it upon myself to to start to learn French and
Um and I managed some I started I thought maybe I could do it for a month and then maybe I could do it for a 100 days and maybe I could do it for a year and and I I lapsed a year um and then I started again and I’m about 1500 days
Into habit of learning French every single day um that’s come about because of um some of the tips and and hints um from from the work around habit so yeah I thought I’d share a little bit about that um that was more about me seeing whether the Habit was possible
Uh but but it this is really important part um of the work that I do with my patients is that that I feel there’s sometimes it’s really helpful to have taken yourself through something in order for you to see the challenges that people come against um uh know know some of the cheats
Perhaps some of the ways that you could work that might make things a little bit easier um and one of the things I’ve actually been adopting a newer habit more recently um uh where I’ve been I’ve been um intermittently fasting and uh I’ve done this now for just over a
Year um so I feel like I’m in the place where I have evidence that suggests that when I commit to a new uh a lifestyle change that that I have enough um resources in order for me to make that stick and this is what we want to do
With our patients we want to be able to figure out you know something that resonates enough with them uh they see value they see meaning um enough that they are going to take themselves regularly through a process and when I’m saying regularly through a process like
A part of habit change means that you’re going to do something and for a lot of the time you’re not going to see any change you’re not going to notice a difference you know fasting for 16 hours in the day for me I know I notice no difference whatsoever really for a
Couple of months um and then maybe there was some small changes after that and and it was more like looking back over a year and saying look how am I feeling now relative to how I how was I feeling then I could really see some some bigger
Changes that have stack up over time so um so a part of what I’m talking about in relation to um to habits are Behavior change um and and with and and I was saying beforehand about the the trouble the difficulty sometimes that you you know you’re asking someone to shift and
Change lifestyle uh something that they’ve always done something that is a part of their identity um perhaps I means let’s say it’s you know relating to dry janary it might be that on a Friday and a Saturday I go out to the pub and I see my friends
And we have a drink and you know who am I going to be if I go to the pub and I’m the person who’s not drinking and feeling awkward and and what have you so so there there needs to be at the heart of it there needs to be like a shift in
Who you see yourself as being um and and that that shift that like that might be too big a shift that you’re saying I’m going to stop drinking um it might be more um achievable to say that uh I moderate my drinking you know I’m going to when I go
Out and see my friends on a Friday and a Saturday if that’s what you can do cuz Joe can we do that I’d love to be able to do that once every six months uh I might go out um so for so for th those
Of you who are lucky enough to do this um choosing something that is actually more achievable is um important if it’s so lofty if it’s so massive you know chances of you um struggling to be able to do it regularly is really really high so so CH choosing something that you
Feel um has some sort of added value and benefit to you and how you want to live your life um and well-being and lifestyle for me is is what we’re really talking about here so you know that choosing the right food or moderating your drinking or stopping smoking or
Remaining active or noticing when you’re inactive and uh learning about yourself your pain the behaviors that you can adopt that might be healthy over a period of time I mean there’s so much there like to do all of them straight away is is is a massive challenge isn’t
It so um the the person that I have like um in the back of my mind um who we’ve spoken to a lot is Richmond Stace where he’s saying it’s it’s not about the destination it’s about the journey um and and and uh making habit stick and making healthy habits stick
Relating to pain and Rehabilitation is about being confident um comfortable that you’ve chosen the right way to go about it and even though you might not be feeling phenomenally different and and better that you know that this is the right course to take this is the right action
To take I love what you said there Tim that’s a very PR as a sort of starting point that’s a very practical approach in that you’re asking somebody somebody to just moderate behavior and to not um you know that idea of you don’t have to change completely and don’t set yourself
A goal um that’s really difficult to achieve so an achievable goal about uh moderating Behavior rather than completely changing who you are yeah and it’s it’s like it’s the successes of little things yeah you know if let’s take so from Pain most people who are listening will recognize the
Importance of moving and activity and there might be like little cheats that someone cheats you know little behaviors little habits that they can get into where walking to work instead of if they’re in London going on an escalator they could walk up the escalator instead of just standing still still and um it
Might be one escalator like you might have 10 escalators to go up and down like you choose one that this is the one that I walk up you know make it achievable do it every day and then look back and recognize that oh well done me for doing that every day so there’s
There’s like I I’m mentioning a couple of things actually here um I mean one is that you’re you’re creating something that’s achievable so make it small enough so that you know that you’re going to be to do it and that you’re going to be able to do it regularly
Um um perhaps have some sort of anchor and the anchor might be the place the time of the day um that you do it so that one particular escalator might be I know when I get to this escalator I’m going to walk up it so so it’s very easy you know that
This is when you do this Behavior this is just this is a part of your behavioral change and then when and then it’s important to also give yourself a little bit of reward for having done it as well um game games and apps and things are brilliant for that because
They give you like little cudos and rewards and uh you know make you feel good about like having done I don’t know 10 days a practice of French or 100 days or whatever or someone can give you some Kudos on stra or apps like that where
They say Well done for going for a run as for some people that’s really really important sort of validates the process of what they’re doing you know Well Done me for doing it um not everybody is like this do you formalize that then is that something that you know do you actually
Uh is it a sort of process of um you do the activity you’ve you’ve done it that day and then you give yourself a reward um quickly after having done it that day no I I don’t think it needs to be like an immediate reward necessarily um but
As part of rehab it it’s important that people reward themselves for the commitments the tenacity the determination Etc that that they are putting in so yeah some reward at some point is is really really important that that we’ve sort of missed a little bit of a step I suppose which
Is is we are saying it um implicitly I suppose but is the relationship with explain pain where someone needs to have reflected on what pain means to them what pain means to their identity why they should buy into some lifestyle change and habit change um relating to to their experience their
Current experience and and what they want to experience in the future as well um which is a sort of a first po part because if you haven’t even reflected on it why bother adopting a new a new Behavior so the reflective piece is a is a really important piece
Um before you even bother to start doing something and explain pain a sort of if you want from a linear perspective the next place to go then is to start trying things out to start doing it and to get some experience of what that might be like um we call them experiential
Processes don’t we but we’re experiencing the experiences so you’re giving yourself some sort of experiment uh maybe it is you know walking up that one escalator if you do it and you don’t reflect on how well that went and whether it’s achieved and whether you
Want to do it again then then it’s a sort of empty token of of of of of action that you’ve taken so it’s it is important to come back as you said about the reward it is important to come back and go oh well done me how did that feel not just
Like well done I did it but how did it feel how am I is there something that I can how could I make that easier next time um I’ve just like I’ve just in the top of my head couple of people that have been working working with today is
In the UK it suddenly went cold didn’t it this week and um and one lady has um neuropathic pain a guy and a guy that I’ve been talking to he also has a neuropathic pain as well and cold really sets things off so we’ve been talking
About how to set up their environment so that that at least the cold has less of an effect on them cuz otherwise you’ve got you put your barriers up don’t you say h cold outside I’m not going for my walk my run whatever it is to do any
Work in the garden and then the things that typically might have been a part of your lifestyle commitments uh for for well-being it’s easy to like the you like can we just lessen the barriers lessen the constraints um so and a part of that would be getting someone
Supporting you so you know clinicians here we have a wonderful role to play here in supporting healthy lifestyle choices and behavior changes but you know how much time is that person with you for a very small amount of time you might be like a little voice on their
Shoulder but but who else can they get to come and support them through that process of change as well so um yeah it’s you know there’s I’m I’m sort of giving you a little bit of a stream of Consciousness here but there are there are sort of key features here that when
You’re choosing lifestyle change it needs to be something that makes sense that person you know why am I bothering to even do this that they see value in doing it as well and uh and not and that they can commit to something and they’re happy with the commitment as well so it
Needs to be small enough and achievable enough that they’re going to do it again um that they perhaps anchor it with something else so they know that this is when I do this particular habit uh that there’s enough support from people around them uh that means that
That they can they can commit to it and they can do it each day I’m thinking about like a five minute meditation in the morning or that for some people that’s too much can we make it a minute so you don’t have to be sitting down for
An hour meditating to start with you know make it something that’s achievable and then when you have achieved it you make sure that you have a way of looking back reflecting noticing how it felt how easy it was whether or not I need to make some changes and and and at times
Give yourself rewards for the for the commitment that you’ve shown as well so there’s some definite strategies there that that you’ve just summarized um from what you’ve talked about um M that it makes sense that the person sees value that it’s moderate change that they can identify with that moderate change not
Huge change that there are anchors that there’s a support network that they create right environment that there’s reward at the end of it and there’s also a reflective process which takes place throughout the the whole repetition of the Habit setting yeah and and and then like fitting this in with pain and and
And health and well-being you know little changes done over a long period of time can actually start to build into quite profound effect in you in you and and there’s a notion of organizational causality where hierarchy you know you can start to do little changes and then they can start feeding
Up feeding up into more systemic systems wide you know body-wide person wide changes as well and and and I I did pick a few sort of habit changes but it might be simple things like taking yourself to bed and reading for half an hour instead
Of you know turning the TV off going up going to bed so so sleep hygiene might be something that you can commit to and and you might enjoy the proc process of reading as well so you might get the added benefit of not just taking yourself to bed but the process of
Bringing yourself into the place to be able to sleep and also being able to enjoy the the reading a book as well um can I just ask a question at this point yes what do you do how do you support patients who are struggling to maintain the process or they feel like they’ve
Fallen off the wagon yeah yeah um that was something we were going to talk about wasn’t it um look the first thing is that a lot of people set the sites too high um and and see when they fall off the wagon even in itself it sounds like failure doesn’t it
Like you’ve done the wrong thing and then we start blaming ourselves and then then it seems unach unachievable as well unattainable so I’m not even going to bother doing it again because I falling off what’s the point so you know the starting process setting up in the first place is important
But when you don’t achieve like for instance I mean food choices what’s so bad about having a bit of chocolate occasionally or a little piece of cake once in a while um but not blaming yourself for doing that after Christmas because you know sometimes it’s nice to
Have a bit of chocolate or a bit of cake or or part of me is coming out here Joe but it doesn’t mean to say that you’ve undone all of the good work that you’re putting in and and that that comes to that sort of moderation as well
Um I personally um offer support for people and and everybody wants support in different ways like some people um enjoy being able to connect and and find support through that way whether that’s sort of messaging emails Etc um other people just knowing that you’re there you’re on their side side that you’re
Supporting them through your intentions and your words um might be important um as well um I suppose from an explained pain point of view we’re we’re also um working with that person to give them the insight to understand whether or not they have failed um and and and giving and working out
Strategies that mean that things are more achievable as well um so if I’ve heard that right Tim explain pain actually is the support sort of rapper around some of these strategies that part of explain pain is it gives people the the tools and skills themselves to
Be able to create this this process and also rescue themselves from it a bit explain pain done really well is is empowering someone to make the right decisions at the right time to know that you know if it didn’t go well in their eyes that they that they can give
Themselves a bit of leeway um so having that sort of active um um strategies and uh um being able to be proactive about it as well to know I just got off a call with a with a the guy I was mentioning before and he’d reached out and he
Connected with a couple of people as well so he knows that it’s a difficult time of the year so he’s gone out proactively connected with people and say actually I need a little bit more support right now I mean that is like to me it’s like deep there’s some depth in
Knowledge and understanding then for him and and and for me that’s what I explain pain is it’s it’s not me doing it for someone it’s me empowering someone to be able to do it for themselves at times I’m going to help a little more and support a little bit more and maybe
Instruct sometimes uh you know coming up with some of those ideas it’s wonderful to work together but sometimes you you need to just give someone a little bit of help yeah you know this is one one of the things about explain pain that isn’t sort of widely
Understood that it’s it’s so much more than just pain science and that it is actually a complete approach to uh to helping somebody with a lot of these sort of I don’t know what what you call them uh Tim but like you know the softer skills about self- support and giving
People giving your patients the tools that they need to be able to support themselves through a process rather than it being something that you’re doing for Them I do see a couple of questions coming in haven’t been able to read them fully but relating to pain very often people come and and they see you and and in their minds and and how they communicate it is they you know what do you want to get from our time together
Is I want my pain to go away or I want my pain to get less and what we know about pain is we can’t definitively say yes you know whether or not we will be able to do that but you’re creating the conditions that means that you are in a
Healthier place and and and might mean that you’re living with pain as opposed to in pain um as you are creating the right conditions for health and well-being and a lot of people live Wonderful lives with pain um uh but some people realize you know shifts and changes and and pain
Does go away as well and and I’m I’m of the opinion that at a biological level we all will change that is inevitable this concept of impermanence comes in here doesn’t it but what that change will look like uh we can instead of you know trying to force change to happen in
A particular direction we can be excited about where change will go yeah agreed completely there is just one question here which um I think is really interesting and it won’t have gone to the whole um audience it’s just come to as him but it was um I can’t say the
Name of the person but it just said a question regarding struggle clients um might have with sticking to change elderly May believe that they have not really a long future or believe they have too much to work towards or believe that they have not much to work towards
Any tips on increasing the belief that uh the elderly can still create a different outcome thinking 75 years plus um yeah I mean it’s a it’s a lovely question I’m not sure I’ve got like uh I mean there are ideas tips and hints and and and ideas on a general level but you
Have to work with the individual um so so if someone sees there being little point then my suggestion would be that you’re working more at a reflective level to begin with you’re opening up you know to to say is you know can we find point in something
You know where might we find that you know what would you value what do you want to do what would you love to really be able to do and and and it would be those sort of anchors that I would be that that I would be directing my um
Energy towards and can be really small things can’t they they do not have to be um you know massive things that somebody wants to work towards just being able to do something that they weren’t able to do and and those small changes and and if it does open up possibilities for
Them I like I’ve only talked one of the pages of the three that I’ve written so far but one of the what I was going to talk about possibilities and opportunities You by you can open up little possibilities in someone’s life and by opening that opportunity those possibilities that actually starts to
Have quite dramatic effects in other places as well so you might find that being able to um safely get on and off the floor I’m thinking of you know very elderly people but safely get on and off the floor when they thought that they would always need someone to help them
That might boy their mood and then that might say I actually now that I know that I can do that I want I want to be able to do these other things as well in my life and and so you you and this is what we find in pain it’s really quite
Amazing is that the relationship between changes let’s say is someone’s sleeping better their mood might be better yeah their relationships might change as a result of it so having made one little change in an area like sleep actually can have quite a profound effect in a
Number of other areas in their life as well back right to what you’re saying at the beginning ter which is the person seeing the value in the change that they’re going to make and putting the effort in um to make the change to get the value
Out at the end it’s the same process it seems to me that no matter what the age of the person the the the goals may become a little smaller but they won’t have any less meaning to the person yeah and and and I suppose something to say
About goals is like and particularly for the elderly um if you’re always reaching towards a goal are you ever able to um be satisfied and enjoy the process yeah and and then there is quite an important part of perhaps the the work that you’re doing together with someone is being
Able to enjoy the process um that small cycle of a process daily where they get that little reward on a daily basis is as important as achieving the actual thing exactly yeah then what happens when you’ve achieved it as well I know I mean there’s two things what happens
When you’ve achieved it and what happens if you never achieve it so it’s a life thing isn’t it is that you know don’t I won’t be happy when I get to the end you got to enjoy the process yeah I mean it’s kind of ridiculous isn’t it like when are you
Going to be allowed to give yourself the enjoyment of life we’ve gone four we’ve gone four minutes over already so we need to wrap up um but I knew this was going to go on it was such a good topic and thanks so much for people who have put um their
Thoughts in the comments we love interacting with you like this it’s uh it’s what makes these sessions so enjoyable for Tim and myself uh just to let you know that um as I said these this will this recording will be available on the YouTube channel if you
Uh follow the link uh we’ll be sending it out to everybody after we finish click the link and subscribe and then you’ll you’ll know when these are uploaded um Tim’s got two explained pain courses coming up so if you are interested if you haven’t done the course and you feel like uh learning
This sort of this whole approach will uh enhance your clinical practice then he has two courses coming up uh one start one starts at the end of February which is a 3-day format and then the second one starts in March which is the8 week longer form format
Tim could you just very very quickly four four days Fe because it straddles into March oh sorry so four sessions um is the the um February course and then the the spring School uh could you just very quickly say what yes spring spring school is different uh it gives us an
Opportunity to try out some exercises weekly and and get some feedback and and connect with others as well and hear how how they went and and their experiences and we also pick some um some of the literature the pain literature and and we we talk through what we got or didn’t
Get and and whether it has any application to our practice as well as we’re talking about explain pain the two day or the four session explain pain um well the four session it gives us the ability to try some things over a week um it’s a little more based uh with some
Reflective pieces and some group work um yeah so so there um yeah there’s slight slight differences and if you feel like T on the alonger phone course you get to spend eight weeks with Tim the longer form course I mean that’s that fits the what we’ve been talking about here
Around Behavior change because in a week you aren’t going to change an awful lot but and it straddles normally straddles a holiday as well so let’s say it’s 10 weeks you spend so it gives you an opportunity to to try things out for a little bit longer yeah okay thanks Tim
And um thanks ever so much um to all of you for joining live and for sticking with us everybody who joined at the beginning is still here at the end so thanks very much guys and uh there’ll be another one of these coming up in two
Weeks time uh in the meantime take care and we’ll see you again soon