I am L’s voice.
When she talks about pain, it is a level of pain that leaves most people in tears. Having dealt with constant physical pain every day of her life, she has a high pain threshold. So when she talks about being bothered by pain, listen carefully and do not dismiss a single word.
When she says the pain is preventing her from sleeping, realise that “being tired” is her way of saying she is experiencing severe sleep deprivation from nightly lack of sleep. Realise that fragmented hours of sleep are nowhere near as beneficial as a solid block of deep sleep. Realise that this has been her experience for months. Realise how difficult it is to still function under these conditions, and that running on autopilot is not a healthy situation.
The pain takes so many forms. It is frequently the sharp stabbing pain of knives. It is hot and cold throbbing, sweats and swelling. It is spasms of nerve pain that make her whole body jump, that occur all times of the day, and are particularly disruptive when asleep. There is currently no relief from the pain, only variations of extremity. Even the most pleasurable of intimate times offers no alleviation to the distressing discomfort.
When the pain brings her to tears, realise that there is nothing left, that she has reached the limit of her endurance, being pounded daily by the various attacks on her physical senses. Realise that the pain has been so severe as to frequently leave her feeling nauseous. Realise that vomiting from the pain is her body’s last resort to expel what currently cannot be removed.
When she says that she has trouble thinking, realise that the pain is so strong that her working memory is functioning at a fraction of normal, and the constant assault on her senses is an underestimated stress. Realise that what she manages to communicate is critical information. Do try to find out more with further questions, for her ability to volunteer information is somewhat limited.
Realise that her emotional struggle is as real as the physical. Realise that many of her normal coping strategies have been taken away, and that her normal physical-mental interplay has been disrupted.
When she speaks honestly about how she feels, it is a big effort, requiring much strength and focus, which is a very tiring process for her. Realise that she has experienced over 20 years of being emotionally smothered. Realise for that time she was conditioned into compliance, criticised, belittled and abused for expressing herself or having a different opinion. Realise that speaking up about herself and for herself is a huge task. Realise how tiring is it to every day push herself beyond the protective shelter of silence that she had created in order to survive most of her adult life.
When she talks about understanding the psychological effects of pain, of reduced function, of limited activity and changed behaviour, realise this is a master instructor with nearly 30 years experience. Realise this is a teacher at the top of her game, with a professional interest in the psychology of behaviours. Realise this is an educator of the most difficult children in this city, who daily has a positive influence on the future of some of the most disadvantaged children here. When you talk about the psychosomatic influences during this time of dramatic changes in her own life, realise this person intimately understands the territory and must respond daily to assist children and adults experiencing such effects.
Realise that this woman is incredibly strong, having saved herself from an abusive relationship. Realise that this woman had the strength to prevent herself from becoming another statistic of domestic violence. Realise that right now she is coming to you for help, because she needs help. She is relying on you for the best care possible.