The Headache Healer’s Handbook. Jan Mundo

      • Were you injured or ill, or did you have an accident? Were you going through a difficult personal or family situation? Did you move to a new area or change schools? Were you traumatized, assaulted, or abused?

      • Perhaps you were going through hormonal changes, or starting contraceptives, hormone replacement therapy, or new medication.

      • If you were starting college and living away from home for the first time, think about your newfound freedoms; any academic, athletic, or social pressures; and the changes in your eating, drinking, sleeping, and postural habits.

      • If you were an adult, think of all you were trying to juggle between spouse, kids, and work — or any job or financial uncertainty.

      You can mine all of your answers for clues in this way. Some questions might seem more relevant to you than others, but any of them could reveal triggers you might have previously discounted, like starting or stopping a medication, hobby, job, or routine. So consider everything, and don’t give anything short shrift. The hidden gems are often found where you least expect them, and others could bubble up later.

       The Power of Your Story

      Your story has power. Each chronic headache sufferer has a story, and telling yours — describing the pain and giving voice to the frustration you’ve experienced in trying to heal it — brings its power to the fore. Part of the healing journey is learning how to spot clues in order to gain insight, and both clues and insight might be hidden in your story. This section introduces you to a new way of listening to your inner voice — a practice that continues throughout the healing process.

      Early on in my practice, as I led classes of patients who were referred by their neurologists, we would do brief introductions on the first day and check-ins throughout the course. The depth of pain and suffering and the mood in which each person told his or her story spoke volumes.

      Hi, my name is Carol. I’ve had migraines for thirty years now, since I was fourteen. I get them every day, and I’ve been using over-the-counter pain medication daily for the past ten years. I’m afraid that if I stop taking it, the pain will be even worse. My headache doctor referred me to this class, and I’m skeptical of trying one more thing. But I’m here to give it a shot.

      Based on my somatics training, I would listen to each story by centering in my body and holding a neutral space. By neutral space, I mean a feeling of empathy for the person without falling into sentimentality about their pain. (More “I hear you” and less “Oh, you poor dear, that’s horrible.”) While holding a vision for each person’s healing, I could also hear voice quality and tone, word choices, mood, and posture — which would inform my assessments and coaching. To my surprise, the classes spontaneously adopted my mode of listening, and whoever was sharing would start to listen to herself in that way too. It was so touching to feel that mood of compassion pervade the room.

      Finding a setting in which you can tell your story and listen to the stories of others can be revealing and helpful. Although it can be hard to imagine beforehand, there is usually someone who is worse off than you are, and hearing their story lets you empathize and takes the focus off your own pain. (“Geez, and I thought that I had it bad.”) Hearing someone in the group talk about doing better shows you that the possibility for healing exists. (“If she’s doing better, maybe there’s hope for me.”) And, of course, being heard and believed is internally settling.

      The story you tell yourself and others about your headaches plays a powerful role in healing them. Listen to the words and the voice you use to describe your pain, yourself, and your life. Try to listen to yourself and others with compassion — as if you were in that classroom of headache patients, hearing their headache stories and being heard.

       4 The Mind-Body-Headache Connection

      In his writings, seventeenth-century French philosopher René Descartes assigned the flesh and blood of humans to medicine and their spiritual side to the church, and it stuck. In Western culture, we tend to move through life as if our bodies are simply vehicles on which to carry our heads around — just well-oiled machines unrelated to our thoughts, aspirations, and behaviors.

      In the 1960s, Eastern spiritual philosophies and practices began flooding into Western culture. Over the next forty years, a large variety of meditation, yoga, tai chi, martial arts, and bodywork disciplines became widely available, and new forms were created and adopted. Classes were offered at medical centers and sports clubs; doctors referred patients to complementary medicine practitioners; and the National Institutes of Health (NIH) began researching alternative therapies in medicine. People who practiced these disciplines and received these therapies found that relaxing their bodies calmed their minds, and calming their minds relaxed their bodies.

       What Is the Mind-Body Connection?

      The term mind-body (or body-mind) is used in conjunction with health and healing. For nearly a century, researchers have been trying to prove what Eastern and indigenous cultures have known and practiced for millennia (and what Descartes had wrong): People are more than their flesh and blood. Rather than being purely mechanical operating systems, living beings have intuitive intelligence, from the cellular to the cosmic level.

      The mind-body connection means that your body and mind are one; they are inextricably connected and constantly interacting. But what is this connection, why is it significant, and what does it have to do with headaches?

       The Biofeedback Revolution

      At about the same time mind-body approaches were growing in popularity, biofeedback therapy created a revolution in the scientific world when it showed that people could exert voluntary control over their own nervous system functions that were previously thought to be involuntary. The central nervous system, made of the brain and spinal cord, sends and receives information to and from the body via the peripheral nervous system, which has two branches: (1) The somatic nervous system controls conscious, voluntary functions, like skeletal and muscular systems, and general senses, like pain, temperature, touch, vision, hearing, and joint position. (2) The autonomic nervous system controls unconscious, involuntary actions — like heart rate, respiration, skin temperature, blood flow, and digestion — and cardiac and smooth muscle (blood vessel) tissue.¹

      The two branches of the autonomic nervous system govern the body at rest and in action: (1) the parasympathetic nervous system (PNS), which is the body in balance, or homeostasis, governs the body at rest, and (2) the sympathetic nervous system (SNS), which mobilizes the fight-or-flight response, governs the body during activity.

      In biofeedback training, a patient, who is fitted with sensors and hooked up to an electronic device, learns relaxation techniques, then receives instant feedback of the results through the device via sound or visual cues. Researchers showed that trainees could engage their PNS, slowing heart rate and respiration and aiding digestion, and override their SNS. The goal of the training is to reproduce those relaxed states using mind-body cues in lieu of the device’s feedback.

       Biofeedback Pioneers

      In the 1930s, German psychiatrist Johannes Heinrich Schultz developed autogenic training, where people are taught to use mental visualizations, passive concentration, and verbal commands to induce a relaxation response (“Now my hands are heavy and warm”). In 1958, psychologist Joe Kamiya, PhD, experimented with electroencephalography (EEG), or brain-wave biofeedback, now known as neurofeedback, at the University of Chicago. Dr. Kamiya demonstrated that test subjects could learn to recognize when they were in relaxed, intuitive, alert mental states, called alpha, and control their brain waves to produce these states.²

      In the 1970s, Joseph Sargent, Elmer Green, and Dale Walters of the Menninger Foundation began investigating the use of autogenic feedback training to control migraine and tension headache. By combining autogenic training and biofeedback, subjects were able to control heart rate,