Comprehend Pain-Fear-Panic-Burnout (eBook)

1. Prologue

1.1 Chess and the Fascial Distortion Model

The „Game of Kings“ fascinates a lot of people. It works with six different pieces: the king, the queen, rook, bishop, knight and pawn. Every chess piece has defined possibilities to move on the chessboard. 20 minutes are basically enough to get to know the moves. But there are people who are fascinated by this game of strategy throughout their lives. Many books and magazines are only about chess. Some people already start to play chess as a child and take part in competitions. Why? We think, it’s because of the numerous different ways and strategies of how to play the game. The players are repeatedly challenged. Action, reaction, interaction and a goal. In chess the participants play against each other to win.

The therapist isn’t a therapist without the patient

Now what does chess have in common with the Fascial Distortion Model? The Fascial Distortion Model shows us six different fascial distortions pointed out to us by the patient. The distortions are quickly explained, but we need time and practice to learn action, reaction and interaction with the patient and to achieve a goal – in the case of FDM in collaboration with the patient. He knows the problem, even if he’s unaware of it. The therapist’s part is to read the symptoms and to try to act accordingly. Now a lively interaction takes place, the goal of which is to solve the patient’s problem. During this interaction the patient becomes the expert for his complaints. In this book we will show you how to make this interaction improve as well as show you some ideas, that will support you in achieving the goal together with your patient. The therapist is not a therapist without the patient. Both have to collaborate as equal partners until the job assignment is fulfilled.

We are happy, if we succeeded in writing a book that also enables laypersons to understand the method. Our special thanks go to the colleagues, who made available to us their knowledge and experience in order to make this book a success.

1.2 If someone reveals himself to be your teacher

If you talk, you will only repeat what you already know.

But if you listen, you might learn something new.

Dalai Lama

The following story starts in an everyday situation with a private doctor’s visit during a rehabilitation program. After three weeks one knows each other and meets every day in various therapies. Patients come to individual sessions of psychotherapy as well as to work in groups. They find social contacts, dance together or withdraw to the studio, working on relaxation and creativity. Among the many patients a 32-year-old woman attracts the doctor’s attention. She has described as a person who “always struggles”. Since some days she behaves in a different way.

She is arriving in time like every Thursday for the private session but seems to be unhappy and sweaty. Her hair is kind of greasy and she slumps in her chair. She is agitated, seems to be tense and is constantly changing position.

“How are you today?” the therapist, who is already assuming the answer, asks her.

Patient, “So so, thank you.”

Therapist, “What is oppressing you?”

Patient, “Everything is so difficult. For ten days I’ve been having massive tensions and anxiety attacks of changing intensity.”

Therapist, “How is this anxiety manifesting itself?”

Patient, „It’s coming up again and again in waves, overrunning me without a preliminary warning. Sometimes their intensity is strong, sometimes weak. I’ve known these panic attacks for quite some time now, but they occur more often. They start all of a sudden with palpitations, sweating and my mouth goes dry. I feel a tightness in my throat. My chest seems to be tied up, like suffocating me. Then I feel like losing control.”

The patient’s problem is that these vicious attacks don’t disappear and the tension remains. “Meanwhile I’m taking three Xanor (Benzodiazepine, a medication reducing anxiety, having antispasmodic, tranquilizing and sleep-promoting effects. It’s applied for states of anxiety, excitation and stress, for sleep disorders and epilepsy). Still, I can’t relax. Added this oppressive feeling and these painful tensions becoming stronger the minute. I don’t feel capable of anything. I’m only a shadow of my former self. For two days now I’ve been suffering from severe headaches. These migraine and tension headaches – nobody really knows what they are – I’ve already known. I did have them more often during the last months. They wear me down further. It’s all extremely difficult and exhausting. I try to get through the complete therapy but I’m starting to see that I won’t make it. It’s so difficult to let go. I always try to do everything right but I just can’t do it. Meanwhile I’m feeling worse than at the beginning of rehab”, the patient complains.

Therapist, „And how’re you sleeping?”

Patient, “I’m not very refreshed after sleeping. I always wake up in between and can’t go back to sleep. I keep brooding and suddenly its morning. My upcoming wedding scares me. Like I’m feeling now, I probably won’t be able to hold out and enjoy this day. I’m urgently seeking improvement. I came here to get better and fitter and to regain control over my life. Can you do something against my pain?”

Therapist, “Where is your head hurting?”

The patient grabs in the cervical region left with three fingers, presses her fingers lightly in the tissue and sways her head but only for a moment. She thinks. Then describes a linear pain in the lateral cervical region.

Therapist, “Does the pain move along in your head or does the line go to the eyes?” She’s a little bit irritated and answers, “It’s been moving for months now but it always starts in the cervical region and then it gets more severe.”

Therapist, “And where is the anxiety located you mentioned earlier?”

The patient grasps with her fingers at the neck region for a moment. She kneads the region in the area of the larynx. Then she describes the panic attacks, showing the tension in the cervical region with two fingers as a line again. Additionally, during the hard phases the tension is always pulling strongly under her breast which feels quite unnerving to her. If this happens, she feels “a kind of narrowness in her heart”. In this state she even fears to suffer a heart attack. She says that she has been to the hospital because of that but they couldn’t find a heart disease, although it felt very real to her. Anyway, she is frightened to death in situations like these. Again she indicates a line beneath her left breast. Then she describes a pull in the direction of her thoracic spine. Towards the end of her report she grasps with both hands for her chest but this time flat/ laminar. She splays all her fingers, touches the region for a moment and moves the palms of her hands as if removing wet clothes. She says: “The pull on the left breast drives me crazy!”

As the therapist noted how impressive she showed the whole situation, he asks her, if she’d allow him to touch her there. A nurse being with them, she consents and the therapist starts with a soft triggerband technique in the cervical region, where she has indicated the pull. He asks her, how this feels.

Patient, “Yes, exactly there is the pain. You can press stronger.”

The therapist treats her with the triggerband technique following the shoulder-mastoid-triggerband left and right. Finally the therapist asks the patient again how she feels.

She seems to be nearly enthusiastic and answers, “THIS is the pain. Yes, this is exactly MY pain.”

Therapist, “Is it okay for you if I’m going on like that?”

She smiles and says, „Absolutely. It feels to be right!”

The therapist works on the herniated triggerpoints above the collarbone on both sides. After he has treated the first triggerpoint the patient wants to know, what he’s doing. She is kind of irritated because it feels just right and she thinks herself finally understood. A comfortable and relaxed mood is beginning to develop. While therapist and patient get more quiet in their interaction and work together step by step, he explains to her, that what she is observing is real for him. It is called fascial distortions. This line she is indicating is at the surface, it can be reached and has to be corrected. It is this structure which is always pulling and causing her pain. To explain the matter better, the therapist shows her the distorted stitching at the outer layer of his trousers. He also explains to the patient that the thing, causing so much pain in her neck is something incarcerated/pinched. However, the cause of this isn’t somewhere to be found in the cervical spine and therefore can be reached from the surface.

The lady starts to cry during the treatment with the triggerband technique. The pain is getting severe. The therapist stays calm and assures her that there is nothing to feel embarrassed about, that everything is okay and her reaction quite normal. After he asked whether he should go on with the treatment, she nods and agrees while sobbing.

Subsequently the therapist treats the triggerbands in the...