Chronic pain is an epidemic. The Institute of Medicine of The National Academies estimates that 100 million American adults live with chronic pain, yet there are few effective treatments. Doctors only receive about nine hours of education focused on chronic pain management during the course of medical school, and The National Institute of Health (NIH) spends only about 1% of their budget on researching chronic pain. Judy Foreman, a highly respected medical journalist for many years before she developed chronic pain, recently wrote a book “A Nation in Pain: Healing our Biggest Health Problem,” about how little doctors know and understand chronic pain and how it works.
Living in constant pain is both physically and mentally exhausting. With the lack of understanding by both the medical and non-medical community it can be very frustrating, isolating, lonely, etc. Pain cannot be seen and too often people are told the pain is in their head or that they are exaggerating it. Chronic pain does cause permanent changes to the brain and living with chronic pain can cause depression, which as its own set of possible physical symptoms. Though some people with chronic pain are also depressed does not mean there isn’t something physical going that needs to be addressed.
Fortunately, my experiences with depression did not last long though I was diagnosed with PTSD for a short time following an accident. I have gone through periods where I have felt sad, down, lonely and isolated, but with the exceptions of a few brief periods never lost hope that my situation would improve. There are many people in far worse situations than I am. For example, I have been blessed with the world’s best support system. I cannot imagine living with and treating my chronic pain alone and without support. I am also fortunate that I have always been positive and optimistic. Though it is possible for core traits to be buried by your situation and life experiences, I believe that if you are fundamentally positive and optimistic, there is always a way to tap into those core traits.
I met Karen Jones through Lori, my friend and Urban Zen (UZ) teacher. From the first moment we met, Karen and I connected, and I knew we would play a significant role in each other’s lives. I continued to work with my therapist and to focus on UZ, an integrated therapy that works in conjunction with western medicine. UZ uses a combination of reiki, aromatherapy, mindfulness and nutrition to treat the WHOLE person not just the disease. Even though I saw no medical improvement or decrease in pain, the work was starting to pay off, and I started to notice changes in myself. I was becoming more comfortable in my own skin (something with which I have always struggled), and I felt like I was discovering who I was at my core. Most importantly, I was learning to take back control, as much as possible.
I was making great progress in getting out more and meeting new people, but I still felt like something in my life was missing. The only thing I could think of at the time was that my pain level was still so high. Karen and I met in person for the first time at a coffee shop near me. I was filling her in on “my story,” when she asked if I had ever done Laughter Yoga (LY) before. At first, I thought she was joking but quickly realized that she was not. Karen briefly explained Laughter Yoga, and gave me contact information for Meg Scott, who teaches LY. She happened to have a LY leader-training course coming up, and I decided to give it a try.
Dr. Madan Kataria started Laughter Yoga in India in1995. In doing research to write a medical journal article about “laughter as the best medicine,” Dr. Kataria found many scientific studies on laughter and its health benefits. He was so inspired by what he learned that he decided to start a laughter club. He discovered that our bodies could not tell the difference between real laughter and faked laughter; the same endorphins were released either way. He thought back to his amateur theater days and remembered some role-playing and improvisation activities he thought could be adapted to help people tap into the “inner 5yr old” we all have in us.
Dr. Kataria’s wife, Madhuri, taught yoga and quickly saw similarities between laughing and Pranayama, a type of yoga that translates to “extension of the breath” or “life force”6.This yoga practice focuses on controlling the breath, breathing out all of the “stale air” and filling our lungs with fresh air. She incorporated elements from Pranayama yoga with Dr. Kataria’s laughter activities, and LY was born.
When I wheeled into class on the first day of LY training, I was nervous and had no idea what to expect. I knew that there was movement involved in laughter yoga, and I was not sure what I would be able to do. Looking back, I also realize I was still adjusting to my loss of mobility. If you had asked me at the time, I would have said being in the wheelchair didn’t bother me, as it was only temporary. I realize now that I was still very uncomfortable with the idea of using a wheelchair. When I was with people I didn’t know well or was in a new environment, I would get anxious.
Going from being able bodied and very independent to being on four wheels, unable to go beyond a couple blocks without help, was difficult. With my parents both in politics, we attend a numerous variety of events. I always wore a smile and pretended as if everything was fine, even though I was very uncomfortable and anxious.
If being in a wheelchair is not hard enough, due to the CRPS my legs and feet are extremely hypersensitive and I had to keep my legs elevated all the time. It made me feel as if I was taking up so much physical space and was always in the way. When people would talk to me, I could see how uncomfortable they were. They would not know where to stand and whether they should squat or kneel beside me. Often, they would end up standing at the bottom of my feet talking to me. Being an affectionate person, I didn’t realize at first that their standing at that greater distance made me even more uncomfortable.
There were ten people in my LY class, who, on the surface, appeared, very different from one another. They ranged in age from 26 to the mid-70’s, and were from all over Ohio and out-of-state, as far as Minneapolis. Our backgrounds and careers were also very different from one another. Despite these clear differences when I entered the room, I knew another puzzle piece would soon be put in place.
We started the training by taking turns introducing ourselves and stating why we were there. When it was my turn, I said my name and briefly explained that laughter had helped me through a lot of hard times and that I knew it was special that my family and I still laughed together, but wanted to learn how to do more. I let my classmates know that my legs and feet were extremely hypersensitive and could not be touched and that my upper body for the most part was fine and could be touched. I was asked two questions: 1) was it ok to hug me, to which I quickly responded, yes, absolutely, and 2) was it okay for others to move me in my chair while doing exercises, to which I also said yes, thanking them for asking. I am sure I am not alone in the experience of having someone come up from behind and who just starts moving or repositioning me before saying anything. The immediate sense of vulnerability is frightening. That ended talk about my chair, and for the rest of the training, it was as if my wheelchair didn't exist or even better in some ways realizing I had some advantages.
LY consists of four basic components: gentle stretching, rhythmic clapping, deep breathing and lots of laughing. Many of the exercises seemed silly, and at first, and like many people I faked my laughter initially, but it was not long before the laughter was real. One of my favorite exercises was laughter meditation, where we laid in a circle with our heads all facing the center. I was in my chair, facing in the same direction as everyone else. We were told to relax, breath and get any last laughs out of our systems. Depending on the group, its’ energy and other variables this can last from less than a minuet, to in as in our case, until we were stopped to move on.
Nothing was going on, we all just laying quietly with the lights down relaxing. It didn’t take long before, someone would start laughing, and before long, we were all laughing uncontrollably. It was amazing.
Because this was a training to learn how to become a LY leader, we all took turns leading parts of a session. It was incredible to watch everyone grow, become more open and confident.
By the end of the second day, we had bonded and made some real connections with each other. It was also clear that something else inside me had shifted. I don’t if it was the immediate acceptance my wheelchair and me or due to the laughter itself, but for two days I nearly forgot I was in a wheelchair. Laughter has always been a big part of my life, but this was different. My pain had not diminished, yet I somehow felt lighter, more free and energized.
It was at this point things started to really click into place for me. Knowing wheelchairs make a lot of people uncomfortable I realized that if I were truly comfortable in my chair, I could put other people at ease. When people would come to talk to me and stand at my feet, I would rotate myself to put them closer to my side. If it would be more than a quick hello, I would ask them to sit down next to me. I had no idea small things like these would make such a big difference.
I am fortunate to have always been optimistic and positive, but it took the laughter yoga training in combination with urban zen and a lot of hard work with my therapist, to learn that I could both be in a very high level of pain and happy at the same time - these feelings were not mutually exclusive.
I was also right about Karen and I playing a large role in each other lives. She is also a certified LY leader and we have become laughter buddies we talk several times a week to laugh for five to ten minutes. Every time we get off the phone, I am still surprised at how much better and lighter I feel.
As my journey continues, I continue to discover more about myself. I learn new ways to cope with pain, the loss of mobility, and how to manage all that comes with a chronic medical condition. Of course, I would be thrilled if my doctors could figure out a way to control my pain and restore my ability to walk but for now spend my energy focused on the UZ and LY which have become an important parts of my life. I also feel that with the work I have done with my therapist, UZ and LY have provided me the tools and inner resources I need to live my best life, regardless of my “medical status.” I am back in the driver’s seat.
 Gaskin, Darrell J., PhD, and Patrick Richard, PhD. "Economic Costs of Pain in the US." The Economic Costs of Pain in the United States. Http://www.ncbi.nlm.nih.gov, 2011. Web. 18 Oct. 2014. <http://www.ncbi.nlm.nih.gov/books/NBK92521/>.
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 "Brief History Of Laughter Yoga & How It Originated." Brief History Of Laughter Yoga & How It Originated. Laughteryoga.org, 2010. Web. 02 Nov. 2014. <http://www.laughteryoga.org/english/laughteryoga/details/97>.
 Kataria, Madhuri. "RARE! Madhuri Kataria Talks About Laughter Yoga." YouTube. YouTube, 29 Mar. 2010. Web. 02 Nov. 2014. <https://www.youtube.com/watch?v=57N5MChkeBg>.
 " Pranayama." Pranayama, Yoga Breathing, Pranayama Types. Yogapoint.com, 2013. Web. 02 Nov. 2014. <http://www.yogapoint.com/info/pranayama.htm>.
mobileWOMEN.org contributor, Daryn Brown, has learned to live with and manage Complex Regional Pain Syndrome (CRPS) for about 18 years. During most of these years, she lived and worked successfully in NYC as a Theater Stage Manager. Nearly five years ago, Daryn's CRPS worsened considerably and spread to her legs after a car struck and knocked her down while she walked in a crosswalk. Despite extensive and continuing medical attention, her intense and continuous pain has not lessened, and she uses a wheelchair. Daryn was introduced to Urban Zen and Laughter Yoga about a year ago and has since become a certified laughter yoga leader. Since using these practices Daryn has been able to return to work part time, getting back into theater where her passion lies and is getting ready to move into her own apartment making another step toward being more independent.