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It's generally not ideal when you notice your client's eyes welling up with tears. "How could I have so grossly underestimated the pressure I was using?" I thought. Just as I was about to inquire about her experience, her expression hardened. "I knew it," she stated with authority. "Wait, what?" I thought. She was clearly having a very powerful personal experience, and I didn't have the foggiest clue what it was about. This client, I'll call her Mrs. M., was referred to me by her physician, where she was also a new patient. During her intake, she described her long odyssey with aching pain in her left lower ribs. "This started three years ago, and there isn't an accident or injury that explains it," she said. "It started as a mild discomfort that happened occasionally, but then the intensity and frequency slowly started increasing. Over time, it had an increasingly negative effect on my daily life. The pain is generally dull but can spike at random occasions. It's never completely debilitating, but it never goes away either. I shouldn't complain too much, but the constancy of this pain just wears me down." "Pain can be incredibly draining," I said. "Is there anything that makes it better or worse?" "It can be so random," she replied. "The dull ache is pretty much constant, but activities like vacuuming the carpet are a no-no. Sleeping on my left side isn't great either. Actually, any activity that gets my heart rate up can trigger an episode of pain." I think she saw my eyebrows raise for a second, and then responded. "I know what you are thinking, and my doctors were all over the idea that this was a heart issue," she said. "I've had just about every cardiac test you can imagine, and they all came back negative. Next, they thought it was my gall bladder, then possibly the pancreas, and then a long list of other possibilities. The good news is that I have had the full organ recital and my internal organs are doing just fine. The bad news is that I still have the same pain, and no one has been able to figure this out. It's incredibly frustrating." 84 m a s s a g e & b o d y wo r k n ove m b e r/d e ce m b e r 2 0 2 2 essential skills | TABLE LESSONS The Road to Healing Often Starts with Validation By Douglas Nelson

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