הפסיכולוגיה שמאחורי הכאב

הגענו לפוסט השלישי בסדרת הפוסטים הסוקרים את השיטה שבה אני עובד – ביו-נוירו-פסיכולגי. לאחר שלמדנו על המרכיב הפיזי, ועל המרכיב הקוגנטיבי, כעת נלמד על המרכיב הנפשי.

הכלל הגדול שעומד ביסוד הדברים הוא שהרכבת נוסעת לשני הכיוונים.

בעולם המערבי ההנחה הרווחת היא: "בגלל שיש לי כאבי גב נוראיים, ואני לא יכול לעבוד תקופה ארוכה, וזה פוגע לי בפרנסה, וגם ביחסים עם אשתי ומכניס אותי למתח גדול, התפתח אצלי גם דכאון, ונדודי שינה..".

זו כמובן אפשרות אמתית, אך הרכבת כאמור נוסעת גם לכיוון השני.

לעתים קרובות המתח הנפשי עומד ביסוד הבעיה הפיזית, וכאן צריך לזכור – לא מדובר בהכרח במתח נפשי בהקשר שלילי. אחד הדברים שאני שומע ממטופלים לעתים תכופות ביותר הוא: "אני צריך תור דחוף כי יש לי כאבים חזקים בברך, ובעוד כמה ימים אני מחתן את הבן הבכור, ואיך אעמוד תחת החופה, שלא לדבר על הריקודים…?" גם כאשר המתח הוא סביב דברים שהם בסך הכל חיוביים ומשמחים – הגוף עשוי להגיב להם.

הבוס מלחיץ אותך?

ישנם מצבים שבהם האדם מודע לחלוטין למתח שבו הוא שרוי; קשיי פרנסה, בניית בית, גירושין וכדומה. אבל במקרים רבים המתח אינו קשור למשהו ספציפי.

קחו לדוגמא מצב בו הגב שלי תפוס. יתכן שהוא נתפס בגלל שהרמתי מקרר גדול, ויתכן שהוא נתפס כי ישבתי 10 שעות ברצף.. עומס יכול להיות גדול מאוד לזמן קצר, או קטן ולזמן ממושך והתוצאות יהיו דומות מאוד.

כך גם בנפש. מספיק שיש לי בוס בעבודה שלא נוח לי במחיצתו, ואי הנוחות הזו היא יומיומית, התוצאה לאורך זמן עלולה להיות מאוד דומה למתח שנוצר בעקבות ארוע טראומטי במיוחד.

ועוד עניין חשוב – כאשר בכל זאת מדובר במתח נפשי כתוצאה מחוויה קשה במיוחד, על פי רוב הגוף 'יתפרק' לאחר שהמצב יחלוף. בתקופת הארוע הקשה בדרך כלל הגוף לא יראה סימני משבר, ממש כשם שחייל באמצע קרב לא ירגיש כאבי ברכיים.

אז מה עושים?

השלב הראשון הוא להכיר בעובדה הזו. למטופלים רבים לא נוח להיכנס לנושא הזה מכל מיני סיבות מובנות. הרבה יותר קל להתמודד עם כאב צוואר (אפילו חמור מאוד), מאשר עם בעיה רצינית הקשורה לבת המתבגרת למשל…

השלב השני הוא לפתח הבדלה ברורה בין המצוקה הנפשית שלי לבין המהות העצמית שלי. בעיה אובייקטיבית, קשה ככל שתהיה, יכולה לגרום למצוקה נפשית רק אם אני מרגיש שהיא חלק בלתי נפרד מהישות שלי, ולכן היא מהווה איום קיומי עבורי.

השלב השלישי יהיה המתקת הבעיה. רק לאחר שנעבור בע"ה בשלום את שני השלבים הראשונים, ניתן יהיה לזהות את הפוטנציאל הגדול הטמון בבעיה עצמה, ואיך היא עשויה להוות מנוף גדול לצמיחה מחודשת.

במאמר הבא אסקור בקצרה את יחסי הגומלין בין שלושת המרכיבים הללו: גוף – מוח – נפש.

ועד אז שיהיה לכולנו חורף בריא ושמח

עמית

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