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PAIN: A Musical Experience - A Synopsis of Bahram Jam’s New Musical
By: Bahram Jam, MPhty, BScPT, Cred. MDT, FCAM; Editor: Maggie Bergeron, co-founder of Embodia ∙ Estimated reading time: 5 minutes

What’s our problem?

Modern society is in conflict with millions of years of pain evolution. 

Our ancestors were motivated by pain to make behavioral changes in order to reduce exposure to harmful stimuli or events. 

However today, individuals in modern society have the option to bypass behavioral changes that often involve significant effort and lifestyle changes; after all why not?  

Pain can simply be defeated via medications or other passive interventions in the hopes of a "quick fix".

Embodia Instagram meme about pain


There are two extremes in how modern society manages pain that may be contributing to the maintenance of its persistence. On one extreme, sometimes behavioural changes such as adequate rest are ignored where people have the mentality to just ignore pain or numb the pain and just keep pushing through. This stoic approach can be counter-productive to optimal healing and may even backfire and contribute to the persistence of pain.

On the other extreme, sometimes the primary behavioural change utilized to deal with pain is rest and avoidance, which is maintained by fear. The dependence on dulling pain through fear avoidance, or through various therapies and/or medications can offer relief in the short-term, but may once again backfire.

Both extremes, either the fearless dismissal or the excessive fear of pain can be contributing factors to the persistence of pain.

Billions and billions of dollars are spent annually by those desperately seeking relief from pain. Sadly, despite the continual rise in healthcare expenditure on its management, the prevalence of this condition labelled “chronic pain” is also on the rise. What is going on?

The truth is, the answer is complex and multi-factorial, and certainly to date, no magic solution seems to exist.

 

In my personal experience

During my 30 years of practice as a physiotherapist, I truly did my best to help my patients who were dealing with persistent pain. I attended conferences and courses; I read countless books and articles on chronic pain. I felt like I wanted to do more. So I thought of a crazy and preposterous idea to write a musical, a musical on pain.

Over a year ago I started my journey of writing and creating this theatrical production. It is a story about PAIN; specifically persistent pain. PAIN in the body that simply does not go away no matter how hard one tries and irrespective of how many doctors and therapists are consulted.

 

Pain: A Musical Experience

Pain: A Musical Experience by Bahram Jam


I’ve named the show
PAIN: A Musical Experience,  where the theme is that PAIN is understandably not desirable, but essential for health and well-being. Instead of reflexively attempting to either ignore it or fight it in order to eliminate it, it is wiser to go in with the mindset of helping PAIN through compassionate communication and asking PAIN exactly what it is trying to say. 

In the theatrical production, I imagine PAIN being an abstract character and the narrator of the show who goes back and forth speaking to the audience and the other performers on stage. The actors and performers will be individuals with real-life experiences of pain and disability.

PAIN has a sister, PLEASURE, and her secret weapon is dopamine. Dopamine is what motivates us to do anything potentially pleasurable. If dopamine was absent, we would do nothing, at least nothing pleasurable. Without dopamine, our incentive to do anything potentially enjoyable switches from anticipating PLEASURE to escaping or avoiding PAIN.

We all have only 2 goals in life; to either escape PAIN or to move towards PLEASURE. This makes sense except for the fact that the relationship between PAIN & PLEASURE is complex and intertwined.

PAIN is envious of PLEASURE. PAIN certainly understands why people try to escape it and wish to move towards PLEASURE, but PAIN feels underappreciated when in fact it is even more vital for health and survival than PLEASURE.

PAIN has only one option when it feels unheard or unaccepted. Every attempt that is made to frantically escape it, it persists or becomes even louder.

If one is moving towards a perceived PLEASURE with the conscious or subconscious intention of escaping PAIN, the PLEASURE experienced is eventually converted to PAIN.

If one frequently focuses on escaping PAIN, the nervous system senses it in danger and remains in a constant state of fight or flight, which only magnifies PAIN.

The story in the musical is about four frustrated individuals dealing with their years of persistent disabling pain. They all understandably have a strong hatred towards PAIN and have desperately come up with their own futile methods of escaping PAIN.

Through emotionally charged conversations, PAIN attempts to convince the four individuals that PAIN is simply a messenger and that it means no harm, and that it always has a purpose to help; it is not an enemy but an ally.

PAIN explains how fear and the constant battle to obliterate it are only increasing the suffering associated with PAIN.

 

Treating PAIN is a bad way to cure PAIN

Even if the pain persists for a while, life is better knowing that despite PAIN, PLEASURE can still be experienced, but that requires a change in mindset and a change in one’s relationship with PAIN.

Some say, “Only once the PAIN is gone, will I be able to experience PLEASURE.”

That is similar to saying, “I cannot learn French unless I forget to speak English.”

It is similar to sitting in front of a fireplace and saying, “Give me heat and then I’ll throw in some wood.”

The truth is that kind of thinking backfires for those experiencing persistent pain.

If the focus is only on escaping PAIN, and not the intentional pursuit of PLEASURE, the dopamine system cannot be stimulated.


Positively altering our relationship with PAIN will inevitably positively alter our relationship with OURSELVES, as PAIN is always and only within us.

PAIN is inevitable and an inseparable part of us, so our relationship with it matters.

 

I would be grateful if you supported or just learned more about PAIN: A Musical Experience

In the name of love, Bahram Jam, PT

Sign up for the free course to learn more about
opioids, chronic pain, and Bahram's musical!

 

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Written: 5 April 2023
Last update: 16 July 2024

Bahram Jam (he/him)
PT, D.SC.PT, M.PHTY, B.SC.PT, FCAMT

Bahram is a physiotherapist and founder of the Advanced Physical Therapy Education Institute (APTEI). He's taught 1000+ continuing education courses to healthcare professionals across Canada & internationally.

He has instructed over one thousand post-graduate orthopaedic and pain science courses and has been a guest presenter at several physiotherapy and medical conferences across Canada and internationally.

His primary clinical approach is to identify relevant functional impairments and determine the best self-management strategy to maximize patient independence.

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