Are you a creative person who suffers from headaches or migraine? Have you ever suspected that emotional factors or stress were contributing to the problem? Do you sometimes wonder if counselling or therapy could help?
Well, counselling or psychotherapy may be able to help to reduce the frequency of your attacks. It is possible, however, that your headaches/migraines may persist despite counselling or psychotherapy (even though therapy is likely to be helpful in other ways)
So… no miracle cure, but there’s definitely some hope!
Everyone who suffers from headaches or migraine will have their own unique pattern of causes and triggers. This is usually a complex mixture of genetics, physical triggers (such as foods, smells, hormonal patterns, or weather conditions), and emotional triggers (such as stress, anxiety, held-in feelings, or unprocessed grief).
Here’s the story of a fictional client, a musician called Nadia*. Emotional triggers played a big part in Nadia’s migraine patterns, and therapy turned out to be particularly helpful for her.
Nadia came for therapy feeling exhausted and depressed. Her migraine attacks and headaches had been getting increasingly frequent, and she felt sure that it was because she often felt so “wound-up” inside.
First, I checked whether she had visited her GP about this (she had) and I suggested she might return there, to discuss trying a different preventive medication.
I also asked Nadia what she knew about migraine prevention, triggers, and management, and I encouraged her to visit websites such as www.migraine.org.uk which provide useful advice.
Discovering the wisdom inside
I was interested to learn more about Nadia’s “wound-up” feeling. I asked her if she could try and show me using the art materials.
‘I’d like to’ she said, doubtfully, ‘but I don’t know if I’ll be able to come up with anything’. I reassured Nadia that no response would be ‘bad’ or ‘wrong’ – I had no ‘correct answer’ in my mind, just an attitude of wanting to help Nadia discover the wisdom that was already inside her. As a musician, Nadia didn’t feel confident about her ability to use the visual arts, but she agreed to give it a try.
Nadia quickly drew some black swirly lines on a sheet of paper. We looked at this together and then she frowned and said, ‘that’s not quite it’. She didn’t know why, but she just had an urge to add in some pale blue squares. The squares looked as though they were being tossed around in the black squiggles. ‘It’s strange’ she said, ‘but this is kind of how it feels’.
’See if you can get in touch with your image, from deep inside yourself’ I suggested, ‘as if it’s your tummy or heart that’s connecting with these swirls and squares and colours.’
Nadia was quietly reflective for a few moments. Then she looked up, animated.
‘I know what the blue squares are now! They’re windows through to something calmer – but I can’t see clearly through them because of all this churned-up black swirly stuff.’
Nadia added some red v-shapes. This time she knew exactly what they represented: ‘all the critical comments’. Nadia explained that others made critical remarks when she had to take time off from work or family events because she was incapacitated by migraine. Through talking about this in the session, Nadia found she could think more clearly about communication and relationship strategies she could try.
The next week Nadia came to her session feeling more hopeful.
‘I’ve been thinking all week about that image I drew’ she told me. ‘I think I was starting to show you something that I’ve not shown anyone before… it felt like such a relief to be able to really describe what I go through’.
We got the drawing out, and Nadia spoke movingly about the pain that she suffered. This included
- the physical pain of migraine
- the pain of never feeling able to make plans, because of the unpredictability of migraine attacks
- the pain of feeling guilty for letting workmates down
- and also the pain of other people’s reactions to her being unwell
We talked about Nadia’s wound-up feeling again, and I asked her to give me an example. ‘Just this morning’ she said. ‘My brother called and got mad at me about something. I just felt really confused and wound-up — and then this headache started. I’m so stupid – why do I let myself get so upset by things?’
I gently pointed out that Nadia’s ‘I’m so stupid’ attitude was making her pain even worse than it needed to be. In therapy, part of our work would be to help Nadia find a deep, healing compassion for herself.
Another aspect of our work would be to gradually help Nadia sort out and identify her feelings and thoughts so that she would become better equipped to deal with difficult interactions (such as the conversation with her brother) as they occurred.
How therapy helped reduce migraine frequency
Over subsequent sessions, Nadia became increasingly able to get in touch with her inner ‘knowing’ about her problems. She discovered what needed to happen, and how to help it happen. Her new understandings allowed her to make small, subtle shifts in her attitudes and behaviours that actually had quite a marked effect on how she felt inside.
Over time, Nadia learned to manage her ‘wound-up’ feelings much more effectively. She learned how to express her emotions safely and straightforwardly; and rather than continually feeling overwhelmed by confusing feelings, she gained a new perspective and overview of what was going on in her life. Because feeling wound-up was Nadia’s biggest migraine trigger, reducing this meant that she suffered migraines less often.
Expressing and sharing the pain of migraine
Occasionally Nadia would have a migraine when she came to a session, and she reported a deep sense of relief in simply being able to express honestly and with deep emotion how it felt to be in such pain. ‘I’ve never ‘said it like it is’ to anyone before – not really. That made me feel so isolated’ she told me.
Even though I couldn’t take away Nadia’s physical pain in that moment, she felt the pain was lessened a little by being shared.
By the end of treatment, Nadia’s migraines were less frequent, and she was feeling much better generally. ‘I’m so much calmer’ she told me. ‘I now know how to recognise the very beginnings of the ‘wound-up’ feeling, and to use it as a signal to listen to myself. In therapy I’ve learned safe ways to express my feelings and needs, and I feel much more accepting of myself in lots of ways. I’d recommend it to anyone!’
Nadia even found a way to incorporate her musical skills in headache prevention. ‘There’s a certain chord I’ve identified’ she told me one day, ‘and whenever I get the wound-up feeling I connect with that chord and somehow it just puts me in touch with myself in a very vivid way’.
If you suffer with headaches or migraine, and you have a sense that perhaps there’s an emotional component to it, it may be well worth finding a counsellor or therapist – particularly if they have experience of working with headache and migraine sufferers. Always have a health check with your doctor, too, both to rule out an underlying serious condition, and also to discuss whether preventive medications could be helpful for you. And make sure that you are well-informed about lifestyle changes you could make which would reduce your attacks, through visiting websites and associations aimed at helping sufferers. Good luck!
*I have invented ‘Nadia’ and she is not based on any one person.