It’s All About the Nail: Resolving the Underlying Source of Suffering
It’s Not About The Nail is a short film by Jason Headley that is widely embraced for its honest and relatable depiction of a couple trying to communicate. The video has gone viral with over 16 million views and continues to remain relevant. This is partially due to the fact that the video can serve as a parable for many other lessons. At A Healing Place – The Estates, this video helps explain what we believe to be the underlying source of suffering related to chronic pain, mental health problems, and addictive behaviors.
When the video begins, we see a woman opening up to her boyfriend about terrible sensations she has been experiencing, and it is apparent she is emotionally distressed. The boyfriend indicates what appears to be the obvious source of discomfort by pointing out the nail in her forehead. However, she makes it clear that whatever it is she is feeling, it is not about the nail.
While this makes for a comedic back and forth, we believe there are deeper issues at play here and so we ask the following questions.
- Why is it the woman ignoring the nail?
- Why does she react when her boyfriend points it out?
- Why does she continuing living with something that appears to cause her to suffer?
- What will it take for her to confront her physical and emotional pain?
There is something more here than meets the eye when it comes the the nail. There are underlying issues that have yet to be addressed which influence pain, suffering, and substance use disorders.
What is the Nail?
One common trend we have witnessed with chronic pain patients who have developed substance use disorders is a history of trauma. This trauma experienced earlier in life becomes further complicated by traumatic events that resulted in the chronic pain condition.
This multifaceted complex trauma – coupled with additional co-occurring disorders – are what make up the nail. The nail fuels our perception of pain, and often goes untreated due to stigma, shame, and denial.
The co-occurring disorders that often accompany chronic pain conditions, in addition to trauma, include depression, anxiety, PTSD, medication management issues, and sleep disorders. Genetics and family history are important factors that play a part as well. We have seen this to be true in the invisible illness community (ie. disorders such as Crohn’s, Lupus and Fibromyalgia), with first responders, veterans, and the workers compensation population, etc.
How the Nail Complicates Recovery
The nail complicates chronic pain recovery for a few reasons. Many times people don’t even recognize they have unresolved trauma. Many of those who grew out of their traumatic experiences feel as if that period of their life has passed and don’t want to bring it up again. The trauma, remaining buried, untreated and unprocessed, has the potential to become the nail in the forehead.
Denial is also a major roadblock in the recovery journey. This is the case with the woman in the video. When we show this video at conferences and seminars, our Chief Medical Officer, Dr. Joseph Cabaret always points out “If you can’t treat the trauma, you can’t treat the pain”. When people falsely believe their trauma is resolved, they can be resistant to recognizing there is a correlation with their pain, suffering, and substance use disorder.
Unfortunately, we have been conditioned by the medical community to look for biomedical (pharmaceutical) “fixes” while ignoring the psychological, social, and spiritual components of our suffering. If we get a cold, we can expect an over the counter medications to ward off symptoms that would otherwise force us to rest. But in reality, the cold medicine is merely masking symptoms while the cold runs its course. This works perfectly fine to manage a cold, but it becomes significantly more problematic for individuals using opioids to manage not only the bio-medical aspects of their chronic pain condition, but the psychological / emotional as well.
Similar to the cold medicine example, many chronic pain patients feel as if they can return to their prior levels of functioning because their pain symptoms have been subdued. Unfortunately, trying to return to prior levels of functioning, can put pain patients at risk for overexertion, pain flare ups, or reinjury. The desire to get their quality of life back perpetuates the continued use of opioids until the medication is no longer effective.
It’s All About the Nail – Continued Soon!
At A Healing Place – The Estates, we specialize in serving these complex chronic pain patients. We are bringing hope and healing to these individuals by treating the pain, trauma, and substance use disorders concurrently. Concurrent treatment, according to the American Society of Addiction Medicine (ASAM), this is the most effective way to guide a triple diagnosis patient to long term recovery. The ASAM Handbook on Pain and Addiction concludes that:
“Studies show that untreated or inadequately treated mental disorders can interfere with the effective treatment of addiction. The two disorders may have a seperate etiology, or one disorder may play a role in initiating the other. Typically, they become intertwined, thus complicating the treatment plan and process. Therefore, whenever a patient enters treatment for either an SUD [Substance Use Disorder] or mental disorder, especially in the presence of pain, he or she should be assessed for the presence of the other problem. Many patients with co-occurring disorders do well with simultaneous interventions for pain and psychiatric or substance use disorders.”
We understand the sensitive nature of discussing trauma as it pertains to chronic pain conditions, and we are here to help. Take the first step towards achieving freedom from suffering by contacting our staff for a free and confidential assessment.