People who live with pain are hungry. We are searching. We are invisible survivors. We are starkly seen. We are resilient. We are ghosts of our former selves. Our hearts ache to know relief. We are owl screeches at midnight. The plants in your garden know. They bend towards our bedroom windows. It is our job as herbalists to direct the call.

I started experiencing pain after being hit by a motorcycle when I was 15 years old. It was here that I understood what feeble help looked like. It was here, in the hospital alone, I learned how to let go of hope. As I write, I am coming to you as both practitioner and client; both healer and under served population. The most brilliant healers I know have experienced the conditions they now treat.

This is a call to action to dismantle the idea that healers must only be well in order to be worthwhile in our callings. I can not come to you any other way but merged.

As patients, we are told about our bodies. Our charts are our limitations. Doom in the doctor’s voice. As healers, we want to help and relieve. Work diligently to find relief-but don’t wait for it to work on the healers timeline. When do we ask for help?  What do we receive instead?

Think of a time where your health ruled your days. What was the emotional component to a sprained ankle or a bad case of the flu? Do you recall the last time you asked for help? What shade did your vulnerability take? Was there guilt or shame attached? Did you have to ask more than once? Was it exhausting or easy? When were you first let down and did it shape your future interactions when you are unwell? Let’s take this understanding and push through the confines of redefining strength. Apply this to your friends, comrades and clients with chronic illness, pain, and disabilities.

When we ask for your help, looking away is a political act.

There is no more averting your glance. When I use my cane, people comment on my age, how I walk with it, inquire as to what happened, talk about my body and my wellness. When I don’t, people forget that I am gritting my teeth. I skirt by with a sigh. I am not enough proof. Being seen in my pain on a daily basis is like the day of my accident, lying on the pavement, watching people getting out of their cars-and I am most worried that I stopped traffic, that I am late, that someone will be mad at me. They all stand around-and tell me not to move. My whole life-silenced in my body. My whole breath, hesitant on the exhale. I didn’t mean to-but it is my fault -that is the point of a word like “accident”. And yet, when do we decide that fault does not equal punishment.

A lot of my clients have normalized the discomfort and pain they are in. Often, they come for different health concerns. Told their pain is a life sentence, invalid, in their heads, hopeless, and misdiagnosed. My chronic pain clients ask for help, but they usually have a breadcrumb trail of attempts at pain management. Some have found a good combination and are looking for herbal alternatives. Most don’t believe they can feel better.

As herbalists we are allies. We are gardeners. We are listeners. We are realistic dreamers who believe in recovery. To believe in change is a radical act. Picture your body as a social movement. To create systemic change-we must have a multifaceted approach. Of course, I was taught to work with the root causes, looking for patterns of inflammation, keys to what exacerbates symptoms and decreases management. This approach also includes topical, internal, nutritional, supplemental, lifestyle changes and referrals. I have seen clients get the results they are looking for by a long term combination of the aforementioned. By additionally addressing the oppression, triggers, micro-aggressions and internalization that individual has faced, the relief goes further.  

What I have learned from living with pain, is that it is imperative to chart and measure progress. Setbacks feel like lifetimes of hurt. Tweaking formulas can feel like experimentation. It is important to instill in your client an understanding of why you are adjusting formulas. As chronic pain clients, doctors and practitioners often have a “throw something at you and see if it sticks” philosophy. Especially with pain that comes and goes, there is no diagnosis/ pattern to go along with it. If you have never experienced pain that is recurring, constant or debilitating, or made this the focus of your practice-please do not experiment on our bodies. We are the patients who know the waiting rooms by heart. I’ll show you the bathroom. It’s individualized or it’s doing the body a disservice.

Herbalists have the opportunity to meet someone where they are at. We must listen as quietly as the plants do. We must decide to counteract every medical interaction that person has had before us. Often, my clients thank me for the work we do together. I appreciate the thank you-but every healthcare provider should treat you with respect, dignity, and be your ally in your struggle for wellness. When someone asks you for help, it is your obligation to find that help for them. If it isn’t in your scope, then give them a referral.

There are herbs that are perfect for pain. All of their constituents combine to address conditions. Only nature could design such a formula. And yet, we stumble at accessing their uses. The western medical model has extracted constituents at hopes to maximize its efficacy. As if isolation has ever come to anything useful. Pain is often seen as temporary. As a person who suffers from chronic pain, I can tell you that fleeting or not, relief is rarely realized by those living in pain. Increasing quality of life is one of the main goals of the herbalist.

How bad does the pain get before we are seen? Being seen in our pain is sometimes worse. It’s not that I don’t feel like I have support around me-it’s that I have to accept that I need help and there is no consequence to showing that vulnerability. Time and time again I am let down by the people in my life who are waiting for me to get better.

Creosote Bush grows alone. It isolates itself and shines it’s yellow sticky flowers. We are not chaparral. We are gorgeously intertwined. Even cacti prick fingers and our blood turns red from oxygen created from the plant exchange.

I have laid in bed instead of going to protests, stayed home instead of lending my voice to forums, canceled meetings due to muscle spasms I couldn’t hide. You are building a movement without us-and we are too busy surviving to troubleshoot how we can show up more. Trust me when I say, we are showing up. Trust me when I say, your clients are complying.

The goal of the healer is not to fix the problem. The goal of living with a condition is not to be cured. It is to live each day accepting what the world does not accept and survive on our own terms. Pain isn’t about a sick-to-better straight line. It’s about believing that you can manage a life, relationships, hobbies/organizations, and work with the tinge of pain attached. The idea of the “supercrip” is alive and well in the herbalist community. As healers we are supposed to rise above our health conditions because of our knowledge of healing. As if knowing about endometriosis stops the estrogen dependent tissue from growing. It is not enough that herbal medicine offers an alternative, it is supposed to “cure us” so we can be the poster child for perseverance.

As radical herbalists, we must accept our challenges and erase the concept of the cure. I will not sell you a cure, I will offer something better. The ability to leave behind the narrative that you are not well.

Leaf scars bare the burden of last years growth. It’s texture provides so much history to the viewer. Let the scars of people with chronic pain and illness implore you into action. Do not wait until we have a crisis. We are a majority of people seeking answers from the western and alternative medical models alike; yelling for help in a hallway and waiting for the echo.

Here is what I have learned in my personal practice and from getting to know the plants. I am not including the multitude of fabulous information, but rather tips that have informed my practice that are less talked about in books and schooling. The best teachers are always and forever, the plants and a variety of experience.

Dosage: Part of what I have found in my practice is that dosing is key. It is hard to convey this to folks who normalize pain. Because discomfort does not always signal to them to do something about it. It is important to explain to your clients about dosage with pain herbs and that it is harder to chase pain then to prevent it.

Multi-faceted approach: Always look for ways of relief that are directly applied to the area and include both topical and internal applications. It is a lofty thing to ask a singular herb or formula to relieve pain that is years in the making.

We bring flowers to our friends as get well messages. Think of flower essences as bouquets of resiliency.  Keep in mind the individual, but here are some that I have seen serve as allies to my clients. Goldenrod (Solidago spp) instills a strong sense of self despite other’s (often offensive) opinions of you. Gentian (Gentiana spp) is the essence for when someone has a setback-and loses the ability to see all the progress they have made. Often this can happen as people progress in their conditions, and this essence provides perseverance perspective. Arnica ( Arnica montana) flower essence helps release where shock is held. When I add this to my pain potions I have noticed the response to the formula is well received. People say that they “think it’s working but don’t know how.” Daylily (Hemerocallis fulva) essence is for transitions and watching life’s processes unfold without building a narrative around limitations or obstacles. I’ve used it for many different scenarios and have found that it helps one remember to take their medicines. Purple Crocus (Crocus tomasinianus) flower essence assists in our resonance and release of the tension around pain and grief. These remedies are profound, yet subtle. Like waking up one morning and changing the bedsheets.

Daylily flower in it’s full glory on a hot summer June day.

Embodiment: For many people being present in our bodies is not always safe. Including survivors of sexual violence, trauma, body and gender dysphoria, misogyny, etc. It is best to ask inquisitive and respectful questions to get at the heart of what helps folks enter their bodies. I often ask what my clients like to do for recreational fun to let down. This differentiation is key. I find that Kava Kava (Piper mythesiticum) is excellent for those who are anxious when fully relaxed. Pedicularis (Pedicularis canadensis/grandlandica) or Wood betony (Stachys officinale) is great for those that have a hard time being present in their bodies because their nervous systems aren’t sure it is safe to do so. If someone doesn’t feel safe when feeling relaxed or heavy in their bodies-I don’t suggest giving them sedative or hypnotic herbs.  You can try a low dose of nervous system restoratives like Milky oats or Oat straw (Avena sativa). Chamomile (Matricaria chamamilla) and Catnip (Nepeta cataria) are excellent for someone who is worried and hesitant at the idea of being present. I have also had success with many clients using Rose (Rosa spp) herb and Rose flower essence for creating new neural pathways of safety in the body. It allows one to still feel protected as they open up. Vulnerability without full exposure.

Stachys betonica from our garden in full bloom.

Harm Reduction: In all the work we do, having a harm reduction approach is paramount. Trust that no one knows what is better for your client then your client. Whether it’s being on medications, practicing behaviors deemed harmful, or eating inflammatory foods-relief can be found and respect can be the foundation of your clinical practice.

Clinical Skills/Cultural Competency: Medicine comes in all different forms. For each client I ask, Where do you feel pain in your body? Where do you hold tension? When do you feel the least amount of pain. When you have felt relief-what was that like? Again, remove the language of “curing”. Talk to your clients about their own goals for their health. Talk about expectations. Instead of trying to meet your ideas for their wellness- help them achieve theirs. Often times, this is one of the more insightful intake questions. Expectations are always surprisingly low. I hold the hope for them even if they can’t pick it up.

Nutrition for bones and tissues can also tremendously shift recovery time. I highly promote bone broth and gelatin rich foods. Mineral rich teas and foods, as well, added throughout the day make a dent in how fast one recovers from injury or setbacks. Think outside the box of pain herbs and into the realm of what the tissues need to function optimally.

There is a concept called “spoons theory” that I have found useful in my practice. It is measuring one’s energy levels not by low/medium/high and instead by how many “spoons” of energy one has.  I have seen “Low spoons” nutrition and herbal suggestions increase quality of life for the client that experiences extreme fatigue or is having a hard time doing tasks for themselves. I highly suggest talking with your clients about where they are at and working up to where they want to be. This includes dosage, teas and meals. Compliance can be a goal you work towards without shame.

Pain scales, though can be useful, are often hard to gage. I’ve noticed that I need follow up questions, especially those living with chronic pain and illness, to understand what each number means to them. I think pain scales could be fleshed out to be more inclusive and accurate.

Pain potions and tinctures: The typical formulations consist of anodynes, anti-inflammatories, nervines, and nervous system relaxants. It is also important to consider the affinity for the body part that each herb has. The emotional response to pain is key in finding your plant profile. In my practice I have seen Skullcap (Scutellaria lateriflora) work well for those that describe themselves as “sensitive” or “jumpy”. They may describe the sensation as uncomfortable when someone touches them. Sometimes associated with those that don’t hug in a greeting. (There is also nothing wrong with not wanting to hug! Gotta earn the trust, folks.). I have also seen Black Cohosh (Cimicifuga racemosa) work well for those with Fibromyalgia. I can attest to the Matthew Wood profile picture of Black Cohosh having an affinity for the spine. However, I would add that I have seen it be a key player in those exhausted by pain and feel a general dull ache or fatigue in their bodies. Jamaican Dogwood (Piscidia piscipula/erythrina) seems to kick my pain formulas into high gear. And I hardly ever leave out California Poppy if I have it on hand for chronic musculoskeletal pain. Pain management is the art of asking for help. Every tincture drop is a prayer. I believe this is an area where formulation really shines.

One of my focuses has been on pelvic pain, since my pain stems from multiple fractures in my pelvis. I can attest in my body as well as many clients to the eclectic herbalist’s triad of White peony (Paeonia lactiflora), Licorice (Glycyrrhiza glabra) and Damiana (Turnera difusa) for pelvic pain. When I leave one out (if an herb is contra-indicated) I find this trio to be crucial in driving the formula where I want it to go. Damiana as a pain herb has been a tried and true addition. It allows one to feel present and possibly experience relaxation or moments of joy in their body without sedation. The emotional aspect of stagnancy is addressed through Damiana and it’s personality to assist in providing perspective. Black Birch (Betula lenta) is used in Appalachia as a main anti-inflammatory. My good friend and compassionate herbalist, Janet Kent of Medicine County Herbs, explained to me that Black Birch is used in our woods to help wash the grief off of you. I use it in my practice for both ritual baths for grief and for pain after traumatic events.

After acute injury I have been adding grounding herbs into my formulas to help the body remember which direction to go during a crisis. One special herb I use is Appalachian Osha (Ligusticum canadensis), which the late and powerful herbalist Frank Cook taught me, helps to bring on courage. It can also be useful for bringing on circulation if illness or pain is aggravated by stagnation.

Salves are excellent for topical application, but they need to be applied often. Sometimes, it is a large surface area. Over time this can cause acne if the skin isn’t breathing properly. Lighter carrier oils such as Jojoba or Almond can be used instead of the heavier oils such as olive if this starts to happen over time. I have also had success with clients using medicinal patches instead of salves when there needs to be constant application to provide stamina in the relief.

Some of the pain salve I have in my apothecary, just poured, before it hardened.

Ask your client to dream big with you. Believe in the work together. Explain why you trust in the herb’s ability to help.

The goal of health is not to always be healthy. The role of the healer is not to be able bodied, able minded, and uphold a young/white/wealthy/thin beauty standard. Not all bodies are this-and healthy comes in many states. Practice this knowledge in the expectations of your clients and yourself. Dig deeper.

What does a healthy body look like in America? The more we are asked to live up to that standard of wellness the more we poison ourselves with the toxicity of the oppression of those that came before us. I am a witch. I am casting a spell. The string attached to your throat, weaved by your oppressor has been cut. What will you do with your voice, your body, your legacy of violence? Which plant do you take with you on the journey into your own liberation? Which plant resembles an egg? Crack it- live. Learn yourself. Your own body and how it works. Ask questions to see how you are similar or unique to the ones you love? Measure yourself up to your own well of energy. It is a thimble. It is a well. It is a tea cup sweating in Sunday morning light. It gets cold, it gets empty.

I am not a fool. I am a strong willed professional who is trying to stand beside my clients. Comrade to Comrade. Shoulder to Shoulder. In defiant unrest at their discomfort. The plants are angry with us. Even as depleted soil, it nourishes us. Even as broken leaves decay,they create a soft spot to sit. Come, create space with us. In your body; home. In the earth; home. In the struggle; home.

We are a kettle boiling. We are those that use healthcare on a regular basis. The doctors tell us to relax, that we have a lot of work to do. But you can’t stop the rise from the bottom of the kettle to the whistle.

Harvesting is an able-bodied sport. Walk to the higher elevation, bend over and dig deep, pull up, cut, blend, wash, stand, peel, collapse. I missed the peach blossom, missed the honeysuckle, the osha and pine. Laying in bed, staring at the wall looking at the trees outside my window. I can’t do it anymore; I can’t wait to feel better. The seasons are calling and it breaks my heart. Anti-inflammatories and anodynes are not enough.

As an herbalist with a disability I am constantly trying to prove myself and my legitimacy. In the confines of the “wellness” world-people want their herbalist to always be humbly shining with the secret to health. I am asking for a dismantling of the ways our herbalist culture creates space. The amount of conferences I can’t go to because the buildings are spread too far apart, the affordable lodging is camping, because the seating is hardback chairs or the floor. As herbalists we know pain is a distraction. It takes us out of the present and we aren’t able to focus. The herbalism academia world is in misalignment with accessibility. I know we can do better.  If we are able to model to our clients that wellness is not a constant state-then disability justice needs to be at the forefront of the practice.

Our country is fatigued with no one to stop us from working ourselves into the ground but ourselves. And we are too in the grind to notice. We are shaming our needs, shaming the people in our community who need things, and shaming our culture for handing us the rotten deal. What I am asking for is shame resilience. What I am asking for is resistance.

As herbalists we know this. We know how to embrace the soft elegance of a crocus in spring. Sturdy and delicate all the same. It’s personality is different than the trillium. Trillium begs to be noticed-it brings you over for an interaction. Trillium is a storyteller. Crocus is a flirt. If a leaf is broken, the constituents do not change. We must not honor that plant less. Tell me; can we not still connect and learn from the millions of plant species in our areas? Tell me; do we want them all to be pristine. Tell me; do you want all flowers to be lady slipper? You do the plant kingdom a disservice.

We dry plants with certain conditions. Strip the leaves from a woody stem. Extract the constituents with certain proof alcohol. We add specific weight to volume. Or, perhaps we hear the plants speaking to us. They say add more water. They say my leaves are bruised. They say use me anyway or let me be.

That is what the bouquet asks of us on its last day on the kitchen table.

That is what your lover asks on their fifth sick day.

Do not turn away. Don’t make me ask for help from a world who wants me to need less.

As allies to the radical concept of wellness, we must not only make our spaces accessible. We must find a way to let the healer need healing without shame. And fight alongside the person struggling with chronic pain.

The revolution will not be with us begging on our swollen knees for help. It will be with the herbs in our baskets, the mending of our hearts, and the salves on our scars. The revolution will be in those of us who are told we are broken believing wholeheartedly that the goal is not in our fixing. It is in the healer undoing systemic oppression and experimentation by listening to the unique story of our clients. It’s in modeling self care and acceptance as radical healers. Don’t stop until relief is a tangible sword you wield.

Don’t stop. Don’t turn away. Thrive. Speak. Stay.

Resources and concepts mentioned in article:

The spoon theory: http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/

The “supercrip” stereotype:

https://bitchmedia.org/post/the-transcontinental-disability-choir-disability-archetypes-supercrip

Harm reduction for survivors:

http://eminism.org/readings/harmreduction.html

Shame resilience

https://www.ted.com/talks/brene_brown_listening_to_shame?language=en