11/05/2017 12:24 BST | Updated 11/05/2017 12:24 BST

On Pain, Mental Health, Opioid Addiction, Spirituality And Kung Fu

A few weeks ago, Crystal and I, with many other students, joined the grading to our next level of Kung Fu training. Kung Fu grading is a stressful business, and it is difficult for everybody. But for Crystal, it should have been impossible. Or at least so it seemed, last year.

It is Mental Health Awareness Week, and I want to discuss how personal development through continuous efforts over months and years can improve mental health. No, I am not talking about psychotherapy, although everything I say here equally applies to psychotherapy. I am talking about Kung Fu.

A few weeks ago, Crystal and I, with many other students, joined the grading to our next level of Kung Fu training. Kung Fu grading is a stressful business, and it is difficult for everybody. But for Crystal, it should have been impossible. Or at least so it seemed, last year.

Because Crystal is featured in an episode of the 2016 BBC Programme The Doctor Who Gave Up Drugs, dedicated to the excessive use of medications for pain in our society. At that time, Crystal was taking 30-40 painkiller pills a day: opiates, anti-inflammatory drugs, and drugs to counteract the side effects of the opiates. Her chronic pain was so bad that she would constantly be hunched over, or she would lie in bed on her back. Crystal's difficulties were primarily with physical pain, although depression and physical pain often cohabit and worsen each other.

People who think that antidepressants are overprescribed and dangerous (they are not) should check out the real tragedy with opioid painkillers. Outcries for the US opioid painkillers epidemic have been resonating for years: nearly 20,000 US citizens died as a result of prescription opioid overdoses in 2014, and the death of the musician Prince has also been associated with an accidental overdose on an opioid painkiller. Concerns that opioid painkillers are prescribed excessively in the UK have recently been brought to the attention of the All Party Parliamentary Group for Prescribed Drug Dependence.

In January 2016, Crystal stopped all medications over the course of two weeks, while starting to practise the slow, Suang Yang Tai Chi style of Kung Fu, and few months later started the more active, hard style White Crane Kung Fu. Today, she rarely takes painkillers, and has learned, in her own words, to "exercise through the pain rather than remaining still and turning to pills".


Crystal with our Chief Instructor, Dennis Ngo. Photo by Sharon Ngo.

Crystal's journey has made me reflect on the indissolubility of mental and physical health: on the bond between the mind, the brain and the body. Her experience demonstrates that you cannot address one dimension without addressing the others.

Physical exercise has anti-pain and antidepressant effects, and the internet is full of personal accounts of how exercise helps with sadness and even with suicidal ideation. Experimental studies show that this might be due to the ability of physical exercise to dampen the activity of the immune system, and research from my group and others has shown that both pain and depression are associated with a hyperactive immune system, which participates to the development and maintenance of the symptoms.

But Kung Fu is more than just this physiological explanation. Kung Fu would be considered, in technical terms, a 'complex intervention', meaning that there are multiple 'active ingredients' that could help therapeutically, spanning biology, psychology, alternative medicine and spirituality.

So, how has Kung Fu helped me?

First of all, Kung Fu has taught me acceptance of physical pain. Pain is a normal part of learning, and an experienced instructor will be able to differentiate training pain from injury pain and to offer the correct programme of exercise for the individual student. And by learning to tolerate physical pain, I have also learned to tolerate emotional pain: surviving a hard session of training, or getting punched and kicked while sparring, has pushed my limits and made me find a stamina I never thought I had.

Clinical studies have shown that acceptance of physical and emotional pain is associated with less stress and better quality of life. For me, acceptance of pain has increased my self-esteem: it has taught me to stand tall, to walk straight, to hold my opponent's gaze. Not only in Kung Fu situations: I have become less tolerant of intimidation, and more able to take care of myself, even within my professional environment. If you think that a sparring competition triggers aggressiveness, you should come to a meeting of academics!


Here I am, competing in hard style Kung Fu patterns. Photo by Ben Hallifax.

But, if you accept the principles of alternative medicine, Kung Fu also mobilises the same mental and physical spirituality that is accessed, in different ways, by yoga and meditation, both of which are beneficial for health. My instructor once said to me that focussing on breathing as part of Kung Fu training helps to clear negative thoughts. Meditation has a positive impact on mental health, and thus these comments on Kung Fu and breathing point to the enormous power of sustained personal development, whatever the theoretical framework.

In addition, Kung Fu is a martial art, and thus all the movements that we learn have the technical potential to be lethal. While I do not want to suggest for a moment that I am trained as an assassin, I have developed an understanding of the fragility of life. Action movies, with their lengthy fighting scenes, trick the viewers into thinking that it takes a lot of blows to take someone down. But Kung Fu teaches the truth: that you could be killed in an instant, by a single blow of a bare hand. Understanding the fragility of life has enhanced my compassion, acceptance, and gratitude. And compassion meditation is an effective psychological intervention for depression.

Of course, I do not think that Kung Fu (or yoga, or physical exercise) is the solution for every pain, for every patient, or for every occasion. And the concerns about over-medicalisation and over-prescribing should not distract us from the fact that, in general, most people cannot access painkillers or antidepressants, even when it is clinically appropriate.

But we should never forget that someone with a mental health problem also needs physical exercise, personal development, and spirituality.