Tuesday, October 09, 2007

HOW TO MAKE PAIN LESS PAINFUL

Those who work in the field of healthcare have known for some time that a connection exists between our underlying beliefs and thoughts and the functioning of our bodies. Dr. Herbert Benson, in his 1970’s landmark book, The Relaxation Response, articulated the concept that stressors can trigger a “fight or flight response”, an inner startle response that indicates we are about to experience an unpleasant event. Although there is a healthy fear that protects us from harms way, many times how one interprets stressful events and one’s ability to manage it, can affect the immune systems functional capacity. There is now sufficient research to validate Benson’s work, that relaxation techniques such a meditation, can have a direct link to minimizing the effect of a wide range of disorders such as high blood pressure, irritable bowel syndrome, back problems, neurological pain, and headache problems. Relaxation strategies calm the sympathetic nervous system, making it easier for the body to heal.

In Barbara Levine’s book, Your Body Believes Every Word You Say, she explores how our thoughts and underlying beliefs about our physical maladies affect our auto-immune system which regulates our ability to ward off illness, manage pain, and promote healing. In other words, legitimate pain from various illnesses and somatic complaints can be intensified by the kind of messages we tell ourselves. Spontaneous self-defeating thoughts such as, “What’s the use, my body will always betray me and never get better.” can reinforce the pain cycle of making things worse. People with such chronic self-defeating reactions have been shown to create inner chemical changes and constricted blood flow which further erodes the individual’s ability to manage pain. How we respond to our bodily disorders, in terms of core beliefs and inner dialogue, may affect the outcome of our health.

Some time ago, I attended a presentation by psychiatrist M. Scott Peck. He talked with mental health providers about his struggles with neck pain, a problem that had plagued him for years. An operation resolved some of his pain, but he felt that there might be some negative underlying belief that was also contributing to the problem. He ultimately concluded that he was a conflict-avoider, lacking the ability to appropriately assert himself, refusing to “stick his neck out.”

Physical illnesses can be intensified by self-defeating underlying thinking that is a metaphor for the chronic condition experienced. For example, people with back pain may at times lack the “backbone” to express their thoughts and feelings courageously. Individuals with gastrointestinal problems may not be unable to “stomach” certain intolerable thoughts and feelings. People with headache syndromes may experience beliefs and thoughts about events that make them want to say, “Life is making my head hurt.” Eating disordered people may experience core assumptions such as, “I’m so angry that I could just vomit, or if I monitor my weight and eating habits, at least it’s one area in my life that I can control!” People with neurological pain such as inner ear disorders may exacerbate their pain by experiencing thoughts of panic such as, “Oh my God, here it comes again, that nasty, annoying pain. I’ll never get over this because the volume in my life is turned up too high.”

Anxiety, panic, and depression are typical characteristics associated with physical pain. The more effectively one manages these symptoms, the less troublesome the pain may be. Learning to cope with anticipatory anxiety by rationally responding, “Ok, I know that this pain can be troublesome, but when it comes I will do my deep breathing and manage just fine!”, or dealing with panic, “When a wave of pain comes, I’ll just go with it. It’s not a big deal, my scary feeling are time-limited, they’ll be over soon”), and managing depression, “Just because I feel awful doesn’t mean I can’t do things to stay active and make me feel involved” are important ways of adaptively responding to pain.

The following ideas are some guidelines for managing pain more effectively:
· Try to get you pain in perspective. Make a realistic appraisal. “In the scheme of things, how bad is my condition?”
· Don’t fight with your symptoms, it only makes them worse. The more you accept your symptoms, the more they are likely to diminish.
· Use various activities to refocus away from your pain. Dwelling on pain makes it more painful. Stretching, music, swimming, meditation, and other activities are important.
· Seek a multidisciplinary approach to your problem, if necessary. Get a team of healthcare specialists, including a quality physician, psychotherapist, physical therapist, message therapist or other providers of pain management.
· Develop a solid support system of family and friends. Also, there are many support groups in our community for people suffering from a variety of physical ailments.
· Remember, that the things we tell ourselves have an impact on our physical and emotional well-being.

James P. Krehbiel is an author, freelance writer, and nationally certified cognitive-behavioral therapist in private practice in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at http://www.booklocker.com/. He can be reached through his website at http://www.krehbielcounseling.com/.

7 comments:

Anonymous said...

A few years ago i was hit by a car and injured my back this caused me so much pain it was ruining my life and then i tried one of those mattresses that mould to your body shape and adjust to your weight and i slept great for the first time in months and woke with no pain at all! You should try it!

James P. Krehbiel, Ed.S., LPC, CCBT said...

In this article I am talking about those who experience pain that is intensified by emotional suffering.

Unknown said...

Emotional suffering can feel very much like physical pain.

Preparing for the depression, anxiety and panic that swarm around difficult life decisions is like preparing for surgery. Ultimately you know the ground will be shifted from under you and your brain fights the notion that you are purposefully putting yourself in a place of danger. Logically you know you're headed into a sea of potential threats without full knowledge of how to steer the ship. You know that when you wake up there is going to be physical pain, struggle, depression, and...... possibly more of the same mistakes you made before. Any pain that was tolerable before is now unbearable.

Moving through change - even if you know it might make life better (or at least different) - is still scary and painful. Especially if you've been through it before. You know full-well how hard it is to pop that bubble. Maybe the first time some horrible mistakes were made. Will it be the same this time? Or worse? Perhaps.

Hopefully, resilience will be there to pat your shoulder and make you a cup of tea, inviting humor to tickle creativity into inventing the horse you need to get back on.

Anonymous said...

Krista,
Thanks for commenting. Things WILL get better. Keep in touch. james

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