Coping with Pain (Pain Management)
Definition
Pain: ” An unpleasant sensory and emotional experience
associated with actual or potential tissue damage, or
described in such terms” (Int Assoc for the Study of
Pain).
Pain affects the whole person
It may seem unnecessary to define pain which is something
we have all experienced at some time in our lives.
However the above definition is valuable in that it makes
pain officially a physical AND emotional experience.
Ongoing pain due to medical treatment or illness
(sometimes unexplained illness) involves not just the
original “ouch” of pain but also feelings of frustration,
impatience at lack of progress or available help,
exhaustion, anger and social and economic consequences
such as relationship problems with friends, family and
partners, inability to work, sexual problems and others.
Psychology and Pain
Don’t be offended if a doctor suggests that you speak to
a psychologist about your pain. It does not mean that
anyone is suggesting it is imagined or exaggerated.
Psychology is not just about the head. Remember that our
thoughts, behaviours and experiences are all changed into
chemical messages which travel though the body and affect
the whole person. It is a complex two-directional
communication system where the body communicates with the
mind and the mind communicates with the body. This
communication is done via the immune, nervous and
hormonal systems among others. For example, when we are
ill with flu, the sleep centre in our brain is stimulated
to encourage us to sleep to preserve energy so that most
of the body’s energy can be re-directed to the immune
system’s fight against infection. This is the body
affecting the brain.
The brain decides the pain
The Pained Brain
Several different parts of the brain are involved in the
sensation of pain and its source,duration, familiarity,
intensity and other aspects will affect how we experience
it. For example, when a competitive athlete does not feel
the pain of an injury until afer the game is over, the
players attentional focus (located to the front of the
brain) has been directed away from the incoming pain
messages traveling up through the spine. As an
experienced player, his / her brain will have made
several analyses about the arriving pain message;its
importance to survival, previous experience of the pain -
the pain of a knock against another player or a cut to
the skin may be a familiar pain etc. All of these
“computations” are done by the brain unconsciously -
without the player being aware of it. In addition, the
body’s natural pain killers, opiods and enkephalins as
well as adrenalin will flood the brain and body during a
match, making sure that for a time at least, the pain
stays below the player’s pain threshold. When the match
ends, the body’s chemistry changes and new areas of the
brain become active leading to an increase in pain.
From this example we can see that pain is far more
complex than just a simple cause – effect model as shown
in so many old school biology text books. What messages
arrive in the brain, brain chemistry and what is already
going on in the brain all affect our experience of pain.
This is good news as it means that we have new
opportunities to alter pain suffering.
What do you most want to do pain free?
Help for Managing Pain;
Relaxation, cognitive techniques
and hypnosis
Treatment for chronic pain should always be managed by
your doctor. However, for many sufferers,
medical treatment does not help, or side effects
out-weigh the benefits. Others may have been told that
there are no other options available to them and they
must just live with the pain.
The most current psychological / medical treatment for
pain aims to give control back to the individual who may
have been attending specialists, undergoing procedures
and taking whatever they were told to take for many
years. Pain affects the whole person, their whole lives
and their family’s lives. Pain clinics aim to educate
the person about different ways of managing and reducing
pain rather than curing pain. While this may be
disappointing for the sufferer it should be remembered
that decreasing your experience of pain (levels) and
reducing the ways in which it affects your life can share
the same benefits as a successful or partially successful
treatment. It also gives control back to the individual
who will have probably have had to rely on specialists
for long periods of time.
Western culture relies heavily on medications and most
have a high faith in medicine being able to find a cause
and cure for everything. It can be extremely frustrating
when we are faced with a condition that medicine cannot
cope with. While some pain patients may feel too
exhausted to have to take on board responsibility for
their own treatment, others will welcome the feeling of
regaining control.
Targets of Pain Management Programmes
Managing Pain through psychology
Psychological treatment should begin with education
about how pain is processed in the body and how and why
psychological techniques can affect feelings of pain.
Relaxation and stress management exercises are a vital
component as they target the pain process in the body and
the brain. Whether you are aware of it or not you may be
holding yourself in a particular way in order to avoid
putting pressure on the area of most pain. This action
in itself causes tension in other body parts as it tries
to compensate, and results in further pain and fatigue.
You do not have to be “in to that sort of thing” to be
benefit. The benefits of relaxation techniques (which
can vary according to your preferences) do not rely on
belief but affect the musculature of the body and also
brain chemistry. (Self) hypnosis is one proven way to reduce pain due to its action on various parts of the brain. Contact us for more information on hypnosis for pain.
Cognitive techniques also affect the whole body by
altering physiology and body chemistry. We all develop
habits in how we think and most people never ask
themselves if those habits are working for them. If not,
it is possible to change them. Pain and its effects on
sleep and energy levels changes activity in the brain and
which parts of it are “switched on”. Again, the areas of
the brain that are activated like this can become a
habit. Cognitive techniques target these habits in
thinking and can change brain activity so that a person
feels less pain.
Personal goal setting is vital part of managing pain. If
you know that your pain is a temporary part of an illness
or treatment programme your goal may be to just lessen
your experience of pain until you are well again. If you
have been told that you must learn to live with your pain
then your goals might be to get back to work , find a
more suitable job, to be able to walk a little further,
to be able to sit for a meal,to regain contact with
friends, to be able to hold a kettle of water etc. It is
really important that you (with or without the help of a
professional) set yourself a goal that will bring you
nearer the life you had or wanted before pain took over.
Contact with nature is proven to reduce pain
Exercise is another important component to getting on top
of chronic pain. While rest may be recommended for short
periods of time it is rarely recommended long term.
Again, exercise affects both the body and the brain.
Many people may have tried to get exercise on “good days”
but this often results in a “crash” the next day andso
continues a pattern of peaks and troughs.
Exercise should be done in a step by step approach in
order to avoid these peaks and troughs. Aim to increase
your activity by a very small but set amount every day
for a set period of time such as a week. This might mean
walking to one house further down the road than you have
been able to to date. For others it might mean 5 strokes
more in the swimming pool. What is important is that
even if you feel capable of doing more you dont but you
do push yourself that little extra on days you dont feel
like doing so. Not only does this increase your physical
abilities gradually and avoids the over-activity – crash
cycle, but it also puts you back in control of your pain
rather than your pain controlling you.
NOTE: The above describes an exercise plan best suited to
chronic pain sufferers. Any such plan should be first
discussed with your doctor.
For more information see Access Psychology Ireland clinic
or contact us. An online programme which will include
online or clinic consultations will also be available
soon. See Home E-Learning Online programmes or contact us
for more information.
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