The mind, the source of thoughts and feelings, gives meaning to our experiences, including pain. Your mental outlook and your emotions can either build up or slow down the pain cycle. The fact that pain has emotional behavioral, and mental parts doesn’t mean that the pain isn’t real. These are included in pain management programs because learning good coping skills makes pain more manageable. Working to understand and apply these coping skills to yourself can help you manage chronic pain and possibly improve other portions of your life.
THE POWER OF THE MIND
Chronic pain involves the mind, body, and spirit. Some people cope with the continuing aches and pains very well. Other people have become frustrated, irritable, and depressed about their prospects of coping with their pain.
Because chronic pain is continuous, it impacts every phase of your life. Emotional problems can multiply because of unrelieved pain. Normal responses to chronic pain include denial, anger, and depression.
- Denial gives the individual time to adjust to reality. People in many cultures are taught to suppress anger
- Anger produces more energy than any other emotion, but it can sometimes be directed into productive activity. The energy that anger produces builds up if it is suppressed. This leads to depression and muscle tension, both of which generate more pain
- Depression lowers pain tolerance and contributes to physical inactivity and feelings of hopelessness and helplessness.
Emotions are not harmful in themselves, but negative emotions feed the pain cycle. Focusing on pain intensifies it in your mind and also can lead to other behaviors such as seeking more medical treatment, using additional narcotic drugs, and engaging in unnecessary conflicts with family and caregivers. There are no wrong emotions, only wrong actions.
NEGATIVE FEELINGS ARE NORMAL
Our feelings force us to take certain actions. For instance, anger might make us shout, wave our arms in the air, or take physical action. Fear might lead us to withdraw from a situation, to take excessive bed rest, or to become immobile. These actions are valuable in healing acute pain, but self-defeating in healing chronic pain. Anxiety or fear of creating additional pain may lead you to avoid physical movement or activity, which create physical disability.
Anxiety is a fear of something that hasn’t happened, it is a stress created in your mind. Anxiety heightens bodily awareness, constricts blood vessels, and causes the release of pain-producing substances in your body that intensifies pain.
In any chronic illness, negative feelings such as fear, anxiety, and anger are normal. Other common negative feelings include: frustration, resentment, isolation, loneliness, guilt, irritability, and a feeling that life is out of control. Several studies show that giving a person a feeling of control over the pain helps relieve it.
Among older people who experience chronic pain, the normal traumas and disappointments of life, such as losing friends and family and experiencing the limits of dreams and hopes, also may contribute to feeling of despair and depression. These feelings affect pain level and tolerance and can create a cycle where psychological effects mask physical effects and vice versa.
An important factor in mental health is self-efficacy which is a belief that you can do what’s necessary to survive. In coping with any illness, especially chronic illness, your belief that you can handle a situation is important. Positively reinforcing your successes in learning to control or manage your pain can help you feel powerful enough to meet the challenge living with pain.
Another concept, self-reinforcement, can help you reestablish a feeling of self-control. Self-reinforcement involves rewarding yourself when you achieve a goal. Many people with chronic pain become dependent on external rewards from caregivers and other people, instead of rewards they created. If this is the case for you, it may be hard to set appropriate goals for yourself and to reinforce your own good behavior.
Another concern is that people who are depressed often fail to recognize their own performances and find it hard to reward or recognize their own achievements.
IS IT ALL IN YOUR MIND?
When patients describe their physical, emotional, and social limitations, it is clear that the mind and body are involved in the experience of chronic pain.
Generally, doctors emphasize either the mind or the body in their treatment of chronic pain. A doctor who treats the body might not look at the emotional or behavioral factors of their patients who live in pain. Likewise, a doctor who treats the mind might not give patients physical examinations.
While it is helpful to look at behavioral symptoms, it is possible that too much labeling of chronic pain patients who do not get better exists. This labeling can get in the way of helping with relieving chronic pain. Let’s look at some of the labels commonly used in chronic pain.
Source: Prairie Spine and Pain Institute, Dr. Richard A. Kube II, MD.