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How your mind helps your chronic pain (the pain is not all in your head)

Many people experience injuries over their lifetime which can result in chronic pain, perhaps from an accident, work related injury or sporting injury, as well as illnesses with body aches like fibromyalgia, arthritis or life threatening illnesses like cancer. Psychologists know that every physical experience is mediated by our mind as well as the actual physical sensation.  How we perceive an experience, our approach and attitude to it can make a large difference in how we experience it.

Imagine this for a moment.  Imagine that, right now someone approaches you, and stands on your toes and doesn’t seem to notice, and when you point it out, that they appear to be very apologetic and embarrassed.  In your imagining, notice how much the physical sensations of the experience might be a part of your focus. Now, imagine that instead, that someone approaches you and says, “I don’t like you” and then appears to deliberately step on your toes, long and hard, making eye contact with you the whole time?  Now, notice how this might feel different in terms of you noticing the physical sensations. Which experience do you think you would be more likely to rate as being more painful? Which are you more likely to remember or forget? Our perception of the situation often makes a difference in how we experience it.  

The experience of chronic pain (generally a pain condition lasting more than six months) can often be unrelenting and difficult to simply ignore.  In terms of associated psychological symptoms, most people describe feeling irritable and frustrated, low or anxious. In a significant number of cases, people develop psychological conditions like depression or an anxiety disorder.  

Here are some psychological strategies on coping with chronic pain, and hopefully preventing psychological conditions from developing.  

1:   See the choices you have within the pain experience

While the physical sensations you are experiencing may technically remain the same, I’d like to suggest that you have a choice where you take your mind to.  Everyday examples of where to take your mind, might include, to allow your mind to become absorbed with the world around you.

You can choose how much you focus on the conversations with people around you, the landscape around you, or how much you listen to a story, a podcast, a song or the sound of your lovely family around you.  The strategy is to become more absorbed in experiences outside of your own body.

Having choice in itself is important to allay a sense of helplessness or hopelessness, which people often described when they feel “stuck” with a condition.  Seeing the parts of activities that you can still do, becomes an important choosing, rather than focusing on the ways you might be feeling limited or restricted with what you can or can’t do.  

  1. The importance of adaptation and acceptance

Often people with chronic pain feel limited in what they can do, and finding themselves disengaging from the world.  Instead, it is important to problem solve and adapt activities or tasks to retain a sense of independence. It’s often about doing things in smaller pieces and working within a manageable pain level

For some people the reason that they become very frustrated with their pain condition is that they push themselves to do what they used to be able to do, causing their pain to increase.  I often think about how, if we had a person who was, for example paralysed from the waist down, we wouldn’t insist that they run around the oval. Instead we would alter the environment to make it possible to reach things, and would provide aids, like a wheelchair to make it possible for them to be mobile.   We would accept the condition and adapt the environment.

  1. Specific psychological strategies like mindful meditation and hypnosis

Psychology has developed specific strategies, which can used to manage the sensations of pain.  

Hypnosis often teaches a person breathing and relaxation techniques, as well as how to use your imagination to take your mind to a more comfortable place, with the goals of separating your mind from your body’s experience.  Often suggestions for healing and relaxation help the person manage the physical sensations, giving them a sense of autonomy and choice, as well as acceptance.

Similarly mindful meditation also teaches a person how to breathe and relax, in order to help the mind and body to engage in a more comfortable experience, however, the ethos is more about acclimatizing the mind and body to the sensations rather than separating from the body, or of suggestions of healing.

About the author

Lisa Irving, Clinical Psychologist,

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