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WHAT’S THE PAIN TRUTH
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| When our friends or family members respond to our moans and groans with attention and sympathy, the pain only gets reinforced and becomes a pattern of behaviour |
Have you ever wondered why a severely wounded soldier continues to battle on so defiantly, or an athlete injured during a race, goes on to win it? It so happens because the brain does not react immediately to the pain signals, it just ignores them because there are more important tasks to attend. It registers only after the task or event is over. Perception of pain has been studied extensively by psychologists who suggest that there is a ‘gating system’ in the central nervous system that opens and closes to let pain messages through to the brain, or block them. Psychological factors such as attention to pain, emotional state of a person, anticipation of pain and the way the person interprets a situation can both open and close the ‘gates’. This is why when you are depressed or anxious your pain seems worse and intolerable—because your feelings can open the pain gate. On the other hand when your attention is diverted or focused on pleasant tasks, your pain is almost imperceptible. Thus, the physical cause of the pain may be same, the pain circuits identical, yet the perception of pain is dramatically different.
Thoughts and emotions can directly influence physiological responses (like muscle tension, blood flow, release of brain chemicals) that determine production of pain. Psychological factors can also indirectly influence pain by affecting the way you cope with it. Anticipating pain before it strikes can actually worsen it. So does feeling helpless about it which augment pain, as it takes away the will to fight back. Hence a catastrophic view of pain episodes may only make it more unbearable.
Pains may get inadvertently reinforced by our social interactions. Moans, groans and grimaces are our behavioural vocabulary of pain, helping to communicate our distress to others. When our friends or family members respond to them with attention and sympathy, rubbing our backs or fetching things for us, the pain is only getting reinforced and becomes a pattern of behaviour. But it is important to realise that though mental and emotional factors can significantly affect the experience of pain, they rarely are the root cause of it, and all cases of chronic pain at least initially, was rooted in a physical problem.
Coping with pain:
Acute pain, that which is caused by injury, burns, following surgery is quite easily treated with potent analgesic drugs and surgical procedures, followed by brief period of rest. But chronic pain is a different story altogether, where the pain exists for years, without any apparent organic bases and that itself becomes the disease! Common chronic pains are headache and backache, which afflict millions of people, affecting their quality of life.
Here are a few suggestions to cope with chronic pain.
- Don’t overmedicate yourself—it can lead to abuse and addiction to pain killers which can even cause ‘rebound’ pain when the dose wears off.
- Continue to be active and exercise lightly to keep muscles and joints supple and mobile. Inactivity only worsens the pain due to stiffness and loss of muscle tone. Exercise also releases natural pain killers in the body.
- Learn muscle relaxation exercise—it helps to prevent spasms, controls muscle tension, changes functioning of the nervous system arousal and pain production. It also reduces anxiety and promotes sleep.
- Learn to meditate—observe your pain, detaching yourself from it, as if it were not your pain, it will seem to be less.
- View stressful situations calmly and realistically rather than catastrophically.
- Identify the problems and situations that trigger your pain and attempt to solve them through realistic means.
- Defocus from pain through distractions—involvement in pleasurable activities, attending to others or the environment.
- Visualise—create pleasant images in your mind, that are peaceful and pain free.
- Visit a specialised pain clinic that offers multidisciplinary treatment.
The ultimate truth for chronic pain patients is that only their active participation in their treatment and their hard work is likely to make them feel better and in control of their body and mind.
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—Dr. Avdesh Sharma is a celebrated mental health expert and Heads 'Media and Public Education Committee' of 'Psychiatry in Developing Countries Section' of World Psychiatric Association.
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April 2007
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