Understanding pain, and how to begin changing it
What is pain
Pain is a subjective experience, unique to an individual, impossible to measure, and affects so many people, and the medical world is continuously under pressure to solve this extremely complex problem.
Although some drugs can help, for anything serious and persistent, when it comes to pain, as the Verve once famously said "The Drugs Don't Work, They Just Make Me Worse......". (I am pretty sure they weren't referring to traditional pain killers, but hey).
There are so many examples of the subjective experience of pain. If you search Manteo Mitchell Pain on Google, you will find much information about how the U.S. sprinter finished his leg of the relay with a broken leg, and only lost 1 second. He is reported as saying something like 'it really hurt', but clearly that is subjective too.
In the military, I have seen similar examples of soldiers finishing extreme tests, with a limp or a niggle, for them to later learn a bone is fractured.
There is acute pain (intense, here and now), and chronic pain (pain which persists after the 3 - 6 months necessary for the healing process to occur).
Acute pain changes the way we behave to protect the tissues as they heal.
Chronic pain however, has no real use and very often becomes a bad habit. Some researchers feel that it is a disease (DIS - EASE) in itself. This TED video by Elliot Krane gives a good visual insight into how this occurs.
An understanding of the word dis-ease gives a good indication of how there is often a lot of tension, and a lack or relaxation and ease in the areas affected, and also in that persons' life.
Researchers also say that pain can be a reflex, an emotion, or a memory, and I have certainly seen that in my work with chronic pain clients over the years. One particular client, suffered from a huge amount of chronic pain, was under intensive physiotherapy for arthritis, large prescriptions of opioid based drugs, and after a true emotional understanding of the 'root' of the pain, was released in so many ways from the 'habit' of chronic pain. This client increased movement from a 20% range to 40% in a matter of weeks, and also realised many other benefits and changes in their abilities, physically, mentally, and emotionally. They also are now free of drugs and therapy. They learned to unlearn pain, for good.
The long and short of what we now understand (research continues and is rapidly developing in this area) is that pain is related to the perception of dangerous situations - it is your brains' way of telling you that something is presenting a danger to you.
Here is a good explanation of how it works from leading pain researcher Lorimer Moseley in another great TED talk.
So pain is the answer if the brain decides something is dangerous. The level of complexity doesn't end there, as many of the brain's networks are involved in the perception of danger, including memory, learning, cultural, emotional, the senses........., and they all send signals to each other concurrently.
Now we have reality to add to the equation, and particularly the perception of reality. Scans are now able to detect a certain amount of the direction of traffic between areas of the brain. Studies have shown that the reality that a person experiences is approx. 5 times more influenced by what is already in their head, than what is being received by the light streaming in through their eyes. So that means your reality is more about what you expect to happen, or what you have learned, than what is actually happening in front of you.
This level of learning is complex, especially when pain is concerned, and because it is triggering your innate survival mechanism, your brain learns pain and changes very quickly due to its perceived level of importance.
The fact is that chronic pain is a mistake, where part of your brain is sending a constant alarm signal, which doesn't switch off, despite the fact that any physical damage is long since healed. It is stated that approximately 80% of amputees will experience 'phantom pain', - pain in the limb that they no longer have, which means the pain is very much a memory, often wrapped up in emotion.
To begin to correct the mistake of chronic pain, we must influence and communicate with the subconscious part of the mind, or nervous system. There are a number of factors at play, including the depth of rapport, trust, and belief in another person's ability to help you, previous experience of pain, social and or cultural influences.
How to change pain
There are a number of long established ways to successfully influence this experience of pain, often involving various methods such as:
Visualisation - vapour floating out, colour draining, filling with cooling liquid etc.
Dissociation - focussing internally and going to a 'safe, happy, or special place' which is unique to the individual.
Direct suggestions and ideas - Numbness, frozen, wooden, free of sensation.
Relaxation/reinterpretation of sensations - , tickling, tugging, warmth, pressure etc.
Creative use of imagination - using 'tools' such as control panels, and many others.
The development of focussed, proactive, and reactive use of breathing to raise activity in the parasympathetic part of the autonomic nervous system, boosting the immune system
Deliberate increase in saliva production keeps adrenaline levels low, and reduces pain.
Every person is unique, so it is key to experiment with a range of different 'tools' to find what 'works' best for you.
However, the key to this is opening your mind to the possibility that it can change - belief and hope, whether you feel the belief yet or not.
How belief influences pain
Essentially, if you believe that the pain can go, and you know how to practice (and do so consistently), it can actually go.
When I first discovered these ideas, I was fascinated, however a little skeptical (everyone must be initially because of what we have learned in our lives). So I took a test, and with a couple of weeks of dedicated practice, I was delighted with the result of having pain free dentistry with a procedure which cut away at my gums and interacted deeply with the nerves under the gum. Here is a 5 min clip of the test, and the results described by the dentist. I was convinced.
So, belief is the key, and not conscious belief. So it doesn't really matter if you think this is true or not at an intellectual level. Will power or intellectual knowledge alone is not the answer. The key is to retrain the brain and nervous system to relax.
Ironically, if we believe something will be painful, we tense up in an effort to protect against the pain and draw more nerve endings in to the experience, thus enhancing the feeling of pain. This increase in pain, leads through fear to more tension, and therefore we enter into the cycle of fear, tension, pain, more fear, more tension, more pain.....
If we live in a constant state of fear of the pain (or anything else), our nervous system becomes more sensitised to pain, and in the same way, if we learn to expect positive experiences, a feeling of comfort and relaxation in the area affected, we get better at processing those signals.
Neuro-plasticity is the brains ability to change itself in terms of its structures, membrane receptors that receive the communication from neurotransmitters, and patterns of thinking. It is happening all of the time. The key is to know that, and then decide to learn something different, despite the way it feels right now.
Studies have shown that chronic pain patients have had more results of changing the pain experience with two 30 minute reading sessions of understanding how pain works, and two follow up calls, than 20 sessions of physiotherapy. So raising awareness, and understanding, can go some way to changing the experience on its own.
I have also witnessed many times what I call the battle between 'elasticity of the mind' and 'plasticity of the brain'. Essentially, the longer you have persisted in a certain pattern of thinking, the more resistance there will be to changing those patterns and replacing the 'default' mode with more healthy and beneficial patterns of thinking. This often translates in rapid gains as you 'stretch' the elastic band of the mind, followed by a perception of regressing somewhat, as the elastic nature of the mind returns to its 'normal' state.
This is where you must have a deep underlying belief, support, and hope that you can change, and then stretch the mind again. Over time (maybe months) neuro-plastic changes take more effect, it becomes easier, and takes less 'stretch' to think in the new way. This is an ongoing process of developing new patterns of thinking. There is a famous saying that neurons that fire together, wire together, meaning every time we think in a certain way, we are strengthening the connection between neurons, essentially building habits.
This is not solely to do with pain, it is evident in any change in thinking, feeling, and acting.
So if you are, or have suffered chronic pain, there is hope, and the 'treatment' is possible for anyone who is willing to learn how to use their imagination in different ways to maybe how they have been used to using it in the past.
I welcome your thoughts on this persistent, and thought provoking topic.
A useful, and simply explained book to develop understanding in pain is 'Pain is Really Strange' by Steve Haines.
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