Monday 16 August 2010

Pain management Part 1 - Changing your mind about pain

So far, the survey has confirmed my expectation that pain is the factor that most bugs you about IBD, so I thought you'd like me to share this with you....

I have studied various aspects of this huge subject - pain and its management - for many years, both personally and with my clients. I almost never take pain medication, including after a major operation.

When I was in my teens most of my circle of friends had their ears peirced. It was a kind of rite of passage. Parading our newly studded lobes at school after "the big event" we all remarked on how the second piercing hurt so much more than the first. I was so concerned about my second ear that I asked the piercer, whether it was OK. "Oh yes," she explained, "...strangely  the second ear seems more of a shock even though everything is exactly the same."  This started me thinking about the subjective nature of pain, which continues to facinate me to this day.
When you having an injection or a blood test in the UK, the unversally adopted warning appears to be, "Sharp scratch!". Well I don't know about you, but for one thing, the feeling is nothing like a sharp scratch, and for another, I would much prefer the feeling of tight pressure I actually experience than a sharp scratch, any day. As a result, on hearing, "Sharp scratch!", my anxiety levels increase and when the needle is inserted it feels more painful than if I had been told, "Tight pressure". So now I ask them to say nothing or, "Tight pressure" and I hardly notice it. There are many more examples I could give you just like this, where words change the experience. Especially important are those words that influence the attitudes of children for life.
So why am I  saying this? It's because I'm trying to convey how our experince of pain and its impact on our lives depends on many things. How we prepare for its arrival (in the case of anticipated acute pain) and the context in which we experience it, (in the case of chronic pain) can greatly influence its perceived severity.
Most of us know from personal experience that sudden unexpected acute pain quite often only hurts afterwards - like when the heavy file fell on my nose (earlier post). Chronic pain or cold often diminishes when our attention is focused elsewhere. A very painful condition surrounded by the fear of sinister causes can become greatly more tolerable when its source is revealed as relatively innocent. One typical example is  wind. Wind can be the most excruciating feeling imaginable. I know people who thought they were dying of some terrible corrosive illness. After some time, some medical advice (to roll around on the floor in a specific formation) and large volumes of expelled gas, the pain was gone. This doesn't mean that the pain was any less real, but each person experiencing this said that when they were told it was wind, this changed the context or the "frame" of the pain: instead of feeling at the mercy of some malevolent fatal lurgi the pain became information equipping them to locate and relieve the pressure. For all sorts of reasons, this meant the difference between being able to bear the pain and not. Same pain, different mind equals different experience.
I've talked about this for rather an long time now, so I'll save the story about medication "where the painkiller is the packaging" and another one about "how dentists can get it so wrong" for a later post.
I have a number of tools that I use to manage different types of pain that I share with my clients to help liberate them from theirs. If you would find it beneficial I will hold a (free) webinar to share some of these with you. Just let me know in the comments box below. You might like to think which of your friends would benefit and get them to let me know here as well. : )

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