Pain: What you don’t know might hurt you (and what you learn might help!)

On January 25, Steven Woolpert, LPC and I led the first in the “Feeling Good” series of community classes in Maupin. The class is one of the projects and programs that he and the Deschutes Rim Health Clinic and I have begun collaborating on to provide more behavioral health information and services in the local community. And since “pain” is something we all experience at various points in our lives (and which many people live with on a daily basis), This first class focused on that topic specifically. So I thought I’d devote this post to the information we shared with the class about pain, and about working with pain, instead of against it.

The more I learn about the pain, the more interesting I find it (though it’s more interesting when I am not in pain: the experience of pain itself is, well, a pain!).

Pain, which itself can feel kind of singular and solid, is actually the result of very complex processes, including memory and emotion, and involving the parts of the brain where these are stored; it is not only a direct, sensory response to information being delivered from body tissue. In fact, pain does not always mean that there is current tissue (disc, joints, muscle, tendon, organ) injury, damage or danger. When an injury does exist, we “hurt” where the brain thinks the injury is located, which may not be where the injury actually is. Unattended emotional pain (sorrow or emotional injury) which has been “buried” can show up later as physical pain. In addition, degrees of pain depend on the brain’s evaluation of how much danger we are in, and stress (worry, and other stress-related demands on our energy) increases the brain’s perception of danger, in turn increasing the intensity of the experience of pain. Chronic pain results from a “wound up” nervous system that keeps trying to solve the problem (pain) with the signal (pain), which keeps creating more pain, like a telephone that just keeps ringing.

And though pain may be initially felt when there is tissue injury (in musculoskeletal, organ, or other body tissues) and may feel like it is “in” that tissue, pain is registered in the brain through the spinal cord and nerves. In short, the experience of pain is always a nervous system experience.

Working with (instead of working against) pain

Since pain is the body-mind’s signaling device that something is injured, or was injured at some time, or is in danger of injury in the future, ignoring, fighting, or otherwise resisting pain tends to only result in increasing the signal-strength. Think of what tends to happen when you ignore a child who is trying to get your attention: “mommy, mommy!, mommy!!, mommy!!, MOMMY!!! By the time you say “WHAT?!” the child is so upset and angry that he may not remember what he needed in the first place, and even the attention you give him will not be effective: by then he is too “wound up,” and his distress is now about his distress! Same with the nervous system.

To be effective in responding to pain, then, it is necessary to become willing to pay attention to the experience of pain (ideally when it first occurs), rather than ignoring or fighting it, and then to dedicate effort to retraining the nervous system. Since one or both of these first steps may result in an initial increase in perceived pain, it is important to know that we are not causing any damage; you are simply “listening to the child,” or “answering the phone” instead of ignoring the cry, or the signal. At first, your caller may shout at you a little, now that he has your full attention, but eventually your attention itself will calm him down.

Below are some effective ways of working with pain, once it has your willing attention:

*Mindfulness meditation, which decreases resistance and increases attention and acceptance, in turn allowing pain “room to move”

* Relaxation techniques which use breathing, visualization, and/or biofeedback techniques to decrease tension and increase relaxation.

* Hypnotherapy: a guided process which accesses and activates the body-mind’s own ability to support healing and other hoped-for outcomes.

*“Self-talk” re-training, through Cognitive Behavioral Therapy and other approaches which focus on identifying and shifting the beliefs, judgements, and thought habits which may be contributing to the experience of pain.

* Massage and self-massage: Caring/healing touch increases relaxation and blood flow through muscles and joints to improve pain and mobility, and to support the body’s own ability to heal.

* Physical activity of the sort that helps you connect with nature and which stimulates (versus strains) the mind-body. These include yoga, walking, Pilates, and water exercise.

* “Feel Good” foods: the ones that support the immune system, provide steady energy, and decrease painful inflammation. An “elimination diet” experiment directed by an allergist or naturopathic physician can help you discover if certain foods (gluten, lactose, or others) are not healthy for you, since pain anywhere in the body can be the signal of a food intolerance, too.

* Sleep: including the regular use of techniques known to improve both the ability to fall asleep, and the length of restorative sleep (since lack of sleep makes pain worse).

“Energy medicine” treatments, which work to support and to stimulate the body’s bioenergetic field to move from imbalance to balance. These include acupuncture, Reiki, “Healing Touch” technique, cranio-sacral therapy, and others (be sure to choose a certified and/or licensed practitioner).

* Writing, or other creative activity. When unexpressed, buried sorrow or other emotional experience is (or may be) showing up as physical pain, creative expression can be a powerful means of release. The word “express” itself means “to press out,” and this is exactly what creative expression can do for buried pain.

In the class in January, we ended by inviting participants to choose to experiment with even one of these techniques on a regular basis for a month, and see what results from the experiment. I extend that invitation to you! Let me and other readers know how it goes by posting a comment on this blog.

(Thanks to Steven Woolpert for the information he contributed to the above list from his own experience and knowledge, some of which is from the book Painful Yarns, by G.L. Moseley; 2007, Dancing Giraffe Press, Canberra, Australia)