Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it

Mind Control: Coping with Chronic Pain

I can see for miles.

We are told this: The mind is able to control the body. For the chronic pain patient who may have seemingly exhausted treatment options, this notion of mind over matter takes on a hopeful urgency.

When there is some sort of injury or insult causing pain, the signal conveying pain travels to the brain via a sensory pathway and an emotional pathway. This emotional aspect of the experience of pain travels to the parts of the brain known as the amygdale and the anterior cingulated cortex. The mind-body treatments that involve such activities as meditation and relaxation likely affect these emotional networks.

Researchers have used functional magnetic resonance imaging to allow chronic pain patients to "visualize" pain. These images allow a patient to actively participate in manipulating what has heretofore been an amorphous concept. The chronic pain patient becomes empowered, whether it be through yoga, biofeedback, or meditation.

Any such coping technique for chronic pain should begin with controlled deep breathing:
1. It is best to be in a relaxed position in a dark room, with eyes closed or focused on a point.
2. Breathe deeply, while continuing to focus.
3. Continue with controlled breathing for a few minutes.
4. If you sense this control of respirations is allowing for a slowing down of breathing, then try a particular imagery technique.

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Examples of imagery and chronic pain control techniques include:
1. Focus on a non-painful body part, and see whether this diverts the mind away from focusing on, say, chronic back pain.
2. Mentally separate the painful body part from the remainder of the body; use dissociation to keep the pain away.
3. Divide different sensations of pain into separate parts: If a patient feels burning associated with pain, he or she might find it helpful to focus solely on the burning sensation, and not on the pain by using such sensory splitting.
4. Imagine a numbing injection of some miraculous medicine.
5. "Travel" back in time, when the patient was pain free.
6. Imagine a symbol for one's chronic pain, for example, a loud noise; turn the volume down, and reduce the pain.
7. Use positive imagery to focus on something pleasant.
8. Count silently to divert the mind from the chronic pain.

These tasks seem silly to some; or at best, self-evident. But for some chronic pain patients, they do help. A professional may be needed during the learning process; and it may take practice before these techniques have an impact on the chronic pain patient. Such a patient should work on these pain coping mental exercises at least 30 minutes three times a week.

You know you are good when you can reduce pain and increase relaxation with a few deep breaths. The sense of control that accompanies such mastery in and of itself can be responsible for a significant reduction in chronic pain.

Mark Borigini, M.D., is a board-certified rheumatologist who has devoted his career to treating illnesses that cause chronic pain and disability.

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