Overcoming Pain

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

Religion and Chronic Pain: Avoiding Hysteria

We do not have to necessarily believe; but we should try to fathom.

I was thinking about writing a blog about Spring Break, maybe a documentation of the quest for the ideal bikini line. However, the better angels of our nature instead gently touched my shoulder, and they and my age convinced me that it is better to write about this week as Holy Week—and not Spring Break. After all, to paraphrase the Jay Leno of twenty years ago, we already had the experience of putting up with the shenanigans of one fifty-something American (Teddy Kennedy) who persisted in going on Spring Break when the time for going on Spring Break had long passed. Just where did I think I was going?

This is one of those times of the year when many of us do reflect on religion, whether it has meaning for us, or what has it done for us lately. It is a time of the year that can have a significant impact on the psyche of individuals suffering from chronic pain. It is important that we all be reminded of the overwhelmingly positive impact that spirituality and religion have on the patient with chronic illness.

A concise but comprehensive review of research on religion and spirituality and both mental health and physical health was published by Dr. Koenig in 2012, in the journal “ISRN Psychiatry.” It can readily be understood how pain and other distressing somatic symptoms can motivate people to seek solace in religion through activities such as prayer or the study of Scripture. Religion and spirituality are used in order to cope with such symptoms: In one study of 382 adults with musculoskeletal complains, coping via religion and spirituality was the most common strategy for dealing with pain and was considered the second most helpful in a long list of coping behaviors. This phenomenon has been corroborated via additional research.

Nonetheless, religion and spirituality may somehow cause an increase in pain and somatic symptoms in some individuals, perhaps by an unhealthy focusing on negative symptoms or through the physical manifestations of hysteria, as claimed by Freud.

A closer look at the published studies that examined relationships between religion and spirituality and pain reveals the following: 39% found benefits from religion and spirituality; 25% showed greater pain levels associated with religion and spirituality. Some research actually suggests that meditation is particularly effective in reducing pain, although the effects are magnified when a religious word is used to focus attention. Importantly, it appears that no clinical trials have shown that meditation or other religious or spiritual interventions increase pain or somatic symptoms.

Now, no one is claiming that supernatural mechanisms are responsible for the relationship (be it positive or negative) between religion and spiritualtiy and health. The pathways by which religion and spirituality influence physical health that researchers can study using the scientific method are those that exist within nature, and make us who we are; we are a product of psychological, social, behavioral, and genetic influences.

The existence of supernatural forces is a matter of faith; but there is nothing supernatural about inquiring as to whether belief in such forces (and the behaviors that result from such beliefs) has an effect on health. There is every reason to think it does.

The field of religion, spirituality, and health is growing rapidly. As health care providers, we do not have to necessarily believe; but we should try to fathom.

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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