The Power of Mindset Science for Pain Relief and Health
Pain management skills can alter the trajectory of pain and neural function
Posted January 19, 2018
Your thoughts, beliefs, and expectations—your mindset—can impact your health, how quickly you heal, and how well medications work for you. It’s important to develop new drugs and surgical techniques to address health problems like pain. It’s also important to address the factors that exist within ourselves and influence our experience of pain.
Thirty to 40 percent of people worldwide are living with ongoing pain. Chronic pain is more prevalent and costly than heart disease, diabetes, and cancer combined. Chronic pain is the number one reason people are out of work and is one of the main reasons for lost productivity. Estimates suggest it costs the U.S economy $635 billion each year.
Chronic pain persists either because our treatments are inadequate or people do not have good access to the ones that work. Often it’s both.
No matter where pain is felt in the body, pain is processed in the central nervous system: the brain and the spinal cord. Pain is highly responsive to each person’s psychology and mindset, and this presents an opportunity to reclaim some control over the suffering.
Scientific studies spanning three decades and conducted across numerous independent research groups reveals that negative pain mindset — a pattern of expecting worse pain, feeling helpless about it, and ruminating on it —predicts pain intensity, need for pain medication after surgery, recovery after surgery, length of hospital stay after surgery, how well multidisciplinary pain care works, and disability from pain. Science conducted by our research group and others has shown that a negative pain mindset entrains neural networks and brain connectivity in such a way that the central nervous system is primed for future pain. (Jiang et al 2016)
Humans are born motivated to escape pain but they are not born knowing how to modulate pain or the distress that it accompanies it. This must be learned. And, this is critical information if we are entrain different neural network that correlate with pain relief. This is the realm of behavioral medicine for pain. We will always need medications, surgeries and various procedures to address pain. Behavioral medicine can help support outcomes from those treatments.
My research group develops brief, low-cost, and scalable interventions that teach people how to calm the nervous system and cultivate thought patterns that enhance functioning in regions of the brain associated with pain control. Neuroimaging research on longer-course group-based treatment lasting 11 weeks suggests that the function and structure of the brain is favorably altered such that pain is downregulated. When pain relief skills are actively used, pain processing is diminished in the nervous system. (Seminowicz et al 2014)
Our recent research has shown that a targeted, two-hour pain relief class equips patients with the tools to reduce suffering from pain. The class is not intended to cure pain or the underlying medical conditions that are causing the pain. Rather, the tools learned in the class help individuals entrain neural network that correlate with reduced pain-related distress, pain, and suffering (Darnall 2014; Darnall 2018).
Health and pain relief mindset interventions can be applied as early as possible to help medical and pain treatments work better. This the power of mindset science — patient empowerment, and cost-effective, low-risk pain relief.
1. Darnall BD, Sturgeon JA, Hah JM, Kao MC, Mackey SC. ‘From Catastrophizing to Recovery’: A pilot study of a single-session treatment for pain catastrophizing. J Pain Research. 2014; (7):219-226. PMID: 24851056.
2. Jiang Y, Oathes DJ, Hush J, Darnall BD, Charvat M, Mackey S, Etkin A. Perturbed Amygdalar Connectivity with the Central Executive and Default Mode Networks in Chronic Pain. PAIN ®.2016 Sep;157(9):1970-8. doi: 10.1097/j.pain.0000000000000606.
3. Seminowicz DA, Shpaner M, Keaser ML, Krauthamer MG, Mantegna J, Dumas JA, Newhouse PA, Filippi C, Keefe FJ, Naylor MR. Cognitive-Behavioral Therapy Increases Prefrontal Cortex Gray Matter in Patients With Chronic Pain. J Pain. 2013 Dec; 14(12):1573-84. Epub 2013 Oct 14.
4. Darnall BD, Ziadni MS, Krishnamurthy P, Mackey IG, Heathcote L, Taub CJ, Flood P, Wheeler A. “My Surgical Success”: Effect of a Digital Behavioral Pain Medicine Intervention on Time to Opioid Cessation After Breast Cancer Surgery—A Pilot Randomized Controlled Clinical Trial. Pain Med. 2019; 20(11): 2228–2237. https://doi.org/10.1093/pm/pnz094 (open access)
5. Darnall BD, Ziadni MS, Roy A, Kao MC, Sturgeon JA, Cook KF, Lorig K, Burns JW, Mackey SC. Comparative Efficacy and Mechanisms of a Single-Session Pain Psychology: Protocol for a Randomized Controlled Trial in Chronic Low Back Pain. Trials 2018; 19:165. PMID: 29510735 https://doi.org/10.1186/s13063-018-2537-3 (open access)