Pain is bi-directional it runs from the body to the mind or the mind to the body. We can interrupt these signals and you will not feel as much or any pain. In a meta-analysis of studies examining how our brains register pain Apkarian, Bushness, Treede, and Zubieta (2004) found evidence for using distraction as a non-medical pain management treatment. Participants in the studies reviewed had decreased rates of pain when distracted in a variety of activities (activities were dependent on study performed).
If you are a person who lives with chronic pain what methods have you employed to help yourself shift perspective, accept, and create a life that meets your needs now? So many who experience chronic pain feel dejected, disappointed, and angered when medical treatments fail, and they are unable to reduce their pain with pharmaceuticals. Pills are estimated to be about 40% effective with pain states (Turk and Winter, 2014). They are miracles for certain types of pain and negligible for others. If you are someone who has hit a wall with medical treatments, are tired of the side effects (drowsiness, lack of engagement, constipation, stomach/digestive issues, brain fog/cognitive decline) it may be time to look into options for non-medical pain management supports.
Many find relief using a combination of treatment models, acceptance, and perception change. Psychological treatments can be helpful in these areas. They can support the medical prescriptions while supporting behavioral changes, processing the grief and loss the pain has created, and help build a new paradigm for successful living with the physical changes.
Pain is an interesting signal. It is here to help us pay attention. Sometimes our signals get crossed. We find pain in situations that are not physical, yet feel physically painful – the broken heart, gut response, or goosebumps rising. Physical and emotional pain run on the same circuits and there are a variety of options for treating it. Use your mind to help your body. Seek psychological treatment for chronic pain states.
The problem with pain – is a big topic in our media right now. There is so much talk about the opioid crisis, questions about what is chronic pain, and wonderings about how we got here. The conversation is large and happening in all sorts of places. In my practice, I deal a lot with pain. I have many clients who struggle with chronic pain, or have been hurt and the acute pain keeps them from activities they love leading to depression or anxiety, or the trauma of the injury disrupts their nervous system, leading to a host of problems. In addition, I see a lot of opiate addiction as a result of prescription medications. Many do not even know how they got to the place of addiction, let alone how to get out of it. I often get questioned about how to deal with pain, especially when opiates are not something available or wanted. This week we’ll be looking closer at pain and what to do about it.
What is pain anyway?
For most they would answer, this is the signal your body gives when it is hurt or there is something you need to avoid because of potential hurt. However, pain is not always physical and physical problems do not always cause pain (Turk and Winter, 2014). Physical and emotional pain run on the same circuits and whether the pain started as a physical problem (injury/disease) or an emotional problem (depression/grief/anxiety/trauma) the result can feel the same. Physically painful.
Due to mental health stigma, lack of understanding of the body’s “warning” systems, and heavy marketing of pharmaceuticals many who experience pain sensations turn to drugs. Unfortunately, many of these pills to fix the problem make it worse. Pain medicines often lower your threshold for pain, thus causing a cycle that creates the need for more pain meds.
Since it feels physical, and our society lacks understanding of how the mind-body connect, we turn to physical solutions. Often at the expense of solving the problem or trying options that may be more powerful. Now, this is not to say medications and physical medicine do not have a place in pain treatment, however many people do not engage in the other half of health – mental health – as part of pain management. Thus, they are left with only half the equation, half the treatment, and often lots of frustration.
“But it’s so physical you say, it must be a physical problem.”
Maybe. According to Apkarian, Bushness, Treede, and Zubieta, “… emotional state can influence pain perception, and a recent study shows that negative emotional states enhance pain-evoked activity in limbic regions, such as ACC and IC”, (pg. 474, 2005). In a meta analysis on questions related to how humans experience pain, their study looked at areas of the brain responsible for pain sensations. Findings from the many studies in their analysis suggest that pain is felt in different areas of the brain for acute versus chronic pain states and that cognition and emotions influence how, when, and why we experience pain. They also showed evidence for non-medical pain management treatments, such as distraction and acceptance. Yet, for many they never think to turn to or are offered options for non-medical pain management, and end up in the opiate cycle of addictive patterns and need.
We know our mind and our bodies are connected. Most would say “yes, Stacy you are right”, but not everyone understand’s just how closely connected they are. In my world of somatic psychology we do not even consider them to be separate entities we can speak of. The mind lives in every cell of the body and every biological cell in your body is responding to the environment you are in, including your thoughts and emotions, all the time, every minute of every day.
When you consider that your physical structure is actually a mental structure with a physical container it becomes easier to see how much your thinking and feeling – which are subjective to the environment around you – play a role in what you feel physically. In my graduate research I studied how the physical body is influenced by psychological trauma. This trauma could be an event(s) or negative thinking patterns or a chronic sense of overwhelm. All create a similar physical response in the endocrine system that responds as though you were physically hurt or fighting off a disease. The bodymind senses a problem, inflammation rises, and your immune system gets ready to fight. However, in the case of psychological trauma and chronic stress states there may be no tangible predator and your body begins attacking itself. This leads to chronic inflammation – heart problems, cognitive issues, joint pain, digestive issues, chronic pains states like fibromyalgia, and more. The cellular structures sense a problem, however it may not be a physical problem per say, but … it becomes one. The end result is the same … sensations of pain.
Non-medical pain management treatments.
Many people want to know why pain syndromes are on the rise in our society. This is a complicated issue with many facets, however if we take a global look we can see a number of ideas and areas you may be able to influence your own behavior and help decrease pain in your own life.
Pay attention to what you allow into your psyche. We “share” pain.
Humans are biologically pack creatures whose brains developed to connect to other mammals. Our brains respond to others in pain. When we are exposed to others in pain, we feel it in our own systems. Even if we do not feel the pain as a physical process, our personal sensitivity to pain is activated (Liu, Meng, Yao, Ye, Fan, and Peng, 2019). By watching that daily news program, listening to stories on the radio of atrocious things happening around the world, and by reading about torturous things we are activating our own pain system and could be elevating our own sensitivity to pain from other sources.
Food and environmental toxins: another source of inflammation.
In the United States of America our food options can be a source of increasing inflammation in our physical structures. As noted above, when inflammation rises so does our susceptibility to other problems that may seem unrelated but need medical attention. The Standard American Diet (SAD) is very sad, indeed. Most of the foods we are offered are loaded with chemicals, sugar, and salt. On their own these ingredients may not be a big deal but the enormous amount of them in our food, cleaning, and hygiene products is too much for our system. In addition to what we may consume by mouth or through our skin, the mass production of single crops creates a high need for pesticides and chemical trails that get into our water supplies, poison the air we breathe, and lands on our skin through indirect contact.
Learn to read food and product labels and remember cheap food is not always good food. Keep in mind that bigger is not always better and more does not always equal care. As many in our culture look to food to fill emotional gaps in our life, find the “sweetness” of life, or “fill up” when we are feeling empty, lacking, alone, bored, or fearful it is important to examine how you use food. The “value” sized cheap chips loaded with “cheese” flavors may be creating an empty feeling you will not be able to fill no matter how much and how often you physically eat.
If you are confused or feeling overwhelmed by these concepts reach out – there is support and education to help you learn more and work through these issues.
Another source of stress in our life … ease!
What, you say. How can this be?! Well, the more comfortable we get the harder it is for us to find our own confidence, esteem, worth, and strength. When things are easy we do not have the opportunity to “test” ourselves and learn about our edges. These edges are important for self growth and expansion. Instead, we stay in our comfort zones and let other people’s lives distract us from living our own.
We stay in the same cultures, doing the same things, and operating on autopilot. This creates boredom and a lack of engagement. Then we look to other things to “fill us up”, see the food paragraph above. We also start to consume media, mood altering substances, tech / internet / using devices, and other items that are not healthy in large quantities. When this overindulgence happens we shift our internal chemistry and we can create situations in which our bodies are overpopulated with bacteria and flora that is not helping us. This imbalance can create a decrease in our body’s ability to create the neurotransmitters, hormones, proteins, and enzymes we need for optimal mental and physical health.
The more we watch, listen to, and read about tragedies around the world, see images of others in physical and emotional pain, and engage in mindless distraction the more we feel lost. Remember our systems are created to connect, thus our passive engagement with these things creates a physical response in our system, even if indirectly – we are being impacted by everything we consume, in every way we consume it. Guard your consumption well.
Living in a Fear based culture … real or imagined / accurate or created. It all ends the same in the body – inflammation.
Lastly let’s talk about stress. In our society we talk a lot about stress, but instead of decreasing it, it often seems like it gets harder to control, even when we know about it. Many of us are not great at setting boundaries and struggle to find the limits to what we want to give, engage in, participate in, and be involved in. We feel pulled to say yes to the groups we are part of (schools, friends, religious, community, kid activities, non-profits). We haven’t learned to say no … or say yes appropriately for our personal system.
Understanding outside influence and group dynamics to set up our fear based culture
Many of us continue to get asked to “do more with less” at work, school, in our household budgets. We are fed lines about what we should want, need, have and do not know what the “spin” is. Some of us are not good at checking the source. We consume media, conversation, social media as though it is true. We figure if the information is coming from a source we like, trust, or feel is “like” us it must be true. We forget that many of these sources are mining our data, targeting us, and working to activate us toward something – usually something that gives that group profits or power. As a result of being overwhelmed we narrow our focal areas and become more rigid and polarized. This is a classic outcome of group dynamics. Social sciences have been studying how groups form, polarize, strengthen, and implode for decades. We have many great examples of group dynamics to study throughout the years. As a result of this polarization and rigidity we become more fearful about “others”. This fear results in a physical change in our bodies.
Fear is a response we need. It is really helpful when we need a warning system. It is very good when we need to run and get away, however when we are engaged in the activities listed above we can create a sense of fear in the world based on the messages being “spun” to capture our dollars, attention, and engagement. This fear, the kind that is created in the mind based on what we see, read, hear, has the same physical responses in the body as fear based on being chased by a mountain lion. As a result our physical body reacts and feels something that prompts us to move away or fight. This is caused by an increase in adrenaline, norepinephrine, and cortisol. When we are not actually running away, we do not have the opportunity to metabolize the stress chemicals pumping through our system. As a result our system stays “revved up” and inflammation begins to rise. When it is chronic and there is no opportunity to metabolize the hormones, the inflammation states create physical health problems – again, see the above list. The quick result is often a pharmaceutical and all its side effects.
Couple all the above with a lack of exercise and movement, which helps our bodies metabolize out the inflammation states, and you have a recipe for a physical disaster. Add the fuel around mental health stigma, feeling overwhelmed, being too busy, and suddenly it is clear why it is easier to go to a medical doctor and get a pill. Pills are easy and often very effective for the symptom. They just aren’t always the answer for the problem. Often the problem is a behavioral change(s) that will take time to implement and willingness to do the hard work of self examination and radical acceptance. This work does not always result in zero pain, but neither does the quick answer, it just masks it for periods of time. Mental health treatment for pain helps us engage in our life to the best of our abilities and can increase our quality of life even if we continue to experience chronic pain states.
You get to choose how you will live, what you consume, and what you do with the time you have – Which will you choose?
Feel like you struggle to regulate yourself? Can’t seem to find a way to calm down when things are tough. Just Breathe … and here’s why.
Take 5 long breaths in and slow your exhale. Begin your count on the exhale and it will automatically slow your inhale. This equals about 30 seconds of deep breathing, which engages the relaxation response through your endocrine system. This response counteracts the stress response and they cannot exist at the same time.
Your breath controls your mind. It does this by impacting your heart rate, known as heart rate variability. As you breathe you are changing and shifting your nervous system between parasympathetic (rest/digest) and sympathetic (fight/flight) all day long. By taking control of your breath, you take control of your heart rate, when you do this your brain gets the signal that things are ok.
This builds self confidence by allowing you choices in each moment. Over time you learn that you have skills to figure things out, even when you do not like any of the choices in front of you.
Choices allow you to respond rather than react, thus you are more regulated in every interaction throughout your day, doing just what is needed in each moment. No more, no less.
Increase your mental health by getting outside and moving everyday. It doesn’t have to be overwhelming or expensive to start.
Did you know that walking can help you maintain a positive outlook and decrease symptoms of common mental health disorders? Research expands the links between leisure time activity, being in nature, and increased mental health in a variety of conditions.
It also doesn’t have to take a lot of time. Balance your life by fitting your strength training into your trail run or walk.
Thank you to UWS Counseling Students for a great evening of exploration regarding the mental health field. In this post I also outline and more in-depth explanation of treating and healing from early trauma. A list of somatic psychology resources is also included.
Thank you for letting me come speak about our profession! I enjoyed the exploration and interest areas. There are some many possibilities and avenues for careers in behavioral health. I am grateful to be able to share my experience and hope for the next generation of LPCs. I wish you well, and please feel free to contact me if more questions/thoughts arise.
As I reflected on the questions I believe I didn’t answer the question about early trauma fully – to heal from psychological trauma we do not need the story/details of the event. Trauma happens in the body, even when it is verbal in nature, the physiology of the fear disrupts the endocrine system and dysregulates the brain processes. As a result we see dysfunctional behaviors and coping skills. To treat this we can use a number of therapies that target body sensations, as early trauma is stored in brain centers as sensations – not as words/symbols. We can then use the body sensations to track and allow neuropathways to develop while using the present moment therapist to client regulation. This allows the person to process through the trauma in the brain via the body with safety, then make meaning of the event(s) using words, art, music, etc. I tend to use somatic therapies most of the time along with cognitive work to help make meaning and keep the process moving – help clients understand what’s happening when that’s what’s needed for safety. And Dialectical Behavior Therapy to teach regulations skills prior to trauma protocols. Many somatic modalities teach them along the way, however some struggle with the mindfulness and/or aren’t used to being in the body, tracking sensation for long periods of time. Cognitive work can help balance the fears and safety while building endurance. Some resources for the somatic work:
USABP – United States Association for Body Psychotherapies
SE – Somatic Experiencing, Peter Levin has a good book on trauma in the body
Hakomi – Hakomi Institute
Sensorimotor Psychotherapy – check out Pat Ogden’s book on trauma and the body
EMDRIA – Eye movement densitization and reprocessing therapy main association website.