How the Heck Does Talking About It Help? Practical Tools for Understanding and Managing Chronic Pain.

As a psychologist specializing in pain, I'm used to folks being suspicious the first time they meet me. By the time they get to my care, they've usually been through the healthcare wringer.  The first thing they want to know is: Do you think this is in my head? The second: How is talking going to help?

To which I answer: it is not in your head, and just talking probably won't help. This may sound strange coming from someone like me, but it's true! Talking about your pain - without building tools to address the factors that are exacerbating your pain - is likely not going to help. On the other hand, learning about the science of pain and applying it to your daily life can dramatically improve your ability to manage your pain.

Once I provide more explanation about how pain works and strategies that can help, the third thing folks want to know is: Why has no one told me this before?! So here I am sharing a brief summary that should be helpful to anyone dealing with chronic pain - or caring for someone who is. (For those in a hurry - feel free to skip to the even shorter bullet points at the end). I hope this is a useful resource!

What is Pain?

Unpleasant sensations are sent from your body to the spinal cord. This can activate reflexes - for example, quickly pulling your hand away from a fire. The unpleasant signals are then sent to various parts of the brain.

The brain decides how dangerous the situation is and responds accordingly. Past memories, current mood/stress level, and many other factors influence this decision.

When the brain detects a threat, it can respond in several ways:

• Set off a stress response (fight or flight) to help you get out of danger

• Increase the amount of pain you feel to help protect you from injuring yourself again

• Expand the area of your body that feels painful to prevent you from using that body part until it heals

Acute Pain is a Helpful Protector: With acute pain or pain from situational trauma, like breaking your leg, the pain signal from the body serves its purpose of alerting the brain about danger/harm. Once the injury is healed, the pain signals stop and the brain can stop the protective responses. Your body and brain go back to how they were before you were injured, and pain has done a great job of protecting you while you healed!

Chronic Pain is an Unhelpful Protector

When pain becomes chronic, the brain continues to use protective responses to try and help you, but they can become unhelpful when there is not an injury to heal from. Over time, the nerve pathways that connect the brain and the body can become hypersensitive, causing the brain to continue to turn up the “volume” on pain signals.

Turning the Volume Down on Pain

Relaxation Skills: Calming the Nervous System

Bodies can get stuck in "fight or flight" due to pain. To counteract this, you can tap into the “rest and digest” system to help the body and mind calm down. Some examples of strategies include:

• Deep breathing – breathing from your belly, not your chest

• Mindfulness – grounding yourself in the present moment

Thinking Skills: Changing Your Mindset

We can think about any stressful event (including pain) as a threat, a loss, or a challenge. Your body and brain are hard-wired to see pain as a possible threat. It is also easy to see pain as a loss, since it may interfere in many parts of your life.

Unfortunately, while it is natural to view pain as a threat or a loss, this leads to unpleasant emotions and less effective coping strategies, which tend to turn the volume up on pain. The more you can learn to view pain as a challenge - something that is hard, but you can get through - you’ll feel calmer, more in control, and make better decisions about how to cope with it.

Doing Skills: Changing Your Actions

Pain can keep you from doing the things you enjoy and connecting with the people you care about. Sometimes, by trying to avoid or control pain, we end up missing out on the things that matter most to us. This negatively affects our well-being, which will further turn up the volume on pain.

We can turn the volume back down by connecting with what is most important to us, even when pain is present. This does not mean that you stop listening to your body or start over-doing! It means moving toward the things you value and doing this in different ways than you might have before.

As you do more (gently and safely) your brain will get the message that things aren’t so dangerous.

In a Nutshell

Pain is a protector, and our brains help to decide how much pain we feel

• Acute pain is a helpful protector

• Chronic pain is often unhelpful and causes our brains to turn up the volume on pain over time

There are several strategies we can use to help turn the pain volume back down

• Tap into your “rest and digest” system through deep breathing, mindfulness, or other relaxation practices

• Change your thoughts about pain – reframe pain as a challenge instead of threat/loss

• Change your actions around pain – do more of what you value now, even though it may look different than before you had pain

Your pain is real AND there are things we can do to help!

At Rezenity Health, all our clinicians are trained in pain science and effective approaches to help manage chronic pain. We offer a variety of supports for individuals living with chronic pain including:

• individual psychotherapy

• skills groups

• pain coaching

 If you or someone you know is struggling with pain, reach out!

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