Pain and Emotion

Traditional treatment of chronic pain has focused almost exclusively on the injured body part or area. Rehab, injections, electrical stimulation and surgery are all physical forces applied to the injured area. This physical focus creates an unhealthy belief that treatments that focus on the mind are for people who don’t really have pain. If they can talk their way out of it then maybe it was never really there in the first place. This idea is very unfortunate, and it completely misunderstands what pain is.

Consider this fascinating study. Professor Moseley is an internationally known pain researcher. He conducted a brilliant study clear back in 2007. The results of that study are found in this graphic:

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Volunteers were asked to rate the pain of a very cold object applied to the back of the hand. The experiment was done twice, on separate days. On one day there was a bright red light in the exam room. On the other day, there was a bright blue light. That was the only difference. The results were stunning. Each yellow line in the graphic represents the same person. On the day with the red light almost every single person rated their pain higher than on the day with the blue light. Why?

Emotional context. Red means caution, warning, danger. Blue means normal, calm, peaceful. Each color is associated with an emotional response and that emotional response impacts the pain. Dramatically.

Which of the pains was real? Was the pain on the day with the red light any less real than the pain on the day with the blue light? There was a painfully cold device pressed into the back of the hand on both days. It hurts to have your skin nearly freeze. What this study shows is that all pain is real, it’s just that sometimes (actually a lot of the time) your pain is amplified by your emotions.

Your pain is rarely experienced without an accompanying emotion. When your pain flares, are you aware of the accompanying emotion? Fear is almost always one of these emotions. Also anxiety, sadness and loneliness. Recognizing which emotion is dominating is essential if you would like for your pain to become less disabling. Because each of these emotions tends to amplify you pain.

This has been very dramatically proven not only with studies like the one already mentioned, but with sophisticated brain imaging devices that accurately show which areas of the brain are active when a person experiences pain. We used to think that pain was felt in the “pain center” of the brain, but now we know that no such place exists. Instead pain is felt in multiple areas of the brain and almost every area affected by pain is also an area that is responsible for processing and/or expressing emotion.

Pain is an emotional experience. You surely know by now that this is true. What may be less obvious is that emotions can trigger physical pain. Your chronic pain can seem very acute when you are experiencing intense emotions. But what can you do?

Mindfulness therapy is a fantastic tool that has totally transformed the experience of many. It teaches you to be able to identify your emotions in real time and to then modify the impact they can have on you and your pain. Mindfulness has been studied scientifically in patients with chronic pain and has been proven to reduce pain, sometimes dramatically. Part of what we I do in my pain management program is to introduce patients to mindfulness.

As I stated in a previous post, chronic pain and PTSD share many commonalities. The emotions you experienced at the time of your injury or onset of your disease will have had a significant impact on the severity of your chronic pain. The trauma of these early emotions may not respond to simply becoming mindful of your current emotions. This is where counseling can be invaluable. As you become more mindful and in tune with your current emotions, spend some time thinking back to your emotional experience at the onset of your pain and consider spending some time with a trained counselor to work towards an understanding of how these emotions have shaped and intensified your pain.

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