Living With Chronic Pain

Positive Thinking

Positive thinking. I can just imagine what that sounds like- the pain isn’t real. But that couldn’t be further from the truth. The pain is very real. It impacts and often directs our lives. How we interact with the pain can make all the difference.

Ever notice how it’s better when you’re distracted? I have. It’s not gone, the pain just becomes more bearable during those moments. When I’m having fun and engaged at dinner. Laughing and celebrating with friends and family. Playing and cuddling with my dogs. Doing something new for the first time. For my birthday I was introduced to a pottery wheel. For one hour I became enthralled with turning a lump of clay into a work of art. Truth be told, the teacher had more input into the final project than I did. Even with the awful positioning I had a wonderful time and for a few brief moments, the pain was no longer my focus.

The brain is massively interconnected with the rest of the body. New studies show that when people feel physical pain the same areas of the brain get activated as when they feel emotional pain- the anterior insula and anterior cingulate cortex. There are direct neural connections via the brain stem and spinal cord. The circulatory and lymphatic systems also carry neurotransmitters (hormones and immune cells) that find receptor sites in the brain which feedback and modulate the links between brain and body. In this way, every cell in the body, every cell, is linked into the nervous system and as such, can be sensed and felt, whether or not we allow ourselves to be aware of this psychobiological fact.

With a physical pain, there is an obvious link between the emotional experience of the pain and an awareness of where it originates from inside the body. We know an elbow, toe, or hip hurts. Weirdly, we can feel the physical pain in that location even though most, but not all, of the processing is going on in the brain. The neural, blood, and immune pathways between brain and body are tagged with body location information, beginning in the spinal cord and with successively more specific tagging up through the brain stem and thalamus. Each adds another layer of redundancy and complexity, until the experience becomes conscious and further identified as “mine” in the insula, parietal, and motor cortices.

The marvel of the nervous system is that even though body sense awareness is largely a creation of the brains cortical complexity, we feel in 3-D (for example, the pain is “in” my knee) that object “out there” in space. With physical pain, we’d be in big trouble if we could not define where it hurts. How would we (our brain) know how to deal with the pain (how to move, how to sit, or how to lie down without further injury) in the absence of a location and a direct body sense? The real question? How do we learn ways to deal better with the brains perception of that pain.

One option is Cognitive- behavioral therapy (CBT). This is a way to cope with health problems by changing how we think about them, since how we think affects how we feel. It focuses on thought (cognitive) and action (behavioral), discouraging thoughts that make us feel bad and replacing them with helpful ones. This way we’re in charge of the perception and can stop or alter negative, harmful, feelings before they have an impact. This kind of thinking also involves calming our mind and body through the many ways I’ve already discussed in past posts- meditation, yoga, biofeedback, muscle relaxation, hypnosis, guided imagery, and exercise. A trainer, therapist or counselor can be beneficial but they’re not imperative, this can also be done on your own. 

CBT can teach ways to manage thoughts, feelings and bodily responses to help control pain. There’s that word again, control. It’s the linchpin in all treatment programs. Empowering us to take back our lives. Making it clear we, not the pain, decide our path.

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