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Physical relaxation.
The first thing the body does in response to pain is tighten up, squeeze around the painful area. This gripping has some unfortunate consequences for the person in pain. First, it constricts blood flow which is necessary for healthy functioning and for removal of toxins. Second, if the muscles remain cramped and held, lactic acid will accumulate and the muscle itself will begin to ache from over-use, compounding the problem. Third, the stiffness will unbalance body posture and movement, producing problems in areas trying to compensate for the stiffness in the painful area: you may remember the Olympic runner who suffered a pulled hamstring while trying to favor a slightly sprained ankle. Finally, the muscular squeezing of an already tender area hurts.
It is easier said than done to re-learn how to achieve physical relaxation in areas of the body experiencing pain, but doing so generally results in a significant, even dramatic reduction of the experience of suffering. It also reduces or eliminates the associated problems described above. Remembering when you have felt most relaxed in your life, and noticing the changes in your body - breathing slowing and becoming more rhythmic, belly and chest loosening, neck and shoulders releasing tension, hands and feet opening, face and eyes softening - can help recall and re-learn the experience. Progressive relaxation exercises can re-train specific muscle groups. Attentive practice is often necessary if the body tightening has become habitual.
Processing emotions skillfully.
The first emotional response to acute pain is usually fear. The response to chronic pain is often anger and depression. Knowing how to properly name and process emotional states can reduce the distress associated with physical pain. There is no one right way and no set of "bad" emotional experiences. For example, for people who habitually repress anger and let others run over them, getting mad will probably feel freeing and like a great relief. For people who carry resentment and anger around all the time, letting go of their holding on to these states will relieve suffering. It's a question of what your relationship to anger is, and if your habitual pattern is helpful or gets you into trouble. The same goes for sadness and fear. How do you relate to the experience of having that feeling? What does your body do with it? Developing the skills to notice (1) what you are feeling in the present moment, (2) what your attitude toward that feeling is, and (3) how your body holds it, can be extremely helpful in not making your pain worse by how you respond to it emotionally. Those skills can also lead to a way of relating to painful experience that builds self-esteem and confidence rather than erodes it.
Tools for Pain Management
Approaches to mindfulness training are varied; many involve versions of meditation practice which teach the skill of observing and identifying mental and emotional states arising, while not identifying with those states. Other approaches involve simply centering attention and gently returning it to center when it (inevitably) wanders. These techniques are wonderful practice for the kinds of mental discipline called for in using self-hypnosis in pain management. My approach to self-hypnosis is to ask the part of the mind (or of the brain, or of the self) that can change the experience of the pain to do so: this can mean anything from complete alleviation of pain to subtle reduction of suffering. We know we are capable of this from the experiences of people in crisis situations who report feeling no pain while sufficiently distracted by emergency. Some people are lucky enough to have a natural talent for self-hypnosis and can achieve remarkable pain reduction quickly. Most of us have to learn gradually and practice a lot.
The trick is in learning how to invite the process to occur, and how to let it occur, without stopping it from occurring by trying to make it occur.
Spiritual attitudes and practices: acceptance, service.
Pain is the ultimate negative trance. It says, "pay attention only to me. Only I exist. There is nothing but pain and suffering in your consciousness. You are alone." It encourages you to leave your body, to be run by fear, anger, and despair, to feel hopeless and isolated. Isolated from the experience of comfortable connection with your body, with your feelings, with friends and family, and with your sense of connection with an intelligence greater than your own: God, life-force, nature, Allah, Buddha-nature, higher power are some of the names it has been called. This sense of connection does not have to be mediated by religion; it can be felt by a simple walk in the woods hearing birds sing and frogs croak. It refers to a felt sense of connection with the world, and the practices that cultivate that sense, not to a set of religious beliefs. Finding ways to return to this sense of connection in the presence of pain can be difficult, but developing the subtle kinds of awareness called for reduces the intrusion of pain's negative trance and helps return your normal sense of yourself.
Most spiritual practices encourage the cultivation of two attitudes that seem especially helpful in reducing the suffering and isolation associated with physical pain: acceptance and service. When cultivating an attitude of acceptance, you stop trying to eliminate or change the pain. You notice that you may be angry or fearful about being in pain without trying to change that. The key is you don't identify with the pain or the emotional reactions; you notice they exist as part of your experience. Part of your experience. What else can you experience? What else do you notice? Are there subtle changes in your feelings and in the pain experience itself that arise from not fighting against them? Does a sense of curiosity begin to develop as you pay closer and closer attention to different parts of your body and different parts of your experience (including but not limited to different parts of the pain experience)? Acceptance is not an end-point, it is an opening to different qualities of experience.
Similarly, service seems to be a way for people to focus their attention on another person (and away from over-focusing on their pain) and to re-establish their sense of connection with the world and on their value to others, breaking the cycle of hopelessness and isolation that pain invites. When I watch people in pain group talk about their experiences of service, whether it is about taking their nephew fishing or running a group at their church, I see the muscles in their face relax, their postures shift, and their entire being seem to orient to comfort and peacefulness as if the pain was gone.
Taking a careful inventory of your responses to physical pain will reveal which of these approaches will most comfortably fit your
temperament and abilities. Most people find some of all four helpful to pay attention to. Having a therapist as coach and trainer can keep you focused and on track as you learn these skills and practice them regularly so that the habits you develop lead you to reduce suffering and minimize reactivity to pain, and more reflexively use it as a signal to trigger attitudes and behaviors that feel healthy and nurturing.
Copyright © 1997 Chuck Holton All rights reserved.