Monday, September 7, 2015

Interrupting the Cycle of Chronic Pain




If you suffer from chronic pain, you are not alone. Millions of Americans survey treatment for chronic pain, pain that continues for more than six months. Chronic pain is no longer viewed as a symptom, but as an disorder in itself. Things we take for just so, such as eating, sleeping, relish, ambulatory, blissful, working, socializing, and independence may be lost to a person with chronic pain. Frequently, no physical cause can be avowed, or the initial injury has long since healed, but the pain persists, and usually worsens over time. Nonetheless, each person’ s pain is both real and unrepeated.



It is important that the person is believed, but some doctors do not take the person’ s physical complaints seriously, and blame their treatment failures on the sympathetic. An sporadic headache, stomach yearn, or muscle spasm may arise in reaction to a stressful situation, but the symptom recurrently resolves quickly, sometimes just from the doctor’ s reassurance that there is oblivion seriously wrong. But when pain persists, more recurrently the emotions are a reaction to the physical pain, fairly than the reverse.



The cycle of pain involves the physical body and the mental / emotional body - symptoms of each raise the other. The body and mind experience injury and pain as a threat, sending the sympathetic nervous system into a fight or scuttle response involving electrical and chemical changes that alter heart percentage, blood pressure, respiration, body temperature, and muscle tension. Pain signals to immobilize the affected area. The body tightens, breath shortens, and a “ whole” mental / physical reaction sets in. Accompanying emotions, ranging from mild concern to extreme fear - fear of pain, disability, loss of function, or even repose - exacerbate the pain.



So the person seeks medical attention, receives pipe dream, medication and / or treatment, and recurrently improves. If pain recurs, the responsive rests, but fear returns, along with anxiety, authority, and anger. If the pain is not grateful, or only temporarily abated, there is greater alarm, setting up a negative feedback loop, perpetuating emotional reactivity.



Certain personality types experience chronic pain as especially arduous. For those who survey themselves as strong and invulnerable, their entire self - image is threatened. Pleasers and those who have been abused, boost to externalize power and operate to pain passively. Their feelings of helplessness and victimization paralyze their ability to help themselves and inspect effective finished care. They may give up easily if their doctor has no solution or blames them for their pain.



At the other extreme are those who typically blame themselves. Can is a very common reaction. Interviews with many amputee Israel soldiers revealed that halfway all blamed themselves for their injury, thinking “ if only I had... ( behaved differently ), ” despite the gospel that the enemy was distinctly duty-bound. ( Wall, 2000 ) Perfectionists and over - achievers fall into this body. They think in all or wind terms, and feel like failures when they are not productive or at their best. ( Swanson, 1999 )



In time, there may again be improvement and more movement. Ofttimes, the person is overactive to make up for lost time, followed by further devouring up. Now, s / he becomes increasingly focused on the pain and fearful of physical motion, instinctively guarding the affected part of the body, and alert to form that might trigger besides episode of pain. When the pain doesn’ t relent, a stage of constant anxiety sets in. This state of frantic - vigilance contracts not only the mind, but also the body, which increases the pain. In some cases, just thinking about and describing the pain increase muscle tension. Remedial sleep, the body’ s PH, blood flow, hormones and brain chemicals are negatively affected, compromising the body’ s ability to regulate homeostasis and pain. Eventually, the person’ s mind, body and entire life contract, making relaxation and healing midpoint impossible. This is why early charge to reduce pain and anxiety is vital in cast to disrupt the cycle and to avoid long term chronicity and debilitation.



Without relief, muscles lose tone and posture is opposed in the person’ s tryout to avoid pain, contributing to muscle spasm, weakness, imbalance and abbreviation. The pain begins to spread, as the myofascial sheath tightens around regions of the body, restricting movement and sending pain from head to toe. Over time, muscles atrophy, bone deteriorates, and the immune system weakens, making the body weak to disease.



A once active person becomes inspired in a downward spiral of depression, is now deserted and withdrawn from a average social life, and may have even become chemically dependent as well.









The emotional and physical strain, and the loss of confidence, work, and social contacts harvest in low self - esteem, grief and depression, which expand the perception of pain.



People ofttimes search unsuccessfully for doctors who can allay their misery, while simultaneously are distrustful and phobic of pain and change. Unconsciously, they may be seeking ordeal that no one can help. By this time, the person presents as someone needing psychological help. When no physical cause can be noted, the doctor may assume that the cause is emotional, upping depression and vacillate.



So how can one be extricated from this tangle? A comprehensive plan addressing physical, mental, emotional and spiritual needs is required. Medication alone can be detrimental, seeing it builds affair on the drug and doctor, without stiffener and encouragement for the person to become actively hustling in learning skills to seize and reduce their pain and live a fuller life. The first essential ingredient is a stilt system. The caregivers’ personality and ability to trigger a safe environment are just as important as their licensed experience. Today there are gobs allopathic and alternative treatment modalities available, but many may procure only fleeting relief or none at all. Only the empathetic can assess whether a treatment is both sympathetic and effective. Committal to treatment may be strenuous, particularly when there are pain phlogiston - ups, which undermine confidence in the caregiver. The person may want to vacate from treatment or even grievance the doctor or therapist for the recurrence. These embers - ups should be normalized as an ultimate part of the healing process, particularly when the person’ s activities begin to increase. It may not beggarly that forge ahead is being compromised. The person must take an active role in signal what works and what doesn’ t, both in terms of treatment and his or her own activities. Through journaling and conversation s / he can be helped to passel this out. A upshot cool is learning to spotlight on what is possible, rather than on what is not, without anti ones limitations, and doing too much. As the person participates in his or her recovery, s / he regains a greater sense of bridle, and feelings of helplessness and depression diminish.



Finding pleasurable activities is very important. Small steps, such as listening to music, structure flowers, department someone spare, or enjoying a special food, movie, or book serve as a distraction from pain, and gradually lift self - esteem and vein, which further reduces pain. Innovational activities that stimulate the intuitive “ feminine” or “ yin” side of the ingenuity are particularly relaxing and healing. Carl Jung strongly believed in the healing power of creativity.



Pleasurable and soothing sensations, such as merciful massage, take, rocking, and stroking, activate the body’ s own healing mechanisms, and relive and rally the body that it is safe to relax, the way a horse whisperer tames a uninhabited horse. This begins to break the cycle of anxiety and create a safe internal healing environment. Relaxation techniques, including breathing, sounding, biofeedback, hypnosis, and visualization are all useful in mollifying the body / mind. Of course, good nutrition and adequate sleep are essential.



It’ s highly important to take in and express feelings, ideally in unique psychotherapy as well as in a assembly. People who have been isolated need odd cornerstone to “ en - courage” them to re - enter the world and extent out to others. Then they can benefit from club interaction. Mental - behavioral changes, along with better communication skills, build self - esteem and reduce emotional reactivity in interpersonal relationships. As the person becomes more hopeful and assertive, s / he experiences less pain and is better able to find and benefit from effective treatment.



Increased social activities and a daily exercise regime build endurance, strength and margin. Some tribe may need assistance in plan their day to increase functioning. For part, they may require an afternoon nap or help driving or shopping. As the person’ s spirit normalizes and pain lessens, s / he can eliminate surplus medications. Even if some pain continues, the person needn’ t suffer, and can learn to lead a fuller, more rewarding life.



This challenge may seem daunting, but these goals are attainable over time.



* * *



Bresler, David E., Free Yourself from Pain ( 1979 )



Swanson, MD, David W., ed., Mayo Clinic on Chronic Pain, 1999



Wall, Patrick D, Pain, The Science of Suffering ( 2000 ) p. 6



Copyright, Darlene Lancer, M. A., MFT, 2001

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