Wednesday, April 17, 2024

Pain: The Body and Mind Unity Of Defense -- Or -- Learning To Live With Hurt

 


In 2015, Lesley Paterson broke her shoulder during a practice run the day before the Costa Rica XTERRA triathlon that caused her to lose the ability to use her arm. Not only did Paterson compete in the race, but she also won. Furthermore, the now five-time world champion triathlete, battles with debilitating, chronic Lyme disease. She attributes her ability to persevere, despite experiencing mental and physical pain, to the power of her mind.

It’s a mindset you develop across years and years,” says Paterson, now 43 years old, living in Los Angeles, California, and working as an Oscar-nominated screenwriter. “It’s something both you’re born with and you develop and cultivate. I’ve dealt with pain my whole life, or rather sought it out.”

Paterson’s ability to navigate pain by leveraging her thoughts is also backed by current research.

Jake Panasevich, E-RYT, focusing on the practical benefits and applications of yoga and mindfulness

The Mind-Body Connection

Ellen Langer, professor of psychology at Harvard University and author of The Mindful Body, Thinking Our Way to Chronic Health published the landmark “counterclockwise” study in 1979, in which elderly men were put in a retreat and lived as if they were 20 years younger. As a result, the men grew "younger" in health-related measurements.

We had elderly men live there a week as if they were their younger selves,” Langer says. “For example, they spoke of the past in the present tense. In a period of time, less than a week, what happened was, their vision improved, memory improved, and their strength got better, and they looked noticeably younger, without any medical intervention.”

This study is part of a larger body of research that illustrates what Langer calls “mind body unity.” Other studies have demonstrated that how participants perceive time can speed healing and alleviate symptoms of fatigue. These findings show that the mind and body operate in unison

(Jake Panasevich, E-RYT . U.S. News. “Pain and the Mind-Body Connection.” January 11, 2024.)

Older folks learn to deal with pain as a regular part of their daily regimen. Whether trying to live with impingement discomforts, major aches aches and, or chronic illnesses, the mind plays a major part in improvement of their life/painful conditions … and, as it comes to light, pain itself can lesson with mindful intervention. At the very least,mind and body unity is a major path to feeling younger and more vibrant.

Langer says that being mindful about making decisions leads to less pain -- acute and chronic -- and stress and, therefore, better overall health. Studies have shown that instead of telling someone to “try” something, you tell them to “do” the task, and the doers always outperform those who try.

Instead of wasting your time trying to make the right decision, make the decision right,” Langer says. “The stress from making decisions comes from the fear of not making the right decision. You can’t know what the right decision is because things are always changing. They look different from different perspectives. Make it work.”

Langer says that research on Parkinson’s disease, multiple sclerosis, arthritis and other chronic pain conditions shows that people find great relief by becoming aware that their pain is on a spectrum. Once someone realizes their pain doesn't only get worse but feels better at times, it is crucial to consider why it improves. This is an exercise in mindfulness and helps those who are suffering to stay hopeful and seek out solutions.

According to Tom Walters, a physical therapist and author of “Rehab Science: How to Overcome Pain and Heal from Injury,” navigating pain is both an exercise in therapy and physical movements.

Often there’s a fear-avoidance scenario, where you have pain and you get scared to do certain movements because you’re worried it’s going to injure you,” Walters says. “Not being able to do those causes depression. Then you move less, and you create more pain. A lot of people get caught in that cycle with both anxiety and depression.” Embracing, not avoiding failures help the mind set to better heath.

(Jake Panasevich, E-RYT. U.S. News. “Pain and the Mind-Body Connection.” January 11, 2024.)

Help With Pain and the Mind/Body Connection

  1. Cognitive behavioral therapy (CBT). This talk therapy teaches people to redirect their thoughts, feelings, and behaviors in response to chronic pain. For example, when a pain flare-up strikes, instead of bracing yourself and thinking, “Oh no, here it comes again,” tell yourself you’ve handled this before, and focus instead on your favorite place in the world: picture it in your mind, and feel how happy or relaxed you are when you’re there. A therapist trained in CBT can train you to hone your skills.

  2. Meditation. Like deep breathing, meditating triggers the relaxation response and may reduce the perception of pain. You can use many methods to meditate, such as transcendental meditation (repeating a word, phrase, or sound to quiet your thoughts); yoga (a series of strengthening and stretching postures combined with breathing techniques); or mindfulness meditation (focusing objectively on negative thoughts as they move through your mind, so you can achieve a state of calm).

  3. Deep breathing. We typically take short little breaths without noticing our breathing, especially when we’re in pain. Focusing on breathing and taking deep breaths quiets the mind and induces the relaxation response, a well-studied physiologic response that counteracts the stress response, and may lessen chronic pain severity.

  4. Mindfulness-based stress reduction (MBSR). This approach combines mindfulness meditation and yoga to build awareness and acceptance of moment-to-moment experiences, including pain.

  5. Relaxation. Relaxation techniques, such as progressive muscle relaxation, may also help reduce the perception of pain. To try progressive muscle relaxation, start with your facial muscles and work your way down the body. Tighten each muscle or muscle group for 20 seconds before slowly releasing the contraction. As the muscle relaxes, concentrate on the release of tension and the sensation of relaxation.

(Heidi Godman, Executive Editor, Harvard Health Letter. “5 ways to ease pain using the mind-body connection.” Harvard Health Blog. Harvard Medical School. August 24, 2020.)

The View of the American Psychiatric Association (APA)

Chronic pain, commonly defined as an unpleasant experience felt in any part of the body that persists longer than 3 months and that may or may not be associated with a well-defined illness process. Chronic pain affects up to 28%–65% of the U.S. population and often leads to reduced occupational activity and subsequent economic loss. In 2008, the costs of chronic pain in the United States ranged from $560 to $635 billion. In addition to health care costs, chronic pain results in lost economic productivity, as well as exorbitant financial compensation for persons unable to work. Providing pain relief that is clinically significant and sustained and that has few adverse effects is the goal of chronic pain management. Here, we assess the role of the mind-body connection (i.e., social, emotional, and behavioral factors influencing physical health) and how it relates to mindfulness techniques that can alleviate chronic pain.

(Pills, pills, and more pills. Addictions increase!) Currently, the most commonly used and most widely available treatment modality for chronic pain is medication, with the goal of maximizing efficacy with the fewest toxic side effects. The most commonly prescribed agents are opioid-based medications, nonopioid agents (nonsteroidal anti-inflammatory drugs and acetaminophen), and adjuvant medications (anticonvulsants, muscle relaxants, corticosteroids, topical-numbing agents, and antidepressants). However, there are nonpharmacologic treatment modalities, including mindfulness techniques, exercise programs, brain and spinal cord stimulation, and virtual-reality hypnosis. The most effective results are typically seen in multidisciplinary pain clinics, but these clinic services are not widely available to all patients.

Numerous studies have demonstrated the inadequacy of current pain management modalities and the need for newer, more widely available interventions. Physicians should consider supplementing or replacing medications with nonpharmacologic modalities such as mindfulness.

Dr. Jon Kabat-Zinn, founder of the Center for Mindfulness in Medicine, defines mindfulness as "paying attention to something, in a particular way, on purpose, in the present moment, non-judgmentally.” The goal of mindfulness in the treatment of chronic pain is to cultivate a quality of openness and experiential acceptance of pain, rather than rejecting or avoiding the pain. In this way, mindfulness can be beneficial in treating chronic pain through a noninvasive approach via the mind-body connection .

Conclusion: Although mindfulness has been well studied as an effective supplement or augmentation for pain management, few studies have simultaneously examined the neuroanatomical and neurophysiological alterations that can occur as a result of mindfulness to actively reduce pain. There are some contradictory studies that have demonstrated the potential ineffectiveness of mindfulness; however, it is important to consider that mindfulness is a modality that has minimal risks and can be beneficial. Further studies are needed to expand our understanding of the neurophysiological and psychological mechanisms underlying the effects of mindfulness on pain processing and perception. Mind -Body Connections produce minimum risks.

(Raymond St. Marie, M.D. And Kellie S. Talebkhah, M.S. “Neurological Evidence of a Mind-Body Connection: Mindfulness and Pain Control.” The American Journal of Psychiatry.”

April 1 2018.)

On Pain”

Kahlil Gibran 1883 – 1931

And a woman spoke, saying, Tell us of Pain.
     And he said:
     Your pain is the breaking of the shell that encloses your understanding.
     Even as the stone of the fruit must break, that its heart may stand in the sun, so must you know pain.
     And could you keep your heart in wonder at the daily miracles of your life your pain would not seem less wondrous than your joy;
     And you would accept the seasons of your heart, even as you have always accepted the seasons that pass over your fields.
     And you would watch with serenity through the winters of your grief.

     Much of your pain is self-chosen.
     It is the bitter potion by which the physician within you heals your sick self.
     Therefore trust the physician, and drink his remedy in silence and tranquility:
     For his hand, though heavy and hard, is guided by the tender hand of the Unseen,
     And the cup he brings, though it burn your lips, has been fashioned of the clay which the Potter has moistened with His own sacred tears. 

(FromThe Prophet (Knopf, 1923). This poem is in the public domain.)

 

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