Thursday, September 9, 2010

The Mind and Chronic Pain

Pain comes in three stages: (1) acute, or adaptive and lasting less than six months; (2) chronic, enduring beyond the time of healing, constant and self-perpetuating, and often occurring in the absence of detectable tissue damage; and (3) prechronic, which essentially includes characteristics somewhere between the former two.

The most significant factor to chronic pain is its invisibility. That is, acute pain can usually be traced to an obvious injury--a cut, an infection. The removal of the cause will produce relief from that pain. Chronic pain is typically not so easily remedied, which is why it is so difficult to understand.

While explaining acute pain can be as simple as pointing to an underlying physical problem, chronic pain does not necessarily serve as such a useful warning of a physical problem. Rather, it often becomes a problem in itself.  Indeed, chronic pain takes on many of the characteristics of its own root cause, leading to further problems, resulting in a vicious cycle. Psychological trauma and the actual physical processes--sometimes seemingly unrelated--seem to fuel each other.

Pain, for instance, can alter our moods and perceptions of stress, causing us, mostly unknowingly, to crave certain foods that naturally release serotonin, to elevate our moods, and endorphins, which are natural opiates that relieve pain. Candy and pastries fall into this category,  for example, which can lead to obesity.

Psychologically, pain is generally described as a perceived response derived from our emotions and thoughts. The view in Eastern part of the world is generally more graphic. While Western science tends assume that the causes of pain exist on the physical level, Eastern thought regards that level as secondary.

Pain, from the general Eastern view, is an illusion, grounded in a conviction that we are helpless. Pain is simply viewed as information about what must be changed. This philosophy may be an explanation for the reputation of Eastern peoples for their often superior tolerance to pain. Tolerance to pain depends on memories, experiences, family history, personal biology, and culture.

From a my own perspective, chronic pain is a prolonged absence of well being. The most obvious, of course, is physical pain. Yet there is also emotional pain, which can be just as torturous, just as debilitating.

The typical Western method of treating either pain, of course, is through medication. While this has produced temporary relief, it by no means has approached a “cure,” either on a physical or emotional level.

Moreover, this form of treatment has had its own consequences: How many addicts, for instance, has it produced? And side effects can be serious–even fatal. This is what is so attractive about the Eastern philosophies: They imply that there are possibilities of procedures to help to eliminate chronic pain from the psychological side.

The power of the mind over pain can be absolutely astounding. This has already been demonstrated through my own counseling.

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