What is pain? How can therapy help?

By: Liz Gruber, Ph.D.

If you are reading this, you are likely one of the 50 million Americans that struggle with chronic pain (Yong, Mullins, & Bhattacharyya, 2022). You probably have suffered physically and psychologically. Perhaps you have left doctors offices feeling more disappointed, anxious and/or hopeless than when you arrived. These feelings might be related to another unsuccessful treatment, being told that “nothing else can be done”, or medical gaslighting.

Although chronic pain is one of the most common medical conditions (American Chronic Pain Association & Stanford Division of Pain Medicine, 2021), many pain sufferers are underdiagnosed and experience poor medical care, especially for women and people of color (Mcgregor, 2021). Unfortunately, it is common for doctors to minimize pain and question the reality of someone’s reported pain. This manipulation can influence the way a pain sufferer perceives their condition; also known as medical gaslighting (American Migraine association, 2022). Regardless of the intentionality behind these interactions, they often stem from a doctor’s lack of understanding about someone’s pain.

Hundreds of billions of dollars are spent annually trying to tackle the complexities of pain (American Chronic Pain Association & Stanford Division of Pain Medicine, 2021). Treatments are often unsuccessful due to primarily focusing on the structural aspects of pain and leaving out the crucial role of the mind. Despite us frequently experiencing pain as unpleasant, it is actually very beneficial and important! From an evolutionary perspective, pain is a helpful tool with keeping you safe and preventing further harm to your body. For example, say you are walking on the way to work listening to your favorite song on a typical hustle and bustle Friday morning. You are excited for the weekend and the beat just dropped in the song… and so do you, as you trip. You quickly pick yourself up and try to laugh/walk it off hoping no one else saw but you soon feel a pain in your ankle, prompting you to limp over to the closest bench and sit down. The pain in your ankle was a response from your brain cautioning you that something is wrong after being alerted by pain signals from your ankle.

Pain is understood as a conversation between your brain and body, however, such dialogues often have misunderstandings in those with chronic pain (Gordon & Ziv, 2021). Although the human brain is skillful at learning, it also has some pitfalls, as it can become “too good” at experiencing pain. An example of this process is when individuals that initially injure one area of the body later experience pain “spreading” to other areas.

Treatment approaches that incorporate the mind and body are effective at helping you live a life not dominated by pain. In contrast to your instinct of trying to “control” chronic pain through avoidance, mindfulness and pain reprocessing frameworks similarly involve turning “toward” the pain, as a genuine observer while identifying where unnecessary tension is held in the body and the reactions that accompany pain (Dahl & Lundgren, 2006; Gordon & Ziv, 2021; Stahl & Goldstein, 2010). We tend to reflexively tense up and feel irritation, fear, sadness, and/or grief when we sense pain which also amplifies it. Mind-body approaches help one increase bodily and emotional awareness and understand ways to work with pain.

Please stay tuned for future blog posts to learn more about how mind-body frameworks can alleviate your suffering, as a result of pain. For now, I will leave you with some food for thought: “physical pain is a reality, but suffering is optional” (Stahl & Goldstein, 2010, pp. 71).

References

American Migraine Association (2022, October 27). What is medical gaslighting? https://americanmigrainefoundation.org/resource-library/what-is-medical-gaslighting/

American Chronic Pain Association & Stanford Division of Pain Medicine. (2021). ACPA and

Stanford resource guide to chronic main management: An integrated guide to medical, interventional, behavioral, pharmacologic and rehabilitation therapies. American Chronic Pain Association, Inc. & Stanford University Division of Pain Medicine.

Dahl, J. & Lundgren, T. (2006). Living beyond your pain: Using acceptance and commitment therapy to ease chronic pain. New Harbinger Publications, Inc.

Gordon, A. & Ziv, A. (2021). A revolutionary, scientifically proven approach to healing chronic pain: The way out. Penguin Random House.

Mcgregor, A. J. (2021). Sex matters: How male-centric medicine endangers women’s health and what we can do about it. Quercus.

Stahl, B. & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. New Harbinger Publications, Inc.

Yong, J. R., Mullins, P. M., & Bhattacharyya, N. (2022). Prevalence of chronic pain among adults in the United States. Pain. 163(2), 328-332. https://doi.org/10.1097/j.pain.0000000000002291

Disclaimer: These blogs are for informational and educational purposes only. They are not a substitute for medical or mental health assessment, diagnosis, or treatment.