Psychology of pain: chronic pain or the cycle of fear.

Pain is part of life, trying to avoid it, we avoid life."

Chronic pain is a scourge of modern society. She catches people in the Prime of life, it makes them the ruins, the disabled, the mad doctors and insurance companies.

It is a pain that should not be, but it is.

She's not talking about the danger, because her reason is long gone, but nevertheless does not make it less real. She is in our memories, in our minds, how we behave, and her father - fear.

The nature of pain

The pain is necessary, pain is important...to draw back his hand from the fire and do not burn yourself to understand what to poke fingers in the socket - a bad idea. To understand that this stuff is no longer there. People without a reaction of pain (known as analgesia) often do not live up to three years.

As I have no time repeating the challenge of pain is to draw attention, to distract from everything NOT vitally important at the moment, to do something that would get rid of the threat. That's a normal pain.

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"Pain disease"

But there are the so-called "pain disease", "pathological pain", "dysfunctional pain" or chronic pain.

This pain ceases to play the function of "signal", because we either already can do nothing with this pain (pain with incurable diseases or diseases which require the intervention of a specialist, but the man himself is helpless), or the source itself is not (or it is almost impossible to detect).

Often pain, the disease also is associated with pathologically increased pain sensitivity.

When little impact is perceived as painful.

This pain is debilitating, exhausting, "knocks out from a habitual way of life," it's endless stress, anxiety, feeling helpless, crippled, defective.

What would advance to deal with what I have in mind in this post I'll give a small classification pain at its source:

Somatic pain - damage or threat of damage to the body.
Visceral pain - damage or threat of damage to internal organs.
Neuropathic pain - cause of pain - damage to the nervous system.
Dysfunctional pain - there's no apparent reason.

Here I will consider chronic pain as a dysfunctional pain (NOT the RESULT of a CHRONIC ILLNESS) without apparent reasons, but that is how life and unpleasant reality for us, our consciousness. Which is supported not by a physical disability, but at the expense of our psyche and behavior, contributing to an increase in sensitivity to pain and to preserve her memory.

Real pain or memory of it

The definition of chronic pain is as follows:

"Chronic pain - pain that is formed during prolonged exposure to pain - beyond the normal healing period (3 months). In the formation of chronic pain is dominated by the cerebral system, with the involvement of non-specific integrative (monoaminergic) systems of the CNS. "

Most doctors shrug, after all, just have to be a reason, but often chronic, dysfunction pain causes no, it was a risk, but in fact, our body still grants the memory of this press.

(Stephen J. Linton, William S. Shaw; the Influence of psychological factors on the pain experience, physiotherapy, volume 91, issue. 5, may 1, 2011, pp. 700-711)

Doctors know how to treat the wound, but what can one do with memory?

From the definition it is necessary to highlight: "prolonged pain exposure", isolation from the normal healing period and the dominance of the Central nervous system (brain) or if easier, .... ...the body, the brain long feeling the pain (e.g. after surgery) got used to it, I remember from her.

Why is the memory stored?

Why do some people the pain is remembered and the other the body stops to remember her?

Anything is saved in our memory, if it often occurs in our lives.

Pain can be a memory, an emotion can "grow" neural connections and to exist independently in our brain. But why do some people the pain is forgotten, while others remain in memory? Plays the role of three factors:

- Attention.

- Fear of pain.

- The behavior of the avoidance of pain.

Attention

Our attention is arranged in such a way that all what it was perceived to focus better, clearer. And with attention to our body. If we focus on any area, it will feel much sharper than other parts of the body.

Example: If you focus on (for example) on the right big toe, then after a while we can begin to see it a little larger than the left, can change the feeling of temperature and so on.

The same thing, if you constantly pay attention to the place where we feel the pain. If you keep doing this, the pain sensitivity will increase and we will feel more pain.

Fear of pain

Even more, this effect exacerbates fear of pain. If we are afraid of pain, any manifestation of a cause for concern. Or, say, if we think that pain is a sign of something bad, very dangerous and incurable. And we begin to "scan" to check whether we have pain or not?

Behavior

The pain is not just the experience of pain causes us to do something. Rubbing the injured spot, to draw back stung hand...to stop moving that would be even more not to injure any part of our body. And in the beginning it can really help. But this is only the beginning...

Imagine that having experienced the pain you have any fear to experience it again (this is normal), but that this fear began to lead to the fact that you do all that you just would under no circumstances this pain not to worry:

Take care of yourself in every way (even when the testimony of doctors this is not required).
To avoid those situations in which you want the activity (which in your belief can lead to pain).
In General, to build their lives so as to avoid pain.

BUT, in doing so, we:

on the one hand avoid the pain
on the other always make it clear to the body that this place is vulnerable to pain, that it is possible THERE pain.

This is so that our attention, our muscles makes US FORGET, to distract from the fact that this place was a pain.

And our brain more and more remembers it....prolonging our pain.

The role of depression in shaping pain and pain sensitivity

There are studies confirming the role of depression in increasing sensitivity to pain

(in severe depression this leads to a significant enhancement of pain sensitivity that invaliditetom people even more).

The same effect produces anxiety, which "configures" our focus is on the sensitivity to pain.

(Bair MJ, Robinson RL, Katon W, Kroenke, K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003;163:2433–2445.)

How to deal with it

The most important is a thorough medical diagnosis. You need to ensure that significant there is no objective reasons, and most importantly-physical activity does not threaten your health.
You need to get reliable information about the consequences of pain, that pain for you is not perceived as a disaster.
Need to know the mechanisms of pain generation and patterns of your attention (described here). The influence of depression and stress (if it is chronic and you are exhausted).
Try to prevent the formation of a psychological "role of the patient".
Know that when we are struggling to withstand the pain - then it is increasingly becoming the focus of our attention, flaring up like fire, who blow. When we accept pain, we stop paying attention to it.

LIMITATION: These guidelines are suitable to a greater extent for those types of chronic pain that are not associated with chronic disease (when there is OBJECTIVE DAMAGE, which CAUSES PAIN). However, the General mechanisms of the formation of pain sensitivity and pain avoidance mechanism as well suited for them.

Conclusion

Chronic pain currently (USA, Western Europe) is more a Biopsychosocial phenomenon. That is, there are as biological, individual, and social background to it. Currently, in Western society the priority is the comfort, lack of suffering. This leads to the fact that pain is recognized almost unequivocally negative phenomenon. Pain causes fear, is a disaster. However, the more we fear it the more power it has over us.

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