Pain-Techniques for Dealing with it

Fantasies, Sexual or Not, May Ease Pain

To cope with discomfort, take your mind off it:

People in pain should consider taking a dose of fantasy along with their aspirin. Coping with pain can be a case of mind over matter, claim some medical researchers. Relaxation, meditation -- even sexual fantasies -- can help take a person's mind off pain, they say, and make discomfort easier to bear.

"You put pain in the background and put something else in the foreground," says psychologist C. Richard Chapman, president of the American Pain Society. "It's very powerful."

Pain is experienced not in the body, but in the brain, Chapman says.

"We construct pain, just like we construct every other kind of experience we have," he says. "The brain, from multiple centers of stimuli, pulls together a coherent experience."

"The important principle here is to capture and direct the spotlight of attention away from pain and toward something else," he says.

That "something else" can be just about anything that evokes a positive feeling in the person who's feeling the pain: a gourmet meal, a day at the beach or a night with a lover.

Dr. Peter Staats, chief of the division of pain medicine at Johns Hopkins Hospital in Baltimore, recently concluded a study in which college students were asked to keep their hands in a tank of ice water until the pain became unbearable. The students were told to think about different subjects during the test.

The power of sexual fantasies

Those who thought about sexual fantasies, Staats says, were able to keep their hands in the water twice as long as the others.

"It worked," says Staats, who nonetheless cautions against overdramatizing the findings.

"Sex is just one of many positive subjects that can affect the response to pain," he says. One of his patients lessened the pain of cancer by visualizing himself driving a sports car around a racetrack, Staats says.

The mental approach to pain management is possible, researchers believe, because both emotions and pain are processed in the same area of the brain, the thalamus.

Physicians traditionally have been more inclined to treat pain with pills than with positive thinking. But the mental approach may be gaining more acceptance in the medical community. A spokesman for the American Medical Association says the group doesn't take a position on what sort of treatment methods its member physicians should use.

But Dr. Kazi Hassan, for instance, has a full-time clinical psychologist affiliated with his pain-management practice in St. Petersburg, Fla.

"Pain is stimuli that originates from the nerves, but it causes significant emotional disturbance," Hassan says. The psychologist helps some of Hassan's patients learn pain-control techniques such as meditation.

Chronic pain sufferers also can be helped with group therapy sessions, Hassan says. "Talking to people about it, venting -- this can help the pain," he says.

Longtime pain sufferers can become depressed or angry, which makes their pain even worse, adds Staats. But he believes treating the anger and depression often eases the pain.

The search for the best approach

There's no general agreement on what kind of pain responds best to the mental approach. Staats says it should work in both short- and long-term cases.

"If one considers pain an emotional response with its basis in biology, which I do, then you may think it's going to work in all situations," he says.

Chapman, on the other hand, says his experience shows that nonmedical techniques may work best on short-term pain. A burn patient getting his dressing changed may be able to lessen the pain with meditation or visualization, but that may not work as well with an ongoing condition such as chronic back pain, Chapman says.

Staats disagrees.

"We have done studies on patients with rheumatoid arthritis," Staats says. "If they say words that evoke a positive emotional response, they get better -- and for quite a long time."

Can you do this yourself? Yes, doctors say. The most basic pain-control technique is simple relaxation. Breathing deeply and relaxing your muscles slows down the nervous system -- and the transmission of pain impulses.

Next, visualize something positive. Imagine yourself on that beach in Tahiti. Dream of what you'd do if you won the lottery. Think about your kids, your spouse -- or imagine yourself on a date with your favorite movie star.

It helps if you're already a good daydreamer, Chapman says.

"You've got to have the ability to concentrate your attention and form mental images," he says. "Some people do it well, and others do it very poorly."

"Some people believe you can do anything with the mind," he says. "Others believe the right thing to do is have a drug or a nerve block. They don't tolerate that you're going to do some fuzzy thing with the brain."

"It's not for everybody," Chapman says.

Thanks to: John Reinan HealthScout Reporter

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