In our last lesson we discussed Bill, who had a back injury and subsequently suffered from severe pain. We showed how "getting physical" with pain could alleviate the Thought component of the SEAT of pain and suffering (Sensation, Emotion, Attention, and Thought). This time let's look at how "getting physical" can alleviate the Emotion component. Part of our suffering is due to our attempt to escape from the pain, or to fight and struggle with it. The emotions associated with escape and struggle are fear and anger, respectively. There is fear that the pain will recur, become worse, or never go away. There is anger because you cannot have your way with the pain, you cannot make it go away. These emotions are extremely unpleasant, and they cause changes in your body that intensify pain. Fear and anger cause muscle tension, hormonal changes, and blood vessel changes that increase our suffering. The muscle tension alone can make a back injury worse, or prevent it from healing. Muscle tension can increase pressure on disks and nerves, and deprive the area of needed blood flow and oxygen. Chronic muscle tension alone can cause additional pain.  For example, try standing with your back and heels against a wall, and then lower yourself until your knees form a 45-degree angle.  This creates muscle tension in your thighs. Stand in this position for a while, and experience the pain that will start building up in your legs. Now imagine this type of pain in your back muscles, added to the back pain you already have. Ouch!  This is only one of the consequences of chronic fear and anger. A good way to deal with the Emotional component of pain is to stop trying to escape from the pain, and stop trying to fight with it. If possible, relax and move your awareness TO the Sensation of pain. This is counterintuitive, and it is the last thing most people in pain would think of doing. It helps if you have previously done some practice with relaxation training. If you can, let your awareness gently rest on the Sensation of pain, without trying to escape or struggle. Try to locate the pain exactly, and describe what kind of pain it is.  That is, is it sharp, dull, searing, prickly, etc.? Paradoxically, the release from pain comes from going to the center of the pain. If the pain is extremely intense, or if you have not done much practice with relaxation training, this can be very difficult or impossible.  What can you do then? Suppose you are in excruciating agony, and you cannot relax and let your awareness rest on the pain. You cannot help trying to escape or struggle with the pain. You are focused on your distress and your misery. If you could only bring yourself to the physical "present moment" and stay there it would help greatly. That is, come to your senses, literally.  Bring your awareness to the sensations in your body. If you can focus on the Sensation of the pain, or even the body sensations of your struggle with the pain, it will help you turn away from your thoughts of distress, and you will stop being overwhelmed by your emotions. One of the best ways to bring yourself back to the present moment is to acknowledge that you are trying to escape or struggle, and to bring your awareness to the physical sensations of this in your body. In other words, bring your awareness to the physical manifestations of your emotions. Ask yourself if you are angry or afraid.  Really look into it, don't make assumptions. More importantly, ask yourself where in your body you feel this attempt to escape or fight.  What do you feel in your head, throat, chest, and stomach?  Keep an open mind and really look. Investigate how your body feels. Do not think about it, and do not form a firm opinion of what it feels like.  Keep looking!  An open, investigative mind, focusing on physical sensations, can greatly alleviate pain. One word of caution here - once a person experiences how effective this technique is, it is common to attempt to use it as a tool to conquer pain. That is, you may say, "Oh, I know how to defeat this pain.  I will just concentrate on the feelings of emotions in my body, and that will make the pain go away."  That won't work, because now you are attempting to use a specific technique to escape or struggle with the pain.   This is just more escape or struggle. You cannot escape from your attempt to escape, and you cannot fight with your attempt to fight.  To end the escape or struggle you must come to the present moment and accept what is going on. If you are attempting to escape or fight, acknowledge that, and ask yourself what it feels like in your body. Look at it, investigate it, and ask what it is.  Be with it, and let it be.  Only then will the technique work its magic. ================================================= The Role of Exercise in Pain Relief Physical exercise can be a very important part of a pain relief program. Exercise is helpful in several ways. First, vigorous exercise causes the body to produce endorphins, which are natural pain relieving chemicals that act like morphine. Second, exercise is a great stress reliever, and we already know how stress contributes to many kinds of physical pain. Third, exercise can strengthen muscles and tendons that prevent and counteract certain types of pain. Exercise can also condition blood vessels and nerves to avert pain. Appropriate exercise can greatly aid the healing of your body. The medical community has recently changed its mind about how much exercise is optimal for certain conditions, especially back pain.  For example, physicians used to recommend long periods of bed rest for back pain. The reasoning was that the body needed time to recover from injury. This makes sense, but recent research indicates that excessive bed rest weakens back muscles and tendons, and this contributes to further injury and pain. Now physicians are more likely to recommend an easy form of exercise, such as walking, as soon as possible. Unfortunately, when people experience severe back pain, they also tend to protect themselves and avoid any sort of activity that might injure their back. The bad thing is that this protection and lack of activity leads to atrophy of important muscles, and consequently even more pain in the future. What sort of exercise should you do? Any form of mild aerobic exercise is beneficial for most pain. Walking, bicycling, dancing, skating, swimming, paddling, or any continuous activity that increases your heart rate over a long period of time will reduce stress and increase endorphin production. The only counter indication is if you have cardiovascular disease, and/or pain in your chest or left arm. You should always see your physician to determine if a program of aerobic exercise is advisable for you. Exercise that involves repetitive movement is especially beneficial because it leads to a relaxed, meditative state, particularly if you focus on the movement and the feeling in your body. This takes you "out of your head" and the many unpleasant, depressive thoughts that frequently accompany physical pain. If you cannot, or would rather not do mild aerobic exercise, there are some alternatives.  Mild stretching and yoga are excellent ways to achieve endorphin release, relieve stress, and become more aware of your body. These activities are also excellent ways to stretch out muscles and tendons whose tightness may contribute to pain.   Tai chi, Qigong, and so forth are also worthwhile activities because they can strengthen muscles, and bring the focus of your attention to your body and your immediate physical presence, rather than on your thoughts.

Getting Physical with Pain - Part Two

© 2016 by Dr. Ken Pfeiffer