By Catherine A. Sanderson, Amherst College
One of the most important insights from the field of psychology is the power we have to manage pain, a finding that now influences many parts of health care, including childbirth classes, preparation for dental procedures, and instructions for patients recovering from surgery. Using psychological approaches for managing pain is especially important for anyone with a personal or family history of substance abuse.
Progressive Muscle Relaxation
Many strategies to reduce pain involve people changing their behavior. For example, people whose attention is distracted away from pain in some way—listening to music, reading a book, watching television—during medical procedures consistently report lower levels of pain and even need less pain medication. Distraction can be an especially important technique for reducing pain in children, who may have trouble using other methods of pain control.
One approach, known as progressive muscle relaxation, involves people tensing and then releasing each part of their body (hands, shoulders, legs, etc.) one at a time. This process trains people in ways to relax their bodies in virtually any situation. Progressive muscle relaxation can also be paired with guided imagery, which focuses the mind on a specific pleasant image. This approach is designed to help people relax and distract their attention away from the pain.
Biofeedback
A somewhat more complicated approach is biofeedback, in which people are trained to monitor and change various physiological functions in their bodies, including heart rate, muscle tension, and brain wave patterns. First, people are hooked up to a machine that measures a particular biological response, such as heart rate or muscle tension.
The patient is then asked to practice different thoughts or behaviors to try to influence that response, such as by thinking relaxing thoughts or tensing their muscles. Over time, they can then directly train how their own thoughts and behaviors influence their physiological responses, and control various types of chronic pain, such as headaches and back pain.
Behavioral techniques are thought to help reduce pain in two ways. Physiologically, they help reduce muscle tension, which can then directly reduce some kinds of pain. Psychologically, they give people confidence that they have strategies they can use to cope with pain. But this expectation that their pain will decrease also seems to lead to physiological changes in the body that, in fact, make them feel better.
The Cognitive Method
Yet another psychological approach to reducing pain is the cognitive method. This approach focuses first on helping people understand how their thoughts and feelings influence the experience of pain and, specifically, how stress and anxiety increase pain. Next, people are taught strategies for changing how they think about and react to pain.
They could learn, for example, to adopt positive thoughts about their ability to manage pain: “This really isn’t so bad, I can get through it.” Simply increasing people’s confidence that they have some control over pain can help lessen its severity. In fact, giving someone training in cognitive techniques for managing pain increases the level of endorphins in the body, which reduces pain.
This article comes directly from content in the video series Introduction to Psychology. Watch it now, on Wondrium.
How They Work All Together
Many psychological approaches to pain management combine all three. For example, classes in so-called natural childbirth give women information about distraction strategies, such as concentrating on a focal object during labor and behavioral strategies for relieving labor pain, including specific positions to use during labor, massage techniques that a partner can do to help reduce pain, and special breathing exercises.
And they provide cognitive information about what to expect, such as the types of sensations they will experience, which can decrease anxiety, and thereby help the body relax in ways that reduce pain. This combination of pain reduction strategies may be why women who attend childbirth-training classes experience greater reductions in pain during labor as compared to those who don’t attend such classes.
Managing Pain through Managing Stress
Pain and stress are two distinct, but overlapping, processes that, if not managed, can combine in a vicious cycle. Conversely, this interaction between pain and stress is why strategies for managing stress can also help with managing pain. Remember, dwelling on pain not only makes the pain worse, but also increases the psychological stress response and reduces the resources available to promote long-term healing.
Keep active. Do whatever activities you enjoy, even if you need to make some modifications. If you can’t run, play tennis, or golf, try lower-impact exercise options: swimming, walking, yoga. Staying active can reduce the intensity and duration of pain and may prevent future pain.
Non-medical Approaches
Try physical and occupational therapy, massage, or acupuncture. Mind-body techniques, such as meditation and mindfulness, can also help reduce physiological arousal and muscle tension, which in turn can bring down pain.
Make connections. Social support can help take your mind off of pain and reduce the chronic stress response leading to anxiety and depression.
Stay positive. Remember, catastrophizing merely increases pain. Remind yourself of the things you are grateful for in your life and appreciate the small joys in daily life. Whenever possible, focus on your ability to manage your pain.
A final strategy, and one of the most effective, for reducing pain is in some ways the easiest: getting enough sleep. In fact, a 2019 study published in the Journal of Neuroscience found that insufficient sleep impairs the brain’s natural ability to relieve pain. After a night of sleep deprivation, a part of the brain associated with pain sensitivity will stay hyperactive, suggesting that inadequate sleep interferes with the body’s natural ability to help manage pain. Adequate sleep is an essential part of helping the body cope with and reduce pain.
Common Questions about Psychological Approaches to Pain Management
Yes, distraction can help with pain management. People who are somewhat distracted away from pain report lower levels of pain and even require less amount of painkillers. Reading, listening to music, and watching TV are among the ways to distract the attention away from pain.
Behavioral techniques help with pain management in two ways. Psychologically, they reassure people that they can use strategies to deal with pain. Physiologically, they help people reduce and manage their pain by reducing muscle tension that directly affects certain pains.
One of the psychological approaches to pain management is the cognitive method. People are first made to understand how thoughts and feelings affect the experience of pain. They are then taught strategies to change the way they think and react to pain.
