The struggle with pain makes us more fragile

I am sure you have heard so many times in your life, “don’t give up, fight for what you want, fight against pain”. You hear people pushing you, you need to be brave, if you quit, you are weak.

Thinking about mechanisms and techniques to avoid pain, we try to last shorter, to stop hurting us. But do we really need a fight?
 
What do I mean with this?
I will start with what is pain. Pain is a complex stressor that presents a significant challenge to most aspects of functioning and contributes to substantial physical, psychological, occupational, and financial cost, particularly in its chronic form. Pain may contribute to development of maladaptive cognitions and behavior that worsen daily functioning, increase psychiatric distress, or prolong the experience of pain. Individuals suffering from chronic pain tend to show increased vulnerability to a variety of psychiatric conditions, including depressive disorders, anxiety disorders and posttraumatic stress disorder.
New understanding shows that our cognitive, thinking process, make pain even greater.
 
The basic idea is that in some people who have ongoing pain, there are changes between the body and brain that increase pain sensitivity — to the point where even things that normally don’t hurt are perceived as painful. That means some people with chronic pain may actually be suffering from malfunctioning pain signals. So again, it’s what’s going on in the mind that matters for their pain, more so than what’s going on in their bodies.
 
How our mind does this?
 
1. Pain catastrophizing is defined as a negative cognitive and affective mental set related to expected or actual pain experience. Pain catastrophizing is characterized by magnification of the negative effects of pain and feelings of helplessness in coping with pain. Pain catastrophizing also contributes to poorer pain coping and overall functioning. Catastrophizing is associated with worse pain outcomes: more intense pain or higher levels of fatigue.
2. Pain-related fear reflects a fear of injury or worsening your condition through activities that may trigger pain. Pain-related fear is associated with increased pain intensity and increased disability. Pain-related fear contributes to disability by fostering passive or avoidant pain-coping behaviors, so you start avoiding pain, but also people, activities, hobbies, life.
 
When we realized how we can increase pain with our thought and beliefs, what is the solution?
 
Acceptances. Hm, sounds easy, but is much easier to say than to do.
First of all, acceptances is a long process, with all ups and downs, it is never final. It takes small steps, minor improvement and uncertainty.

What would mean acceptances when we speak about pain?

It would mean flexibility.
Psychological flexibility has been defined as an ability to engage in the present moment in a way that allows the individual to either maintain or adjust his or her behavior in the way that is most consistent with internally held goals and values. Pain acceptance is defined as a process of nonjudgmentally acknowledging pain, stopping maladaptive attempts to control pain, and learning to live a richer life in spite of pain. Acceptance of pain predicts lower levels of pain catastrophizing and greater levels of positive affect, which in turn reduce the association between pain intensity and negative emotions.

The goal is restructuring this negative cognitive beliefs into a more realistic appraisal of your current condition. Nonetheless, it is curiosity about pain and engagement with pain. There is no final destination, it is a journey where we try to understand pain and give it a meaning.
Researches say we are participating with pain by how much attention we give to it, by the contents of our thoughts.
 
By Andrea Nenadic, Psychotherapist and Social Worker