When we are in pain, it is hard to focus on anything else. Pain becomes a focal point, and our job, family, friends, and activities we normally enjoy take a back seat. We become trapped in a painful world. It’s not surprising at all that pain, depression, and anxiety are highly correlated.
But correlation is not the same as causation. Which means it isn’t clear in many cases which came first—the physical or the psychological pain. Nor is it clear which is more important to treat. It is a classic chicken-and-egg situation, where our mental state causes or exacerbates pain, and the pain conversely causes the depression or anxiety to continue or worsen. Given the ambiguity of cause and effect, it is essential that both the physical and psychological parts of this pattern receive adequate treatment.
There is significant evidence that even pain that can be attributed to a physical condition or injury can be intricately connected to our state of mind. This has been my own experience. Years ago, I suffered for a number of years from chronic tendinitis in my wrists. There was inflammation and very real pain associated with using my hands to type, or even to open doors or jars. I was treated with physical therapy, massage, and chiropractic, all of which helped to some degree. But the pain kept returning, and I had to severely restrict my activities to prevent it. I got voice-recognition software, an ergonomic work station, regularly wore splints on both wrists, curtailed activities such as knitting and gardening, and still had debilitating pain on a regular basis.
Then I came across an interesting book written by a doctor of rehabilitative medicine, John Sarno. In his work with people who had undergone back surgery, he discovered that there was very little relationship between the severity of the objective problem (a bulging disc, arthritic vertebra, etc.) and the level of pain experienced. And he noted that other people who had the same conditions, as shown on their x-rays and MRIs, experienced no pain.
Dr. Sarno’s book, Healing Back Pain, addresses the psychological factors that produce pain in the body. He shows how stress and suppressed anger manifest in physical conditions that cause pain, and he has helped thousands of people overcome pain without any medical intervention. I read his book, and using his techniques I all but eliminated my wrist pain. I now type as much as I want and don’t restrict my activities, and I experience only occasional, fleeting pain. Pain does not affect my life in any significant way anymore. I highly recommend Dr. Sarno’s books, and his second book, The Mindbody Prescription, addresses other sources of pain and illness.
I recognize that there are circumstances where pain is not due to psychological factors, as it clearly was in my case. However, a person’s mental state still has a huge impact on the perception of pain and the degree to which pain impacts quality of life. Individuals with chronic illness or who experience pain on a daily basis need to learn coping strategies to minimize the impact pain has on their daily life, allowing them to engage in activities they enjoy and not let illness or pain define who they are.
When I work with people experiencing pain, the focus is on exploring the origin of the condition, what makes it better or worse, and how pain impacts thoughts and emotions. Often, giving voice to unacknowledged feelings and needs can rob pain of its power in your life. Giving yourself permission to take better care of yourself, and eliminating self-limiting thoughts and behaviors, can help prevent chronic pain from defining who you are, and help you find a way to be yourself again.
- Sarno, M.D., John E. Healing Back Pain: The Mind-Body Connection. New York, NY: Warner Books, 1991.
- Sarno, M.D., John E. The Mindbody Prescription: Healing the Body, Healing the Pain. New York, NY: Warner Books, 1998.
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