Pain

I was at White Hen the other day, jonesin' for something to read. They didn't have O Magazine, but they did have Psychology Today. Go figure.

The cover promised an article on 10 Soothing Truths About Pain so I bought it. Turned out to be false advertising (not that soothing), but still very interesting.

1. "Heartburn and Heartbreak: It's All Connected." There are interconnected parts of your brain that process pain. They call it the "pain matrix." Some parts of the matrix provide descriptive info about the pain - intensity, type, etc. But another part of the matrix, the anterior cingulate cortex, "registers the unpleasant 'hurt' of pain. It connects the physical sensation of pain to feelings of distress."

What is significant about this is that the anterior cingulate cortex doesn't distinguish between emotional and bodily injury, and so emotions can effect how "hurt" you perceive yourself to be. "Change the mood, and it changes the pain."

2. "The 'Pain Personality' is a Myth." Dang straight it's a myth, what's wrong with you people? How about trying a little thing called empathy? Jeez!

3. "The Bad News: You Learn to Suffer." This is one I have a little experience with. The backs of my arms, neck, and the sides of my legs have become incredibly sensitive to pain from, of all things, wearing clothes. Here's what the article says "Through the same neurological process that makes you gradually get better at hitting a racquetball or driving a stick shift, your brain 'gets better' at perceiving the pain - you become more sensitive and more likely to register a poke or a twinge as painful. Eventually, people with chronic pain disorders such as fibromyalgia...can find even mild sensations agonizing."

4. "The Good News: You Can Learn Not to Feel the Burn." Amputees that were given a memory impairing drug right after their surgery were less likely to suffer from the phenomenon known as "phantom limb." Research has also shown that amputees fitted with a prosthetic limb begin to lose the pain of the phantom limb. And the recent study of FMS sufferers and dextromethorphan showed that dextromethorphan seemed to block "learned pain." Unfortunately, the doses used can cause hallucinations and memory problems. This isn't quite the good news I'm looking for - give me a bottle of O24 anyday!

5. "Being Cruel to Be Kind: Don't Indulge Your Partner's Woes." This one is pretty straight-forward - by babying someone suffering from chronic pain one can become the dreaded "enabler," allowing them to live a truncated, sad little life.

I think this warning is especially relevant to folks with a codependent streak. However, in my experience, most people's problem is not that they are too good at empathizing with their loved one's chronic pain, especially if that pain is what is commonly referred to as an "invisible illness."

At the onset of a chronic illness, most sufferers experience denial. If their loved ones are also happy to ignore the illness, the sufferer is likely to get stuck in that stage for a very long and very counter-productive stretch of time. Keeping hope and seeking treatment are essential to a happy, productive life with chronic illness, and, at least in my experience, the engagement of friends and family members is the difference between success and failure in these endeavors.

6. "Sex is the Opiate of the Masses." Orgasm doubles the pain threshold, but only for a short time. There's also some stuff about vaginal and rectal pressure dampens pain reception.

7. "Why Women Don't Fear Pain - and Why Frightening Pain Hurts More." "In response to pain women initially report stronger sensations and higher anxiety than men do. As the hours go by, though, while women still say they hurt more, their anxiety decreases, whereas men's increases."

What I have noticed is that the most debilitating aspect of pain is not the pain itself, but the fear that accompanies it. While I don't think it's possible to "get used to" pain (as we just read, you become more sensitive to pain over time) it is possible to get over the fear. The first couple of years after my FMS really flared up, a brand new, often breathtakingly intense pain was being added to my repertoire every week or two. With each one I had to wonder "Is this the FMS or something else? How long will it last? Is it gonna get worse? Is it safe to drive a car while I experience it? Is it gonna spread?"

It took time to answer these questions, but once I did, the same pain would not cause nearly the same amount of distress, and as long as I stayed within my boundaries (for example, some pains just require puttin' down the pen, while others require calling for a friend to come pick you up, 'cause you can't operate a gas pedal) I didn't feel afraid.

I can't speak to why the anxiety actually increases in men, except that maybe what they fear is the pain itself.

8. "Drugs Don't Stop the Pain - They Help Us Ignore It." Hmmph. And they are addictive, make our stomachs bleed, and our brains mushy. I'm all about the O24 (a topical analgesic with no reported side effects - plus it really works!)

9. "Don't Tough It Out." Because it's difficult to "unlearn" pain, prevention is the way to go. "The longer and more intensely the pain is felt, the more likely it is to become chronic." So treat your pain. If your doctor won't help you, go to a doctor who will.

10. "Exercise May Work Out the Kinks." If you suffer from chronic pain you'll probably have to relearn how to exercise. Playing basketball or riding a bike may no longer be a good idea. If you don't have a physical therapist to help you develop an exercise regimen I highly recommend "Sit and Be Fit" on PBS.

So thanks to Psychology Today and Maia Szalavitz for an interesting article.