Chronic pain is highly complex. Oftentimes, we think of pain as stemming from a physiological issue and nothing more. Our knee hurts, and we think that the problem must be in the knee and only there. But this perspective forgets that all pain is processed by the central nervous system. Your nerves through your spinal column and up into your brain combine with your neural pathways to communicate to you the sensation of pain. This process means that there can be differences in how pain is perceived and experienced. Our mindsets affect, in very tangible and real ways, how much pain we experience and how much that pain affects our quality of life.
Scientific research has shown that pain is a complex experience deeply influenced by psychosocial factors, including how one thinks about their pain. A negative mindset is shown to both increase pain and increase the level of disability a person suffers. Aspects of a negative mindset include fixating on pain, catastrophizing about pain, seeing one’s identity as irrevocably connected to pain, and viewing everything (including one’s pain and the implications of it) in extremes. Incredibly, the more one thinks negatively, the easier it is. Given that negativity increases pain, this also cements neural pathways to trigger more pain in the future. We are not powerless, though, in the face of increasing pain, and there are various strategies that we can use to help alleviate pain and, even, increase our happiness level.
One such strategy is mindfulness. Mindfulness is, quite simply, awareness, and uses simple strategies such as focusing solely on the rhythms of one’s breath or fixating on all aspects of a sensory experience, such as the texture, flavor, smell, or temperature of a food while eating it. These strategies might sound simple and unrelated to pain relief, but they are very effective because they allow you to mentally step back from the negative thoughts and sensations you are experiencing, gives your mind something else to think about and allows you to experience positive emotions in place of the previously negative ones. In doing all of this, mindfulness allows you to curate your emotional experience, giving your brain a distraction from the pain, thus lowering your pain levels.
Mindfulness can also be used as a gratitude practice. This is not some “Pollyanna” optimism that ignores everything bad and conjures up fake positivity; instead, mindfulness, when used as an awareness tool to notice the good things about your life and the positive slants of negative experiences, can actually open your mind to be able to identify the good. Instead of mindfulness acting as a blindfold to negativity, it is instead a pair of lenses that helps you recognize and acknowledge the good things. Gratitude can replace destructive thought patterns such as the catastrophizing of pain, the blaming of oneself and the fixation on potential negative outcomes and show you a brighter side to life.
In pain science research, there is such a thing as “positive affect”. Both mindfulness and the cultivation of gratitude help create this. Positive affect refers to positive emotions and positive moods, and collectively has been shown to reduce pain, especially because positive emotional states are associated with higher levels of resilience, greater optimism, more self- efficacy, greater levels of autonomy, and, overall, a better quality of life.
Pain can become a vicious emotional cycle because of the nature of what pain is. At a base level, pain is an alert that signals to your body that something is wrong. It often begins because of an acute injury and is there so that you are prompted to remove yourself from a dangerous situation and seek help. When pain becomes chronic, however, the acute phase has passed but the neural processing hasn’t recovered. Whether the issue is still there or not, your body is having a hard time letting go of it. Pain can be a self-protective measure: your body’s efforts to keep you safe and prevent you from getting hurt again.
Given this, how you think about your pain dramatically changes how you experience it. If you catastrophize it, view it as a permanent thing, and allow it to consume you, you will end up suffering more. You will be more likely to avoid behaviors and activities that could worsen your pain, and inactivity will then be added to the mix as a trigger for increased pain. This cycle can be stopped, but it takes enormous effort.
Rewiring thought patterns is hard work, but it is worth it. Don’t underestimate the power of your mind. Intentional habits of mindfulness, gratitude, and positive thinking strategies not only change the way that you perceive your pain but also how much you feel it.
Pain, by nature, is interruptive. This is effective when pain is acute, but when pain is chronic, this can be debilitating. The fascinating thing, though, about pain’s interruptive capabilities, is that the level of interruption is not universal, and can be lowered if there is a strong enough competing motivator. Behaviorist Wilbert Fordyce is known for having said, “Pain patients would suffer less if they have something to do.” Passions, goals, and a life outside of pain are essential for chronic pain sufferers. Pain fights to be the only thing in your mind, but you don’t have to let it succeed. You are more than your pain, and it does not rule you. The positive effect mentioned earlier can result from doing things that you love. Don’t let the fear of pain stop you from living, because that fear will not only stop you from living, but it will also make you feel more pain than you did before.
A meaningful social network is also essential to managing chronic pain. Negative experiences, of which life offers plenty, have a negative effect on pain levels, causing them to increase, but this effect can be mitigated when that negative experience is shared with someone else. Suffering alone increases your suffering. I encourage you to build meaningful connections and spend time with those you love. Your mental and physical health will be better off because of it.
These tools of mindfulness, positive thinking, meaningful goals, and rewarding interpersonal connections are ones that you can use to lower your pain. Chronic pain is more complex than an isolated physiological issue; it is a complex experience that is affected by numerous biological, psychological, and social factors. You can use the powers of your mind and your habits to shape your experience with pain and not have it be the determining factor in how you feel inside and how you live. There is hope!