David Kannerstein, Ph.D.  
     
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Mind-Body Approaches to Managing Pain

suffering from painThe mind can play a tremendous role in either alleviating or exacerbating pain.  I’ve found the following approaches to be very helpful. While some of these may appear simple enough to do on one’s own, I have found that it is often more effective to initially learn and practice them with a psychologist to guide you through.
           
Hypnosis—The American Society of Clinical Hypnosis (ASCH) defines hypnosis as “a state of inner absorption, concentration, and focused attention.”  They point out that this involves the use of imagination, suggestion, and unconscious exploration (that is, it bypasses the conscious mind which has been unable to solve the problem being worked on).  For chronic pain, hypnosis can not only be used to achieve deep relaxation but to help reprogram some of the negative beliefs that get in the way of coping.

Mindfulness Meditation—The use of meditation for pain has been around for awhile.    While many patients with pain think they cannot meditate or at least not well enough to help with their pain, the reality is this approach can be used by practically anyone willing to practice it.  One simple form of mediation involves focusing on a stimulus such as one’s breath and simply focusing back on it when distracted.  One can also focus on sounds or words or on visual stimuli.  The key is not attempting to make anything happen but simply to pay attention.

Guided Imagery (Visualization)—Guided imagery involves having the person with pain imagine (using all or as many as possible of their senses, not just the visual) something that contributes to relaxation, healing, or the lowering of pain and suffering.  This could be going to a relaxing place such as the beach or imagining what your pain looks (sounds, smells, tastes, feels) like and changing the image!  Imagery often plays a role in hypnosis but can be employed without formal hypnotic induction and without bypassing the conscious mind.

Breathing techniques— Stress (and pain is surely stressful) can lead to shallow, rapid breathing which aggravates one’s anxiety and one’s pain.  Changing how one breathes can often bring about deep relaxation (or energization if that is desired).  Breathing techniques include diaphragmatic or belly breathing and inhaling and exhaling for various lengths of time. 

Progressive Muscle Relaxation involves focusing on different muscle groups in the body and then first tensing, then relaxing, each group until you have covered the entire body.  For those who find that tensing muscles actually aggravates their pain, passive relaxation can be substituted.  You just focus on the muscle and give yourself instructions to relax. 

There are other techniques not covered here that also can help with pain including biofeedback and autogenic training.