Ask anyone who experiences chronic pain, and they will tell you that what they are feeling is very real – in fact, you can usually tell someone who is in pain just by looking at them. It affects their whole physical existence.
But pain is not merely physiological – the perception and experience of pain is a mix of both physiological (body) and psychological (mind) processes. In other words:
Pain is a construct – that is, a feeling that is made up of different elements.
This construct can be divided into two elements – firstly the sensory experience of the pain itself (the “raw” pain), and secondly, the degree to which the person is affected by that sensory experience (the “affective” element).
Pain is disagreeable to the extent that we are bothered by it. A simple analogy would be to take as a stimulus the volume of the television in a room. If the broadcast was a news story you had an intense interest in, you would likely turn up the volume in order to hear it clearly. The loudness would serve a positive function in your experience. But what if a program you really didn’t like was playing at that volume? The loudness is now contributing to your negative experience.
The perception of pain is also influenced by the inconvenience or difficulty it causes. Pain from a condition or injury that results in loss of function or employment is usually perceived more acutely than the pain that does not involve such loss. For most people long-term pain will almost certainly involve elements of depression, anger, anxiety, or despair. These elements may seem separate to the actual physical pain, however their presence is inextricably woven into the person’s experience of pain.
A person seeking pain management or relief through hypnotic measures will usually have suffered significantly over a period of time. It is likely that during this time they will have a been evaluated and treated by a number of clinicians and specialists. Where a good outcome has not been achieved, this process often serves to reinforce the person’s experience of helplessness, and sometimes despair at the apparent lack of effective treatments. Returning a sense of control back to the sufferer brings relief from these debilitating emotions, instead providing a sense of control and confidence.
Given certain situations, the mind’s ability to transmute or eliminate pain is easily identifiable. A soldier in a battle may be unaware of injury until there is time to stop and notice it. A mother who slips and falls while in the process of protecting a her baby may not notice (in other words, will not feel) pain until the baby is safe. While both these examples involve significant distraction, they nevertheless reveal a startling change in perception.
Opinions vary as to the actual neuro-physiological mechanisms by which hypnotic processes can reduce or eliminate pain. However the ability of almost all people to reduce or eliminate pain in this way has been objectively established.
Hypnotic suggestions are able to target different aspects of the experience of pain to produce an encompassing effect. These include reinterpreting or substituting sensations, dissociating from the sensations, displacing pain from one area of the body to another, while simultaneously addressing surrounding emotional aspects such as fear or anger. In this way a person can change their relationship to not only the physical experience of pain, but also to the inherent implications of threat, fear and disruption.
The sense of powerlessness can be one of the most difficult psychological aspects of living with pain. As a person begins to discover a level of control, powerlessness is transformed into empowerment, and a sense of taking charge develops. A flow-on effect of this positive development is often observed in other areas of management and treatment.
A common misunderstanding is that hypnotic methods are helpful in pain management simply because they produce relaxation (often people think hypnosis and relaxation are much the same thing, which is not correct). Relaxation is commonly used as an element of hypnotic processes, but hypnosis can occur without relaxation. In reality these states are a separate and distinct. It’s not difficult to imagine that most people suffering pain will find relaxation difficult or even impossible, nevertheless that person can be led into a useful hypnotic state.
As uncomfortable as it may be, pain serves an obviously important function in alerting us to problems, and as such, we will not treat undiagnosed pain.
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