Behavioral Management of Pain
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Overview
These are skills that help people managing pain and discomfort. Just like
learning anything new, practice will improve your response. It takes time to feel
comfortable with using new skills and know when to use them.
Counterstimulation
Counterstimulation involves using one of your basic senses to send a
signal to your brain that opposes the pain signal, to reduce attention and intensity
of focus on the pain signals. Stimulation can be light and relaxing, or stronger to
block the pain sensation with another. Practice is important to know what your brain
is sensitive to. (Practice 3-5 minutes per session, focus on stimuli that are
SIMPLE, STRONG, PLEASANT).
Vision
Focus thoughts on details of a single visual stimulus, letting it go
in and out of focus, as it wants. Think of things like details in a picture,
focusing on a single color or texture, the inside of your eyelids, how your
perception is of the dark when eyes are closed, or something external like a
flame or image.
Hearing
With eyes closed, focus thoughts on details of a single sound, letting
it get louder and softer with focus. Mundane sounds like a fan, outside noise,
metronome, or clock, dissecting more complex sounds like a single instrument or
simple melody in music.
Smell
With eyes closed, focus thoughts on details of a single, strong smell,
breathing in and out. Think of smells that cannot be ignored like strong
lotions, concentrates or essential oils, muscle or vapor rub, other pleasant and
strong smells.
Taste
With eyes closed, focus on details of a single, strong taste, not
chewing or swallowing but letting it sit on your tongue or melt. Think of strong
things like hard candy, spicy mint, ice or frozen fruit, chocolate, frozen-juice
cube, lemon or fruit slice.
Touch
With eyes closed, focus thoughts on details of whatever you are
touching. Stimulate the sense of temperature or pressure with heat, ice, weight
on skin, cool water on your wrists, soaking your feet, squeezing or stretching
muscles, focusing on body position and single sensory stimuli like your clothes
on your body, your body on your seat, your watch band on your wrist, shoes,
etc.
Distraction
Distractions work to keep our minds from focusing on pain, reducing
attention given to pain, and relaxing our bodies.
Activities
Hobbies, cleaning, call or visit with a friend, games, drink cool or
warm fluids slowly. Listen to soothing, or exciting music, sing, hum a well know
song to yourself.
Opposite Emotions
Read a book or watch a movie that is OPPOSITE to current emotion,
watch cartoons, seek religious material and music, listen to peppy
music.
Pushing Away
Leave the situation mentally, build an imaginary wall between self and
situation, put pain “on the shelf” - box it up.
Other Thoughts
Count to 10, color, do puzzles, watch TV.
Cognitive Control
Your brain is a powerful pain-relieving tool. You can use your mind to
focus away from pain; since pain is susceptible to attention, controlling thoughts
can provide you with pain-free times, lost in your thoughts.
Imagery
Imagine relaxing scenes, imagine a secret room inside yourself and see
how it is decorated — go in and close the door, imagine everything going well,
imagine pain draining out like water out of a pipe. Imagine your desired outcome
— what you are doing, what you are experiencing.
Mindfulness in the Moment
Focus entire attention on what you are doing right now, keep in the
very moment you are in, stay in the present, focus all attention on sensations
in tasks that require little thinking, such as walking, doing dishes, playing
sports, cleaning, be aware of how the body moves, do awareness
exercises.
Self-Talk
Cheerlead yourself: "I can handle it!" "It won't last forever"; "I
will make it out of this"; "I'm doing the best I can!" "I know what to do to
feel better."
Relaxation
Relaxation is a great pain reliever. It results in changes to muscle
tension, blood flow, breathing, and thinking patterns that remind your body of its
own ability to be comfortable. It is especially responsive to
practice.
Progressive Muscle Relaxation
Tense and relax muscle groups starting with hands and arms, then going
to top of head and working down. Relax by letting go or tensing, then letting go
face, neck, shoulder, and half smile with lips slightly upturned with a relaxed
face, teeth apart, serene facial expression. Repeat slowly for 2-3
minutes.
Apps/YouTube
Having someone help guide you with a script can improve your technique
(Search relaxation; pain management; child).
Body Awareness
Be mindful of the position of your body, focus on breath, where the
body touches an object, and focus entire attention on a sense of connection.
Where are your arms? Legs? Moving as little as possible, let the body sink into
the sensation of its position.