Mind as Medicine - How to use the power of thought to control pain.
by Peter S. Staats, M.D.If you're in pain, you can immediately decrease your agony, reduce your need for medication, heal more quickly and possibly even live
longer.The secret: an attitude adjustment.
The "power of positive thinking" isn't an optimist's fairy tale. Here at Hopkins and elsewhere, scientists are now studying and
harnessing the tremendous power of the mind to control pain.Elementary biology teaches that pain is a purely physiological reaction: Burn yourself or sprain an ankle and nerve endings send
chemical signals racing to your brain. The brain responds to these signals with a burst of sensation we call "pain." But while this scenario
is basically correct, it leaves out one of the most important aspects of pain perception: emotions.While pain itself is an affective state fed by biological mechanisms, it is magnified or diminished by emotion. In other words, pain
results in an unpleasant physical sensation, but your emotional state affects how you interpret or perceive that pain.The Science of the Mind
In a given day, we tend to experience a multitude of emotions in varying degrees, and our overall mood is a sum of all these emotions. In general, negative affective states such as depression, anxiety or just being in a bad mood usually make the pain seem worse, while positive affective states such as optimism or joy typically decrease the perception of pain. That means that a stubbed toe or burned finger will hurt less on the day you win the lottery than on the day you get fired.
Changing the emotional state of a patient to promote health has been the mainstay of medical therapy for thousands of years, but
we're only now beginning to examine the power of the mind-body interaction scientifically.For instance, in one study I conducted with Hamid Hekmet of the University of Wisconsin and Arthur Staats of the University of
Hawaii, a group of volunteers were asked to place their hands in a bucket of ice water and keep them submerged for as long as possible.
Those who first were told that "ice water has curative properties for your heart" and "ice water improves blood flow" tolerated the pain
better and longer than those given negative or even neutral messages.Doctors see this in practice quite often. A patient might come in with tremendous pain, thinking she has cancer. Once she discovers
the pain is only due to a pulled muscle, the pain decreases almost immediately. Being anxious or worried about the pain contributes to
that sum of emotions, making pain worse. Likewise, saying things that bring about a positive mental state, such as, "This is a good kind
of pain because it means I'm healing," decreases pain.Other research has shown that positive emotions are healing, and negative emotions are destructive. At least one study with cancer
patients found that mood is related to life expectancy, with depressed patients dying much sooner than non-depressed patients with the
same disease.Treating Pain with Perception
This is why ideal pain treatment is multi-disciplinary, with experts from different specialties offering different perspectives and
options. For example, treatment at the Johns Hopkins Women's Center is often made with joint recommendations by a psychologist, a
neurologist and an anesthesiologist.Acute pain, such as that resulting from a broken bone or influenza, will be less responsive to positive emotions than chronic pain,
which can become intricately interwoven with emotions over time. But generally, a positive emotional state can contribute to a faster
recovery, and may allow you to take less medication and find greater life satisfaction.
So how can you achieve a more positive outlook -- especially when in pain?
- Stop negative self-talk and negative behaviors. Complaining and dwelling on the pain will only make it worse. Pay attention to the things you say and do, and rid your mind of self-defeating and martyring thoughts.
- Make positive, soothing statements to yourself during the day. Congratulate yourself for small physical victories. If your pain results from injury, remind yourself that this is your body's way of telling you to slow down.
- Think about things that make you happy. Some specific words that have been shown to create positive emotional responses in the brain are "sex," "strawberry," "good," "helpful," and "ice cream."
- Avoid negative statements -- by you and others. Ask that those around you refrain from dwelling on your suffering or other negative talk. Words that can create negative emotional states in the brain are "liar," "malingerer," "cheat" and "cancer."
- Take time for fun. Any situation that brings about a positive emotional state can help, such as watching funny movies, spending time with a hobby you enjoy, having lunch with a friend or planning a vacation.
- Practice relaxation techniques. They decrease stress and anxiety, and can put you in a more positive emotional state.
- Keep tabs on depression. Depression worsens the pain, which creates greater life restrictions, which further reinforces the depression, and so on. Left untreated, depression can keep an individual from getting well, even if the biological aspects of pain get better. Your medical doctor can treat the physical causes. But it's up to you to get the support or treatment you need to treat the emotional ones.
Peter S. Staats, M.D., is an Associate Professor in both the Department of Oncology and Department of Anesthesiology and Critical
Care Medicine, of which he is also Director of the Division of Pain Medicine. He is also Director of the Anesthesia Pain Medicine Clinic
at The Johns Hopkins Hospital.
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