Coping techniques: Chronic pain

Please note that you should always consult with your physician before making any changes in your diet, your level of exercise and activity, medication or behaviors related to substance use.

The best way to make use of these techniques is to read through them, select three that stand out to you and practice them. I would be glad to hear from you on your responses.

  1. Although you have legitimate grounds for complaint, make a list of those things in your life for which you’re grateful. Not just once, but on a daily basis. The problem of pain can absorb all of your attention—this is a place where you can counter that tendency and reclaim more of your life.
  2. Take suffering apart. Consider that while pain often appears to be the problem, physical sensation is just one part of suffering. Other parts include what we think about pain, what our mood is in relationship to pain and what we do in response to pain. While issues related to medication are a topic for conversation with your doctor, and exercise a topic for your occupational therapist, these other components are things you can address right now.
  3. Therefore notice how you think about pain. Thoughts such as “My life is more than just pain” can decrease the psychological component of pain. While pain may be a fact of life suffering can be a matter of negotiation.
  4. Acknowledge and address emotional issues related to pain, including denial, grief, anger and depression.
  5. In terms of what you do in relationship to pain, remember that most of us tense up when we hurt. Relaxation practice can support decreasing tension around the painful area, and decrease levels of pain. One goal of relaxation is that it will become your automatic response to flare-ups. Deep breathing is one such practice. Loosen your clothing if necessary and sit in a comfortable chair. Focus on the area of your belly just below your naval. As you inhale breathe into that area. Feel your body fill with air. Let your attention hover in the brief moment after inhaling and before you begin to exhale. Then exhale and feel your body empty into a relaxed state. Let your focus stay in the sensation of breath moving into and out of your body.
  6. Learn to distinguish between activity and stress. Has pain led you to restrict your activities, so that one of its impacts is to claim larger and larger areas of your life? Realistically assessing your pain and energy levels, how much of your life can you reclaim? Is it possible that that might increase as you engage in life again?
  7. The flip side of this is stress, which can correlate with higher levels of tension and pain. Where is it possible to decrease or space out triggers for stress? Visualization can be useful in decreasing stress levels. This includes focusing on the image of a compassionate person, or of a peaceful and containing environment.
  8. Because self-compassion is linked to lower levels of suffering practice this by providing yourself with feelings of loving kindness.
  9. What meaning do you give to the presence of pain in your life? A lot of us judge ourselves negatively when we hurt. Thoughts like “I must not be living the right kind of life” can come up in a number of different forms. What can follow from such judgments is the thought that pain is therefore a punishment that you have somehow earned. Thinking of pain as, for instance, the “wrath of God” can greatly increase suffering. Therefore one practice of self-compassion can be to interrupt such thoughts when they occur. Deep breathing is an effective technique for interrupting negative thoughts. As you breathe in, breathe in acceptance of your situation and presence to this moment. As you breathe out imagine that toxins such as fear and self-hatred are leaving your body on the breath. As much as you can, as often as you can, be present to your own existence with patience, acceptance and mercy.
  10. Talk yourself through flare-ups. Tell yourself that you can survive this.
  11. Consider low-impact aerobic exercise (walking, biking, stretching), which is associated with reduced levels of pain and higher levels of endorphin release. Consult with your doctor about which forms of exercise are appropriate for you.
  12. Find what in your life fills your attention, or what can, with practice. Find what in your life provides you with the experience of “losing yourself” for a few moments or for longer. For some this is playing with a beloved pet, for others it’s tending to plants, or prayer, or solving puzzles, or being of service to others, whether in person or through social media. Cultivating this heightened awareness is linked to claiming more of your life back from pain, and is more adaptive than simple distraction.
  13. While distraction can be useful in the short term consider that acceptance can be helpful in the long term as it helps you adapt more and more successfully to your circumstance. Resistance to pain—flight from pain or attempts to control pain—is associated with higher levels of distress. Acceptance has been correlated to decreased distress, as well as to lower levels of anxiety and depression.