Managing Chronic Pain, Part 2: Applying a Shift in Perspective

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by Dr. C |

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Second in a series. Read part one

Pain attacks me every day, and I set aside much of my time to manage it. Chronic pain management is now a significant part of my wellness map. Pain management techniques are rooted in the conceptualization of total pain as suffering plus pain, and that some of that suffering is connected to dysregulated emotions. I know that I can make positive changes that will reduce my daily pain levels.

Recently, pain has become a daily experience and has since become the focus of my wellness map tweaks. My tweaking is a more concentrated look at the “pause between.” This is a mental, and often physical, pause that I take before I continue to think or act to decrease the occurrence of dysregulated emotions and their consequences. Putting this into practice decreases my suffering, reduces my frustrations, and thus lowers my perception of pain.

Pain often triggers the “fight or flight” response, which then activates emotion. Emotions generated by pain are followed by thought and often action — a feedback loop designed to keep us safe from danger. But the loop can spin almost out of control. To prevent it from doing so, it is possible to insert a pause in the loop between pain and emotion, emotion and thought, and thought and action.

The pause between is first brought into focus through recognizing its potential and directing attention to that possibility. This represents a shift in perspective that says, “I can practice the pause between, and it will lower my pain.” It is an adjustment in how the mind is used during the day. Wherever I decide to take my mind each day is the easier path to walk on the following one. The brain likes familiar roads.

Sitting with the pause between takes daily practice. Maybe I should be grateful for my chronic pain, which reminds me of the importance of such a practice. On some days, my Parkinson’s disease-related chronic pain is draining — at all levels. No matter what I do, I can’t sit in the pause between. But I firmly believe in neural plasticity. If I keep my brain practicing pain management, then it will become easier.

The construction of a wellness map enhances its success. The CHRONDI elements can serve this function. Techniques that help to quiet the mind and slow it down allow more opportunities to sit in the pause between. A mentor, something I have been for many students, can also help you to experience the pause between and arrive at a better understanding of your resistance to sitting there.

The pause is a suspended moment emptied of normal emotion, thought, or action. Judgment is halted, and focus is aimed at sitting in the pause between. It is very brief at first, but with practice, the pause between can become longer in duration and more easily accessible.

It is like a fork in the road. Choose which fork to take, initially using thought and action, and eventually emotion. The pause between helps to change patterns of thought and action, decreasing the frequency of those that contribute to suffering. If you decide to select the other fork, the pause gives us the time to walk down that new path, implementing new patterns of thought and action, thereby helping to reduce suffering and lessen pain.

From the place of sitting in the pause between one can apply any of a wide range of techniques. Following are a few of my suggestions:

  • Divert your attention to other tasks — for example, reading a book or playing a video game.
  • Engage in physical exercise; take a walk or a bicycle ride.
  • Get involved in a positive activity that brings meaning and purpose.
  • Meditate.
  • Talk to someone who can help.
  • Use T.O.O.T.S. — “time out on the spot.”
  • Calmly and rationally evaluate your choice of thoughts and/or actions, and choose wisely.

I use all of these techniques. They work better when I recognize and start first with the pause between and the goal of reducing personal suffering.

What techniques do you use to help to reduce your suffering? Please share your story in the comments below.


Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.


Eman Ragheb avatar

Eman Ragheb

Parkinson destroy all my life

Dr. C avatar

Dr. C

I share in your loss. Hopefully my columns will provide information, comradeship, and hope. Finding family, friends or support groups will help you feel part of this community as we all have to help each other through the journey. Compassionate blessings to you.
Dr. C.

Alan Tobey avatar

Alan Tobey

I learned in a neurophysiology class decades ago to think this way: pain is not a condition, pain is a reaction to a message about a condition. So when needed I try to see if I can alter my reaction, or weaken/intercept the message, or do something about the condition— taken in that order. This gives me three things to investigate, which at least helps me become more distracted from the situation for awhile.

Dr. C avatar

Dr. C

Great comment! Do what you can on all fronts to decrease the impact of chronic pain in your life. Distracting the mind is one strategy, but replacing the distraction with health promoting mental activities can be an improvement over distraction alone. See the next column on "Having a conversation with my mind".
Dr. C.

Dr. C avatar

Dr. C

I really like your comments both on my column and in response to the "exercising with Parkinson's disease". We have similar mind-sets in that I also try to alter my reactions to pain or do something about the condition. Resting has never been a big part of my life until PD. Now I find that I must allow myself those days when resting is the major concentration of my efforts. I appreciate your sharing your thoughtful, and mindful, insights.
Dr. C.


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