Finding Solutions That Help You Manage and Decrease Chronic Pain

I spent years with chronic pain and fatigue that often felt random like there was no reason for the pain.  I did not know what to do to find solutions to provide relief.  This feeling for me was one of the worst things about having pain, it was out of control and at random which felt incredibly frustrating.  Throughout my exploration of my chronic pain, I discovered a framework that has helped me immensely and that I continue to use today with myself and those I work with.  Improving my understanding of how I react to and think about pain has helped me to:

1. See what I do now and HOW it affects me
2. Make sustainable changes to help me have consistently less pain

Let’s start by defining a few things…..

Thinking Systems

Within Psychology, two different thinking Systems are labeled System 1 and System 2.  These principles help address chronic pain. Daniel Kahneman’s book “Thinking Fast and Slow” delves into this topic in detail and I think is worth a look. 

• System 1 thinking: quick and automatic reactions such as swerving to miss something in the road. Requires less energy.
• System 2 thinking: slow critical thinking. Requires more attention and energy. For example: solving an algebra equation.  

Chronic Pain and Thinking Systems

On a biological level, pain triggers adrenaline and cortisol to decrease pain so we can get away from whatever is causing pain.  This leads to an increase in fast thinking (System 1 thinking), needed for quick actions to survive.  After this dissipates, ideally System 2 thinking will help reflect and deliberate.  However, activation of System 2 thinking requires slowing down for adrenaline and cortisol to be able to dissipate.  Thus, if this step is skipped, we may never be able to reflect on the cause of pain. 

Environmental, cultural, and emotional aspects of pain:

Continual activation of System 1 thinking, continuing without slowing down to allow for adrenaline and cortisol to dissipate, can be from a combination of environmental, cultural, and emotional patterns. 

• Environmental: The number of stimuli we are surrounded by, noise, light, social stimuli, etc., plays a role in the state of our Nervous System by activating the release of more adrenaline and cortisol.  This would be why you feel a difference in the quality of sleep or rest while in a quiet, dark space compared to sleeping in a hospital. 
• Cultural: Depending on where you live in the world the cultural ideas of productivity and pace vary.  In most of the Western World, doing more equals better.  This means keeping a continual fast pace to produce more, be more, make more, etc.  
• Emotional patterns: Our patterns around pain are a combination of nature (genetics) and nurture (learned from our parents). In terms of nurtured patterns, what a parental figure in a child’s life does when experiencing pain (emotional or physical) and how they respond when a child is in pain can shape the child’s responses to pain as an adult.  Therefore, some automatic emotional processes may not include System 2 thinking. 

Now that we have the basic definitions.

What is Impacting Your Chronic Pain?

What if the combination of one’s emotional patterns, culture, AND environmental factors exacerbates pain?  I commonly see (in clients and myself) responses to pain that do not help heal but instead create more pain. 

For example, common efforts to get away from pain include the following.

• ignoring it
• pretending it doesn’t exist
• covering it up with busyness
• increasing caffeine intake or other stimuli to not feel the pain 

While these strategies work in the short term, the long-term consequences often mean persistent and increased pain. 

Partially, I think this is a result of the effort it takes to look and see where our pain is coming from, the type of effort to slow down and tap into System 2 thinking.  This type of effort differs from what is commonly viewed as “effort” in terms of health.  Engaging System 2 required that Cortisol and Adrenaline must dissipate, meaning we must allow ourselves to not push as pushing will likely activate adrenaline and cortisol. Instead, we need to allow our brains to focus in a similar manner needed to solve a hard math problem or puzzle.  This does not mean that thinking system 2 is easy! Instead, that System 2 thinking may feel significantly different than our quick- System 1 thinking- reactions. 

The Puzzle of Chronic Pain

Putting together the puzzle of our pain that is often complex and can benefit greatly from System 2 thinking- slowing down.  The steps I use to tap into Thinking System 2 include:

• Paying attention:  The effort to be mindful in one way that calls allows us to slow down enough to be able to utilize System 2 thinking.  Asking questions like,
  • How does my body feel?
  • What are my pain levels at different points of the day?
  • Does my pain change around certain activities?
  • What are my fast or “gut” reactions to pain?

This sounds quite easy, but I have found the discovery process is quite challenging and may take continual effort to slow down and notice.

• Allowing time to “puzzle”: Once you have noticed how you feel, it will likely take time to puzzle or mull over different possibilities.  Asking questions like,
  • What did I do differently in the last few days? (If the pain is new)
  • Was there a time when I did not have this pain, if so, what was different? (If the pain is consistent)

Answers may not come immediately; actually, it is unlikely they will.  It takes time to learn how your body responds AND put it together with possible stimuli. You can test by making a behavior shift.

After noticing, and once you are ready, choose what behavior you want to change and try it out.  Due to the behavior being new, it will need to be conscious and will therefore be more tiring (think driving on a new road or navigating a new town).

Is It Worth Thinking About?

So, why do it? Why spend the extra effort?  I think it’s a choice that is worth considering between the outcomes:

• Remain in the habits and norms you have, which you know the outcome for.
• Spend the energy now and use your attention to try to solve some parts of the pain puzzle. You don’t know the outcome yet, but from my experience, it can have very positive results!

I don’t think there is a right answer and what’s great is that you can choose every day- some days, times, and situations System 1 thinking will serve you VERY well, while others may do well to spend some time tapping into System 2 thinking. 

Making changes in lifestyle, strength routines, or nutrition is challenging. Getting support from a professional is one way that can help. I offer one-on-one training that is individualized to help you meet your goals. My goal is to work with you to find creative solutions where you can see improvement in your overall strength and movement while making adjustments to decrease pain over time. Call or text me today at (360)774-1607 to learn more or set up a complimentary informational session.