Pain - Control, Regulation and Management

In my previous article I had a look at what ‘pain’ actually is - the signals and the neurology behind it. So now we have a better understanding of pain this blog post introduces approaches to control pain, as well as the management and regulation as to when, and how much we feel.

In summary of my previous post pain is the result of a signal, a signal that says we need to pay attention to something. The source of that signal could be tissue damage or risk of tissue damage, learned behaviour, or unresolved emotions. These signals are passed to our brain where we interpret the signals and pain is perceived. This process is there to protect us from harm – pain is in our best interests for our health and safety.

Some quick definitions for you. Control is a digital switch, a switch on, or a switch off – black and white. Regulation is an analogue scale, the amount, the extent, and timing of pain – shades of grey. Management is the process of allowing life to continue with pain and the process of control and regulation. The good news is that a hypnosis approach can help with all three of these, and my next post will explain some of the methods that we can use.

But first, pain is a perception in our minds, although very real, it is a perception created in our minds. And as such we actually control, regulate and manage pain on an every day basis. This is a usual every day occurrence. Have you notice your pain coming and going, varying at different times and in different circumstances?

Let’s start with pain from nociception – the pain that results from damage or risk of damage to tissue. The two ways of regulating the pain are ‘afferent regulation’ and ‘descending regulation’.

Afferent regulation is the process that can most easily be explained by rubbing your shin after bruising it to reduce the pain. The ‘let mummy rub it better’ approach. This can be explained by the ‘gate theory of pain’ where the neurology is both excited by the nociceptors detecting the pain and inhibited by the signal of rubbing it. Perhaps it could be simple put that by rubbing the injury, further signals from the rubbing are sent to the brain as well as the nociceptors signal that results in pain, therefore giving too much information and dulling the nociceptors signal – and therefore less signal for pain is received.

Descending regulation is something that as a fighter I use on a daily basis. Especially when we compete, and often in heavy sparring, we have to ‘switch off’ from pain. This is common in athletes and soldiers where injuries are incurred but no pain is felt. The suppression of the pain is thought to be carried out in the brain including the area known as PAG (periaqueductal grey matter). This area of the brain sends signals down the neurology effectively depressing the nociception signals coming up.

Pain from learned behaviour has a slightly different approach. Here we have been hurt in the past and therefore our minds look to protect us in the present by giving us a pain signal – often, though not exclusively, from the source of the original pain. I work with many athletes who have pain from old injuries on the way to training, but at no other times. To regulate or control the pain we need to work out what the signal is that the pain is telling us, and pay attention to it in order for the signal to not be necessary. And then we can switch off as it’s not needed.

The final source of pain is unresolved emotions. Dr Sarno is a leading name in the field of psychosomatic conditions including pain coming from unresolved emotions. If you are suffering from long term pain I would definitely recommend reading his works – just by reading his books many people become pain free as they understand the sources of their conditions. I regularly am helping people turn off and turn down long term pain by paying attention to unresolved emotions. Often this pain is first experienced around the time of emotional stress or trauma. As the emotions from this time are repressed by our unconscious minds the pain is a reminder that we need to process or resolve these emotions, even though we are mostly not consciously aware of them. Resolve the emotions, and then there is no need to feel the pain.

It is interesting to note that in my studies I have come across numerous reports as to the use of placebos in pain relief. A patient may be given sterile saline instead of an analgesic and report relief from the pain despite having no drug. A belief that the treatment will work can be enough to cause activation of the pain relief systems of the brain.

In my pain control/management/regulation I work with an understanding of all of these methods, the processes by which we experience pain. And by understanding these methods I am better placed to ethically assist people in living free from pain. In my next blog post I will explain some methods that I use, including some that you can try without a hypnotherapist, to control, regulate and manage pain.

What is Pain?

I’ve been working with several patients in respect to their ‘pain’ lately, including in conjunction with their consultants at their Pain Clinics. In this blog post I thought I’d explain what pain actually is, and how we experience it. (Everything here is put as a generalisation to enable simpler understanding.)

In later posts I’ll talk about pain control, management and regulation, together with the uses of hypnosis in the same. But first, what is pain?

Pain exists to keep us safe. It is a response to an alarm signal, our body’s way of saying ‘pay attention’. And this response helps us to avoid harm. Pain and withdrawal reflexes help us to keep ourselves safe. Pain makes us rest injured parts of the body which assists in recovery from any damage. It also reminds us to keep away from situations where in the past we had pain, or to pay attention to emotions that are not yet resolved.

Pain is a ‘somatic sensation’, in other words, it is a sensation felt in the body. But how is it created? Pain is a response to a signal. That signal could be from tissue damage, risk of tissue damage, learned behaviour, or unresolved emotions.

Pain as a result of tissue damage or risk of tissue damage is through a process called ‘nociception’. This starts with the nerve endings, or nociceptors, detecting the damage or risk, and sending this signal through our neurology to our brain. In the brain the signal is received, interpreted, and the synapses within our neurology fire accordingly and often produce the sensation of pain.

It is worth pointing out that the process of nociception is not in itself pain – it is just a signal that we can interpret as pain.

Pain can be as a result of learned behaviour. In the past we may have incurred injury and experienced pain, so if we are about to do that behaviour again, or are doing that behaviour we may experience pain, telling us not to do so. It is also well documented that current social norms also influence pain, and we can learn to feel pain as a result of other people’s behaviour, or even just hearing about it.

Unresolved emotions are also a source of pain, especially those with chronic pain. It has been documented that unless an injury is getting worse or being aggravated pain shouldn’t be felt six weeks after the injury – if it is, there is very likely an emotional element to that pain. Often repressed emotions become a source of pain – the pain being the signal that we need to pay attention and process that emotion through to resolution.

Pain is a cognitive process and it is due to this that our perception of pain can vary. Pain can come and go, may be intense, or just in the background, or we may just not feel it at all. And we can also experience pain whilst having no tissue damage or risk of damage to that tissue. We can control it by turning it off or on, or regulate or manage it to lessen or increase its intensity. And we can do all this because pain is created in the brain.

Now, whilst it is true that all pain is a perception in the brain, whether from tissue damage, threat of tissue damage, learned behaviour or unresolved emotions – all pain is most definitely real. And we all know how real that pain can be. So in future posts I’ll describe pain can be controlled, regulated and managed, so when we experience pain, we know how to pay attention to it.