From the desk of Dr. Rosenberg …

Six Attitude Strategies for Coping with Chronic Pain

It hurts too much… I can’t stand it one minute longer … I just want it to stop … it’s not worth it … I can't go on.

Sound familiar? These types of thoughts, running through the mind of a pain patient, are not that unusual, in fact, are common. Unfortunately, thoughts of feeling victimized, when repeatedly stated, form an attitude of defeat and end up magnifying awareness of pain sensations, limiting tolerance of pain, and continue a cyclical process of undermining coping efficiency.

Thoughts and attitudes are critical factors in determining how a person gets through the next hour, day, week, the present and the future. Here are 6 important strategies you can use immediately and repeatedly use to regain control over your thoughts and attitude. Try these active coping strategies to boost your pain tolerance and effectively limit your emotional suffering.

H andle pain in the present, in the here and now. While there is no doubt that pain sensations are very uncomfortable, it is never truly intolerable unless you believe that it so. What often exaggerates pain awareness and intensity is fear of its current intensity, worry about how much more intense it might get, this combined with worry about when it will ever end.

By staying in the present moment you CAN direct your efforts to cope with pain one moment at a time, without fearing for anynegative future. And as you succeed in tolerating pain in one moment, you end up bolstering your confidence in your ability to succeed in the next, and the next, etc. Use this method to break the pain-fear cycle.

Use pain as a signal of challenge. The usual reaction to pain flaring up, intruding more than expected, is passivity – waiting for medicine to work, limiting activities, avoiding everyone. While this may be necessary during a pain flare up, many times this is more a habitual response. Pain patients need to be aware that passive responding send you a strong message: PAIN CONTROLS MY LIFE. Instead, consider responding to a pain flare by producing a checklist of active coping strategies to follow. Challenge yourself in those pain flares to follow the checklist, using mental and physical ways (see the other steps) to cope, all which limit you feeling overwhelmed. Challenge yourself to respond more effectively to pain situations you previously thought were impossible to manage.

Use pain as a signal to relax. Muscle tension increases may increase the number and speed of pain messages sent to your brain. More tension à more pain intensity and awareness. And a stressed and worried reaction to pain sensations also interferes with pain tolerance - more stress and/or worry à more pain awareness.

Now look at the opposite. More physically relaxed responses to pain sensations means fewer, slower pain messages sent to your brain – pain is no longer an emergency. Less stress and worry, better tolerance of pain. Learn to use relaxation skills in the face of pain, bolstering your pain tolerance and coping confidence.

Shift your focus of concentration away from pain. Whatever your brain focuses on becomes more dominant in your awareness. Pay attention to an itch - it magnifies and gets the best of you. Pay attention to worry and it gets more frequent and distressing. Pay attention to pain, the sensation appears to magnify.

Practicing not paying attention to what is bothering you, physically or emotionally, is an important active coping skill. To do this, practice a distracting hobby, or use your 5 senses to shift focus (listen to music or watch nature, etc.). You could talk to others, but restrict the topics to non-pain issues. These ways, and many others, all break the cycle of pain magnification. Concentrate on coping, not "paining."

Use pain coping as a reminder of your toughness With practice of active pain coping skills you become stronger and more effective in your ability to manage pain.

Remind yourself how well you're coping and how much better you'll cope as you practice active coping skills more. Give yourself praise for efforts as well as successes. Help yourself to see how you are becoming mentally tough facing this new and difficult challenge – persistent pain. You are reasserting control, learning ways to adjust, coping with pain. Give yourself credit for your toughness.

Be prepared to deal with pain. Who would you want handling your loved one's emergency ?: 1) someone new to the situation, 2) someone who had once read a book about it, or 3) someone who is practiced and experienced in how to manage it. No contest, is it? - You would want someone who knows what they're doing à #3.

Every chronic pain patient has emergencies. Be prepared - not just by relying on health professionals, but by relying on yourself - make yourself an active coping expert.

Think about pain situations you're likely to deal with, then write down your coping plan. Consider alternatives, backup plans. Have supplies needed available. Plan what you'll think, what you'll say to yourself, what you'll focus on, etc. Have emergency practice drills. If the crisis really comes, use your plan. Afterwards, look at what worked and what didn't. Use a crisis coping plan that you have made effective.

Knowing you have that plan to cope is half the battle - finding out how well it works will bring you feelings of self mastery.