Barking Up The Wrong Tree March 27th, 2023 ---------------------------------------------------------------
Before we commence with the festivities, I wanted to thank everyone for helping my new book become a bestseller! To check it out, click [here](. --------------------------------------------------------------- This Is How To Deal With Pain: 4 Powerful Secrets From Research ([Click here]( to read on the blog) Thereâs a [case]( in the medical literature of a butcher who slipped while working and got his arm caught on a meat hook. Yeah, ouch. The pain was bright, attention-grabbing, impressive, and very good at what it does â it was the Beyoncé of pain. He was in agony. Then he realized the hook only caught his sleeve. Didnât even penetrate the skin. And the pain went away. Weird, right? [Hereâs another one]( -- and at the risk of sounding less Eric Barker and more Clive Barker, Iâll warn you itâs a bit darker... When you read the testimony of political dissidents who have been tortured, they describe a consistent pattern: before the process began, they were made to stare at the implements that would be used to harm them. A cruel but effective method of intimidation. But it was also effective at increasing the subsequent pain they felt. Huh? In [my first book]( I discussed people with a gene variant that confers the ability to never feel pain. (Might sound great but, trust me, itâs not good.) And in [my second book]( I talked about the mind-bending nature of the placebo effect. (Placebos even work if you know theyâre placebos.) Pain is emotionally terrifying but intellectually, uh, kinda fascinating. Pain is a mystery. 20.4% of American adults [deal with chronic pain]( And weâve all dealt with acute pain. When youâre the one feeling it, itâs not quite as interesting. You suddenly find yourself in another dimension. The innocuous elements of life rub up against the horrific. Makes H.P. Lovecraft seem like Barney the dinosaur. Oscar Wilde once quipped, âGod spare me physical pain and Iâll take care of the moral pain myself.â Time to get to the bottom of this and learn what we can do about it. Whether youâre dealing with chronic pain, injury, illness, or recurring issues like migraines, there are insights from the science we can use to reduce suffering. And if youâre helping someone with pain, there are insights here you might want to pass along. This is medical territory which means we need to be on our best epistemic behavior. Caveat emptor, YMMV, for informational purposes only, etc. This is information you want to discuss with your doctor. When it comes to anything serious, never accept without question anything you read from âsome guy on the internetâ and as much research as I look at, Iâm not a doctor. Iâm still âsome guy on the internet.â Weâre going to draw from a wide range of sources including â[The Pain Management Workbook]( â[When the Air Hits Your Brain: Tales from Neurosurgery]( â[The Body in Pain: The Making and Unmaking of the World]( and â[The Psychology of Pain]( Okay, letâs limp to it... How Pain Works The pain in your arm isnât in your arm. All pain is in the brain. (If it wasnât, there would be no [phantom limb pain]( And pain is complex. Medicine calls it a âdiffuse neurological process.â There is no single âpain centerâ in your gray matter. Not to go all oenophile on you but pain does have different âflavors.â Youâve had shooting pain, searing pain, and dull pains and theyâre all distinct. A good doctor can actually use that information to help diagnose whatâs going on because arthritis pain often presents one way and cancer pain another. Your nervous system has two ways of dialing back the pain signal: endorphins and âgating.â Endorphins are the bodyâs natural opiates. Theyâre what allow athletes and soldiers to keep going when injured. Great for acute, severe pain, but pretty ineffective against chronic pain. [Gating]( is about logistics. Tons of sensations are constantly flying up your nervous system and your brain is like âHey! One at a time. Youâre flooding my inbox.â So sensations get prioritized. If one is first in line, the others get gated. Blocked. This is why you rub your leg when itâs cramped, and why ice packs and heating pads help. Youâre superimposing one sensation over another to block the ouch. Napoleon suffered terrible pain due to kidney stones and he would repeatedly burn himself with a candle to gate the abdominal pain. (Yes, this works. No, I donât recommend it.) But thereâs another aspect to pain that gets discussed a lot less â psychology. The story about the butcher makes it clear that pain isnât an accurate indicator of tissue damage. Hurt and harm are not the same. Weâve all dealt with pain that had no obvious cause and weâve all seen bruises in the shower that we never felt. Iâm not going to be dismissive and say âpain is all in your headâ but, well, sometimes it is. The current concept of pain is called the âbiopsychosocial model.â Pain has biological, neurological, cognitive, emotional, social, and behavioral elements all intertwined. And psychology is a big factor. Bigger than we give it credit for. Why did the pain of the torture victims get worse after seeing the weapons? Because your emotions, beliefs, expectations, and thoughts all influence what you feel. Especially the negative ones. A pinch from your partner might be as objectively painful as the poke of a doctorâs needle but it wonât be experienced as the same amount of pain. And an injury on a stressful day might feel far worse than if you were feeling good. (Thereâs a reason why childrenâs hospitals are brightly colored with cute murals on the walls. Thatâs not an accident.) Simply put: âindications of danger make pain worse, while credible evidence of safety reduces pain.â And this is no small effect. In [lab studies]( where they can control a patientâs context, reducing fear and anxiety, opiates are much less effective. Why? Because a good part of what morphine does actually works via psychology, not just biology. Whatâs all this mean? If we reduce stress and anxiety, improve mood and shift attention, we can reduce pain perception. Itâs far from a magic âoffâ switch, but it can definitely help. So whatâs the first step? Itâs really simple. But when youâre in pain it can seem really hard... Relax If you were in horrible pain and I said, âJust relax!â I wouldnât blame you if you wanted to hit me with a sack of batteries. When pain hogties your emotions, when your blood is more stress hormones than hemoglobin, relaxation is hard. So donât just do it psychologically, do it physically. Try progressive muscle relaxation. Starting with your feet, tense them for 10 seconds and then let them relax. Then do your calves. And up your body all the way to your face. Really feel the relaxation after each time you let the tension go. Studies show this can strengthen your emotional infrastructure and allow you to better cope. Now this will help your body but attention is also a factor so we need to address the mental part more directly. If all you can think about is the pain, youâre going to tense up again soon and the pain will be back... Distraction Pain seems like an escape room you canât escape from. Like itâs tattooed on your consciousness. [Elaine Scarry]( writes that, âthe absence of pain is a presence of world; the presence of pain is the absence of world.â Pain screams âpay attention to me!â and so we do. But [focusing on pain makes it worse]( Similar to the butcher story, hypochondriacs donât actually have a medical problem yet their overactive attention actually [causes the perception of pain]( where there is no harm. Luckily, the reverse is also true. When we redirect attention â when weâre distracted â [pain can be dramatically reduced](. Youâve experienced this inadvertently. Something grabs your attention and you briefly forget youâre supposed to be miserable. I suggest you leverage this more deliberately. Donât dwell on pain. To the degree you are able, stay busy, stay distracted. See friends. Watch comedy or engrossing TV and movies. Brainstorm possibilities and see what works for you. âFuzz therapyâ can help. Yes, pets. Even looking at a cute animal [reduces stress and blood pressure]( (For a bit of instant pain relief, click [here]( Unfortunately, we canât stay distracted all the time. (Though this clearly has not stopped me from trying.) Pain can fight back. It goes quasi-sentient. Pain, with its menacingly broad smile, starts whispering things to you... Thoughts âThis will never end. I canât take it. This is killing me.â Totally normal and natural thoughts when youâre in pain. But theyâre not helping. As we discussed, your beliefs, expectations and emotions affect perceived pain. The problem here is our cognitive distortions. In other words, overreacting. When stressed, we tend toward many errors of thought like Black and White Thinking (âIf life isnât perfect, itâs unbearableâ), Overgeneralization (âThis hurts, so my entire life is terribleâ), and catastrophizing (âThis is never going to end.â) Theyâre all exaggerations, all irrational, all too extreme. And these thoughts affect pain. Itâs like casting a dark spell on yourself. What to do? Strike back with The Logical Hammer of Rationality +4. Yes, CBT to the rescue. Itâs a simple as asking yourself a few questions to dispute the irrational thoughts. So pain starts whispering: âThis is unbearable. My life is over. The world is coming to an end.â Ask yourself: Is it a fact? Nope. You are bearing the pain, however reluctantly. You know the world is not burning down because youâre still receiving spam texts. Accept the presence of the thoughts â but donât believe them. Ask yourself: Are you predicting bad things? Yes. And given you only have âThe Logical Hammer of Rationality +4â and not the âOrb of Prognostication and Prophecyâ you canât predict the future, Nostrodamus. Ask yourself: Are you using the words: all/nothing, always/never/forever, best/worst? Yes. That means youâre exaggerating. Saying âthe plagues of Egypt got nothing on thisâ may not be appropriate. Ask yourself: What has happened in the past? Pain went away. Resumed taking health for granted and never thought about it again. Hmm, maybe that will happen this time, too... Ask yourself: What elseâneutral or positiveâmight happen in this situation other than what youâre predicting? Hey, maybe there are explanations other than the worst-case scenario. There are perspectives that can save us and others that imprison us. Choose the former. Okay, weâve covered a lot. Letâs round it all up â and learn how to overcome the biggest threat that pain presents... Sum Up Hereâs how to deal with pain:
- Ouchie!: Pain definitely gets a one-star review -- but itâs important to realize psychology is a big part of it. Thoughts, feelings and expectations of doom make it worse and anything that makes you feel safe and calm will improve it a bit.
- Relax: Yes, this is hard to do when you feel like youâre dying a millimeter at a time but progressive muscle relaxation can help.
- Distraction: This gives you license to do unproductive stuff you might normally feel guilty about -- like watching comedy, listening to music or seeing friends. (Looking at cute animals can save the day.)
- Thoughts: The lacerating ones pain brings can make you feel worse. Dispute them to get realistic and reduce the sting.
When pain consumes you, you can feel like an outcast in your own life. You arenât even âyouâ anymore; youâre a philosophical treatise on ontological anarchy. Pain has pressed itself so close to your nose that you can't see the world. Or yourself. You feel you are your pain. You cannot let pain become your identity. This is a self-betrayal. And it makes things worse. Chronic pain patients who identify with their â[sick role]( donât improve. Research shows it helps to broaden your perspective. To think about what you like best about yourself. Your hobbies and passions. What youâre curious about. Your favorite things. What youâre good at. What youâre proud of and what you love. Pain is only one facet of your life, not the defining quality. Take the time to strengthen a positive vision of yourself so the pain is a mere footnote. Youâre more than your pain. Pain is difficult. Pain is a challenge. But at least we now know that pain is an acceptable reason to spend more time looking at puppies. ***If you are one of those lovely people who bought "Plays Well With Others" please leave a review on Amazon [here](. Thanks!*** Email Extras Findings from around the internet... + Want to know the simple thing that can help reduce bodyfat -- and your chance of getting diabetes? Click [here](. + Want to know how to improve your public speaking? Click [here](. + Want to know the everyday thing that has a huge effect on quality of life? Click [here](. + Miss my prior post? Here you go: [New Neuroscience Reveals 6 Secrets That Will Increase Your Attention Span](. + Want to know how to use AI to get unstuck? Click [here](. + You read to the end of the email. I hope I distracted you from any pain you might be feeling. And thank you for reading. More importantly -- it's Crackerjack time: Why the heck does your skin get wrinkly when you're taking a bath? For the answer, click [here](.
Thanks for reading!
Eric PS: If a friend forwarded this to you, you can sign up to get the weekly email yourself [here](. This email was sent to {EMAIL}
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