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Anxiety

Getting in Touch With Pain

Feeling emotional and physical pain may help to ease suffering.

Key points

  • Most people tend to suppress, avoid, and distract themselves from painful experiences.
  • Pain relieving medication and drugs act only temporarily to blunt the pain.
  • We can learn with practice to simply feel both emotional and physical pain.
  • Feeling our pain can bring lasting relief, because it changes how the nervous system relates to the pain.

Pain is a neuro-psychological experience meant to be a wake-up call to a wound or trauma. Pain can be emotional (grief, anger), or it can be physical (an injury or disease in the body tissues). Instead of utilizing the wake-up call to find ease, pain is often treated as an unwelcome guest. We try pushing through the pain (fight), we avoid accepting that we are in pain (flight), or we tune out our body sensations, pretending they don’t exist (freeze/dissociation).

An interview study was done using participants who suffered from chronic back pain at the Royal United Hospital in Bath, UK. Some interviewees reported dissociating themselves from their embodied self-awareness. One participant said: “I never thought about my body before; I just abused it, I suppose. Now bits of it feel really weird as if they are not part of me anymore . . . the numb bits down my leg where it hurts . . . they’re somehow separate now.”

Although seemingly helpful in the short term, detachment or dissociation can make things worse.

A research study done on another group of chronic low-back pain patients at Rosalind Franklin University of Medicine and Science in Chicago, Illinois, revealed that the avoidance of emotions related to pain was connected to higher levels of depression and anxiety and higher ratings on pain and fatigue.

It is more helpful to find ways to gradually learn to pay attention to the pain as an embodied felt experience. A study done at the Karolinska Institute in Stockholm, Sweden, examined the effects of a treatment program to help clients with anxiety notice where they held pain and tension in their body and to become aware of any emotions or other felt experiences that arose as they become aware of the muscle tension and its related painful feelings.

When clients first entered the treatment program, they reported that avoiding the pain worsened their condition: “I really don’t want to be sad; I used all my defenses not to feel anything, and most of the time I succeeded . . . and I don’t like the pain, if I’m crying then I get a headache, terrible headache and I wanted to avoid that.”

As the treatment program progressed, the first step was learning to trust themselves sufficiently to let go of trying to avoid the pain and learn to pay more attention. “I noticed that my muscles were so tense and the impact it had on my anxiety symptoms, so now I try to counteract the tenseness in my body. I do some relaxation exercises that I learned during therapy. I have the feeling that I can control it now. Before, it was the anxiety that controlled me. Now I know directly that if I don’t feel well, I get muscular pain.”

This leads to a paradox. The only way out of the suffering is to jump back into it.

The only way to ease the pain, and at the same time to heal the body, is to attend to and feel the pain, at first in small doses. Analgesics and opiates, alcohol, and psychoactive drugs can only temporarily blunt the pain.

Another study—this one out of the Osher Center for Integrative Medicine at the University of California, San Francisco—recorded discussions during focus groups made up of skilled teachers/practitioners from different body-awareness practices (yoga, tai chi, Feldenkrais, Somatic Psychotherapy, Somatic Experiencing, Breath Therapy, and Alexander Technique). There was also another focus group containing 4-6 students of each of these practitioners.

Many of the participants reported that—after spending months or years engaging in their particular embodied practice—they learned to be with, accept, and just feel their pain. “The whole notion of pushing away unpleasant experiences that I would just do anything to avoid... Now I can just pay attention to what’s happening in the moment, and it’s much more pleasant to get through it. And the recovery from an unpleasant experience is much quicker as well.”

The researchers concluded that for the participants in this research study, “a key element that changed in their relationship to their body sensations appeared to be the awareness of the differences a) between thinking about a sensation and directly sensing the sensation, and b) between a willful attention and a more relaxed, accepting, and allowing attitude in their attention towards these sensations.”

Finally, a research study from Sahlgrenska University Hospital, Göteborg, Sweden, found that body awareness training reduced the pain and discomfort of people suffering from irritable bowel syndrome (IBS). People with IBS experience daily abdominal pain and discomfort as well as disrupted bowel function, including alternations between constipation and diarrhea. They may also have headaches, painful urination, fibromyalgia, panic disorder, anxiety, and depression.

Participants met with a trainer for two hours each week for a total of 24 weeks, learning to pay attention to felt sensations during daily movements. The body awareness treatment group, compared to a healthy control group, showed a reduction in IBS symptoms such as gastrointestinal dysfunction and pain, reduced body tension, increased ease of movement, improved body awareness, fewer headaches, and reduced anxiety and depression. In addition, participants reported greater self-confidence, increased coping ability, and showed lower levels of salivary cortisol[v].

The bottom line is to learn—on our own or with professional guidance—to become comfortable with our discomfort. When our system fights against the pain, it causes more pain and other distressing symptoms. It may sound counter-intuitive, but just allowing ourselves to feel our physical and emotional pain actually helps the nervous system to recognize and integrate those sensations. This has the effect of teaching us that pain is not a threat and also reducing the felt intensity of the pain. Accepting and feeling our pain is another way in which our body sense can become restorative and healing.

References

Mike Osborn and Jonathan A. Smith, “Living with a Body Separate from the Self. The Experience of the Body in Chronic Benign Low Back Pain: An Interpretative Phenomenological Analysis,” Scandinavian Journal of Caring Science 20, no 2 (2006): 216-222. doi: 10.1111/j.1471-6712.2006.00399.x. https://pubmed.ncbi.nlm.nih.gov/16756528/, p. 219.

Phillip J. Quartana, John W. Burns, and Kenneth R. Lofland, “Attentional Strategy Moderates Effects of Pain Catastrophizing on Symptom-specific Physiological Responses in Chronic Low Back Pain Patients,” Journal of Behavioral Medicine 30, no. 3 (2007): 221-231. doi: 10.1007/s10865-007-9101-z. https://pubmed.ncbi.nlm.nih.gov/17443402/

Adrienne Levy Berg, Christer Sandahl, and Jennifer Bullington, “Patients’ Perspective of Change Processes in Affect-focused Body Psychotherapy for Generalised Anxiety Disorder,” Body, Movement and Dance in Psychotherapy 5, no. 2 (2010): 151-169. https://doi.ord/10.1080/17432979.2010.494853. https://www.tandfonline.com/doi/full/10.1080/17432979.2010.494853.

Wolf E. Mehling et al., “Body Awareness: A Phenomenological Inquiry into the Common Ground of Mind-body Therapies,” Philosophy, Ethics, and Humanities in Medicine 6, no. 1 (2011): 6. https://peh-med.biomedcentral.com/articles/10.1186/1747-5341-6-6, p. 8.

Elsa M. Eriksson, et al., “Body Awareness Therapy: A New Strategy for Relief of Symptoms in Irritable Bowel Syndrome Patients,” World Journal of Gastroenterology 13, no. 23 (2007): 3206-3214. doi: 10.3748/wjg.v13.i23.3206. https://pubmed.ncbi.nlm.nih.gov/17589899/.

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