THE SELF-MANAGEMENT OF DIFFERENT KINDS OF PAIN:
Wednesday, April 29, 2009 | 4:35 amTHE SELF-MANAGEMENT OF SUDDEN UNEXPECTED PAIN
This is a different clinical problem again. The difficulty with sudden unexpected pain is that the pain is likely to get out of hand and overwhelm us. It is then easy to be overcome with distress before we can compose ourselves. It happens in the case of an unexpected blow, a broken bone, a burn, or even a severe sprain.
Our studies in the self-management of pain help in two ways. If we have learned something of the approach and have had some experience in the mental exercises, we do not react so drastically to sudden pain. This has been my own experience, and a number of patients have volunteered a similar observation. In the second place, if we should find that we are suddenly threatened with loss of control in this way, we now have the means to bring ourselves quickly under control and restore our composure.
As in each of the other aspects of pain and anxiety, we work to bring our principles of
self-management more and more into our everyday life. So when we experience some sudden and unexpected pain, even if it is only of minor degree, we immediately restore our composure by momentary mental relaxation instead of giving vent to our feelings as we have done in the past. Be warned that there is a good deal of false teaching by psychiatrists and those who should know better that it is good to give vent to our emotions and feelings. If we give vent to our feeling of pain, we too easily become distressed, and the intensity of the pain is increased.
Four years ago a dentist came to me. He has a degenerative condition of his backbone so that the nerves are pinched as they come from the spinal cord between the bones. He suffered sudden unexpected twinges of acute pain as well as quite severe chronic pain. His work as a dentist with the long hours on his feet and the necessity of leaning forward over the patient made him very vulnerable to this condition.
He has learned to control the pain. He is still working full-time. Between patients he occasionally lies down in a side room for a few minutes to re-establish his mental and physical relaxation.
A seventy-two-year-old single woman was referred to me in the hope that I might be able to help her with the pain in her tic douloureux. This is a shockingly painful condition characterized by sudden jabs of acute pain in the side of the face. The first attack had come on eleven years previously, but this had settled down. She was now subject to continual jabs of pain when she was talking or eating. On occasions the pain was excruciating. Three years previously she had developed trigger points on the face and tongue, and if these were touched, it would precipitate excruciating pain. At night if she moved in her sleep and the bedclothes brushed her face, pain would be precipitated in this way.
She was a very courageous, stoic woman, and I have no doubt that at times she experienced really terrible pain. However, she wanted to avoid the orthodox treatment by injection or the operation of cutting the nerve, both of which leave that part of the face without feeling and so open to injury.
She was a particularly good patient, as are many people who are in extreme pain. I only saw her on four occasions. She then claimed that she could reduce the pain to quite bearable proportions; and she did in fact allow me to touch the trigger spots, which previously had been so exquisitely tender.
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(posted in Anti Depressants-Sleeping Aid)
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