Stress = Pain = Stress

Stress and pain are intimately related.

In our case, often, being stressed causes pain AND/OR pain causes stress. Psychological therapies – including hypnosis, meditation, and relaxation – may help break the cycle.

For pain therapists, these treatments, which focus on the relationship between the mind and body, are considered mainstream.

For other health professionals, they may be considered alternative or complementary therapies.

And for the layman, they may be considered hocus pocus!

Regardless of how they are labelled, there is evidence that for many people they work.

Hypnosis

fate2For many, hypnosis brings to mind a parlour game or nightclub act, where a man with a swinging watch gets volunteers to walk like a chicken or bark like a dog. But clinical or medical hypnosis is more than fun and games. It is an altered state of awareness used by licensed therapists to treat psychological or physical problems.

During hypnosis, the conscious part of the brain is temporarily tuned out as the person focuses on relaxation and lets go of distracting thoughts. The American Society of Clinical Hypnotists likens hypnosis to using a magnifying glass to focus the rays of the sun and make them more powerful. When our minds are concentrated and focused, we are able to use them more powerfully. When hypnotized, a person may experience physiologic changes, such as a slowing of the pulse and respiration, and an increase in alpha brain waves. The person may also become more open to specific suggestions and goals (such as reducing pain!) In the post-suggestion phase, the therapist reinforces continued use of the new behaviour.

Benefits of Hypnosis

Research has shown medical hypnosis to be helpful for acute and chronic pain. In 1996, a panel of the National Institutes of Health found hypnosis to be effective in easing cancer pain. More recent studies have demonstrated its effectiveness for pain related to other conditions. An analysis of 18 studies by researchers at Mount Sinai School of Medicine in New York revealed moderate to large pain-relieving effects from hypnosis, supporting the effectiveness of hypnotic techniques for pain management.

If you want to try hypnosis, you can expect to see a practitioner by yourself for a course of 1-hour or half-hour treatments, although some practitioners may start with a longer initial consultation and follow-up with 10- to 15-minute appointments. Your therapist can give you a post-hypnotic suggestion that will enable you to induce self-hypnosis after the treatment course is completed

To find a hypnotherapist, speak to your doctor.

More reading on Hypnosis: Look into my Eyes

Find a licensed Hypnotherapist:

The American Society of Clinical Hypnosis

American Psychotherapy and Medical Hypnosis Association

Mind Motivations – For US, UK and Australia

Therapy Tribe – for US, UK, Canada and Australia

Meditation

Meditation involves using a number of awareness techniques to help quiet the mind and relax the body. The two most common techniques are:

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  • Transcendental meditation. The patient repeats a single word or phrase, called a mantra, and is taught to allow other thoughts and feelings to pass.
  • Mindfulness Meditation. The person focuses all of his or her attention on thoughts and sensations. This form of meditation is often taught in stress-reduction programs. Want to give this a try?

meditationBenefits of Meditation

Studies suggest that meditating can increase pain tolerance, activity levels, and self-esteem and decrease anxiety, stress, depression, and use of pain medications.

Mindfulness meditation has been used successfully in programs to reduce pain and improve mood in patients with chronic pain from a variety of conditions, including headache, low back pain, chest pain, and gastrointestinal pain.

Because there are varied forms of meditation and opinions about requirements for training, there is no formal certification or licensing process for instructors. Training requirements differ widely by institution. If you would like to find a meditation instructor, speak to your doctor or a friend, who may be able to recommend one.

To practice meditation, repeated meetings with the instructor may not be necessary. A recent study examining the perception of pain and various mental training techniques has found that relatively short and simple mindfulness meditation training can have a significant positive effect on pain management.

Relaxation Therapies

Relaxation therapies include a range of techniques with the goal of reducing stress. In addition to meditation, the major types of relaxation techniques are:

  • Progressive muscle relaxation: Also known as systematic muscle relaxation and Jacobson relaxation, this technique involves slowly tensing, briefly holding, and then releasing each muscle group in a systematic fashion, starting with the muscles in the toes and moving upward. During this exercise, the person should notice the differences between tension and relaxation.

MINI-RELAXATION PROCEDURE (for those on a tight schedule!)

For relaxation to be of the most benefit, you need to learn how to relax and calm yourself instantly upon your awareness of tension or irritability. While a 20-30 minute relaxation period is great, and very pleasant, you cannot escape and listen to your tape or do your long practice when you are tense in traffic or irritated with your family or co-workers.

A mini-relaxation is done as follows:

  1. Take a deep breath and raise your shoulders slightly (until you can feel increased muscle tension).
  2. Starting at the top of your head, focus on letting go of muscle tension (beginning with the muscles across your forehead). Allow sensations of relaxation, release, and heaviness to flow downward from your forehead, downward through your face, shoulders, arms, torso, and legs and imagine all the muscle tightness and tension draining right out your feet. Exhale as you allow the tension to drain away, and use your “key word” as you do so (this may be Relax, Peace, Calm, Serene, Ocean or any other word or phrase that denotes deep relaxation to you). Be certain that your deep breath was a deep diaphragmatic breath.
  3. This whole procedure should take no more than about 30 seconds (and can be done in as little as 10 seconds if that’s all the time you have). At the end of this period, go about your business regardless of how relaxed you feel.
  4. Repeat this process many times during the day, at least 20. Use the coloured dot procedure to remind yourself to do a mini-relaxation, preferably several times an hour. Place coloured dots in places you will see them often: your telephone, kitchen faucet, refrigerator, bathroom mirror, the door frame of doors you walk through frequently, your notebook or appointment book that you consult frequently, and even cut a small part of the coloured dot to place on your watchband. Whenever you see the coloured dot that is your reminder to do a mini-relaxation: deep breath, raise shoulders, let go of muscle tension as you breathe out and drop your shoulders, while repeating your ‘key word.’ You will notice that you become better and better at producing sensations of relaxation in a very short period of time, as you practice this over days and weeks. Do not extend your mini-relaxation more than one minute. If you are still tense, continue with what you are doing, and do another mini-relaxation the next time you see a dot, or the next time you are aware of feeling annoyed.

NB: A note of caution regarding relaxation if you are driving your car: Never practice long periods of deep relaxation while driving. Never listen to a deep relaxation tape while driving. Frequency is the key! The more you practice relaxation, or mini-relaxation, the better you will become at releasing stress and tension quickly and effectively.

Autogenic training: This technique uses visual imagery and body awareness to achieve relaxation. The person imagines being in a peaceful place and then focuses on different physical sensations, such as heaviness of the limbs or a calm heartbeat. People may practice on their own, creating their own images, or be guided by a therapist. Patients may also be encouraged to see themselves coping more effectively with stressors in their lives.

Breathing: Breathing techniques teach people to breathe effectively to relieve stress. While placing one hand on the chest and another on the belly, the person is instructed to take a slow, deep breath, taking in as much air as possible. During this, the belly should press against the hand. After holding their breath for a few seconds, patients are instructed to slowly exhale.

Benefits of Relaxing

According to a 1996 National Institutes of Health report, there is strong evidence to support the effectiveness of relaxation techniques for reducing chronic pain related to a variety of medical conditions. Other benefits may include reduced muscle tension and insomnia and increased activity level.

chronic comic 167The best way to learn relaxation techniques is with the help of a trained practitioner (although you can find many guided meditations, etc. on the Net). Usually these techniques are taught in a group class and then practiced regularly at home.

There is no widely accepted license for practicing relaxation therapy. However, it is often practiced by therapists and psychologists. Ask your doctor for a recommendation.

More reading on Relaxation: Relax

Risks of Mind-Body Therapies

Although mind/body therapies don’t have the risks of medical or surgical therapies, there have been rare reports of adverse reactions from them.

  • If you have poorly controlled cardiovascular disease, experts recommend avoiding progressive muscle relaxation, because abdominal tensing can cause increased pressure in the chest cavity, slowing of the pulse, decreased return of blood to the heart, and increased venous pressure.
  • If you have a history of psychosis or epilepsy, you may wish to speak with your doctor before trying meditation. There have been reports of some people having further acute episodes following deep and prolonged meditation.
  • Hypnosis or deep relaxation can sometimes worsen psychological problems in people with post-traumatic stress disorders or a susceptibility to false memories. Its use should be avoided in patients with borderline personality disorder, dissociative disorders, or with patients who have histories of profound abuse. Because competent hypnotherapists are skilled in recognizing and referring patients with these conditions, only appropriately trained and experienced practitioners should undertake hypnosis.

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