21-09-2014 PAGE 5: PSYCHOSOCIAL ASPECTS OF CHRONIC PAIN: ANGER OVER CHRONIC PAIN Hi folks. Previous blog summary: On the previous page, I spoke about the following aspects of anger: 1. When angry, the object of anger focusses our attention such that usual rational thinking is mostly blocked, and we tend to act instinctively and impulsively; 2. Anger can be seen as a stress response which exacerbates pain perceptions, especially if the object of the anger is related to the suffering from the chronic pain condition. Research has shown this is partially due to the body’s stress endocrine responses, and that pain, particularly chronic pain, mobilizes a stress supersystem involving the sensory, endocrine and immune systems; 3. irritating, repeated minor stresses, over a prolonged period can be more harmful than a large stress episode during which an anger outburst occurs and then subsides, because, with the minor irritations, the stress supersystem is activated over a prolonged period, and the harmful effects of such activation have longer to do more harm. 4. Learning ways to behaviourally calm oneself in anger-provoking situations makes sense in view of the physiological, psychological and behavioral adverse consequences that can accompany constant irritability or anger outbursts. As pointed out in the Las Vegas Recovery Center’s blog on anger, resentment and chronic pain (lasvegasrecovery/anger-resentment-and-chronic-pain) is worth reading as the author points out some common behavioural consequences to anger and associated psychodynamic processes that are involved in such responses. In dealing with daily chronic pain and one’s emotional responses thereto, the following are some ways that have been shown to be useful in gaining better control over one’s natural emotional reactions, be they anger or other emotions: • Let’s consider the water-drip treatment of daily irritations first. If the sources of such irritations cannot be altered so as to avoid the causes of irritation, and one has to live with the situation, a problem-solving process needs to be engaged to produce feasible possible solutions. Perhaps a basic question to start with might be to ask oneself: “what do I need to do to help myself cope better with my reactions in that situation?” Answers to this question might produce a series of possible answers with further questions to be answered. What is happening in this problem-solving process is that you are using your rational mind to calmly think of possible ways of dealing differently with the problem – quite different from the kind of thinking that has been occurring in the heat of past encounters! In this sense, you are consciously engaging in mental processes for (cognitively) reshaping your previous behavioural repertoire of responses – you are engaging in the process of “cognitive-behavioural therapy” (CBT) because now in contemplating solutions without the situation “in your face” you may well change your ideas about the nature of the problem recognizing that some of your past thinking did include unrealistic or irrational thoughts, which are better set aside for new thinking on the problem. • Here it is useful to find out about the basic 10 kinds of irrational or illogical thought processes discussed in CBT, and accordingly trying to recognise if any of these apply to your past ways of thinking about the problem when you became upset by it. Use the search terms “Illogical or irrational errors in CBT.” The importance of these CBT “errors” is that they produce distortions in our thinking about situations, which then adversely affect our coping behavioural responses, among which are our emotional responses – in our example – feelings of annoyance, irritation or even anger outbursts. Once you are familiar with the nature of the “errors,” one can pick up when they are happening in the thought interpretations that you apply to problematic or stressful situations, including episodes of severe pain. From CBT, you will then know that you need to find rational ways to change your mental interpretations (thoughts) about the situation so as to cope better with the nature of the problem behaviourally. You may become aware of how your beliefs or expectations towards the object of anger may need to be revised so as to relieve your emotional responses to aggravating situations. • in the interests of stress management, you might realise that your irritation, annoyance or anger outbursts generates a eat deal of physical tension and you may therefore think: • I need to learn how to release the tensions generated by my physical, mental and emotional reactions. What would I need to do to achieve this release of tensions? • Here learning how to practice a deep relaxation technique is useful. There is a wide range from which to choose – from Progressive Muscular Relaxation to Visualization and Meditative Techniques – all of which achieve the release of physical tensions, induce calmer emotional states and focus the mind’s attention on the processes of reaching a deeply relaxed state. On YouTube, there are a host of videos on relaxation techniques that are worth exploring – even specifically for pain management. • Mind-based Stress Reduction (MBSR), for example, has been used by Professor Jon Kabat-Zinn, from the 1980s to the present time, to assist chronic pain patients for whom conventional medical treatments were not helping. Over a few months, many of these sufferers have become enthusiastic about their better control over their severe pain levels through the use of MBSR. • Much research has now been done into the benefits of both conventional relaxation practices, including MBSR. These studies are showing the positive effects on the brain of MBSR, or of combining aspects of CBT with meditative practices. I would recommend the blog articles by Dr Jon Lieff PhD on his Internet page “Searching for the Mind” and particularly his articles on Meditation for those who may be interested. These can be found at: • jonlieffmd/; jonlieffmd/blog/meditation-and-brain-update-2014 If you are interested in finding out more about any aspects of the above therapeutic approaches, you’re welcome to contact me through the VODH email or directly at [email protected] Rob Boell (B.Soc. Sci. SW Hons): Clinical & Medical Social Worker: Volunteer Service Provider: V.O. Disability Homes: PRACTICE No.: 10-07726 SACSSP
Posted on: Sun, 21 Sep 2014 15:07:20 +0000
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