The Anticipation of Pain

A study done in 1999 by researchers in England and Canada shows how the brain reacts to pain by showing that the fear of pain is worse than the pain itself. Many of us have learned that anticipating physical or emotional pain can actually make the pain worse. People who worry about having panic attacks are almost certain to have them and the more they worry the worse the attacks are. Similarly, waiting in the dentist’s chair for the drilling to begin can be excruciating for some people. Then, the sound of the highspeed drill can send them over the edge.

The researchers built a "pain machine" that could deliver pain to a person without actually causing harm. It might be noted that the head researcher tried the machine on himself before using it with the research subjects.

When a participant was hooked up to the pain machine, a light came on before the pain was delivered. The light-pain combination was delivered randomly so that the person didn’t know when the light would come on. However, the subject did know that when the light came on, the pain was soon to follow.

The scientists monitored brain activity as the light-pain combination was delivered. What they found was that one part of the brain was activated when the light came on and another part when the pain was actually felt. These two brain areas were very close to each other.

The anticipation of pain caused the brain to respond and may prove that the anticipation of pain is worse than the pain itself. This anticipation is often accompanied by automatic physical reactions such as rapid heart beat, muscle tension, rapid breathing and a racing mind. These reactions often makes the pain worse. Studies have shown that if a person relaxes as a response to pain anticipation, the pain is actually less intense.

What makes this even more interesting is that previous research has shown us that we often become aware of something unconsciously before the awareness hits our consciousness. That means there may be times we will "feel" the anticipation of the pain before it happens but do so at a low level of awareness — the "gut level feeling."

The reason certain medications such as narcotics, alcohol and antidepressants seem to reduce pain is not that they act directly on the pain. By reducing awareness of it and damping the sympathetic nervous system, we just don’t feel the pain as badly.

So what can you do if you have a dental appointment coming up? Or maybe you experience anxiety in closed places. You can check out our blogs on stress management.

These skills are excellent tools for managing pain and stress. You may want to begin with the introduction to stress management. The skills you will need to learn are Natural Breathing, Muscle Relaxation and Mind Calming. As with all skills, how well you can do them will depend on well they work. Some people try to use these skills only when they are in a stressful situation. This is too late — sort of like trying to learn how to swim after falling out of the boat.

Practice these skill now, so that when you need them, you can manage your pain more effectively. Doing so will also increase your self-confidence and well-being.

If you would like to leave a comment, click on the comments link below.

For an index of all blogs, go to Blog Index

What We Don’t Know Can Kill Us

Research on our immune system is continuing to help us better understand ourselves. Recently, researchers have discovered that when stress negatively affects our immune system, it can have disastrous results on the actual cells in our body. These problems are not to be taken lightly. Allergies, arthritis, some types of cancer, diabetes and heart attacks are on this daunting list.

One researcher discovered that all these dire results are the result of one body event. Stress causes chronic inflamation. If this inflammation continues, the body’s alarm bells keep us on Red Alert. Although the inflammation is meant to help our body fight garden variety substances in nature that can kick off allergies, there is a high price to pay. While our body is fighting off allergies, it is also less able to deal with more serious problems such as actively dealing with infections and wounds.

This problem is not hidden or rare in our population. Studies have found that about forty percent of children and thirty percent of adults suffer from allergies. The scary part is that this can be worsened by only a one-time social situation that is stressful. Many people in our society must cope with an anxiety disorder on a daily basis. Unfortunately, they are more likely to have asthma and any additional stress can make it worse.

As stress continues over long periods of time, the immune system can age faster than normal. That’s why the list at the beginning of this article is so frightening. The more you stress yourself, the more sooner you may have to deal with serious illness.

Some studies found that ongoing stress – such as being a long-term caregiver for a loved one – can make a 55-year old have the immune system of a 90-year old. As we get older it is harder to heal from wounds and other daily ailments. We may also be less likely to be helped by vaccinations. Chronic stress can make these problems appear early than usual.

Sometimes, stress need not be chronic to affect our body’s immune systems respond. A study in 2008 found that even a small fight between married couples affected the immune system. The more the couples continued the argument by being nasty to one another, the more slowly there body healed from wounds. It seems the inner wounds affect the outer wounds.

Reducing your stress on a daily basis is not only a good idea but one that contributes to your physical health. You can do this by being aware of your breathing during the day and if necessary practice your Natural Breathing. To deal with bigger stressors, allow yourself time to release muscle tension and calm your mind. You can find instructions for these two skills at the blog article entitled Muscle Relaxation.

If you would like to leave a comment, click on the comments link below

For an index of all blogs, go to Blog Index

Muscle Relaxation

I been helping people manage stress for over 30 years. In addition to Natural Breathing, these two skills in this blog will complete the three skills you need for activating your parasympathetic nervous system. The first part will teach you to release muscle tension and the last part (mind calming) will begin to show you how to slow your mind down and focus on the present.

There are many ways to release muscle tension, all of which can work quite well. If you already have a favorite method and it is currently working for you, you may want to continue using it. But for beginners, this method is probably the easiest of all available methods:

• the muscle feedback you receive while you are using this method helps you to quickly identify the contrast between muscle tension and muscle relaxation.
• it relies on no external devices (biofeedback instruments) to tell you when you are relaxed;
• it is capable of being streamlined so that its inherent clumsiness is eventually eliminated.

There are two ways of learning Muscle Relaxation. You can either have a friend read the instructions for you the first time, or you can record the instructions yourself on a recording device of your choosing. The first time you try Muscle Relaxation, you can listen to the recording and follow the instructions. But after this first time you need you to practice your muscle relaxation without listening to the recording. Although you will find it more difficult to relax without listening to a recording, it will work better for you in the long run. It is too easy to get hooked on the recording for relaxation—it becomes a electronic Valium. You want the recording inside your head, not inside an external device.

Either way you choose, make sure the instructions are read slowly, in a fairly monotonous but clear voice. You need to be in a room with as few distractions as possible (or you can be outside if this works best for you). Be sure that the television and radio are off, the telephone is unplugged, and all pets do not have access to you. Although many people think that relaxation is done best lying down, I have found this hinders you in the long run. When you are starting out, always practice your Muscle Relaxation sitting up. Preferably you want a high-backed chair or some other type of arrangement that can support your head.

You will notice that the muscle relaxation instructions are immediately followed by a set of simple instructions for calming your mind down. Do not be concerned if you find your mind wandering. It will take months of practice before you can correct this natural tendency.

Use the following instructions word for word unless you have a compelling reason for changing them. These words and phrases have been revised over the years due to client feedback. They work quite well for almost everyone. When you see a series of dots within the instructions (. . . .), each dot stands for a one-second pause. You should read these instructions slowly. They should take about fifteen to twenty minutes to complete.

Muscle Relaxation Instructions
You're going to go through an exercise that many people in our speeded up and tense society could profit from doing on a regular basis. This exercise is basically simple, and in its simplicity lies its importance. One might say you knew more about relaxing as an infant than you do as an adult. This ability to relax like an infant is what you can achieve through practicing this exercise. I want you to experience, now, for a brief period, that blissful, carefree relaxation of infancy. But first, to realize the experience of relaxation, it is important for you to feel the full effect of its opposite, namely tension, throughout your body. To do this I would like you to focus your complete attention on each part of your body as I mention it.

First, concentrate all of your attention on your RIGHT FOOT and the toes of this foot. With your right foot flat on the floor, lift your toes upward and fan them outward. This will create tension in your ankle and the calf of your right leg. . . . Now relax it quickly, just let go completely. . . .

Next, focus on your LEFT FOOT and toes. Extend your left toes upward and fan them out as far as they will go. Once again there will be a feeling of tension in your ankle and calf. . . . Now, relax your left foot completely. When I ask you to release the tension, try to let go as much as possible. The secret in relaxing is in the letting go.

Now tense the muscles in your RIGHT THIGH by pressing down with your right heel. Press down really hard on the heel of your right foot . . . feel the tension. . . . Now relax your heel and thigh—let go and notice the difference. In fact, each time you let go try to identify the difference in feeling between tension and relaxation. Notice how pleasant it feels just to have your muscles relaxing and letting go.

Let's do the same thing with your LEFT THIGH. Tense it as tightly as you can by pressing down with your left heel. Press down hard with your left heel and feel the tension as much as possible. . . . Let go and relax all over. . . . You may have noticed by now a pleasant sensation arising as you relax a group of muscles.

Next, focus on your STOMACH muscles, your abdomen. Tighten your stomach muscles into a hard knot. Keep your stomach as hard as you can for just a little while and notice that tension. . . . Now relax, just let go, let all your body muscles loosen completely, and notice the difference once again. . . . You may notice an inner feeling of well-being coming over you as you are able to relax more and more of your muscles. But you need to remember that relaxing is not something that you do, but something you allow to happen. You cannot force it, because it is a perfectly natural response to letting go. You were born knowing how to relax. All you need to do now is to allow it to happen. Just let go.

Next, direct your attention to your LOWER BACK—arch up your back. Arch your back way up and make your back taut and hollow and feel the tension up and down your spine. . . . Now, relax and sit back comfortably again. As you let go, try to remember that there is no limit to the amount of relaxation you can personally experience. Theoretically, you can relax to the point of infinity. Go ahead and relax your back—relax your body as much as possible. . . . Just relax further and further, letting the relaxation go deeper and deeper into your muscles.

While you keep the rest of your body relaxed, I want you to clench your RIGHT FIST. Clench your fist tighter and tighter . . . study the tension in your hand and arm as you do this. . . . Now relax and let the fingers of your hand become loose, completely loose. Notice how different your arm and your hand feel.

Next, clench your LEFT FIST, really tight. Clench it really tight and notice the tension in that arm. . . . Now, let go. Relax your left fingers. Let them straighten out and become limp. . . . Notice the difference once again.

Next, bend your RIGHT ELBOW and bring the fingers of your right hand up to your right shoulder. With your fingers touching your shoulder, tense the muscles of your right arm hard. . . . Study that tension in your bicep. . . . All right, straighten out your arm and let go. . . . Just relax all your muscles and feel the warm, pleasant heaviness that comes with relaxing completely.

Let's do the same thing with your LEFT ARM. Touch your shoulder and tense your left bicep tightly. . . . Hold that tension really tightly and observe it carefully. . . . Let go, let out your left arm. Let it, too, drop limp—relax it as much as you can. . . . Try to let yourself actually feel the relaxation. Continue to let go. Let your whole body relax further and further into deeper and still deeper levels of relaxation.

Now, let's focus on your NECK muscles. Press your head back as far as you can. Press it back hard, really hard. . . . Feel the tension in your neck. Hold that tension briefly. . . . Let go. Let your neck relax as much as possible. Let the muscles loosen so completely that your head is as heavy as a bowling ball. Allow the back of the chair to completely support your head so that your neck muscles can relax totally and completely.

Next, hunch up both of your SHOULDERS. Bring your shoulders right up to your ears. Feel the tension. . . . Now drop your shoulders, let them go completely limp and feel the relaxation. . . . Let that relaxation go deeper and deeper into your shoulders—then let it filter right down into the rest of your body.

Now, raise your eyebrows so that it makes your FOREHEAD and the top of your SCALP all tight and wrinkly. . . . Feel the tension. . . . Relax your forehead, smooth it out. Try to picture, as in a mirror, your forehead becoming smoother and smoother as the relaxation increases.

Next, squeeze your EYES tightly shut . . . tighter and tighter. Feel the tension in your eyelids. . . . Relax them and keep your eyes closed gently and comfortably. Notice how relaxed they feel.

Finally, let's tense the muscles around your MOUTH. Clench your jaws and lips. Clench them tightly together and study the tension around your mouth. . . . Relax those muscles, let your cheeks and lips hang loose, limp. Relax your jaw and keep your teeth slightly apart as you continue to relax all the muscles around your mouth.

Try to notice the contrast throughout your entire body between tension and relaxation. If any tension has crept back into your body, release it and let it go. . . . In your mind's eye, picture your face as though looking in a mirror and actually see the relaxation all over your face. Observe the relaxation around your mouth . . . notice it around your eyes . . . see it all over your forehead. . . . Actually feel the relaxation progress further and further. Just allow yourself to feel the relaxation take over and go deeper and deeper, and still deeper into the muscles and very fiber of your body.

As you become more and more deeply relaxed, your body may feel very heavy. It is also possible that parts of your body may feel very small or maybe even quite large. You may also feel warm all over, or perhaps parts of your body have no feeling—for instance, maybe a hand or foot even feels like it is disconnected from the rest of your body. Whatever you feel as you sit there completely relaxed, just go along with it and enjoy it. Let it happen without bothering to control or question it. The reason is that these things are perfectly natural in a deeply relaxed state. They are normal, for instance, when you are drifting off to sleep; but the difference here is that you can let your mind go blank or let your thoughts drift around without going to sleep. Let yourself feel calm and peaceful . . . warm and relaxed.

The final part of training in relaxation is the most important part, because it is concerned with mentally letting go as well as physically relaxing, of getting rid of cares and frustrations and mentally relaxing without going to sleep. To begin, I want you to picture in your mind's eye a scene representing pure, unconditional pleasure to you. Just give yourself the mental set to picture what you're thinking as you sit there, completely relaxed with your eyes closed.

You may want to concentrate on something you have experienced recently, or perhaps you remember something wonderful about a vacation you've taken, or you may recall something you've seen in a movie or read in a book. It is even possible to think of some happy event that may have occurred while you were in the middle of some hectic activity. Of course, you may want to recall something serene or pleasurable from your childhood.

Whatever comes to you, let it be your private experience to feel fully again for just a little while. Let your mind drift peacefully and relaxed wherever it wants to go. If your mind begins to wander, don't be concerned or fight it. Rather, gently bring your mind back to the scene you have chosen. I am going to remain silent for a few moments while you allow yourself to follow anything pleasant . . . happy . . . or peaceful that appears to you. Let it take you wherever you want to go, just drifting and enjoying. After a few moments of silence I am going to count forward from one to five while you then bring yourself back to the present, at which time you will arouse yourself, refreshed and calm.

***TWO-MINUTE PAUSE***

Please keep your eyes closed until you are asked to open them. It is now time to come back to the present. But you may have been relaxed for so long in this session that it may take a minute or two for you to become fully alert again. This is to be expected at first, but with regular practice you will find that you can become relaxed very quickly, and that when you have refreshed yourself in this way you will always be able to arouse yourself effectively by counting from one to five. This counting will always bring you back from your deep relaxation fully alert and refreshed with all physical exertion and emotional strain gone.

I'll count for you this time. You may wish to count silently to yourself along with me.
One. You are more aware of the present and finding yourself more refreshed and more invigorated than you have ever been in your whole life.

Two. It's time to stir about by moving your feet and legs. Remember, when you open your eyes, you will be refreshed as though you were awakening from a long nap.

Three. You might want to stretch your arms out. From head to foot you are feeling perfect: mentally, physically, and emotionally.

Four. Now you should move your head around a bit. You are now completely refreshed, rejuvenated, and ready to open your eyes.

Five. Open your eyes!

If you would like to leave a comment, click on the comments link below

For an index of all blogs, go to Blog Index

Panic Attacks, Part 2

If you missed Part 1, you can see it here: Panic Attacks, Part 1

If you have been told by your physician that your panic attacks are not the result of a biological condition, then you can concentrate on learning the skills needed to minimize your panic attacks. When psychologists first began working with panic attacks, our goal was to help you totally eliminate panic attacks. We eventually found this goal unworkable and unnecessary. The problem was that too much pressure existed to "never ever again have another panic attack." This level of perfect expectations would often backfire.

If you believed that you could never have another panic attack, the elephant in the room (your mind) was the thought that you just might have one. This germ of an idea would eventually grow into a fatal prediction that you, indeed, would have one. As you now know, this prediction would then bring on the panic attack. Psychologists have a different goal today: we teach people how to get to the place where they don’t care if they have a panic attack or not. This new attitude is more reasonable. It is possible because once you have the tools, then any panic attack will be short lived and under your control. In other words, it will merely be an inconvenience, not a terrifying experience.

So what do you need to do to bring your panic attacks under control? The first is to learn to activate your brain’s parasympathetic nervous system. You can do this by learning, practicing and mastering three simple skills: Natural Breathing, Muscle Relaxation, Mind Calming.

First, learn how to breathe properly (see Monday, October 6, 2008 post). When you are panicking, your breathing is shallow, fast and continuous. Learn to belly breathe by pushing out your stomach as you inhale; pull your stomach back in when you exhale. Then slow your breathing down by continuing to inhale and exhale as you spell the word "relax" at the rate of one letter per second. Finally, pause (stop breathing) momentarily after you exhale and before you take the next breathe. I call this type of breathing, Natural Breathing. This name is appropriate because this is the way that babies breath when they are born.

You also want to get rid of all the muscle tension that accompanies panic attacks. Learn to relax about 15 different muscles in your body by tensing a muscle for about ten seconds and then quickly releasing the tension and observing it for another ten seconds before tensing another muscle. This entire exercise should take between fifteen and twenty minutes. Do this slowly and observe the difference in feeling between a tense muscle and a relaxed muscle. Sometimes, relaxing a group of muscles results in a warm or tingling sensation. This indicates you are relaxing the muscle properly. Traditionally, people start with relaxing their feet, legs, stomach, back, shoulders, neck, and facial areas.

When you are finished relaxing your entire body, you want to practice calming your mind. Think of a pleasant scene (most people pick a peaceful water scene) and try to experience this as much as you can. The trick is to deal effectively with a wondering mind. You can do this by merely coming back to your chosen scene every time your mind wanders. This is often discouraging to beginners because our mind is supposed to "wander." You want to train your mind to focus on one topic for an extended period of time. This may take several weeks or months to become effective. Don’t be disheartened if the learning is slow because you will eventually be proficient. You only need to stay with this scene for a few minutes each time you practice Mind Calming.

The major mistake most people make in learning these three skills is to expect these skills to work with only minimal practice. When I teach these skills to my clients, they must practice Natural Breathing five times every hour while awake until it becomes automatic and easy. This usually takes place within a few days. They are expected to practice Muscle Relaxation four times a day. Mind Calming needs to be practiced about eight times a day.

The other skill you need to develop for your Panic Attack toolbox is to learn how to switch from worry to concern. The skills above are designed to activate your relaxation response in your body. Eliminating worry eliminates the panic attack trigger. You can learn this skill by reading our blogs on worry (there will be more to come) for checking out our book, The Worry Free Life.

If you would like to leave a comment, click on the comments link below

For an index of all blogs, go to Blog Index