The Science of Pain Explored

     Most people think of pain as a purely physical experience. A hot stove burns my hand, my skin is hurt, my brain sends a pain signal, Ouch!  This sensory feeling is but one source, one explanation of pain. The second explanation is the role of emotions in the experience of pain. Fear and example, for example, amplifies the pain signal.  If we are worried about our pain, it hurts more.  The more we worry the stronger the pain signal.  The brain is a complex interaction between our physical selves and our emotional experience of what our body is feeling, especially where chronic pain is concerned.

     To help us understand more about this, Nicola Twilley has written about the neuroscience of pain in New Yorker magazine, here. 

Even on the Sidewalks of NYC

In broad daylight, a person can relax and meditate:

For more on-the-street photography, you can visit Brandon's website,  Humans of New York.

Vitamin C May Prevent CRPS Chronic Pain Syndrome

Sharing a chronic pain resource, Princess in the Tower, while educating myself on Complex Regional Pain Syndrome, formerly known as Reflex Sympathetic Dystrophy (RSD),.

Thought I'd share an informative post talking about this really difficult pain syndrome, ranked as one of the most painful medical conditions known in the scientific literature.  CRPS symptoms include "burning pain, increased sensitivity to all stimuli, and sensations of pain in response to normally non-painful stimuli including: light touch, a breeze, sound, vibration, bright lights and more." (Birklein et al., 2000; Wasner et al., 2003).

It is believed CRPS is more likely to occur following an injury that accompanies severe emotional trauma, such as rape or assault.

According to the post, research recommends that, to prevent an injury from developing into CRPS, take 1000mg/day Vitamin C every day following a sprain or strain.

Sandy Andrews, PhD is a Clinical Psychologist and Psychotherapist who practices CBT in Austin, Texas

Ready, Set, Sleep!

I may stand corrected.  Which would make me and a lot of clients happy.  And sleepy.  As a cognitive behavioral psychologist (CBT) I typically teach a 6-4-8 breathing exercise as a stress relief technique and as a sleep aid,.  This involves a 6-second inhale, 4-second hold, and 8-second exhale (or 8-4-10, depending on the individual's starting point).

But in this post  by Alina Gonzalez entitled, How I Learned To Fall Asleep In Under 1 Minute, she advocates using Dr. Andrew Weil's breathing technique which she calls the "4-7-8 Trick."  You can go to Dr. Weil's website to see him demonstrate, here.

So I plan to take the 4-7-8 versus 6-4-8 breathing challenge.  And I invite readers to do the same. Leave me a comment and let me know which breathing exercise calmed, relaxed, and helped you get to sleep the most quickly.

Ready, Set, Sleep!

And a big shout out to my sister for 

bringing my attention to the article Under 1 Minute blog post. 

--Sandy Andrews, Ph.D.

Cognitive Behavioral Psychologist 

Austin, Texas

Stress and Pain and "No Pain Pathways"

     If you experience pain on a daily basis and especially if you are in chronic pain (where chronic pain is defined as any pain lasting longer than 3 months) it is so important for you to learn as much as you can about how the brain responds to pain.  There is so much new information about pain, so much we are beginning to understand about how we experience pain, the role stress and earlier emotional wounds play in chronic pain and most importantlly, how we can learn to control pain.  I urge all of my pain patients to read and watch videos explaining what the experts now believe helps alleviate pain. But before we can control our pain we must first believe we can.

     Below is one such video that you can watch from your laptop or tablet or whatever device allows you to see videos.  Dr. Howard Schubiner is a board certified physician who works with chronic pain patients.  He is the founder and director of the Mind Body Medicine Program at Providence Hospital in Michigan.

     Dr. Schubiner describes two concepts related to pain:  pain that is a direct result of injury and pain caused by nerve pathways learned over time. These pain pathways are activated by fear, stress and various triggers. We also have what he calls no pain pathways.   Behavioral therapy is all about learning how to de-activate our pain pathways and activate our no pain pathways.
Imagine you are in pain somewhere in your body.  You are lying on your couch watching a really good movie.  There is a part of the movie that is so engrossing that your entire focus is on the story you are watching.  During this period of being highly focused you will probably notice that you are not aware of your pain.  What is happening then?  Dr. Schubiner would say that our no pain pathways are working and helping free us from our pain.

If you or a loved one suffers from chronic pain, watch the video so that you too can begin the process of learning to lessen your pain.




Want more?  More links to videos talking about chronic pain are listed below.  Please educate yourself and watch:

Understanding Pain and What to do about it in less than five minutes

A TED Talk by Elliot Krane The Mystery of Chronic Pain

Lorimer Mosely on The Brain and Chronic Pain   This is long but fascinating and funny.

Sandy Andrews, PhD is a Clinical Psychologist and Psychotherapist who practices CBT in Austin, Texas

Understanding Chronic Pain

The causes of chronic pain come in many shapes and sizes.  Sometimes chronic pain stems from recurring migraine headaches.  Sometimes it's lower back pain caused by a range of problems with the spine.  Chronic pain can result from a serious injury that fails to heal completely or following surgery.  Other conditions associated with chronic pain include arthritis, TMJ (temporo-mandibular joint), fibromyalgia, endometriosis, pudendal neuralgia, and repetitive strain injuries.  

Regardless of the cause, people who suffer from chronic pain often feel misunderstood by their friends and family.  Typically during the initial phases of an illness pain sufferers receive sympathy and understanding .  After a long period of prolonged pain, however, it is common for loved ones to appear uncaring and "tired of" the patient's persistent complaints of pain, particularly in the midst of decreased functioning.  Unable to help with household chores, attend social functions, or participate in recreation activities formerly shared with others, chronic pain patients begin to feel like a burden.  It is not unusual to feel blamed for the persistence of their condition.  Losing the support of loved ones is one of the most emotionally distressing aspects of chronic pain.  

Given the importance of feeling understood, I am sharing the following letter written to help enlighten people close to the person suffering from chronic pain.  The letter was previously posted on the HOPE website (Health Organization for Pudendal Education).  

LETTER TO PEOPLE WITHOUT CHRONIC PAIN:

Having chronic pain means many things change, and a lot of them are invisible. Unlike having cancer or being hurt in an accident, most people do not understand even a little about chronic pain and its effects, and of those that think they know, many are actually misinformed.


In the spirit of informing those who wish to understand …


These are the things that I would like you to understand about me before you judge me…


Please understand that being sick doesn’t mean I’m not still a human being. I have to spend most of my day in considerable pain and exhaustion, and if you visit, sometimes I probably don’t seem like much fun to be with, but I’m still me– stuck inside this body. I still worry about school, my family, my friends, and most of the time – I’d still like to hear you talk about yours, too.


Please understand the difference between “happy” and “healthy”. When you’ve got the flu, you probably feel miserable with it, but I’ve been sick for years. I can’t be miserable all the time. In fact, I work hard at not being miserable. So, if you’re talking to me and I sound happy, it means I’m happy. That’s all. It doesn’t mean that I’m not in a lot of pain, or extremely tired, or that I’m getting better, or any of those things. Please don’t say, “Oh, you’re sounding better!” or “But you look so healthy!¨ I am merely coping. I am sounding happy and trying to look normal. If you want to comment on that, you’re welcome.


Please understand that being able to stand up for ten minutes doesn’t necessarily mean that I can stand up for twenty minutes, or an hour. Just because I managed to stand up for thirty minutes yesterday doesn’t mean that I can do the same today. With a lot of diseases you’re either paralyzed, or you can move. With this one, it gets more confusing everyday. It can be like a yo-yo. I never know from day to day, how I am going to feel when I wake up. In most cases, I never know from minute to minute. That is one of the hardest and most frustrating components of chronic pain.


Please repeat the above paragraph substituting, “sitting”, “walking”, “thinking”, “concentrating”, “being sociable” and so on … it applies to everything. That’s what chronic pain does to you.


Please understand that chronic pain is variable. It’s quite possible (for many, it’s common) that one day I am able to walk to the park and back, while the next day I’ll have trouble getting to the next room. Please don’t attack me when I’m ill by saying, “But you did it before!” or Oh, come on, I know you can do this!” If you want me to do something, then ask if I can. In a similar vein, I may need to cancel a previous commitment at the last minute. If this happens, please do not take it personally. If you are able, please try to always remember how very lucky you are–to be physically able to do all of the things that you can do.


Please understand that “getting out and doing things” does not make me feel better, and can often make me seriously worse. You don’t know what I go through or how I suffer in my own private time. Telling me that I need to exercise, or do some things to get my mind off of it¨ may frustrate me to tears, and is not correct if I was capable of doing some things any or all of the time, don’t you know that I would? I am working with my doctor and I am doing what I am supposed to do. Another statement that hurts is, “You just need to push yourself more, try harder…” Obviously, chronic pain can deal with the whole body, or be localized to specific areas. Sometimes participating in a single activity for a short or a long period of time can cause more damage and physical pain than you could ever imagine. Not to mention the recovery time, which can be intense. You can’t always read it on my face or in my body language. Also, chronic pain may cause secondary depression (wouldn’t you get depressed and down if you were hurting constantly for months or years?), but it is not created by depression.
Please understand that if I say I have to sit down/lie down/stay in bed/or take these pills now, that probably means that I do have to do it right now – it can’t be put off or forgotten just because I’m somewhere, or am right in the middle of doing something. Chronic pain does not forgive, nor does it wait for anyone.


If you want to suggest a cure to me, please don’t. It’s not because I don’t appreciate the thought, and it’s not because I don’t want to get well. Lord knows that isn’t true. In all likelihood, if you’ve heard of it or tried it, so have I. In some cases, I have been made sicker, not better. This can involve side effects or allergic reactions. It also includes failure, which in and of itself can make me feel even lower. If there were something that cured, or even helped people with my form of chronic pain, then we’d know about it. There is worldwide networking (both on and off the Internet) between people with chronic pain. If something worked, we would KNOW. It’s definitely not for lack of trying. If, after reading this, you still feel the need to suggest a cure, then so be it. I may take what you said and discuss it with my doctor.


If I seem touchy, it’s probably because I am. It’s not how I try to be. As a matter of fact, I try very hard to be normal. I hope you will try to understand. I have been, and am still, going through a lot. Chronic pain is hard for you to understand unless you have had it. It wreaks havoc on the body and the mind. It is exhausting and exasperating. Almost all the time, I know that I am doing my best to cope with this, and live my life to the best of my ability. I ask you to bear with me, and accept me as I am. I know that you cannot literally understand my situation unless you have been in my shoes, but as much as is possible, I am asking you to try to be understanding in general.


In many ways I depend on you – people who are not sick. I need you to visit me when I am too sick to go out…


Sometimes I need you help me with the shopping, cooking or cleaning. I may need you to take me to the doctor, or to the store. You are my link to the normalcy of life. You can help me to keep in touch with the parts of life that I miss and fully intend to undertake again, just as soon as I am able.


I know that I have asked a lot from you, and I do thank you for listening. It really does mean a lot.


Author Unknown