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I often talk about accepting chronic pain with the patients I work with. Acceptance doesn’t mean liking pain. It means not letting pain become the central focus of your life, and living life as fully as possible despite pain.
It’s challenging to get to this point of accepting pain. Is it worth it? Yes! Research has shown that acceptance of pain leads to:
- greater tolerance of pain
- better ability to cope with pain
- less disability
A recent study done by the Department of Psychology at Missouri State University looked at whether including a “values” component when teaching people about acceptance helped them cope better with pain.
The researchers used a “cold-pressor task” to simulate pain. This means study subjects put their hands in ice-cold water – which quickly becomes painful – to create a situation where subjects could use acceptance exercises to try to tolerate pain.
The results showed that when subjects were taught about using values as well as acceptance, they tolerated pain better.
The acceptance skills the subjects were taught included:
- you don’t need to control pain
- you don’t need to like the experience
- you can tolerate negative thoughts (“This ice water is really hurting me.”)
- you can tolerate pain (feeling pain is okay)
- thoughts (“This ice water really hurts”) and feelings (distress about feeling pain) don’t have to determine your behavior. You can make a decision to keep your hand in the ice water, even though it’s unpleasant. Even if you have the thought, I can’t stand this another second, you don’t have to act on that thought.
The values component focuses on leading a life consistent with your values, despite having pain. If playing with your kids is one of your top priorities, do that even if it causes pain. If going to work is one of your top priorities, do that. Using values to cope with pain means letting your values determine what you do – doing what’s most valuable to you - even if this increases your pain.
For the research study, subjects were taught to endure pain while imagining their top-ranked area of life. For example, for a subject who valued his family most, he would imagine swimming in ice cold water to rescue a family member. Imagining he was experiencing pain for a reason that was “worth it,” helped him tolerate the pain.
Readers, have you ever used this type of approach to cope with pain? What are your thoughts on letting values direct your life, despite pain? Your thoughts on acceptance of pain? I look forward to your comments.
The study, Personal Values and Pain Tolerance: Does a Values Intervention Add to Acceptance?, was published in The Journal of Pain 2009, Vol 10, Pages 887-892.
Photo ”Ice Scream” by Frank Williams, Auburn University – Montgomery, courtesy of University Photographers’ Association of America.
Grand Rounds is published this week at Nuts for Healthcare.
12 responses so far ↓
Diana // Dec 9, 2009 at 2:34 am
These are exactly the skills I learned at my behavioral pain management program. It always takes work and I’m only at the beginning of the journey with these coping skills, but they really do help.
Nickie // Dec 9, 2009 at 5:42 pm
I definitely agree that the coping skills of making a choice and focusing on values are helpful. Finding something to focus on that isn’t the pain, or even saying “I don’t like this,” and letting that thought go. It didn’t make the pain better, but I’m enjoying more than I did for so long.
I still have days where I flare and go to the doctor for a block or something, but I am slowly trying to tolerate more.
Teresa // Dec 9, 2009 at 6:08 pm
No I still stuggle with day to day, The more I try the worst it gets, Thank to the FIA of Michigan I go without food and the medication eats my stomach with no food. Consumer’s Energy shut off notices and added late fees for what I can pay adds to the stress. I am the only one that can deal with this, when I dont no one can help I have tried for 3 years to get help, guidence, and the pressures of living get worse. They say have faith, I am as low as I can go before hitting the streets of Michigan in a snow storm. And yet the state of Michigan could care less.
I ddnt ask to get run over, I didnt ask to live in pain, I didnt ask to be without 3 jobs, I didnt ask to live on welfare. While the mn that did this to me is warm, and free without a care eating and traveling to warm states.
Rick // Dec 10, 2009 at 5:51 pm
I must say this is a strange approach for me to accept being a physical therapist. I believe our bodies are not designed to be in pain and that we need only discover the reasons for our pain to then unlock them. I find that the body heals very quickly given this understanding.
That’s not to say that I don’t understand people’s need to cope. I work with these people and understand their desperation. I’m fortunate to be able to make a big difference in people’s lives by unlocking the secrets to their pain.
I think this site is a great resource to that end. Bravo.
How to Cope with Pain // Dec 10, 2009 at 10:35 pm
Rick, I certainly agree that when pain can be decreased, by all means, we try to do that first. Unfortunately, for many of the patients I work with, who truly have chronic pain, finding ways to cope with and accept pain is crucial to living a full, happy life despite pain.
Dorian aka coffeesister |_|) // Dec 11, 2009 at 10:25 pm
Thanx for the advocacy w/needed realism. I consider myself a realistic optimist for, tho’ I know a positive attitude helps, that optimism isn’t sustainable w/out honesty. Chronic pain (as opposed to how pain was designed to work) isn’t my friend but my body is & we need to fight this affliction together. Diet & psychology are both contributing factors to pain levels yet, for many of us, the pain is more far-reaching than anything we may or may not be doing. Thus, whether we’re in pain canNOT be the focus (too many of us always have been & don’t know anything else); instead, it really is a question of whether we’ll be defined by it or – worse yet – give in to it. That’s what IS in our control. I may >_< but will still ^_^!
(|_|*ch33rs*|_|)
“It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience. ” -Julius Caesar
flamingorosy // Dec 22, 2009 at 12:37 pm
A couple of comments here- I have RSD or CRPS type1- whatever you call it the result is the same. chronic, unending pain. After a year of this I am redefining and reinventing myself.
Teresa-I think we all struggle from day to day. My full time job with great benefits is part time with no benefits- but I am glad to be here at all. You need a support group- and there is help there- local churches are 1 option- and there is an organization here called Meals on Wheels that will bring a meal (hot, nutritious and free) to those in need. Look for something like that in your area. Angel ministries will help. Most hospitals have “reach out” programs. Google help. call your friends. and no, the state doesn’t care- but individuals do. Really. If I did not live in Virginia I would roll over and give you a hug. And a large meatloaf… Make the calls, please.
flamingorosy // Dec 22, 2009 at 12:49 pm
And about the chronic pain- we do need to learn to accept it and live a full life in SPITE of pain. If everything I do hurts- and the endurance I have is limited- then I must decide what is most important and do that. I am trying to appreciate the gift I have been given- NOT the pain- but the ability to grow in unforeseen directions, and appreciate the good things in life.
This is a constant process for me- one step forward and 2 back- but it is the process that will help me grow and one day use this affliction in a positive manner to help someone else.
And believe me- some of my days are dark indeed…
Becca // Dec 29, 2009 at 5:33 pm
It is so nice to read all of these comments, I am encouraged to know that you all are finding ways to deal with your pain. I have a hard time with “acceptance” because I, too, think that is linked to “liking”. But the comment (Dorian’s) about the pain not being a friend, but my body is my friend does help. Still, acceptance after 5 yrs of dealing with this, is still a long ways off. But I think acceptance is a journey, too. And sometimes I say to my ankle, “Okay, ankle, I hear you. I know you hurt. I am paying attention to you.” That, I think, is a step towards acceptance without judgement.
kaylynn // Feb 2, 2010 at 1:29 am
So far in my 17 years of life, I have had the misfortune of experiencing a lot of pain. People ask me how I continue to go to school, race bikes and, hold one of the highest school leadership positions. My answer is: “I just do.” I know that someday, the pain has to get better and I know that if I just continue on with my life and pour my energy into doing what I love and doing good in the world then the pain can’t stop me. It is just pain, it is just searing, burning, and shocking pain that makes very movement torturous, but it just pain…not life. I have learned to just live my life, and pain happens to be part of it, but not all of it.
Dot // Feb 4, 2010 at 1:28 pm
Dear HtCwP,
Thank you so much this post! After I read it, I applied the “value principle” to my chronic pain condition yesterday. I was feeling overwhelmed with pain and discomfort b/c of a sudden flare up in my ear. The acute throbbing pain, on top of my daily chronic pain, pushed me pretty much to my limit.
So I used imagery suggested in the study. For about 20 mins, I mentally pictured myself swimming in frigid waters towards an iceberg to rescue my mother, who means the most to me.
After a few mins of visualization, my ear pain became manageable. Surprisingly, my body began to feel the cold from the icy water. This, in turn, caused an actual REDUCTION in my neck and shoulder pain where I always have burning muscle pain.
I’ve used visualization before for relaxation and preparing for sports competitions – but I was always focusing only on myself. Thinking of someone else (esp a loved one) really made a difference in increasing my pain threshold. I plan to keep experimenting with lifesaving scenarios!
How to Cope with Pain // Feb 4, 2010 at 2:46 pm
Dot, that’s an excellent example of combining visualization with the values component. Thanks for sharing!
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