Turning Reactions into Responses

The pictures below show how reactions to pain can be turned into responses to pain. Reactions are automatic and you need to become conscious of them before you can turn them into responses. Read on after the pictures to find out more about turning reactions into responses.

REACTIONS can become RESPONSES

People naturally react to pain. They don't want it because it hurts, it is unpleasant and interferes with their enjoyment of life. These reactions are automatic but, unfortunately, instead of helping to get rid of the pain, they can actually make it worse. If you can learn to spot your reactions and change them to responses that you choose, you can resume control of your life and, in time, reduce your pain until it disappears or is an insignificant part of your life.

Your family and friends may be able to help you identify your reactions. Some of the most obvious reactions to pain can be seen in the body. People tense up and hold their breath. It is common for them to get restless and keep changing their position. However, some people do the opposite and freeze. Do you know whether you make faces or sigh and make other noises. Perhaps you hold parts of your body such as your neck, back or head. These reactions tend to increase the pain by tensing the muscles and aggravating already sensitive parts of the body. Instead of reacting you could choose to respond. For example:

• Instead of tensing up you could relax.
• Instead of holding your breath you could breath gently.
• Instead of changing your position constantly you could let yourself be still.
• Instead of making faces, holding yourself or sighing, you could let the experience in and let the pain be.

• It's never going to get better.
• There's nothing I can do.
• There's no hope for me.
• The future looks bleak.
• I can't go on.
• My life's not worth living.
• I can't do anything I used to do.

We call this sort of self-talk "catastrophizing" because you see your situation as a catastrophe and then panic. When you think this way you can feel overwhelmed by fear, anger, anxiety, frustration and despair. However, you can actually stop catastrophizing, and defuse the panic by changing your self-talk from a reaction to a response using coping statements.

With these responses your feelings can change. There may be relief and a sense of control. Hope can follow, as well as peace and acceptance.

There are a number of other techniques and practices which can help you gain control. First it is always worth reminding your self that; Hurt is not necessarily harm.

Pain does not mean you have damaged yourself, simply that you may need to make some adjustments to what you are doing and how you are doing it.

Second, pain can become "just a sensation". This is when you peel off the layers of resistance and find the pure sensation. You won't suffer as much when you find the sensation. Exploring the pain by describing it to your self can help. Remember... its shape, size, density, texture and colour. This method is described in a meditation on one of my tapes called "Opening to Pain".

The third practice is to learn to dissociate from the pain. You pretend that it is not part of you, or you separate yourself from the pain. Have you noticed that you don't experience as much pain if you become interested or involved in something else? You could think of something pleasant or remember times when you have had fun and were relaxed. Perhaps you could distract yourself with an absorbing activity so that you ignore the pain. Yes, focussing closely on the pain by exploring it and the opposite, or ignoring it both work. It is when you become absorbed in the catastrophe that the pain becomes unbearable.

Summarising these approaches now:

• Hurt is not necessarily harm.
• Explore the pain by describing it to yourself. Remember pain is just a sensation.
• Dissociate or separate yourself from the pain.
• Distract yourself by remembering something pleasant or getting involved in an absorbing activity.

What feelings do you have when you are in pain? Do any of these sound familiar?

• I get scared of the pain and about what's wrong with me.
• I hate the pain.
• I feel I must get rid of it.
• I panic because there is nothing I can do.
• I feel overwhelmed.
• I hate losing control.
• I get angry with the pain, or my family, or my doctors, or my employer.
• I feel depressed.
• I feel frustrated by my limitations and lack of progress.
• I worry about what is wrong.
• I can't stand the pain.

You could change these reactions into responses in the following way.

• Could you face your fear?
• Could you focus on accepting the pain as it is now?
• Could you be curious about what the pain is telling you?
• Could you let the pain be and it will let you be.
• You could feel calm and in control if you repeat your coping statements.

When you panic you react by desperately seeking help or giving up. Do you react in this way?

• I reach for the painkillers.
• I rush to my doctor to find out what's wrong and get help.
• I must have physio, chiro, or massage.
• I withdraw from everyone and isolate myself.
• I carry on regardless.
• I lie down.I cancel all my engagements.

Instead of reacting you could act. The first step would be to notice your self reacting and then calm yourself with breathing, muscle relaxation, self-talk or music. Then you could use some of your self-management techniques. Go to "10 Tips for Flare-Ups" to discover more ways of self-management techniques.

Here are some further suggestions. Instead of withdrawing, you could stay connected by ringing a friend or someone who understands. Rather than carrying on regardless and aggravating the situation, plan to do less and take things one step at a time. Could you do something enjoyable instead of lying down? What about taking a bath or watching a film. Perhaps a hot or cold pack would help: you don't have to go to the physio for this.

Pain is Potent
It's worth remembering that pain is potent and that it evolved as a signal to warn us of threat or damage. It is wise to treat pain as a warning signal when it is acute because it could mean that something is wrong. However, when pain has become chronic, it is not a warning signal. The pain is due to pain sensitisation not tissue damage. It can be hard to remember this when you have a flare-up.

We respond to threats with the stress response or fight and flight response. I say fight, flight and freeze. There is only one way out and that is to learn to flow instead. There are many ways to flow but here are some ideas;

• Learn to let go.
• Accept how it is now.
• Discover the opportunities.
• Replace rigidity with flexibility.

Water flows around rigid objects like stones. Trees bend in the wind. How could you flow when you have a flare-up?

Chronic pain andacute pain
Remember chronic pain is not a warning signal like acute pain but you may need to listen to it in a different way.

Two common strategies are:

1. To stop when it hurts
2. To ignore it and keep going.

Neither one a good strategy. They represent two ends of a continuum. Your response to pain needs to be much more finely tuned. Sometimes people begin the second strategy and turn to the first because they can't keep it up. They have to leave work or stop most activities around the house. We could call it an all or none reaction or black and white, without any shades of grey. We have alread discussed many ways that you can turn your automatic reactions into responses which you consciously choose.

• You can change your body's reaction.
• You can change your thoughts.
• You can change your feelings.
• You can turn reactions into actions.

Learning to dance with your pain
A fixed reaction is very limited and dancing, or being in step with your pain, offers much more flexibility. Remember the cartoon when the self-manager says "let's dance" to the pain. You may need to;

• slow down
• pace yourself
• use less effort
• have a break
• do less or sometimes do more
• plan better
• let go your fear

Being Mindful
To be able to dance with your pain you need to stay mindful. This means watching yourself all day to notice how you are moving, breathing, feeling, sitting, standing and relating. Yes, it is a full-time job but with practice it becomes automatic just like our tendency to be unaware. Which would you prefer?

Listening to your pain
When you listen to your pain it could be telling you something deeper. Many people with chronic pain syndromes don't get better because they are not prepared to listen to these deeper meanings. Let's start with the possibility that the pain could be telling you something about the way you live your life. Have you been very busy? ...too busy to relax, have fun or take care of yourself? Perhaps you think it is selfish to take care of yourself. Remember, "We are human beings not human doings".

Work, Rest, and Play
Has you life got out of balance or has it always been out of balance. Remember the old expression, 'Work, Rest and Play'. How much rest and play do you have? You may be curious to discover what it is that you avoid by constantly doing? Are you avoiding intimacy or aloneness, strong emotions like fear, anger or grief? Now you have chronic pain you are probably experiencing all of these. Chronic pain is certainly a very hard lesson but perhaps it is a wake-up call... to live consciously or mindfully, to face your self and even love yourself. Have you always put others first and ignored your own needs? It's possible that chronic pain is telling you that "time's up". You can't put your needs on hold any longer.

Wouldyou describe yourself as a perfectionist, or do you expect a lot of yourself? Perhaps you never have enough time to do everything. If you need to get everything just right and feel under pressure to fit it all in you will experience a lot of stress. Perhaps you weren't even aware of the stress because it has become habitual. Sometimes chronic pain triggered by an injury, or just developing over time, can be linked to unresolved traumatic experiences in your life. Even painful childhood experiences can be expressed through chronic pain. Psychotherapy which addresses those old wounds, can be a very important part of the healing process for some chronic pain sufferers.

Keep listening to your pain - it may have a lot to tell you.

Finally, 3 simple rules when your pain increases.

One - Catch yourself reacting.
Two - Calm down.
Three - Be still and open to the pain.