Wednesday, February 13, 2013

Pain perception and Psychosomatization

When doing my physical therapy, I chatted with this neighbor who was, apparently, very much in pain and is leaving for the US tomorrow.  Somewhere along our chit-chatting... the notion of relaxing and ignoring pain came up.  Since she had to go, I didn't have the chance to clarify fully with her what I had wished to convey, and since the thoughts have already emerged, I might as well share it with you... some notions I might have spoke of... buried in the scarily huge amount of limited my words... 8-X

When she revealed that she was advised to try to relax, I also suggested to her that when the pain is manageable, it would be good for her to try to learn to focus on anything other than pain (though I have no idea whether things outta my mouth were interpreted in accordance to what I intended to express during our chit-chatting).  

Since somewhere out there and someone else might be going through the issue of coping with pain and discomfort, I decide to come back to the topic again.

Regardless, somewhere during the chit-chatting, the notion of in your head arise... which, inevitably, reminds me of the notion of psychosomatization.

Let me speak of pain first... it is my believe that among the multidimensionalities of pain, there should be one dimension labeled as "manageability."  Some pain is more manageable than others-- I know it because the aches and pains I have to endure today is far more manageable than what I had to live with years back when the body was in ground zero... after the accident in 2007 and after the chiropractor's manipulation in 2010.  For most people suffering from excruciating pain that takes out the full control of cognitive processing, with proper treatments and therapeutic interventions, the day shall come when unmanageable pain becomes more manageable... at some point.

Personally, after the pain becomes more manageable, it becomes much easier to focus on something to distract myself from bodily comfort, and to practice the art of ignoring pain. (Sounds almost like the notion of ignoring my psychotic symptoms... so it is... the story of my ain't-no-nothing-new-ever-happen life. 8-O lol)  When the time comes for the pain to be manageable, you will know.

I always remember, one day, how my disability coordinator at worker's com said... something like... "You might just have to live with the pain" since that's what many others do.  I was absolutely upset by the notion of "well, just live with that pain" while I can't stop asking myself... "Could it be true that it is me too lame to live with the pain that no one else have problem living with?"   It was not until the pain finally became manageable did I understand that it is possible to live with the pain... except for... it was not until when the pain became manageable to me did I realize that... yes... I might have to live with that pain and I think I can live with it.

So, how does relaxing have anything to do with anything?

When people are stressed, they feel tensed... psychologically and physically.  Think about it... if my nerves are already impinged, what good would it do for the surrounding tissues already two-tents?  Make it three tents, I guess?  Unless enough tents to build a village?  This is why the experts recommend again and again--telling us to relax.  At the same time, though I am no big proponent for pain killers--since I have surely had my share of quota and suffered from it-- when I sense the conditions are to go beyond the level of manageability, I would pop my pill of Alleve to prevent things from escalating.  Yet, relaxing is an art... an art I yet have to learn to master and I don't know whether there would come one day when I will learn to truly relax.  Yet, since it is my own body and my own suffering, who else is to work on it... I guess?

Next in line... it's all in your head... Of course, it really is all in your head since it is your head that performs pain perception.  In addition, them neurotransmitters such as serotonin, dopamine, norepinephrine all have been found to work for the department of pain modulation.  Also, organic changes in brain structure been found in people suffering chronic pain.  The only thing I can say about it's all in your head is that... accept it!  It surely is all in your head! 8-O lol

What about that good old notion of psychosomatization?  Psycho and soma are, beyond a doubt, interlinked... sort of like... the serotonin, dopamine, norepinephrine in the pain modulation department are the same serotonin, dopamine, norepinephrine contributing to, for instance, my private mental department.  Thus, there is no doubt that psycho affects soma and vice versa. (Gotta say though... whether my mental model of psychosomatization is the same as others' mental model of psychosomatization...)

Sounds like more bad news than good news I have been sharing so far...

OK... now I have run through my facts... Yet,  facts are all good but insufficient because what is most important is to say, given the facts, so what can can be done to live when all possible organic changes have incurred or there is nothing organic and when all is but psychosomattic?

For me, personally, it took me years of living with what I have and what I have to live through to come to the following way of thinking... regardless the cause... all psychosomatic, all organic or the combination of both psychosomatic and organic...  Take the extreme scenario for instance... like what my friend Jan had me told when this neurologist speculated the diagnosis of "conversion disorder"... "So you have conversion disorder but what can they do about it?"

Unterwegs zur recovery... face the reality that if you are in pain and in unbearable pain, you are tensed and it surely is mighty difficult for you to relax!  Quit lying to yourself that you are already all relaxed!  Also, accept all possible causes as it is (like... already got done with it many a blue moon before yesterday) so that you can stop worrying whether it is all in your head and it is all psychosomatic with the purpose of accepting it all being--getting rid of the impact of such notion so that you have less to worry about and be more relaxed (rather than accepting it all and continue to worry about its implication).  Thereafter, dedicate your  focus on what you can do to help yourself get better, feel better, and be more relaxed--do the right things you can do one day at a time.  Like what Dr. Martin Luther King, Jr. said...

At the same time, having pain not corresponding to anatomical evidence? Check out... Beyond size and sensation... lol

PS. I know, I know... I have discussed the same notion too many a time... almost like a broken record already... 

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