Anxiety and pain - all in the mind?

Can pain really be affected by anxiety? Can it be reduced by relaxation? Is a person’s perception of pain, their mood and overall health anything to do with how they sense pain? 

Cast your memory back, no matter how distant or recent, to the last time you went out dancing with friends. You were having such a great time-feeling the music pulse through you, and also the food, the drink, and the great company.  

Whatever the heady mixture, you were having a ball, gleefully partying away into the wee hours, until suddenly, the music stops. You plead for more music, but it’s a no. It’s time to go home. Before long, you’re aware of how painful your shoes are, how sore your feet are, how cold it is, and how tired you feel. This is the power of distraction at work. So yes, pain is a subjective experience and can be influenced by many factors. But is it in the mind?

The pain gate theory

In 1965, psychologist Ronald Melzack and neurobiologist Patrick Wall submitted the theory that proved many factors influence the interpretation of pain. Say you accidentally slam your thumb into the car door. The pain is not actually felt in the thumb automatically. That sensation needs to be signalled to and registered in the brain in order to be felt in the thumb. However, there isn’t a pain receptor at the thumb with a hotline directly to the brain. Nerves from all over the body meet in the spinal cord in order to be sent up to the brain. And that process can happen in the blink of an eye. But within the spinal cord are a complex series of gates (or blocks) that will control the rate of how those messages from the nerves actually reach the brain - or if they reach the brain at all.  

The experience of pain can also be influenced by messages coming down from the brain. These downwards messages also carry pain relieving chemicals and are the messages responsible for us to pull our hand away, or cup the sore thumb with the other hand for comfort, for example. The downward message can also be via our mental state or thoughts. For example, the experience of pain could be influenced or reduced by the person being less fearful or more informed about the pain and its implications - how long it might last, if it will become more painful or subside, if it is a normal reaction...

It could also be influenced by feeling you have the resources to cope with the pain. Anxiety can play a role in the thought process by catastrophising, worrying about the return of pain, or overly focusing on the sensation of pain thus accentuating the experience of pain. Conversely, thoughts (coming down from the brain) that are appropriately soothing and calming can reduce anxiety, physical tension and thus reduce the experience of pain.  

Closing the gate

Knowing that this gate system exists between the body and mind can be incredibly empowering. You may like to think about and make a list of factors that you can identify which allow your gates to be more open, such as stress, insomnia, inactivity.

Then think and make a list of what is likely to keep the gates closed such as certain medication, having a routine, diet, spending time in nature, or relaxation for example.  

Closing the gate with hypnotherapy

It’s important to say that hypnosis doesn’t take away the pain, but it can alter and reduce the experience of pain, or one’s perception of pain. It can also reduce anxiety and help you feel more relaxed and in control, and this can enable you to engage in and enjoy other aspects of your life which is important with pain managment.

There are many different hypnosis techniques that can help with the experience of anxiety and pain. Having a lot of physical tension and focusing on physical sensations is one sure way to open the gates. Using hypnosis is a wonderful way to produce feelings of physical relaxation and release mental tension.  

Using different breathing techniques can be helpful in some settings, for example, when at work or in public. There are breathing cues you can use so that no one would know, and with practice, these can be very beneficial.

Using trance or self-hypnosis to obtain a sense of being more in control of the sensations is another helpful technique so that you feel you can compartmentalise the pain-put it beside you, for example. Or, using the same self-hypnosis, be able to alter the sensation from searing hot to pleasantly warming. There is also the technique of dissociation whereby you detach from the pain altogether and mentally go to a safe or more pleasurable place or experience.  

It's also good to think about what helps your anxiety normally. Sometimes when you’re in pain you can’t remember, so making a list when you feel a bit better makes it easier to reference. Is it listening to music, colouring, or even cleaning out a drawer or attending to dull overdue paperwork? Distraction will help you cope with the anxiety and close the gates-the same way the dancefloor did before the music stopped. Depending on the nature of your anxiety and the cause of the pain, sometimes physical counter stimulation can be very helpful such as a heating pad or gentle massage - which could need to be checked out with your GP first.  

It’s also important to pay attention to your thoughts. This could involve getting to know the type of thoughts that surround the experience of pain and what it represents. This can take a bit of exploration, as we often aren’t aware of the thoughts we are thinking. But sometimes we can develop unhelpful patterns of negative thinking.

Using CBT techniques to support hypnosis can really expose some of the fearful or stressful thoughts that we may be thinking without even realising it. We can explore how these may link to your emotions, feelings, and behaviours. Taking the time for you to take control of some new thoughts that you feel are more supportive will also have a positive follow-on effect on our emotions, feelings, and behaviours. These new, more helpful thoughts can be underpinned in hypnosis if you wish. You are in control the entire time.  

How can I help?

Many patients have benefited from hypnotherapy to improve pain management.  If you would like to improve your experience of pain, anxiety, or chronic pain with hypnotherapy, I’m very happy to help. You can read client testimonials on my profile or website. It's a positive step to stand up to anxiety, overpower it, and know that you can develop the inner resources to cope – as many clients have said to me, they only wish they had tried hypnotherapy sooner. 

Visit my profile to learn more about me and to book an introductory call.