“Pain can be endured and defeated only if it is embraced. Denied or feared, it grows.” ~ Dean Koontz, Velocity
The discomfort relief industry is a multibillion-dollar one. There are medicines to relieve headache, stomach distress, sore throats, back spasms–seems like if there’s a complaint, there’s a medicine meant to treat it.
But I can’t be the first to notice that, despite a pill in the medicine cabinet for seemingly every complaint, we still have lots of unmanageable pain and distress.
Unfortunately, the cancer patient often experiences numerous unpleasant and distressing symptoms as a result of treatment–and, as we’ve come to expect–doesn’t always get a lot of relief for these through medication.
It’s common for patients undergoing chemotherapy to feel nauseous, be constipated, have mouth sores, feel tingling or weakness in their hands and feet, have dry skin and rashes, experience hot flashes–seems like the fun never ends.
I could go through the standard treatment recommendation list (wear socks and gloves in cold weather! Use mild soaps and cleansers! Try deep breathing! Eat a well-balanced diet!), but I’m sure people have heard it before, and the self-evident nature of it is frustrating in its simple-mindedness.
So I have a suggestion that in its very simple-mindedness is actually quite deep. We, all of us, spend so much of our lives trying to distract ourselves from our symptoms. We reach for a pill, we ignore it, we “work through it,” as people cheerlead us to do, we try to think of something else, as we’re so often advised.
But what if–and stay with me here–you stopped all the noise, refused to let others tell you to think of something better–and, as you felt your symptom, took some time to focus on it, solely on it?
Intuitively I think most of us would say the symptoms would get worse if we stopped distracting ourselves and entered into the world of distress.
Well, there’s evidence to show, contrary to what we’d all suspect, that you just might get some relief.
It’s wild and counter-intuitive, I know, but somehow all the pills and stiff-upper-lips and thinking happy thoughts don’t work that much of the time. So some researchers are suggesting that you actually allow yourself to experience the symptoms when they dominate your thoughts. Instead of rejecting them, instead of allowing your mind to race forward and fear the symptoms’ impact on your future, just bring your attention calmly to them. Some might call this mindfulness, which encourages acceptance of yourself as you are, no matter what. And let your mind enter right into the full-blown feeling of the symptom, scary as it is.
This isn’t an idea I’ve just concocted to entertain my fan club, you know. There’s solid research suggesting that this might just be the way to manage those otherwise unmanageable symptoms.
The May 3 issue of Behaviour [my spell-check hates the way this journal spells that word] Research and Therapy has an article entitled ”Health anxiety moderates the effects of distraction versus attention to pain.” The researchers [and I share the lead researcher's name to just to really send my spell-check into paroxysms--it's HD Hadjistavropoulos. Pretty good, right?] found that, particularly among patients who had anxiety about their health, “attention to sensations resulted in lower anxiety and pain than did distraction.” Pretty wild, right?
The July 2004 issue of the journal Pain has an article with another one of those titles that I love for their sheer lack of creativity, and their tendency to give away the ending before the reader has the chance to read all about the literature search and the ever-sexy [to statisticians, I suppose]‘p-value.’ It’s called [ready?] “Distraction from chronic pain during a pain-inducing activity is associated with greater post-activity pain.”
Now, you might not need me for this analysis, but I don’t want to feel useless, so I’ll tell you what happened. Researchers took a group of people with chronic lower back pain and had them lift progressively heavier weight until they experienced pain. [I don't know who signed up for this study, and I certainly hope they were well-compensated.] The subjects had the privilege of doing this pain-inducing activity twice; the second time they lifted while performing, as researchers termed it, “a simultaneous cognitive distraction task.”
And what did they find? First, that distraction had no positive effect at all on levels of self-reported pain during the lifting task, so that theory was out on its ear. But, further they found that “distraction had a paradoxical effect of more pain immediately after the lifting task.” Once again, researchers found that simply allowing people to pay attention to their symptoms actually eased the suffering.
One more example for you, since third time’s a charm. Jon Kabat-Zinn, Ph.D., author of Full Catastrophe Living, ran the Stress Reduction Clinic at the University of Massachusetts Medical Center. Before people, all with catastrophic illnesses, enter his stress reduction program, they complete a questionnaire where they check off the physical and emotional symptoms they’ve experienced in the preceding month from a list of over 100 common symptoms. They complete the same questionnaire upon completion of the stress clinic program, eight weeks later.
Most people enter the program with a relatively high number of symptoms–an average of 22 out of 110 possible choices. The program does not spend time discussing the symptoms–either as an outlet for fears, or as advice on how to alleviate the symptoms. Rather, when the leaders have the group members deal with symptoms, they use what they call “wise attention,” encouraging the members to simply experience the feeling of the symptom, without fear, or anxiety about the future, or judgement of the symptom.
And when people leave the program, 8 weeks later, they check off–on that original questionnaire–an average of 14 symptoms, which is 36% fewer symptoms than when they started.
Look, clearly spending your whole waking day focusing on your distress would leave something to be greatly desired. But when you have a symptom that, beyond causing you pain, also causes you fear and anxiety, perhaps it’s time to quit all your distraction tactics, and enter the world of the symptom, experiencing it as it is, without judgement, for a given period of time. You just might conquer your distress–at least temporarily–in a way you never thought possible.