Ways to Deal with Serious Pain beyond Medication

Originally published in Comfort Zone Newsletter: February 2012

We know from our questionnaire research that most highly sensitive people are more affected than others by pain (there will be exceptions, of course). Individuals vary broadly in how much they feel pain, as they vary on so many things. One study of women after childbirth found that a few needed no anesthesia and felt no pain during labor and delivery–indeed they didn’t really know what pain felt like. And then there’s us.

One resulting problem is that we seem like complainers or wimps when something bothers us that would not bother others. For this reason, I think we often learn to endure pain even better than others, but that doesn’t mean we don’t feel it more. Indeed we are often trapped between the problems created by speaking up about pain and those caused by staying quiet. In the first case, we can be told, “How could that bother you? It doesn’t bother most people.”

This happened to me when I was 20, having a cavity filled. It hurt terribly, even after a nerve block. The dentist was furious with me–not much fun being in pain and having an angry man drilling on your teeth. The next year I went to the University of California Dental School’s free clinic where I was the subject of kindly interest. It seemed the nerve the Dental Devil had been trying to numb enters at a slightly different place in my mouth than it does in most people’s. That difference still might have allowed the nerve to become numb enough for some patients’ pain sensitivity, but it didn’t work for me.

Then there’s the other problem, the times when we don’t complain and find ourselves in big trouble. I know one HSP who was considered to be quite a hypochondriac by her doctors and even herself. When she felt what she considered severe pain in her abdomen, she tried to ignore it. You know the rest of the story: burst appendix and lectures from doctors.

The Risk of Over Treatment

One problem HSPs have to watch for is being given too many medications or too much, since usually we need lower dosages than others. Pain medication could be an exception, but you still might want to start with a low dose and see if it works. We also can have more side effects from large doses. Behind this is the fact that if you feel and report pain, you will usually be given a treatment for it. The more pain, the more treatment of all sorts. A study of sensitive children and their less sensitive siblings found that for the same childhood diseases, the same family doctor gave more medications and did more treatments for the sensitive sibling than the non-sensitive one.

This is probably as true as we age as in childhood. In spite of our caution, we may find, over a lifetime, that we are taking more pills than other people because, for example, some of us are prone to more anxiety, depression, or insomnia. After about age 40, everyone gets more aches and pains, but we probably feel them more. Of course we worry about taking too many medications, but we often do need something since we want to stay active and pain itself is hard on the body. Alas, even ibuprofen and Tylenol can have serious effects on the stomach, kidneys, and liver if taken often and for very long, or lead to rashes or allergic reactions.

Even herbal medications can cause problems if taken in excess, as I discovered with turmeric and its derivative, curcumin. I tried to use it to replace ibuprofen. I guess I took too much, and had an allergic reaction that has ruled out all anti-inflammatories for me, I’m sure only temporarily. In the meantime, I discovered that heat and ice work just as well, and even if they don’t, the discomfort may not be that bad and is soon gone. Before this, whenever I mentioned some little hurt, my husband would tell me to take an ibuprofen, which he never needed himself, and I would think that was a good idea also. Overmedication sneaks in….

The Problem of Unbearable Pain

What about big pain? Maybe we can learn to handle little aches and pains differently. However, intense pain is different, and we are more likely to experience it at least once in our lives–the sort of pain so bad that you wish you could get out of your body. Childbirth can be one such experience, and I don’t think it’s true that women forget that pain. It helps that they know this is a normal experience and can feel some pride in having gone through it, but it still really hurts, especially the first time. Thank heaven there are solutions. It’s hard, however, when we hear natural childbirth praised and feel we “failed” at it. But once again, we are different.

If you have known unbearable pain, I think it leaves a scar. For an HSP there’s probably at least one case of it in childhood. Mine was smashing my thumb in a car door when I was about five. Naturally unbearable pain leads to a fear of experiencing anything like it ever again, and that creates a complex about it. The complex can make us overly afraid of injury, medical procedures, a long illness, or the experience of dying. Sure, if we are spiritual or meditate, we know we can witness it, detach from it, philosophize about it, and all that good stuff. But what if even those defenses are overwhelmed? Yes, modern medicine has excellent ways to control such pain, but what if…?

Remember that with any complex, knowing thoroughly about its source and what triggers it (e.g., an emergency room or hospital, the sight of blood, a child’s cry) can help you to step outside of it and consider the odds, the facts, and then do a little better with this fear. Sometimes. You could also argue that this complex provides an extra dose of what could be healthy caution.

To repeat myself, we are relatively different about pain. At the other extreme, just as there are some people who answer “false” to every statement on the self-test, there are people who literally have never felt strong pain. They find us hard to understand. It’s always difficult to have empathy about something you have never experienced. It’s good there are some of them among us, but even the people in the middle may not understand us. The problem of pain and the fear of unbearable pain is simply one of those items that go on the negative side of the ledger. Thank goodness there are so many on the positive side.

Ways to Deal with Serious Pain beyond Medication

One question is how to speak to doctors and nurses. Besides printing out and bringing in my latest research article (I’m half serious here), you can remind them that in their own experience, they have surely noticed that some people are more sensitive to pain than others, maybe even members of their own family. “Well, I’m one of those. I’m probably in the top 10% on this. I understand that some people are just born that way. I’ll bet you have some tricks up your sleeve for dealing with the ones like me.”

In other words, be positive, compliment them, tell them you assume that they are smart enough to deal with this problem. Otherwise they will become anxious or defensive, or associate you with their most difficult patients, and next thing it’s your fault if you are in pain, not theirs. Maybe it’s “all in your head.” You don’t really have to discuss the entire trait, just your innate high sensitivity to pain.

When you are on your own, it’s good to remember that there’s considerable research demonstrating something you probably already know: Distraction helps. The brain can be consciously aware of only so much information. It gives top priority to information from the body about pain. Indeed, that may be the purpose of pain–to move us to correct the problem, fast.

This is what’s called, in brain jargon, a “bottom up” process–body up to brain. But we have all ignored pain, as when we are getting hungry but can’t get to any food at the moment, or uncomfortable while at the computer. This is a top-down process–brain telling body to be quiet. Research verifies that it is possible to turn pain off “from above” through distraction, by consciously turning your attention to something interesting so that all of your “space” in the awareness department is used up.

One of the worst pains comes from third degree burns, especially when dressings have to be changed and dead skin pulled off. A new pain management technique used with horribly burned soldiers back from Iraq and Afghanistan has been to give them a virtual reality game to play at these times. This is no ordinary video game, but a complete immersion of all the senses into a three dimensional world requiring concentration, keen observation, and rapid responses. I heard one soldier interviewed who said that while playing the game he did not notice any pain at all during procedures which had been excruciating before. Maybe someone should design a virtual reality game that HSPs would especially like, such as saving little animals that are in danger!

Meanwhile, if you look on the standard pain management websites you see similar advice about distraction:

• Call a friend and chat about anything other than pain.
• Read a book.
• Participate in a relaxing hobby, such as knitting or card-making.
• Do a challenging word puzzle.
• Listen to soothing music.
• Watch your favorite television show.
• Play a video game! One that completely absorbs you.

Love Helps, Also

My husband and I (these days mostly my husband) do research on love and the brain. We have found that when people who are deeply in love then look at a photograph of their beloved during a brain scan, there is activity in the reward or “approach eagerly” areas of the brain (associated with dopamine). So my husband, one of his graduate students, and two scientists at Stanford who study pain all decided to see whether looking at the photograph of someone we love helps us feel less pain.

It was already known that if you cause pain to subjects (with their permission of course) and distract them well, they feel less pain than those given no distraction. If you do this during a brain scan, you see activation in areas indicating strong attention. As we predicted, looking at the photograph of the beloved worked just as well to reduce pain, but different areas were activated–not the ones that indicate distraction, but the ones that are activated by thinking about someone you love. This is good to know, isn’t it? (Martin Buber would like this research.)

Interestingly, just about everything that can be said about physical pain also applies to emotional pain. Both kinds are part of being human. Another aspect is that, more than any other species, when one of us is in pain, others gather round and try to help. There is no doubt why researchers also are trying to help figure out how to lessen pain. That’s the good news, isn’t it? I’m sure that soon, researchers will also begin to focus on helping those who are especially sensitive to pain. We will no longer be the problem patients, but people particularly needing the support of others.

I’ve met some people who, when hurt and someone tries to help them, don’t want to be touched. They say almost frantically, “I’m all right–leave me alone.” There must have been times in their past when others did not treat their being in pain kindly. If you are one of those who brush off help out of fear, you obviously know that you need to work on recognizing those you can trust, because giving and receiving loving support during something painful definitely helps. These can also be some of the dearest moments in our lives, even when the pain is there, too.