by Adam Sargant, Dip.H.Ed (Nursing Studies), Dip.Hyp., NLP (prac)

What is pain? How does pain manifest? What is the "structure" of pain? How can NLP and hypnosis assist in the management of pain?

A recent Scientific American article stated: "Though often denigrated as fakery or wishful thinking, hypnosis has been shown to be a real phenomenon with a variety of therapeutic uses -- especially in controlling pain"

Pain is an experience that blights many lives and comes in many forms. Chronic pain is often classified as pain that persists for a period of a month or more beyond the normal recovery time of an illness, or pain that persists for several months or years as a result of a chronic condition, and can be of any intensity. Even low-level chronic pain can be debilitating. Acute pain is a short-lived condition within the normal experience of an acute illness or injury. Breakthrough pain is a transitory flare of pain of moderate to severe intensity occurring on a background of otherwise controlled pain.

Pain originates in the nervous system and clearly has a useful role to play in the development of avoidance strategies for situations and experiences that can cause us harm. However, multiple factors can conspire to produce the sensation of pain in situations where the information is no longer useful. It is obvious that in some injuries and illnesses, the brain receives information about pain that the person experiencing that pain is able to do very little about in terms of avoiding the stimuli. What is not so obvious is that the conscious experience of pain is modified by many other factors such as memory, emotion, and physical condition. In other words, the experience of pain is determined by the context in which that pain takes place. This further complicated by the fact that some pain cannot be found to have an organic (disease or injury) related cause at all.

Milton Erickson described pain as a construct that consisted past remembered pain, present pain experience and of anticipated pain in the future. These combine to give the meaning that the pain has for us, and this is one of the reasons that chronic pain (of any intensity) can be so debilitating. Nothing will intensify one's experience of pain as much as the anticipation that it will be there tomorrow, and the day after and so on. Similarly, learning to relax and simply let go of the anticipation and the fear can result in remarkable changes in our experience of pain.

As a child, I suffered several bouts of recurring osteomyelitis, a bone marrow infection that was often accompanied by high fever and severe pain. The pain persisted as a result of the deformations of bone that took place and the necessary surgery, but I learned very early on that I could alter my own experience of pain through what I considered back then to be a number of mental tricks. I did not know what I know now about the nature of pain but I was able to effect some remarkable changes to my experience of pain, which laid the foundations for my current understanding of the nature of experience.

So, let's look at a few techniques that we can use to experience pain differently, and take some control over how it affects our lives.

Relaxation and Trance

One of the simplest (and the hardest) things to learn to do is to learn to relax. I do not intend to cover relaxation and trance techniques in this article, there will be others on those, but I suggest that you simply think about words and phrases that help you relax, and test them out. I find I can go a long way into trance simply by telling myself to "Breathe...and relaaax" in a gentle and deep tone, and feeling my body relax further on each out breath. I can then take it a little further by telling myself that as I count down from 5 to 1, I will relax further and further into a trance. Try it. Play with it.

Meditative Approach

The first technique I would like to share is the first one I discovered as a child with osteomyelitis. And that was to simply focus all my attention on the pain, in as relaxed way as possible. The pain became a focus for a form of meditation, whereby it is observed dispassionately for what it is.

Synesthesia

An extension of this technique (and best carried out in a light trance in my experience) is to observe the pain as a sensation, and then observe it as one would see it if it had a physical existence. What shape is it, what colour, what texture, what movements does it make? Where is it, does it move quickly or slowly? Don't worry if this seems difficult, don't put too much effort into it – make it up! The important thing is that the image you are working with is a metaphor for your pain, and as such, it makes sense to your unconscious mind.

The next stage is to move the representation of the pain outside your body, where it is easier to observe. Continue to examine it from, say, two meters in front of you. Now become aware of any sound it might make. What pitch is it, how loud is it and so on?

Now we can start to change some of the qualities of the representation. We can make it smaller or darker for example, or change the colour(s). Alter the way it moves, change it's position. Change the sound; turn the whole thing up side down. As you experiment with this, notice which changes cause changes in the pain. Finally, when you are satisfied with the changes you have made you can either send the whole thing off into the distance over the horizon, or you can put it back in your body in a different location where any discomfort might be more manageable or simply turn it upside down and put it back so it cancels out the original pain.

Increasing Energy

The debilitation caused by pain leaves us depleted of energy. Very simple visualisation exercise can help combat this. Put yourself into a very relaxed state and focus on the breathing. Imagine a golden ball of light around your body, that you can both hear and feel vibrating. Spend some time experiencing this, the sensation of the vibration on and through your body, the sound of the vibration as a gentle mixture of harmonies weaving together.

Now, simply become aware that as you breathe in, you take in energy. The golden light gets brighter, the harmonies louder and richer and the vibrations stronger. As you breathe out, waste and tension are expelled, so the light gets clearer, the harmonies more harmonious and the vibration serves to further relax and massage your body.

These techniques are simply presented as an introduction to the idea of taking control of your experience of pain. They are not "NLP" or "hypnosis" techniques, and they are not necessarily the sorts of work I would do on a consultation. I don't know how successful you have been with the techniques discussed in this article, but I do know that you have embarked on a quest to explore the nature of your own relationship with experience. And that is the key. Successful pain management is less about a practitioner intervening and taking away your pain, and more about you understanding and gaining control over the factors that influence your pain.

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