Most People Think Of Pain As Resulting From Physical Injury Or Disease,but Psychological Factors Play A Huge Role In Pain Perception. Pain Is Intimately Tied To Brain Functions That Govern Behaviour And Decision Making, Including Expectation, Attention And Learning. Pain Makes One Feel Tired; It Is Mentally Draining, Making One More Irritable, Emotional And Unable To Remain Positive. It Is Hardly Surprising That As A Result, Things Can Rapidly Spiral Out Of Control. After All, If A Person Goes From Being Energetic, Fun-loving And Happy, To Being Edgy, Withdrawn And Lethargic Because Of The Pain, It Is Inevitable That Very Quickly Family & Social Relationships Begin To Change. An Employer Or Colleague Who Sees A Promising Employee Beginning To Look Tired, Stressed And Tearful, May Quickly Change Their Opinion About That Person’s Abilities To Cope. A Definition Of Pain Pain Is Not Easy To Define. In 1979, The International Association For The Study Of Pain(iasp) Published Its First Working Definition Of Pain: “an Unpleasant Sensory And Emotional Experience Associated With Actual Or Potential Tissue Damage, Or Described In Terms Of Such Damage.” This Definition Emphasizes Not Just The Sensory Nature Of Pain And Its Relation To Tissue Injury, But Also Its Unpleasant Emotional Component And The Fact That It Can Be Felt Just The Same Without An Obvious Cause. The Definition’s Significance Is Exemplified By Pain Lasting Beyond The Point Of Tissue Repair (spinal Cord Injuries) Or Appear Without Tissue Damage (migraines) Or Be Felt By Stimuli That Do Not Normally Evoke Pain, Like Lightly Touching The Skin (post Herpetic Neuralgia). So There Is Much More To Pain Than A Simple Sensory Process. Psychogenic Pain Psychogenic Pain, Also Called Psychalgia Or Somatoform Pain Is Pain Caused, Increased, Or Prolonged By Mental, Emotional, Or Behavioral Factors. Headache, Back Pain, And Stomach Pain Are Sometimes Diagnosed As Psychogenic. Sufferers Are Often Stigmatized, Because Both Medical Professionals And The General Public Tend To Think That Pain From A Psychological Source Is Not “real”. However, Specialists Consider That It Is No Less Actual Or Hurtful Than Pain From Any Other Source. “the Term ‘psychogenic’ Assumes That Medical Diagnosis Is So Perfect That All Organic Causes Of Pain Can Be Detected; Regrettably, We Are Far From Such Infallibility… All Too Often, The Diagnosis Of Neurosis As The Cause Of Pain Hides Our Ignorance Of Many Aspects Of Pain Medicine.” Ronald Melzack, 1996. Why Visit A Psychologist For Pain? One Might Wonder “why Consult A Psychologist If I Have Pain? Are You Telling That The Pain Is All In My Brain?” In One Word, No! Pain Is Seldom, If Ever Exclusively Psychologically Caused. However, The Mind And The Body Are Tied Together In Physiological & Philosophical Terms, And The Mind Can Either Be Of Incredible Help In Healing Or Can Be An Overwhelming Obstacle. Consulting A Psychologist Certainly Does Not State That The Pain Is All In The Person’s Brain, As Unfortunately Some Clients Have Been Advised By Physicians Unable To Establish The Physical Basis Of The Pain. How Can Psychology Help? Psychology May Reverse Some Of The Impact Of The Pain Giving People A Greater Sense Of Control, Reducing Anxiety, Whilst Improving Memory, Concentration And Self-esteem. The Aim Is To Help People Work Out How To Live Their Life As Normally And In The Most Satisfying Way Possible, Despite The Pain. The Psychologist Will Not Tell How To Live One’s Life- After All You Are The Best Expert On How To Be Yourself. Our Role Is To Help One Explore And Discover What Things In Life Are Important And Meaningful, And What Factors Past And Present Stand In The Way Of Regaining Control Of His Or Her Life. Psychologists Assess And Treat Individuals Coping With Chronic Pain. Assessment Often Involves Examination Of Coping Skills And Looking For The Presence Of Depression, Post-traumaticstress And Other Disorders Which Can Occur In Chronic Pain And Traumatic Injuries. Psychologists Employ Treatment Strategies Such As Muscle Relaxation And Cognitive-behavioural Approach To Help Manage Pain And Improve Functioning. Chronic Pain Causes Disruption Of Self-esteem, Occupational & Family Roles. Stress Reactions And Pain Cause The Mind & Body To Become Aroused And Ready For Action. Increased Emotional And Physical Tension Accompany This State Which May Become Chronic, Resulting In Further Increased Pain, Reduction Of Function And Increased Risk Of Anxiety & Depression. Chronic Pain Sufferers May Find It Difficult To Focus On Things Other Than Their Pain, And Lose Access To The Satisfying Things They Previously Enjoyed. Others May Find It Difficult To Reduce Their Expectations And May Overdo Activities Resulting In Further Injuries Or A Cycle Of Overwork And Disability. Relaxation Therapy Along With Cognitive Behaviour Therapy Is Our First Line Of Treatment, Along With Medical Interventions. It Is Customized To One’s Individual Needs, And May Include: Relaxation Training Cognitive Restructuring Stress Management Sleep Hygiene Activity Pacing Coping Strategies & Assertiveness Training The Psychological Interventions Which We Provide At Axon Pain Management Are Highly Effective In Reducing Pain, Disability And Distress, With A Positive Impact On Your Quality Of Life. About The Author: Dr Johnsey Thomas Is A Registered Practitioner Of Clinical Health Psychology In Hyderabad – India, Associated With Axon Pain Management. He Deals With A Wide Range Of Problem Areas, With A Passion For Working With People Suffering From Pain. He Mentions Chronic Pain As One Of The Most Demanding Problem People Come Across With, Which Can Devastate Lives In Terms Of Work, Activities And Relationships

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As A Counsellor, I Am Fortunate (?) To Experience A Varied Gamut Of Human Relationships Through The Cases That Come To Me For Therapy.one Such Case Was That Of A Young Adolescent Boy, Who Was Referred To Me For Academics, As Well As Behavioural Issues. On Meeting The Boy, He Seemed Compliant Enough For The Questions And Answered Them Willingly, But I Could Sense Intense Rage Within Him. On Probing, I Found That His Primary Anger Was Directed Against His Mother. Reason? She Insults Him In Front Of His Uncle And The Servant! The Mother Looked Surprised That This Was A Topic Of Dissent With The Boy. Her Logic Was That If He Is Scolded In Front Of Someone Else, Then He Would Learn To Behave Better. When I Asked Her What Her Expectations Were She Had Only One Thing To Say: I Want Him To Respect Elders.i Found Her Need To Be Very Amusing… Considering She Was Using Humiliation As A Tool To Discipline Her Son.everybody Has This Need In Them To Be Respected, Whether Young Or Old. How Could The Mother Expect The Child To Develop A Sense Of Respect And Reverence, When Everytime She Would Deride And Belittle Him Not Only In The Privacy Of Their Home But Also In Public? It Is, According To Me, The Lowest Form Of Disciplining Tactics, Which Would Have The Person At The Receiving End Seething Inside With Humiliation. I Remember, When I Was Working In A Publication Firm, We Would Have This Monthly Meetings, Which Were Called “hall Of Shame”. The Names Of All Those Editors Who Had Not Met Their Targets Would Be Written On The Board, And They Would Be Asked For Detailed Feedbacks And Explanations. This Could Also Be Done In The Cabins Of The Senior Professionals, But I Think They All Got A Perverse Pleasure, Seeing Them Squirm In Front Of An Audience. What Irreparable Damage Was Being Done To The Psyche Of The Person, I Dread To Think. A Personal Memo Calling The Person Filthy Names Is So Much Better Than This Public Flogging. Coming Back To The Case, When I Started Handling The Issues With The Mother, I Could Understand Where She Was Coming From. She Was A Perfectionist, And Theirs Was The Most Passive Marriage I Have Ever Seen! When Asked If She Expected Others To Respect Her As A Person And Her Opinions, She Wanted To Know What I Was Talking About! For The Husband, She Was Just A Wife; One Who Took Care Of His Physical And Biological Needs. He Could Not Describe The Person That She Was: Her Identity Was That She Was His Wife. She Was Labelled A Bad Mother Because Her Son Did Not Behave ‘properly’. So To Get Social Approval She Was Being Punitive With The Son. Her Life Revolved On Social Approvals. She Could No Longer Establish Her Own Identity, And Establishing The Importance Of Being Herself Became The Focus Of Counselling. She Was Gradually Able To Understand That You Do Not Demand Respect; You Command It. And You Can Only Teach How To Respect If You Practise It. The Point Took A While To Sink In; But When She Was Able To Withdraw From The Controlling Relationship, And Also Refused To Take Responsibility For Her Son’s Misbehaviour, And Refuse To Accept The Label Of Being A ‘bad Mother’ Simply Because He Misbehaved, Things Started Turning Around. When People Around Realised That She Was Not Accepting The Blame For His Behaviour, They Started Handling The Boy Differently; And He Too, In Subsequent Sessions Was Able To Understand The Scenario. Sessions Are Still On; The Husband Continues To Be Passive, Though He Is Beginning To Think There Is More To A Marriage Than Just Staying Together, And Is Slowly Willing To Enrich The Relationship.it Is Not ‘all Is Well’ As Yet…. But I Hope It Would Be.mohana Narayanan