NAVIGATING PAIN

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Pain teaches us to be helpless

March 21, 2018

 

If you’ve ever done any sort of psychology course you will be familiar with Pavlov and his experiments on dogs in the late 19 century. Briefly, Pavlov rang a bell every time he fed the dogs. He did this repeatedly until it got to the point that they would salivate simply on hearing the bell, because they were expecting the food. This is called a conditioned or learned response – Pavlov had conditioned his dogs to expect food when they heard the bell.

 

A century later, psychologist Martin Seligman looked further into conditioning in dogs. When he rang a bell he gave a group of dogs a light electric shock. As he repeated this procedure the dogs began to react to the shock on hearing the bell, even when no shock was given.

 

This is the interesting bit. He then put these dogs in a crate divided in half by a low fence and put the dogs on one side. The side he put them in was electrified but the other side wasn’t. He expected the dogs to jump over the fence to the safer, non-electrified area but instead they lay down and gave up. He then repeated this with a group of dogs who had not been subjected to the earlier bell/electric shock procedure and immediately they jumped over the fence to safety.

 

This experiment shows how dogs can quickly learn to become helpless when they expect and fear that pain will result. I believe that human beings are similar too. If you want an example of how we give up in the face of difficulty check out this short video.

 

Being in pain is a good example of how we learn to become helpless. If we try to do an activity and it hurts, invariably we will stop. We begin to find that every time we try that, or a similar activity, pain occurs. We come to the logical conclusion that this activity is somehow harmful and we avoid it. On the surface this seems sensible - why would you question it? If running hurts, then don’t do it.

 

However, it is not as simple as that. What if you really want to run? Or to engage in other forms of fitness? Annoyingly, the problem often gets worse over time. At first pain may occur when you run a long distance. Then, if not addressed, pain may start anytime you run or even do other activities, leading you to think that running is bad for your body and you stop.

 

In reality, one factor occurring is is that you have learned to find certain activities painful as a protective mechanism. It’s an evolutionary survival thing. Your brain has assessed that this activity is dangerous and wants you to stop. Pain is a good way to do this. The big problem is the more you avoid this activity the stronger you make this learned or conditioned response. It is as if you are reinforcing the view that this activity is dangerous: expect pain-get pain-fear/avoid and so on*. Like Seligman’s dogs you begin to believe there is no point doing an activity because you ’know’ it will cause pain.

 

So how do we break the fear-avoidance cycle?

 

As you can imagine this is not an exact science and there is not just one way to approach this. And, as ever, always get pain checked out if you are worried about serious causes. But when you’ve been checked out, here are a few things to try:

  1. Face the pain – trying to block it out or get away from it often makes it worse. Can you, in a manner of speaking, ‘turn around and face it’? What does it really look like? How bad is it? Will it allow you to carry on a little, feel into it a bit? N.B. I don’t mean ignore the pain – this is not advisable.

  2. Self-reassure – very often our reaction to pain, other than fear, is irritation – with ourselves, the pain, the weather etc! Try to notice when you do this and attempt to say a short reassuring phrase to yourself such as: Its ok, I’m safe, Come on, we can do it. If you find this tricky, think how you might reassure a small child. You wouldn’t lay into them (hopefully!) so try not to do it to yourself.

  3. Notice what you feel in your body – If you find tension there – shoulders up by ears, tense buttocks (trust me, it’s a thing) then can you gently feel into these areas with your mind and allow them to relax? Again, try not to feel frustrated but adopt more of an attitude of curious interest. What are those muscles doing? Can I relax them?

Have a go at these techniques and attempt a gentler version of your activity (slower, shorter). How does it feel now? But as ever, be kind to yourself. It’s an important part of making positive changes.

 

 

*NB If you want to read more about this model it is called the Fear Avoidance Model by Leeuw et al 2007:

Leeuw, M., Goossens, E.J.B., Linton, S., Crombez, G., Boersma, K., Vlaeyen, J., 2007. The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence. Journal of Behavioural Medicine, 30(1): 77-94

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