The gate theory of pain suggests that the pain “gate” can be opened or closed and that pain is a complex brain-determined event. This means that certain non-medical factors can increase and decrease pain. These include mental ways that pain is sensed and perceived, its implications judged, and how it is acted upon.
Certain attitudes such as hypervigilance or increased focus on the painful sensations tend to increase the impact of pain. If you are feeling depressed, stressed, or going through a difficult time in your life, career, or family, all this can add additional sensitivity to painful sensations. Neural impulses from the brain related to thoughts and moods including anxiety and depression are capable to modulate the pain signal that is sent to the brain from an injured area. Negative thoughts open the gate and make your brain more sensitive to pain, whilst positive thoughts close the gate and restrict the pain message.
With the help of cognitive behavioural therapy, your psychotherapist will help you to gain emotional stability and calm, identify triggers, unhelpful behaviours, unhelpful emotional attitudes and thought patterns that may affect your experience of pain. Some of the common unhelpful attitudes include:
- Black and white thinking is present when a person perceives their body to be either in pain or not in pain. This attitude disallows from seeing progress and may increase the sensations of pain.
- Disqualifying positives is present when a person decides that since they are in pain nothing really matters. This often leads to low mood, lack of motivation, and avoidance.
- Catastrophising might be present when a person magnifies negative outcomes if they engage in any activity whilst in pain. For example, “If I exercise or even move I could cripple myself”.
- Low frustration tolerance is present when a person repeats to themselves that their pain is unbearable and intolerable when there is no objective evidence that this is the case.
- Overgeneralisation is present when a person perceives their pain as present at all times and forever.
- Self-criticism, high standards and non-acceptance may lead to low mood.
- Increased introspection and focus on the body and pain.
- Perceiving oneself as helpless increases suffering from pain.
- Becoming less active leads to loss of muscle tone and stamina.
- Fear of pain rather than viewing it as a part of life.
Your psychotherapist will help you deal with the mental health issues that aggravate your experience of pain, assist you in setting goals, problem solve, suggest pacing your life, and develop a graded activity schedule. You will learn the physical and psychological strategies designed to alleviate your suffering. Your psychotherapist will assess whether you may benefit from relaxation techniques, meditation, imagery exercises, or the elements of psychoanalytic psychotherapy.
Before your sessions begin you may benefit from the exercise in which you close your eyes and take a deep slow breath in and imagine blowing the feather away as you breathe out through your mouth. You may imagine your pain being blown away instead of the feather.
Ensure you get adequate sleep, prioritise your tasks, have a healthy diet, dedicate time to pleasurable activities, and keep a sense of humour.
You may wish to pair it with the imagery where you close your eyes and imagine cool wind, ice, soothing cream, or being on a beach using all five senses. Try to see it in your mind’s eye, smell it, hear it, touch it, and taste it until the pain reduces. This could take up to 20 minutes for the effect to be felt.
As the first signs of pain push into your awareness, try to absorb yourself in another activity. It is important that the activity is significantly absorbing and this could be an imagery practice or any other hobby, important call, or urgent task at hand. Alternatively, you may choose to focus on your breath and away from your body.