Understanding Pain

 

Prior to 1965, there were two key theories on pain: 

•      The Specific Theory initiated in the 17^th century by Descartes that proposed pain was a specific sense of its own, in line with taste, smell etc, with its own central and peripheral apparatus.

•      Pattern Theory proposed by Von Frey and Goldstein in the 19^th century, described how pain was the result of an “intense stimulus of non specific receptions”, Korn & Johnson, p106.

While these two theories appeared to be diametrically opposed, the Gate Control Theory put forward by Melzak and Wall in 1965 provided the context by which they could be seen to have co-existed.

 

The Gate Control Theory described how we have a:

•     Sensory Discriminative system that reports the location and intensity of a stimulus to the central nervous system (CNS), and

•     A motivational-affective system which reports on the quality of pain

The needs and motivation of a person impacts on how pain is processed to the extent that the impact of the pain can be intensified or reduced and as such we have symbolic gates that appear to let the pain in and keep it out to varying degrees.

 

In 1973, the Gate Control Theory was explained a little further when research revealed that opiate agonist and antagonist bind to brain tissue.  Earlier research had shown that when opiates bind the brain tissue they could produce analgesia and europhria.

 

The Gate Control Theory helps explain how two people with the same injury can experience the pain differently.  “In an individual disease, the pain is a result of present and past experiences and perceptions – many of which remain in the unconscious mind” (Korn & Johnson, p107).

 

The pain experience is greatly influenced by expectation and can vary enormously from person to person and even within the one person.

 

Take, for example, someone who stubs their toe.  When they realise they have also taken a significant amount of skin off, the pain can increase significantly.

 

As a subjective response, pain moves along a continuum from acute to chronic.  Acute pain is characterised by:

           definable cause

           being temporary

           feedback

           sudden onset

 

Chronic pain is characterised by:

           sufficient time to develop

           precondition event

           expectation of continuation

           constant or intermittent

 

Imagery Used in Pain Control

 

Pain is a specific phenomenon and a warning signal.  Therefore pain control needs to be used with care and be specific.  Examples of imagery methods used for pain control are:

• Glove Anaesthesia
• Light Switch Image

 

Glove Anaesthesia

Anaesthesia or Analgesia is induced in the hand and then transferred to any other part of the body.

 

While a variety of methods can be used to induce the anaesthesia Korn & Johnson, p155, cite the work of David Bresler at the UCLA Pain Control Centre.  In his book, Free Yourself from Pain, the image is created of a person putting their hand in a bucket of very potent anaesthetic solution.

 

Other methods include:

•      Hand encased in a very thick glove.  The more details about the beneficial impacts of the glove the better.

•      Hand in snowdrift – feeling the tingly sensation become numb.

•      Recall an experience of anaesthesia (eg dentist) and replicate those feelings.

The client needs to be instructed on how to restore the normal sensations.

 

Light Switch Image

Install a dimmer switch with an electric wire from it to the painful area and a further electric wire from the painful area to the brain.

 

When pain is felt, the wires will jump to life with heat and vibration and you can then turn the switch down until it reaches an appropriate pain.

 

Choose the intensity that you feel the pain by controlling the dimmer switch.