A New Take on Managing Pain

In this guest post, Dr. Aliza Weinrib advocates for a new take on managing pain.

By Dr. Aliza Weinrib Clinical Psychologist, University Health Network

We have all been there. That moment when your doctor asks you, “So… how has your pain been since I’ve seen you last?”

At that moment, you turn to your memory to provide you with a summary of all the ups and downs that you have been through. Of course, you remember your pain! Your pain is very hard to forget or ignore!

We often think of our memory as being a kind of camera that records what happens in our lives. Research shows that memory is less like a camera, and more like an artist’s painting. If the artist feels blue, the painting will show that. If the artist feels vibrant and full of life, the painting will show that too.

When you are in pain, your mind can more easily focus on memories of pain. When you are in pain, your mind goes through your photo album of memories and shows you more pictures of past pain, ignoring pictures of pain-free moments.

This is not just true for physical pain; it is true for emotional pain too. Physical pain is what you feel in your body:

  • how intense this pain is (“It is 6 out of 10“)
  • what it feels like (“It burns like electric shocks“)
  • where the pain is located (“It’s in my back“)

Emotional pain is just as real, and sometimes what hurts the most is the pain of not being able to do the things that matter to you:

  • “The hardest part is that I can’t work.”
  • “My favorite thing is going for long bike rides and I miss it so much.”
  • “I really want to make a big birthday party for my kid, but it is too much.”

Both kinds of pain are important, and experts agree that it is helpful to track both your pain and the meaningful activities you can do. When you track both, it gives both you and your doctor a fuller picture of how you are doing from day to day. It can help you and your care team to figure out what treatments and coping tools help you to do more of what you most want to do.

What kind of activities count as meaningful activities?

Sometimes it sounds intimidating, like an activity has to be a very big deal and take a lot of time or effort to be meaningful, and that sounds like too much when you are in pain. Keep in mind that sometimes the smallest, simplest actions are the most meaningful.

Has a little time outside refreshed you? Has cleaning up one part of your living space felt good? Has getting out of bed or having a shower felt like a small victory?

These are all meaningful activities! For the sake of our well-being, we all need to find meaningful activities to do each day that are within our reach.

These meaningful activities can include:

  1. Activities that connect you with people you care about. It can be as simple as watching a TV show with a friend, eating a meal together, or sharing some funny texts.
  2. Hobbies and fun activities that you enjoy. What do you like to do? Some examples from patients are hobbies like knitting or gardening, playing with pets, reading a good book, or playing a game.
  3. Activities that may not be fun, but feel satisfying. Most people don’t love doing chores, running errands or paying bills, but it sure feels good when they are done!
  4. Activities that are important for your health. This could include things like gentle exercise, grocery shopping, cooking, and going to medical appointments.
  5. Activities that are part of taking care of yourself. We all have hard days when we can’t do as much. On those days, having a bath or a shower, or taking some time for rest and relaxation, are important things that you can do for yourself.

When we look at it this way, we do meaningful activities each day.

Sometimes, we can’t eliminate the pain entirely. This is like when I am making soup and I add too much salt. The salt is in there and I can’t get it out! The only thing that I can do is add more of the other ingredients – more veggies, more beans, more broth. And then the soup tastes much better. In a similar way, even when you can’t get rid of the pain, you can add small, manageable, and meaningful activities to your day. Bit by bit, this can change the flavor of your life.

Dr. Weinrib is a clinical psychologist specializing in Acceptance and Commitment Therapy for pain. In addition to her private practice, she practices as part of the Transitional Pain Service at the Toronto General Hospital. She is a Board Member of the Ontario Association for Contextual Behavioural Science and a Researcher at York University.

Dr. Weinrib guides content development for the Manage My Pain app as the lead Pain Psychologist at ManagingLife.

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