Distraction is a cure?

I have read many articles online and in print about chronic pain. Some were written by doctors, some by social workers or therapists, some by journalists. I have also read blogs written by people who live with chronic pain. Sooner or later the topic of distraction shows up.

What amazed me was this one article was posted with a title that misrepresented the contents of the article.The title is "The Most Powerful Pain Reliever Revealed". It made it sound like someone had found a cure for chronic pain, yet when you read the article it simply states that distracting yourself cures pain. The example it gave was not one of distraction, it was one of a person in full fight or flight mode, full survival mode complete with a major adrenalin rush. The example was of a woman going back into her burning house to save her cat from death and not noticing that she sustained 2nd and 3rd degree burns while doing so. It used this example as proof that by being distracted one doesn't feel pain. It was a doctor who posted this article. You can find the article and the comments generated here.

The responses to this article ran the gamut from agreeing that distraction works in controlling pain, to anger that anyone could think that such a life and death situation counts as mere distraction.

There were a few things that bothered me when I read this article. First, the title. I agree with the opinions stated that the title was in fact misleading. It is misleading. When I read the title, had I not known better, I may have felt hope that finally something to truly help me had been discovered. I may have felt that finally I might have a chance at leading a more normal and active life with little or no pain. Luckily, I knew that there is no miracle cure for pain so I did not feel those things. What I felt was curiosity and wondered what wonderful so called powerful thing the author would espouse as such a great treatment for pain.

Second, the example provided in the article really bothered me. I agree that the example provided is not one of distraction. It is, in fact, one of a person in full survival mode. Science has shown that when a person is put into a position by a life threatening emergency that their body goes into fight or flight, survival mode. To do this, non-necessary bodily functions shut down such as digestion. The brain sends commands to increase adrenalin and endorphins and these chemicals are released into the blood stream in large quantities. These chemicals cause many different physical responses, but one of them is the inability to feel pain or the dulling of pain so it is easily ignored while the brain is focused on surviving the situation. You can find many examples of people ignoring serious painful injuries while in a situation that could have easily taken their lives. There is a difference between being distracted and being mind-locked into truly surviving when your life is threatened.

Distracting yourself through hobbies or other activities does not cause the body to dump massive amounts of adrenalin and endorphins into the blood stream. It can cause some release of these chemicals, such as during sex, but it rarely happens with fairly sedentary activities such as reading, or other hobbies. Hobbies such as running (marathoners often experience "runner's high", which is a result of such adrenalin and endorphin release into the bloodstream) may cause these chemicals to be released but not many severe chronic pain patients can run or do marathons. They simply hurt too much and the cost of such activities in increased pain is just too high.

Thirdly, the response of the doctor who posted the article to the comments really bothered me as well. The people who posted positive things about how distracting themselves with hobbies can provide some relief of pain were praised as survivors, having heart, being beautiful and other positive things. Whereas the ones responding with anger or disbelief were judged as having "negative thought viruses" and worse. The doctor who posted the article states she has lived with chronic pain for 10 years, at the time the article was posted. I understand that this person has obviously chosen to try to stay as upbeat and positive as she possibly can and that is fine. But to be so derogatory towards those who took offense with the way the article was presented was exclusionary and wrong. To hold those people who commented only with positive things up as "survivors" and beautiful people, to lord them over the ones who were angry at being mislead and then belittled is very wrong in my opinion. Especially from a doctor. Chronic pain patients get mistreated and misunderstood by doctors far too often as it is. We are judged as drug addicts, drug seekers, attention seekers, as having mental illnesses and worse, far more often than we are believed when we describe our pain. For most of us it takes years to get a doctor to listen to us and start exploring possible reasons for our pain. For those who are harder to diagnosis, they often have to see many different doctors over periods of years to finally get one who will seek an answer and then treat them even a little bit. Even after having a diagnosis (or more than one) of a condition that causes severe pain, we are still seen as weak, drug seeking addicts who just want attention and dismissed by many doctors because we can't be easily "cured". To have another doctor, publishing articles that just add another reason to dismiss chronic pain patients as weak minded is, in my opinion, counter productive and wrong.

Many chronic pain patients try very hard to stay on the positive side. To see the little things in their lives that are still good, the things that make it worth getting out of bed every day. But they also have every right to be upset, offended, and angry when an article such as this one is presented as the cure to chronic pain.

Distraction is not a cure, nor does it give the same physical response as a life and death situation. Distraction merely takes the conscious mind and focuses it on something other than the pain your body is feeling. It does not make the pain go away, nor does it really lessen the pain. It just shifts your focus so the pain becomes secondary to whatever you are focusing on, but you still feel the pain. And when the pain gets bad enough, it distracts you from whatever you are doing, it takes over your mind.

I agree that the mind is a wonderful tool that can be utilized to help one control their pain in different ways. Meditation, relaxation techniques, distraction, visualization techniques and more can all be used to help manage pain, but they can not get rid of the pain completely, they are not a cure. To present it as a cure is, in my opinion, wrong and belittling of those of us who live every day with severe pain by making us out to be weak minded, psychologically inferior or somehow less than other people. To teach other doctors (as this article purported to do) that distraction will cure pain or cause a patient not to feel it, is to make being properly treated for pain even more difficult than it already is.

Think about it, you are in severe pain and have been for months. You finally break down and go to the doctor, hoping for some kind of relief, any kind of relief. The doctor then tells you that you merely have to distract yourself with other activities and the pain will go away. How would you feel hearing that? Yet, this is the exact scenario that this article and the presentation (to doctors no less) that it describes is teaching doctors; to cure pain all a patient has to do is distract themselves.