Pain is a need state

Pain can be thought of as a need state like hunger or thirst. Similarly, emotions are considered to be indicative of our inner physiology that guide as towards a range of actions to make sure that we maintain healthy parameters.

Pain is an experience unique to the person. It cannot be seen, it has no shape, colour or form. Pain is typically hard to describe although we have a large number of words that attempt to capture the feeling. Using the word itself tells us that the person is having or has had an experience of the sensation, yet it tells us nothing of the type of sensation. The particular qualities are always private and part of the inner world. Much like thirst. Try and describe the sensation of thirst…

What is a need state? This is when we become aware of a feeling, often closely associated with thoughts (the brain basis of thoughts and feelings co-exist, which makes sense), which has the purpose to motivate action. Our brains and its body systems need each other, and this is part of how we obtain what we need to survive. Our brains are only interested in survival, which is why many people suffer as a consequence of the lives we lead within the current society.

We are designed to look out for danger, and together with the ability to think back and ahead, we can perceive threat very easily. As we keep practicing this, we get very good at it! The consequences of worrying about things that usually don’t happen, or replaying past unpleasant events include all sorts of common ills. For example, chronic pain, IBS, headache, migraine, functional movement disorders, anxiety, depression, pelvic pain, skin disorders and autoimmune diseases. The reason is because we become ‘inflamed’ by the way we live, spend much time in a protect state and hence the healthy mode is quashed. We can change this as soon as we decide to improve our lives in a number of ways.

All of these feelings mentioned above are all signs. They create the opportunity to make changes, create new habits and build a better life. This makes sense because there are many ways we can now satisfy our wants, and indeed society encourages this everyday. You may want to buy things, accumulate stuff, eat junk food, drink alcohol, smoke cigarettes and more. Yet we do not need these things, which only bring very short term relief before the next urge.

Pain as a need state to be transformed requires facing the reasons why the person remains in pain. This can be challenging because we don’t usually like to deal with our ‘stuff’. Instead, it appears easier to take a pill or have an injection or something else that appears to be quick fix. However, none of these things truly transform suffering and liberate the individual. Medical care can contribute a little, but it is the work of the individual to understand their true needs and meet them each day that makes the difference. Pills do not teach you how to live well moment to moment. You must learn the skills of being well in your own way.

This is the purpose of The Pain Coach Programme. To deliver the insight to people so that they can understand their pain and move on to a fulfilling life. This is whether they are a struggling athlete who feels on-going pain, someone with a condition that features pain, a person who feels life has got on top of them and they hurt (and feel exhausted all the time), right across the ages and certainly spanning our society.

We must revise our thinking in society so that the suffering eases. That’s the purpose of Understand Pain (UP and why I am running (follow #upandrun on Twitter) many miles, writing these blogs and giving talks. We can do this together, so please share! All of what I write is based on the latest research and understanding of pain, so whilst it may sound different (and I hope it does), this is because we have been conditioned to believe something more simple. But the more simple version is not solving the problem. It is likely making out worse because people are continuing to rely on drugs and other means to get better, when they do not provide the answers. You do.

Pain is what the person says it is

This may sound obvious but I think that we need this to be loud and clear. There are still too many people who say that they feel that they are not believed when they describe their experience.

I started my career in healthcare in ’93 training to be a registered general nurse. My fascination with pain began in the theatre recovery rooms when I noticed how propel responded so differently. The ‘size’ of the operation did not seem to matter. How the person was, in other words their state, really did.

Studying pain, I came across a quote from McCaffery (1968). She stated that it was ‘…whatever the experiencing person says it is, existing whenever the experiencing person says it does.’

This has ever-stuck with me. Everyone behaves in such a way as to meet their needs. When a person describes their pain experience, these are not merely words. It is an expression of need. In chronic pain, we must ask why is pain a predominant feature of this person’s life? What are the needs that must be met for the suffering to ease?

To understand this, the person must be free to express their lived experience from the first person perspective. As clinicians and therapists, we can only gain insight through deep listening within a supportive, encouraging and compassionate environment.

Deep listening involves being present and paying full attention to the person. Not only do we hear their words but we see how they are embodied and delivered. Getting to know our own biases and beliefs allows us to let these go so that there is no ‘filter’, just pure awareness. This begins the therapeutic process.