The Power of Language in Chronic Pain Self-Management

“There is something about words. In expert hands, manipulated deftly, they take you prisoner. Wind themselves around your limbs like spider silk, and when you are so enthralled you cannot move, they pierce your skin, enter your blood, numb your thoughts. Inside you they work their magic.”

—Diane Setterfield, The Thirteenth Tale

Very little could encapsulate the power of words as well as British author Diane Setterfield’s observations. Even though they are often underestimated and taken for granted, words do matter. And they matter even more so in the context of self-talk, that is, what we tell ourselves and the language we instill in our psyche.

Still, what do words and language have to do with health and, in particular, chronic pain? The simple answer is: plenty. In fact, the relationship between words and health is like that of fish and water. The foundations of this intrinsic connection are wholly scientific in nature; psychology and language can affect health just as poor lifestyle habits or illness can. How we talk to and about ourselves affects both our minds and bodies. For those struggling with chronic pain, negative words can take an even bigger toll.

Chronic pain: a New-Age epidemic

Globally, close to 1.5 billion people are believed to suffer from some form of chronic pain. In the U.S., it is the leading cause of long-term disability, with close to 80 percent of chronic pain sufferers reporting depressive symptoms because of their pain. Against the backdrop of such alarming figures, it is becoming progressively critical to understand the inner workings of chronic pain and techniques to conquer it. Beyond the constant battle between pain and painkillers, how are practitioners facilitating chronic pain self-management? One of the broadest and most critical schools of treatment for such conditions is cognitive-behavior therapy (CBT), which deals with what we tell ourselves about our pain.

CBT and positive self-talk

CBT is a form of self-counseling that leverages self-talk to help those living with pain change their thoughts and behaviors. Modifying your awareness of pain and developing coping mechanisms beyond medication enables you to stop being so controlled by your pain. The underlying principle of CBT is that thoughts, feelings, and behaviors are all intrinsically linked to your physical well-being. Therefore, thoughts and behaviors can train the brain to control and even block out the pain it senses. In other words, CBT can change how you perceive your pain and thus how you respond to it.

According to some, CBT is the gold standard in pain treatment. Given the biological, psychological, and social nature of chronic pain, CBT appears to be an obvious treatment choice because it addresses the problem holistically, taking into consideration psychological and social influences as well as biological factors.

CBT is a skills-based approach comprised of techniques that can empower you to take the helm of the chronic condition ship. The techniques can help you alter your negative thoughts and words through strategies such as positive self-talk, filtering negativity, gray thinking (as opposed to black and white), and self-affirmation. Self-talk features predominantly as a tool to retune the brain by changing the way we talk to and treat ourselves.

According to Ramez Sasson, founder of Success Consciousness, a website designed to help build positivity, “Repeating positive statements or affirmations is a self-talk technique that works because the subconscious mind accepts repetitive thoughts.”


Putting a positive spin on pain

Negative thought/talk: I can’t deal with this pain.
Modified positive coping statement: I can control the pain.

Negative thought/talk: The pain has taken me over.
Modified positive coping statement: I am more than my pain. It’s nothing compared to me.

Negative thought/talk: It hurts too much.
Modified positive coping statement: It could be worse.

The science behind self-talk

Scientifically, the connection between the brain and pain has been a subject of considerable debate for decades. Traditionally, it was believed — and still is to some extent — that when an individual experiences pain, the message of this pain travels from pain receptors to the brain via nerve cells near the spine. However, it is now widely accepted that people can experience pain without nociception (the sensory nervous system’s response to potentially painful stimuli) and have nociception without pain. Many scientists argue that pain has two physical causes: neuropathic and nociceptive. Nociceptors are nerves that react to bodily damage, such as in the case of injury. Neuropathic pain tends to be less tangible and mysterious, such as phantom limb pain. The brain–pain link, although complex in nature, undoubtedly exists. It is believed that when the brain is more stressed, this pain messaging tends to be stronger. This is referred to as “windup” or “sensitization” — when the body is already highly stressed from focusing on the pain in question. Self-talk techniques help by training the brain to desensitize and, therefore, feel less stress and less pain.

According to pain specialist Eric Visser, clinical psychology is intrinsic to chronic illness management and a “vital pillar of holistic pain management.” He is a strong believer in patients actively participating in the pain-management process: “The best pain and stress-management techniques are those in which you are the major player in your therapy. We have a constant stream of thoughts and emotions whirring around in our head, often called ‘thought chatter’ or ‘self-talk.’ When we suffer with chronic pain, stress, anxiety, or depression, our thought chatter is usually negative, which produces negative emotions and behaviors.” These give rise to other negative thoughts, inadvertently creating a vicious cycle that can worsen your condition. In this context, self-talk and the words you use within your self-talk can enable the recognition and deconstruction of such patterns in the thought process. Awareness of negative self-talk patterns can lead to a path on which you consciously — and gradually subconsciously — develop a way to change negative thinking into a positive mindset.

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