4 Mental Strategies to Manage Chronic Pain with Your Mind

Jennifer Mulder
Written by
Jennifer Mulder Mental Health

When you’re living with chronic pain, you can find lots of advice on how to reduce your symptoms. From finding the right pain medication to holistic treatments and making lifestyle changes, there seems to be a pain-relief method for everyone. But when your pain doesn’t fully go away, no matter how much you try, how do you deal with the aching – or down-right suffering – that remains? There’s one kind of coping strategies that’s easily overlooked: mindfulness for chronic pain.

Mindfulness for Chronic Pain – Your Brain

You probably think of pain as an unpleasant physical experience, something that happens to your body. But actually, your brain plays a central role in processing and interpreting pain signals.

When you bump your knee against the table or you accidentally touch a hot pan, your nervous system sends warning signals to your brain. Those pain alerts urge you to take action before your tissues gets (further) damaged. In return, your brain releases pain-reducing chemicals like endorphins into your bloodstream to solve the problem.

But when pain persists for months or even years, the continuous flow of warning signals between your brain and spinal cord rewires your central nervous system. To prevent danger, the pain pathways become highly sensitive to potential threats to your body. That means that the threshold for your brain to accept pain signals from your spinal cord becomes lower, resulting in more pain sensations. This process is called central sensitization.

That’s why how you interpret pain based on previous experiences and how you respond to the threat posed by pain plays an important part in pain management.

But chronic pain does not just have sensory and cognitive dimensions, but also an emotional aspect. You’re probably feeling upset, fearful or frustrated, wondering what’s happening to you and if this pain will ever go away.

Don’t get me wrong: The fact that pain has a psychological component does not mean that you’re making it up or that you’re being overly sensitive.

It simply means that, because your thoughts, emotions and behaviors also play a role in the continuation of chronic pain, your mind is one more tool to manage your pain levels.

Research confirms that psychological and mindfulness techniques for chronic pain can literally take your mind off pain. What’s more, they can break the vicious cycle of experiencing pain, negative thoughts and emotions, built-up tension and unhelpful behaviors.

Take a look at 4 mental strategies you can turn to when living with chronic pain. 

1. Mindful Body Scan

Have you ever heard of a body scan meditation? It’s a mindfulness for chronic pain technique to tune into your body and become aware of its sensations. Basically, you mentally ‘X-ray’ your body, slowly scanning for tension or pain. When you notice any discomfort, you simply sit with the feelings that arise, accepting the bodily sensations and emotions without judgement.

These kinds of mind-body interventions are known to relieve tension in your body and mind, which results in less pain. What’s more, practicing mindfulness meditation improves the psychological aspects associated with chronic pain, like depression and quality of life.

So how do you perform a mindful body scan?

  1. Find a quiet spot where you won’t be disturbed. Sit or lie down in a comfortable position, preferably with your arms alongside your body and your legs slightly apart.
  2. Close your eyes to focus on the sensations inside you and not what’s happening around you. Bring your awareness to your body: feel how your body rests on the floor or chair, where the surface supports your spine and the back of your limbs.
  3. Focus on your breathing. Notice how the air enters your nose and how your belly rises and falls with each breath you take.
  4. Turn your attention to the sensations in your body, starting at your feet and slowly working your way up. Notice the feelings: are your feet warm, cold or tingling? Do your legs feel cramped or relaxed? Pause at every body part and pay attention to how it all feels.
  5. Whenever you come across pain, discomfort or emotions, don’t resist those feelings but try to accept it without criticism. Mentally zoom in on the tense area and breathe out slowly and deeply. Relax your muscles. This may release some build-up emotions. Notice the sadness or frustration and then let it go.
  6. Keep breathing and imagine the physical and emotional tension being released each time you exhale.
  7. In your mind, move your way up from your toes to your head. Finally, let your breathing flow freely and bask in the stillness.
  8. When you feel ready, gently stretch your body and slowly bring your attention back to your surroundings.

Ideally, you first want to practice this mindful body scan when you feel relatively good. Once you’ve gotten into the habit of scanning your body, you can perform mindfulness meditation in more challenging circumstances, like when you’re in pain, at the doctor’s office or while you’re doing chores.

2. Visualizations

You may not realize it, but your thoughts trigger physiological responses in your body. When you vividly picture eating a chewy chocolate cookie, your mouth will literally start to salivate in anticipation. Being scared, on the other hand, increases your heart rate and breathing to prepare your body to run away.

Luckily, you can also use this mind-body connection to your benefit, by visualizing soothing scenes. Studies show that visualization can reduce pain and anxiety, even during scary medical procedures. That’s because painting pictures of peaceful settings redirect your thoughts away from the pain, while also relaxing your body and mind.

Imaginary scenarios create real physical reactions. So the next time you’re in pain, engage all your senses and envision a quiet beach or a cabin in the woods – whatever soothes you. Get specific. In your mind’s eye, see yourself walking through the sand, pain-free. Hear the sound of the waves, feel the breeze on your skin, taste the salty air on your lips. Infuse your visualization with all the smells, textures and emotions that make it feel real.

3. Calming Mantras (or Other Helpful Thoughts)

You’re probably all too familiar with the physical sensations of chronic pain, but have you ever noticed how pain triggers hurtful thoughts? Maybe you’re wondering what’s caused this bout of pain, and if it will ever go away. Or perhaps you worry about how to keep up with work and family when you can barely move.

As a result of these thoughts, you may start to avoid situations that could cause or worsen your pain. That’s only human of course, but it’s not always the best strategy to manage living with chronic pain in the long run. For example, if you’ve experienced pain after shopping for groceries, you might conclude that you’d rather delegate that task in the future. But staying active and mobile – alternated with adequate rest – can actually ease chronic pain.

Psychological strategies can help prevent a negative cycle of pain sensations, unhelpful thoughts and behaviors. Cognitive Behavioral Therapy (CBT) is a well-known technique that helps you change pain-related thought patterns and reduce chronic pain. If you’d like to learn more about CBT to manage your chronic pain, please talk to your doctor or therapist.

But if therapy is not an option for you, there are still things you can do to ….

  1. Become aware of your automatic negative thoughts about pain. Observe your thoughts objectively and see if you can find a pattern. For example, you might notice a tendency to immediately expect the worst when you notice the first sign of pain.
  2. Challenge negative thinking patterns. Ask yourself: Is this thought true? Is there any evidence that supports my belief? Is this thought helpful in the long run or just stressful? What’s the worst thing that can happen and how likely is it that this will actually happen?
  3. Replace your automatic thoughts with more helpful alternatives. That doesn’t mean you have to push away your feelings and pretend you’re not in pain. You only choose more constructive statements over thoughts that keep you stuck in the chronic pain cycle. For example, if you feel “There’s nothing I can do to stop this pain“, you could replace that thought with something like “The pain may not completely go away right now, but there are still things I can do to ease the pain. And there will be better days ahead.”
  4. Come up with a calming mantra. Instead of tackling each thought, you could also choose a general calming mantra that you can use when your pain’s coming up. Your own ‘Automatic Positive Thought‘, so to speak: “I can do this” or “This too shall pass”. 

Working on mindfulness for chronic pain does not mean you’re denying the gravity or the source of your pain. You’re only building more constructive thought patterns to improve your pain levels and daily functioning.

4. Positive Distractions

Being mentally engaged takes your mind off the pain – literally. Your working memory can only handle a limited amount of input at once. So when you turn your attention to happy thoughts or engaging activities, there’s less capacity left to process pain signals. Being absorbed by simple distractions like watching TV doesn’t take away your pain, but it does put it in the background. Research shows that listening to music actually ‘tunes out’ painful sensations and makes you feel more in control over your pain. What’s more, positive distraction also reduces stress levels and stops you from excessively worrying about your health problems.

Unfortunately, the downside of a limited working memory is that constant pain signals also make it harder to concentrate. Reading Tolstoi probably won’t be the best distraction when you’re in pain. So choose positive distractions that require just the right amount of brain power, like short stories, adult coloring or easy games. 

Living with chronic pain is a challenge, and some days there’s little you can do to prevent or stop the pain. But hopefully these four mental coping strategies will give you some guidance how you can practice mindfulness for chronic pain.

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