Recognition of Chronic Pain as a Disease

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If you’re suffering from chronic pain, then understanding how pain works is key to overcoming it. The New York Times has a pertinent article regarding this very strange issue from which so many suffer.  Giving Chronic Pain a Medical Platform of Its Own highlights a growing understanding of chronic pain by some medical professionals (and a misunderstanding by many more medical pros).  The main points are these:

“Among the important findings in the Institute of Medicine report is that chronic pain often outlasts the original illness or injury, causing changes in the nervous system that worsen over time. Doctors often cannot find an underlying cause because there isn’t one. Chronic pain becomes its own disease.

“When pain becomes chronic, when it becomes persistent even after the tissue and injury have healed, then people are suffering from chronic pain,” Dr. Sean Mackey, chief of pain management at the Stanford School of Medicine said. “We’re finding that there are significant changes in the central nervous system and spinal cord that cause pain to become amplified and persistent even after the injury has gone away.”

We see now that in many many cases, pain DOES NOT equal injury.  (If you fall and bang your knee, cut your finger, or touch a hot stove then yes, the pain is quite indicative of an injury.  These are acute injuries, not chronic pain issues.)  Read the rest of the article for some of the latest ideas on pain science.  If you want more excellent information on the very strange subject of pain, check out Body In Mind, a blog by pain researchers based at the The Sansom Institute for Health Research at the University of New South Wales in Australia.

Snacking & Weight Loss Psychology

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“The average American now consumes about 2,375 calories per day, about a third more than in the ’70s.” – Time Magazine

Snacking

Two articles may help you understand why so many of us are overweight and why it’s tough to lose the fat.  First, Time Magazine gives us Snack Attack!  Americans Are Eating More Between Meals.  The information here comes from a recent study on Americans’ eating habits over the past 30 years.  Among the findings:

“Analyzing data from four nutritional surveys conducted between 1977 and 2006 by the U.S. Department of Agriculture and the Centers for Disease Control and Prevention, the study found that Americans went from eating an average 3.8 meals and snacks a day to 4.9 a day over the last three decades — a 29% increase. The average American now consumes about 2,375 calories per day, about a third more than in the ’70s.”

A lot of this makes sense.  Look at our opportunities to eat (another factor examined in the study).  We’ve had food in the grocery store checkout for years but now we’ve got food at the Bed Bath & Beyond!  I can get candy at Home Depot!  I can remember when gas stations had a gumball machine and a cigarette machines–and that was it.  Now the average gas station is packed to the gills with weird, low-nutrition/high calorie snack food.  Garbage is everywhere and we’re eating it.

Your Brain on Weight Loss

The Huffington Post gives us Weight Loss Psychology: Why Your Brain Might Be Holding You Back.  I love this stuff because I’m fascinated by brain function especially at it pertains to exercise.  Anyone who’s tried to lose weight has discovered several things.  First, everyone knows how to do it: Eat less.  Exercise more.  Easy?  No way!  The other thing we’ve all learned is that though weight loss is easy in concept, it’s diabolically difficult to pull off.  There’s way more than a simple desire to lose weight.  Our short-term pleasure typically wins out over our long-term healthy goals.  I like this description of the struggle:

“What drives our behavior is not logic but brain biochemistry, habits and addiction, states of consciousness and what we see people around us doing. We are emotional beings with the ability to rationalize — not rational beings with emotions. If we are stressed, depressed or addicted, no matter how good the advice we are given, chances are that we will not be able to act on it. The more primitive, emotional brain generally has precedence over the newer, more rational brain.”

The article also gives suggestions to help address weight loss:

1.) Focus on a change of heart, not a change of mind. Losing weight through changing what and how much you eat doesn’t happen because you rationally decide to lose weight. You have to have a change of heart; that is, you must get in touch with your deepest, heartfelt desires.Your motivation may not be positive. Indeed, it may stem from a fear of loss. For example, you may not want to get sick. Or you may not want to be ostracized. To get in touch with your motivation, think about the negative consequences of not changing as well as the positive ones. Getting fit must become a priority and your life must be organized accordingly. Nobody can change you but you, and once you’ve made the changes, you need to stay focused. Successful individuals keep their motivation in the forefront of their minds all the time.

2.) Practice self-discipline. Self-control is a muscle that, like other muscles, needs exercise and strengthening. Change doesn’t happen because you want it to happen. Each time you resist temptation, you are developing greater self-control. Success breeds success. Facing down temptations builds strength for future decision moments. Some of my clients throw away their favorite food as a symbolic act that shows they have control over the food and not the other way round.

Self-discipline is required for behavior change, but does that mean that the lack of self-discipline causes obesity? No. That would be like saying aspirin helps a headache go away, so headaches are caused by a lack of aspirin — which is nonsense!

3.) Eliminate or reduce sugary, fat-laden foods. Such foods create physical changes at a cellular level that alter how our brains and bodies react. When analyzing your level of addiction, consider both physical dependence (changes at the cellular level) and psychological dependence (the habitual repetition of a behavior in an attempt to satisfy an emotional need). For example, how often do you use a sugary treat to lift your spirits?

What is often misunderstood is that these dependences exist on a continuum. You can be mildly, moderately or severely dependent, and the degree of dependence determines how difficult it will be to change.

4.) Make history your teacher, not your jailer. You can learn from your mistakes. Instead of [beating yourself up] when you fail to keep your promises to yourself, seek to gain self-knowledge so you won’t repeat the error. No one is perfect. Be sure to acknowledge what you are doing right, not just what isn’t working.

5.) Surround yourself with friends, family and colleagues who will support your effort. Getting fit and losing weight absolutely require others. Although you alone can make the changes you need to make, you can’t make the changes alone. Not only in terms of eating, but in all areas of our lives, we are much more influenced by other people than we imagine. One of the most potent forces for positive change is the emotional support of the individuals who surround you.

You must, however, ask for the support you need. Don’t assume that others know what would be most helpful to you. Similarly, you need to avoid those people who aren’t on the same page as you. Social pressure can work for you or against you. Hang out with the right people.