Tuesday 1 August 2017

Overcoming Pain - Perception of Control

There are many psychological facets that result from or contribute to pain, one such as I described in last week's post. It's important to remember, though, that no trait is independent of one another; they'll occur concurrently and are interrelated. That being said, I'll continue to break it down to help both my readers and myself understand the psychology of pain better in order to overcome it.

After a large sample of patients were interviewed, another of one the biggest predictors of chronic pain that was found was poor perception of control.

In a nutshell, when individuals are in pain, (even if it's only acute pain) and they don't have high self-confidence in their ability to recover from it, the result can be that those misconceptions may come true. Why is this?

To quote the above study, perception of low personal control can "lead to passivity, inactivity, reduction or cessation of coping attempts, avoidance of specific behaviours and poor adherence with advice". It may sound like a deplorable attitude toward one's own body and wellbeing, but if you think about it, it makes sense. If you were a mechanic and were told by your boss to do everything you could to repair a car while every inherent ounce of your gut told you that it couldn't be done, would you still put in the same amount of effort in the attempt?

This fact isn't helped by the fact that so many individuals go through the rungs of  other medical professionals who use language that enforces these beliefs!
  • "You'll have this for the rest of your life."
  • "It's only going to get worse with time."
  • "You have the knees of a 70 year old."
  • "You need to see me every week if you want to keep walking."
"My elbow hurts."
"We'll have to cut it off."
No wonder why so many people plateau in their rehab! Everyone is telling them they can't do it and bringing them down!

As an Athletic Therapist, specializing in exercise rehab, I can provide one of the best methods to help my clients boost their confidence in their recovery. What better way is there to increase their perception of control over their health than by giving them the tools that allow them to do the work themselves? (In contrast, if an individual only sees a clinician that massages or adjusts them without any other intervention, that puts all the control of their recovery into that clinicians hands.)

To help the matter, I make very sure to educate my clients on what every single exercise that I prescribe is doing; which muscle it's helping, what this stretch will do, how it replicates their daily activities. Clients need to know exactly how much power they have in propelling their own recovery. They want to know how their bodies are working. They need to hear less about what their therapist can do for them and more what THEY can do for them.

At the same time, I'm careful with my language. Essentially, it's important to put an optimistic spin on things in order to maintain a positive outlook and efficacy.
  • "This muscle could be stronger," instead of, "This muscle is weak."
  • "We need to get your hip moving better," instead of, "Your hip keeps getting stuck.
  • "You'll feel better the more you do your exercises," instead of, "If you don't do your exercises, you'll be in more pain."
See what I did there?

This topic was written with consult and collaboration with Alison Quinlan, a Sports Behavioural Consultant in Victoria, BC who is also pursuing continued education in dietetics. Follow her on Twitter and visit her website and blog to see some of her own authored articles. 

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