Psychological Self-Help

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minorities, and rural groups (Rebecca Clay, APA Monitor, April, 2002).
Try to sidestep these barriers if you can. 
Research confirms that psychological treatment--biofeedback,
relaxation, and cognitive therapy--can effectively reduce headaches
without side effects (Blanchard, 1992). Of course, aspirin, drugs, ice,
heat, massage, and hypnosis can reduce pain too. Acupuncture helps
some people; even sex relieves a migraine for 15-20% of sufferers.
Drugs are effective for many sufferers but they may be depended upon
excessively. Hypnosis is surely under used (see chapter 14). There is
no magic solution but several techniques may make pain more
tolerable: (1) have a hopeful attitude, "I want to...I
something about this pain," (2) focus attention away from the pain,
perhaps to pleasant memories, exciting plans, socializing, games, TV
or music, (3) use relaxation (chapter 12), (4) try self-instructions and
stress inoculation (chapters 11 & 12), and (5) if you have a sense of
humor, use it now. (6) Much like self-hypnosis, mental imagery can
help: (a) imagine that the hurt leaves your body, e.g. "flows out your
toes," or is no longer a part of your body, e.g. "the dentist is drilling
out the pain," (b) imagine being a popular athlete or war hero who is
very tough and has done something great, (c) imagine Novocain being
injected into the hurt and the area becoming more and more numb, or
(d) imagine studying the pain in great detail, e.g. notice how the pain
is sending an important message, it is demanding attention to get me
well, the muscle or artery is saying "I'm healthy and trying to help but
I need more oxygen," the hurting part is getting what it needs to heal,
etc. You have to create your own fantasies; only you can discover how
to use fantasy to reduce pain (Kleinke, 1991). 
Clearly, painful disorders, such as low back pain, frequently involve
psychological factors; they often have a long history of various
physical complaints besides pain, even more alcohol dependency and
impaired daily functioning (Bacon, et al., 1994). The best predictor of
a bad back at work is job dissatisfaction and stress, not physical
strain. Sarno (1994) says back pain is a natural (painful but harmless)
reaction to emotions, especially perfectionistic tendencies. The pain
distracts us from life's troubles. He suggests that the sufferer
concentrate on dealing with his/her life stresses and not on the body
pain. The treatment often involves changes in your attitudes and
thinking about your emotional problems which result in well planned
self-help efforts. The difficult part is convincing yourself to assume the
responsibility for your own improvement (not drugs or surgery) and
then figuring out what needs to be straightened out in your life. Telling
yourself how awful and unbearable the pain is or how weak and
helpless you are is harmful, not helpful. By the way, the success of
spine surgery is influenced in large part by your psychological health;
so, if emotions caused the pain in the first place, don't expect surgery
to help. 
Chronic pain victims are frequently depressed; they tend to be
passive and unexpressive of emotions but, in general, pessimistic
"awfulizers." If they blame themselves for the pain, they experience
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