Diabetes Self-Management Blog

Last week, we reported on ways to help or relieve chronic pain by treating the part of the body that hurts. This week, we’ll discuss some effective things you can do to treat pain with your mind.

Remember that all sensations, whatever their cause, are felt and interpreted in the brain. Feelings, thoughts, and other sensations get mixed with the pain signals and determine how much you hurt.

In wartime, soldiers’ wounds are often less painful than the same wounds would be in a civilian. Why? Because the wounds signify that the wounded soldier will soon be going home, but the civilian’s injury is a source of fear and anxiety. This is known as the “Anzio effect,” after the battle of Anzio, where it was first noted.

When pain is a source of fear, anger, or grief, it usually hurts more. Cancer patients may experience worse pain, because they fear it means their disease is worsening or that they may be dying. How we think about our pain has a major effect on how bad the pain feels. So what can we do about it?

Mental Pain Relief

  • Distraction—A reader called Whatnext wrote: “Basically: if you can’t do anything about the pain, what you can do is change the way you think about it. In my case, I have decided not to think about it, as much as possible. I realized, for example, that when you’re doing something like reading an interesting book, or walking and talking with a friend, you were not consciously feeling pain.”

    And Jeanne in Reno, who has terrible neuropathy, wrote “I keep my mind busy with genealogy during the day. I play sudoku and crosswords at night until I can fall asleep.”

    This technique is called distraction. The Chronic Disease Self-Management Program developed at Stanford teaches several distraction methods—for example, counting backward by sevens, focusing on sensations in other parts of your body, listening to music, or trying to think of one fruit (or insect, or state, or whatever) that starts with each letter of the alphabet. Calgary Diabetic wrote that this program has been very helpful.

  • Laughter—Studies consistently show that laughter is an extremely powerful pain reliever.

  • Thought-changing—thoughts can make pain worse or better. We want to change unrealistically negative thoughts to more realistic, more balanced ones. For example, “I can’t stand this,” is a thought that will make things harder. Perhaps you change that thought to something a little less stressful and more accurate, like “This is really hard for me.”

    A thought like “I’ll never be able to work again with this pain” is in itself painful. But is it accurate? How do you know the future? Can you change to a better thought like, “I have a long way to go before I can work again?”

  • Guided ImageryImagery is a powerful self-healing practice. Here are two simple processes you could try. For both of them, you have to get very relaxed, perhaps with a relaxation tape, prayer, or progressive muscle relaxation.

    1. Glove anesthesia—Close your eyes and imagine that you have a large bowl or paint can full of a glowing liquid. This liquid is anesthetic—it numbs everything it touches. You dip your hand in the numbing liquid. Imagine the hand becoming numb. Give it time. Then rub your hand over the area that hurts. If the pain is in a place that’s hard to reach, just imagine that you, or someone else, is applying the medicine to the area.

    Do it once, twice, three times, and see how it feels. Give the medicine a chance to sink in. Keep breathing comfortably, and keep relaxing. Then do it again. You can’t overdose!

    2. Talking with your pain—In your mind, go to a comfortable, safe, beautiful place. Imagine what you see, hear, smell, and feel in this place. Then allow an image to come that represents your pain. The image can come in any form. If it’s too scary, tell it to go away and send someone else.

    When you can sense the image in some way, thank it for coming. Observe it and get to know it. What does it want from you? What does it need? What can you do to get some relief from the pain? Talk with the image until you get something you can use in your life. Perhaps make an arrangement to meet again. Then thank the image and let it go.

You will probably learn some strategies that will help. But there is much more you can do for chronic pain, including medications and pain programs, as we’ll get to next week.

Have any readers tried mental techniques like these? How have they worked for you? Have you learned from others who have written in? If you try the guided imagery, let us know how it goes. I really thank everyone who has written in about their pain experiences. You can see more about imagery and self-care at my Web site, www.davidsperorn.com.


  1. Dear David.

    I wonder if it would be of some use to get a continuous heart rate monitor and use it in a biofeedback to lower your resting rate ? Does this have a chance of succeeding?

    The reason being that some recent research has shown that resting heart is as important as blood pressure and cholesterol in avoiding coronary problems.

    This sounds plausible as in nature the longer lived creatures have slower heart rates and it is reasonable to think that if there is a longer pause the more chance the arteries have to recover from the hydraulic shock.

    Posted by CalgaryDiabetic |
  2. I wonder if this pain ‘helps’ will work for a person with bone-on-bone osteoarthritis who has excrutiating pain in both knees because cartiledge is gone and is not a candidate for surgery.
    any ideas out there?

    Posted by Renie |
  3. Hi, David. Thanks for mentioning my suggestions. I know that, for people in pain, this sort of “happy talk” sounds a little like nonsense. But, really, if we’re miserable and in pain, what on earth have we got to lose by trying to put “mind over matter?” If our desire is to have at least some measure of relief, and if other approaches have failed or, like Renie, are not available to us, what have we got to lose by trying some of these techniques?

    Posted by whatnext |
  4. The idea of using biofeedback to slow your heart makes a lot of sense. Can you get a heart monitor that beeps, so you don’t have to look at it all the time? Best would be something that displayed your rate as a color or wave on a screen. Good idea.

    Renie, my suggestions were for chronic pain - what you are having is acute pain from ongoing injury. HOWEVER, a lot of the strategies still work - distraction, heat, arnica cream, a dozen other things. The good thing is that your knee bones may polish themselves against each other, until they fit together better. The pain will then stop. So keep walking, not too much at one time, but regularly.


    Posted by David Spero RN |
  5. If you want a biofeedback device that helps promote relaxation, try the GSR2. Thats the one my doctor used to show me some relaxation techniques. You set it to a low sensitivity until you can make it stay quiet at that setting, then gradually raise sebsitivity levels. I just looked it up and they run about $75.

    Posted by Ephrenia |

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