One thing everyone should know about pain

Pain has been defined as a ‘complex constellation of unpleasant sensory, emotional and cognitive experiences provoked by real or perceived tissue damage and manifested by certain autonomic, psychological, and behavioral reactions’.[1] Simply put, pain is essentially a defence mechanism: it is a warning signal telling us that something is wrong. All over the body there are sensory neurons known as nociceptors that alert us to potentially damaging stimuli. However, pain does not come from nociceptors; all pain comes from the brain.

The way our brain processes pain is complex, but we don’t need to know the detailed workings. There is one thing, however, that we should know about pain:

We can shift our perception of pain, and this shift will allow us to use pain in a positive manner.

Before we can initiate this shift in our perception of pain, we need first to have a basic understanding of how we perceive pain. Perhaps the easiest way of explaining this is to look at, and compare, the pain suffered by two very different groups – athletes and patients – and start by asking a very simple question:

Why is the pain suffered by patients struggling with serious illness feared and hated, yet similar, or often higher, levels of pain suffered by athletes frequently loved and sought out?

Some may argue that you can’t compare the two groups as the pain felt by the athlete is easier to bear because he or she knows it is short lived. But for countless athletes there is only a break in pain, as their training requires them to endure extreme pain on a daily basis.

One of the key factors for the difference between the two groups is their interpretation of the warning signals.

An excellent example of how interpretation of warning signals directly affects the actual pain we feel is explained by Lorimer Moseley during a TEDx seminar in Adelaide entitled ‘Why things hurt’.[2] In brief, the level of pain we feel relates directly to the level of danger we perceive from it.

In the following example, for simplicity of explanation, the athlete is female and the patient male.

The athlete on a hard training run knows this pain; she does not fear it because she has learnt that all it can do is make her stronger. Aware that a training run will only help her reach her goal if she experiences this pain, she wants the pain, and will push herself harder, seeking it out. The top athletes take this approach to the extreme: the former world champion boxer, Mohammad Ali, stated that he had to experience a level of pain before he considered his training session to have even started.[3]

In contrast, the patient believes pain is a warning that damage, has, or is, taking place. He desperately wants it to stop and becomes increasingly distressed by it, focussing on it and, as a result, increasing the intensity of the warning signals, thereby increasing the pain itself.

Another factor responsible for the difference between the two groups is the effect that enduring pain has on self-worth and self-belief.

For athletes, the act of putting themselves through extreme pain increases self-belief and self-worth. It’s a natural reaction as each training session is a challenge, and each time athletes meet, and exceed, that challenge by enduring greater pain, the greater the sense of control, and the greater the confidence in themselves and their physical abilities.

In contrast, the more pain a patient endures, the more there will be a tendency to feel the illness is taking over, and that control is being taken away. That individual patients can do nothing about this – particularly if medication is having little effect – can result in their adopting a victim-like mentality, with the pain steadily increasing, as self-worth and self-belief decline. 

The pain is similar for both groups, but how it is interpreted is making a difference to far more than the warning signals.

The first step for the patient in changing his perception of pain is to establish that everything medical is being done to ensure the root cause is identified and appropriate action taken (correct diagnosis is crucial). The second step is to ensure that appropriate pain relief is given. If the patient does all he can to take these steps, then there is nothing more that personally can be done about the pain (there is no need to pay attention to the existing warning signals of illness/physical trauma as they have been passed over to medical experts to deal with). All that remains is the pain itself. Acknowledging this then allows the understanding that the pain now becomes, for the individual patient, a challenge, and with that challenge comes a decision as to how the pain is faced, how it is endured. In the understanding that there is now a choice, the patient regains a level of control.

Unlike the athlete, the patient won’t see pain as way to increase performance, but by shifting his perception of it, increased self-belief and self-worth are possible. This could be crucial in getting through the day, but the patient can also use these increases in self-belief and self-worth to fight for some other goal in the future.  

The more the patient believes in himself, the more he is able to believe in recovery.

Research on the placebo effect provides substantial evidence that the greater our belief in recovery, the more our body works towards recovery.

What then is the mental process for the patient to take something from the pain, allowing it to be used?

Firstly, the power of belief has to be acknowledged. This may require some basic research into the placebo effect. It also has to be understood how important self-belief is in this ability to believe. Then some form of mental action needs to be taken – like visualization – to help with the belief in recovery. It doesn’t have to be recovery specifically that is visualized; just as long as there is a significant goal that needs self-belief and self-worth in order for this goal to be attained.

The patient then has to stop resisting the pain, to stop wishing it would end; instead accepting the pain as a challenge and that he is up to the challenge – a sense that it can, and will, be handled. As soon as this fact is acknowledged, the fear of pain is lost. This is the point where the relationship with pain changes, and the patient can begin to focus attention on what is being taking from the pain: that by enduring it without fear, self-worth and self-belief are being built, and the greater the pain, the greater the potential to achieve individual goals.

Using this approach is not easy. The pain can, and will, hurt us, but the more it does, the stronger we can become mentally. It will work this way as long as we believe it will. By believing we are taking something positive from pain, we are. 

[1] Terman G.W. and Bonica J.J. (2003) ‘Spinal mechanisms and their modulation’. In: Loeser J.D., Butler S.H., Chapman C.R. and Turk D.C. eds. Bonica’s Management of Pain. 3rd ed. Philadelphia, Pennsylvania, USA: Lippincott Williams and Wilkins; p.73

[2] Moseley, L. (2011) [Online lecture] ‘Why things hurt’, TEDx Program, Adelaide, November, Accessed YouTube November 2011: https://www.youtube.com/watch?v=gwd-wLdIHjs

[3] Ali, M. and Durham, R. (1975) The Greatest: My Own Story, New York, Random House

Anton FitzSimons is a former soldier and award-winning business graduate. To combat the fear and loss of control he experienced with illness, he developed a strategy to exploit the placebo effect. Extreme Mental Combat is characterized by its simplicity and use of ruthless tactics to attain, and maintain, total belief in a desired future. The use of pain to build self-worth and self-belief is seen as a key part of the strategy and FitzSimons’s experiences of using pain are described in detail in his fourth book on the strategy: Extreme Mental Combat (2015).

How to use the mind to fight cancer and serious illness

Why we feel fear

When our lives are under threat our primordial instincts take over and we feel fear. In ancient times we needed fear on a regular basis: it triggered the release of cortisol and adrenaline from our adrenal glands; it gave us the strength to run from, or fight, the wild beasts that were intent on killing us. Today, in the external situations that involve action, we can usually channel fear. But, in the internal fight against illness, fear – which was, and in some situations remains, a key survival emotion – now works against us.

Why illness-related fear is so destructive

We are not designed to be inactive when our life is under threat. When we leave the fighting totally in the hands of others we tend to lose direction – in our actions and in our thoughts. The fear remains and, if our condition doesn’t respond quickly to treatment, becomes increasingly destructive. It keeps us awake at night, it erodes our self-esteem; unable to fight we feel our lives are out of our control; we feel victims.

How we can fight back

The placebo effect points the way to how we, as individuals, can fight illness with our minds. Research provides us with evidence of the benefits of believing in recovery. Belief boosts the immune system; it triggers all kinds of healing mechanisms and potentially activates the unknown resources of our ‘inner pharmacy’ and the production of killer cells to attack illness. Believing in recovery also cancels out fear, and reduces the risk of other destructive emotions that often accompany illness such as depression and despair.

A question of belief

However, the efficacy of the placebo effect is based on belief resulting from external deception as opposed to taking a deliberate decision to believe. Even if we did take that decision, how exactly would we believe? Whilst there are a multitude of self-help books out there telling us we should believe, most fall short on explaining how to believe. They leave it up to us, as if justifying why we should believe is enough; probably because belief is seen as a feeling, something that has to come naturally. The books which try to give an insight into how to believe are over-complex with key factors obscured by information that is of no interest to someone who is looking for a way to fight. When we are in pain and discomfort, things need to be simple. Besides, for those with an unfavourable prognosis, immersed in the destructive thoughts and emotions of life-threatening illness, the very idea they can somehow defy reality and attain total belief in recovery will seem fanciful.

Extreme Mental Combat was developed under precisely those conditions, and shows us a straightforward route to attain total belief in a desired future, irrespective of how unrealistic that future may appear.

How we attain belief - stage one - redirecting the mind

The strategy works by redirecting the mind. With illness, as opposed to trying to imagine a future when we are well, the start point is to identify an image that encapsulates the achievement of a great goal in the future – a goal for which attainment of recovery is necessary. The focus then is on the goal, recovery becoming a by-product of attaining that goal. The identified image is opened out into a short film of imagery and sounds to be visualized as often as possible. This is the first stage to redirecting the mind and is an art frequently used by magicians, commonly known as misdirection: what the eyes see and the ears hear, the mind believes.

The key to believing - the visual cortex

By examining and rating her patients’ visualizations, psychologist Jeanne Achterberg* predicted, with 93 per cent accuracy, who would recover and who would get worse or die. The recovery group were those who had a greater ability to visualize vividly, convincingly and regularly. The misdirection, correctly referred to by a number of magicians as redirection, occurs because the brain’s visual cortex (the area responsible for processing images) cannot tell the difference between what is vividly imagined and reality.

Stage two - rediscovering our inner child - the art of pretence

The second stage is via the stratagem of pretence, which requires us to act and think ‘as if’ we are going to attain our goal. It is based on the premise that if we pretend a reality for long enough then we naturally start to believe it. The two stages take considerable mental effort, but by persevering with them our self-worth and self-belief are heightened. The feeling of retaking control adds to this. The increased self-belief, relentless visualizing and pretence all work together to redirect the mind into accepting the reality of our desired future. The mind is viewed as a computer, one which will eventually have to respond to data constantly fed into it.

Ruthless perseverance

A crucial aspect to the strategy is that the visualizing and pretence continue beyond the point where we would ordinarily stop. The ability to persevere comes down to the use of extreme tactics normally employed in wartime; specifically, when a policy of total war is adopted – one where every available resource is utilized. Coercion and the most powerful emotions, such as love and shame, are employed to create drive.

Our fight - our future - our choice

It is clearly not for everyone. It is a personal decision to decide whether we are going to leave the fight completely in the hands of the doctors, or if we are going to join in the fight. There will be some who, particularly if their prognoses are favourable, will be happy to leave everything to others. But if we do choose to fight with our minds, learning the basics of the most extreme strategy could be a starting point to adapting and creating our own strategies.

 *Achterberg, J and Lawlis, G F (1980) Bridges of the Bodymind: Behavioural Approaches for Health Care, Champaign, III: Institute for Personality and Ability Testing

Anton FitzSimons is a former soldier and award-winning business graduate. To combat the fear and loss of control he experienced with illness, he developed a strategy to exploit the placebo effect. Extreme Mental Combat is characterized by its simplicity and use of ruthless tactics to attain, and maintain, total belief in a desired future.

Extreme Mental Combat (2015) is available on Amazon now