In Can Stress make Pain Immortal? we discussed how our emotional state and stress affects how much pain we experience. This article discusses how the absence of emotion regulation skills increases the risk of abusing opioids by taking them other than as prescribed. Abusing opioids increases the risk of addiction and overdosing.
What is Emotion Regulation?
Emotion regulation involves thinking about what you’re thinking, why you’re thinking what you’re thinking, and asking yourself questions like:
Is this thought true?
Is there a better way to view this situation?
What is the silver lining in this situation?
Have other people been in a similar situation and experienced a good outcome?
The goal of positive reappraisal is to identify a perspective that is less stressful but true enough that you can believe it could happen. Once you identify a less stressful perspective, do what you can to adopt the perspective as your own.
Chronic pain can leave a person in despair, feeling that they don’t have a way to escape the pain. These types of thoughts make things worse because they increase the amount of stress experienced. I remember when plantar fasciitis first made walking difficult every morning. Not only did I worry that every morning for the rest of my life would be that way, I made it even more stressful by imagining that it would get worse. I remember imagining myself with a walker next to the bed someday. I was in my 30’s and already mentally making myself old. I wasn’t doing myself any favors.
Learning that there was a lot I could do to improve my situation allowed me to discard those mental images. I also learned that the less worried I was, the less pain I felt. I wasn’t doomed to spend the rest of my life enduring painful mornings. Now, decades later, if a new pain shows up, I don’t assume it is permanent. I assume it is temporary and immediately begin identifying things I can do to ease my pain and prevent it from happening again.
You can control how you perceive a situation. In this moment, that’s the choice you have. It is what you can control. Increased stress increases pain and inflammation. Beating an opioid addiction is easier when you can exert some control over the amount of pain and emotions you feel.
Emotion regulation skills provide a host of benefits. Reducing the amount of pain you experience and increasing the amount of time you spend feeling good are just the tip of the iceberg. This is a skill that is worth learning. It pays daily dividends. One of the biggest benefits of learning emotion regulation skills is avoiding some of the bad things that are more likely to happen to people who don’t have these skills.
Deficits in Emotion Regulation Skills
Individuals who experience chronic pain and don’t use positive reappraisal practices, experience more negative emotions and have an increased appetite for consuming opioids. Even when pain severity and emotional distress are considered, individuals who are more skilled at regulating their emotions experience more positive emotions than those who don’t use emotion regulation strategies.
I recently read a scientific paper, Pain in Times of Stress, that talked about the relationship between stress and pain:
A crucial factor for the occurrence of stress-induced analgesia and stress-induced hyperalgesia in humans is the influence of psychological and cognitive elements on stress and pain processing, which will in turn determine the outcome of the pain response.
Analgesia means you experience less pain. When you learn how to feel better just because you want to, without drugs, you can reduce the amount of pain you experience by changing your thoughts.
For example, anxiety increases pain. Distracting an anxious person reduces their experience of pain. A person’s habits of thought have a significant influence on how much pain they experience. Someone who leans toward expecting the worse experiences more pain than someone who leans toward expecting a positive outcome. The severity of the injury is not the determining factor in how much pain is experienced. A sudden unexpected injury can feel much worse than an anticipated injury even when the actual injury is the same.
Maladaptive Emotion Regulation: Two Paths to Pain and Addiction
Maladaptive emotion regulation contributes to abuse of opioids through two separate pathways. First, individuals who use unhealthy emotion regulation processes experience more pain so they are more likely to take more opioids for pain.
Secondly, the absence of healthy emotion regulation skills increases the amount of negative emotions they experience. This increases the risk that they will use opioids to counteract negative emotional states. Individuals who have healthy emotion regulation skills will use those skills to improve their emotional state without the use of drugs.
A Good Beginning
It doesn’t need to be overly complex. You can simply use deep diaphragmatic breathing to help you relax and gain temporary relief. Shallow breathing that doesn’t involve expanding and contracting our stomach increases anxiety. Slow, deep breaths can relieve anxiety and reduce pain. This is something you can do anywhere, at any time, and no one will be the wiser.
You don’t have to be a helpless victim to chronic pain. There are science backed methods you can use to make your life feel better.
Addicts tend to relapse when the level of stress they experience increases beyond their ability to manage it. Regulating emotions and learning stress management skills reduce the risk of relapsing. Recovering opioid addicts frequently tell me that they feel more capable of preventing relapse once they know how to reduce stress using the power of their mind.