Session 7: Pain Behavior
Overview
I. Review of Homework – Reframing Worksheet
II. Defining Pain Behavior
III. What Can Influence Pain Behaviors?
IV. What Happens When We Use Pain Behaviors?
V. How Can We Influence Cycles That Occur When We Use Pain Behaviors?
VI. Homework – Changing Pain Behaviors
VII. Relaxation Technique – Relaxation Response
II. Defining Pain Behavior
III. What Can Influence Pain Behaviors?
IV. What Happens When We Use Pain Behaviors?
V. How Can We Influence Cycles That Occur When We Use Pain Behaviors?
VI. Homework – Changing Pain Behaviors
VII. Relaxation Technique – Relaxation Response
Session 7: Pain Behavior
I. Review of Homework – Reframing Worksheet
Reframing Worksheet
How was this exercise useful in reframing irrational thoughts?
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How can you use this exercise in the future?
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II. Defining Pain Behavior:
A. Definitions
Pain – is not easily definable, because it varies from individual to individual and from culture to culture. Webster’s dictionary defines pain as unpleasant sensation, occurring in varying degrees of severity as a consequence of injury, disease, or emotional disorder.
Behavior –ones’ actions or reactions, which can be observed or heard by others.
Pain Behavior – the things people do to communicate that they are suffering.
Behavior –ones’ actions or reactions, which can be observed or heard by others.
Pain Behavior – the things people do to communicate that they are suffering.
B. Discussion
1. Is a feeling a behavior? Is an attitude a behavior?
2. One interprets feelings/attitudes by behavior but they are not.
2. One interprets feelings/attitudes by behavior but they are not.
C. List examples of behavior.
D. Discuss the differences between pain and pain behavior.
D. Discuss the differences between pain and pain behavior.
III. What Can Influence Pain Behaviors?
1. Pain behaviors serve a function at first. (i.e. Limping and Guarding)
2. They then can cause problems.
3. People do not show pain behaviors just to “get attention.”
4. You should ask yourself, “At this point in time, is the pain behavior helping me or hurting me? Do I want to change it? “
5. If something desirable happens following a pain behavior, that pain behavior is more likely to occur in the future. If something undesirable stops following a pain behavior, that pain behavior is more likely to occur in the future. Ignoring a pain behavior should decrease the occurrence of that behavior.
2. They then can cause problems.
3. People do not show pain behaviors just to “get attention.”
4. You should ask yourself, “At this point in time, is the pain behavior helping me or hurting me? Do I want to change it? “
5. If something desirable happens following a pain behavior, that pain behavior is more likely to occur in the future. If something undesirable stops following a pain behavior, that pain behavior is more likely to occur in the future. Ignoring a pain behavior should decrease the occurrence of that behavior.
Silently answer the following questions:
1. What do others do when you are hurting?
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2. What do you not do because of pain?
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3. What would be different if pain were significantly decreased?
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4. What do others do when you are being more active?
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IV. What Happens When We Use Pain Behaviors?
A. Points about Pain Behaviors
1. Pain Behaviors are ambiguous – their meaning is not clear to the observer.
1. Pain Behaviors are ambiguous – their meaning is not clear to the observer.
· Yet they communicate something.
· What are some possible meanings of pain behaviors?
1. I hurt.
2. Help me
3. I need you
4. Leave me alone
5. Come closer
6. I can’t do _____.
7. Don’t expect much from me today.
Problem: People may misinterpret your own Pain Behaviors.
· What are some possible meanings of pain behaviors?
1. I hurt.
2. Help me
3. I need you
4. Leave me alone
5. Come closer
6. I can’t do _____.
7. Don’t expect much from me today.
Problem: People may misinterpret your own Pain Behaviors.
2. Pain Behaviors are very powerful – they grab attention, and people respond to them.
· Physiological responses to pain behaviors.
· Do pain behaviors elicit responses from others?
Problem: People may not respond the way you want.
· Do pain behaviors elicit responses from others?
Problem: People may not respond the way you want.
3. The environment influences behavior:
. Church Vs. Bar
· Restaurant Vs. Home
· People’s responses to us influence our mood and behavior.
Problem: People may not respond the way you want.
· Restaurant Vs. Home
· People’s responses to us influence our mood and behavior.
Problem: People may not respond the way you want.
B. These concepts can help us understand what can happen in our relationships to other people around pain. The following is two kinds of cycles:
Patient
Other
Pain Behaviors
Sympathy
Take Over Activities
Take Over Activities
Pain
“Rest” “Don’t Do That”
Depressed
“I Can’t”
Irritated
Decreased Activity
“I Can’t”
Irritated
Decreased Activity
Patient
Other
Pain Behaviors
“Burn Out”
Ignore
Ignore
Pain
Resentment/Anger
Leave You Out
Leave You Out
Depressed
Resentment
Irritated
Decreased Activity
Resentment
Irritated
Decreased Activity
Tension
Do these pain cycles look familiar to anyone? Please give examples.
V. How Can We Influence Cycles That Occur When We Use Pain Behaviors?
You can influence pain cycles. You can intervene anywhere in cycle where you think it would most positively impact the problem.
Pain is difficult to influence directly, but you can influence the pain behaviors you engage in.
Pain is difficult to influence directly, but you can influence the pain behaviors you engage in.
1st - Identify your pain behaviors (i.e. limping, grimacing, etc.)
2nd - Eliminate pain behaviors by retraining.
2nd - Eliminate pain behaviors by retraining.
What are some ideas for changing pain behaviors?
1. PT/OT
2. Good Posture
3. Decrease Medication Use
4. Avoid Lying Down
5. Avoid Talking About Pain
6. Get Involved in Nonpain Activities
7. Remind Each Other
2. Good Posture
3. Decrease Medication Use
4. Avoid Lying Down
5. Avoid Talking About Pain
6. Get Involved in Nonpain Activities
7. Remind Each Other
Remember:
We are not saying that people engage in pain behaviors to get attention. Pain behaviors are not good or bad in and of themselves. The question is, are the ones I show helping me or hurting me? If hurting, then it is time to change.
You can also influence other people’s responses to your pain behaviors.
We are not saying that people engage in pain behaviors to get attention. Pain behaviors are not good or bad in and of themselves. The question is, are the ones I show helping me or hurting me? If hurting, then it is time to change.
You can also influence other people’s responses to your pain behaviors.
1. Ask them to ignore.
2. Be affectionate regardless of pain behaviors.
3. Be clear in your communication. (Assertiveness).
2. Be affectionate regardless of pain behaviors.
3. Be clear in your communication. (Assertiveness).
VI. Homework – Changing Pain Behaviors
Instructions
· Write down some pain behaviors that you typically exhibit.
· Decide whether or not these pain behaviors are helping or hurting you.
· Focus on the pain behaviors that are hurting you.
· Write down how you will replace those pain behaviors? Write down a date for implementing your new strategy.
· Decide whether or not these pain behaviors are helping or hurting you.
· Focus on the pain behaviors that are hurting you.
· Write down how you will replace those pain behaviors? Write down a date for implementing your new strategy.
VII. Relaxation Technique – Relaxation Response
Get into a comfortable position you may either lie down on the floor or sit up straight in your chair. Make sure not to cross your legs or arms.
Process Questions:
Process Questions:
Describe how relaxed you feel.
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What can you do to make yourself feel more relaxed while completing this activity?
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How will you use this activity in the future?
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