Pain is a physical event. Moreover, when there’s an injury or any type of organic damage, it’s necessary to intervene to treat it. However, did you know that our minds also play an important role in increasing or reducing our suffering?  In fact, some of the most curious phenomena are the so-called pain behaviors.

Pain behaviors are the reactions, actions, or behaviors that we carry out as a result of pain or discomfort. For example, putting pressure on the painful area with a hand, adopting certain postures to mitigate the sensation, or avoiding certain activities when we’re in pain. These kinds of behavior seem logical. Indeed, to start with, they can be helpful. However, in the long run, they might make our discomfort last longer.

Pain behaviors

Normally, we tend to think of pain as something purely physiological. For instance, cramps, burning or itching sensations, pressure, or tension in a specific area. Nevertheless, in reality, it has several other components:

The cognitive aspect

This refers to the thoughts, ideas, and beliefs that are generated and maintained around pain and illness. They’re not the same in all of us.

For example, there are those who adopt a catastrophic attitude that accentuates the common negative vision we tend to have of pain. These people constantly ruminate about it and can’t get it out of their minds. The attention they pay to it generates a greater sensitivity in them to the pain itself as well as a more intense perception of it.

The emotional or affective aspect

This is related to the emotions generated by pain. Obviously, pain isn’t pleasant for anyone, but there are those who develop excessively negative effects. For example, they feel helpless and unable to control the ailment, exaggerate the threatening properties of the pain stimulus, and feel that they can’t do anything about their situation.

These associated emotions amplify their pain and also add a component of psychological suffering.

The behavioral aspect

Finally, all pain has a component related to behavior. It’s reflected in the actions we take in this regard.

This can range from touching the area that hurts, verbalizing how sick or sore we feel, visiting the doctor, taking medication, or limiting our movements or daily activities. These are all so-called pain behaviors.

The role of pain behaviors

All of these actions occur naturally when we’re in pain. It’s normal for us to carry them out and they can help us feel better, obtain comfort, or find solutions. However, if we over-commit to them, they can become a problem.

Those who adopt this type of pain behavior the most are more likely to adopt a ‘sick role’. This has certain consequences. Although in the face of specific pain, this kind of behavior may not have great relevance, if we’re talking about a chronic condition, it can aggravate the situation and disability.

Those who adopt these behaviors and take on the ‘sick role’ tend to suffer more pain. Moreover, they experience more symptoms of anxiety and depression, higher degrees of disability and inactivity, and worse employment status. These results have been found when analyzing patients with conditions such as low back pain, rheumatoid arthritis, fibromyalgia, and migraine.

In view of these findings, psychotherapeutic strategies have been designed to reduce or eliminate pain behaviors in order to reduce discomfort and improve the quality of life of patients.

Psychotherapeutic interventions

The behavioral approach to pain focuses on modifying the behaviors associated with discomfort. Thus, the patient is urged to progressively eliminate the reactions they’ve developed.

These procedures are known as operant techniques. They’re based on the principles of instrumental conditioning or the idea that behavior is repeated and maintained because it’s reinforced in some way.

From this point of view, we must bear in mind that pain behaviors are often linked to some type of secondary benefit. For example, the sufferer gets attention, affection, and comfort from their loved ones. Or, they can free themselves from unpleasant activities, like working or doing housework. Unconsciously, they might understand that the ‘sick role’ provides them with advantages, and thus continue to embody it.

Therefore, conscious commitment and work to reverse this situation are sought. For example, the sufferer should:

• Stop verbalizing their discomfort.
• Eliminate their facial and body gestures of pain.
• Avoid situations that ‘welcome’ the disease. Resume and restore all their daily activities that have become limited (as far as possible).
• Introduce physical exercise to their routine.

Through these gradual programs, each advance is reinforced and the objective is achieved. While a comprehensive approach that doesn’t neglect the physical and physiological aspects of pain is still necessary, working in the other areas (more specifically, the behavioral one) promotes a better quality of life.

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