EMOTION REGULATION AND PAIN
BY
NNAJIEGO DOROTHY NKIRUKA
INTRODUCTION
A BRIEF DEFINITION AND TYPES OF PAIN
Pain is a sensation that elicits unpleasant feelings in the mind, sensory, nerves, and body of an individual, with its occurrence in an emotional, bodily, or physical pattern. It is also associated with actual or potential tissue damage (Gorczyca et al. 2013). Its elicitation is of different kinds and degrees. Acute pain, which comes suddenly as a result of disease, injury, or inflammation is considered the least form of pain as compared to chronic pain. It can be diagnosed and sometimes often goes away. However, in some cases, acute pain can progress into a long-term situation, therefore, becoming more recurrent and extending into a chronic situation with resultant severe health conditions. Another important kind of pain is Psychogenic pain which is involved when our body expresses what our minds cannot handle, like feelings and the sense of knowing. Psychogenic pain is however difficult to treat unlike the pains directly caused as a result of injury or any kind of skin and nerve injury.
PAIN PROCESSES WITHIN THE BRAIN SYSTEM
The brain is an essential organ important in pain processes because, without activities within the brain, pain cannot be felt or perceived. There are different stages of pain processing in the brain. Transduction requires the actions of nociceptors to encode, recognize and characterize a painful stimulus (this could be mechanical, heat, or chemical) in order to trigger a corresponding defense response to the stimuli (Kleiman et al. 1987). The nociceptors stimulate nerve endings when pain is experienced, and this stimulus is transmitted to the brain regions where they are perceived. However, the activity of modulation in this pain process acts specifically to reduce the activities of the pain stimulus when they are being transmitted within the brain regions. Perception on the other hand is the final pathway in pain processing, and this part involves the combination of various sensory signals into a meaningful whole. The experience of pain is usually of two types of well-defined courses of pain including the signal coming from any part of the body and activating the anterior cingulate cortex(related to pain perception), as well as the medial prefrontal cortex and nucleus accumbens (related with motivation and emotion) parts of the brain (Wlassoff 2019).
EMOTION REGULATION OF PAIN
Emotion regulation entails the tendency and capacity of an individual to control or modulate their feelings (Goldin, 2008; Adrian et al. 2011). In the context of pain, it emphasizes the processes involved in modulating and expressing emotion in relation to pain. This pattern, however, encompasses both the cognitive, behavioral, as well as psychophysiological responses of individuals reacting to the pain stressor elicited (Dorn et al 2013).
The use of cognitive emotion regulation has been shown to modulate pain both on a short and long-term basis during pain perception among individuals. The application of cognitive appraisal, as a way of emotion regulation, enhances the well-being of individuals(Gross and John 2003; Troy et al. 2013) by the reduction of their negative perceived state which could also be a result of pain felt. Studies have shown the effectiveness of cognitive appraisal on physical pain (Thomas et al. 2014) when participants in the cognitive appraisal study were asked to dip their hands in a bucket of cold water. The study revealed their efficacy to withstand physical pain despite the long time their hands were immersed in the cold water. Also, cognitive behavioral therapy on long-term stressors (Gaab et al. 2013) has been shown to be efficient in the treatment of psychological and psychosocial difficulties (Campbell et al. 2006) including anxiety and depression. In as much as cognitive emotion regulation helps in the modulation of pain perceived, its long-term use, especially in the case of extended applications of cognitive behavioral therapy can be detrimental in individuals and lead to more chronic and disastrous health conditions.
The Physiological and behavioral aspects of regulating emotion during pain, especially relating to the use of a response-focused strategy have been shown to be effective in emotion regulation during pain, for instance in situations when an individual tries to withhold tears in public(Koechlin et al. 2018) can be a way of evading the experience of negative emotions and related internal experiences. Also, behavioral strategies of avoidance, withdrawal, and passive aggression in regulating pain have been shown to be of great importance in the relief of pain. Even Though this application has proven to be crucial, its maladaptive use could be a risk factor in the development of chronic pain. Thus the resultant effects of its continuous application can be more disastrous than beneficial. Another behavioral aspect like suppression which is used in managing the expression of pain has been shown to be associated with negative affect as a result of its habitual use (Gross and John 2003). Although individuals can successfully control the outward expression of pain, it does not stop the pain from having its effect, especially with regard to an increase in sympathetic arousal to a greater extent (Gross 1998). Studies on thoughts and pain have also revealed some crucial effects of suppression after its effort to reduce pain has ended. For instance, unwanted thoughts linger on during the post-suppression period (Wegner et al 1987) as well as the continuation of pain during the post-suppression recovery period(Cioffi and Holloway 1993).
It's important to note that with regards to physical pain which is a result of external sensation and other kinds of internalized emotional pain, the cycle of pain and emotions are interrelated, as pain is mostly influenced by our emotions since pain in some cases is not physically elicited but occurring in the mind. Take for instance the case of psychogenic pain which is more explained by the mind-body syndrome, this emphasizes the ability of the mind to create various kinds of pain in the body by contributing a great deal to the pain experience. Other instances can also be seen in situations where the mind has a specific kind of thought process while trying to express a certain kind of pain. As an example, a relaxed mind has the tendency to not feel much pain and stay longer when the hand is dipped in a bucket of cold water. However, the reverse may be the case in an angered mind. Thus, the quick removal of the hand in the presence of stimuli does not justify the pain perceived, rather the mind plays a huge role in this pain perception. Humans naturally experience real headaches, ulcer pains, and different kinds of pains but the fact remains that most of these could have an emotional origin.
In conclusion, pain exhibits a serious impact on the body system which is regulated using various kinds of emotional strategies. Although these emotion regulations, when applied to modulate pain, can be more disturbing than helpful in some cases depending on the severity of the task and the cognitive process the task is involved in. Also, emotions and pain tend to form an association, in some instances, the pain felt is sometimes more influenced by the mind and not the physical pain as perceived in all cases.
REFERENCES
Adrian, M., Zeman, J., Erdley, C., Lisa, L., & Sim, L. (2011). Emotional dysregulation and interpersonal difficulties as risk factors for nonsuicidal self-injury in adolescent girls. Journal of abnormal child psychology, 39(3), 389–400. https://doi.org/10.1007/s10802-010-9465-3
Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006). Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders. Behavior research and therapy, 44(9), 1251–1263. https://doi.org/10.1016/j.brat.2005.10.001
Cioffi, D., & Holloway, J. (1993) Delayed costs of suppressed pain. Journal of Personality and Social Psychology, 64, 274-282.
Dorn, C.G. Spindler, A. Kullik, F. Petermann, S. Barnow, Erfassung von Emotionsregulationsstrategien–eine Übersicht Psychol. Rundsch., 64 (4) (2013), pp. 217-227, 10.1026/0033-3042/a000176
Gaab, J., Blättler, N., Menzi, T., Pabst, B., Stoyer, S., & Ehlert, U. (2003). Randomized controlled evaluation of the effects of cognitive-behavioral stress management on cortisol responses to acute stress in healthy subjects. Psychoneuroendocrinology, 28(6), 767–779. https://doi.org/10.1016/s0306-4530(02)00069-0
Goldin, P. R., McRae, K., Ramel, W., & Gross, J. J. (2008). The neural bases of emotion regulation: reappraisal and suppression of negative emotion. Biological psychiatry, 63(6), 577–586. https://doi.org/10.1016/j.biopsych.2007.05.031
Gorczyca, R., Filip, R., & Walczak, E. (2013). Psychological aspects of pain. Annals of agricultural and environmental medicine : AAEM, Spec no. 1, 23–27.
Gross, J.J. (1998. Antecedent-and response-focused emotion regulation: divergent consequences for experience, expression, and physiology. J. Pers. Soc. Psychol. 74, 224—237.
Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of personality and social psychology, 85(2), 348–362. https://doi.org/10.1037/0022-3514.85.2.348
Kleinman A., Mechanic D. (1987)editors. Pain and Disability: Clinical, Behavioral, and Public Policy Perspectives. Washington (DC): National Academies Press (US); 1987. 7, The Anatomy and Physiology of Pain. Available from: https://www.ncbi.nlm.nih.gov/books/NBK21925
Koechlin, H., Coakley, R., Schechter, N., Werner, C., & Kossowsky, J. (2018). The role of emotion regulation in chronic pain: A systematic literature review. Journal of psychosomatic research, 107, 38–45. https://doi.org/10.1016/j.jpsychores.2018.02.002
Thomas, F. D., Creswell, J. D., Terides, M. D., & Blundell, K. (2014). Cognitive reappraisal increases neuroendocrine reactivity to acute social stress and physical pain. Psychoneuroendocrinology, 49, 69–78. https://doi.org/10.1016/j.psyneuen.2014.07.003
Troy, A. S., Shallcross, A. J., & Mauss, I. B. (2013). A person-by-situation approach to emotion regulation: cognitive reappraisal can either help or hurt, depending on the context.Psychologicalscience,24(12),2505–2514.https://doi.org/10.1177/0956797613496434
Wlassoff, V. (2019). The physiology and psychology of pain. Neuroscience and NeurologyAvailableatwww.brainblogger.com/2015/03/19-physiology-and-psychology-of-pain/.2015. Accessed may 22, 2019
0 Comments