Three Steps to Quell Pain-Induced Panic

Navigating Agony: Expert Strategies for Handling Extreme Pain

Experiencing extreme pain can be a terrifying ordeal, leaving individuals feeling overwhelmed and helpless. Whether it’s a sudden, severe injury or a chronic condition, understanding how to manage intense discomfort is crucial for both immediate survival and long-term well-being. This guide, drawing on insights from experts, offers practical strategies to help you navigate moments of extreme pain, focusing on psychological techniques and physiological responses.

Imagine yourself in a dire situation: alone in the remote Australian bush, hours away from any assistance, and having sustained a severe injury, perhaps a chainsaw accident that has significantly damaged your foot. The agony is unlike anything you’ve encountered before. What is the immediate course of action when faced with such overwhelming physical distress?

Clinical psychologist Amy Underwood, who specialises in pain management and is affiliated with the Australian Pain Society, acknowledges that initial panic is a natural and expected response. “You’ll probably panic at the beginning – and that’s normal,” she states. However, she stresses the importance of moving beyond prolonged panic. “But if you’re sitting around for another hour, there isn’t much point having a continuous panic attack. It’s just exhausting and overwhelming. That’s why you put in place better behaviours.”

Understanding Your Mind’s Role in Pain Perception

Underwood explains that humans possess a “predicting mind.” This means our expectations can significantly shape our experience of reality, including pain. “When our brain predicts a threat, we get into a protective state where attention narrows, we can’t find options and opportunities get missed, which isn’t helpful when you’ve cut off your foot,” she elaborates. Instead of focusing on worst-case scenarios, such as others who may have succumbed to similar injuries, it’s more beneficial to shift your focus towards positive outcomes, like those who have been successfully rescued.

To mitigate panic, a key strategy is to actively name and observe your emotions. “When we name an emotion, we put some distance between us and it, which reduces its intensity,” Underwood advises. This process isn’t a one-time fix. Even when experiencing intense pain – like the realisation that a significant part of your foot is injured – you need to continuously observe your emotional state. This involves a degree of detachment, as if you are an observer of your own experience. If panic begins to resurface, a grounding technique is to identify three things you can currently see, hear, or touch. “It’s a diversion technique, but it also helps ground you,” Underwood notes.

Physiological Strategies for Calming the Body

The ultimate goal in managing extreme pain is to achieve a state of calm. This involves engaging your parasympathetic nervous system, a vital network responsible for relaxing your body after periods of stress or danger.

Breathing Exercises: “Breathing is crucial,” Underwood emphasises. She explains the physiological impact of inhales and exhales: “When we inhale, we engage the sympathetic nervous system – to activate an adrenaline surge. But the out-breath is what activates the parasympathetic system.” She recommends a specific breathing exercise: inhale for a count of four, hold for a count of four, and then exhale for a count of six. “This will send a message to the brain to calm and settle,” she assures.

Temperature Stimulation: If you have access to something cold, such as ice, a chilled drink, or a water bottle, applying it to the back of your neck for approximately 10 minutes can be highly effective. This action stimulates the vagus nerve, which acts as a direct link to the parasympathetic nervous system’s control centre.
Vocal Vibrations: Interestingly, the vagus nerve can also be stimulated through vocalisation. “Interestingly, your vagus nerve can also be engaged by humming, singing or chanting because it sends vibrations through your vocal cords,” Underwood explains. She offers a relatable example: “This might explain why we hum to babies: it’s soothing.” Engaging in these activities can help to promote a sense of calm and reduce physiological stress responses.

By combining psychological techniques to manage the mental impact of pain with physiological strategies to calm the body, individuals can develop a more robust approach to handling extreme pain, even in the most challenging circumstances.

Further Reading from How to…