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In addition to its toll on the body, unrelenting pain has a devastating effect on the emotions, typically producing a flood of anxiety, depression, and anger. As physicians become more aware of the interplay between mind and body, they are prescribing a variety of techniques to cope with the emotional side of a chronic illness, notes Roberta Olson, clinical associate professor or psychiatry, University of Oklahoma Health Sciences Center. The approaches vary widely, depending on the age and condition of the patient.

"Pain is a physiological phenomenon, but it also causes strong emotional responses. A person who is in constant pain feels out of control. This leads to anxiety, depression, and anger, which in turn can worsen the physical pain."

To help regain control, patients first should learn as much as they can about their illness and how they can help with their own medical regime. "This usually involves changes in diet and lifestyle, plus learning about medications and stress control techniques," Olson indicates. Some other approaches can be helpful:

* Support groups. "Overcoming feelings of isolation, of |I'm the only person in the world who has this problem,' is very important. Another benefit of these groups is the realization that you have support and comfort to offer someone else. People who are chronically ill often lose some of their societal roles; they may be unable to work or to go to school. Becoming a member of a support group can re-establish a person's role as a contributor and improve their self-esteem."

* Relaxation/visualization. "Relaxation can help to avert pain, and we know that medications are more effective in a patient who is relaxed. These strategies also add to the sense of control and decrease anxiety and fear."

* Becoming involved in the treatment process helps all patients, particularly youngsters. Even such simple activities as removing their own bandages allows them to feel in control. "Young children in particular often feel that they have |been bad' and that is why they are sick. Parents can be very effective in countering these feelings. Let children express their fears, perhaps by acting them out with a doll. Also, don't be afraid to reward [them] with stickers or small toys when they have coped well with a procedure or treatment."

What is most difficult for chronically ill individuals to face is that they permanently must adapt their lifestyles to accommodate the illness and keep their bodies under control. "What also is frustrating for these people is that some conditions--diabetes, asthma, digestive illnesses--may flare up even if [they are] following a strict program," Olson points out. "The issue here is learning how to cope emotionally, as well as physically.

"It's terribly difficult to live with chronic pain. The time-honored |stiff upper lip' approach is not really in a person's best interest. Learning how to diffuse depression, anxiety, and fear is critical, so that [patients do] not becoming more limited than they absolutely have to be."

COPYRIGHT 1993 Society for the Advancement of Education
COPYRIGHT 2004 Gale Group

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