Of pain and agitation and PTSD

I am really excited to report that my pain has subsided considerably. The inflamation across my iliac crest — the top of my pelvis at my lower back — has really gone down, to the point where it’s a little painful, but it’s more discomfort than pain, now.

Also my skin is not as sensitive to every contact, like it was. I still have my moments, when I start to sting and throb and my clothes hurt me, but when that starts to happen, I press the pressure point on my hand that I talked about in this post, and I take a few deep breaths to chill myself out and stimulat my vagus nerve, and I do a quick check-in with myself to see if I’m getting agitated about things.

Agitation really seems to get to me physically. Anxiety, too. When I’m worked up, everything feels more intense. So, calming my system down really seems to help matters.

Looking around, I found a June 2001 post from Science Blog that speaks to this. It’s ‘old news’ — over 7 years old — but it makes for good reading, and it really put things in perspective for me.


From Texas A&M University

Fear, anxiety affect pain

COLLEGE STATION, June 12 – Human emotion can be a powerful force, fueling everything from improbable sports championships to tragic acts of violence. Now there’s evidence showing how powerful human emotional states can be when it comes to determining a person’s ability to feel pain.

Texas A&M University psychologist Mary W. Meagher, who has conducted pain research for 16 years, says two emotional states – fear and anxiety – have profoundly different effects on a person’s ability to feel pain.

“Fear and anxiety have divergent effects on pain reactivity in humans: fear reduces pain, whereas anxiety has a sensitizing, or enhancing effect,” says Meagher, who holds joint appointments in clinical psychology and behavioral neuroscience.

Her conclusions are based on her and graduate student Jamie L. Rhudy’s recent work focusing on the role of human emotion on pain. Previous animal studies have suggested that fear inhibits pain and anxiety enhances it, but Meagher’s results support the view that emotional states influence human pain reactivity.

“From a clinical perspective, these data suggest that a patient anticipating an unpredictable threatening event will experience enhanced pain,” she says. “In contrast, a patient that has been exposed to a threatening event will experience a fear state that inhibits pain processing.”

Meagher believes previous conflicting reports of the effects of anxiety on human pain were due to a failure to properly distinguish between the emotional states of fear and anxiety.

Fear, Meagher explains, is an immediate alarm reaction to present threat, characterized by feelings to escape and accompanied by specific physiological changes. Anxiety, on the other hand, is a future-oriented emotion characterized by anticipation of potential threats.

Fear mobilizes a person to take action – the commonly known “fight or flight” response – but anxiety leads to scanning of the environment and body, resulting in increased sensory input, she says.

With these distinctions in mind, the conclusions make sense from an evolutionary point of view, Meagher notes.

Confronted with life-threatening situations, which would elicit fear, the body reacts by shutting off the pain response because feeling pain might get in the way of survival, she says. “Alternatively, during times of low threat – those times likely to produce a state of anxiety rather than fear – the chance of survival is increased if pain is enhanced so that behavioral responses can occur to minimize tissue damage,” Meagher explains.

Meagher’s work also shows that positive emotions can lead to pain reduction as long as a minimal level of arousal is reached, but negative emotions only lead to pain reduction when they are highly arousing. In fact, she says, negative emotions can actually facilitate pain if they are only low to moderately arousing.


This is consistent with my own experience — I can definitely confirm that in my own life, if I’m presented with a situation that involves a specific, verifiable threat, all my systems kick into action and I can actually perform at a higher level, than if I’m just rolling along in a relatively event-free, stress-free life. I can see better. I can hear better. I can interact with the world around me better. Fear actually forces me to focus — that is, if the fear relates to something that is real and significant.

Anxiety, on the other hand, throws me into a panic and sends me spiraling. I can totally see many examples in my life where non-specific threats “triggered” a hyper response to everything and anything around me. It makes me more sensitive, it makes me more jumpy, it makes me more pain-filled.

And thus the vicious cycle begins… because my hypersensitivity causes me to interact with the world poorly — it makes me sensitive to pain, it heightens my hearing, my eyesight, my sense of touch… everything. It makes me avoid situations I shouldn’t, it makes me choose to wear clothing that isn’t the most socially advantageous. (Note: Wearing a sweatshirt and jeans every time I go out in the world is not sending the best message — if anything, it sets me up to not be taken seriously by other people. In fact, I believe that a number of my interactive difficulties, from dealing with doctors to dealing other professionals/consultants, have been made more difficult because I chose to wear well-worn but comfortable clothing, rather than clothes that “sent the message” that I was someone to be taken seriously.) My tactile defensiveness makes me avoid human contact, from handshakes to hugs, which impedes me socially, as well. And it makes me more sensitive to light and sound, which causes me to unconsciously avoid situations that are bright and loud — which is where an awful lot of people hang out, and where an awful lot of deals are done.

But when the offshoots of my socially and physically impactful anxiety result in poor choices or actions that endanger my social standing, my employability, my ability to function in the world at large, it sets up conditions that produce fear. Existential crisis. Serious problems that endanger my job, my house, my family, my safety, my very life. And my sensitivites shut down — they swing to the opposite end of the spectrum. I don’t pick up on clues that people send me. I don’t notice things I should. I don’t realize that I’m falling behind in my work, or that there’s a traffic cop standing in the middle of an intersection ahead of me, waving their flashlight for me to stop. I kind of “click off” in some ways, becoming numb to the world around me, as I deal with my most pressing issue at the moment: I’m late for an appointment that will get me in trouble, or I’ve fallen behind in a task I was supposed to have done by tomorrow, or my back yard is so grown up, the ticks have started to come into the house.

I’ve been in more questionable situations than I care to think about, in no small part because I was shut down while I was dealing with some other crisis that took my mind off what was right in front of me. Or because I’d just come off a crisis I couldn’t deal with and that fried my system. I’ve gone walking in areas where there was active hunting going on, following deer paths on purpose, because I was more interested in getting in touch with nature than noticing the hunters around me. I’ve hung out with underground criminals who were obviously and openly checking out my various assets and having side discussions about me, when I was in a totally new area, having just moved there on my own and not having any real way to support myself and not having a clue, frankly, where my livelihood was going to be coming from. I’ve taken chances behind the wheelof my car that almost got everyone with me killed, when I was overwhelmed with coping with some really intense, deep-seated interpersonal issues that were more than I could handle.

And the aftermaths of these times resulted in more anxiety … and behaviors that made it all but impossible for me to deal effectively with the  demands of the world around me. I descended into intense pain. Or I started drinking heavily. Or I plunged head-long into a long period of over-work, in order to block out the drama, the pain, the trauma… the pain.

I think this business of psychogenic pain — that has both logistical and physical causes AND effects — is an area that should be examined more closely, especially by the mental health field. I think that the connection of emotions — fear and anxiety — and the physical results from them, can actually explain a fair amount of how TBI and PTSD can combine and worsen each other. And it could help explain additional sources of distress and trauma for people who are dealing with emotional issues… some of which won’t “budge” despite years of psychotherapy.

Therapists, in my experience, often focus so intently on the emotional root causes, the past events, the sources, of psychological issues, that they miss the physicality of the experiences they’re addressing. And in the process, they overlook both a contributing factor and a symptom of psychological distress and dysfunction. I suppose it’s to be expected, since psychotherapy is about the psychological side of life. But the more we learn about these things, the more closely connected we realize the mind, body, heart, and spirit are… and to discount any of them, in my mind, short-circuits the process of healing and recovery from the rough-and-tumble aspects of life.

I’m working with very limited time, here, so I don’t have all the hours in my day to devote to this study, but I hope someone else out there is looking at this. Or maybe they have, and I just don’t know about it.

One person who is looking at this, I believe, is Belleruth Naparstek, a psychotherapist who works with guided imagery to address effects of trauma and PTSD and other psychological dysfunctions. She’s got a website at http://www.healthjourneys.com/ where she not only has CDs and tapes and MP3s for sale, but she also includes research and articles about the use of guided imagery in healing.

I have friends who swear by her work, and I  myself have used her PTSD and Stress Hardiness Optimization and Panic/Anxiety guided imagery with some surprising results. I’ve never been much “into” guided meditations — people who try to “guide” me tend to irritate the sh*t out of me, and it often feels like this namby-pamby coddling pansy-ass touchy-feely crap that is one of the aspects of “new age healing” that just drives me nuts. Okay, so maybe I’m being harsh and it just goes to show I have plenty of healing to do, but I just hate feeling talked down to an patronized by people who are “more enlightened” than me. I usually feel condescended to ann treated like an infant.

Belleruth’s style, however, is not like that. She seems very down-to-earth to me — at least, in her CDs — and she’s very accessible and no-nonesense. She also strikes me as being very competent and intelligent, which helps. I hate it when dense people condescend to me. It makes me crazy and is a terrible distraction. Anyway, I’ve been very surprised by the effect her CDs have had on me — after being unable to shed a tear for many, many years, I’m actually able to cry. Okay, so I’m not very good at doing it around other people, and it stresses me out when they see me cry, but every now and then, I can really use a good breakdown in the privacy of my own home. And when I’ve listened to the imagery, I can sleep. This is big. I often fall asleep in the middle of the imagery, and then I wake up when it’s done. I suppose I may be getting some benefit while I’m sleeping, but the real boon is that I can sleep, at all. I went for years, after my last TBI in 2004, not being able to sleep through the night, waking up at 3 a.m. regularly, not being able to sleep on the weekends, not being able to really rest… which fried me even more after the fall and probably impeded my recovery terribly.

Anyway, to get back to the point of this post — in tracking the sources of my pain and finding out ways to deal with it, I have to look at the emotional aspects — the agitation and anxiety and fear pieces of the puzzle — and address them. When I address them, through deep breathing, monitoring and controlling my stress, and keeping myself relatively chilled out — or as chilled out as I can be — it helps me cut back on the pain. I also do things like cuss out people who make me angry, when I’m far from polite society — in the woods, or in my car (tho’ I have to be careful when I’m venting in my car)… write letters to the people who I feel have done me wrong, and then rip up the letters (never send them)… try to get more sleep, so I can deal with the physical issues that lead to the emotional ones that lead to the physical ones… and so on.

And I use the pain points on my hands to at least give myself a little immediate relief.

If you’re dealing with pain and you’re looking for ways to deal with it, I wish you the best of luck! Everyone is different, of course, but life is all about cause and effect. Even if what I use to cut my pain doesn’t work for you, if you engage in your own process and just keep trying, you may be able to find ways that you can use to address your own situation, and get more out of life, with each passing day.

Life can be wonderful, if we figure out how to let it be just that.

About these ads

2 thoughts on “Of pain and agitation and PTSD

  1. Very interesting post. It makes perfect sense to me that “fear” and “anxiety” would produce differing results in the body. Now I think I need to think through how that might relate to my own PTSD and various responses I’ve had to fear-producing and anxiety-producing stimuli over the years. Thanks for sharing.

  2. And thanks for commenting. It’s been quite eye-opening to me to read about how fear and anxiety can produce different physical sensations/experiences. It changes a lot in my mind, and I’m now starting to research this in earnest. Check back soon to see what I’ve come up with. Cheers – BB

Talk about this - No email is required

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s