Monday, 1 July 2013

Helpful, Effective Attitude Changes towards Pain & Discomfort

     Rapid relaxation (RR) is a brief (~2 minute) set of suggestions, given immediately pre-operatively (eg while applying topical anesthetic), to reduce anxiety during local anesthesia & subsequent minor surgical procedures. RR is recommended for managing mild-moderate pre-op anxiety, which is almost universal. RR combines elements of hypnosis, meditation & good basic bedside / chairside manner. It empowers patients by giving them an attractive, immediate alternative to stressful catastrophization AND can markedly improve the quality of the surgical experience for both patients & clinicians.
       Lovas JG, Lovas DA. Rapid relaxation - practical management of preoperative anxiety. J Can Dent Assoc 2007; 73(5): 437-40.

     Palliative care, which “includes consideration of psychosocial & existential / spiritual factors in addition to the physical domain,” has been shown to have the “counterintuitive capacity to support
an increase in quality of life even when introduced only days prior to dying.”
       Mount B. Healing, quality of life, and the need for a paradigm shift in health care. J Palliat Care 2013; 29(1): 45-8. 

 
     Similarly to RR (top), briefly telling research volunteers a little bit about mindfulness - specifically that they had the option to be OK with the discomfort of heat - just before applying the (experimental) thermal stimulus, changed the experience. Both the pain ratings AND brain activity were significantly reduced. In general however, benefits are proportionate to the amount & quality of mindfulness practice - see Study 1: https://www.mindandlife.org/the-contemplative-path-how-do-we-learn/

     When options are clear & perceived need imminent, human beings tend to choose wisely. Under duress, we often learn that a higher level of consciousness, and an associated higher quality of life, is (and always has been) readily available. 
     Hedy Kober PhD describes their experiments at Yale in an excellent (19min) TedX presentation (in English):



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