Psychological self-help to help with chronic pain

This article examines the inherent loneliness of being a neuropathic chronic pain sufferer. It makes a lot of sense to me although if you also feel slightly uncomfortable, or feel like giggling nervously while reading the 'tips' in the second half, you can translate them into methods which work for you.
There's nothing wrong with meditation as a relaxation tool but
I've never been a fan of 'thanking myself for being me' and 'praising myself for doing the best I can'...I'd rather throw a brick at the TV thanks!

Optimizing Wellness
Part III: Accept, Understand, and Improve Your Mood
BY BRIDGET T. CAREY, M.D., WEILL CORNELL PERIPHERAL NEUROPATHY CLINIC

Many patients have told me that since developing neuropathy they feel they have changed— something about their personality is fundamentally different and not in a good way. They feel their mood has deteriorated, frequently to the point of depression. Some feel anxious and irritable; others angry. These feelings may start as a specific reaction to pain or disability but can then become consuming. This is difficult for people to talk about.

As a society,we have made great progress in our understanding of depression and anxiety; however, many continue to feel that there are stigmas associated with these conditions. This article addresses this uncomfortable topic head-on to dispel misconceptions and discuss some strategies to improve quality of life while living with neuropathy.

If you have neuropathy and find you are having mood problems, you are very normal. Consider the following: many neuropathy patients are in pain most or all of the time; many have had to alter their lives, giving up activities they enjoy or curtailing their productivity. These are not happy situations: so,why would any sane person feel happy about them? In accepting a chronic illness diagnosis, grief is always a component. The illness does not have to be fatal or even devastating for this to occur. Realizing that your life has changed, that your expectations may need to be lowered brings a sense of loss. Feeling sad is a normal reaction, and becoming depressed is an understandable outcome.
Anger is also a normal reaction to grief. As one grapples with the 'Why me?'there will be feelings of anger. Anxiety may also be heightened as one fears the worsening and/or continuation of pain or faces the unpredictability of living with an illness having fluctuating symptoms. Such emotions are normal reactions to chronic illnesses in general, and neuropathy in particular.

Our emotional states are largely automatic: you do not make a conscious decision to feel or not to feel them. For example, if you see a skinny, abandoned, abused puppy on the side of the road, do you stop and think, 'Ok, that is sad, so I will now decide to feel sad?” No, the feeling just happens.

We can all relate to having a sudden, uncontrollable rush of anger. Feelings and moods usually come unbidden, sometimes in reaction to a known stimulus and sometimes for unknown reasons. This is how our brains function.
Emotions modulate and modify our thoughts— but they are not actual thoughts. Emotions are not subject to the same conscious decision-making process. We can choose what to think, with varying success to 'block out' thoughts; emotions and mood do not submit to that sort of mental manipulation.

Many people think of mood and mental outlook as something over which they have ultimate control. They should be able to “buck up,” “snap out of it” or “pull themselves together.” When they find they cannot, they feel failure. Changing one’s mood is not a matter of willpower or character.
By acknowledging this, it may be easier to accept one’s mood state for what it is. Depression is difficult enough without feeling embarrassed or guilty.
A frequent misconception is that depression or anxiety cannot be treated if it is a reaction to existing circumstances. Many believe that as long as the unfavorable circumstances exist, the mood state will persist. This is not necessarily true. While something specific may precipitate depression or anxiety, once established, these conditions cause real brain changes.

Neuroscientists have established that mood is a brain function. Depression, anxiety, and happiness are correlated with changes in brain chemicals (neurotransmitters) and connections between brain cells and brain regions (neural networks). These changes, based in neurochemistry, are physiological and real: they are in your brain, not “in your head.” As such, they are amenable to measures shifting them back, including the two “M’s”: medication and meditation. Many people hesitate to take medications for mood, correctly realizing that a pill will not change facts. True, medications treating depression and anxiety will not eliminate neuropathy. Depression and anxiety can, however, actually amplify the pain experience by altering the brain’s neurochemical environment. Also, depression and anxiety can foster feelings of isolation, often already a problem for neuropathy patients. So, while medications are not magic, they can improve quality of life in some cases by reducing the suffering associated with pain and, in other cases, by promoting a better mood. These medications are not “happy pills,” but they can re-establish the normal neurotransmitter balance disrupted by depression and anxiety. It is worth discussing treatment options with your doctor, as medications exist that are quite safe, effective, and well-tolerated.

Meditation can rewire brain connections and minimize the perception of pain. Meditation can also be used to improve mood, which can modify thoughts. If thoughts are nouns, moods are adjectives. Feelings and moods are associated with thoughts and memories. We can exercise our brains by focusing on thoughts linked with emotions such as happiness, joy, contentment, and gratitude. By even transiently experiencing “positive” emotions, we can temporarily change the pattern of neurotransmitters and neural connections.

With time, the brain becomes better and more efficient at doing this and it becomes easier. Meditation will not change facts, but it can regulate and ease some of the sadness, anger, and stress associated with a chronic illness.

Meditation to Promote Happy Neurochemicals

(Try to do this every day! See if you can build up to a full 30 minutes.)

1) Think of 2 things you are grateful for and 1 happy memory. Your “grateful
things” can be “big” (a loved one; faith in a higher power, etc.) or
“small” (good weather; eating chocolate, etc.). Be sure the memory is
associated with genuine happiness.

2) Sit in a quiet place. Take time to make sure you are comfortable.

3) Start to breathe deeply. Focus on your breathing. As thoughts flutter into your brain, gently recognize them and let them go. Focus on your
breath. Do this for at least 3 minutes, or until you feel quiet and relaxed.

4) Keep breathing, but focus your attention on your 2 grateful things.
Recognize and experience your gratitude. You may simply say to yourself,
“I am thankful for _____.” If you believe in a higher power, you can
give thanks for the gift of these things. Do this for at least 2 minutes, a
full minute per thing.

5) Next, focus on your happy memory. Visualize yourself in the happy state,
and attempt to remember and recreate how you felt. Concentrate on
that and maintain it for at least 3 minutes. If you lapse, gently call yourself back to the happy place and start over.

6) Finally, thank yourself. Thank yourself for being you and for doing the
best you can. Thank yourself for giving yourself this peaceful meditation.

Neuropathy News, September 2008