Behavioral Medicine Services

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Pain can dramatically affect all aspects of your life—including the things you do, the way you feel, and how you think. The opposite is also true: The things you do, the way you feel, and how you think can affect your pain. For instance, athletes who injure themselves during an event frequently don’t feel pain until the event is over and their attention is drawn to the injury.

Psychologists at Boston Children's Hospital help patients to examine and change their behavior, feelings and thoughts. For that reason, the psychologist is an important part of the Pain Clinic Team.

Behavioral Medicine uses the skills of a psychologist to teach you how to manage a medical condition. In pain management, several behavioral medicine techniques are commonly used, often in combination.  Some of these include:

  • relaxation training
  • biofeedback
  • imagery and distraction techniques
  • self-hypnosis
  • stress management and cognitive behavioral therapy

Read more about these techniques below.


Relaxation training

Relaxation training is frequently used with pain patients. When you experience pain, your body automatically responds to protect painful area by tensing muscles in that area. In chronic pain, the muscles are chronically tight, and this tightness actually increases the sensation of pain. 

Relaxation training involves learning to do the opposite of what your body wants to do, and decrease the muscle tension in order to decrease the pain. It's a skill that must be learned and practiced to optimize its effects. Relaxation audiotapes help patients practice at home, and can also help other problems that can be related to pain, such as trouble getting to sleep at night.

Biofeedback

Biofeedback simply means that you're getting information (“feedback”) about what your body (“bio”) is doing. Stepping on a scale to learn how much you weigh, or taking your temperature to see if you have a fever are examples of biofeedback. 

 A psychologist uses biofeedback to give you information about your body so you can learn how to change what your body is doing. 

Our biofeedback equipment works with a computer to actually show you on the screen how fast your heart is beating, how often you take a breath, what your skin temperature is, and how tense your muscles are. All the sensors that collect this information are put on with tape, like a band-aid. Often people are surprised to learn how much control they actually have over their own bodies.

Learning to control your body in this way can also help you learn to control your pain.

Imagery and distraction techniques

By learning some simple strategies to distract your attention from pain, you can actually decrease your pain.

It's often thought that pain is a “thing” that's just there, whether or not you pay attention to it. In reality, pain is a sensation, and if you don't feel it, it isn’t there. Learning to divert your attention away from the pain is actually learning to control your pain level. 

Just like the injured athlete in the middle of an important event, your mind can turn down—or off—the pain signals by focusing on something else. Unlike the injured athlete, these techniques are taught as skills that you can use whenever you like, not just in the middle of the big game.

Self-Hypnosis

There are a lot of misconceptions about hypnosis, mostly because the average person’s exposure to the technique is limited to entertainment hypnosis, where it appears that the hypnotized individual is under control of the “hypnotist.”

In reality, hypnosis is simply a state of mind in which you're so concentrated and focused on something, that your focus excludes practically everything else. Almost everyone has entered a state of mind similar to hypnosis on their own—such as a daydream, or getting “lost” in a book or a movie. 

Learning self-hypnosis is a lot like learning to go into a daydream, except that you also have the ability to control what you daydream about, as well as when, how deeply, and how long you daydream.

Stress management & cognitive behavioral therapy

All of the above strategies enable someone to gain more control over their pain. But much like pain medicines, they may not make pain go away completely. Pain can be very limiting, and depression and anxiety are very common in patients with pain. Stressalmost always makes pain worse, and pain flares can lead to feelings of helplessness and hopelessness.

Psychologists are trained in how to listen to people and help them learn how to talk about, and solve, their problems. These aspects of treatment are just as important as learning techniques to manage pain. 

Pain is invisible—nobody can see it. People with the exact same injury or diagnosis can have very different types and intensities of pain, and often, no diagnosis can be found for the pain. It can be a frustrating problem, and the frustrations of pain can lead to stress, which can makes pain worse. 

Talking about these frustrations, finding different ways to combat stress, and working with someone who has experience in helping people cope with these difficulties can be extremely valuable and can lead to improved physical functioning.

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The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO
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