[...] But the one thing that did seem to dramatically affect my pain level was my belief about what was causing the pain. At one point, I was lying on my side and a nurse was pulling a bandage off of one of my burns; I couldn’t see what she was doing, but it felt like the bandage was sticking to the wound, and it was agonizing. But then she said: “Now, keep in mind, I’m just taking off the edges of the bandage here, so this is all normal skin. It just hurts because it’s like pulling tape off your skin.” And once she said that — once I started picturing tape being pulled off of normal, intact skin rather than an open wound — the pain didn’t bother me nearly as much. It really drove home to me how much of my experience of pain is psychological; if I believe the cause of the pain is something frightening or upsetting, then the pain seems much worse.
And in fact, I’d had a similar thought a few months ago, which I’d then forgotten about until the burn experience called it back to mind. I’d been carrying a heavy shopping bag on my shoulder one day, and the weight of the bag’s straps was cutting into the skin on my shoulder. But I barely noticed it. And then it occurred to me that if I had been experiencing that exact same sensation on my shoulder, in the absence of a shopping bag, it would have seemed quite painful. The fact that I knew the sensation was caused by something mundane and harmless reduced the pain so much it didn’t even register in my mind as a negative experience.
Of course, I probably can’t successfully lie to myself about what’s causing me pain, so there’s a limit to how directly useful this observation can be for managing pain in the future. But it was indirectly useful for me, because it proved to me something I’d heard but never quite believed: that the unpleasantness of pain is substantially (entirely?) psychologically constructed. A bit of subsequent reading led me to some fascinating science that underlines that conclusion – for example, the fact that the physical sensation of pain is processed by one region of the brain while the unpleasantness of that sensation is processed by another region. And the existence of a condition called pain asymbolia, in which people with certain kinds of brain damage say they’re able to feel pain but that they don’t find it the slightest bit unpleasant. [...]
(Warning: Graphic medical descriptions)
I’m reminded of Reflections on pain, from the burn unit: