Doc n°1: "La maniera in cui pensi al tuo dolore può sviluppare un maggior effetto positivo su di esso"(Come migliorare la sintomatologia dolorosa).
Doc n° 2: La procrastinazione: qualche riflessione/consiglio
How you think about pain can have a major impact on how itfeels.By Melinda BeckThats the intriguing conclusion neuroscientists are reaching asscanning technologies let them see how the brain processes pain.Thats also the principle behind many mind-body approaches tochronic pain that are proving surprisingly effective in clinical trials.Some are as old as meditation, hypnosis and tai chi, while others arefar more high tech. In studies at Stanford Universitys Neuroscienceand Pain Lab, subjects can watch their own brains react to pain inreal-time and learn to control their response—much like building up amuscle. When subjects focused on something distracting instead ofthe pain, they had more activity in the higher-thinking parts of theirbrains. When they "re-evaluated" their pain emotionally—"Yes, my backhurts, but I wont let that stop me"—they had more activity in thedeep brain structures that process emotion. Either way, they were ableto ease their own pain significantly, according to a study in thejournal Anesthesiology last month.While some of these therapies have been used successfully for years,"we are only now starting to understand the brain basis of how theywork, and how they work differently from each other," says SeanMackey, chief of the division of pain management at Stanford.He and his colleagues were just awarded a $9 million grant to studymind-based therapies for chronic low back pain from thegovernments National Center for Complementary and AlternativeMedicine (NCCAM).Some 116 million American adults—one-third of the population—strugglewith chronic pain, and many are inadequately treated, according to areport by the Institute of Medicine in July.Yet abuse of pain medication is rampant. Annual deaths due tooverdoses of painkillers quadrupled, to 14,800, between 1998 and 2008,according to the Centers for Disease Control
and Prevention. The painkiller Vicodin is now the most prescribeddrug in the U.S."There is a growing recognition that drugs are only part of thesolution and that people who live with chronic pain have to develop astrategy that calls upon some inner resources," says Josephine Briggs,director of NCCAM, which has funded much of the research intoalternative approaches to pain relief.Already, neuroscientists know that how people perceive pain is highlyindividual, involving heredity, stress, anxiety, fear, depression,previous experience and general health. Motivation also plays a hugerole—and helps explain why a gravely wounded soldier can ignore hisown pain to save his buddies while someone who is depressed may feelincapacitated by a minor sprain."We are all walking around carrying the baggage, both good and bad,
from our past experience and we use that information to makeprojections about what we expect to happen in the future," saysRobert Coghill, a neuroscientist at Wake Forest Baptist Medical Centerin Winston-Salem, N.C.Dr. Coghill gives a personal example: "Im periodically trying to getinto shape—I go to the gym and work out way too much and mymuscles are really sore, but I interpret that as a positive. Imthinking, Ive really worked hard. " A person with fibromyalgiamight be getting similar pain signals, he says, but experience themvery differently, particularly if she fears she will never get better.Dr. Mackey says patients emotional states can even predict how theywill respond to an illness. For example, people who are anxious aremore likely to experience pain after surgery or develop lingeringnerve pain after a case of shingles.That doesnt mean that the pain is imaginary, experts stress. In fact,brain scans show that chronic pain (defined as pain that lasts at least12 weeks or a long time after the injury has healed) represents amalfunction in the brains pain processing systems. The pain signalstake detours into areas of the brain involved with emotion, attentionand perception of danger and can cause gray matter to atrophy.That may explain why some chronic pain sufferers lose some cognitiveability, which is often thought to be a side effect of pain medication.The dysfunction "feeds on itself," says Dr. Mackey. "You get into avicious circle of more pain, more anxiety, more fear, moredepression. We need to interrupt that cycle."One technique is attention distraction, simply directing your mind awayfrom the pain. "Its like having a flashlight in the dark—you choosewhat you want to focus on. We have that same power with our mind,"says Ravi Prasad, a pain psychologist at Stanford.Guided imagery, in which a patient imagines, say, floating on a cloud,also works in part by diverting attention away from pain. So doesmindfulness meditation. In a study in the Journal of Neuroscience in
April, researchers at Wake Forest taught 15 adults how to meditatefor 20 minutes a day for four days and subjected them to painfulstimuli (a probe heated to 120 degrees Fahrenheit on the leg).Brain scans before and after showed that while they were meditating,they had less activity in the primary somatosensory cortex, the part ofthe brain that registers where pain is coming from, and greateractivity in the anterior cingulate cortex, which plays a role in handlingunpleasant feelings. Subjects also reported feeling 40% less painintensity and 57% less unpleasantness while meditating."Our subjects really looked at pain differently after meditating. Somesaid, I didnt need to say ouch, " says Fadel Zeidan, the leadinvestigator.Techniques that help patients "emotionally reappraise" their pain ratherthan ignore it are particularly helpful when patients are afraid theywill suffer further injury and become sedentary, experts say.Cognitive behavioral therapy, which is offered at many pain-management programs, teaches patients to challenge their negativethoughts about their pain and substitute more positive behaviors.Even getting therapy by telephone for six months helped Britishpatients with fibromyalgia, according to a study published online thisweek in the Archives of Internal Medicine. Nearly 30% of patientsreceiving the therapy reported less pain, compared with 8% of thosegetting conventional treatments. The study noted that in the U.K.,no drugs are approved for use in fibromyalgia and access to therapyor exercise programs is limited, if available at all.Anticipating relief also seems to make it happen, research into theplacebo effect has shown. In another NCCAM-funded study, 48subjects were given either real or simulated acupuncture and thenexposed to heat stimuli.Both groups reported similar levels of pain relief—but brain scansshowed that actual acupuncture interrupted pain signals in the spinalcord while the sham version, which didnt penetrate the skin, activatedparts of the brain associated with mood and expectation, according to
a 2009 study in the journal Neuroimage.One of Dr. Mackeys favorite pain-relieving techniques is love. Heand colleagues recruited 15 Stanford undergraduates and had thembring in photos of their beloved and another friend. Then he scannedtheir brains while applying pain stimuli from a hot probe. On average,the subject reported feeling 44% less pain while focusing on theirloved one than on their friend. Brain images showed they had strongactivity in the nucleus accumbens, an area deep in the brain involvedwith dopamine and reward circuits.Experts stress that much still isnt known about pain and the brain,including whom these mind-body therapies are most appropriate for.They also say its important that anyone who is in pain get a thoroughmedical examination. "You cant just say, Go take a yoga class.Thats not a thoughtful approach to pain management," says Dr.Briggs.Write to Melinda Beck at HealthJournal@wsj.comHow to Stop ProcrastinatingBy Margaret Paul, Ph.D.Do you tell yourself that you will get the things done you needto do, and then just end up procrastinating?Sherry was behind on many important things in her life. She hadunpaid traffic tickets, the insurance on her car had lapsed, she had astack of unpaid bills and her apartment was a mess. Sherry was nothappy with this situation, yet seemed unable to do anything about it.Even when she set aside the time to get these things done, somethingalways got in the way.Sherry consulted with me because things had finally reached a pointwhere her life was actually breaking down from her procrastination.She had had a minor car accident that she had to pay for herself dueto her unpaid insurance. Her phone had recently been shut off due toher unpaid bills. She was angry and frustrated with herself, yet found
herself doing the bare minimum -- just enough to get by. What waskeeping her so stuck?As we explored Sherrys deeper intention, she discovered that asmuch as she wanted to get things done, there was something shewanted even more: To not be controlled. Not being controlled hadbecome Sherrys focus early in her life as a way to protect againstbeing consumed by her very controlling father. She would do anythingto not be controlled by him, even to her own detriment.The problem was that it was no longer her father whom she wasresisting. She was now resisting to her own inner controlling parent,the part of her that was just like her father. As soon as thisauthoritarian part of her tried to get stuff done by saying thingslike, "Okay, its time to get this apartment cleaned up. I cant livein a dump like this any longer," an unconscious and very resistant partof her would take over with behavior that clearly said, "You cantmake me. I can do whatever I want. Youre not the boss of me."This resistant child in her had learned to respond in this way when shewas very small; so now this behavior was unconscious and automatic.Sherry was stuck in an unconscious power struggle between twowounded parts of herself, the part that wanted control and the partthat didnt want to be controlled. The moment she told herself shehad to do something, she would immediately resist doing it.How could Sherry find her way out of this stuck place?Before she could change it, she needed to become aware of it,rather than continue to operate on automatic pilot. We cant changesomething that we dont know we are doing. Sherry needed tobecome aware of both inner voices: the adolescent bossy, controllingvoice of her father and the younger voice of her resistant child. Sheneeded to choose to be controlling and resistant -- rather thandoing it subconsciously -- before she could have other choicesavailable to her."But why would I choose this?" she asked.
"Good question. Yet, this is what you are choosing every day. Butuntil you are aware of choosing this, you cant choose anything else.How can you change it if you are doing it subconsciously? Just keepdoing what you are doing, but now do it consciously. Watch yourselfmaking this choice."Sherry agreed to try this for a week. She was ecstatic at our nextsession. "I actually got the apartment cleaned.""Thats great. Now, I want you to start to become aware of whatyou want to do and what is really in your highest good, rather thanwhat you think you have to do. The challenge here is for you todevelop a loving adult part of you that is neither controlling norresistant, but concerned with taking loving action that supports yourhighest good. This will take time, but when you are thinking of whatis really loving to yourself, rather than controlling and resisting beingcontrolled, you will be unstuck in all areas of your life."Sherry did practice, and found that the more she thought about whatwas in her highest good, and took loving action for herself, theeasier it became to get things done.In the course of our work together, Sherry learned to develop aconnection with a personal source of spiritual guidance to help herunderstand what was in her highest good, and to follow through withthe loving action. She found that the more she stayed connected withher spiritual guidance, the more powerful she felt within. When thecontrolling and resistant parts of her were no longer in charge ofher choices, procrastination became a thing of the past.[ PDF created by Vulvodinia.info www.vulvodiniapuntoinfo.com ]