What Is the Goal of Pain Management?

It seems like a silly question. I mean, it should be obvious that the goal is to get rid of a person’s pain.

Restoring Function vs. Resolving Pain

Actually, the primary goal is a little bit different: it’s not so much resolving pain as restoring function. Don’t get me wrong—resolving pain is an excellent outcome! However, even more important is returning to normal activity, even if there is still some residual discomfort. In part, this is because pain typically improves only after function returns.

Additionally, we want to avoid the inappropriate resolution of pain. When pain serves an important function, alerting us that there is a problem, we fix the pain by fixing that underlying problem. The kind of pain that CHYP addresses is the non-useful kind, that has taken on a life of its own and become a whole different problem, even when the original trigger is healed.

However, it is possible that both kinds of pain can overlap and be present at the same time, leading to a tricky situation. The same young person who has had months or years of chronic abdominal pain is just as likely as anyone else to develop appendicitis! So how do we treat the chronic pain without running the risk of missing a new problem?

Using Hypnosis to Treat Non-Useful Chronic Pain

Dr. Leora Kuttner, a prominent Canadian psychologist and professor, has extensive experience in the use of clinical hypnosis for pain management in children. She is also a documentary filmmaker whose work demonstrates the effectiveness of mind-body techniques. One film, No Fears, No Tears, includes the stories of eight children with cancer who learned to use self-hypnosis to help themselves to get through painful procedures and treatments in a setting where suitable pain medication was not always readily available. She then made a follow-up film, No Fears, No Tears: 13 Years Later.

Although I saw these movies several years ago, a particular story has really stuck with me. A young woman who had recovered from cancer went on to become a figure skater as a teenager. When she started to have pain from hyperextending her spine, she used her self-hypnosis techniques to eliminate the discomfort… only to end up with a serious injury. That pain in her back was serving an important function, as a symptom of injury—and it was the injury, not the symptom, that really needed attention. This situation is a real-life parallel to the hypothetical patient above with longstanding abdominal pain who then develops appendicitis.

For just that reason, we are careful to be precise when teaching young people how to use hypnosis. Rather than suggesting that they eliminate their pain, we suggest that they remove whatever pain is not helpful or does not serve to keep them safe. Or we focus on function rather than pain, trusting that once a person is back to a typical level of activity, the pain will continue to fade.