Increasing Performance (#4-Pain and Fear)

Repeated practice of imagining oneself successfully performing a task leads to improvement in task performance. Mental rehearsal of physical movements alone can actually increase strength. Combined with repeated physical practice of performing the same task, mental rehearsal may greatly enhance an individual’s ability. For best results, training to improve strength, flexibility, endurance and body mechanics required for the task is necessary too.

The value of combining mental and physical practice is reflected in current sports and military training programs all over the world. Mind-body training methods have a long history that predates the modern research that strongly supports their use. Qigong is a Chinese term (literally: energy skill) referring to exercises that involve mental imagery combined with postures and movement to improve health. Meditation and mental imagery have been used for centuries by warriors and martial artists to improve their skills.

Whether ancient or modern, these practices all emphasize achieving a relaxed mental/physical state and repetition to maximize effects. All can be applied to the management of chronic pain.

Many of my patients find standing for some length of time painful. A mind–body approach to dealing with this involves mentally rehearsing the act of standing while practicing relaxation techniques. In addition, standing in a relaxed state using mental imagery to imagine one has ideal posture is practiced. Done repeatedly, this can improve the ability to stay relaxed even as the muscles needed for standing get stronger. This is exactly what we do in our chronic pain group sessions.

It is important to take a break if one becomes too tense or struggles because of pain, fatigue or anxiety to avoid reinforcing the bond between pain and fear. Patience is required to improve and with pain always looming this can be very difficult. However, the example of standing illustrates the potential to limit pain and fear’s effect on performance.