Having looked all over the place for some suitable activities for people to become aware of their own pain behaviour and then learn to change it, I decided to put together one of my own. Now, unlike the posts I’ve made recently, I have no research to determine its effectiveness, but I hope you’ll forgive me for this!
The basis for considering behaviour change in pain management is behavioural psychology – by selectively reinforcing ‘well’ behaviour, pain behaviours should reduce in frequency. And it certainly does work – by simply asking someone ‘what have you been up to recently’ rather than ‘how is your pain’, we are able to reinforce activity rather than elicit a list of woes! But because I also want people to develop their own awareness of their behaviour so they can independently choose to alter their patterns, I think it’s helpful to
- become aware of what may be relatively automatic patterns
- start to alter one behaviour at a time
- use behavioural principles to reward well behaviour
This is the activity I chose, and a variation.
In pairs, I asked the group to ask each other this question:
“How do you know when I’m having a bad day? What do I do?”
I also gave them a list of pain behaviours to use to help them identify specific behaviours they may do.
Then I asked them to complete their own personal ‘pain thermometer’. You know how people often say they don’t have a thermometer or a plaster cast to say they have pain – well their behaviours can certainly act as a thermometer to other people!
In this activity, the thermometer is copied onto A3 paper, and the list of words and pain faces given to them to paste onto the thermometer. In pairs, they are asked to complete a pain thermometer to reflect the pain intensity and pain behaviours that they do.
The idea is to give the participants an opportunity to reflect on the range of pain behaviours they carry out, and to consider the effect on each other.
I also asked the group to carry out one of their pain behaviours to the extreme – walking from one side of the room to the other with these exaggerated behaviours. Asking the group to discuss what it was like revealed some interesting insights like ‘I don’t know what I do when I’m really sore’ to which another participant demonstrated exactly what that person does! And another said ‘I never knew how hard it was to move and how frustrating when I do these movements’.
Then I asked the group, in pairs, to choose one behaviour and discuss the impact it has on them and others – the good things about it and the not so good. Participants identified that pain behaviours can act as a warning sign to others, that they communicate very well – but have unintended effects that are not so good, like people either avoiding them, or ‘smothering’ them!
Then they chose that one behaviour and decided to spend a day learning how often they actually do it – and because they are in a group, learning to remind each other when they inadvertently revert to old habits.
All in all, I think this was an interesting activity – and hopefully will have at least increased the awareness of pain behaviours in this group. Changing the behaviours – that will take time!
If you use this activity, let me know how it works for you – and any modifications you may.