This post was first published in November 2019

Many years ago (decades actually), I watched a child screaming in fear as a Doctor prepared an injection. The child had severe kidney problems and had regular treatment so she (even at the young age of 7) recognised that an injection meant pain. The very sight of the Doctor preparing the injection was enough to send her into paroxysms of panic.

As a leukaemia patient, I’m well used to the experience of having stuff put into me or stuff taken out of me via a needle. Yet still now, after all these years, I always get a frisson of fear (ooh! Nice alliteration Gibbo!) when I know I’m about to get a needle in the arm (or elsewhere!). In reality, one barely even feels the needle go in and even if one does, the sensation is so fleeting that it barely registers. So why do I get anxious? It’s ridiculous.

As I have mentioned before, one of the bravest warriors I’ve ever had the honour to know is currently on the home stretch of a period of 16 chemotherapy sessions (Go girl!). She regularly tells me that the worst time is the day/ hours leading up to the chemo sessions. So is the fear of impending pain worse than the reality of pain?

This has led me to ponder on the psychology of handling illness and treatment (well – it’s better than worrying about the next set of results/ treatment/ financial worries/ Liverpool’s star midfielder’s injury) and more importantly, the psychology of managing pain.

I know logically that pain is simply an electrical impulse sent to the brain to tell it that something’s wrong and I presume it is meant to trigger a variation of the fight or flight response. I also know from working with my beloved (and massively missed friend and psychologist) Heather, that one can (to a degree) fight those impulses in order to ‘tone the volume down’ on the pain levels and I use those techniques she taught me on days when the pain is at its worst.

But that raises another issue – For people like me, as we have discussed before, the pain is constant. It’s simply a matter of how severe it is which determines how much I can do on any given day or whether its just a day for resting. So – can I train my brain to turn the pain volume down to allow me to live a more active and fulfilling life? I believe I can and I try to – but am I really – or am I just convincing my brain that I am? Does that make sense? Is it real or am I doing a mind trick on myself? And even if it is just an illusion, is the illusion sufficiently persuasive that it actually feels like the pain is lessened? Man! You can go cross-eyed thinking about this stuff!

But the reality is that no matter how powerful your brain may be, pain is as much an emotion as it is a sensation. I am a big ruffty-tuffty northern boy who does not cower easily. And yet – every time I’m having blood taken, I get a little anxious about the needle going in. As I mentioned, my warrior friend tells me that the fear and anxiety leading up to the chemo treatment frequently abates once the treatment starts (although I should point out the treatment itself is still bloody unpleasant!).

For those of a certain disposition, the prospect of a visit to the dentist (morning Sis!!) is far more anxiety-ridden than the actual visit itself. Visits to the Dentist these days are pain-free and comfortable, by and large.

So, if pain is as much an emotion as it is a sensation, should we not train ourselves to handle emotion? We train (or through experience, learn – which is the same thing) ourselves to manage grief, heartache, sadness and so on – so why not pain? For 35 years, (like most people who ‘do’ change and transformation management, I used the Kubler Ross (KR) grieving curve and other tactical tools to help large organisations through major change programmes. KR started off as a way of helping people through grief, so can it also therefore not be used to help people trough stressful pain?

My fellow patients always tell me they also experience the same regular emotions that I do: anger, frustration, resentment, tears, resentful acceptance, peaceful acceptance, bargaining and so on. These are all emotions which the KR grieving curve discusses and addresses to allow people to get through and move on. And if I know how to help people through the a grieving curve in a change environment, can I not also do so in a medical environment?

I don’t know the answer yet but I am talking to my clinical team and MacMillan to see if there is any mileage in researching this further. I’ll keep you informed. If nothing else, it will stop me worrying about the star midfielder’s injury…

Gosh – that was a long one. Sorry. Thanks if you got all the way to the end before yawning.

Stay strong. Fight hard. Smile lots.