The very nature of police work means that injuries will occur. At times, those injuries can result in long-term pain that substantially impacts an officer’s quality of life. In addition to the unpleasant physical sensations and functional impairments associated with chronic pain, the psychological and emotional impact of pain can have dire consequences if not properly managed. To the extreme, dealing with chronic pain can become so overwhelming that an officer might suffer from severe depression or anxiety, abuse substances as a means to cope, or even consider suicide as a means to end their pain and suffering.
Substance misuse/abuse is another issue associated with chronic pain. This does not mean that police officers with chronic pain are doomed to become alcoholics or prescription-opioid addicts. Many officers do not like the sense of losing control and avoid taking prescription medications consistently due to addiction concerns. Others drink alcohol as a means to self-medicate. Changes to daily functioning because of an injury can contribute to feelings of depression, anxiety, irritability and general emotional discomfort. As a result, some officers may begin to enjoy the temporary relief from physical and/or emotional pain that substances offer. This is problematic and can pose serious concerns to the officer’s well-being.
Research has consistently demonstrated the brain–body connection associated with chronic pain. Some studies have suggested that insufficiently treated chronic pain may alter the brain’s chemical environment to increase the likelihood of developing depression and anxiety. Other studies have suggested that insufficiently treated persistent depression and anxiety may change the brain’s chemical
environment in such a way that the person might experience increased sensitivity to pain. The silver lining (yes, there is one) is that you can train your body and brain to better respond to chronic pain and regain some control over your pain experience. The following non-medication-based techniques have been shown to be effective in helping people better manage their chronic pain when used in conjunction with medical interventions.
A person’s thinking and mood can impact their physical perception of pain. For example, what are the thoughts connected with the pain? How does the pain make the person feel? How does pain impact the person’s sense of purpose? Common responses I’ve heard from officers with chronic pain include: “I can’t take this anymore,” “It will never go away,” “I’m miserable,” “I can’t even be a good spouse/friend/partner” and “I can’t do anything I used to.” These are examples of cognitive distortions — they reflect a person’s mood state but are not necessarily true. Let’s take the thought, “It will never go away.” This definitive statement suggests that nothing can be done to help the chronic pain. Although the nature of an injury or illness can medically cause prolonged physical pain, people with chronic pain will often report fluctuations in their pain level throughout the day in response to movement, external stressors, etc. As much as the brain may want to focus on the negative, it is equally important to focus on when the pain may not feel quite as bad as it does at other times in the day. Modifying the thought to something like, “It will never go away, but I know it will feel a little better at the start of my day,” helps the brain also pay attention to how the body feels during moments when the pain is less intense. For people with chronic pain, even the slightest bit of relief is welcomed. Training the brain to balance thinking to incorporate both negative and positive (or less negative) aspects of the pain experience can improve mood over time. Chronic pain physically stresses the body out (in addition to the injury itself), which can tense muscles and increase inflammation. Training the body to shift to a more relaxed state can provide some relief. Breathing techniques (e.g., box breathing or diaphragmatic breathing) are an effective way to physically relax the body. Focus on slowing down breathing to a steady pace and imagine the sensation of relaxation with each exhale. There are several guided breathing exercises available online to help you train this skill — I like the free phone apps Headspace and Blue Life Coach.
Another relaxation technique is something called a pain–comfort pendulation exercise, which involves intentionally shifting focus between parts of the body where pain exists and where there is an absence of pain. Begin by getting into a comfortable position and taking a few deep breaths. With eyes closed, focus on a part of the body where the pain is (e.g., back) and pay attention to what it feels like — hot or cold, sharp or dull, pressure or tightness, hard or soft, etc. Mentally put this pain aside and shift focus to a part of the body where there is an absence of pain or discomfort (e.g., earlobe or tip of your nose). Pay attention to what the absence of pain feels like — hot or cold, soft or smooth, heavy or light. Mentally put this comfort aside and shift back to the pain. Again, spend time focusing on what the pain feels like. After a few moments, shift back to the comfort, and so on. Repeat this a few times and end this exercise with the comfort sensation and a few deep breaths. I’ve found this exercise to be particularly effective with officers who experience chronic pain as it shows how powerful the brain can be when it comes to how a person perceives physical pain.
Healthy diet and exercise (as tolerated) are also effective ways to help manage chronic pain. Talk with a medical provider about what foods to avoid that might worsen inflammation or other biological functions associated with the injury and pain, and/or ask for a referral to a dietician or nutritionist to learn more about which foods are best. Physical activity, including exercise, is also important but often limited due to physical limitations associated with injuries and chronic pain. Talk with a medical provider about which physical activities are safe to do, such as therapeutic massage, stretches, swimming or light walking.
Lastly, take the time to learn about pain and seek professional help when needed. Information is a powerful tool and often a readily available resource. Learning about the human pain response provides knowledge to understand the chronic pain experience and can help a person regain a sense of control over how they choose to cope with their pain. I recommend the book, Change Your Brain, Change Your Pain by Mark Grant. Police officers can also benefit from professional counseling with a licensed mental health professional who has experience in treating chronic pain, who can provide specific therapeutic interventions that have demonstrated efficacy for chronic pain management.
As with police officer tactical training, brain and body training for chronic pain requires repetition and consistency to build proficiency. Practice, practice, practice! The brain and body need to learn new ways to think, feel and respond to chronic pain. Be patient and persistent. Choose to focus on developing skills to achieve healthful means of coping with chronic pain.
Medina Baumgart, Psy.D., is an organizational psychologist who works in the Psychological Services Bureau of the Los Angeles County Sheriff’s Department.