4.3.2 Distraction and Reframing
Distraction is the strategy of focusing one's attention on stimuli other than
pain or the accompanying negative emotions (McCaffery and Beebe, 1989; McCaul
and Malott, 1984). Distractions may be internal, for example, counting, singing
mentally to one's self, praying, or making self-statements such as "I can
cope," or external, for example, listening to music as an aid to relaxation
(Beck, 1991; Munro and Mount, 1978), watching television, talking to family and
friends, or listening to someone read. Distraction exercises often include
repetitive actions or cognitive activity, such as rhythmic massage or the use
of a visual focal point. Distraction may be used alone to manage mild pain or
as an adjunct to analgesic drugs to manage brief episodes of severe pain, such
as procedure-related pain.
A related technique, reframing or cognitive reappraisal, teaches patients to
monitor and evaluate negative thoughts and images and replace them with more
positive ones. For example, patients who are preoccupied with a fear of pain
can be encouraged to use positive self-statements to facilitate coping (e.g.,
"I've had similar pain and it's gotten better"). Reframing can add to patients'
feelings of control over their situations (See Attachment C).
Psychosocial Interventions
Relaxation and Imagery
Psychotherapy and Structured Support
Hypnosis
Peer Support Groups
Pastoral Counseling
Suicide and Cancer Pain
Anxiety
Index