It's sometimes convenient to think that everyone is a unique human being, yet the truth is rather more everyday. We can and do group people together based on shared characteristics. Some deal with pain well. We may call them brave, patient or insensitive. Whatever. They just seem unaffected by levels of pain that would reduce the ordinary person to a quivering wreck. Then there are those who are supersensitive, weak or cowardly who flinch even at the thought of physical contact. All of which goes to show that half the battle with pain goes on inside our heads. Pain even gets confused with pleasure, but we don't need to go there for this article. In general terms, there's no objective measure of pain. We can't say that people react in a predictable way to a given number of units of pain. It all comes down to mood and context. Looking at some television reality shows, there seem to be hundreds of people queuing up to endure pain for our entertainment. Their excitement or competitive attitude allows them to accept quite severe punishment. Then there are those professional sportspersons, whether in contact sports, who keep playing despite obvious injury. So, for whatever reason, some of us are capable of tolerating and working through quite severe levels of pain.

The point of cognitive behavioral therapy is to tap into the resources of the mind to find the strength for people to change their attitude and cope with the pain. The first step comes through cognition. You have to understand what pain is and how it affects the body and mind. You cannot control what you do not understand. So, for example, if you have a tendency to panic when pain affects you as you walk down a flight of steps, you can learn relaxation techniques. This steadies your mind and allows you to complete the descent without falling. There are a wide range of different techniques you can learn to overcome your reactions to pain and learn to live within the new limits imposed by your bodies. This involves looking very carefully at your behavior. How you move or approach different tasks may be aggravating the injuries. Just as there are mental techniques to learn, so you may have to devise different ways of completing routine tasks. Put all these together, and you have a way of rebuilding your life.

Unfortunately, this approach is labor-intensive and in hospitals and clinics where everyone is supposed to be chasing the maximum profit, there's no time for CBT. The moment you say a small team will be put together with different specialists to help one patient, the administrators need to be put on watch for a heart attack. So what is becoming more routine in the rest of the world, is still only available in some parts of the US and then only for people who have the resources to pay for it. This leaves us all with Ultram, the world's most reliable painkiller. If our healthcare service cannot give us the best overall treatment, it can at least give us Ultram, the best pain relief drug in the market.