Thankfully these days there is more and more evidence showing that chronic pain is often not actually due to trauma, or damage to cells in the body, but to psychosocial stresses.
People new to this concept sometimes believe erroneously that we are saying “their pain is all in their head”. Nothing could be further from the truth. In fact from my 30 years’ experience as a Physio, I would now agree with pioneers in this field, that if a persistent symptom is not due to a tissue damaging disorder, such as cancer, infection, a fracture or an auto-immune disorder, then it is a psychophysiologically induced condition. This is a bold statement bearing in mind the materialistic world we live in, where everything has to be tangible and the widespread belief is that pain is due to a physical cause.
A question I am often asked is “Why would our own body cause us pain?” It seems strange and often frightening. Many people fear not only their pain but anything to do with it, sometimes believing they have to “fight” it or use positive psychology to distract themselves from it. Yet fighting it often causes internal resistance and actually adds to the underlying cause of the psychophysiological pain. Although positive psychology can definitely help, if the underlying cause is not acknowledged, then pain will often only be managed, rather than cured. The pain itself is a result of the stimulation of the emotional part of the brain which sets up a response in the body via the unconscious part of the nervous system. In fact it is this same system which causes any other emotional response in the body, such as the ‘fight and flight’ response to fear, blushing with embarrassment and an erection.
Why does pain occur when it’s not due to an injury?
One or more of the following explanations often help my patients understand and accept how their symptoms become a reflection of what is going on in their mind, consciously or unconsciously.
1) The symptoms are caused by the autonomic nervous system (ANS) which is responsible for all the automatic processes in the body. E.g. digestion, heartbeat, breathing, bladder function, hormone regulation etc. It is also responsible for our primitive fight and flight response, or our Stress Response. This is how our body reacts automatically and unconsciously to a stressor or fear. Psychophysiological pain can be seen to be a maladapted ‘fight and flight’ response. In other words the pain is the mind-body’s way of protecting us from something we perceive, however falsely, to be a threat to us.
For example, pain such as backpain, whiplash and RSI, often develops to protect us from being overwhelmed by how we feel. We unconsciously ‘fear’; having an emotional meltdown, making a fool of ourselves, not living up to our own exacting expectations or even someone else’s, what other people think of us, how we might react if we allow our intense anger to surface etc
a) One patient of mine had been unable to write for a few months. If he wrote more than a few words his arm would go ‘dead’ and he was physically unable to write. He had collapsed with life threatening heart problems and remembered he had been writing when he collapsed. In this case his brain had incorrectly and unconsciously linked writing as being related to his near death experience. His arm going ‘dead’then became his maladapted response in this instance to protect him from dying if he wrote.
b) One of my patients was 79 years old and although reasonably active and independently mobile, her daughter popped in every day to keep an eye on her. This lady suddenly developed severe and debilitating back pain after her daughter told her she was going to Australia for a month. Despite extensive spinal degeneration which would have been present for years, this pain was a response to the fear of being left on her own and having strangers visiting her daily from the Home Care team.
2) According to John Sarno MD, pioneer of the work around TMS, or Tension Myoneural Syndrome, the pain creates a distraction from the underlying emotions. Basically our focus is so much on the pain that it distracts us from what are sometimes very difficult to deal with emotional memories. The pain therefore allows us to cope and carry on with life without falling apart emotionally, which is socially unacceptable.
3) Another way to understand how the pain is there to protect us, rather than punish us, is to recognise it is our body’s way of telling us to slow down and take time out. For example, consider the adult part of you as the part that makes you do what you ‘ought to’, or ‘should do’. Then consider your inner child, which resists the adult expectations. This is the part of you that ‘can’t be bothered’, says ‘it’s not fair’, ‘I can’t do it’ or ‘I don’t want to’. The internal turmoil between the two can in itself cause psychophysiological symptoms. In fact it can help to consider your symptoms as being a result of your inner child crying out for help, or urging you to back off and take a break. Unfortunately persistent symptoms occur when we don’t recognise these messages and just push on despite everything.
a) Pain often results from perpetually being on the go, never taking time out from constant distractions, such as the TV, radio, reading, socialising, computer, work etc. The inner child ‘kicks off’, trying to get you to take time out to ‘defuse’, relax and allow the unconscious mind to process everything that’s happened and acknowledge how you feel, which it can’t effectively do while being constantly bombarded by sensory and information overload.
b) Pain can also result from having to cope with difficult situations or traumas, or the triggering of emotional memories from the past. Your inner child might be crying out for help, feeling he/she can’t cope anymore.
c) Internal resistance might also be caused by your learned beliefs, behaviours and attitudes. E.g. a belief that you’re not good enough, being judgemental of others or your behaviour if one of your ‘buttons has been pressed’. This inner turmoil between the inner adult and child causes self-induced stress, resulting in symptoms.
d) Finally pain might be your inner child’s way of telling you to back off from your constant negative inner chatter. This might be due to you being overly self-critical, your need to be good or perfect, conscientious or analysing everything. These traits can create huge amounts of self-induced stress which manifests as psychophysiological symptoms.
All these can be modified once recognised, as you respond to your inner child’s attempts to back off and learn to be kind to yourself.
However you understand your symptoms, the more allowing you are of them, the more chance you have of getting to the bottom of them. If you fight and resist them, unfortunately, ‘what you resist, persists’. The good news though, is that because psychophysiological symptoms are reversible, full recovery is possible.