New Program Day 2: The Nature of Pain

Day 2: The Nature of Pain

To better understand the treatment techniques we’ll be going over in the coming days, here are two basic facts you should know about pain.

Fact 1: Pain = Danger

Imagine that you're out on a run. You're listening to music, enjoying the early morning breeze, and pondering the mysteries of nature. Suddenly you trip over your shoelace, come down awkwardly on your left foot, and feel a sharp twinge. You've sprained your ankle. Frustrated, you limp home, wondering how bad the swelling is going to be.



As awful as it feels, pain is meant to help us. It’s your brain’s way of saying: “You are at risk of causing tissue damage, kindly back off until we heal.”

Without pain, you'd have no idea that you sprained your ankle, you'd continue running, and you'd injure yourself even worse.

Put simply, pain is our brain's way of screaming: DANGER!

Fact 2: Our brains are not perfect

Throughout human history, our brains have developed the capacity to achieve some remarkable feats. We’ve unlocked the secrets of DNA, we’ve discovered the boundaries of the universe, and we’ve invented 72 distinct flavors of Oreos (Nabisco, you had me at “triple double chocolate mint.”)

But our brains are not perfect. In fact, sometimes they can get downright confused.

Over millions of years of evolution, we have developed different signals to warn us of danger. Pain warns us of causing additional tissue damage, fatigue lets us know we need to rest, hunger warns us that we need to refuel with food. And usually these signals work just fine.

When you’re in pain, you rest the injury so it can heal. When you’re fatigued, you take a nap so that you can recover. When you’re hungry, you have a glass of milk and some Berry Burst Ice-Cream Oreos.

But, our brains never developed a system that can perfectly distinguish one type of danger from another. Oops.

This means that sometimes our danger signals can get activated by mistake.

Let’s look at anxiety as an example. Anxiety is a danger signal that developed so we could run faster or fight harder when we’re faced with a physical threat.

Anxiety is great when a bear is chasing you, but it’s not so helpful in the middle of a big job interview.



And since the brain can’t always distinguish one type of danger from another, it can respond to a psychological danger (I really hope I don’t blow this job interview) as if were a physical danger (I really hope this bear doesn’t eat me).

This is why we can develop anxiety even in situations where our lives aren’t in danger. Our brains are misinterpreting the nature of the threat, and activating the wrong danger signal.

To see some examples of other psychological dangers (as well as how they can develop) watch the following clip:

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The Blunderous Brain

You may be asking yourself, what does any of this have to do with pain?

Remember, pain is a danger signal too. So when we sense a psychological danger, our brains can misread the situation and respond with pain. It’s simply another case of our brains activating the wrong danger signal. This is how we can develop pain even if there’s no actual tissue damage.

Isn’t neuroscience fun??

Here’s a story to illustrate these concepts.

One night during my second year of grad school, I was studying for a big final exam. I needed to do well so I could get a good GPA so I could get a great job so I could make a lot of money so I could pay off my grad school loans (ah, the circle of stress…)

Out of nowhere, I developed terrible back pain.

What caused my sudden pain? Nothing happened to my back physically. But I was under a lot of psychological stress (If I don’t do well on this test, I’m going to end up poor, unemployed, and living with my parents.) My brain sensed danger, it misinterpreted what the actual threat was, and it flipped the wrong danger signal: pain.

And that’s how we can develop pain even when there’s no injury.

Treatment Approach

Assuming that you have neural pathway pain, there are two main goals to overcoming your symptoms.

1. Teach your brain that the pain is not dangerous

2. Teach your brain that the psychological stressors that it learned to fear (anger, sadness, confrontation, intimacy, etc.) are not actually dangerous.

For the next three weeks, we’re going to work on achieving these goals. You’re going to learn new techniques to confront your fear, overcome psychological barriers, and work toward deactivating your danger signals.

In other words, we’re going to try and give your brain the thing it needs most: a feeling of safety.

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May I be the first to say I'm loving the gentle humour that brings light and understanding to one goddam complicated subject (neuroscience) and how it explains the puzzle of pain.

I also like the way there are different strokes for different folks (visual, auditory...I'm kinaesthetic so I'm holding out for the literal strokes ).

But most of all I totally dig the way you've taken the scary away and replaced it with giggles. I've repeatedly noticed my TMS feeds on seriousness but is given a royal shakedown by laughter.

Here's to Day 1

 

Thanks, Alan, for the easy to understand explanations, graphics, and humor. Still, I have a few questions:

What is the correct danger signal?

How are fear and anxiety related?

Is the drawing in the graphics a giant loufah sponge?

Edit: using the reply function didn't work too well with this format. Sorry.

 

Hello,

First of all, I wanna thank you for the time and effort you're putting into these forums.

The timing couldn't be more perfect, I just finished Alan's Recovery Problem which is great by the way. It brought my attention to some vicious, destructive behaviours I wasn't even aware of... Now, I am wondering if I should continue with this one or move on to the Structured Educational Program ?

Thank you so much !

 

Makes perfect sense to me and can relate to it.

I let something from my past make me angry for too long, moved to new city, job etc and that's when my symptoms started (dizziness and vertigo) which then caused huge health anxiety then muscle tension= chronic pain/anxiety

Plausible that all these external forces made my brain get confused and sense danger, thus creating symptoms.

Will be following the program with interest each day.

 

Now that makes a whole lot more sense than a giant sponge!

 

I have this fear that because of the extreme nature of some of my past experiences that I won't be able to re-wire myself aka feel safe again. Would a person with severe post traumatic stress have more wiring issues to sort out then say someone with just some run of the mill anxiety? Stands to reason that if a person has suffered horrific abuse and is constantly hyper-alert that it might take a little more work to feel 'safe'. I think I cling to the idea that if I give up my defenses I will be vulnerable and therefore in 'danger'. Unfortunately that response seems to go hand in hand with pain. For some reason I don't think I can be safe and pain free - it sounds crazy when I put it like that.

 

It doesn't sound crazy at all my dear. Baby steps can take you all the way home no matter how far you have psychologically wandered. Most of us need to learn to self-soothe, most especially when we have endured trauma. Go gently. Vulnerability is a beautiful thing and is the gift of learning to be compassionate with yourself and with your healing.

Don't fret about wires and such. Trust in the bigger picture, in the elevation of mood and feeling that comes with bathing your mind/brain, heart and soul in well-being. You can learn to nurture these states until they are second nature and who you are to the core of your being.

 

Grateful this is so clear. After working with TMS and back pain for three years, I feel like I have mastered the first goal -- Teach your brain that the pain is not dangerous
by engaging in a lot of physical activity, tennis, hiking, Pilates etc. I'm not afraid there is anything physically wrong with my back. But I must have some hesitation somewhere, because I still struggle with pain, sometimes to do with benign activities like sitting -- but more often than not, I'm starting to notice it is triggered by relationships and emotions I feel about (Or try not to feel life/people/pressures.
So I am hopeful about achieving the 2nd goal -- teaching my brain that psychological stressors are not danger. Thank you.

 

So true about seriousness and fear. I always thought the best reaction to a terrorist would be laughter, totally disarming! The same with TMS!

 

I am one of those people. I hear this talk all the time..."self-soothe," "be kind to yourself." etc... I still basically don't know what that means. What are ways I can "be kind to myself and self-soothe?"

 

An excellent question.

Maybe a good place to start is to acknowledge that this concept is alien to you and why this might be so. What are your experiences of care and kindness? Can you readily name gentle people in your life? Are there people who touch your heart? Can you feel those tender feelings? Can you imagine others feeling that way toward you? If not, why not? What judgements do you have around your self-worth and self-esteem? Issues to ponder...


Essentially to self-soothe means to discover and embrace ways and means that calm fraying nerves. It is the realisation that we have never really learned to look after ourselves emotionally and instead we intellectualise, living from the head and not the heart. Many of us initially veer into self-destructive behaviours, such as booze, food, casual sex, shopping, over-exercising and other deadening, zone-out practices before realising that such actions take more than they give. The initial high is not worth the heavy, hard-hitting low. Invariably these behaviours worked once and maybe for a while especially when we were young but the results are ever diminishing and we finally must face ourselves.

Initially being kind to yourself means to go easy on internalized value judgements around the failure of aforementioned coping strategies. It means having the courage and kindness to go beyond knee-jerk reactions and it means forgiving yourself for the events and experiences that led you to become so emotionally shut-down that you no longer even recognise how emotionally flat-lined you are.

Then you begin to switch wires and substitute destructive behaviours for nurturing ones.

I am sure you instinctively know what makes you feel good deep into your bones. These are the things to focus on.

For me they are the small and simple. Cuddling up to my partner. Stroking a friendly dog. An early night. Cloudwatching. And most of all Nature. The forest, sun set, full moon, a powerful storm...moments that take us out of our small selves and connect with something bigger, something enduring.

Self soothing means caring for yourself, your needs as a human being. It means learning how to feel your emotions in the moment and not be thrown a curve ball. It means opening up not closing down. It is Love not Fear. It is the practice and thinking of becoming centred and at peace with who you are and then loving the hell out of yourself.

 

I have had chronic back pain for 40 years since I was 28. as you can imagine I've seen every kind of practitioner including Dr. Schubiner (you may remember me, Doc as the guy who gets cars from insurance auctions and fixes them up and resells them). I became addicted to percocet for years and have kicked that only to have the pain come roaring back. I'll be following the program with renewed hope in my heart. Jesse MacKinnon

 

Indeed. Laughing at TMS and all its silliness is to totally disarm it.

 

Thank you for that wonderful response, plum! I know, at least from my own experience, that is easier said (or written, in this case) than done; however, you have definitely given me/us some good direction on how to be kind to ourselves. This is an area where I intend to give much greater awareness to.

Before the traumatic experience that I had three years ago that set my pain into motion, I believe I did know how to do the things you mention and I believe I lived in a very happy, joyous state...I just need to find my way back.

Anyway, thank you so much for your thoughtful post!

 

Bless You. You will find your way back (or forwards) because it is your natural state of being. Bring memories of those good times into your quiet moments, saturate your brain and being with them. This is the simplest and most effective method of healing because it oh-so-naturally puts us back in touch with who we are (and it serves to both re-wire the brain and transform the overall emotional ecosystem. Our brains exist within a feeling-toned environment.)

Welcome to the forum my dear.

 

That's a great question, Ellen! Many danger signals exist to help in the face of physical threats, but there are danger signals that can warn us of psychological threats as well; shame for example. While the function of pain is to prevent us from damaging our own tissue, the function of shame is to prevent us from damaging our social relationships.

KadyQ, yes, even people who have experienced more trauma can teach their brains to feel safe again. The wonderful thing about the brain is that it is incredibly malleable. It takes patience, persistence, and the right set of tools. In the coming weeks, we'll be going over many techniques to help teach the brain that it's safe.

Alan

 

Alan and everyone,
I loooved the pictures, the humor in them! And yes! yes! I need to create more "feelings of safety" for me and around me!
Yes!

 

Oh, boy, that's what I need, a feeling of safety! My body is so tense that I feel like I'm on constant red alert. And when I get anxious about even little things I'm so tense I can barely move. I really hope this program can help me find a way out of this vicious cycle.