Pain is an unwelcome guardian of our body’s well being; whether it is mild or severe, intermittent or continuous, it serves as a warning against injury. Conversely, when pain persists it has no survival value except perhaps helping us to find the inner resources to overcome misery. Pain is an emotional as well as a sensory experience. It is affected by and, in turn, affects our feelings and behaviours as well as our spiritual beliefs, our social life and relationships.
The pain response involves emotions and memory as well as movement and sensation and can be triggered by stress or fear. A thousand trillion synapses (the site of transmission of electric nerve impulses between two nerve cells) pass electrical and chemical signals from body to brain and back again, processing incoming danger messages from the body and in turn sending pain. Crucially, we can have pain when there is no damage as other factors become wired with, and contribute to, the pain response.
The modern study of the mind/body relationship dates back to the early 19th century but it wasn’t until unexpressed emotions were seen to create disturbances in the body’s neural networks that science began to discover what many indigenous cultures have known for millennia.
Clinicians like John Sarno and Michael Moskowitz developed models of treatment using the mind-body link and the brain’s ability to change its structure (plasticity). Intense emotions like rage have a biochemical response at the cellular level and stress that’s not discharged disrupts the body’s regulation circuits and eventually causes pain and disease.
Moskowitz’ treatment uses the brain’s plasticity to change pain pathways back to normal. “By learning principles of how our brain works, we can begin to use the conscious part of our brain to modify our experience”. He does this by what looks a lot like bombarding the brain with positive sensory, visual and emotional data to develop new nerve connections.
Dr John Sarno, an American physician, attributed most chronic pain to repressed emotions, especially rage and was among the first to include social/emotional factors into pain medicine and the treatment of illness. In his book ‘The Mind/Body Prescription’ he writes: “Our brains have decided that feeling tense, which is the appropriate response to being tense, is too unpleasant to bear and is not as socially acceptable as having something ‘physically’ wrong.” Sarno ignored the ridicule of his colleagues and treated thousands successfully until his death in June 2017.
Lorimer Mosely, an Australian professor at the University of South Australia believes much of the complex pain science and research outcomes over the last forty years can be reduced to a simple equation: “We will have pain when our brain has more credible evidence of danger to our body than credible evidence of safety to our body.” His treatment includes exercises to: uncouple pain from movement, desensitize systems, turn down the pain alarm; and manual therapy to resolve sensitivity and build tolerance.
More recently Polyvagal Theory has added another layer of understanding to how the nervous system responds to our environment and the ways this can disrupt the self-regulation of our bodies which underpins health and well being.
When pain persists, it is even more important to talk about our pain. Many find it hard to put their pain into words but having emotional support is vital. There are many health and social care professionals available who can be involved in managing and treating pain. These are: GPs, District Nurses, Occupational Therapists, Physiotherapists and the treatment programmes outlined above.
Complementary therapies can be a valuable support too. There is evidence that acupuncture helps by releasing the body’s own natural opioids. Interestingly, the myelin sheaths that carry touch sensation to the brain are thicker than those which carry pain signals so haptic or touch sensation gets to the brain quicker, which may be why touch therapies, such as massage and Reiki, can help to turn down the volume on chronic pain.
CBT, Cognitive Behavioural Therapy, aims to change thoughts, feelings and beliefs that may be creating pain; reflexology, as with meditation, can help us to feel more relaxed and thereby reduce stress and anxiety – factors known to increase pain and, as some believe, to cause it. Relaxation itself, deep relaxation where you find a place within free of stress, fear and anxiety, can be a great help in controlling and reducing pain. Anything that helps us to release tension in our bodies helps us with pain.
Most therapists have a story that defies explanation. Mine was Margaret whose 10 years of pain from chronic inflammatory arthritis in her shoulder disappeared after one session of healing. She returned to see me ‘wind milling’ her arm with a big smile. The pain had gone and the range of motion had returned.
Alice Miller in her recent book ‘The Body Never Lies’ says: “Ultimately the body will rebel. Even if it can be temporarily pacified with the help of drugs, cigarettes or medicine, it usually has the last word because it is quicker to see through self-deception than the mind. We may ignore or deride the messages of the body, but its rebellion demands to be heeded because its language is the authentic expression of our true selves.”