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The connection between pain and the brain

Millions of people all around the globe suffer from chronic pain. In fact, one in six people in Australia alone experience it. It’s debilitating and life-changing in all the worst ways—but thankfully, there is hope.

Pain is complicated, and everyone experiences chronic pain differently. But learning about the connection between pain and the brain, and the psychology behind it, can be enormously helpful—because understanding something is the first step to managing it.

Pain and the nervous system

Your nervous system is vital for your body to function—and it plays a huge role in how your body experiences pain.

The nervous system is made from two parts, the brain and the spinal cord. Nerve cells—called neurons—are responsible for sending and receiving signals to the brain, including information from external stimuli, like interpreting pain.

Generally speaking, pain protects the body. It sends “fight or flight” chemicals, called cortisol and adrenaline, to communicate danger, injury, and that action is required. In response, the brain orders physical and chemical changes throughout the body.

How chronic pain can overwhelm the nervous system and heighten feelings of prolonged pain

Pain is usually temporary. But when you live with chronic pain, things aren’t quite so simple—and your nervous system can actually play a huge role in heightening feelings of pain.

When most people experience pain, their cortisol and adrenaline levels will eventually subside, but when you experience chronic pain, these stress chemicals are prolonged. This is highly problematic, because these chemicals are only supposed to be activated for a short period of time, and additional exposure can cause our bodies to be sensitised to pain. It makes your body and brain go into overdrive, as they look for a threat, and can cause your body to receive pain signals from stimuli that wouldn’t normally cause pain.

Over time, this can impact your brain functioning, and even memories of painful experiences can cause your pain to appear or increase—even if there’s no particular cause.

Using psychology to help chronic pain

Being in constant pain can cause additional feelings of stress, fear, anger and even hopelessness—which in turn, can trigger and prolong pain. This is because the body and mind are inextricably linked. In fact, whether you feel physical or emotional pain, the same areas of the brain are activated: the anterior insula and anterior cingulate cortex. Pain can even change the structure of your brain, and researchers have found people with chronic pain experience a reduction in the part of the brain that regulates emotions—so every emotion is amplified. You anticipate pain with fear and worry, and can’t dampen down these feelings.

Thankfully, your brain is neuroplastic, so it can change for the better—although multiple therapies and techniques are usually needed. Understanding pain and the psychology behind it can be very useful for the simple fact that you’re aware of it.

Psychology can be incredibly beneficial for pain management, including things like CBT and mindfulness to challenge negative thought patterns in favour of constructive thoughts.  CBT focuses on the psychological factors of pain, and can help you work through your feelings and fears so they don’t overwhelm you and cause additional pain to appear. Mindfulness, meanwhile, can be a great distraction to take your focus away from your pain, which is very helpful for managing chronic pain in the long-term.

Seeing a psychologist experienced in pain management can be a great first step. They can support you through your mental health journey, and give you tips and advice for managing pain, and the emotions caused by it.

How we can train our brain to better cope with pain

Aside from psychology, mindfulness techniques and CBT, there are numerous ways we can train our brain to cope better with pain.

Activities like meditation and yoga can be extremely helpful for calming down your nervous system and beginning to control your production of adrenaline and cortisol. If you struggle to quiet your mind, guided meditations might also be a great option to get you started. Breathing exercises as part of both activities, or on its own, can also be incredibly useful for the same reason.

Doing things that release endorphins can also help us cope better with pain. When we do activities like gentle stretches, gentle aerobic exercises, and even the simple act of laughing, the endorphins produced can inhibit the cortisol and adrenaline surging through your body, allowing the brain to feel safer, and calming your nervous system as a result.

How goal-setting and pacing helps us cope with chronic pain

It might seem overly simple, but even small tasks can make a huge difference when it comes to managing our pain, and training our bodies (and minds) to cope.

The benefits of goal-setting for chronic pain management

Setting goals is a great way to give you a little more control over your life. It can help you with the day-to-day management of daily tasks, and help with the feelings of overwhelm and isolation that often come hand-in-hand with chronic pain.

A great way to pick your goals is to look at your values, and what’s important in your world—and what you might want to change or cultivate. Your goals could be anything, like practicing mindfulness, spending more time with people you love, work, increasing your strength, or trying new hobbies. SMART goals—which stands for specific, measurable, action-oriented, realistic and timed—can also be helpful for accountability, and keeping you on track. Achieving goals also gives you a sense of progression and increases your dopamine levels, making it easier to cope with pain and feel like you’re living a fulfilling life, even when it hurts.

Pacing and chronic pain

Pacing is vital when you live with chronic pain. Alongside goal-setting, it helps you to stay active and keep doing the things you care about. Pacing is all about breaking up your tasks and activities into small chunks, with a focus on conserving energy for activities you value. By doing smaller tasks, it can help reduce flares, and help you re-write the part of your brain that may be afraid of pain from certain activities, due to past experiences. It can be a great way to remind your brain that you are safe, and that even though activities have been painful in the past doesn’t mean they always will be.

It doesn’t matter how small the task is. And it’s also important to space your activities out with rest, and alternate between tasks—especially when many pain conditions can worsen from overexertion (both physical and mental). Remember: pacing is not pushing yourself. Be mindful of how your body is feeling, and stop when you need to.

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