All of us have experienced and will experience acute pain: the pain from a specific injury or ailment which stops when the injury has been treated. Some people experience chronic pain, which persists even when the injury has healed, or which develops without an immediately identifiable physical injury to begin with.
The problem of pain
Anyone who has struggled with chronic or long-term pain has likely grappled with the question of why it exists at all. Well, from a psychological perspective, pain absolutely has a function – pain is an alarm, and when it’s working well, it alerts us to the presence of threats. An effective pain response is like a well-trained guard dog – it barks at a burglar coming into the house so we can be alert and take action to avoid harm.
Unfortunately, our pain responses – just like our thoughts and our emotions – are not always accurate. Sometimes, they can be a bit more like a perpetually anxious dog. He might bark at an intruder, but he might also bark at the mailman, or a visiting relative, or a leaf blowing in the wind. Our pain system can similarly become overactive, and find it difficult to differentiate the danger of an injury from the noise of everyday life. Regardless of the cause, however:
- All pain is real.
- All pain is felt in the body.
- All pain is processed in the brain.
We tend to be fairly familiar with those first two points, but it’s worth putting them in writing because when we’re dealing with chronic pain, a distinct physical cause is not always determinable. This does not mean the pain is any less real or less felt than the pain of a broken bone, a papercut, or a third-degree burn. It’s the third point that we often forget. Pain is a form of information which is sent by our nerve system to our brain, and the brain’s role is to interpret these signals from the body. How the brain interprets that information can determine not only how we behave in response to the pain, but how physically intense the pain feels.
The role of thought and feelings
Signals to our brains, even those as seemingly biological as pain, are not processed in a vacuum. Our brains are constantly taking account of any number of factors to determine how they’ll interpret the raw data of a pain signal. When your brain receives a pain signal, and it’s combined with fear, it might be more likely to interpret this as a sign of significant danger, and may amplify the pain as a result. A bigger perceived threat requires a louder alarm. Similarly, pain can be amplified when the signal is received alongside hopelessness, or frustration, or memories of past physical trauma. Consider a stubbed toe – on a good day, we notice the pain, maybe react to it a little bit, but we move on fairly quickly. If you stub your toe on a bad day, it’s not just the emotional impact that’s intensified – the pain is too. Pain + stress, or pain + fear, or pain + hopelessness is interpreted differently by our brain than pain + acceptance.
Psychologists who work with managing chronic pain work with clients to help change some of the ways pain is interpreted, so that in turn, the pain’s intensity can be reduced. The focus is not on positive versus negative thoughts – if you’re in pain, no-one is expecting you to be happy about it – but rather on helpful thoughts versus unhelpful thoughts. It’s possible to learn helpful ways of thinking about pain which, combined with behavioural interventions, can lessen its impact on our lives.
Key takeaways
Pain is so intensely individual. Words often fall short of perfectly capturing the experience, and as such, it can be incredibly isolating. Talking to a professional about your pain can help make it less so, and can provide strategies to live with that pain while reducing both its intensity and the impact it has on your life. For now, it can be helpful to remember that regardless of how it feels, pain is not always danger. Our alarm systems can be sophisticated and useful and still sometimes wrong – maybe by changing the way we interpret pain signals, we can make those systems more precise at differentiating hurt from harm.
