B&W picture of woman looking out on a lake on a cloudy, cold day

The Power of Our Perceptions When Suffering From Chronic Pain

B&W picture of woman looking out on a lake on a cloudy, cold day

I am often asked, “What helped you to get better, to overcome pain?”            

There are many things from a healthy diet, to yoga, stretching and exercising, to certain medical treatments like prolotherapy. Those helped me physically. What helped me emotionally cope with chronic pain, and still does, all started many years ago at an event that taught me about the power of our perceptions. I almost did not attend because I knew that one hour of laying on the floor instead of my bed, would cause tumultuous muscle spasms and increased pain; but, I am grateful courage came forth that night. It started me on a path of deep healing. 

That eventful night, I attended a Dharma talk in a run-down, white house in San Francisco. Perfectly centered between gold and red tapestries that cascaded down the front walls of a small room sat a monk whose serene expression contrasted the sharp, prickly hairs that stood erect on her shaved head. Her serenity brought me a glimpse of peace to which I and the other nineteen attendees hungrily clung.

The Dharma talk’s topic was Suffering. I knew this word well, as do most people. Its meaning is understood through experience that encroaches upon us by one means or another. To me, chronic pain was synonymous with suffering.

 “We are the cause of our suffering,” the monk told us matter-of-factly and gave an example: Imagine standing in a long line, and a stranger pushes you aside to get ahead. What is your first reaction? Do you yell at the person or make sly comments out of anger and impatience while she stands in front of you? Do you envision ways to get back at her for taking your spot and making you wait longer? Do you politely tell her that you were already there? “Or,” offered the monk, “do you first consider the possibility that this person may have been distracted by her own thoughts, not even realizing that she jumped ahead in line, or perhaps, she is in a hurry for a very important reason and it is okay to let her go before you?”

Then, she asked us:

  • Which reactions would create anger, impatience, and tension—more suffering?
  • Which reactions would not create suffering?
  • Do you think that the situation created your emotional suffering, or was it your thoughts and reactions to the situation?

 “How we perceive a situation affects our emotions and thoughts,” was the wisdom that the monk shared with us that night. 

   

Does Pain or Our Perceptions of Pain Cause Our Feeling Victimized? 

When I went home that night, I wondered how the Dharma talk pertained to me. I first thought that the stranger the monk talked about was my pain. Pain was a ferocious entity, a parasite that cruelly sucked so much life from me, cutting me off from the world. I was furious with pain. It exhausted me. It exhausted my hopes. I tried to control it, but my inability to do so resulted in feeling victimized—conquered. I resented this, thusly, I feared and rejected pain more.

Yet, later that night after the Dharma talk, I realized the stranger, which I originally thought was pain shoving and pushing me aside, was actually me. I had become my own victim. The pain was not destroying me; my thoughts, beliefs, perceptions of and emotional reactions to pain had been making me feel victimized. As we enter experiences with certain beliefs, we in turn, create a reality to validate these beliefs. Reality, or more literally, our perception of reality, is what we make it. The meaning I gave suffering, and the story about my suffering on which I ruminated, caused my suffering.

Although I hated pain and battled and feared it, I began to recognize that I did not actually hate and fear pain itself, I hated and feared feeling pain. I was not afraid of pain, I was afraid of suffering and what I emotionally identified with the concept of suffering. It is not emotional or physical pain, but the aversion to pain that caused my suffering. I had created a world of rejecting experiences (rejecting the sensation of pain, my body, myself). How could I not feel anything but enormous fear, depression, and loneliness? It was I who had been taking away my power, not pain.

Pain can feel overwhelmingly powerful, physically, mentally, and emotionally; however, just as our mind can play a large part in our suffering, it can also free ourselves from suffering. Our perceptions are subjective, not fixed. We can change our thoughts, perceptions, attitude, beliefs, and our outlook. 

 

That night, the Buddhist lecture initiated my process of learning that when we look through the keyhole into our life, it is important to detach from thoughts, desires, emotions, fears, actions and reactions. When we let go of unhealthful thoughts and reactions, we create space for positive thoughts, open-mindedness, adaptable thinking, and joy. 

I never want to limit my life, but rather, enhance my life with a reality of possibilities.

picture of a stuffed brown dog on bed laying down

A Special Gift for Someone in Pain – A Confidant

picture of a stuffed brown dog on bed laying down

Two friends once gave me something I didn’t realize I needed. It was small, brown, and fluffy. Its eyes looked sad and longing, just as I felt that day. 

My friends, Reme and Sara, gave me a special gift, a stuffed animal. I remember them timidly standing at my feet, searching for words to say as they stared at me, weak, disheveled, and semiconscious in my hospital bed. Reme reached her arms out to me and handed me a soft, brown stuffed dog. I took the dog in my arms and then blacked out once again from pain. When I awoke, I saw long, fluffy ears resting on the coarse hospital bed sheets on top of me, and two eyes staring directly at me, silently asking, how are you? I really don’t know, I replied. It’s eyes stared at me as if waiting…expecting for me to divulge each and every word of fear, will power, hope, anxiety, and despair that comes when experiencing chronic pain.

I named my stuffed dog, Jakey, after my friend’s real dog, and it has never left my bed. Jakey is the only one that knows the extent of my physical, and thus, emotional pain throughout the years. He has seen me screaming in pain and blacking out in the hospital; he has allowed me to hold him so tightly he would suffocate if he were real. He spent endless days and nights silently listening to my fears, hopes, laughs, and cries, always looking at me with his big eyes as if saying, tell me more. Jakey, my confidant. I burdened him with all my tumultuous feelings and thoughts as I lay in bed day after day, year after year, in pain. And the nights I needed to be held, I held him.

I never thought such a simple gift could be so profound. What convinced my friends at that time to buy a stuffed animal for me, a 26-year-old, I will never know. I lost touch with them years ago, but their gift is forever with me. Their gift has filled a void within me throughout all my hospital stays and all the years that followed in which I felt misunderstood, angry, scared, confused, alone, and exhausted.

We all need someone–or something–to talk to; someone who listens to us without judgment, and sometimes, without a reaction or response; someone to whom we can tell everything without trying to leave out parts of our story. With Jakey, I never worried what he might think, if  he would suffer hearing my sufferings, or if he would think I complained too much or clung to irrational hopes and desires. Jakey was my journal.

It is 19 years later. I am 46-years-old now. Jakey’s resting place, night and day, is still in my bed. He holds all my memories, my trauma, my pain. He knows my despair. He knows my struggles. He knows my courage and story of recovery, and my flare ups. He knows me better than anyone else. He knows my truths.

My six-year-old daughter knows Jakey. She is thrilled that I share a love for stuffed animals as she does. She giggles and kisses Jakey on the special nights I give him to her, and she gives me one of her stuffed animals to sleep with in return. When she is sick or having a bad day, I tuck Jakey in her arms. Jakey is healing.

 My daughter is too young to understand my experiences with pain and the meaning behind my love for my one, special stuffed dog, but when I see her talk to her stuffed animals, repeatedly hugging them so tightly that the stuffing thins, dragging them everywhere with her until the material starts ripping, and pouting when she can’t take one or two or three into the store with her, I think, perhaps a part of her does understand.

Sometimes the best gift that says “I care” is something as simple as a stuffed animal. It is something that we can cling to knowing that we are never as alone as we may think. Behind that stuffed animal is the person who unexpectedly gave it to us.

Joy

Podcast: Sharing My Experiences with Pain and Healing

In this podcast, I share with Emmy Vadnais, a Holistic Occupational Therapist, my healing journey from back injuries that kept me bedridden on and off for 2 years, along with 5 years of learning to walk again. For me, healing means connecting to our true self and embracing all that we are so that we may live life with meaning and joy. I also hope to be a voice for people who experience pain, educating others on the multi-dimensional effects of pain and the resulting struggles.

11:20 Meditation as a Coping Strategy
18:38 Emotions & Pain
23:00 The Balance between Activities & Pain
31:00 BioPsychoSocialSpiritual Components
35:00 Fatigue & Chronic Pain/Illness & the famous Spoon Theory
41:46 Pain & Trauma/PTSD/Panic Attacks
45:00 Gaining a Sense of Control
49:50 Discussing Pain Medication & the Opioid Crisis

You can find more podcasts by Emmy at HolisticOT.
Colored synapses lit up

Pain Signals and What We Can Do To Change Them

Colored synapses lit up

 Let’s be blunt. Pain sucks. It really sucks. It interferes with every aspect of a person’s life, and it affects others around us. So, what is pain?  

Our body has “danger detectors” called nociceptors that send messages through nerve roots to the spinal cord, which, in turn, decides to send or not send messages, or to alter and not send all messages to the brain. The brain reads and processes these messages, compares it with our emotions, thoughts, expectations, beliefs, memories and past experiences, etc. and decides if we are really in danger or not.[1] It relays its decision back to the spinal cord, which carries out orders to either set off the danger alarm by turning on or up the volume of pain or to let the body know all is well by inhibiting pain. The brain protects us from danger by sending pain signals and creating pain. Much of this happens quickly and without our conscious awareness.

When Pain Signals Persist

When danger stops, but our fear of pain continues, we remain hypervigilant and on guard, and our brain maintains high alert, sending pain signals to continue protecting us from further harm, even though we are no longer in danger. Overtime, if our brain continues to perceive that we in danger and continues to create pain, the brain starts rewiring. When pain signals chronically over-fire, neural pathways are established that remain intact long after a body has healed from an injury. 

Pain becomes a pattern, or a habit, of the brain even if the danger eventually stops, leading to overstimulated nerves and generalized hypersensitivity. 

Even the smallest touch, sensation, or a memory can be linked to feeling pain. David Hanscom (2016) relates an example of this when he discusses the story of a war veteran. Although his physical injuries had been healed for some time, every time he heard a helicopter, anguishing, physical pain would return at the place of his previous injury.2

Over-firing of pain signals may occur without apparent injury or cause. If you experience pain that has no definable cause and someone tells you the pain is “all in your head”, tell them they are correct, for the brain creates pain, and feeling it is not something you are making up. Danger does not necessarily mean an injury or illness. Emotions, such as anger or depression, negative thoughts, beliefs, lifestyle and life stressors can be interpreted by the brain as dangerous, and the brain is sending signals to the body that it perceives a threat and turns it into pain.

Fight, Flight, or Shutdown

 People who tend to be emotionally “sensitive” and empathic often are more inclined to experience chronic pain and autoimmune disorders. This is also true for people who have experienced some form of trauma in their life. Additionally, those who demonstrate greater anger and emotional distress in relation to their pain, tend to develop or experience higher levels of pain. Whether chronic pain has developed from physical or emotional trauma or an unknown cause, it is well documented that negative emotions exacerbate physical pain. 

Chronic pain signals trigger a continual fight or flight reaction, inducing chronic hyper-arousal of the mind and body and can lead to being withdrawn, depressed, and shutdown because it is too much to mentally, emotionally, physiologically handle.  Chronic pain easily leads to habitual fear of pain, avoidance behaviors, depression, and feelings of helplessness and hopelessness.  

Living with pain is like living with a blaring alarm clock constantly going off in your head. It disrupts the ability to think, to act, and to calm oneself. The hyperarousal I have felt from pain, often caused me anxiety, which caused more hyperarousal and pain, creating a vicious feedback loop. I could even feel my brain changing, in which I could not think as clearly, my memory was poor, my hearing became hypersensitive, I became hypersensitive to foods and my digestion was poor, I developed Irritable Bowel Syndrome, Fibromyalgia, and allergies became heightened, such as a gluten allergy turning into Celiac Disease. Pain can affect us on all levels.

But wait, there is Hope! 

We can play a huge part in modulating pain signals.

Much of that hope comes from realizing that a HUGE part of healing comes from within. Just as psychosocial factors, emotions, thoughts, beliefs, and our perceptions and expectations can all turn up pain signals and pain intensity, they can also turn down pain signals and intensity. Research suggests that a part of the brain called the amygdala, plays a large part in the connection between pain and emotions, as well as anxious behavior. The amygdala “…plays a key role in emotional modulation of pain….the amygdala appears to be involved in the enhancement (hyperalgesia), as well as in the reduction or inhibition (hypoalgesia/analgesia) of pain signals.”[2]

What is Your Self-Recovery Plan?

Self-efficacy refers to a person’s belief that s/he can succeed at something. People who have high self-efficacy tend to exert a high amount of effort for an extended time and demonstrate more adaptive coping behaviors than someone with low self-efficacy.

 Although we may feel broken, we are not. We need to focus our hope inward and empower ourselves. We can play a huge role in our recovery process.

To reduce pain, the brain needs to be distracted from thinking that we are in danger; we need to take action and progressively engage in activities, that over time, tells our brain that we are safe.[3] Active coping skills, movement that feels good, people that make us happy, a safe environment, optimism, joy, humor, mindfulness, creative expression, journaling, decreasing stressors in our lives, enjoying nature are all ways to send signals to the brain that we are safe and the pain alarm system can be turned down. So many options we have to start working on feeling safe!

Pain is not just a physical experience, but also an emotional experience. 

I once took a vacation to a beach resort, where all I basically could do, because the pain was so severe, was lay on the beach, lay in the water or snorkel, nap once a day, and go out to dinner at night. My vacation gave me the experience of safety. Away from hospitals, doctors, therapists, and everything that reminded me of pain and my injuries allowed me to stop thinking about them. Instead, my brain was distracted with warm sun, relaxation, and engaging in activities that brought me a sense of connection with nature and joy. This increased my emotional resilience and ability to cope with pain during my trip. 

pict of palm trees along a beach and ocean in Hawaii

It distracted me from always noticing and feeling the sensation of pain. It decreased my overall physiological state of hyper-arousal and hypervigilance, allowing my mind and body to relax, so much so that my physical therapist noticed reduced muscle tension, greater physical alignment, and improved ability to walk.When we provide ourselves respite in an environment that feels safe, and when we are able to create an emotional state of joy and calmness, we can directly and positively affect our brain and physical state, and improve our quality of life.

When considering this mind-body connection of pain (this painful connection, if you will), remember that our thoughts, perceptions, and beliefs directly influence our emotions. The influence that the mind-body connection has on our health cannot be underestimated. To emphasize the significance of this connection, perhaps we should also consider pain intensity as an emotion—or an emotional reaction—to our state of mind.

 

Try engaging in activities that bring you joy and peace. Start for 5 minutes and work your way up to longer activities. And remember to always give yourself compassion. To help increase your relaxation response and decrease the flight/fight/shutdown response, check out some of my meditations.

 Our emotions, thoughts, beliefs, and attitudes all affect pain and have the potential to be natural painkillers. 

BELOW IS A LIST OF STIMULI THAT INFLUENCE PAIN:

May Increase Pain

May Decrease Pain

Noxious touch

Gentle touch, vibration, heat or cold

Depression

Joy

Negative thoughts, Pessimism

Positive thoughts, Optimism

Fear, Anxiety, Worry, Anger

Confident, Calm, Relaxed, Happy

Past Emotional and/or physical abuse/trauma

Appropriate rehabilitation

Emotional or physical tension

Emotional or physical relaxation

Over-focusing on pain

Distraction

Hopelessness

Purposeful activities

Repressed emotions

Actively coping with emotions

Low self-worth, rejection of body & self

Self-compassion and love,

Self-acceptance, strong sense of self -worth

References:


 

[1] Lehman, Greg. (2017). Recovery Strategies Patient Guidebook, Section 1: Pain Principles, pg. 10. Retrieved from: www.greglehman.ca

[2] Hanscom, David, MD. Back in Control: A Surgeon’s Roadmap Out of Chronic Pain, 2nd Ed. Vertus Press: 2016.

[3] Strobel, C., Hunt, S., Sullivan, R., Sun, J.Y., & Sah, P. (2014). Emotional regulation of Pain: the role of noradrenaline in the amygdala. Science China. Life Sciences. April 2014 (57)4: 384–390. doi: 10.1007/s11427-014-4638-x.

[4] Moseley. Lorimer. 2015, November 18. Explainer: What is Pain and What is Happening When We Feel It.  Retrieved from: https://theconversation.com/explainer-what-is-pain-and-what-is-happening-when-we-feel-it-49040

dock leading out to swamp

Pain and the Mind-Body Connection

dock leading out to swamp
 

At one point, I realized that my physical pain had become emotional pain, and the emotional pain further increased my physical pain. A vicious cycle of pain had formed, and my body had become more stuck in its protective state: contracted, tense, and cringing from the slightest touch, while physical and emotional hypersensitivities heightened.

Emotional pain or distress is physical distress; they are one and the same. The more emotionally stressed I feel, the more tense and painful my body feels, as well as the more likely I am to catch a cold. When my mind is more relaxed, so is my body, and my immune system is stronger.

The mind and body mirror each other.

When one is under stress, so is the other. They endure the same experiences at the same time, yet the effects are uniquely expressed in an individual.

A break-up with a loved one may cause emotional depression and literally a physically hurt heart and a sleep disorder. Ongoing emotional anxiety may mentally cause pervasive, negative thoughts and physically cause nausea, irritable bowel syndrome, and high blood pressure. A misaligned spine may cause anxiety and a feeling (“felt sense”) of insecurity, just as the spinal column is insecure. How many times have you felt anxious and irritable to only discover after “checking in with yourself” that you are hungry and your blood sugar is dropping?

Our behavior and our sense of self are also related to our physical and emotional pains. When my body feels insecure and weak, I know that I feel insecure and less confident, and I act insecure by behaving shyly and studying the floor instead of looking at people in the eyes. When the pain is physically intolerable, I feel anxious, I start talking a mile a minute, and I become fidgety and unable to concentrate.

It is empowering when we recognize how challenges and stressors individually affect us, and learn to cope with them. If we do not cope with them but instead, repress our emotions, eventually mental, emotional, and physical complications arise and our well-being deteriorates. Destructive thoughts and emotions can be just as crippling as physical ailments.

Pain is traumatic.

It affects us on many dimensions. Although it is acknowledged that physical pain can lead to depression and anxiety, I also believe that the mere experience of being injured, the experience of a medical procedure, and the memories from each event are traumatic in and of themselves, and may lead to post-traumatic stress.

Due to this inherent link between mind and body, psychological and physical states, I believe both need to be treated in order to achieve recovery and overall well-being. I believe this leads to a more powerful and effective rehabilitation. Healing is the harmonizing of mind and body.

We have a great gift of inherent wisdom mentally and physically within us. Learning this deep wisdom may seem as difficult as learning a completely new language, or at least that is what I found true for myself. We need to be fully aware. There are no separate levels of consciousness or of one’s self as a whole; there are merely different levels of attention. Through inner awareness we can learn what we need to create harmony within our mind and body.